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Submitted by stuartjordan on Mon, 05/10/2009 - 14:38

There is a difference between being "anti-science" and being critical of the scientific technologies that are developed under capitalism. A Marxist ecology recognises that capitalism, with its control over the "general intellect", develops capitalistic technologies. The car, the television, the cluster bomb, the nuclear power station and alot psychiatric medication would all fall into this category. They are technologies that further capitalist hegemony and would not have developed under a democratically controlled economy. Wholesale cheerleading of all things scientific is not the correct Marxist position. Instead we need a third camp position "Not capitalist technology, not caveman technology, but international proletarian science!"

That said, the scientific basis of psychiatry is highly dubious. Psychiatrists no longer believe that they will ever find a biological cause for mental illness. They accept that medication alone cures nothing. There is no physical test that will reveal that someone is schizophrenic or depressed. To get a diagnosis of schizophrenia you have to have suffered from one of three loosely defined symptoms (thought disorder, hallucinations, delusions) for over one month. If the same standards were applied to cardio-vascular problems, we would see half the population puffing on asthma inhalers whilst thousands died needing heart surgery. Psychiatry does not even know what schizophrenia is, let alone has any idea how to cure it.

My criticism of psychiatry is not an attempt to downplay the suffering of people experiencing mental health problems. Also, I am not wholly against the use of medication. To an extent, the majority of us self-medicate using alcohol and street-drugs. Psychiatric drugs are just another factor in our environment that may help us get through the day. The use of drugs tends historically to go in waves and we seem to be reaching a bit of a climax at the moment. Similarly, some commentators speak of the second age of depression where we will see suicide rates increase. Put crudely capitalism is making us sick and we're popping whatever pills we can get our hands on to numb the pain.

Although far from ideal, Tom is right to say medication is not bad per se. However, I do oppose the forced administration of this medication and the hegemonic status it wields over other means of recovery. Tom rightly comments that I shouldn't equate madness and criminality, however, people with mental health problems are treated like criminals. This is why psychiatric abuse is fundamentally different from the abuse that is seen in other parts of the public sector - it is systemic.

The question of recovery cannot be separated from the social context and the doctor-patient power dynamic. Mental illness cannot be found inside the individual, rather it manifests in social relations. As Marxists we don't believe in souls, we don't distinguish where one human being starts and another begins. We see the individual in a myriad web of relationships, dialectically creating and being created by the world. Similarly, people do not simply have a mental illness, rather they relate to an experience of mental illness (usually an experience that they find terrifying and inexplicable). The ways in which mental illness is related cannot be separated from the social context. At the moment that social context is littered with state-sponsored violence, stigma and forced medication. Recovery depends on the individual having a more healthy relationship with the world, and this inevitably involves a better relationship to their illness.

What would a socialist approach look like? I spoke in the last article about "bridging the gap between madness and sanity". There is a common misconception that mental illness is something completely separate from people's everyday experience. The mad person is an alien who needs to be locked up and restrained. A better approach would see mental illness as something that lies at the extremities of human experience. A socialist approach would seek to discover *how* people relate to these experiences and what could change socially to aid recovery. I am not suggesting that these experiences should be 'embraced', rather the experiences should be taken seriously. We should recognise our own ignorance as mental health workers and reject stigmatising ideology. I would advocate listening carefully and solidarising with the user/survivor movement and looking to the example of the Democratic Psychiatry movement in Italy in the 70s. This coalition of patients, nurses, communists and psychiatrists managed to repeal the laws imposing forced treatment and locked wards. Such a struggle would form the basis of a psychiatric system founded on human solidarity rather than coercion.

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