The anti-psychiatry movement resembles the anti-vaccine movement and HIV/AIDS denialism in many ways. Whereas anti-vaccine cranks claim that vaccine-preventable diseases are not that bad and HIV/AIDS denialists often deny the causal link between HIV and AIDS, anti-psychiatry cranks typically deny the existence of mental conditions outright (claiming they are made up or that they are “natural” states) or blame the individuals for “attracting” the illness into their lives with “too much negative thinking”. All three groups attack the underlying scientific models (e. g. mechanisms for vaccine-induced immunity and herd immunity, that HIV cause a reduction in CD4+ T helper cells, the biological basis and neurological mechanisms of mental conditions), the efficacy of the medical product, pharmaceutical companies, the government and the scientific community.
This post is an attempt to summarize seven of the most common clusters of characteristics, beliefs and approaches taken by various types of anti-psychiatry cranks: the creationist, the alt med zealot, the new age ignoramus, the “sophisticated” mysterian, the selective “skeptic”, the conspiracy lunatic and the scientologist. These archetypes are not based on published scientific studies, but rather on experience with debating anti-psychiatry cranks. Some of them overlap and not all features of a given archetype always occur. An interesting observation is that anti-psychiatry can be found across political, religious and philosophical spectra and divides. Even though a lot of the assertions made and rhetoric deployed is consistent across archetypes, different archetypes have different motivations and a slightly different focus.
The Creationist: the anti-psychiatry creationist represents the worst of two worlds: both a rejection of modern cosmology, geology and biology as well as a rejection of modern neuroscience, psychology and psychiatry. These individuals reject psychiatry and related fields because (1) neuroscience considers the mind to be a function of the brain, which is incompatible with the anti-psychiatry creationist’s faith that an immaterial soul is the entity responsible for the mind and (2) treatments of mental conditions does not involve a consideration of original sin, but focuses on medication and therapy. Although not all creationists are anti-psychiatry, those that are reject additional fields of science in order to keep their religious beliefs afloat. Depending on the individual anti-psychiatry creationist, he or she may reject the existence of mental conditions as medical conditions or go so far as to provide a religious description of mental conditions as demonic possessions or gifts from a deity.
The Alt Med Zealot: the alt med zealot embraces anti-psychiatry because he or she wrongly believes in the efficacy and safety of so-called “alternative” treatments for mental conditions. In reality, these alleged “treatments” are quackery and almost never gives any practically significant benefit above placebo. Most of the time, these individuals accepts the medical reality of mental conditions. However, they tend to shuns positions supported mainstream science, usually by ignorantly dismissing it all by shouting about “evil, multinational pharmaceutical corporations” (apparently without realizing the irony that a lot of “alternative medicine” is being produced and sold by large corporations) and accusing all critics of their beliefs of being pharma shills.
The New Age Ignoramus: although sharing many defining features with the alt med zealot, the new age ignoramus often parrot the law of attraction and wrongly claim that individuals with mental conditions have themselves to blame because they allegedly had too many negative thoughts. Seemingly ignorant about the scientific research on genetic risk factors for mental conditions, the effects of stressful life events and gene-environment interaction, the new age ignoramus rarely accept the medical reality of mental conditions. Instead, they often reject both medication and therapy, suggesting that individuals with mental conditions will attract good things in their life if they just have more positive thoughts.
The “Sophisticated” Mysterian: mysterians are typically non-religious atheists who has a negative visceral and emotional response to the notion that their beliefs, thoughts, feelings and so on are related to the function of a physical brain. The three most common approaches taken by this anti-psychiatry archetype is (1) Appeals to ignorance characterized by “we will never understand human cognitive feature X” were X is love, art appreciation, beauty, consciousness and so on, (2) point out some methodological limitation regarding questions of how the brain generates the mind in an bait-and-switch effort to attempt to undermine the scientific conclusion that the brain does generate the mind and (3) unrelenting accusations of “scientism”, “reductionism” and “determinism”. Mysterians are not seldom freelance journalists blogging for Nature News, Scientific Americans, Washington Post or the New York Times.
