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Wednesday, February 22, 2017

How Psychiatry Can Change Who You Are

Most people do not know what goes on inside a mental hospital. They simply assume that patients are getting much needed psychiatric treatment there. It might be shocking for someone to learn what really goes on inside one of these places.

As well known and highly influential sociologist Erving Goffman (1961) has explained, in the psychiatric hospital every aspect of a patient’s life is considered a component of their psychiatric treatment. P. 149 For example, if a patient is given food, allowed to quietly read a book, or attend to his own personal hygiene these things are considered privileges that are given to the patient as part of a therapeutic program. A patient who misbehaves will have these things taken away. A patient may be reduced to very poor living conditions. A patient may be reduced to sleeping on a wooden bench, eating very little poor tasting food and having nothing to preoccupy his time. As Goffman (1961) explains in a psychiatric hospital patients are subjected to a system of punishments and rewards p. 163. Through this system nurses and doctors exert total control over the patient.

According to an anonymous interview with a former psychiatric patient (2017), the existence of this system is not explicitly communicated to the patient. In fact, according to the former patient (2017), if a patient articulates anything about this system then it might have adverse consequences. Also, the former patient (2017) goes on to say psychiatric treatment may be used as a punishment for behavior the psychiatric staff deem undesirable. For example, if a psychiatric patient has an intense argument with staff they could be forcibly injected with drugs.

Goffman (1961) explains the inpatient hospital alters the person’s self. This process of punishments and rewards is applied to the mental patient’s sense of self p. 148. Goffman (1961) goes on to explain that in the psychiatric hospital a patient’s level of privileges mirrors his current state of mental health and is considered a direct expression of his self p. 149. Meanwhile, the person’s former identity is discredited. A case record of the patient’s past behavior is constructed. Goffman (1961) explains that in the patient’s case record his past experiences are reframed as symptoms of mental illness P. 156. Also, the patient’s own story for why he is in the psychiatric hospital is discredited verbally by the hospital staff.  As Goffman (1961) states, “If the psychiatric faction is to impress upon him its views about his personal make-up, then they must be able to show in detail how their version of his past and their version of his character hold up much better than his own” P. 154.

In my opinion, this process is basically a form of brainwashing. Through psychiatric treatment, the patient is punished for retaining his former identity and rewarded for assuming a new identity. A patient is transformed from someone that believes he is an ordinary person to someone who believes that he has a mental illness. This alters the very core of his identity.

Frightening Consequences


The social environment of the mental hospital can have frightening consequences. For those that haven’t heard of Catatonic Schizophrenia, it is a psychiatric condition where someone, who has nothing medically wrong with them, becomes completely motionless and mute for a long period of time. People diagnosed with Catatonic Schizophrenia can sometimes remain mute and motionless for years. Goffman (1961) points out that the tendency for patients to become mute in mental hospitals is actually a result of the mental hospital itself. Goffman (1961) explains that becoming completely mute for long periods of time can be a kind of tactic to survive in the psychiatric hospital. As Goffman (1961) states,” For these patients withdrawn muteness was the official stand-a defense presumable against both importuning attendants and fellow patients that was grudgingly accepted as a legitimate mental symptom” P. 257.

A person  diagnosed with Catatonic Schizophrenia
 may remain motionless for years. 
Furthermore, withdrawn muteness may be a direct result of the social environment of the institution. Unlike normal life where self-expression is expected to occur freely without too much inhibition, in the mental hospital the patient’s ability to express himself is much more limited.  As Goffman (1961) explains, for the mental patient, any kind of self-expression against the institution is considered a psychotic symptom p. 307. Because of this, as Goffman (1961) explains, a kind of vicious cycle can occur where the more the patient expresses his dissatisfaction with the institution the more he is likely to suffer punishments in the form of deprivations and psychiatric treatment p.306. This process may continue until becoming mute is the only way the patient can express his feelings about the institution. As Goffman (1961) states, “From the patient’s point of view, to decline to exchange a word with the staff or with his fellow patients may be ample evidence of rejecting the institutions view of what and who he is” p. 306.

The mental patient lives in not just a physical prison but also a social one. In my opinion, this can cause the mental patient to retreat to an area where the psychiatric faction can’t penetrate-his own mind. In this way, remaining mute for extended periods of time could be considered a kind of protest against the psychiatric institution. 


A Final Word


In my opinion, through examining the social environment of the psychiatric hospital, it is evident that the psychiatric staff are not really trying to understand the perspectives of the patients they treat. Instead, the psychiatric staff are engaged in a process to coerce patients into conforming to conventional social norms and values. Such a process may cause the patient to behave in an agreeable way but at a cost.  The patient is forced to change. His free will and autonomy as a person are compromised.

I do not deny that individuals at times enter psychological states where they become unreasonable, unreachable or cannot take care of themselves. I write this to point out the often destructive transforming power that the psychiatric hospital can have on the individual and to question if it is always justified when people think and act abnormally.  It seems like an approach to returning a patient to consensus reality that does not coerce the patient but instead recognize him as a thinking, feeling person who is capable of free will could be achieved.


A peer-run crisis respite is one such approach. A peer-run crisis respite is an alternative to the psychiatric hospital. It is a building, typically a house, where individuals can go and stay for two weeks and recover from a mental health crisis. A peer-run respite is not operated by psychiatrists but by individuals that know the path to recovery best, former mental health consumers. There a person who is having a crisis is free to act as they choose and is never coerced. Peer run respites exist in various locations across the country. Perhaps in the future peer-run crisis respites will be widely available to everyone. 

References


Goffman, Erving. Asylums. 1st ed. Garden City, NY: Anchor Books, 1961. Print.
Former Psychiatric Patient, Anonymous. 2017. in person.

