Medications & Psychiatry
Resources

 email page    print page

All Topic Reviews
Psychiatry Under the InfluenceAlternatives Beyond PsychiatryAmerican MadnessAmerican PsychosisAn Unquiet MindAntipsychiatryBad PharmaBefore ProzacBetter Than ProzacBiological PsychiatryBlack Man in a White CoatBlaming the BrainBrain Science and Psychological DisordersBrainwashedClinical Psychopharmacology Made Ridiculously SimpleComfortably NumbCompassion and Healing in Medicine and SocietyComplete Mental HealthConcise Guide to PsychopharmacologyCrackedCultural FormulationDeconstructing PsychosisDemystifying PsychiatryDiagnosing the Diagnostic and Statistical Manual of Mental DisordersDiagnosis: SchizophreniaDiagnostic Issues in Depression and Generalized Anxiety DisorderDimensional Models of Personality DisordersDisordered Personalities and CrimeDoctoring the MindDoctors of DeceptionDruggedDrugs for LifeEmpirical Ethics in PsychiatryEssential PsychopharmacologyEssential Psychopharmacology of Depression and Bipolar DisorderEssentials of Psychiatric DiagnosisEsssential Philosophy of PsychiatryEthics in PsychiatryEvidence-Based Treatment of Personality DysfunctionFinding the Right Psychiatrist:Forces of HabitHandbook of Clinical Psychopharmacology for TherapistsHappy Pills in AmericaHealing the Soul in the Age of the BrainHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHerbs for the MindHigh PriceHippocrates CriedHistory of Psychiatry and Medical PsychologyHookedHuman TrialsInfectious MadnessInspired SleepIntoxicating MindsIs It Me or My Meds?Let Them Eat ProzacLife-Threatening Effects of Antipsychotic DrugsLitLiving with Bipolar DisorderMad in AmericaMad ScienceMalignant SadnessMedicating ChildrenMedicating Modern AmericaMoments of EngagementMommy I'm Still in HereNatural Healing for DepressionNot CrazyOrdinarily WellOur Daily MedsOverdosed AmericaPathologist of the MindPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPharmacracyPharmageddonPharmageddonPoets on ProzacPower HerbsPowerful MedicinesPrescriptions for the MindProfits Before People?Prozac and the New AntidepressantsProzac As a Way of LifeProzac BacklashProzac DiaryProzac on the CouchPsychiatric DiagnosisPsychiatric HegemonyPsychiatrists and Traditional HealersPsychiatry and EmpirePsychiatry and the Business of MadnessPsychiatry as Cognitive NeurosciencePsychiatry at a GlancePsychiatry in PrisonsPsychiatry ReconsideredPsychopathyPsychopharmacology Problem SolvingPsychotropic Drug Prescriber's Survival GuidePsychotropic Drugs And Popular CulturePsychotropic Drugs: Fast FactsRaising Generation RxRe-Visioning PsychiatryRecovery from SchizophreniaReligious and Spiritual Issues in Psychiatric DiagnosisRitalin NationRunning on RitalinRutter's Child and Adolescent PsychiatrySaving NormalSchizophreniaShock TherapyShock TherapyShould I Medicate My Child?ShrinksSide EffectsStraight Talk about Psychiatric Medications for KidsSuccessful PsychopharmacologySuffer the ChildrenTaking America Off DrugsTalking Back to ProzacTextbook of Cultural PsychiatryThe $800 Million PillThe Age of AnxietyThe Anti-Depressant Fact BookThe Antidepressant EraThe Antidepressant SolutionThe Antidepressant Survival ProgramThe Big FixThe Book of WoeThe Complete Guide to Herbal MedicinesThe Conceptual Evolution of DSM-5The CorrectionsThe Creation of PsychopharmacologyThe Cult of PharmacologyThe Dream DrugstoreThe Emperor's New DrugsThe Essential Guide to Prescription Drugs 2005The Essential Guide to Prescription Drugs 2006The Making of DSM-III®The Medicated ChildThe Medication QuestionThe Merck DruggernautThe Mind/Mood Pill BookThe Natural Pharmacist : Natural Health Bible from the Most Trusted Alternative Health Site in the World The Pill BookThe Pill Book Guide to Natural MedicinesThe PlaceboThe Rise and Fall of the Biopsychosocial ModelThe Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Truth About the Drug CompaniesThe Use and Misuse of Psychiatric DrugsThe World of CaffeineToxic PsychiatryTrouble in MindTry to RememberTry to RememberUnderstanding Physician-Pharmaceutical Industry InteractionsUnhingedVoluntary MadnessWarning: Psychiatry Can Be Hazardous to Your Mental HealthWhat Is Mental Illness?What Psychiatry Left Out of the DSM-5What Works for Whom?Will@epicqwest.comWomen, Madness and MedicineYour Drug May Be Your Problem

Related Topics
Psychiatric HegemonyReview - Psychiatric Hegemony
A Marxist Theory of Mental Illness
by Bruce Cohen
Palgrave Macmillan, 2016
Review by Sharon Packer, MD
Feb 21st 2017 (Volume 21, Issue 8)

As someone who was an undergraduate in the 1960s, I will always have a soft spot in my heart for reflections on the "anti-psychiatry" era, even when my brain challenges authors' arguments and wonders if their conclusions are built on a proverbial house of cards because their foundation of facts is flawed. Like so many others, tales about R.D. Laing's carnivalesque Kingsley Hall, opened in London's East End in 1965, enchanted me. Laing himself later recanted his colorful clinical theories about curing psychosis by expressing psychotic symptoms full-force. Laing attributed mental illness to a sick society, unlike some fellow anti-psychiatrists (most notably, Thomas Szasz, MD) who denied the existence of "mental illness" as a distinct clinical entity.

