Mental block: Opposers of Mad Pride protest anti-psychiatrist
NationalPost.com – news
Saturday, Dec. 18, 2010. Joseph Brean, National Post
Professor Neree St-Amand, a sociologist in the University of Ottawa’s School of Social Work, with a focus on “empowerment” and alternative therapies, has a view of mental illness that is common in his academic field, but at odds with the mainstream.
He thinks psychiatrists aim to control people, who then become fat and suicidal, with no libido, hating themselves. He thinks untreated schizophrenia can be a gift, and that in other cultures, hearing voices is revered as a bridge to the spirit world. He thinks psychiatrists mislead the mentally ill about the risks and benefits of drugs, discouraging them against other options, such as spirituality, nutrition and yoga. He is blunt about the dilemma facing their families.
“If people cared for their people, then it changes a lot of the problems,” he said in an interview. “It changes the perspective on the problems, and you don’t necessarily want to give them a diagnosis and treatment, you want to love them and care for them.”
More unusually for an academic social theorist, Mr. St-Amand sits on an advisory committee of the Mental Health Commission of Canada, representing family caregivers of mentally ill people, and devising policy to support them.
His presence there as a supporter of the anti-psychiatry movement — which generally sees mental illness as a bogus corporate invention, and medical psychiatry as a caricatured memory of One Flew Over the Cuckoo’s Nest — has put a wedge between allies at the MHCC, which aims to combat the stigma of mental illness and devise a national strategy of care. Set up by Prime Minister Stephen Harper in 2007, the commission’s formal strategy is not expected for many months, but the project took on a note of urgency this week when a parliamentary public safety committee called for “serious investment” to resolve the “inadequate” treatment of mentally ill people in the federal prison system.
The MHCC defends Mr. St-Amand’s presence as a result of openness to diverse opinions, and even beneficial. “It keeps us from being complacent,” said director of communications Stephanie Lassonde.
But it has rankled a group of activists who think Mr. St-Amand’s “insulting” public denunciation of psychiatry is not only harmful — in that he appears to blame parents and imply psychiatric treatment is a form of neglect or harm — but is also evidence of deeper flaws in the MHCC.
“It’s absurd,” said June Conway-Beeby, a former head of the Ontario Schizophrenia Society. “No family member is going to feel that way. It’s a crazy position. This is from somebody who is looking at it from theory only, in my view….What are you going to do with someone like that advising about what you need as a mother or father of a very sick person?”
“Why would you have this kind of enemy on a committee dealing with families’ needs?” she said.
Although he has a long career as a social worker, it is not obvious why Mr. St-Amand wants to help with mental health policy. He is not casually opposed to psychiatry, nor merely skeptical of the recent proliferation of diagnoses, especially of children, each with a corresponding drug regime. His opposition is more fundamental: Psychiatry, as he describes it, cannot cure. It can only control.
“There’s ways to look at schizophrenia that is not a problem. In a lot of cultures, to hear voices is a plus and not a minus. It’s a sign that you are in contact with other worlds…. It’s a gift, sometimes.” With regard to schizophrenia, he said, “The problem could be psychiatry.”
He dismissed the complaints about his role in the MHCC as coming from people who represent psychiatry “trying to defend their turf.”
Under the newish banner of Mad Pride, with a focus on the plight of psychiatric “survivors,” the modern anti-psychiatry movement is the latest expression of a long-standing unease about the field, whether it rightly claims a position among the medical sciences, or is in fact an unfair labelling regime for unusual people for the purpose of control.
Support for the latter view runs the spectrum from anti-medicine Scientologists to scholars at established universities. The movement enjoyed its heyday in the 1960s, with the publication of milestone works like the French philosopher Michel Foucault’s Madness and Civilization, which gave full form to the idea that mental illness is a social construct. The decade also brought a series of scientific discoveries about the brain — such as the serotonin re-uptake mechanism that enables modern anti-depressants — that seemed to ally psychiatry with the pharmaceutical industry in a closed circle of diagnosis and drug.