Sunday, June 5, 2016

The Treatment Advocacy Center: a Portrait of an Extreme Mental Health Interest Group

The Treatment Advocacy Center (TAC) is nonprofit mental health interest group in the U.S. People who are not familiar with the U.S. mental health system may have never heard of them. The TAC is an organization that advocates for the most extreme views of mental health care. Basically, the TAC’s stance is that people with mental illness are inherently dangerous and their civil rights as well as inability to recognize their own illness are barriers to providing them effective mental health treatment and maintaining public safety. 


In my opinion, the TAC ‘s agenda is to increase stigma for people with a mental health diagnosis in order to eliminate their rights and segregate them from society. The TAC does this by perpetuating negative mental health stereotypes in the media, advocating for mental health legislation that implements coercive mental health treatment practices and increases the number of inpatient psychiatric hospitals. In reality, people with mental illness are no more violent than the general population and mental health stigma prevents them from living successfully in the community. 

The TAC is a big advocate for a practice called Assisted Outpatient Treatment (AOT). AOT refers to mental health treatment laws and programs that require a person to take medication under court order while living in the community. If the person refuses to take medication while on an AOT order they can be committed to an inpatient psychiatric hospital. AOT is a drastic curtailment of a person’s civil rights. A person on AOT is not in control of their own body. Medication used to treat mental illness can have very serious and harmful side effects. If a person on AOT finds a particular medication intolerable or has an adverse reaction to it they have little choice but to continue taking it. The TAC advocates for AOT laws across the nation.

The TAC was founded by a man named Edwin Fuller Torrey. In the early 1970’s Torrey help build the National Alliance on Mental Illness (NAMI) to the organization it is today, the largest nonprofit mental health advocacy organization in the U.S. From 1976 to 1985 Torrey was employed at the prestigious and historic St. Elizabeth’s Hospital in Washington, D.C., (the same place inspired the creation of the transorbital lobotomy and served as an asylum before the Community Mental Health Act in 1964). Sometime during this period he developed his personal theory of the cause of schizophrenia. His theory, which he still promotes to this day, and this is not a joke, is that bacteria found in cat feces has caused schizophrenia in the U.S. on a widespread scale. In 1983, he self published his most well known work, “Surviving Schizophrenia,” which, in my opinion, is actually a very comprehensive reference book about mainstream psychiatric theories and treatments of schizophrenia. However, unfortunately, the book compares treating schizophrenia with pharmaceutical drugs to treating diabetes with insulin injections. This, at the very least, dramatically overstates the efficacy of psychiatric medications.

In 1985 Torrey quit his position at St. Elizabeth’s hospital following a demotion in 1983. In my opinion, 1985 to 1989 or so marked a turning point in Torrey’s career. After he left St. Elizabeth’s, Torrey began to focus more on how the U.S. mental health system cared for people diagnosed with severe mental illnesses, like schizophrenia. Perhaps, this was in part due to the fact that his personal theory of the cause of schizophrenia did not pan out.

Torrey often makes media appearances. He has become the mainstream media’s go to authority on mental illness and violence. Torrey has built a career by stigmatizing people with mental health conditions. So much so that even NAIMI (who is itself is funded primarily by Big Pharma) tried to publicly distance itself from TAC in 1998. In 1997 NAMI was making plans to join forces with the TAC. However, because of outcry from mental health activists who felt that the TAC’s views were too extreme, NAMI abandoned this plan.

Parents and Children


In 1989, after becoming an independent researcher, Torrey met billionaire Ted Stanley and his wife Vada. Ted Stanley had made his fortune selling collectables. His son had been diagnosed with bipolar disorder. Their son had experienced a mental health crisis just a year earlier in 1988. The Stanley’s had been frustrated with their inability to have their son treated for mental illness and expressed concern that when their son was in a inpatient psychiatric facility he was going to be released too early because he did not pose a imminent danger to others.

The Stanley’s saw their perceived inability to provide effective mental health care to their son and the lack of research into the etiology of severe mental illness as a worthy cause to donate their money to and the Stanley Medical Research Institute (SMRI) was formed in 1989. Since then, the SMRI has been one of the largest donors to research in the causes of severe mental illness becoming a virtual pillar of mainstream psychiatry. E. Fuller Torrey developed a philanthropic relationship with Ted Stanley, and in 1998 the TAC was formed by Torrey funded primarily by the SMRI.

The TAC is the most publicized, most financed organization advocating for restrictive mental health policies and practices in the U.S. Torrey has written many books about his views on mental illness. Many of the people that buy Torrey books and ascribe to his beliefs are parents of people diagnosed with severe mental illness, just like Billionaire Ted Stanley. It is not uncommon in the U.S. for parents of individuals diagnosed with severe mental illness to become very involved with their children’s mental health treatment. NAIMI hosts support groups for parents and family members of individuals diagnosed with mental illness across the nation. Some of these parents identify with Torrey’s extreme views of mental health treatment. They share Torrey’s belief that people diagnosed with severe mental illness should be coerced into receiving mental health treatment and that their child’s belief that non-medical explanations for their experiences and behavior are plausible is itself a symptom of mental illness.

Many members of the TAC themselves have family members diagnosed with mental illness. I do not assume to know anything certain about the social dynamics of the families that these individuals belong to, however, it is undeniable that the experiences of some of these individuals are troubling. Torrey himself had a sister who was diagnosed with schizophrenia named Rhoda Torrey. Sadly, Rhoda passed away in 2010. Surely, there is no question that with the aid of E. Fuller Torrey’s extensive expertise his beloved sister would have become a normal productive member of society, right? Unfortunately, despite being 25 years old in 1964, when the Community Mental Health Act was signed by John F. Kennedy, Rhoda Torrey spent the majority of her life hospitalized in psychiatric treatment facilities. The Community Mental Health Act of 1964 lead to the deinstitutionalization of vast majority of mental patients and was intended to allow people who have a mental health diagnosis to live in the community. Such was not the case for Rhoda Torrey.

