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Trauma and Madness in Mental Health Services pp 45–65Cite as

Palgrave Macmillan

The Politics of Madness

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Abstract

Many individuals who are seeking help healing from severe adversity or trauma earlier in life, especially those labeled with diagnoses indicative of “serious mental illness” or a dissociative disorder, have experiences where mental health professionals refuse to work with them, treat them in invalidating and disrespectful ways based on diagnoses, deny their subjective distress and trauma histories, and/or are told their experiences are not real or are efforts to seek attention. This chapter explores how knowledge, treatment practices, and public perception are shaped by the politics of the mental health field, through selectivity of its members and suppressed dissent, the use of authoritative and mysterious language, bias, specialization, vested interests, and ideological faith.

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Notes

  1. 1.

    There also has been discussion of a “biomedical industrial complex” (Relman, 1980) or “psychiatric industrial complex” (Carpenter, 2001) that describes the destructive influence of the medical and corporate interests in defining the nature and causes of psychosocial distress and disapproved behavior. Some have gone so far as equating this with cult indoctrination (Murray, 2009) that is impervious to evidence. See Thomas and Longden (2013) for a theoretical discussion of the resultant harm that comes from technical, medically based frameworks, and their suggestions for non-pathologizing approaches to treating madness in all its varied forms.

  2. 2.

    In 2013, Gretchen LeFever Watson published an article entitled “Shooting the messenger: The case of ADHD” in which she documents a widely publicized incident of losing her job and funding in response to unfavorable results of an evaluation of treatment for “ADHD”. She outlines how professionals with strong ties to the pharmaceutical industry engaged in ad hominem attacks while ignoring these results and, instead, increasing potentially harmful drug interventions.

  3. 3.

    See, for instance, Bodenhausen and Wyer (1985) for a discussion on how individuals tend to process complicated information and use judgmental heuristics that underlie problematic stereotypes. Diagnoses, as discussed further in Chap. 4, are conceptual categories that function specifically to allow for quick assumptions and broad classification of complex behaviors and subjective experiences. In general, category-based assessments are closely associated with prejudice and tend to preclude understanding an individual’s subjective experience (e.g., Wheeler & Fiske, 2005). See also Jutel (2009) for a discussion of the sociology behind diagnoses and how they function as stereotypes and social tools.

  4. 4.

    It is difficult to ascertain exact numbers for the mental health field, at large, but the project by ProPublica has created an online tool that details drug device or company money paid out between August 2013 and December 2015. The numbers are staggering, with a total of $6.25 billion paid out to 810, 716 doctors and over 1100 teaching hospitals during this time.

  5. 5.

    Willful blindness is a legal concept that allows a defendant to claim a lesser offense than outright negligence or carelessness. This psychological process as it pertains to the court of law was outlined in Margaret Heffernan’s book Willful Blindness: Why We Ignore the Obvious at Our Peril. Using this term in the context is not necessarily to imply that clinicians or researchers are doing anything illegal, per se, but rather that they are blinding themselves to how their practices and ideological pursuits may be harming people.

  6. 6.

    See Rissmiller and Rissmiller (2006) for a review of various criticisms of biological psychiatry and the current paradigm as it has existed within the so-called antipsychiatry movement. The fact that dissenters or critics are considered to be “anti-” is, in and of itself, an example of how they become marginalized and how language can do this quite simply.

  7. 7.

    It is common in the United States, and other Westernized countries, to allow for forced treatment (i.e., involuntary hospitalization, involuntary ECT, involuntary drugging) if a person is deemed incompetent or a danger to themselves. While some may assert that this is necessary to save lives, this is based on emotion and ideology, not the evidence. For instance, people who are considered to be an imminent threat for completing suicide are often hospitalized against their will, yet, the more involvement with coercive psychiatry, the more likely one is to actually die from suicide (Hjorthoj, Madsen, Agerbo, & Nordentoft, 2014). Similarly, persons who are considered to be psychotic may also be hospitalized or drugged against their will. Yet, those individuals labeled psychotic who do not comply with standard drugging rituals appear to fare better than those who do (Harrow & Jobe, 2007; Wunderink, Nieboer, Wiersma, Sytema, & Nienhuis, 2013). At the same time, the practice of involuntary interventions is directly associated with PTSD (Mueser, Lu, Rosenberge, & Wolfe, 2010), permanent brain damage (e.g., Breggin, 2003; Moncrieff & Leo, 2010; Morrison, Hutton, Shiers, & Turkington, 2012), prejudice and discrimination (Magliano, Read, Sagliocchi, Patalano, & Oliviero, 2013; Pescosolido et al., 2010; Read et al., 2006), and a profound sense of helplessness (Dillon, 2012). The United Nations has concluded in several reports that involuntary treatment for persons with psychosocial disabilities (i.e., “mental illness”) be considered inhumane and that forced drugging, shock, restraint, and seclusion should be banned from all countries, specifically the United States (see Human Rights Council, 2009; Mendez, 2013; Working Group on Arbitrary Detention, 2015).

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Hunter, N. (2018). The Politics of Madness. In: Trauma and Madness in Mental Health Services. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-91752-8_3

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