It’s the Coercion, Stupid!

In 2011, the Editor-in-Chief Emeritus of the Psychiatric Times, Ronald Pies, stated, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists”.

So how have mental health professionals retained their status despite a lengthy list of invalid diagnoses, punitive treatments, and pseudoscientific theories of mental illness?

“It seems to me that this coercive function is what society and most people actually appreciate most about psychiatry.”

The answer to this question, according to professor of social welfare at UCLA, David Cohen, goes beyond the corrupting influence of the pharmaceutical-industrial complex. The answer is actually darker. Society so values psychiatry’s unique weaponry or what Prof. Cohen calls “psychiatry’s extra- and intra-legal police function” that the lack of science in psychiatry does not matter.

In his 2014 article “It’s the Coercion, Stupid!” he writes that:

“Both Michel Foucault and Thomas Szasz dated the beginnings of a distinct European institutional response to madness to the late 1500s-early 1600s. For Foucault it started in France with the creation of the public ‘hôpital général’ for the poor insane. For Szasz it began in England with for-profit madhouses where upper class families shut away inconvenient relatives.

Despite their different ideas on the beginnings of anything resembling a mental health system, both authors agreed that it was characterized by the coercive incarceration of a specially labelled group.

Since its origins, the psychiatric system has coerced its lunatics and madmen and madwomen in madhouses, its inmates and patients in mental hospitals, its consumers and users in the community. (Yes, for a brief moment in the 1800s, British asylum superintendent John Connolly started a movement to ban all physical restraints within his establishment, but it didn’t last long.) The coercive element of psychiatry has persisted despite all changes in treatments, despite all changes in places for treatments. This is the invariant part of psychiatry …”

You can read more here.

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