Ch12 Anti-Psychiatry Movement

ANTI-PSYCHIATRY MOVEMENT Anti-psychiatry refers to approaches which fundamentally challenge the theory or practice of mainstream psychiatry in general and biological psychiatry in particular. Anti-psychiatric criticisms of mainstream psychiatry include that it uses medical concepts and tools inappropriately, that it treats patients against their will or inappropriately dominates other approaches to mental health, that its medical and ethical integrity are compromised by its financial and professional links with pharmaceutical companies, and that it uses a system of categorical diagnosis that is stigmatizing and is perceived by too many of its patients as demeaning and controlling. A significant minority of mental health professionals and acsademics profess anti-psychiatry views, and even some psychiatrists hold such views in regard to mainstream (biological) psychiatry. Psychiatrists generally view anti-psychiatry as a fringe movement with little or no scientific validity, although it is difficult to quantify the proportion of the general public or professionals involved, or the range of views held. D.L. Rosenhan Anti-psychiatry movement can be understood by looking at an experiment undertaken by an American psychologist D.L. Rosenhan. The experiment was that, three women and five men who were perfectly normal and most of them were well educated, entered in 12 mental institutions of different places in U.S.A. They posed as mental patients saying that they hear voices, but apart from this, offered completely correct information about themselves. These “patients” remained in hospitals for 19 days on the average. Based upon the experiences of these posing patients, Rosenhan concluded that: It is impossible to distinguish between normal people and patients according to the rules and procedures of mental hospitals. Mental hospitals leave extremely negative effects on inmates. Mental hospitals treat patients without pity and with cruelty. That the overall environment of mental hospitals needs great improvement. Further, research showed in this context that up to 80% patients released from mental hospitals went back and are re-admitted. So a realization arose among psychologists that the methods of treatment being used by psychiatrists were inadequate and inappropriate for the treatment of mental disorders. Some psychologists and psychiatrists rejected these methods, and that is why their approach is called Anti-Psychiatry. R.D. Laing R.D. Laing was a British psychiatrist, who was born in 1927 and died in 1989. Laing wrote extensively on mental illness and particularly the experience of psychosis. He is being noted for his views, influenced by existential philosophy, on the causes and treatment of mental illness, which went against the psychiatric orthodoxy of the time by taking the expressions or communications of the individual patient or client as representing valid descriptions of live experience or reality rather than focusing on symptoms of some separate or underlying disorder. He is often associated with the anti-psychiatry movement, although like many of his contemporaries also critics of psychiatry, he himself rejected this label. He made a significant contribution to the ethics of psychology. His book “The Divided Self” appeared in 1959 and is considered to represent the basic view of antipsychiatry movement. Laing used the existential philosophy to understand and explain the concept of mental illness, thereby trying to look at schizophrenia from the patient’s point of view. He was against labeling mental diseases, because he thought that from the patient’s view, he is not suffering from a disease. In his opinion labeling was used to control people. In other words, in his own view no patient was sick. All that he was suffering from was labeled on him by the people who are treating him. Therefore, Laing suggested that the patient’s point of view should be kept in mind while treating mental diseases. In his view the cause of mental disease was division in the self and the therapy suggested by Laing is known as “Metanoia.” Metanoia means a change in the mind. This could be achieved in various ways such as arts, discussions, seminars, etc. He established a place called Kingsley Hall where activities such as seminars, discussions, dance, yoga, painting, stitching were carried out to create and achieve metanoia. Aaron Esterson Another prominent psychologist in anti-psychiatry movement was Aaron Esterson who was born in 1923 and died in 1982. Esterson focused on family therapy and showed that the family picks up a person and then labels that person “mad.” This is called scapegoating. In his book he relates the case of a young girl who was thought by her parents to be mentally sick but in reality she was healthy. Therefore Esterson showed that madness or schizophrenia is an expression of scapegoating of the family. His method of treatment was to expose the mechanisms of scapegoating to the patient and make the patient realize that he or she was not sick but was just being called sick. In that way the patient would be able to deal with any future labeling upon him. PSYCHOLOGY IN THE THIRD WORLD Third world countries are considered those regions and countries that gained independence and self-rule after World War II. Some of these countries were under the direct occupation of the European countries and America; some others were under the control of other occupying forces. These