Curiosity alone compels me to learn about later incarnations of this countercultural movement, and to read intelligent discourses on the subject (that contrast with Scientology's emotive anti-psychiatry allegations). "Anti-psychiatry" sentiment has a complex history, and dates to Mary Baker Eddy's Christian Science, which began in the 19th century, long before the psychedelic sixties (per the esteemed historian of psychiatry, Norman Dane). This anti-psychiatry movement is gaining steam again, albeit for different reasons. This time, "the movement" is led by sociologists more than psychiatrists.

          Sociologist Bruce M.Z. Cohen's "Marxist Theory of Mental Illness"clearly belongs to the anti-psychiatry camp. Cohen attributes mental illness to class struggles and economic gaps among social classes and to psychiatrists' quest for economic hegemony and power plays via prescriptions for psychopharmaceuticals. Simply put, Cohen argues that monies that were once allotted to now shuttered psychiatric institutions are now diverted to pharmaceutical companies that sell "chemical restraints" and to psychiatrists, the professionals who prescribe those psychopharmaceuticals products (and to a lesser extent, order ECT).

It remains to be seen if Cohen's theories will enjoy the staying power of sixties' icons such as psychiatrists Laing, Szasz, and Cooper, or the sociologist Goffman or the philosopher Foucault, whose scathing historical analyses have since been refuted because they were built on flimsy facts. It also remains to be seen if Cohen would revise his theories, were we working in the U.S. and witnessing the collapse of "psychiatric hegemony" in the wake of the expansion of prescriptive privileges to nurse practitioners and physicians' assistants, and, to a much lesser degree, to prescriptive psychologists.

Nevertheless, Cohen's theories are worth considering, so long as we recall that his sociologist's perspective strays far from clinical considerations (except for his closing chapter, which harps back to the mid-1970s and recommends banning all ECT treatments). As a university lecturer in sociology, Cohen uses many sociological and even economic terms and quotes several luminaries in social theory and philosophy, making some of this work beyond the scope of most "psy-professionals," as he calls them. His explications of Karl Marx's sociological theories, as they relate to his topic, are useful to all readers. His in-text references liberally cite certain "outlier psychiatrists" that may cost him credibility among psychiatric readers, but the bibliographic endnotes after each chapter offer informative sources. 

In his concluding chapter, he contends that "the psy-professions were created and progressed to regulate and manage western populations through personalizing social and economic issues, pathologizing political dissent, policing and punishing problematic and deviant groups and reproducing the dominant norms and values of the ruling elite through psychiatric discourse." He is not the first to make such claims nor will he be the last. His allegation that the sociology of mental health is at risk of becoming "an arm of the state" partly because researchers receive state funding is more unique.

One parenthetical references made a special impression on me. Cohen mentions "Mad Studies," which entered the curriculum of a Canadian university. Mad Studies are supposedly an offshoot of "disability studies," a growing academic field that inveighs against "ableism". Such studies evoke the 70s-era madness movement, its rise and decline, and its apparent revitalization in the present day. "Madness Network News" (MNN) broadcast on New York City's now-defunct WBAI radio station through the late 1980s. MNN was an outgrowth of a 1972 San Francisco-based newsletter by the same name. The newsletter sparked the "mental patient liberation movement" in an era that birthed a variety of civil rights and identity movements.  Cohen acknowledges his consultations with members of "psychiatric survivor groups" who remind him of parallels between their cause and his contentions.

          It is curious that Cohen lives and works in New Zealand, which is the only nation besides the U.S. that allows direct-to-consumer pharmaceutical advertising (DTCA). DTCA has been shown to increase patient demand for prescription medications and for pricier brand names at that. Much DTCA does not directly advertise products but instead "educates" potential "consumers" about illnesses that they (or their doctors) may never have known about, were it not for those compelling consumer-oriented "infomercials." Given that background, it makes sense that Cohen is especially attuned to economic forces propelling mental health diagnosis and treatment. It will be interesting to read a similar study—with spreadsheets and accounting ledgers--about the uptick in private equity investments in alcohol and drug rehabilitation and eating disorders centers in the U.S.

          On a final note, I feel compelled to revisit Cohen's comment about the decline of interest in the intellectual underpinnings of psychiatry in the past 35 years.  Is he saying that intellectual discourse that was in vogue in the sixties and seventies faded after 1980, when DSM-III was published? DSM-III focused on validated diagnostic criteria, as it strived for uniformity and veered away from psychodynamic explanations of psychiatric symptoms. Sociological or socioeconomic explanations also faded away.

If Cohen is correct, then perhaps his contention explains my ­encounter with a star medical student soon after. The student had earned highest honors in all rotations and would soon be elected to AOA medical honor society. Yet when I mentioned Marx's claim that material conditions mold human consciousness, rather than the other way around, she said, in all earnestness, "Oh, you mean Groucho?"       

 

© 2017 Sharon Packer

 

Sharon Packer, MD is a psychiatrist who is in private practice in Soho (NYC) and Woodstock, NY. She is an Asst. Clinical Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. Her books includeDreams in Myth, Medicine and Movies (Praeger, 2002), Movies and the Modern Psyche (Praeger, 2007) and Superheroes and Superegos: The Minds behind the Masks (Praeger/ABC-Clio, 2010). In press or in production are Sinister Psychiatrists in Cinema (McFarland, 2012) and Evil in American Pop Culture (ABC-Clio, 2013, co-edited with J. Pennington, PhD.) She can be contacted at drpacker@hotmail.com .


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7700 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716