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By Lauren Tenney, PhD, MPhil, MPA, Psychiatric Survivor
Author’s Note: Recently, on Facebook, I was tagged in the article written by Lieberman (2013) that was said to require a response. The blog post, “DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice” was written by Dr. Jeffrey Lieberman (May 20, 2013), published on the MIND Guest Blog of Scientific American. It is such an inflammatory sentiment that is expressed by Dr. Lieberman, that it demands attention. The blog entry below is my initial response, which I hope generates much conversation.
At least as far back as May 20, 2013, Dr. Jeffrey Lieberman has wanted his readers to think he understands how anti-psychiatry came to hold its position against traditional psychiatry. It is interesting to note that he does not actually refer to any anti-psychiatry materials, many of which do show evidence of how and why psychiatry falsely profits from the lies in which the field presents as science. In my role as an adjunct assistant professor, I am ‘out’ both as someone who is anti-psychiatry and someone who is a psychiatric survivor. I often talk with students about how frustrating it is that a typical psychology textbook will address the importance of non-biased science, but when it comes to the actual science of psychiatry, it offers ‘maybe’ and ‘probably’ to address the etiology of psychiatric assignment via a biological model and that those potential futures are so strong that the lack of evidence is not only acceptable, but would be unethical not to pursue, because if the evidence ever came through, it would show that there was in fact a broken brain, a genetic link, or some kind of biological evidence, such as a chemical imbalance which “never panned out” (Whitaker, 2005, p. 25).
It’s all about the optics. A question I pose to students routinely is, “What would happen to your thinking if the textbook stated they have zero biological evidence of “mental illness” versus that ‘mental illness may be genetic, or probably is biological’?”. Of course, the response is generally that they would not accept psychiatry the way that they do, because of the optics in which psychiatric ‘science’ is presented. So, the twisted version of ‘science’ which psychology students are exposed to is problematic and the fact that Dr. Lieberman perpetuates it is irresponsible of him, and in my mind, a problem.
Dr. Lieberman (2013) himself described the field of psychiatry as having over the last half century “grown leaps and bounds . . . on a course for future growth and success” while he also downplayed the lack of actual evidence psychiatry had to offer, describing its evidence as leaving a sense of dissatisfaction, frustration, and yet a hope for future success. Readers of Mad in America will know that Whitaker (2010) pointed out that when one looks at “patient care episodes” (p. 24) one can find, “nearly a fourfold per capita increase in 50 years” (p. 24) and it seems that Dr. Lieberman is not willing to admit the growth is as much in allocates as it is in financial profits for individual practitioners and industries, respectively.
All of this, for a field whose practices, procedures, and products are able to be court-ordered on people kept in psychiatric places who do not want to comply and who subsequently are subjected to a host of human, constitutional, and civil rights violations (Chabasinski, 2013; Minkowitz, 2007, 2013; United Nations Drafting Committee, 1948; United Nations General Assembly, 1984; United Nations Human Rights Council, 2008, 2013; Weitz, 2002, 2004, 2008).
I suppose Dr. Lieberman (2013) taking a position of authority on the existence of anti-psychiatry by writing, “I do understand how anti-psychiatry ideas first developed and why they have been so difficult to combat” somehow how justifies why he feels he can categorically discount anti-psychiatry and disparage its proponents—and without naming one such person—Lieberman (2013) casts anyone identifying as anti-psychiatry off, by stating, “They are, to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy” (Lieberman, 2013). Last I checked, it was the anarchistic spirit in scientists that has acted as the catalyst for the further development of science, (i.e. Galileo).