Natalie Fuller, daughter of Doris Fuller the Executive Director of the TAC, was 16 when she wrote a book with her mother titled, Promise You Won’t Freak Out: A Teenager Tells Her Mother the Truth About Boys, Booze, Body Piercing, and Other Touchy Topics (and Mom Responds).” The book details Natalie’s experiences from ages 13 to 16 using drugs and alcohol, experimenting sexually, breaking the law and her relationship with her mother. After attending college for four years, she began hearing voices. She was subsequently diagnosed with bi polar disorder in 2008. Following being diagnosed, Natalie often did not take her prescribed medications because she believed that they were not helping her. Sadly, Natalie passed away in 2015. She ended her life when she was 29 years old by stepping in front of a train in Baltimore, MD.

Although I am sure that Doris Fuller cared for her daughter a great deal, in a Washington Post article Doris Fuller stated that Natalie suffered from a, “terminal mental illness.” I would like to point out that epidemiologically speaking mental illness cannot kill you. On a personal note, Natalie’s story is particularly saddening to me because Natalie and I are the same age. Perhaps if Natalie had found alternative mental health therapies to help with the other forms of mental health treatment she received she would not have met the fate she did.

The TAC claims to an advocacy organization. In reality, the TAC is a thought leader of a segment of the American public who want to impose draconian mental health laws and practices on individuals who are diagnosed with mental illness. Many members of the TAC have relatives who are diagnosed with mental illness. Perhaps for these individuals their crusade to implement these laws is fueled social dynamics of their own families.

This is E. Fuller Torrey presenting Tim Murphy with an award.
In recent years, the TAC has been very involved in pushing forward a piece of federal legislation known as HR 2646, aka the Murphy Bill. The Murphy Bill will create more mental health hospitals, provided financial incentive for states to implement AOT laws, eliminate patient’s rights and defund many existing mental health treatment programs among other terrible things. Torrey is working with Tim Murphy, the congressional sponsor of the bill, to have it passed through congress.

A Final Word

Torrey was born in a time when if a person experienced a mental health crisis they would be confined in an institution and possible never get out. Now 78, he is one of the last psychiatrists born in this era. Although our society clearly could do a better job of accommodating people with mental health challenges, the days of institutionalizing mental patients in the U.S. are largely over. Torrey’s views are backward. Instead of funding institutions to house people with mental illness we should provide services to better accommodate them living in the community. We should fund services such as day centers and peer run crisis respites. We should increase funding for community mental health centers and create more jobs and affordable housing. Instead of funding crisis based services we should fund services that help people before they reach mental health crisis.


Individuals with mental illness are not only capable of being integrated into society but making important contributions to it. In the past, people diagnosed with mental illness have made significant contributions to many areas of knowledge like art and mathematics. However, if the TAC had its way people such as these would be locked away in an asylum. Torrey and the TAC have a vision of our society that is very repressive. Hopefully, in the future our society will not repeat the mistakes of the past by returning to an era where people with mental health challenges are confined in asylums and our society will remain a relatively accommodating environment for individuals that think and act differently.

References


(2015). Retrieved June 6, 2016, from www.treatmentadvocacycenter.org

STUART, H. (2003, January 1). Violence and mental illness: An overview. Retrieved June 6, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

Winerip, M. (1998, February 22). Schizophrenia's Most Zealous Foe. Retrieved June 6, 2016, from http://www.nytimes.com/1998/02/22/magazine/schizophrenia-s-most-zealous-foe.html?pagewanted=2

(1996, January 1). Retrieved June 6, 2016, from http://www.pbs.org/wgbh/americanexperience/features/transcript/lobotomist-transcript/

Mental Health Workers Bring Psychiatric Drugs To Your HOME To Assure Compliance: Stop PACT! (n.d.). Retrieved June 6, 2016, from https://web.archive.org/web/20050310192202/http://www.mindfreedom.org/mindfreedom/ioc/workers.shtml

ROBERTS, S. (2016, January 8). Ted Stanley, Whose Son’s Illness Inspired Philanthropy, Dies at 84. Retrieved June 6, 2016, from http://www.nytimes.com/2016/01/07/us/ted-stanley-medical-philanthropist-dies-at-84.html?_r=0

(n.d.). Retrieved June 6, 2016, from https://www.nami.org/

Rhoda Niven Torrey. (n.d.). Retrieved June 6, 2016, from http://www.legacy.com/obituaries/uticaod/obituary.aspx?pid=143619266

Fuller, D. (2015, April 20). My daughter, who lost her battle with mental illness, is still the bravest person I know. Retrieved June 6, 2016, from https://www.washingtonpost.com/national/health-science/the-demons-got-my-beautiful-loving-daughter/2015/04/20/cdaaa338-dfc2-11e4-a1b8-2ed88bc190d2_story.html

HR 2646, The Murphy Bill. (2015, December 11). Retrieved June 6, 2016, from https://stopmurphyslaw.wordpress.com/


Representative Tim Murphy Wins 2014 Torrey Advocacy Commendation. (2015). Retrieved June 6, 2016, from http://www.treatmentadvocacycenter.org/solution/implement-aot/get-aot-where-you-live/2756-representative-tim-murphy-wins-2014-torrey-advocacy-commendation- 

Sunday, October 25, 2015

Frightening Psychiatric Technology

In this day and age we are surrounded by technology. The technology we have available inevitably affects our society and our everyday life. We carry cell phones in our pockets all the time, we stare at computer screens all day long at our employment and we use a variety of appliances in our homes. Technological advances affect our lives in unexpected ways. Sometimes advances in technology may even be employed as a means of controlling us. New psychiatric technologies are being developed in our society. These technologies have dangerous and frightening implications for how we live our lives.

