The fundamental unspoken belief

The fundamental unspoken social belief underpinning capitalist society is "if you don't have a job, you should starve." This belief is now being put into practice. We obviously need to do things differently.

Motto that is so true!

DUX VITAE RATIO. IN CRUCE VICTORIA.

"Doughnut Psychiatry"?

I have put this post back at the top of this mess of a think tank because I think it is one of the only ones in the blog that is really worth having up.
I am glad it has had 63 views and I hope it has more because I think it has good potential for helping things.
In fact, if anyone wants to share or steal the idea, then steal away please!
No acknowledgement is necessary. This is not copyright or anything.

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"You never change things by fighting the existing reality. To change something, build a 
new model that makes the existing model obsolete." 
Buckminster Fuller, theorist and proponent of the term "Spaceship Earth."

"Simply rebutting the dominant frame will, ironically, only serve to reinforce it.
And without an alternative to offer, there is little chance of entering, let alone winning,
the battle of ideas." 
Kate Raworth, economist and inventor of "Doughnut Economics".

I wonder if these observations have any relevance to the work of Thomas Szasz, to antipsychiatry and the need to change Psychiatry?

I think Psychiatry is fundamentally irredeemable and flawed.
I confess that I was close to thinking a similar thing about about Economics, until I recently read Kate Raworth's excellent book about that subject - "Doughnut Economics: 7 Ways to Think Like a 21st Century Economist."
Economics and Psychiatry are not the same thing at all.
But it might be useful to compare them. They are both - very broadly speaking - human or social sciences - that purport to deal with specific areas of human life. They are both prey to the drawbacks inherent to supposed social or human sciences - and are different from natural sciences. Social or human sciences sometimes aspire to the certainties of natural sciences, but it is debatable that this can achieved. It is a very important question for the philosophy of science.

"The human "sciences" are not merely unlike the psychical sciences; they are, in many ways, opposites. Whereas nature neither lies nor tells the truth, persons habitually do both."
Thomas Szasz.

In the case of comparing Economics and Psychiatry, one way that they are perhaps similar is that they both have two much sounder disciplines further up the "tree of science" that they both could be said to branch out from.
These two disciplines are perhaps much sounder for often being more speculative. They are Politics or Political Science (which gives rise to Economics) and Psychology (which gives rise to Psychiatry).
....

I have said elsewhere that I am antipsychiatry. I do believe that psychiatry should be abolished as an official medical discipline.

But is there scope for a "Doughnut Psychiatry"?
By this I would mean a radical rethink of Psychiatry in the light of Thomas Szasz's thought, in a similar way to the radical rethink that "Doughnut Economics" gives to conventional economics.
By it I would mean a radically reformed and simplified form of psychiatry, without any medicalization or coercion.

"Doughnut Pyschiatry" could conceivably be medical in the sense that there is conceivably a relation between the physical body including and especially the brain and nervous system and behaviour and mood - but not in the sense that there are such things as "mental illnesses."

All medical treatment in "Doughnut Psychiatry" would be voluntary and an attempt would be made to base it on science. On both of these two points this is the exact opposite of what happens now.

As Szasz said, "The discovery that all so-called "mental diseases" are brain diseases would mean the disappearance of psychiatry into neurology.” ;“No behavior or misbehavior is a disease or can be a disease. There is no mental disease. Period."

He also said: “I don’t deny the existence of brain diseases; on the contrary, my point is that if mental illnesses are brain diseases, we ought to call them brain diseases and treat them as brain diseases."

Szasz certainly recoiled from the term "Antipsychiatry". Which meant he allowed for some kind of psychiatry to exist. He believed people should be free to believe what they like. And if this included psychiatry or alchemy or homeopathy or astrology, then so be it. As a libertarian like him, I also think that people should be free to believe what they like. So do lots of people.

I do indeed think - as did Szasz - that psychiatry is comparable to alchemy, homeopathy or astrology.

It is one thing to tolerate alchemy, homeopathy or astrology - it would be another thing for a society to give them official recognition and support.

I personally think Psychiatry is a pseudoscience and a crime that needs to end. I don't think it can continue and I don't think that it can continue by another name or by its own name. I don't really think we need anything to "replace" psychiatry. If you think that we need anything to "replace" psychiatry, you have probably missed the point.

And yet even having written what I have just written, I still think that for at least two reasons there could be scope for a "Doughnut Psychiatry" - a simplified and re-thought Psychiatry.

