Women are by far the primary recipients of psychiatric "services," ana men are disproportionately the practitioners. Coercion and forced drug treatment are routine, yet the biological origins of mental illness are far from proven. These problems and more are explored in this section providing an overview of the anti-psychiatry movement.
More people today are undergoing psychiatric treatment-labeled with mental disorders, experiencing psych wards and institutions, psychiatric drugs and electroshock-than at any time in history. If you haven't been involved with the mental health system, you probably have a close friend or family member who has. Many people feel helped by treatment. But those hurt by psychiatry may find their negative experiences ignored or dismissed as isolated incidents. Even progressive and radical movements pay little attention to those who've been through the system. As an activist in the psychiatric consumer/survivor/ex-patient (c/s/x) movement, I find myself constantly trying to make our issues visible, and show how psychiatric oppression affects everyone.
Why We Need to Question Psychiatry
There are many perspectives in the c/s/x movement, but we unite against forced treatment. Psychiatry is dependent on coercion, and claims it's only used on people who are a "danger to themselves or others," and "for their own good." But it's always been used against disapproved behaviors-like certain political beliefs and sexual preferences. No one is totally free from the risk of forced treatment. And even when people are suicidal or self-destructive, how does isolating them in institutions and inflicting restraints or forced drugging help?
Modern psychiatry depends on never-proven causative theories of "genetic defects" and "chemical imbalances"-the brain scans they show are done on patients already taking psych drugs. There are no medical tests for the scores of diagnostic labels. Yet, from years of insisting "mental illness is a brain disease," it's taken for granted, even among many activists skeptical of biological-determinist theories of gender, race, class, and intelligence, that schizophrenic or bipolar or addictive behavior is due to biology. With these theories, those first experiencing severe emotional crisis, often during times of great change in their teens or 20s, are turned into lifelong patients.
Pharmaceutical companies give millions to the psychiatric profession and mental health advocacy groups, whose "educational" material insists certain conditions require drug treatment. The corporations promote not just their drugs, but also actively shape and advertise the diagnoses. And this is all being globalized, with a push to market psychiatric drugs to "third world" countries-who have a higher recovery rate from serious mental illness than the countries that usually use drugs.
Psychiatric drugs are less effective-often hardly better than results with placebos-and far more habit-forming or physically addictive than we are told, can permanently change the brain's structure, and can have numerous unwanted physical effects. The neuroleptics ("antipsychotics") in particular-both the older versions and the newer "atypicals"-have caused often-irreversible neurological movement disorders. If these drugs were used for anything other than such a feared and despised condition as "schizophrenia," they might have been off the market years ago.
Electroconvulsive therapy (ECT), despite much PR to the contrary, is not safer than in the past; the modern use of anesthetic requires higher doses of electricity, and permanent memory loss and other brain damage is a frightening reality for many.
People skeptical of, or hurt by, psychiatric drugs should not be moralistic about those who choose to use them. Using psychiatric drugs does not mean you're giving in to patriarchy, or capitalism; these drugs are just a tool that's available, and in the absence of strong support systems, may seem like the only or best option. They're a risk people can take with informed consent-but since they don't actually fix brain chemistry, I don't consider them more medically valid than alcohol or illegal drugs.
Better Women Through Chemistry: Gendered Diagnoses and Drugs
The legalization of direct-to-consumer advertising for prescription drugs in 1997 resulted in many psychiatric drug ads aimed mostly at women, since women are still the majority of psychiatric patients. Often the theme is that their condition stands in the way of harmonious family life, and the treatment will reunite them with their (male) partners and children.
* More drugs are being approved for post-traumatic stress disorder (PTSD). Trauma sufferers who end up in the system are often re-traumatized, especially if they endure seclusion, restraint, and injections in psychiatric facilities-and many patients are sexually abused within institutions too.
* Even abuse has a biological explanation now. A pro-drug, pro-shock booklet put out by the government for its recent campaign "Real Men. Real Depression." mentions a hypothetical man who "physically or verbally abuses his wife and his kids" and explains "it is important to understand that there is a disease of the brain called depression that may be underlying these feelings and behaviors."
* Institutions, drugs, and ECT are used on those who clearly do hurt themselves through starving, bingeing, or cutting; meanwhile, researchers search for the "genetics" of bulimic and anorexic behavior.
