When Psychiatry Attacks

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An article on Jezebel discusses a new book called The Protest Psychosis: How Schizophrenia Became a Black Disease. The book argues that while psychiatric advertising in the fifties focused on neurotic or hysterical housewives, in the sixties, the focus of the advertising for many of the same drugs shifted to angry and belligerent black male youth and took on a racial dimension:

"They have their own water fountains, so clearly their rage is irrational."

It's only a basic tool until the patent expires.

The point of the book is that psychiatry reacted to the civil rights movement just as every other part of the establishment–with panic, denial, and sublimation. Society is clearly perfect in 1965, so their rage is not rational. But the rage is present so the system has to process it somehow, so we label it as a mental illness, and medicate it.

I think this point is valid, but it is narrow. In fact, the targeting of women and the elderly reflects a denial of both severe gender inequality and post-traumatic stress of WW1 and WW2 vets.

The idea that psychiatry serves and important function in social control was the thesis of Michel Foucault’s first book, The History of Madness. The book explored how something as subjective and ultimately unknowable as insanity could be constituted as an object of knowledge on and be the target of intervention for a specific type of power: specifically the disciplinary institution of the asylum. Today asylums have given way to psych hospitals and court-ordered therapies where doctors prescribed meds that patients must take.

But because Foucault was gay, bald, and French, American society chose to ignore him. Nonetheless, his ideas are very instructive. If we take this idea–that psychiatry and psych medication in particular are routinely used as a form of social control–and apply it to the preset, who is it that need to be controlled today?

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7 Responses to When Psychiatry Attacks

  1. The article doesn’t know the half of it.

    While schizophrenia became more a “black” disease here in America, over in Europe it was the opposite– white. At about the early 90s, when psychiatry became a boom profession not just for Big Pharma but also for academia, it herded all the whites into Bipolar Disorder.

    When you make either diagnosis, you are supposed to rule out confounding factors, e.g. drug use. Also, you’re supposed to consider context: ten fights in a year for an inner city black teen isn’t pathology; ten fights in a year for a 90210 teen might be.

    But at the ground level– where epidemiological studies are done– none of this was considered. Instead, a guy walks into the ER and is “psychiatric” and claims to hear voices. You need to write something down on the admissions paper. So: black= schizophrenia; white= bipolar.

    The disability system encouraged this: you get a poor person who wants to get SSI, it is quite difficult to convince the judge that you are schizophrenic if you are actually able to plead your case– i.e. logical. So, bipolar. If you’re black, the bar seems much lower to convince someone of that diagnosis. Europe doesn’t have this kind of system for their disability, and so the need to make this distinction quickly, as opposed to correctly, did not exist.

    True fact: Fanapt, the new antipsychotic, in the early trials for the FDA, failed in Americans. All that data you see is on non-Americans. When they excluded “schizoaffective” patients (whatever that means), the trials worked on Americans as well. (see: http://bit.ly/9zEpbm).

    The truth of the matter is that which diagnosis you have is completely dependent on the reasons for your diagnosis. If you have money/private insurance, want to work, have involved family, etc, chances are your diagnosis is a good faith attempt. If you are poor, no family, no job, and you need to derive some sort of benefits (not saying you don’t deserve them) your diagnosis has a better than 50% chance of being absolutely wrong.

    • W.Kasper says:

      “While schizophrenia became more a “black” disease here in America, over in Europe it was the opposite– white. ”

      Not true in the UK, at least. Diagnosis of schizophrenia is proportionally more prevalent among Afro-Carribbeans, and even more so for 3rd/4th/5th generation Black Britons. especially the kind that gives the state power to restrict your freedom. This is even when we take into account that they’re much more likely to be put in jail for what are basically behavioural problems, rather than be given treatment (especially if young – at 10, we have the lowest threshold for criminal responsibility in Europe). Diagnosis is lower among Asians and immigrants from eastern countries, but that may be due to cultural/family factors (ie. reluctance to seek official help), along with evidence of ongoing cultural barriers/prejudices among doctors, social workers, teachers etc.

  2. Guy Fox says:

    But because Foucault was gay, bald, and French, American society chose to ignore him.

    I realize this was a throwaway line, but it’s wrong. Liberace was gay, Hank Paulson is bald, and Montesquieu was French. Foucault never got traction in the US because of two reasons. 1) He didn’t work very hard to ensure the intersubjectivity, let alone objectivity, of his work. He’s hard to interpret at times, there are no regression curves, his theses, when you can pin him down, are a b!tch to falsify, and he’d argue that falsifying them is rather beside the point anyway. None of this convenes to American social scientific pretensions. 2) In societies where class/castes dominated at some point, the idea that everyone is stuck in the same self-reproducing machine that is responsible for inequalities at the level of how people behold others as cognitive objects is not such a stretch. Great grandpappy was a serf, grandpappy was an illiterate, itinerant labourer, pappy was a line-worker, and I clean Etonians’ offices. The man, even a ghostly one, in the machine as the perpetuating condition makes sense. But it it is utterly incompatible with the ‘American dream’ in both its individual (i.e. white-picket fence, 2 car garage, stock portfolio in every pot) and collective (city on the hill with invincible marines on the palisades until kingdom come) instantiations.

    Foucault resonates outside of America because it seems historically plausible. Inside, it’s scientific and moral heresy. (At least that’s my Durkheimian just-so-story of “How the American got his post-structuralism histamines”.)

  3. Santos L. Helper says:

    Drapetomania — we can all agree it was a sucky diagnosis, right, but why? Because it was racist (http://en.wikipedia.org/wiki/Drapetomania) or because it was an oppressive use of power.

    Maybe the only reason it was applied to exclusively to negros is because that’s who the slaves were. If the slave population were churning multiculturalism, it would be harder to find biological correlates (requiring may 150 years for the computers to get fast enough) but a well developed psychiatric system should be able to manufacture whatever semiotic structure the Man needs to justify psychiatric attack on people he finds threatening or inconvenient.

    Foucault seems to be outside of mainstream reasonable debate in the US, perhaps because the glare off his pate is in the eyes of people working towards the medicalization (and therefore denial) of social problems.

    When we recognize that people are being mistreated only because certain vulnerable classes (women, blacks, children etc.) are being treated differently, we may be persuaded to overlook the oppressive use of power. Thus complaining about mistreatment of Muslims at the airport gets grannies & children groped too. Oppressive treatment is normalized by being greatly expanding, and there is no longer anything to complain about.

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