Proteus digital health has developed a new device that may lead to draconian measures in the way people are administered medication. The device is known as the Helius. It is a form of smart pill technology designed to give a doctor digital information about a patient’s compliance with their medication regime. The device replaces a patient’s ordinary medication with pills that contain tiny sensors. When the patient swallows a pill the sensor transmits digital information indicating the pill was swallowed to a patch worn on the patient’s body. The patch relays this information to the patient’s doctor. This technology is already being developed for psychiatric uses. The pharmaceutical company Otsuka is currently seeking approval from the FDA to have the device used with their antipsychotic Abilify.

The Helius has frightening implications for how people are administered medication in the future. Medication monitoring technology might be appealing for uses in court ordered outpatient treatment programs to ensure patients continue to take medications. People in such programs may have to endure the effects of medication or face the threat of involuntary hospitalization. As the number of mental health diagnoses increases and more behaviors are conceptualized as illness the more people may be subjected to medication monitoring technology as a compliment to the usual
ways of eliminating crime and other undesirable behaviors in our society.

Such an approach to addressing a person’s mental health leads loss of humanity in mental health setting. Through use of this technology all that is important is that the person continues to take their medication. The person becomes something simply to be controlled through observation and medical treatment. How a patient feels when they are on medication is of little concern. The only thing that matters is that the medication produces the desired behavior.

Use of medication monitoring technology in court ordered outpatient treatment programs is a clear invasion of privacy. Medication monitoring technology monitors a person not only in their home but in their own bodily systems. Because Information that a person has stopped taking a drug may be used as evidence that the person is in need of involuntary hospitalization, such technology prevents a person from keeping this information private and making judgments and decisions based on it.

Medication monitoring technology for psychiatric uses seems like something that should be considered unconstitutional. However, because people who are considered mentally ill are regularly deprived of their civil rights, medication monitoring technology may circumvent the normal constitutional protections that ordinary citizens are afforded. Medication monitoring technology is an example the insidious and pervasive nature of medical control. Because people labeled with mental illness are seen as sick and in need of medical treatment, they are not protected in the same way as ordinary citizens against the deprivation of liberty.

Tele-psychiatry

Tele-psychiatry is the use of telecommunications technology to allow a patient and a psychiatrist to meet face to face over a computer. Instead of going to see a psychiatrist in person you use a computer to speak with the psychiatrist remotely. Tele-psychiatry is already being used in correctional facilities and rural areas.

Tele-psychiatry likely leads to the loss of the human element in psychiatric settings. How can a psychiatrist treat a person’s mind and soul when they meet over a monitor? A session with a tele-psychiatrist is prone to offer the patient little individualized attention. Furthermore, tele-psychiatrists most likely tend to offer quick easy solutions to a person’s problems. These solutions are almost certain to take the form of drug treatment. Tele-psychiatry makes psychiatry more routinized. Addressing a person’s life problems becomes a quick efficient exercise.

Tele-psychiatry also allows psychiatrists to exert their influence in a greater range of circumstances. As psychiatry becomes more pervasive so to do the negative aspects of medical control become more evident in our society and culture. For example, tele-psychiatry is ideal for the prison or correctional setting because it costs less than employing a psychiatrist on site. Forms of Medical control like psychiatry eliminate bad behavior through medical treatments. The more psychiatry becomes part of the prison environment the more inmates will be subjected to medical treatment to control their behavior. Harmful somatic treatments such as psychoactive drugs or electroshock therapy can be administered to inmates on a widespread scale. Often times the use of psychiatric treatments in the correctional setting is a means of making inmates more compliant and passive rather than promoting their mental health.

Tele-psychiatry could be considered a form of surveillance. Instead of going to see a psychiatrist in person the patient can be viewed over a monitor. The patient can be monitored in the home, academic or prison environment. During tele-psychiatric sessions the patient is controlled through observation and analysis just like other forms of surveillance. The patient is not free to act any way they chose. For example, if the patient divulges information indicating they are a harm to themselves or others, their tele-psychiatric sessions may be used as evidence that they are in need of involuntary hospitalization.

Panopticism

The panopticon is an architectural design created by Jeremy Bentham. It is a circular building comprised of cells on the circumference. On interior face of each cell is a window. In the center of the building there is a tower. In the tower one can observe every cell through their window. Blinds on the tower prevent individuals in these cells from knowing they are being observed.

The panopticon is a means of imposing power onto the individuals that comprise it in the most efficient way possible. The person cannot communicate to the people in the cells that adjoin his. Because of this, the inmates in the building cannot work together to accomplish their own aims. And since the person does not know they are being observed, they must assume that they are thereby taking on the burden of their own surveillance. The panopticon controls and individualizes the person through, routinzation, separation and observation. In the panopticon everything can be observed, analyzed and addressed accordingly. Even the lone individual that conducts surveillance in the tower can be placed under scrutiny. The panopticon replaces the need for locks or bars.  In Michael Focault’s words, “It is a fortress of certainty.” Bentham originally created it to be a prison but had theorized it could have other uses such as housing the insane, school children, factory workers, hospital patients, any situation where power was imposed on other people.

The panopticon is a tool of totalitarian control. It effectively prevents the individual from acting in anyway other than his or her intended function. In the panopticon, there is no such thing as self expression, leisure or social change. It is a place void of any kind of humanity. A person is not a human being. They are simply part of a machine of control.

Psychiatric technologies like tele-psychiatry and medication monitoring have the potential to become a true panopticon of medical control, a mechanical and inhuman way of addressing a person’s life problems. The loss of the human element is present in both tele-psychiatry and medication monitoring. These technologies control the individual through observation and analysis. These approaches to mental health are cold and routinized. They are an inhuman way of addressing human conditions.

These new psychiatric technologies sound like they are something straight out of a dystopian novel. They are the signs of our ever increasingly medicalized and technological world, a frightening world of panoptic control. A world we may not want to live in. 

Wednesday, September 9, 2015

Is Religion Being Replaced by Psychiatry?

Social control is the process by which bad behavior is eliminated in a society. Although the term social control sounds bad, having social control is necessary in order for a society to function.  For example, the legal system is a form of social control. The legal system ensures society can function by seeking out criminals and punishing them for their bad behavior.

