The attack of psychiatric legitimacy in the 1960s: Rhetoric and reality

Abstract

During the 1960s there was a sustained attack on psychiatric legitimacy. Thomas S. Szasz was the most vituperative and best-known critic, but he was by no means alone. Individuals and groups from both extremes of the political spectrum were united in their belief that psychiatry was not a legitimate medical specialty, but one that was devoted to protecting its authority as well as enforcing societal norms associated with an unjust society. The attack on psychiatry, of course, did not occur in a vacuum; numerous social and intellectual currents played major roles. To comprehend such attacks and their consequences requires an understanding of the larger societal context as well as the changes that transformed psychiatry in the post-World War II years.

Introduction

“…In Europe and the USA, psychiatry's hegemony over mental illness was increasingly challenged from the 1950s by deinstitutionalisation, attempts to extend patients' legal rights, the expansion of new counselling and psychotherapy services, and the intellectual critiques of the antipsychiatry movement. 59 In the USA, the crisis facing psychiatry created the conditions in which psychiatry moved from an environmental and behavioural model of mental illness to that of the biological, symptom-based classificatory scheme represented by DSM-III. This 'revolution' in psychiatry, according to Rick Mayes and Allan V. Horwitz, was couched in the language of 'objectivity, truth, and reason'.…”

Theorizing the Deep Parallel between Goffman and Freud: Goffman's Interaction Order as a Social-structural Underpinning of Psychoanalytic Concepts of the Self

“…Manning's interpretation not only sees an "empty self" in Goffman, but he, like many others across a wide range of disciplines interprets Goffman's work as "anti-psychiatric" (Bass 2007;Grob 2011;Gronfein 1999;Mac Suibhne 2011;McHugh 1992;Prager 1998;Riesman-Oelbaum 1972;Rothman 1991;Scull 1986;Sedgwick 1982;Siegler and Osmond 1971;Spruiell 1983, Weinstein 1982, 1994). Manning's interpretation is of particular interest, since he sees Goffman's critique of psychiatry as a critique of psychoanalysis (Manning 2003(Manning , 2005(Manning , 2006.…”

A Tricky Object to Classify: Evidence, Postpartum Depression and the DSM‐IV

“…There were also challenges from the proponents of the antipsychiatry movement, which emphasized the negative aspects of psychiatry's social control function. Many antipsychiatrists argued that the psychodynamic concept of a fluid boundary between health and mental illness meant that psychiatric diagnoses could easily be used as a political tool to manage individuals who were considered social deviants (Double, ; Grob, ).…”

“…In the late 1960s, the psychodynamic approach in the United States was challenged by individuals within and outside of the profession (for a detailed history see Grob, ). One attack from within the profession of psychiatry was grounded in the argument that a lack of progress in research about mental illness had resulted in what, some psychiatrists thought to be, a lack of progress in treating mentally ill patients (Wilson, ; Mayes & Horwitz, ).…”