The Selective “Skeptic”: these are self-described “skeptics” who mock anti-vaccine cranks and HIV/AIDS denialists for their flawed assertions and dishonest debating tactics (like misunderstanding basic science, quoting scientists out of context, creating a manufactroversy, false balance, playing the martyr card, misusing statistics and so on), yet has no problem using these exact pseudoscientific tactics when attacking psychiatry. Pointing this out is not sufficient to break the bubble of cognitive dissonance and will usually be met with rationalizations and denial. Published scientific evidence in favor of psychiatric models and treatments are met with extreme skepticism, whereas random blog posts online that attacks psychiatry is often accepted with little skepticism.
The Conspiracy Lunatic: this anti-psychiatry archetype is essentially a misguided freedom fighter stuck in Soviet Union of the 1960s. The conspiracy lunatic thinks that all mental conditions are supposedly without any foundation in reality and allegedly invented by evil psychiatrists in collusion with the government and/or pharmaceutical companies. All treatments are believed to be a form of human enslavement. Medication is allegedly used either to brainwash people or keep them pacified while the government, banks or alien reptiles take over the world. Involuntary psychiatric treatment is seen as kidnapping and imprisonment of dissenters instead of a way to protect a person who is at high risk of serious harm or death. ECT, a last-resort treatment given to individuals with severe and treatment resistant depression when all else fail and the life of the person hangs in the balance, is wrongly seen as cruel punishment (despite the fact that individuals undergoing that treatment are given general anesthesia and a muscle-relaxant and that brain scans show that brain damage does not occur).
The Scientologist: this anti-psychiatry archetype is associated with scientology, but it shares many core features in common with the other six archetypes. This is presumably because of the early and close historical links between the two movements. Some scientologists consider themselves at war with psychiatry: they believe that mental illness is a fraud and thinks that psychiatrists are crime-causing terrorists who kidnap, torture and murder innocent people.
Although not empirically validated by any means, these archetypes are useful representations of some of the common themes and clusters of ideologies that defenders of mainstream psychiatry come across when refuting mental illness deniers and anti-psychiatry proponents.
Overview of Anti-Psychiatry
Lieberman, J. A. (2013). DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice. Scientific American Mind Guest Blog. Accessed: 2013-08-07.
The Debunking Anti-Psychiatry Category on Debunking Denialism.
Steven Novella’s excellent series on mental illness denial.
Mieszkowski, K. (2005). Scientology’s war on psychiatry . Salon. Accessed: 2013-08-07.
Safety and Efficacy of ECT
Abrams, Richard. (2000). … and there’s no proof of lasting brain damage. Nature, 403(6772), 826-826.
Devanand D.P., Dwork A.J., Hutchinson E.R., Bolwig T.G., Sackeim H.A. (1994). Does ECT alter brain structure? Am J Psychiatry. 151(7):957-70.
Fink, Max. (2000). ECT has proved effective in treating depression … Nature, 403(6772), 826-826.
Giltay, E. J., Khol, K. H., Blansjaar, B. A. (2008). Serum markers of brain-cell damage and C-reactive protein are unaffected by electroconvulsive therapy. The World Journal of Biological Psychiatry, 9(3), 231-235.
Lilienfeld, Scott O., Lynn, Steven Jay, Ruscio, John, & Beyerstein, Barry L. (2011). 50 Great Myths of Popular Psychology: Shattering Widespread Misconceptions about Human Behavior. West Sussex: Wiley-Blackwell.
Mayo Clinic. (2012). Electroconvulsive therapy (ECT). Accessed: 2013-08-07.
Palmio, Johanna, Huuhka, Martti, Laine, Seppo, Huhtala, Heini, Peltola, Jukka, Leinonen, Esa, . . . Keränen, Tapani. (2010). Electroconvulsive therapy and biomarkers of neuronal injury and plasticity: Serum levels of neuron-specific enolase and S-100b protein. Psychiatry Research, 177(1–2), 97-100.
Reisner AD. (2003). The electroconvulsive therapy controversy: evidence and ethics. Neuropsychol Rev. 13(4):199-219.
Zachrisson, Olof C. G., Balldin, Jan, Ekman, Rolf, Naesh, Ole, Rosengren, Lars, Ågren, Hans, & Blennow, Kaj. (2000). No evident neuronal damage after electroconvulsive therapy. Psychiatry Research, 96(2), 157-165.