Every kind of social control has its own way of defining and eliminating bad behavior. Religion, the legal system and psychiatry are all systems of social control that define bad behavior differently and eliminate it in different ways. Religion sees bad behavior as a sin and eliminates it through moral means. The legal system sees bad behavior as a crime and eliminates it through legal means. Forms of medical social control, like psychiatry, see bad behavior as illness and eliminates it through medical treatments.


It is well known that religion is declining in Western Society. People today are less religious than they were in previous centuries. In the past, religion was a major component of people’s lives. God was seen as a real thing. To speak otherwise was heresy. Religion controlled how people ate, dressed, how they spent their time, who they married and most importantly what to do about people who misbehave. Today being religious is no longer a matter of critical importance in our society. Being religious is more a lifestyle choice than a necessity for living in society.



This decline in religiosity has left a void in our society. Religion no longer rules our everyday activities. People are no longer instructed how to act by religion. Consequently, there has been an increase of non-conformity in Western Society. Today people are more likely to not follow society’s rules and question what powers that govern them than in previous centuries.


In my opinion, religion is gradually being replaced by medical social control in Western Society. Forms of medical control for bad behavior, such as psychiatry, are gradually increasing in prominence in our social world. Today people are more likely to be given a mental health diagnosis than previous years. Also, the number of mental health diagnoses is increasing. This means that over time more bad behaviors are being seen as illness in society instead of moral or spiritual problems. Instead of controlling bad behavior through religious rules and values our society is increasing controlling bad behavior through medical norms and values. Instead of people being seen as sinners they are given a psychiatric diagnosis.


In my view both religion and psychiatry are forms of social control that are concerned with eliminating behaviors that violate not laws but social norms, social rules that govern the behavior of individuals in a society. Going on wild spending sprees, being in bed all day, believing in things that aren’t real and seeing things that other people don’t see are all examples of violations of social norms in our society. In previous centuries people that acted this way would have been viewed as having religious or spiritual problems when today they are viewed as having mental health problems.

Like religion medical social control is a kind of morality for people who violate social norms. However, medical social control is in reality a form of medical morality under the veneer of science. Consider this, in American society we don’t confine people because they are mentally ill we confine them because they are a “harm to themselves or others.” This is a moral standard. We confine people with mental health problems because we believe it’s the moral thing to do.

We assume that diagnosing and treating people with mental health problems is unbiased and objective when in reality it isn’t. The process of defining certain behaviors as illness and certain behaviors as health is inherently morally biased. We tend to view behavior we see as undesirable as illness and behaviors we see desirable as healthy.

Medical social control and religion even have some similarities. Both religion and medical social control provide a social environment designed to change behavior.  In previous times, people went to church to change their behavior. Today, instead of church, people go to self help groups or therapists. Also, both religion and medical social control impel compliance to their dogma. Christianity requires a person to believe that god is real. Similarly, if a person is given a psychiatric diagnosis it's not enough that a person accept that they have a diagnosis they must believe their diagnosis is real.

What's wrong with medical social control? If social control is necessary for a society to function then why are forms of medical social control like psychiatry a bad thing? Medical social control views the person who engages in bad behavior as sick rather than simply not following the rules. Because of this, medical social control has frightening implications for how society treats people who engage in bad behavior.

If a person who engages in bad behavior is seen as sick they are seen as in need of medical treatment rather than punishment. This means that a person is no longer afforded the moral and legal rights we normally afford rule breakers. A person may be given medical treatments without any legal or moral process to determine if it is justified. Medical treatment may have harmful or irreversible effects on the person. For example, one time the prefrontal lobotomy was at one time used on a wide spread scale as a treatment for people with mental illness.

By viewing bad behavior as illness we prevent it from being seen as evil. That means that people who commit particularly heinous behaviors are not seen as evil but sick. Their behavior is seen as illness, and they are viewed as not fully responsible for their crimes. 

When a person who engages in bad behavior is seen as sick their behavior is no longer seen as a consequence of their social environment. Instead, the individual is to blame for what may be a dysfunctional social environment. This means that instead of the social circumstances changing the individual is changed through medical treatments to accommodate their circumstances.

These are just some of the frightening effects that medical social control has on society. In my opinion, as time goes on medical social control will become more and more a part of our everyday lives similarly to the way religion was a part of people’s live in past centuries. The question we must ask ourselves is, “Do we want to live in such a society?” I think that most would not. 

References

Conrad, Peter, and Joseph W Schneider. Deviance And Medicalization. St. Louis: Mosby, 1980. Print.
Foucault, Michel. Madness And Civilization. New York: Pantheon Books, 1965. Print.

Saks, Elyn R. Refusing Care. Chicago: University of Chicago Press, 2002. Print.

Monday, August 25, 2014

Reality, Delusions and Social Power

Reality is socially constructed in a society. What members of a society accept as reality is not necessarily based on what they perceive with their senses but is maintained through consensus. For example, most spiritual beliefs in a society are maintained through consensus because they have no observable basis.

Although the construction of reality is mostly based on consensus, more powerful individuals and groups have more influence over the construction of reality than others. Powerful individuals and groups can manipulate the perception of reality in a society to support their interests in society. For example, in some countries, a government can influence the perception of realty by controlling what is reported in their nation’s media. Another example is in the dystopian novel, 1984, written by George Orwell, an organization known as the Ministry of Truth worked tirelessly rewriting all the newspapers and other literature in the nation of Oceania to ensure that the existing political regime known as Ingsoc was always accurate about the predictions it made to the citizens of the nation.

These powerful individuals and groups have more influence over the construction of reality than other members of society. In a sense, these powerful individuals and groups monopolize the perception of reality in a society. It is in these groups’s interest to control the perception of reality because it is important to get members of society to think the things these powerful groups want them to so they can maintain their powerful position in society. The ability to influence the perception of reality in a society can, therefore, be considered a form of power. Influencing the perception of reality is also the ability to influence the thoughts and, therefore, the actions of other people.