countries included Pakistan and India, most of the countries in Africa, some in the Far East as Vietnam and Indonesia, and the biggest of them all was China. Where the II World War brought numerous sufferings to mankind, it also resulted in freeing most of these regions and countries form the curse of modern slavery or colonialism. Frantz Fanon (1925-1961) Frantz Fanon Post World War II psychologists have asked themselves a question if being colonized by a foreign power, it influences the psyche of the people of the region? Frantz Fanon was one of such psychologists. Fanon worked in Algeria as a psychiatrist. Algeria is a country in South American continent which was previously a colony of France. With reference to psychology in the Third World, Fanon is a prominent contributor. Frantz Fanon was a black African who was educated in France, specialized in psychiatry and joined a hospital in Algeria. Frantz Fanon's relatively short life yielded two potent and influential statements of anticolonial revolutionary thought, Black Skin White Masks (1952) and The Wretched of the Earth (1961), which have made Fanon a prominent contributor to postcolonial studies. Fanon was born in 1925, in a middle-class family, in French colony of Martinique. He left Martinique in 1943, when he volunteered to fight with the Free French in World War II and he remained in France after the war to study medicine and psychiatry on scholarship in Lyon. Here he began writing political essays and plays, and he married a Frenchwoman. Before he left France, based on his lectures and experiences in Lyon, Fanon had already published his first analysis of the effects of racism and colonization, “Black Skin, White Masks” (BSWM), originally titled "An Essay for the Disalienation of Blacks". Fanon died in 1961. He tried to look at mental diseases and also at the struggle of the colonized people of Algeria. As a result of his practice and observation he came to have some interesting ideas which are included in his two famous books. His books are available worldwide and have been translated into Urdu as well. He put forward the view that as a result of occupation, a region or country comes to have two types of people: The colonizer The colonized Both the colonizer and the colonized have different psyches. Colonizer is the aggressor who tends to dominate the colonized. The colonized on the other hand is obviously meek and receptive towards the colonizer who tends to impose him. Another important aspect of the colonizer, colonized relationship is that the colonizer considers himself superior and the colonized inferior. This means that the practices, views and beliefs of the colonizer are supported as superior by him while the colonized also accepts this. Further the colonizer also considers his culture superior and the colonized agrees. As a result of this division of superiority-inferiority, people feel anger and rage. This anger and rage is expressed in various forms such as political turmoil, protests against the rulers etc. The rage is significant because it is not directed against the real culprit, the colonizer, but against each other. The colonizer uses this tool to keep a hold on the colonized. In other word, in order to ease his survival the colonizer facilitates the flow of this rage against the colonized, by dividing and directing it against religious sects, tribal belongingness, language and other cultural differences. When the colonized adopts the ways of thinking of the colonizer, this adoption in Fanon’s view is called the “Colonial Mentality”. Colonial mentality is considering the culture, language and the general way of life of the colonizer as superior and considering these of the colonized as inferior. Fanon put forward the view that mental disease is the result of rage of the colonized on one hand and the adoption of colonial mentality on the other hand. He saw in his practice that when some of his mental patients started to fight or take part in the struggle to free Algeria from the French control, they started to rid themselves of their diseases also, so his suggested method of treatment was to make his patients conscious of their rage and their acceptance of colonial mentality and prepare them to wage a battle against the colonial powers. An important thing to note in this regard is that the battle may not be fought with guns only, but also in schools and colleges by advancing in education; in hospitals by advancing in research and developing new medicine etc.; and in games and sports also. PSYCHOLOGY IN THE THIRD WORLD CHINA AND PAKISTAN As mentioned in earlier lectures, third world countries are those regions and countries that gained independence and self-rule after World War II. These countries were either under the occupation of America or the European countries. Few of these were also under the occupation of other forces. For example, countries such as Pakistan, India, most of the countries in Africa, some in the Far East as Vietnam and Indonesia, and the biggest of them all was China, are included in the list of third world countries. The Second World War brought numerous sufferings to mankind. Millions of human lives were lost, but this great disaster in the history of mankind also resulted in freeing most of these regions and countries form the curse of modern slavery or colonialism. Following is a review of psychology in some of the third world countries. Psychology in China China became free from foreign domination