A Somewhat Ironic Take on The Context of Psychiatry

Madness Exalted

Madness exalted, if not explained : Written by Miranda Arkwright (Mad and Proud).

I was fascinated by a recently screened programme on BBC2, entitled “The Trap: What Happened To Our Dream of Freedom?” screened on 11th March, and the first part of a three-part series. It told the story of how, in the last 60 years or so, Western society’s own position on its freedoms has been reconstructed, and this was brought about by a redefinition of the way in which relationships and the human heart operate. Ideas about how to produce and maintain Cold War stability ricocheted through society to induce constraints on freedom for everyone.

During the Cold War, the USA and Russia came to a stand off against each other by way of the progressive development of game theory by John Nash and its application in the USA by political theorists. Nash said that self-interest produces social stability through mutual suspicion; it doesn’t lead to chaos but to a stand off position. (Nash turned out to be schizophrenic, so he would say things like that!). He gave an illustration of how his theory worked using his version of something called the ‘Prisoner’s Dilemma’. If a released prisoner (presumably a convicted thief) came into the possession of a valuable diamond, and wanted to sell it on to a dealer to convert it to cash, he would be in a position of needing to trust the dealer enough to meet with him and get the money whilst risking something untoward happening, like the dealer producing a gun on him and killing him for the diamond. The prisoner’s paranoia gets the better of him, and he arranges for each party to bury their booty in two separate fields, hundreds of miles apart. They would then get in touch to swap details of the secret locations. Nash explained that the only way for the prisoner to win in this situation would be to distrust the dealer and double-cross him by keeping the diamond and heading off to collect the cash. If it turned out that the dealer really was trustworthy, he was quids in, but if the dealer was also a double-crosser then he had lost nothing. If the prisoner had blindly left the diamond in the field, he could have lost everything. Thus the USA and Russia could never completely disarm, because they could never completely trust one another.

The programme goes on to explain how the happy days of believing that the driving force behind the motives of human actions is something noble and uplifting, like altruism, were headed for decline. Nash’s new interpretation of the way in which relationships oil the wheels of society filtered down to the mind of the man on the street via politicians and academics.

Of particular note in this respect is the career and mission of one R D Laing (psychiatrist). Laing began working in a mental hospital in Glasgow in the 1950’s. Whilst there, he observed schizophrenics and noted that psychiatrists and other hospital carers never spoke to their patients. He chose 12 patients to get to know about their lives, and treated them to the human touch. After 12 months, all twelve were out of hospital and sent home. A year later, they were all back in hospital. Laing concluded that the family and its interactions were the root of the schizophrenic’s problems. He conducted experiments by developing questionnaires to find out what various individuals thought were the motivations behind the actions of other family members. He computed the answers after converting them to codes, and concluded that normal family relationships were stabilised by a balance of suspicion and power as forecast by Nash’s game theory.

Laing became counter-cultural, saying we need to break away from all the social constraints brought about by the establishment and its institutions, which separate us from our freedom. Laing’s views became popularised on both sides of the Atlantic, as he juggled being a psychiatrist with authoring books and making TV appearances. His counter-cultural revolution claimed that there is no such thing as altruism and working for the public good, especially in institutions and government.

Laing further went on to be instrumental in forming the anti-psychiatry movement, which desired to help patients and society to be free from what it saw as the social control methods of the psychiatric establishment. He went to the USA to try and bring about what he believed was change for the better, but ended up having the opposite outcome from what he intended.

Instrumental in this situation were the actions of one notable anti-psychiatrist, David Rosenham, who devised what came to be called the “Thud Experiment”. Eight people from the new movement, including him, all went separately to different mental hospitals across the USA. Their aim was to see whether psychiatrists really could tell the difference between sanity and insanity. The volunteers presented themselves to emergency psychiatric units saying that they had been hearing a voice in their head repeating the word “thud”. That was the only lie they were to tell, and from then on they were to act completely normally. All 8 were admitted; seven diagnosed with paranoid schizophrenia, one as a manic depressive. Rosenham described his own experience of being detained for months despite protestations. The only way to get out was to capitulate and agree with his given diagnosis and then go on to pretend to get better.

When Rosenham got out and publicised his experiment, there was uproar from the psychiatric profession. The gauntlet was laid down to Rosenham that he could send back more impostors and the psychiatrists would root them all out. After Rosenham took up the challenge, forty-one impostors were discharged. Rosenham revealed that none had been sent!

The profession was thus exposed as lacking the specialist abilities it had long been revered for. The backlash at the time, to validate its existence and value, was to produce new categories of mental illness diagnosable through simple questionnaires. People with no formal training could use them, and all across the United States media campaigns were waged to raise awareness of mental illness, for example, National Anxiety Day. Following a sizeable response, these questionnaires revealed that 50% of Americans were ‘shown’ to have some sort of mental disorder that was previously undiagnosed.

This led to the social acceptability of having a psychiatric condition. The notion of self-diagnosis was popularised along with the promulgation of the ‘ideal’ of what the human condition should be like. Everyday people proceeded to self-diagnose and then present themselves to psychiatrists to be ‘fixed up’ to society’s ‘norm’.

Thus Laing’s goals became wrong-footed, and society disappeared down its own navel. And all because a suffering schizophrenic was gifted enough to put his alternative views across. Now that’s madness for you!

Afterword

My personal take on the morals of this tale is that psychiatrists don’t always judge things rightly, people can be too easily led by mass media, and genuinely mad people like me are quite possibly the only people of real talent, even if our views on life can be quite hard to handle and may require careful interpretation. At the end of the day, we all have our problems.

Written by Miranda Arkwright (Mad and Proud).