* Self-mutilation is a hot topic-a magazine ad for a TV movie on cutting actually called it "the new anorexia." Some have noted the double standard in a culture pathologizing women who cut themselves, while rife with ads for weight-loss surgery, liposuction, implants, and Botox.
* Sexual dysfunction-and the search for a female Viagra-is rarely examined by looking at the gender and socioeconomic factors that structure sexuality.
* Many consensual sexual behaviors are still pathologized through inclusion in the diagnostic manual; so is "gender identity disorder," both a required diagnosis for transgendered people who want services to change their gender, and a label used against non-gender-conforming youth, especially boys who are too "feminine."
* The revelation in 2002, hardly news to many women's health advocates, that hormone replacement therapy did not serve a protective function and carried many risks, was a blow to pharmaceutical power-but now women are told that antidepressants are a "safer" option for hot flashes.
* Women who experience severe physical and psychological problems before their periods now are said to have "Pre-Menstrual Dysphoric Disorder" (PMDD). Prozac has now been repackaged in pink and purple and sold under the name Sarafem.
* In a 2002 book, a male doctor coined "Hurried Woman Syndrome" to diagnose over-stressed American women with a sort of pre-depression. Is attention to milder forms of psychiatric disorders a benevolent strategy to help many more suffering people-or a way to sell many more pills?
* In the wake of high-profile suicides and homicides by disturbed mothers, the attention justifiably paid to postpartum depression/psychosis could have alarming consequences for psychiatrically labeled mothers and pregnant women.
* The reproductive rights of psychiatrized women are endangered by biological theories, with the long U.S. history of sterilizing the "unfit," or putting their children in state custody. Even if actual force is not used, many families with histories of psychiatric conditions are afraid to have children, believing it's genetic.
The Youngest Psychiatric Survivors
The epidemic of psychiatrizing youth continues at a frenzied pace. More and more serious diagnoses, and more and more drugs, in ever greater combinations, are handed out to younger and younger children. This is especially troubling because minors can't legally consent or refuse-thereby, it's all coercive treatment-and their bodies and brains are still developing, vulnerable to chemical interference. Parents who don't drug psychiatrically labeled kids have even lost them to the state for "neglect," and custody battles see the anti-drug parent as unfit. Girls' magazines, from non-commercial, feminist-oriented titles to the beauty-and-boy-crazed glossies, feature psychiatrized girls, symptom quizzes, and referrals to drug company-funded "advocacy" organizations. In my activist work I often point out that youth have heard the imbalances-and-drugs mental health model their entire lives; many are poised to see their troubling emotions as illnesses. And those who have been hurt by the system can end up shamed into silence.
A newer formulation of Ritalin called Focalin is aimed at "attention-deficit hyperactivity disorder" symptoms said to be more common in girls-daydreaming, inattention. (Note that this drug was introduced not long after the scathing Simpsons episode about an ADHD drug called "Focusyne"!) I believe that "ADHD" is often normal, youthful behavior that is a natural response to the one-size-fits-none nature of compulsory schooling.
The Silences Among Activists
Mainstream feminism, and progressive movements in general, demonstrate a disturbing lack of empathy with recipients of mental health treatments. Unlike other causes, in this case they ally on the side of the powerful, relying on the "experts"-perhaps because so many seem to be employed by the "helping professions." If they do criticize psychiatry, it may be how a certain group, like LGBT youth or African-Americans or incest survivors, is hurt by psychiatry-the larger structure of coercion and deception is left unexamined.
Feminist psychiatric survivors have been appalled at the handling of the Andrea Yates case, the Texas woman who killed her five children, and served as the public face of schizophrenia and postpartum depression. Many factors-her husband's behavior, her strict religious beliefs, and the psychiatric drugs she was taking, or withdrawing from-contributed to the crime. Yet the National Organization for Women did not see psychiatric treatment as a cause, using the case to push for more research and treatment.
I've seen disturbing examples of even radical feminists going backwards and muting their criticism of psychiatry, saying that there's now biological proof for mental illness, and now there are safer drugs. I've seen a recent, self-help-oriented book on lesbian and gay depression promote electroshock, condone forced treatment, and minimize the well-proven hazards of antidepressants. I keep finding activists and others who don't even know ECT is still going on, let alone that's it's often forced, is more dangerous now, and is even being recommended for children.
