The Dark Underbelly of Psychiatry - BRIGID Magazine

Thursday, November 1, 2018

The Dark Underbelly of Psychiatry

Image: Xuan Nguyen
I conceptualize psychotherapy as a contemporary spiritual path designed to address the vicissitudes of human suffering through an elaborate understanding of the human condition.

By holding a sacred space with humanity and insight, illusions can be stripped away and truths unlocked. Suffering can be assimilated, so that healing can occur and actualization can unfold. As Jean Vanier wrote in "Becoming Human":

"I have discovered the value of psychology and psychiatry, that their teachings can undo knots in us and permit life to flow again and aid us in becoming more truly human." 

Nonetheless, life and history reveals to us that idealism often succumbs to moral depravity, and ideologies become corrupted. One of our greatest challenges as a species is to defy power's temptation.

"None of us stands outside humanity's black collective shadow." -C. G. Jung

C. G. Jung's contention that noble aspirations and virtuous ideals conflict with the unconscious shadow aspects of the psyche supports the notion that, on a collective level, the human species embodies a proclivity for evil. Regrettably, this proclivity for evil is starkly evident in historical trends of stigmatizing mental disorders, and asserting malevolent social control over those who require compassionate treatment.

Founder of bioenergetic analysis, Alexander Lowen, said, "Beneath the seemingly rational exterior of our lives is a fear of insanity." According to Jung, what we fear becomes a shadow projection, whereby we vilify those who embody the traits we despise within ourselves. Those qualities we find intolerable within ourselves can unconsciously be projected onto select others, who become defined as inferior, scapegoated as deviant, and even designated as evil. Those who personify our feared madness are dehumanized and stigmatized.

Sociologist Erving Goffman defined stigma as, "a phenomenon whereby an individual which is deeply discredited by his/her society is rejected as a result of the attribute." Goffman emphasized the role stigma plays in psychiatric diagnosis and treatment by expounding on its insidious barrier to recovery, and the dehumanization and depersonalization that stimulates further damage and marginalizes victims.

The characterizing of women as naturally masochistic, prone to victimization, and morally undeveloped (Freud) is a grim example of psychiatry's role in promulgating shadow projections and stigmatization. Early in his career, many of Freud's female patients frequently reported sexual abuse, most often naming their fathers as the abusers. Initially, Freud attributed his female patients' symptoms to repressed memories of sexual abuse trauma. That these symptoms were so prevalent throughout Viennese society meant that child abuse was rampant.

Image: Melanie Wasser
According to Freudian scholar, Dr. Jeffrey Moussaieff Masson, Freud dodged the prospect of scandal and political suicide by discrediting his findings of sexual abuse. Rather, he revised that these traumatic memories were unconscious fantasies.

One of the tragic repercussions of Freud's decision is documented in Louise DeSalvo's book, "Virginia Woolf: The Impact of Childhood Sexual Abuse on Her Life and Work" (1989). DeSalvo postulates that Virginia Woolf's confusion about Freud's Oedipal theory, which states that children fantasize the sexual abuse, contributed to Virginia's decision to commit suicide.

The pathologizing of introversion further illustrates the propensity for scapegoating those perceived as different. The reification of cultural ideas about personality is reflected in an ideology that delineates what constitutes socially acceptable behaviour and what deviates from that norm. Although extraversion and introversion span a continuum, in Western society introversion has always been viewed as inherently flawed. This sentiment was loudly echoed in 2010 when the American Psychiatric Association considered including introversion as one of the criteria for schizoid personality disorder in the clinician's diagnostic guidebook, the DSM-5. Due to controversial opposition, this proposal was dismissed.

This trend became particularly detrimental when the first and second DSM (Diagnostic and Statistical Manual of Mental Disorders, 1952 and 1968) listed homosexuality as a mental illness, initially as a sociopathic disorder and later as sexual deviance. Homosexuality was criminalized, and gay men and women were denied their basic civil liberties and rights to physical safety and economic security.

Aversion therapies, including electric shock, were deemed the standard course of treatment. Chemical castration was employed as a "gay cure." Atascadero State Hospital in California was referred to as "Homosexual Dachau" due to the lobotomies, castrations, and other forms of brutality perpetrated on hundreds of homosexual men and women. Neurologist, Walter J. Freeman, creator of the "ice pick lobotomy," is reported to have lobotomized over 1500 homosexuals, in addition to scores of American war veterans. It was only when the APA was vehemently protested by gay activists that the diagnosis of homosexuality was expunged.

We can trace back these barbaric beliefs and medical practices guised as endeavours to cure mental illness, to the eugenics movement. During the American industrial age in the late 1800s, maximizing the potential of the land in order to feed the hungry masses led to selective breeding of crops and farm animals. By extrapolating from this technology, the human species' genetic future could be shaped.

Funded by Andrew Carnegie and John D. Rockefeller, the movement endorsed designating those with "fit" genes as eugenic, while those who were deemed genetically "unfit" were labelled cacogenic. Naturally, those who were economically and politically prominent fell into the eugenic category, while minorities, the impoverished, mentally or physically disabled were assigned cacogenic status. These "diseased" individuals were to be eradicated through segregation, sterilization, or death. Held captive in lunatic asylums, these men and women were subject to barbaric and inhumane treatment of unsettling proportions.