in 1949, under the leadership of Mao-Tze-Tung, who was a leader of the Chinese Communist Party. Before the revolution of 1949 China was under the influence of American psychologists. Peking University offered the first course in psychology in the first decade of the 20th century related to American psychologist’s view point. The books of American psychologists notably, William James and John Dewey were translated into Chinese and became a part of the Chinese courses of psychology. James is considered the founder of the functionalism. William James put forward the view that consciousness is not epiphenomena, which means that consciousness cannot be considered as something whose functions or working cannot be explained. John Dewey was an educationist who put forward the view that education, particularly of children, should be based upon the needs of the children. This means that children of different ages have different needs. The education system should concentrate on understanding those needs and should adjust itself to meet the needs. John Dewey also delivered lectures at various places in China during 1919 and 1920. Another American psychologist named Sailor, who had been educated at Teachers College Columbia University, delivered lectures in China. After the revolution of 1949 in China, Sailor came to Pakistan and delivered lectures in Lahore and other places. So psychology in China before 1949 could be called functionalist psychology. It also carried the influence of behaviorism and psychoanalysis. When the Communist party gained control of the country in 1949, they recognized psychology as an important field of study. Psychology was recognized as a separate science in 1950 in China. In 1956 a commission was established to prepare a plan for the progress of psychology in China. As a result of recommendations of the commission and other sources, three branches of psychology gained permanence in China. They were: o Clinical Psychology o Psychology of work and labor o Educational Psychology In Clinical Psychology research was undertaken in diagnostics and treatment of mental disorders, particularly schizophrenia and manic depressive psychosis. Chinese psychologists developed what they called “Speedy Synthetic Method” for treatment of mental disorders. In the realm of Psychology of Work or Labor, manual labor was declared to be superior as compared to mental labor. Chinese psychologists discovered ways by which efficiency of manual labor could be increased. In the field of Educational Psychology the highest resource and efforts were diverted. Educational psychologists looked into ways and means of improving student’s moral and ethical behavior. They started manual labor classes for students. Chinese psychologists also did research on the developmental stages of growth in children and found out the best age for schooling etc. These were the main features of the developments of psychology in China after the revolution of 1949. Psychology in Pakistan Pakistan became an independent country in 1947. At the time of partition there were only two departments offering master’s degree in psychology. One at Dacca, East Pakistan, now Bangladesh and the other was Government College Lahore, affiliated with Punjab University where master’s classes were being held. Later, RajShahi University in East Pakistan/Bangladesh started offering masters degree and then Punjab University also set up the Applied Psychology Department. Later post graduate departments were also opened at Peshawar University, Karachi University and other colleges in Punjab. The main specializations taught at these institutions were: o Psychodynamics, particularly the Freudian/Jungian approaches o Social Psychology o Clinical Psychology o Experimental and General Psychology o Psychological Measurement Still later a National Institute of Psychology was set up at Islamabad, which undertook research in the areas of developmental psychology, forensic psychology, psychological measurement, etc. The NIP was later merged with Islamabad University. Graduates from these institutions have been employed in the armed forces, the labor departments, education departments, public service commissions in the public sector, and in private sector, in advertising and marketing organizations and organizations undertaking research. Most prominent educational institutions now offer master’s and post master’s courses and degrees. Many graduates from these institutes are engaged in private practice and consultation. PSYCHOLOGY IN THE 21st CENTURY We will now touch upon two relatively modern areas of psychology; the first is organizational psychology and industrial psychology. It may be defined as the application of psychological principles and techniques to business and industrial problems. For example, psychology may be used in the selection of personnel or development of training programs for the employees which may enhance their productivity, make them more efficient and hence result in betterment of the organization. In other words, industrial and organizational psychology are two new branches of psychology which aim at improving overall performance of industrial and organizational workforce in order to improve the productivity of the organization as a whole. Industrial psychology in particular, deals with labor force that works in factories etc., while organizational psychology deals with psychology of members of any organization, may it be an educational institute or a