Firstly, because of the need for a transition or a midway point being needed between a highly psychiatrized world that we seem to have now, and a minimally psychiatrized world - or indeed a psychiatry-free world - that we seek to head towards.

And secondly because of freedom. People should obviously be free to do what they like. There is no point in opposing coercion if you don't believe in freedom.

This re-thought form of Psychiatry would obviously not have to be called "Doughnut Psychiatry". I am just borrowing a phrase from Economics. It could have another name.

By it I would mean a form Psychiatry that actually helps people with problems in living - if they want that help; and a Psychiatry that utterly disbelieves in "mental illness".
A psychiatry that seeks to help rather than dictate diagnonsenses, stigmatize, imprison and destroy. A genuinely libertarian, non-medical and non-incarceratory psychiatry. A Psychiatry that - for the first time - would conscientiously stick to the Hippocratic Oath of doing no harm in Medicine.

I have just noticed that a doughnut is the same shape as a lifebuoy. It could be a lifebuoy to save people, and to save those who are suddenly thrown overboard by the sinking ship that Psychiatry is.

I have just seen that the same image of its being a lifebuoy obviously applies to the original "Doughnut Economics" itself, and I think that "Doughnut Economics" is genuinely the only lifebuoy that can save humanity from drowning!

"You don't need a reason to help people." A very apposite statement.
A psychiatry that genuinely helped people would be a new thing altogether.

It could in a sense be said that Szasz himself gave it a name: "Szasz proposes an alternative word to indicate psychotherapy – 'Iatrology', or healing with words. 
In his book The Ethics of Psychoanalysis (1965) he calls his form of psychotherapy 'autonomous psychotherapy'".

I do not really think a science of psychiatry is possible whilst it still holds on to the central concept of "Mental Illness".

With this concept totally knocked out of it - so it would leave a hole a bit like the one at the centre of a doughnut - perhaps a scientific Psychiatry could finally begin, and in the meantime it could maybe be a humane and decent practice. Maybe.

The space occupied by the doughnut in "Doughnut Economics" represents a safe and just space for humanity.
In the same way the doughnut in "Doughnut Psychiatry" could represent a safe and just space for the individual - which is free from the outer menace of coercion and free from the central intellectual "black hole" of medicalization.

(I knew I could find at least one reason to call it "Doughnut Psychiatry"!).

"Doughnut Psychiatry", or something like it, could maybe have a role to play.

Unhappiness is obviously not in itself a medical problem. 
But unhappiness could obviously in some way have LINKS to Medicine. It would be these possible links that "Doughnut Psychiatry" could allow for and explore, without becoming in any way unscientific.
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Below is an attempt at a diagram for the conceptual doughnut that would be involved in "Doughnut Psychiatry". This has made me feel like a bit of a doughnut but there might be something interesting in it.
The inside of the doughnut is meant to be the INDIVIDUAL BIOLOGICAL HUMAN and the outside of the doughnut ring is the SOCIAL AND ENVIRONMENTAL WORLD.

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Please see my blog "MENTAL ILLNESS DOES NOT EXIST":

https://citizensofamidne.blogspot.co.uk/


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P.S. 5th December 2018.

I have just learnt that Szasz wrote about Economics in some detail in his excellent book "Faith in Freedom: Libertarian Principles and Psychiatric Practices" (2004).

In the book, he compares Economics and Psychiatry, and sees many similarities, implying that both are pseudosciences in similar ways.

"Viewed as the study of human action, economics and psychiatry are fraternal twins: economists are concerned mainly with the material and political consequences of choices and actions; psychiatrists, mainly with their political and interpersonal consequences." 
Thomas Szasz.

............

"I deeply regret the loss of life in the war in Iraq, but I am extremely keen to get stuck into Iran."

Blair is a war criminal and a pathetic, snivelling hypocrite:

He seems to be saying:

"I deeply regret the loss of life in the Iraq war, but I am extremely keen to get stuck into Iran."

The war on Iraq was an illegal crime.
Once we recognize that we will stand more chance of preventing war from happening again and again.

Re-posted 11.11.18 - in honour of the fallen who hoped it would never happen again.

"The Apprentice" is STILL crying out for a satirical version.

2010: 30th September

In preparation for this channel:

"Emma Goldman to appear on the Apprentice".
I am watching "The Apprentice".
I keep thinking of doing a satirical version where the candidates are all revolutionary lefties.