It may be confusing for someone reading this to read about how “reality” can be influenced by other people. So, for the sake of clarity, I would like to distinguish between social reality and the reality people perceive. Social reality is the reality that is constructed through consensus by members of society. Perceived reality is the reality that a member of society perceives and believes to be true. Most of the time social realty and perceived reality are the same thing. However, in a society, what is defined as social reality may be different than perceived reality for certain individuals. For example, a politician may spread propaganda to the citizens of a nation which contains nothing but false information. The citizens the politician governs over may believe the propaganda. However, it’s unlikely that the politician believes the propaganda himself. In this case in this society, for the politician, the social reality is different than the perceived reality.

In the novel 1984, in the fictional super state of Oceania, the difference between social reality and perceived reality was extreme. The citizens of Oceania were controlled through an idea known as “doublethink.” Doublethink was the practice of holding two contradicting ideas in one’s mind simultaneously. Enforcing this practice was necessary to control the citizens of Oceania because in Oceania, the social reality often wildly contradicted the perceived reality.

When an individual is diagnosed with mental illness it sometimes deprives them of the power to influence social reality. While powerful individuals and groups monopolize the perception of reality, certain individuals diagnosed with mental illness are deprived of the ability to influence social reality because of medicalization, the ever increasing tendency in our society to view behavior problems as medical problems. When a person’s behavior is seen as illness, it no longer has the ability to influence social reality.

In my opinion, diagnosing an individual as delusional is sometimes meant to deprive a person the power to influence social reality. However, I believe that sometimes the person’s delusions often involve the socially constructed reality rather than perceived reality. I believe that sometimes when a person is diagnosed as delusional it is because their beliefs or actions have come into conflict with the existing social reality in a society.

For example, in 1928, a nine year old boy named Walter Collins went missing from his home in Lincoln Heights, Los Angeles. At the time of his disappearance Walter Collins was being raised by his mother Christine Collins. During the ensuing search for Walter Collins, the LA police department received bad publicity because of its lack of progress to solve the case.

During this time a boy claiming to be Walter Collins came forth. The LA police organized a public reunion for the boy and Christine Collins. The LA police dept. arranged the reunion in order to gain good publicity for itself. However, at the reunion Christine Collins reported to the police that the boy was not her son. The police suggested Christine take the boy home anyway. So Christine did so. After three weeks went by Christine spoke with the officer in charge of the case attempting to get the officer to reopen the case and continue looking for her son, Walter. On this occasion Christine showed the officer dental records proving that the boy was not her son.

Rather than admit the LA police dept made a mistake in the case, the officer had Christine involuntarily committed to a psych ward at LA county hospital. The reason Christine was committed was that the LA police dept. claimed she was delusional about the identity of the boy. While Christine was committed the boy confessed to being an imposter and Christine was released. After Christine was released she successfully sued the officer who had her committed for damages. Unfortunately, however, Walter Collins was never seen again.

In this example, Christine’s supposed delusions consisted of her beliefs concerning the identity of the boy. In the social constructed reality that the LA police dept had created, the boy was Christine Collin’s missing son Walter Collins. However, the boy was actually an imposter.

Christine was labeled as delusional because her beliefs would have hurt the interests of the LA police dept. The LA police dept. had invested a lot uniting Christine with the boy. If they admitted the boy was not her son they would lose all the good publicity they gained from the public spectacle they created when Christine and the boy first met. So the LA police dept. took the power to influence social reality away from Christine by calling her delusional and having her committed. They most likely did not want Christine going to newspapers claiming that the boy was not her son thus changing the perception of reality in society.

Another example is in the 1960’s a prominent Soviet general named Pyotr Grigorenko believed that the Soviet Union was no longer living up to the ideals set forth by its founder Vladimir Lenin. At the time many Soviet government officials were taking exorbitant salaries for themselves. In 1963 Pyotr founded the Group for the Struggle to Revive Leninism. The group’s goal was to promote principles of Leninism in government. The group began to spread leaflets in order to encourage the public to share their views.

 The Soviet government saw this as an effort to undermine their power and Pyotr Grigorenko was arrested and sent to the Serbsky Institute for Forensic Psychiatry. There it was concluded that his views concerning the Soviet government reflected a paranoid personality disorder with delusions and Pyotr was diagnosed with schizophrenia.

Pyotr was eventually released only to be committed once again to the Serbsky institute for other dissident activities. After being released from being committed for the second time Pyotr was evaluated by a psychiatrist who determined that Pyotr was sane and had been committed because of political reasons.

In this example, Pyotr’s beliefs about the Soviet government were regarded as delusions. In the socially constructed reality the Soviet government had created, the government was not corrupt and still upheld Leninist ideals. However, in truth, this was not the case. The Soviet government was extremely corrupt.

Pyotr was diagnosed as delusional because his beliefs were threatening the interests of members of the Soviet government. Many Soviet government officials were taking high salaries for themselves. This was in clear conflict with the ideals of Leninism. By advocating for principles of Leninism to be practiced in government Pyotr’s activities threatened the likelihood that Soviet government officials could continue to be paid high salaries. Pyotr was attempting to influence the perception of reality in society by exposing the high salaries of government officials and encourage the citizens of Soviet Russia to force government officials to live by the ideals that they supposedly held dear. So in order to prevent Pyotr from achieving this, the Soviet government took the power to influence social reality away from him by having Pyotr committed and diagnosed as delusional.

In the previous examples, these individuals were diagnosed as delusional because their beliefs harmed or threatened the interests of other individuals or groups. They achieved this by having beliefs or engaging in behavior that undermined the social reality that other people were invested in. Because of this, in order to protect this reality, these individuals were diagnosed as delusional by other people. By diagnosing these individuals as delusional the power to influence social reality was taken away from them. Their beliefs were, therefore, no longer regarded as valid but as symptoms of mental illness.

