Crazy or just mad as hell?

There have been many reasons posited for the unprecedented rise in the diagnosis of mental illness across the developed world in recent decades.

What was once the preferred official explanation – that better diagnostic methods and greater access to mental health professionals means that fewer crazies are now going undiagnosed – has now largely fallen out of favour, even within the bastions of mainstream psychiatry.

The US National Institute of Mental Health has condemned the new edition of the Diagnostic and Statistical Manual (DSM) for spreading the definition of mental illness so far that ‘normal’ has been pathologised. Authors of earlier editions of the DSM have been even more scathing.

It has long been recognised that the long-term prognosis for those diagnosed with psychotic illness in the third world is better than it is in countries where the patient is more likely to receive ‘state of the art’ therapies.

In  Anatomy of an Epidemic, journalist Robert Whitaker argues that it is the therapies themselves – specifically psychiatric medications – that are aggravating and perpetuating the symptoms of mental illness. Recent large-scale studies into bipolar disorder – the STAR*D and STEP-BD trials – support his case, showing that bipolar patients prescribed antidepressants have worse outcomes than those who do not receive the drugs. Dr S. Nassir Ghaemi, the director of the Mood Disorders Program at Tufts Medical Center and a proponent of psychiatric medication, suggests the more serious rapid cycling form of bipolar disorder that has reached epidemic proportions in recent decades is entirely iatrogenic – it is caused exclusively by antidepressants.

Another reason cited for the increasing burden on first world mental health systems is the increasing atomisation of society.

A generation or so ago most support for the mentally ill or those in danger of becoming so came from families and the community. Often it was pretty dysfunctional – locking up the crazy old aunt in the attic and not talking about her to outsiders – but the first port of call for those under psychological stress was usually friends, family or clergy. Small communities often found a place for the local ‘eccentric’ that didn’t involve psychiatrists, counselors or a formal diagnosis of mental illness. Many others would never have shown enough symptoms to qualify for a diagnosis because of the social support they received, even if it was only in the form of reduced demands and expectations.

Now an increasing number of people live on their own or share a home with only one or two others who are too pressed themselves to offer much in the way of support. Few would even consider turning to a priest or nun for psychological help. In fact the rise of Neo-Atheism and the wave of church-based sex scandals means that many now see the clergy themselves as pathologically deluded. When someone displays emotional extremes or psychotic symptoms in public they are now more likely to be greeted with fear and a police response than sympathy and a helping hand.

Clinical psychologist Bruce Levine has recently proposed an intriguing alternative reason for the surge in mental illness diagnoses, particularly of young people. Political suppression. Specifically, the suppression of young anarchists.

As Rich Winkel tried to tell Ralph Nader over a decade ago, psychiatry has worked hand in hand with oppressive authority since its inception.

One of the first ‘mental illnesses’ to be defined in the United States was drapetomania, the pathological tendency of some black slaves to run away from their masters. Fortunately the physician who discovered the disease, Samuel A. Cartwright, also developed therapies to cure it. Acute drapetomania could be treated by ‘whipping the devil’ out of the afflicted Negro, while chronic cases were best dealt with by cutting off the sufferer’s big toes. Neuroleptic drugs had not yet been invented.

Women, racial minorities and the poor have always born the heaviest burden of psychiatric pathologisation. Men such as F Scott Fitzgerald who found their wives socially inconvenient could always count on a cooperative psychiatrist to have them locked away. In ‘Toxic Psychiatry‘, Dr Peter Breggin documents the case of Elizabeth Packard, institutionalised at the behest of her husband Theophilus in 1860 for believing humans are basically good and slaves should be set free. The doctors agreed that these were signs of serious insanity. Theophilus then set about stealing her inheritance, selling all her property and moving interstate with her children.

But it is when psychiatrists join up with state authorities that the worst abuses take place.

In the early 20th Century psychiatrists were quick to nail their colours to the mast of the eugenics movement. In 1920s Germany, psychiatrist Alfred Hoche and jurist Karl Binding developed the philosophy of ‘life unworthy of life‘, the notion that certain people, such as the mentally and physically disabled, should be executed so that health resources could be redirected to citizens more likely to contribute to the nation. Their book inspired the Nazi T4 Project, in which psychiatrists emptied the asylums of Germany by sending those who could labour to camps where they were worked to death and executing those who couldn’t, usually with lethal gas. Those psychiatrists would later take their expertise to the concentration camps where it would be used to industrialise the extermination of Jews, Gypsies, communists, homosexuals and Jehovah’s Witnesses.

In the 1950s Soviet psychiatrists under Andrei Snezhnevsky discovered ‘sluggish schizophrenia‘, a mental illness characterised by almost normal day-to-day functioning, but in which the patient developed ‘philosophical intoxication’ or ‘grandiose ideas of reforming the state’. Needless to say the Russian mental health gulag was soon full of political dissidents, would be emigrants and religious believers carrying this diagnosis.

When the CIA wanted to develop mind control techniques to counter what it falsely imagined to be the advanced brainwashing methods of the North Koreans it had no trouble recruiting large numbers of American, Canadian and British psychiatrists and psychologists to the cause. From the early 1950s to the late 1970s programs such as Project Bluebird, Project Artichoke, MKDELTA, MKSEARCH and MKULTRA employed thousands of mental health professionals dedicated to bending the will of government employees and unsuspecting civilians to the demands of the state using methods such as torture, hypnosis, psychological and sexual abuse, subsonic voice insertion, sensory deprivation and covert administration of drugs such as LSD. Although officially shut down by Congress in 1975 several MKULTRA projects continued into the 1980s and similar work is carried out to this day by the Defense Advanced Research Projects Agency (DARPA).

In Australia, notorious psychiatrist Dr Harry Bailey was referred many involuntary patients by the courts, including exhibitionists and homosexuals who, up until the 1970s, were considered criminally insane by the psychiatric establishment. These people were subjected to forced psychosurgery, electroshock and the often fatal barbiturate induced deep sleep therapy. It wasn’t until a media exposé in 1982 that authorities finally turned on Bailey and in 1985, having been publicly humiliated and under threat of imprisonment, he swallowed a bottle full of his own barbiturates. His suicide note read “Let it be known that the Scientologists and the forces of madness have won”.

According to Dr Levine, psychiatrists have now turned their attention to young anti-authoritarians, not at the direct behest of authorities but simply because their own outlook and training prejudices them to see anyone who resists authority, legitimate or not, to be mentally ill. Drawing on thirty years of clinical experience Levine states “many young people labeled with psychiatric diagnoses are essentially anarchists in spirit who are pained, anxious, depressed, and angered by coercion, unnecessary rules, and illegitimate authority”.

As a result we now have an ‘outbreak’ of childhood mental illnesses such as Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) that are leading to the mass medication of young people whose symptoms basically consist of not behaving in a manner approved by authorities. ODD in particular is simply a description of children who resist the commands of adults. Even more conventional diagnoses such as schizophrenia and bipolar disorder are more likely to be applied to rebellious kids.

Levine’s patients have included many anti-authoritarian children who are locked in conflict with their authoritarian parents for reasons that have nothing to do with mental illness. Often defusing the confrontation and ‘curing the illness’ is just a matter of explaining to parents that attempts to coerce their kids into their own mindset will not succeed and will eventually destroy the parent-child relationship.

If only Liza Long, author of “I am Adam Lanza’s mother“, had consulted with Bruce Levine it may not have been necessary for her to publicly equate her rebellious 13-year-old son with a mass murderer and resort to forced hospitalisation as a disciplinary measure.