Ever since, psychiatry’s claim to objective truth about the human mind has enraged anti-psychiatrists even more than prison-style asylums, which are mostly a thing of the past.
Today, as anti-psychiatry retreats from the mainstream into the looser academic disciplines, it remains an influential idea — dangerously so, according to the activists who complained about Mr. St.-Amand, all of whom have close family members with serious mental illness.
For a schizophrenic in the florid hallucinations of a psychotic break, or a family member trying to understand and help, the belief that psychiatry is a scam — or worse, torture — can deter sick people from care, and amplify the very stigma the MHCC was created to fight, they believe.
“As you know, paranoia is a common feature of psychosis and Mr. St-Amand’s comments make it much more difficult to create the important bonds between clients, families and psychiatrists that produce the best results,” the group of activists wrote in a letter to the MHCC executive.
Written by Susan Inman, whose new book about her daughter’s schizophrenia describes encounters with “a broken system that honours their right to be sick,” the letter points out, bitingly, that their sons and daughters were “not saved from these horrors by the work of sociologists, social workers, or other social scientists writing about mental health policies.”
More complaints followed this week. In a letter to MHCC chair Michael Kirby, Howard Fluxgold noted his son Jonah “had serious legal issues precisely because of his refusal to take medication.”
Few carry the weight of the criticisms by Ms. Conway-Beeby, 80. She recalled her efforts at dealing with her schizophrenic son Matthew’s paranoia, especially at crisis moments. Once he was kicked out of a friend’s house and came home drunk and terrified of the UFO following him. A few years later, in 1980, she found him lying on the floor of his new apartment, dead by suicide at age 20. He had taken two ordinary dinner knives, stabbed his eyes, and pounded his head on the ground until they pierced his brain.
To her, the main danger of anti-psychiatry lies in its seductive claim, to the mentally ill, that this is not their fault, and so it must be society’s, or industry’s, or their parents’. The flaw with this message, Ms. Conway-Beeby said, is that it wrongly indulges a peculiar symptom that the seriously mentally ill often share with stroke victims: anosognosia, or the pathological belief that nothing is wrong.
Neither MHCC vice-chair David Goldbloom, who has extensive experience in front-line schizophrenia treatment, nor the chair, Mr. Kirby, a former Liberal senator, agreed to be interviewed for this story. The MHCC’s spokeswoman said Mr. St-Amand’s views are his own. “Anti-psychiatry is not a widespread concern at the commission,” said Ms. Lassonde.
But the commission is alive to the criticisms. In response to the activist group’s letter, Dr. Goldbloom wrote in an email that Mr. St-Amand “is on the Family Advisory Committee along with many others because he has an affected family member and is passionate about the issues.
“Does he agree with all the other members of the Family Caregivers Advisory Committee? No, but not all the people on the Board of the Commission agree with each other either! What we are trying to do is get a variety of views represented and, where possible, build consensus,” he wrote.
“I felt that was no explanation at all,” said Ms. Conway-Beeby.
If there is one piece of humour in this battle in the long war over psychiatry, it can be found in Ms. Inman’s book, After Her Brain Broke: Helping My Daughter Recover Her Sanity. The memoir, endorsed by Mr. Kirby, recounts the frustrations of a mother trying to help a daughter whose symptoms followed a fast arc through bipolar disorder to full-blown schizophrenia.
In the end, the people who came through for Molly were her psychiatrists, not the vaguely Freudian therapist “Veronica,” an “ignorant and dangerous woman,” who brainwashed Molly into thinking her family was dysfunctional and abusive, and that psychiatrists cannot be trusted because they play “mind games.”
With her condition stable after a hellish few years, Molly enrolled in an Introduction to Sociology class. “The instructor explains that the pharmaceutical companies, with the help of psychiatrists, have made up a bunch of disorders for which there is no evidence,” Ms. Inman writes.
It is a testament to Molly’s hard-won sanity that she saw through this popular conspiracy theory and returned the next day with a stack of scientific reports on the neurophysiological and genetic aspects of schizophrenia, which the college lecturer declined to read.
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