"Emma Goldman and Dolores Ibarruri were given the task of handing out the deluxe snacks to the public in Covent Garden.........."

Alexander Berkman, Emma Goldman and Dolores Ibarruri ditch their principles and agree to appear on The Apprentice and vie for the job with Sir Lord Alan.

I first had this basic idea in 2010.

It is now 2017 and "The Apprentice" is still painful capitalist propaganda.

It is still simply crying out for a satirical version in which radical anti-capitalist revolutionaries are the contestants. 

And they vie to be the assistants of Comandante Alan Sugar in toppling capitalism. Or something like that.

Alan Sugar: "I am sorry Mr. Guevara but your handling of that ambush of the capitalist lackeys was amateurish. Che Guevara - you're FIRED!"
Che Guevara: "Thanks, Comandante Azucar. Was pleasure being bossed by you." *gets up and leaves*
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Everything in "The Apprentice" is based upon the assumption that the reason for production and services is solely to make money and profit.

It needs to be said and screamed out loud until it becomes a reality - production should be for need not profit.

Everything in "The Apprentice" is based upon the assumption that everything is a competition between individuals and products and services. The whole idea of co-operation is not allowed for.

The environment and society as a whole are not really permissible concepts in the world of "The Apprentice".

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It is now 2018. It's been EIGHT years. EIGHT fucking years. A long fucking time.

How long must we sing this song? How long has the Apprentice been going for?

This tired and cringeworthy yet addictive format is still being churned out every week.

And YES it is still absolutely CRYING OUT for a satirical version based on revolutionary leftists trying to get the job with Sir Alan.

It could be called "APPRENTICE REVOLUTIONARY" and it could say so much in such a short time.

If no one else does it maybe one of these days I will write a script for it.

As I keep trying to tell myself, you can only go forwards in life - so let's do it some time.

My intellectual heroes.

My intellectual heroes include:-

Bertrand Russell, Karl Popper, Thomas Szasz, Noam Chomsky, Karen Armstrong and Kenan Malik.

"Divide and Rule" is not dead

"Divide and Rule" is not dead.
A rival think-tank - the right-wing "Resolution Foundation" - has seriously spoken of giving young people large financial handouts when they become 25. This is supposedly because the "social contract" between the generations has broken down.
There is no social contract between the generations. What nonsense!
It is incredible that this nonsense made the front page of the Guardian - supposedly the most radical of the mainstream papers.
It is highly unlikely to happen, and is an example of government by the media and diversion by the media.
"Divide and Rule" is not dead. In this case dividing society by generations. A new trick.
The housing crisis is caused by the abandonment of social democratic principles.
Not by any difference between the generations.
Poverty exists in all generations.

Thomas Szasz essay, 1979.

"Male and Female Created He Them" by Thomas Szasz. 1979.

IN the old days, when I was a medical student, if a man wanted to have his penis amputated, my psychology professors said that he suffered from schizophrenia, locked him up in an asylum and threw away the key. Now that I am a professor. my colleagues in psychiatry say that he is a “transsexual,” my colleagues in urology refashion his penis into a perineal cavity they call a vagina, and Time magazine puts him on its cover and calls him “her.” Anyone who doubts that this is progress is considered to be ignorant of the discoveries of modern psychiatric sexology, and a political reactionary, a sexual bigot, or something equally unflattering.

Like much of the medical‐psychiatric mendacity characteristic of our day, the official definition “transsexualism” as a disease comes down to the strategic abuse of language — epitomized by confusing and equating biological phenomena with social roles (in the present case, chromosomal sexual identity with acting as a man or a woman). Although there are connections between these concepts and facts, neither one “causes'.’ or “determines” the other.

Because “transsexualism” involves, is indeed virtually synonymous with, extensive surgical alterations of the “normal” human body, we might ask what would happen, say, to a man who went to an orthopedic surgeon, told him that he felt like a right‐handed person trapped in an ambidextrous body and asked the doctor to cut off his perfectly healthy left arm? What would happen to a man who went to a urologist, told him that he felt like a Christian trapped in a Jewish body, and asked him to re‐cover the glans of his penis with foreskin? (Such an operation may be alluded to in I Corinthians, 7:17‐18.) “But,” the medically informed reader might object, “isn't transsexualism a disease? Isn't it — in the grandly deceptive phrase of the American psychiatric establishment used to characterize all ‘mental diseases’ — ‘just like any other illness'?” No, it is not. The transsexual male is indistinguishable from other males, save by his desire to be a woman. ("He is a woman trapped in a man's body” is the standard rhetorical form of this claim.) If such a desire qualifies as a disease, transforming the desiring agent into a “transsexual,” then the old person who wants to be young is a “transchronological,” the poor person who wants to be rich is a “transeconomical,” and so on. Such hypothetical claims and the requests for “therapy” based on them (together with our cognitive and medical responses to them) frame, in my opinion, the proper background against which our contemporary beliefs and practices concerning “transsexualism” and transsexual “therapy” ought to be viewed.

