© 2016

Psychiatric Hegemony

A Marxist Theory of Mental Illness

  • Emphasizes the proliferation of psychiatric labels, often with little science behind them, and the explosive parallel growth in the numbers of people who have been given psychiatric diagnoses

  • Challenges the status quo of what ‘mental illness’ appears to be and the ‘needs’ that the mental health system appear to serve

  • Offers a return to critical theory in which the available research evidence is framed within the structures and processes of late capitalism

  • Profiles the decline of the social state and an increased focus on the individual from the 1980s onwards


Table of contents

  1. Front Matter
    Pages i-xvii
  2. Bruce M. Z. Cohen
    Pages 97-111
  3. Bruce M. Z. Cohen
    Pages 113-138
  4. Bruce M. Z. Cohen
    Pages 139-168
  5. Bruce M. Z. Cohen
    Pages 169-204
  6. Bruce M. Z. Cohen
    Pages 205-212
  7. Back Matter
    Pages 213-241

About this book


This book offers a comprehensive Marxist critique of the business of mental health, demonstrating how the prerogatives of neoliberal capitalism for productive, self-governing citizens have allowed the discourse on mental illness to expand beyond the psychiatric institution into many previously untouched areas of public and private life including the home, school and the workplace. Through historical and contemporary analysis of psy-professional knowledge-claims and practices, Bruce Cohen shows how the extension of psychiatric authority can only be fully comprehended through the systematic theorising of power relations within capitalist society. From schizophrenia and hysteria to Attention-Deficit Hyperactivity Disorder and Borderline Personality Disorder, from spinning chairs and lobotomies to shock treatment and antidepressants, from the incarceration of working class women in the nineteenth century to the torture of prisoners of the ‘war on terror’ in the twenty-first, Psychiatric Hegemony is an uncompromising account of mental health ideology in neoliberal society.


clinical psychology hegemony Marx Marxism medicine political science political theory politics psychiatry psychology psychopathology social science social structure sociology

Authors and affiliations

  1. 1.Department of SociologyUniversity of AucklandAucklandNew Zealand

About the authors

Bruce Cohen is a Senior Lecturer in Sociology at the University of Auckland, New Zealand. His books include Mental Health User Narratives: New Perspectives on Illness and Recovery, Being Cultural and Routledge International Handbook of Critical Mental Health.

Bibliographic information

Industry Sectors
Health & Hospitals


“Psychiatric Hegemony: A Marxist Theory of Mental Illness examines the genealogy of the current hegemonic status of psychiatry in neoliberal societies. His reconstruction of stories and their historical, political, institutional, and economical embeddedness bridges the gap between conceptualizations of mental illness in the traditions of symbolic interactionism, social constructivism, and more classically Marxist-influenced antipsychiatry. … Cohen’s work reminds us that critical challenges to psychiatric hegemony were once, and should again be, a progressive cause.” (Martin Harbusch and Michael Dellwing, Symbolic Interaction, August 26, 2019)

“Psychiatric Hegemony explains how and why psychiatric discourse escaped from the clinic and spread throughout the masses to achieve hegemonic status in neo-liberal society. … Psychiatric Hegemony will inspire a wide range of scholarship that informs both the social and biological sciences, and that will one day perhaps even make a difference to the health and well-being of diverse populations worldwide.” (Paul H. Mason, Social History of Medicine, Vol. 31 (1), February, 2018)

“In Psychiatric Hegemony, Bruce Cohen offers a critical analysis of the mental health system … . Cohen joins with other voices in calling for a system that provides necessary, humane help to those in need, and that exists to serve those in need … . These objectives seem worthwhile, and perhaps this volume will engage others in thinking outside the sociocultural box as well.” (Andrew Nocita, PsycCRITIQUES, Vol. 62 (25), June, 2017)

“Bruce Cohen has written the best book yet linking mental health to the central characteristics of capitalist society. In this fearless, passionate, and beautifully written book, Cohen illuminates the impact of the “psy-professions” on women, youth, the workplace, the criminal justice system, and militarism associated with endless war. Cohen not only analyzes these problems but also suggests realistic strategies for changing the powerful “hegemony” of the psy-professions. The book is an inspiring, paradigm-shifting achievement.” (Howard Waitzkin, Distinguished Professor Emeritus, Department of Sociology, University of New Mexico)

“A compelling account of the role of neoliberal capitalism in shaping and globalising psychiatric practice. Essential reading.” (Derek Summerfield, Consultant Psychiatrist, South London and Maudsley NHS Foundation Trust, and Honorary Senior Lecturer, Institute of Psychiatry, King’s College, University of London)

“This books places mental hea

lth in its proper social context, offering a compelling alternative to the medicalisation of social experience.” (Frank Furedi, Emeritus Professor of Sociology, University of Kent)