Psychiatry's early support and endorsement afforded scientific validation for eugenics. Money and influence encouraged politicians and judges to make eugenics legal, and by 1933 those deemed cacogenic were imprisoned in asylums so as to prevent them from reproducing in the general population. The United States victimized over 80,000 people with sterilization so that they could never reproduce. This estimate includes targeted minority women in the 1960s.

Due to America's example of putting eugenics successfully into practice, Hitler was able to persuade the Germans to institute their own eugenics program.

By the end of World War I, leading psychiatrists abandoned the movement. Nevertheless, eugenics did not die when psychiatry withdrew its support and this nefarious legacy persisted well into contemporary times. Rather than evolving into a continuum of care, psychiatric institutions such as Danvers State Hospital, Trans-Allegheny Lunatic Asylum, Byberry Mental Hospital, Pennhurst, Pilgrim Psychiatric Center, and countless others perpetuated harrowing acts of torture and neglect.

In 1972, ACLU attorney Bruce Ennis began a class-action lawsuit on behalf of the 5,400 residents of the Willowbrook State School for mentally disabled children in Staten Island. Senator Robert Kennedy referred to Willowbrook as a "snake pit." Journalist Geraldo Rivera's expose of Willowbrook triggered public outrage and greater regulatory control over the quality of care patients received in these institutions.

Image: Daan Stevens
If inpatient "care" was not bad enough, what was to follow in the form of government sanctioned homeless dumping of the mentally ill was just as damaging. In 1967, California passed the landmark Lanterman-Petris-Short (LPS) Act, which virtually abolished involuntary hospitalization, except in extreme cases. By 1975, board-and-care homes had become big business in California. Many of these for-profit board-and-care homes, such as Beverly Enterprises, had close ties to Governor Regan and were contributing large sums of money to his campaign. In exchange, Regan emptied state hospitals. Sociologist Andrew Scull said of the board-and-care industry:

"The logic of the marketplace suffices to ensure that the operators have every incentive to warehouse their charges as cheaply as possible, since the volume of profit is inversely proportional to the amount expended on the inmates."

Under President Ronald Regan and the deinstitutionalization movement, the streets became the asylums of the 1980s. Regan's Omnibus Budget Reconciliation Act repealed Carter's community health legislation ending the federal government's role in providing services to the mentally ill. The repercussions of deinstitutionalization entailed massive homelessness and an increase in incarceration.

Psychiatrist Thomas Szasz asked, "Is psychiatry a medical enterprise concerned with treating diseases, or a humanistic enterprise concerned with helping persons with their personal problems?" He went on to say, "Psychiatry could be one or the other, but it cannot — despite the pretensions and protestations of psychiatrists — be both."

As we move into the psycho-pharmacological revolution beginning in the 1950s, we are inescapably led to the current collusion of Big Pharma and psychiatry promoting psychotropic drug use of endemic proportions. The concerns voiced by Szasz appear to be supported by statistics that reveal a global rise in sales of antidepressants, stimulants, anti-anxiety and antipsychotic drugs totalling more than $76 billion a year.

Undeniably, virtually every major mental health institution is financially interconnected with Big Pharma. Under the Sunshine Act, drug manufacturers are required to report payments given to physicians and teaching hospitals. It was discovered that roughly three out of four physicians seeing patients took money from Big Pharma. Some took only a few dollars. Others received millions. Big Pharma pays psychiatrists to deliver seminars, act as consultants, or enrol their clients into final testing of new drugs.

Along these lines, award winning investigative reporter, Gary Null, has written about another stream of income known as patient brokering, a practice in which doctors and hospital staff falsify diagnosis and medical records in order to obtain payment for treatment that, whatever its value to patients, was not covered by their health plans. Patient brokers make commissions and finders fees from deceptively committing insured individuals to psychiatric facilities.

The high-profile doctor deemed most responsible for the explosion of kids on psychiatric drugs, first for attention deficit hyperactivity disorder (ADHD) and then for paediatric bipolar disorder (1996), is Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of paediatric psychopharmacology at Harvard's Massachusetts General Hospital. The New York Times described Biederman's studies as "so small and loosely designed that they were largely inconclusive." Yet temper tantrums were persuasively masked as mania, resulting in an aggressive medication regime, exposing thousands of children to neurotoxic chemicals. Biederman's take from Big Pharma, specifically Johnson & Johnson, was $1.6 million.

When Rebecca Riley, a four-year-old girl, died from an overdose of drugs prescribed to treat paediatric bipolar disorder and attention deficit hyperactivity disorder, repercussions against Biederman and his followers ensued.

In closing, when I step back to absorb and analyze the totality of harm exacted under the guise of benevolence, it is disorienting and disillusioning. I am astounded by the ubiquitous sadistic exploits and abject indifference in my chosen profession. While history serves as a reminder of the human condition, it does indeed repeat itself in spite of the profound lessons proffered. This is a grave concern as we consider the potential ramifications of the transhumanism movement.

Nevertheless, I turn to the virtues in the work and humble myself to the fragility of our human condition, even when corruption is a pervasive concern. The most I can do is return to the source of my truth where I willingly embrace my moral limitations and do my best to consciously align with my own humanity.

I keep in mind the words of existential psychiatrist Irvin Yalom, who wrote, "Psychiatry is a strange field because, unlike any other field of medicine, you never really finish. Your greatest instrument is you, yourself, and the work of self-understanding is endless. I'm still learning."

by Sheri Heller