In the 1960s, a movement called “antipsychiatry” (prompted in Britain by R. D. Laing and in the U.S. by Thomas Szazs) questioned the basic assumptions about mental illness and its treatment. Not only psychiatry, but methods popular earlier in the twentieth century, such as the prefrontal leucotomy, electroconvulsive therapy (ECT), and insulin coma therapy, lay thoroughly discredited. The anti-psychiatrists encouraged treating the patient as a whole person, putting his “madness” in the social and environmental context. Unfortunately, with the passage of the counterculture the medical establishment returned with a vengeance to explaining mental illness strictly as a manifestation of physical disorders of the brain and treating it with particular medications.
Dr. Richard P. Bentall, professor and practitioner of clinical psychology in Britain, who earlier wrote Madness Explained: Psychosis and Human Nature (2003), exposes the highly dubious nature of reigning presumptions about the causes and treatment of mental illness. He favors the “recovery-oriented, autonomy-promoting” model, particularly cognitive behavioral therapy, over the “paternalistic-medical” model, which favors reductionist diagnosis, genetic causation, and reliance on drugs to correct so-called “chemical imbalances.” Bentall explores why the biomedical approach has become dominant, instead of a social approach to madness, which was gaining traction in the 1960s. There is little evidence to show that psychiatric drugs are effective in the long run; by making spurious connections between damaged brains and drugs alleged to overcome such disfigurement, the medical profession ignores better treatment options.
Some buzz in Britain about a book we’re bringing out here in the fall…
Richard Bentall, a clinical psychologist, is a controversial figure in the field of mental health. An example of the hostility that his conclusions provoke among those practising conventional (that is, drug-based) psychiatry is given in the preface to this book, which raises serious questions about the treatment of mental illness. Bentall describes an encounter with an amiable-seeming psychiatrist who responds to a talk he has given as follows: “Professor Bentall has told us he is a scientist. But he is not! Nothing that Professor Bentall has said – not one single word – is true.”
he unlikelihood of a professor of psychology delivering, in the sober environment of an NHS conference, a talk in which every word is fictitious and every opinion fallacious gives a flavour of the threat that Bentall’s theories pose. The response, as reported, sounds deranged and it is interesting to observe how debate among professionals over the causes of mental illness appears to induce its own version of madness, as if the topic itself were contagious. One sign of sanity, both in the individual and society, is the ability to deal with dissent.
In an earlier book, Madness Explained, Bentall was at pains to distinguish his approach from other anti-psychiatrists – for example, RD Laing, whose radical views were discredited because of his flamboyant lack of rigour and attendant inability to accept criticism. Bentall, as this book attests, is a different kettle of fish. With patient persistence and without recourse to rancorous diatribes, he has appraised the scientific evidence for the success of contemporary psychiatric treatments and come up with a dismal report. It is probably the very balance of his approach that drives his opponents crazy.
Doctoring the Mind is an attempt to clarify the dense array of evidence offered in Bentall’s earlier work. The result is a much easier read. It is also, for that reason, more disturbing. Other recent books (Lisa Appignanesi’s Mad, Bad and Sad, for example) have also traced the dark strains of misperception, mismanagement and downright cruelty in psychiatry’s chequered history, but Bentall’s achievement is to focus on contemporary psychiatric practices, especially those dedicated to treating serious psychoses (his own area of expertise).