Sociology of Psychiatry

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Thomas Szasz (1920-2012) and Michel Foucault (1926-1984) are widely considered as the key figures when discussing contesting perspectives on modern psychiatry. Similarities can be drawn between Szasz and Foucault in general terms, in that they both believed that psychiatry was a product of pseudo-science. Both have criticisms on the limitations of psychiatry. Thomas Szasz, a psychiatrist, academic and author, has been a foundational figure for those who are strongly opposed to modern psychiatry. His views and ideologies came into prominence in the spirit of the 1960s counter-cultural movement, with the questioning of the role of psychiatry as merely a social control mechanism. As a psychiatrist himself, he is also widely criticised for his antagonistic approach to his own field of practice. Bracken and Thomas (2010) are strongly critical of the use of binary distinctions in his work and its lack of sensitivity and its rigidity in terms of how mental health is understood. Michel Foucault, on the other hand, was a post-structuralist and sociologist. His role as a post-structuralist was evident in the anti-psychiatry movement, where his primary concern was on relations of power and how almost all aspects of modern psychiatry relate back to power, or ‘disciplinary power’. He also concentrated profoundly on the history of psychiatry, in what he refers to as ‘archaeology’ – a historical examination of how certain ideas came to be accepted as true. Bracken and Thomas (2010) offer us a framework of both Szasz’s and Foucault’s key concerns in relation to modern psychiatry. They ask the question ‘Does medicine have a legitimate role to play in relation to madness and distress?’ What is compelling about their analysis and criticisms is that they are also trained practitioners in the field of psychiatry; this gives us greater insight into how anti-psychiatry is interpreted by those who practice it. To a large extent, they are more in favour of the Foucauldian approach, which is considered more flexible in terms of how psychiatry can be examined. In this essay, I hope to discuss the contrasting ideologies of Szasz and Foucault and their critical thoughts in psychiatry in relation to aspects such the enlightenment, biomedicine and psychotherapy. In my analysis, I also hope to exemplify how the theories and concepts of both thinkers can be interpreted into modern discourse and in the future of modern psychiatry.

Szasz and Foucault’s attitudes on Mental Illness and the Enlightenment Central to Szasz’s critiques and theories is his rejection of the existence of mental illness through biomedical practices and the true meaning behind human suffering and its representation in modern psychiatry and state-regulated health practices, namely the distribution of medication to mental patients and the issue of institutionalization. Szasz points out that up until the 19th century, (pre-enlightenment), the treatment of mental suffering and emotions did not have a place in society as a medical practice, and as the practice of religion declined throughout this era ‘theological coercion was replaced by psychiatric coercion’ (Szasz 2007). He also argues that the labelling of ‘schizophrenia’, ‘manic depression’ and ‘bipolar’, which in today’s society are becoming increasingly conspicuous, was not based on any medical discovery but only on medical authority and political decision-making (Szasz 1989). Szasz does not dispute the existence of ‘mental suffering’; rather, he denies that it is a ‘disease’ and that psychiatry is best placed to treat it. He demonstrates to us in many of his works that the term ‘mental illness’ is typically affixed to social constructions of misbehaviour, rather than a disease of the brain or a problem with our bodily functions, which are commonly understood to be pathological (Szasz 1989). Bracken and Thomas (2010) suggest that this approach is perhaps limited - as psychiatrists, from experience and practice they are of a more...
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