Clearly, not all desires are authenticated in our society as diseases. Why the desire for a change in sex roles is so authenticated is analyzed with great sensitivity and skill by Janice Raymond in “The Transsexual Empire.” Arguing that “medicine and psychology ... function as secular religions in the area of transsexualism,” she demonstrates that this “condition” is now accepted as a disease because advances in the technology of sex‐conversion surgery have made certain alterations in the human genitals possible and because such operations reiterate and reinforce traditional patriarchal sex‐role expectations and stereotypes. Ostensibly, the “transsexers” (from psychologists to urologists) are curing a disease; actually, they engage in the religious and political shaping and controling of “masculine” and “feminine” behavior. Miss Raymond's development and documentation of this thesis is flawless. Her book Is an important achievement.

The claim that males can be transformed, by means of hormones and surgery, into females, and vice versa, is, of course, a lie. ("She‐males” are fabricated in much greater numbers than “he‐females.") Chromosomal sex is fixed. And so are one's historical experiences of growing up and living as boy or girl, man or woman. What, then, can be achieved by means of “transsexual therapy"? The language in which the reply is framed is crucial — and can never be neutral. The transsexual propagandists claim to transform “women trapped in men's bodies” into “real” women and want then to be accepted socially as females (say, in professional tennis). Critics of transsexualism contend that such a person is a “male‐to‐constructed‐female” (Miss Raymond's term), or a fake female, or a castrated male transvestite who wears not only feminine clothing but also feminine‐looking body parts. Miss Raymond quotes a Casablanca surgeon, who has operated on more than 700 American men, characterizing the transsexual transformation as follows: “I don't change men into women. I transform male genitals into genitals that have a female aspect. All the rest is in the patient's mind ".
Not quite. Some of the rest is in society's “mind.” For the fact is that Renee Richards was endorsed by Billie Jean King as a real woman and was accepted by the authorities monitoring women's professional tennis as a “real woman.” This authentication of a “constructed female” as a real female stands in dramatic contrast to the standard rules of Olympic competition in which the contestants’ bodily contours count for nothing, their sexual identity being based solely on their chromosomal makeup.

Miss Raymond has rightly seized on transsexualism as an emblem of modern society's unremitting — though increasingly concealed — antifeminism. And she correctly emphasizes that “the terminology of transsexualism disguises the reality ... that transsexuals ‘prove’ they are transsexuals by conforming to the canons of the medical‐psychiatric institution that evaluates them on the basis of their being able to pass as stereotypically masculine or feminine, and that ultimately grants surgery on this basis.” The “transsexual empire” is thus a Trojan horse in the battle between the sexes, helping men to seduce unsuspecting women, or women who ought to know better, to join forces with their oppressors.

Still, why should anyone (especially feminist women) object to men wanting to become women? Isn't imitation the highest form of flattery? Precisely herein lies the “liberal” sexologists’ betrayal of human dignity and integrity: They support the (male) transsexual's claim that he wants to be a woman — when, in fact, what he wants is to be a caricature of the male definition of “femininity.” What makes transsexual surgery a male‐supremacist obscenity is the fact that transsexing surgeons do not perform the operation on all clients (just for the money) but insist that the client prove that he can “pass” as a woman. That is as if Catholic priests were willing to convert only those Jews who could prove their Christianity by socially appropriate acts of antiSemitism. Janice Raymond's analysis is bitterly correct. The very existence of the “transsexual empire” is evidence of the persistence of our deep‐seated religious and cultural prejudices against woman.

The war between the sexes is a part of our, human heritage. It's no use denying It. If that war ever ends, it will be not because of a phony armistice arranged by doctors, but because men, women and children will place personal dignity before social sex‐role identity.

 

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In the above essay from 1979 Szasz points out the glaringly obvious.

What does it say about us that by 2018 doing so has become so controversial?

