The Antipsychiatry Movement: Dead, Diminishing, or Developing?

The original antipsychiatry movement was supported by cultural critiques of psychiatry in the form of shocking fictional accounts of mental hospitals and psychiatric treatment, most notably Ken Kesey’s One Flew Over the Cuckoo’s Nest (11). Although in recent times novelists have not seized upon psychiatry with comparable rancor, investigative journalists have examined psychiatry from the vantage point of skeptical outsiders. Two recent books that are highly critical of common psychiatric practice have stirred much response by the media, the psychiatric profession, and the general public. In Crazy Like Us (12), Ethan Watters contends that American psychiatry might actually have erroneously exported its notions of certain mental illnesses, such as posttraumatic stress disorder, to places where they were not recognized as pathologies. Also exported, he argues, are Western modalities of treatment accompanied by Western clinicians and instructors trained in Western models. According to Watters, this process not only introduces new notions of illness to these communities but also destroys indigenous, locally effective modalities of healing.

In Anatomy of an Epidemic (13), Robert Whitaker introduces a different—but similarly critical—thesis tracing the history of psychopharmacology in the U.S. and focusing particularly on a comparison of long-term and short-term outcomes. He concludes that there is very little evidence of the long-term efficacy of pharmaceutical interventions for almost all major mental disorders. In fact, he argues vociferously, these interventions have serious iatrogenic effects that are deliberately overlooked or ignored by many within mainstream psychiatry. These investigative journalists have become highly sought after speakers and commentators, and their critical message reaches disparate audiences.

Most lateral, scholarly, or internal critiques of psychiatry, much like the original antipsychiatry movement, argue for reform and rational reconsideration of common practice on the basis of better empirical studies and more reasoned theorization. However, many examples of grassroots, bottom-up activity can be considered indicative of a more radical form of grassroots antipsychiatry. A notable example of this activity is the mushrooming of citizen Internet activists who devote blogs, Web sites, YouTube channels, and Facebook pages to a critique of psychiatry and psychiatric practices, particularly psychopharmacology. For example, a search of YouTube reveals videos such as “Psychiatry Exposed!” (123,000 views), “Zoloft Made Me Feel Like a Zombie” (55,000 views), and “Things You Do Not Say to a Psychiatrist” (30,000 views). Blogs, such as “Beyond Meds,” have received over 1.5 million hits.

Although there has been little systematic research on this topic, a cursory glance at such blogs and videos suggests that most are vociferously critical of mainstream psychiatry. The comments left by viewers and readers are similarly critical. For example, according to two YouTube video comments, “psychiatrists are beyond brutal and have no conscience” and “the most we can hope for is that [psychiatrists] be exposed and brought to justice in our lifetime.”

It is difficult to imagine similarly angry comments being said about, for example, cardiologists, pediatricians, or other medical professionals. The Internet has given a means for current and former psychiatric patients, who sometimes refer to themselves as “survivors,” to widely disseminate often negative attitudes, beliefs, experiences, and opinions vis-à-vis psychiatry. Such a forum for widespread dissemination—and, indeed, organization—was unavailable to previous generations of patients.

Members of the Church of Scientology, who were an integral part of the original antipsychiatry movement, remain active in opposing the very institution of mainstream psychiatry. They are the driving force behind the Citizens Commission on Human Rights, which continues to produce widely disseminated documentaries that are made more readily available to the masses by YouTube and other social media. These include Psychiatry: Industry of Death, How Psychiatric Drugs Can Kill Your Child, and Making a Killing: the Untold Story of Psychotropic Medication. Furthermore, Scientologists continue to regularly confront aspects of psychiatry in the media, in the courtroom, and even in person, notably by organizing demonstrations at the American Psychiatric Association’s annual meetings. They also bankroll a Los Angeles museum called Psychiatry: Industry of Death, probably the only museum in the world dedicated to attacking a medical specialty.

Together, the various disparate activities depicted in this Open Forum characterize a surge in critical thinking regarding mainstream psychiatry. Critics express widespread concern at certain aspects of mainstream psychiatry, commonly demanding significant reform in several domains. Most notably, this concern focuses on psychiatry’s expansionist—some would say medicalizing or imperializing—tendencies as well as its heavy reliance on pharmacological interventions and the many adverse side effects associated with them.

The reliance on medications is also criticized because of the shadowy relationship that is perceived to exist between psychiatry and the pharmaceutical industry. This meta-observation has been shared by others outside the discipline, notably the physician Marcia Angell, a former editor of the New England Journal of Medicine, in supportive reviews of books by Whitaker, Carlat, and Kirsch (14,15).

The upcoming release of DSM-5 will garner much media exposure and popular interest in psychiatry. This attention may act as a clarion call for the consolidation of the disparate islands of activity that are variously critical of mainstream psychiatry. Though the tarnished name of antipsychiatry is studiously avoided by all, a renewed yet amorphous critique of psychiatry may be developing that is quite distinct from its supposed successor, the patient-based consumer movement. Although not a resurrection of antipsychiatry per se, the critiques described earlier, while not yet a movement, share many of the original concerns raised by the antipsychiatry movement. Perhaps Rissmiller and Rissmiller (3) were premature in announcing antipsychiatry’s transmogrification. Only time will tell.

The author reports no competing interests.