team. Some areas which are studied under the umbrella of organizational/industrial psychology include: Organizational design Organizational design studies how to deal with the design of organization which meets the requirements and needs. For example, an organization may be tall or flat, i.e. having greater layers of management or lesser layers of management. Organizational culture Organizational culture studies how to deal with the culture within the organization. Every organization has its own set of values which are expected to be followed by every member of the organization. These values determine the overall productivity of the employees. Organization culture deals with the principles that govern such cultural practices. It sets out guidelines to develop, maintain and reform (if needed) the organizational culture. o Globalization Globalization refers to a phenomenon which is often misperceived to be quite recent. Globalization means the world becoming one global village where distances present no more a hurdle to communication, trade, mobility of factors, exchange of ideas etc. An important aspect of globalization is that it allows mobility of workforce to move from one part of the globe to another. This mobility of workforce has had a significant impact on the working of organizations which has become more diversified in terms of labor force composition. A modern organization may employee a workforce comprising of members from various countries other than its origin. Therefore, globalization also plays a significant role in determining industrial psychology. o Diversity Diversity refers to the workforce of an organization comprising of individuals with different characteristics and traits which may differ to a great extent. Modern organizations, in order to survive in harsh competition need to diversify their workforce. Therefore, diversity studies shape a vital part of industrial psychology studies. Personality related factors in organizations Personality related factors in organizations refer to factors such as motivation of the employee or attitude of the employee towards the organization and his work. Therefore, organizations need to concentrate on such factors which are now a part of industrial and organizational psychology. A motivated employee, for instance, would be more productive and would be more useful for the organization. Leadership Leadership styles are also studied under industrial and organizational psychology. Leadership is an important determinant of overall productivity of the organization, team or group. Therefore, organizations tend to determine the best possible leadership styles for their managers. Stress and Fatigue Stress management is another area under the umbrella of industrial and organizational psychology. American organizations spend a huge amount of money on stress management of their employees. Many productive employees lose their productivity because of work stress. Therefore, psychologists need to determine ways and means to help these people with stress management. Stress results into fatigue for the employees which need to be handled before it mars the productivity of the employees. The best way to do it, is to help the employees manage their work stress. Selection and Training Selection and training are also a part of industrial and organizational psychology. Psychologists are hired to determine the personality characteristics of the employee and find the best fit for the organization who would suit the needs and requirements of the work being assigned to him and would be productive for the organization. Further, training, such as, to manage stress, diversity training, etc. are also areas under study in industrial and organizational psychology which help the employee to be more productive. Another more recent expansion of the subject of psychology is Environmental Psychology. Environmental psychology focuses on human interaction with environment. It deals in how humans effect environment and how in turn environment affects human psychology. It includes such topics as o Personal Space Personal Space is the region surrounding each person, or that area which a person considers his domain or territory. Often if entered by another being without this being desired, it makes them feel uncomfortable. The amount of space a being (person, plant, animal) needs falls into two categories, immediate individual physical space (determined by imagined boundaries), and the space an individual considers theirs to live in (often called habitat). These are dependent on many things, such as growth needs, habits, courtships, etc Territoriality Territories may be held by an individual, a mated pair, or a group which are then defended by them from intrusion of outsiders. Territoriality is only expected to emerge where there is a focused resource that provides enough for the individual or group, within a boundary that is small enough to be defended without the expenditure of too much effort. Environment toxins Environment toxins are things which are harmful for the environment in which humans live and therefore, in turn harm human beings as well. For example, noise pollution may be a cause of fatigue. Temperature changes which are caused due to human beings, such as that explained by global warming are also studied under this topic. Organizational psychology, Industrial psychology and Environmental Psychology are some of the new areas where modern psychology is growing and expanding.