Women and psychiatry

Women are more likely to be victims of psychiatry than men.

It is the case.

I wrote the following two comments under an article by the Critical Psychiatrist Joanna Moncrieff:

You write the following: “We should acknowledge, however, that neurological conditions cannot always be detected in the brain, and may only be identified through the characteristic way in which they are manifested in publicly observable behaviour. This does make judging what is and is not a brain disease a complex and imprecise matter in some cases.”
Surely a “neurological condition” is absolutely always potentially detectable in the brain (or nervous system) – by virtue of its being a physical neurological condition. What “is and is not a brain disease” is not really a question of judgement, but of science. Until a disease is categorically scientifically identified, how can it be said to exist at all?

Also – how can a “neurological condition” be completely “identified” by its manifestation in behaviour? Surely this is a category error. Surely a “neurological condition” can only be fully and unequivocally identified by a physical examination of the B.C.N. – brain and central nervous system – of some kind.

Joanna Moncrieff's reply to my comments was as follows:

Hi citizen sofa,
This is not the case. Dementia, including Alzheimer’s disease, is not diagnosed by brain imaging or any other physical tests. As a group, people with a diagnosis of dementia have more of the brain pathology associated with aging than those who do not (plaques and tangles and infarcts identified in brain scans), but most people at a certain age have some of this pathology and there is overlap (ie. a person without dementia may have more pathology than an individual with it). Brain imaging cannot therefore be used to make a diagnosis, and no other physical tests specifically identify dementia either. Dementia is diagnosed by someone’s behaviour and performance on tests of cognitive function.

I think people do not realise this because if you look at information on diagnosing dementia it is very vague and does not make this clear. When someone is being investigated for possible dementia, they will have various blood tests and other examinations, but these are for the purpose of excluding other diagnoses (like hypothyroidism) that may be producing the symptoms. Dementia is diagnosed when no other physical explanation of the symptoms (behaviour and cognitive deficits identified on testing) is found.

Source:

https://joannamoncrieff.com/2017/11/27/philosophy-part-6-are-mental-disorders-brain-diseases-in-waiting/

What I wrote in my comments is indeed the case, in spite of what she says above.
Her reply seems to ignore my basic point.
 A neurological condition can indeed only be neurological.

Her reply to my comment shows why Szasz's perspective is absolutely vital, even in areas that are not related to so-called "mental illness".

Szasz was a true upholder of the spirit of science and the Enlightenment.

If dementia is merely degeneration then it is not strictly speaking - and hence not scientifically speaking - a disease. If dementia is not identified in pathology of some kind then it is not a disease - it is merely an observed behaviour.

If it is only observable in behaviour then we cannot say it exists at all. If and when that behaviour is demonstrated to have been directly caused by physical pathology, then we could possibly say that a behaviour has been caused by an illness. We can never say that a behaviour is an illness. It is indeed a category error.

I have already made a similar point in my blog on neuroscience.

[
http://nervescienceisnonsense.blogspot.co.uk/2014/05/clueless-about-alzheimers-disease.html 
]

Szasz's basic point is absolutely right and absolutely vital. A behaviour is not in itself a disease. 

A diagnosis can only mean a disease in the light of the evidence of medical science.

My obvious point is that cancer - for example - would never be diagnosed solely on the basis of changed behaviour. Neither would treatment for it be initiated. You would not give someone oncological brain surgery, merely because they had slurred speech and were very confused. Cancer would only ever be diagnosed on the basis of scientific evidence. Neither should any other disease be diagnosed on the basis of anything other than scientific evidence.

If people need a diagnosis of dementia in order for them to receive the help they need, then I don't believe in sacrificing science for social reasons. If people need a diagnosis for social reasons, then we have a social problem, not necessarily a medical problem. Why should people need a diagnosis to get help? A diagnosis should be a scientific question and nothing else. 

People should get all the help that they need. This applies to everyone and every possible problem. There is simply no need to sacrifice science to the social institution of what remains of the medical profession.

This compromising of science has been going on for too long. And Szasz seems to have been one of the few people aware of it.

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"The Critical Psychiatry Network's position is not in my view psychiatric criticism at all.
It is a plea for what I have long called prettifying the psychiatric plantation. 
Psychiatrists either have the right to forcibly molest persons or they do not have such a right. 
Some things are either-or.  You are either arrested or not arrested. 
You are either sitting here or you are in jail."

Thomas Szasz, 2011.