The organizations responsible for having these individuals diagnosed as delusional had considerable influence in society. This allowed them to manipulate the perception of reality in society so that all members of these societies would accommodate the belief that these individuals were in fact delusional. Individuals who are diagnosed as delusional in this way are often, but not exclusively, people who threaten the interests of powerful people or organizations. Other situations where a person might be diagnosed as delusional in this manner might include dysfunctional families as well as abusive work or academic environments, or any situation where consensus can be achieved that the person is delusional and there is a desire to take away power from the person by other people.

This is an example of how medicalization is harmful. In my opinion, if medicalization increases in our society so too will instances of people having social power taken away from them through medical means because of the interests of others. This practice will become a more common occurrence in our society and a bigger part of our culture.

References:

Dean, M., & Orwell, G. (2003). 1984. Harlow: Pearson Education.
Conrad, P., & Schneider, J. (1992). Deviance and medicalization. Philadelphia: Temple University Press.
Newman, D., & Harper, D. (2004). Sociology. Thousand Oaks, Calif.: Pine Forge Press.
RASMUSSEN, C. (2015). The Boy Who Vanished-and His Imposter. LA Times. Retrieved 24 July 2015, from http://articles.latimes.com/1999/feb/07/local/me-5769/2

Eghigian, G. From madness to mental health.

Sunday, April 27, 2014

The Medical Model and the Individualization of Social Problems

Medicalization is the process through which human problems and or conditions come to be seen as medical in nature. The Medicalization of human behavior is increasing in western society. In western society, as time goes on, an ever increasing number of human behaviors are defined as illness. Also, the medicalization of human behavior is increasing in spite of the fact the vast majority of behaviors defined as illnesses have little to no empirical basis as such. Seemingly, behavior is defined as illness mainly for political and moral reasons rather than scientific ones.

Because Medicalization views behavior as illness it tends to seek medical explanations for behavioral problems and treats them through medical means. For example, although it has not been scientifically proven, modern psychiatry operates under the belief that mental illness is caused by a chemical imbalance in the brain and that psychiatric medication corrects this imbalance.

Medical explanations of human behavior tend to focus primarily on the individual while ignoring the individual’s social environment when determining the causes of their behavior. For example, substance addiction is now believed to have a strong hereditary component. This explanation focuses on the genes that predispose someone to become addicted to a substance while ignoring the socio-cultural aspects of substance addiction. Likewise, medical treatments tend to focus on changing the individual instead of their social environment. Take mental illness treatments for example. Somatic treatments such as psychiatric medication, psychosurgery, and shock therapies all focus on changing the individual not their social environment. One could even argue that non-somatic treatments such as psychotherapy focus more on changing the individual rather than their social circumstances by focusing on changing the individual’s behavior, thinking and perspective.

By defining behavior as illness it also loses its political influence. When behavior is labeled as illness it is no longer seen as having been caused by the political context. Instead, it is seen as symptomatic of illness. For example, in the past political dissidents in the former Soviet Union have been labeled with mental illness by the Soviet Government in an effort to put an end to their political activities.

Medical social control prevents society from changing
 when sometimes it clearly should.
A person’s social environment may be the primary cause of their behavior. For example, a person may be prone to anger because they are frequently bullied or they may be depressed because they work long hours and don’t have much time for a social life. Because medical explanations and treatments of behavior focus on the individual and not their social or cultural environment the unhealthy social environment that is responsible for an individual’s behavior often goes unchallenged and therefore remains the same. Likewise, the current state of the political system is generally why individuals engage in political protest. However, when political protest is defined as illness or the protesters are defined as sick, their behavior is seen not as protest but as illness and the political system is allowed to remain the same. Because of these things, in my opinion, medicalizing human behavior protects the status quo.  medicalizing human behavior protects the current state of society so it does not have to change.

In my opinion, medical social control is oppressive.  Medical social control protects the status quo but it achieves this at the cost of the individuals that make up the society in which it is present. Because medical explanations and treatments of human behavior focus on the individual and ignore the individual’s social environment, people don’t change their circumstances to make themselves happy. People are changed, sometimes by force, through medical treatments such as medication or therapy to accommodate their circumstances. Also, because medical social control has the power to take away the political influence of bad behavior, Individuals who have a problem with the way society functions or do not do well because of the way a particular society is created are stigmatized and seen as second class and defective.

The social environment in our society plays a significant role in acts synonymous with mental illness such as mass shootings and suicide. Doctors in our society claim individuals who engage in these behaviors are sick however their behavior often has social causes such as bullying, isolation as well as our cultures emphasis on materialism and individual gain. Many studies show that the social environment in our society also plays a significant role in the way in which minorities are more likely to be diagnosed with mental illness. Minorities are more likely to experience prejudice and discrimination in social situations which cause them stress. This stress increases their likelihood to be diagnosed with mental illness. Multiple studies show that there is a relationship between socioeconomic status and mental illness. Although these studies do not examine the nature of this relationship, they do show that the lower a person’s socioeconomic status is the more likely they are to develop mental illness. By diagnosing these individuals as mentally ill our society is not helping them. Our society is medicating them so they can better tolerate their circumstances.

I think that as long as medical social control exists, it will oppress people. A human beings behavior is significantly affected the society they live in. However the medical perspective inherently tends to seek explanations for human behavior within the individual instead of within the society they live just like as it does with all physical illness. The medical model of mental illness or the tendency in our society to view what is known as mental illness as physical illness and treat it by physical means is in its ascendency. Members of our society need to, instead, focus on the ways in which our society causes people to engage in behavior that deviates from the norm and work toward changing them. It is my belief that, No matter how much people are medicated, or how much therapy they receive, human behavioral problems will continue unless the society that causes them changes.