However, Dr. Lieberman flat out left out people who identify as psychiatric survivors, or people who have survived psychiatric atrocities and our rallying cry against psychiatry. Perhaps, if Dr. Lieberman actively privileged the voices of those of us who have experienced psychiatric practices, procedures, and products and still experience pain from psychiatry, as a doctor, Dr. Lieberman would not be able to deny the evidence he had and therefore would not be able to disparage those of us who challenge and expose psychiatry. Instead of hearing and actively responding to the voices of people who have survived psychiatric atrocities, and immediately acting in a support role to ensure that others are not subject to such human rights violations via psychiatry, Dr. Lieberman does something that ought not ever, in my opinion, have ever been done. Dr. Lieberman assigns this act of being anti-psychiatry, akin to racism and other horrible displays of discrimination and hate:
“Like most prejudice, this one is largely based on ignorance or fear–no different than racism, or society’s initial reactions to illnesses from leprosy to AIDS. And many people made uncomfortable by mental illness and psychiatry, don’t recognize their feelings as prejudice. But that is what they are.” (Lieberman, 2013)
Please note, this special type of prejudice, as being discussed by Dr. Lieberman, is not only toward the people who have been psychiatrically assigned, but is also aimed at the psychiatric assignor or provider. Lieberman did state that in 2013 it might have been the “right time to grapple with the prejudice against mental illness and its caretakers.”
Everyone ought to be concerned that one of the most powerful psychiatrists in the world is using analogies of discrimination to what it is he experiences as a psychiatric provider. Dr. Lieberman should not be able to get away with comparing those who are anti-psychiatry to exhibiting something similar to “racism, sexism, homophobia, and other prejudices” (Lieberman, 2013).
Dr. Lieberman, perhaps this can serve as a brief reminder to you about the history of institutional and structural racism in psychiatry and how it continues to repeat on us today. Most people now know that at least dating back to Cartwright’s 19th century alienist diagnoses such as Drapetomania: a slave running free, or wanting to run free (Cochrane, 2004; Jackson, 2001), and Dysaesthesia Aethiopica, or a slave who would break tools, or disobey one’s master (Cochrane, 2004; Jackson, 2001); or one hundred years later, Szasz’s (1977, 2002) clear comparisons between those who are psychiatrically assigned and chattel slavery; and decades after that, the current over-representation of people of color involuntarily involved with psychiatry (Swartz, et al, 2009; Tenney, 2008; The New York Lawyers for the Public Interest, Inc., 2005). Dr. Lieberman’s (2013) language concerning groups, who are oppressed and discriminated against, ought to be railed against. Particularly in light of the intersection of race and disability, it strikes me as a problem that someone with such a position of power could legitimately make such claims and maintain one’s seat at the helm.
Dr. Lieberman (2013) calls the anti-psychiatry movement “relatively small” but clearly we are large enough for him to feel he ought to address it. According to his Twitter page, Dr. Lieberman is the Chairman of the Department of Psychiatry, at Columbia University and the Director of the New York State Psychiatric Institute and the Psychiatrist-in Chief at CUMC-NYPH. Because of some of these roles, I would like to shine light on the work of Linda Andre (2009) and McLain and Christensen (1996) who have highlighted the places where Dr. Lieberman currently presides over.
“I do not overlook the checkered history of psychiatry itself,” wrote Lieberman (2013). The “crude instruments” Lieberman acknowledged included “strait jackets, cold packs, fever induction, insulin shock therapy, and psycho-surgery” (Lieberman, 2013). However, the place of which he is Director, the New York State’s Psychiatric Institute, has been thought to be a leading place responsible for the advancement of the biomedical model.
“It is impossible to chronicle every single accomplishment achieved over the past 100 years at PI,” McLain and Christensen (1996) wrote under a heading, “Milestones in PI’s History,” which included more than a dozen examples of “accomplishments” of human and animal medical research conducted at PI. Hailed for its contributions to the field of psychiatry, these accomplishments of PI included being the earliest institution to conduct genetic research, and ‘medical’ advances including the first to use electroshock. PI also was the first to use of phenothiazines and lithium carbonate. As it is the DSM-5 which is at the heart of Dr. Lieberman’s (2013) blog, it is important to note that McLain and Christensen (1996) pointed out that at least three times prior to 1986, the institution was the hub for the updating of the rulebook of psychiatry, the DSM.
