Defining Anti-Psychiatry

"You run into these people, the ones who say that psychiatry is evil, that they can get by without the medications. You look at their comments on other blogs and you see that they have self-control problems because they post responses to EVERYONE about EVERYTHING that is said. They declare themselves masters of their illness, but it is obvious that they lack control of their impulses. They are miniature Tom Cruises without Scientology, proponents of anti-psychiatry who declare to have found a magical remedy for their illness, droning like crickets whose one word is chirp.

Mind you that I am not a lot of things: a fan of big drug companies and their profiteering, a believer in ECT, or a supporter of involuntary commitment without evidence of danger to self or others. But I have little tolerance for the stigma from within the body of the afflicted, from those who refuse to take medications because they are so caught up in their mental illness that they are thralls to their disease.

Here is what I wrote, in part, in response to someone who has been making the rounds of bipolar and therapeutic blogs in a crusade to insult us by association with the psychiatric profession.

Read more... Pax Nortona: Response to a Refusenik

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That's Joel. He's referring to me. I ran into him via that conversation with psychiatrist #2. Anyway, he's got me thinking about something...

I read a comment the other day that Loren Mosher -- a highly devoted psychiatrist -- was in fact, an "anti-psychiatrist". I, too, am apparently an anti-psychiatrist, even though I have two blogs packed to the rim with quotes and links from psychiatrists I sincerely admire. What's more, I seem to be encountering and finding numerous others who are also anti-psychiatrists, even if they're psychiatrists. On reflection, it seems to me that being an anti-psychiatrist isn't really about being a psychiatrist or sincerely admiring any of them. It seems to me that it's about this...

"...they can get by without the medications."

That's the critical identifying characteristic; an anti-psychiatrist is someone who can get by without medication. Loren Mosher did it, John Weir Perry did it, Jaakko Seikkula is doing it, I did it, many others have done it, and still others are doing it right this very moment. What's more, many of them are doing it very well. I haven't figured out all the rules yet but I think that being an "anti-psychiatrist" is supposed to be a very bad thing. The important thing is, if you see me in the lunch room you probably shouldn't sit at my table -- after all, it might be catching!

I once met a woman who said that she "hated" people like me; "people like me" being people who get well without medication. Interesting, isn't it? Not having taken medication is enough to get me hated and labelled as someone who "thinks psychiatry is evil... a miniature Tom Cruise without Scientology... a proponent of anti-psychiatry ... a declarer of a magical remedy... droning like a cricket whose one word is chirp... on a crusade to insult us by association with the psychiatric profession."

Perhaps, a bit of history is worth repeating: When I went through my experience I didn't know that what I was going through was considered a "schizophrenic break". As a result, I didn't go to the hospital. Instead, I went into the experience and found that to be enormously helpful and incredibly insightful. More than a year passed before I actually had a name for that experience. By then, I was certainly no longer in a state of psychosis. People don't take an aspirin for a headache they had a year ago and I couldn't see any reason why I should take anti-psychotic medication for a state of psychosis that was over and done with. Besides, I couldn't afford to hire a psychiatrist and even if I could, the local one had a waiting list that was eight months long. Quite honestly, I'm glad that's the way it went. I seem to have made it through without medications and I'm not comfortable with what I'm learning about them now.

There are, of course, many people in the world who go through psychotic episodes without taking anti-psychotic medication, just as there are many women who give birth without pain medication. There are a multitude of reasons for why a woman might do so: she might be concerned about side effects; she may have had an unpleasant experience previously; she might believe it's her moral duty to suffer; she might find the presence of loved ones helps her cope quite effectively; she might believe a drug-free birth will be best for her baby; she might find the pain tolerable; she might not think to ask; she might not be aware that it's an option; she might not have the option available at all. Can anyone come up with a good reason why a woman should be considered evil or deserving of hatred under any of those circumstances?

For what it's worth, here's my stance on medication, schizophrenia, psychosis, and recovery.

I believe that... if you take medication you are entitled to know the potential risks and benefits so that you can make your best informed choice; ditto for parents who may make this decision on behalf of their child. I don't think you should expect your caregiver to provide every piece of that information to you, although you can if you want -- just remember that what they think is most important might not be what you think is most important. If you do your own research you can better share your specific concerns with them, which means they'll be more likely to know what you think is most important.

I believe that... you should take medication if you believe it's helpful and if you do, you should take it without apology or shame -- it's your recovery. Naturally, I'm assuming that you are aware of all the potential risks and benefits. If you're not, you can hardly make an informed decision. If at some point you determine that medication is no longer helpful to you, I suggest you explore and thoroughly research your options before making your own best decision. As I understand it, many psychiatric medications should never be stopped abruptly so find someone who can support you through the withdrawal phase.

I believe that... if you are getting better without medication that you should continue to do so, without apology or shame -- it's your recovery. If at some point you decide that medication might be helpful for you, I suggest you research the matter throughly and try some. If it helps, and you feel the benefits outweigh the risks, keep taking it. Otherwise, try something else. If you're looking for inspiration, try some cross-cultural studies. People in other countries don't always have access to medication and many of them get well; it's worth taking a look at how they manage to do so.

I believe that... the goal is recovery according to your own definition, not according to someone else's. It's not a contest. There are no gold stars being handed out for those who had the most ECTs or the least clozapine. The reward is your life, lived to the best of your ability, on your terms.

I believe that... your experience is your experience and my experience is mine. If you are free to speak of your experience I think I should be free to speak of mine, including what I found most beneficial -- even if you didn't. You are welcome to do the same.

I believe that... if you ever find yourself hating someone because they're different from you, that you should maybe sit down and think long and hard about why that "difference" bothers you so much. Then, keep thinking about it and sorting it out until it doesn't bother you anymore, and you no longer find it necessary to hate people who are different from you.

See also:

My Personal Definitions of Recovery

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Schizophrenia, Psychosis, Recovery, The Recovery Based Model, Hope for Schizophrenia Sufferers