References:

Price, M. (2015). Apa.org. Retrieved 25 July 2015, from http://www.apa.org/monitor/2008/06/genes-addict.aspx
Eghigian, G. From madness to mental health.
Conrad, P., & Schneider, J. (1992). Deviance and medicalization. Philadelphia: Temple University Press.
Meyer, I. (2015). http://www.ncbi.nlm.nih.gov.Retrieved 25 July 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072932/

Hudson, C. (2015). Apa.org. Retrieved 25 July 2015, from http://www.apa.org/news/press/releases/2005/03/low-ses.aspx

Monday, January 13, 2014

Mental Illness is a Social Construction

When someone is diagnosed with a mental illness most of the time they question their mental illness diagnosis. They do not think that they are sick and that they have a disorder. They question psychiatry and perhaps even their entire worldview. In my opinion, this is a normal reaction to being diagnosed with a mental illness. This is because mental illness, as it’s commonly known in society, isn’t real. Mental illness is a social construction.

In a society, reality is socially constructed. Members of a society agree with what the names of objects are, what the names of colors are, what language to speak, what currency is, etc. Through this consensus members of a society socially construct the reality they share. Things that cannot be physically observed or proven to exist can be socially constructed by members of a society as real. For example, although they are not visible, in some societies spirits and witchcraft are socially constructed as real. In our society, although it is not proven to exist, mental illness is socially constructed as a real thing.

Members of a society socially construct rules that all individuals in that society should follow. These rules are known as norms. Some norms are explicit such as laws. Other norms are implicit guidelines like don’t cut in line at the grocery store. When individuals in a society violate norms it is known as deviant behavior. Every mental illness is essentially a form of deviant behavior. talking to god in public, seeing things that other people don’t see, spending a month in bed, going on wild spending sprees, having multiple sexual partners or not wanting to have sex at all are all examples of what our society considers deviant behavior and mental illness.

Shown above is a legal definition of mental illness.
This is one way our society socially constructs mental illness
What is considered deviant behavior isn’t the same in all societies. There are no universal forms of deviant behavior that all societies share. Definitions of deviant behavior are socially constructed. What is and is not considered deviant behavior is culturally relative to a society. Therefore, what is considered mental illness in our society would not necessarily be considered mental illness in another society. In theory, every behavior regarded in our society as mental illness could be regarded in another society as a perfectly acceptable form of behavior. For example, hearing voices is considered an acceptable form of behavior in some African tribes, however, in our society it’s considered a symptom of schizophrenia.

The deviant behavior that constitutes mental illness is not necessarily a medical problem. In other societies this behavior may be conceptualized as a moral or spiritual problem. The process through which a behavior or physical characteristic becomes seen as a medical problem is known as medicalization. There is a long history viewing certain behaviors as illness in Western civilization. In Western civilization, since ancient Greece, behaviors such as depression, mania and hallucinations have been thought of as illness. This does not mean that these behaviors are actual diseases. It just means they are seen and treated as medical problems in our culture.

Many people who are diagnosed with mental illness have doubts that their mental illness diagnosis is legitimate. This is not surprising considering it is highly questionable whether or not mental illness is actual disease. Consider the following:

The etiology of mental illness is not known. Unlike doctors in all other fields of medicine, psychiatrists cannot explain the diseases that they purport to be experts in treating. Although many theories that explain the cause of mental illness have been made, such as the viral theory and the genetic theory, none of these theories have been proven true. No viruses or genes that cause mental illness have been discovered. Consequently, there is no medical testing for mental illness. A mental illness diagnosis is based on the subjective determination of a psychiatrist.

Although individuals diagnosed with certain mental illnesses suffer higher rates of suicide and are more likely to die earlier than individuals who are not diagnosed with mental illness for a variety of reasons, unlike bodily illness, there is no relationship between mental illness and death. If a person develops cancer and if that person does not have cancer treated it will spread until it reaches their vital organs and they will die. The same cannot be said of mental illness.

There are no cures for mental illness. Most bodily illnesses can be cured. Bodily illnesses either heal on their own or are aided to heal by medical treatments. Although some illnesses have no cures there are medical treatments for some of these illnesses that can eliminate them from the human body for the duration of a person’s lifespan. For example, cancer has no cure, but chemotherapy can eliminate cancer from a person’s body. This is not the case for mental illness. Mental illness is considered a lifelong problem. A person diagnosed with mental illness is expected to receive treatment for the rest of their lives.

In summary, mental illness is a social construction for several reasons. The basis of mental illness is not physical but behavioral. What is considered deviant behavior in a society is culturally relative. There are no universal definitions of deviant behavior that are the same in every society. Deviant behavior is not necessarily a medical problem. Treating deviant behavior as a medical problem is known as medicalization. For a number of reasons, it is highly questionable whether or not mental illness is actual disease. Considering these ideas, one can logically conclude that mental illness is not real but a social construction, something that lacks any actual basis for existence but is bound by the collective agreement of individuals in a society.

References:

Scheff, T. (1999) Being Mentally Ill: A Sociological Theory, Third Edition. Hawthorne, New York: Aldine De Gruyter.
Eaton W.W. (2001) The Sociology of Mental Disorders, Third Edition. Westport, Conneticut: Praeger Publishers.
Conrad P., Schneider J. (1992) Deviance and Medicalization: From Badness to Sickness. Philadelphia: Temple University Press
Barlow D. H., Durand M. V.(2009) Abnormal Psychology an Integrative Approach: 6th Edition. Belmont, California, Wadsworth Cengage Learning
Kyung S.M. (2003, October 22) Diagnosis of Mental Illness Hinges on Doctor as Much as Symptoms. The SeattleTimes.Retrieved,January13,2014,from http://seattletimes.com/html/health/2001771296_diagnosis22c0.html
Joseph, J. (2013, February 13) Five decades of gene finding failures in psychiatry. Mad In America. Retrieved January 13, 2014, from http://www.madinamerica.com/2013/02/five-decades-of-gene-finding-failures-in-psychiatry/