The prison justice/abolition movement should be a powerful ally, as the prison-industrial and psychiatric-pharmaceutical complexes have so much in common ideologically and physically. Yet many activists see "treatment" as an alternative to prison for offenders deemed mentally ill.
Since well before 9/11, the "seriously mentally ill" have been hysterically regarded as a threat to public safety, facing preventive detention and treatment. This mental profiling is a major civil liberties issue, but few have noted the similarities between the government's repression of immigrants and of mental patients.
Feminism and other social justice movements did not tell me the whole story about psychiatry's function. I had to be personally involved to learn for myself.
Six Months and 111,002 Milligrams: My Brush with Psychiatry
In 1998, I suffered through a frightening period of despair that seemed to have no explanation. I felt I wasn't accomplishing anything, school and other activities seemed impossible, and my social life had plummeted. I diagnosed myself as depressed and eventually saw a psychiatrist, a woman I saw as authoritative and a bit glamorous. Put on Effexor, I felt better almost immediately-but then went through two solid weeks of moderate mania. Instead of seeing this as drug-caused, I was changed to "bipolar" and put on a mood stabilizer. Over six months, I was on four different drugs, one or two at a time, with varying effects. I interpreted my behavior, even innocuous things like taking lots of notes in the doctor's office, as symptoms. Then I found a book by dissident psychiatrist Peter Breggin and wondered if his critique of psychiatry was relevant to my case. Since I seemed better, the psychiatrist helped me taper off the drugs-but it can be hard to find doctors willing to help.
I discovered the c/s/x movement and decided to get involved, amazed that this enormous issue was neglected by activist movements. I realized my lack of recent accomplishments was the cause, not the effect, of my depression. The movement was a crucial part of my recovery. I started a small group (Mad Lib), organized protests, produced art and writing about psychiatry, gave talks, interviews and workshops, and brought my message around the U.S. and Canada. My time in this movement-especially meeting many other young and radical people at activist conferences-has been incredibly empowering.
From the Unity of Oppression, To the Unity of Liberation
The movement against coercive, corporate psychiatry has much in common with struggles against the harmful practices and globalization of the chemical, pharmaceutical, agribusiness, meat/dairy, biotechnology, prison, military, and media industries. We are in a system that tries to prove social inequality is in our genes. A system that medicalizes difference and seeks to prevent or cure people with disabilities and emotion, behavior, or learning differences, fat people, and intersexed people. That develops more intrusive reproductive technologies for the privileged and new ways to control or prevent reproduction of the "unfit." That poisons our environment and promotes unhealthy foods produced in oppressive ways, then tortures animals to develop profitable cures for the resulting illnesses. That prefers developing genetically modified plants and "magic bullet" drugs over ensuring basic nutrition and health. We must see how these oppressions are unified in order to move towards liberation.
Helping Each Other
We need to take psychiatrically labeled people in our communities seriously, not patronize or pathologize them. We need ways to help activists battling depression, burnout or paranoia in these Patriot Act days, so they won't see psychiatry as their only option, and ways to check-in with each other emotionally to prevent emotional difficulties. We need consciousness-raising and support groups, and self-help centers, that take a nonjudgmental approach to psychiatric drugs, but inform people of their limitations and help them withdraw if desired. We need to promote many options-artistic, nutritional, spiritual-for emotional healing. We need more noncoercive, nonhierarchical facilities for seriously disturbed people-there are only a few in the U.S. now, like the San Joaquin Psychotherapy Center. Safe houses are important to keep newly diagnosed people away from the mainstream mental health system, and help those who've been in and out of institutions for years. It's also important that the burden of caring for people with emotional/behavioral difficulties does not fall back on female relatives.
Challenging coercive psychiatry begins with educating ourselves, with including psychiatry in our political analyses of domination, and taking psychiatrized people seriously in their fight for self-determination. We cannot afford to lose any more people to this system that criminalizes emotion and punishes difference, not when we ourselves are the true experts on our experiences, and we ourselves hold the power to support and heal one another.
by Katherine Hodges
Katherine Hodges is a founder of Mad Lib (www.MadLib.org) and Chicagoland Alliance for Psychiatric Alternatives, and the 'zines Noncompliant and Pharmocracy. You can contact her for more information on the examples in this article-and the wonderful women psychiatric survivors who inspired it-at email@example.com or PO Box 64415, Chicago IL 60601.
Copyright Off Our Backs, Inc. Jul/Aug 2003
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