Depathologization from the Left

DEPSYCHIATRIZATION FROM THE LEFT

Capitalism is sickening, and the left urgently needs to link with alternatives to the damaging 'treatments' that are doled out by mainstream psychiatry. In this brief review, I contrast a limited reductive kind of Stalinist realist 'materialism', which works hand in hand with psychiatry, with an open communist pluralist approach to the different ways of being human that are possible, if another world beyond capitalism is to be possible.

Psychiatry is often confused with other 'psy' disciplines (like psychology, psychotherapy and psychoanalysis), but what marks it out from the others is that it is deliberately and explicitly medical; psychiatry is underpinned by a 'medical model' of distress so what we feel when we feel bad is treated by specialist doctors as if it is really a 'sickness' that has a physical organic cause that can then be 'cured' by physical, usually drug interventions.

What that assumption about sickness and cure does, and it is drummed into the psychiatrist in their medical training before they specialize in 'mental disorders', is to effectively ignore the alienation, exploitation, oppression and misery of living under capitalism. The psychiatrist instead is trained to search for the 'real' underlying causes, as if poverty, exclusion, austerity, racism and sexism were mere additional factors that might just intensify or 'trigger' what the doctor detects underneath the symptoms they are trained to attend to.

The fiction that medical psychiatrists really now work according to a 'bio-psycho-social' model is a hopeless distraction, false path. When it comes down to it, they end up reducing distress to biology, or they break with psychiatry.

Doctoring

A psychiatrist, like other medical professionals, is under pressure to make speedy diagnosis, choosing a category from the DSM (the Diagnostic and Statistical Manual of Mental Disorders) or the ICD (International Classification of Diseases), and to administer treatment, and so the reduction of distress to a physical cause is the understandable default procedure. This pressure is added to by the marketing of an increasing number of new 'disorders' by the drug companies, and by the promise that symptoms can be dealt with by targeting a chemical imbalance in the brain.

So-called 'psychopharmacology' is a massive drug market, legalized and state-sanctioned drug-pushing, and big pharma pours huge investment into identifying disorders that are dampened by drug treatments. That investment includes paying medics to endorse or even add their names as authors to already-written research reports, and it includes smearing those who have second thoughts, whistleblowers and psychiatrists who realize that the medical model just does not work.

In some ways, the approach does work, of course. Symptoms are certainly dampened down by the drugs, and patients are got off the books. And many patients are relieved to be given a diagnosis, to find an answer of some kind to their distress, and to accept what they are handed as a life sentence, that is, to accept that the sickness is deep within them and could return at any time. The illusion that root causes have been found is often a comfort to the patient and, of course, the doctor, but it is disabling.