Dr. Lieberman’s joint position as Chairperson of the Department of Psychiatry at Columbia and Director of the New York State Psychiatric Institute ought to have people concerned for multiple reasons, not least of which, the conspiring of state and private entities. This public-private partnership has a long history in New York State, which without challenge is a trendsetter state, so the issues discussed here are not specific to New York. McLain and Christensen (1996) also reported that in 1925, Dr. George H. Kirby was the director of the Psychiatric Institute and he solidified this goal of a joint venture of research, practice, and policy with “an agreement with the new Columbia entity [Columbia-Presbyterian Medical Center] to build a new hospital and an institute.” As part of this agreement, PI moved from Ward’s Island (where Meyer had established its offices in 1902) to Manhattan. Meyer:
“pledged to make the facilities available to staff and students of Columbia’s medical college. Thus, PI became the headquarters of Columbia University’s Department of Psychiatry.” (McLain and Christensen, 1996)
Of course, Dr. Lieberman was awarded the “Adolph Meyer Award” by the American Psychiatric Association. Adolph Meyer (Tenney, 2014), was assessed through an analysis of work done by Grob (1994) and Scull (2005) was one the most dangerous players in the organization of organized psychiatry in the early 20th century. Scull (2005) suggested, “Meyerian psychiatry turned out to be as intellectually empty as its author was ethically blind” (p. 288). The organizers of organized psychiatry knew they had to protect their institution (Tenney, 2014).
Linda Andre (2009) also addressed this relationship between Columbia University and PI, which above, we saw was initiated by Meyer, in 1906. Andre (2009) zooms in on the 1925 marker as a solidification and formalization of the arrangement, which I see as evidence of the organization of State-sponsored Organized Psychiatric Industries (SSOPI) in New York State:
“Nevertheless, as we shall see, P.I. has played a larger role in the selling of electroshock than any other institution in America. This is largely because it is a research facility that has aggressively and successfully sought state and federal funding. More funding equals more publications equals more influence. Although it is a state facility, P.I. has had, since 1925, a unique affiliation agreement with Columbia University’s College of Physicians and Surgeons, which adds immeasurably to its perceived prestige.” (p. 40)
This is crucial evidence of the deliberate organization of organized psychiatry in New York State due to its connections between research, practice, policy, power, and profit—and that these connections did not end in 1907 as PI is still considered a prominent research institution. PI is still a State-Sponsored research institution. McLain and Christensen (1996) report the massive public expenditures directed at PI:
“New York State Psychiatric Institute is among the top institutions in terms of total dollars received from the federal government for medical research and is a leading recipient of grant money from the National Institute of Mental Health.”
Most recently, Dr. Lieberman twittered a picture of himself and three other tuxedo-wearing men at what seems to be the “Crown Awards” with the tweet, “defining the future of #genomic #medicine @Columbia @ColumbiaPS @drjlieberman “ (@drjlieberman, 5 December 2014). Because of this reconnection to genetics through his hashtag, #genomic, it is interesting to note that in a listing of selected accomplishments of the New York State Psychiatric Institute list as the second major milestone in PI’s history:
“Recruitment of the first psychiatric geneticist (Dr. Franz Kallman) in the United States, who conducted the first genetic studies of schizophrenia.” (McLain and Christensen, 1996)
Torrey and Yolken (2010) wrote:
“The systemic sterilization and killing of individuals with schizophrenia in Nazi Germany from 1934 to 1945 was influenced by several factors. Perhaps of greatest importance was a belief that schizophrenia was a simple Mendelian inherited disease, passed down from generation to generation. In Germany, this theory was promoted by Drs. Ernst Rudin and Franz Kallman, among others.” (p. 26)
Torrey and Yolken reported that Kallman, who became known for his studies of twins to find genetic roots of schizophrenia, was “a student of Rudin” (p. 26). Torrey and Yolken suggested that:
“In a 1935 speech, Kallman advocated the examination of all relatives of individuals with schizophrenia to identify nonaffected carriers, which he believed could be done by noting ‘minor abnormalities,’ and then the compulsory sterilization of such individuals. A year later he emigrated to New York, where he continued his twin research and later became one of the founders of the American Society of Human Genetics.” (p. 26)
I can go on, and in fact, in (de)VOICED: Human Rights Now (2014) I do go on for more than 600 pages. For now, I will leave off that Dr. Lieberman and I do have something we share. We both, as he wrote, are “amazed by the debates surrounding the DSM-5” (Lieberman, 2013). It does amaze me that an entire profession, which still gears itself with the authority of those ordained as leaders, as did Adolf Meyer one hundred years ago (Tenney, 2014), can get away with continually proposing that they are operating with facts and science when at best they have a creative, highly lucrative fiction.
Brava, anti-psychiatry for holding light to the issue of requiring evidence.
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