PBM makes a very long, detailed and strong-sounding case about the dangers of psychiatry and the necessity of its dissolution.
Were the purpose of the book to critique psychiatric practice for the purposes of improving it, lobbying for safeguards, different standards, etc. a series of carefully documented anecdotes, thematically joined, would suffice.
Yet, the goal is far more audacious—to logically prove that psychiatry is fundamentally and irrevocably flawed. This is a tall order, impossible perhaps. Why take that step? The only conclusion I can draw is that it’s less about the noble pursuit of truth, and more about gaining converts to the antipsychiatry movement. The more the better, and especially those who are the most militant in their convictions that psychiatry is inherently wrong and must be defeated. People reading a mountain of evidence may be persuaded, yet open to the idea that there might be another side to things. But if it’s logically proven—well, there’s no room for doubt!
Let me highlight four manipulative techniques that are used to great persuasive effect in PBM: veneer of credibility, suppressed evidence, appeal to conspiracy theories, and obscuring logical fallacies within volumes of examples.
Veneer of credibility
PBM is a large academic book. It adopts a generally appropriate academic tone, though the neutral stance is frequently supplanted by the unmistakeable passionate activist trying to restrain herself. It strings together what appear at first glance to be logical and coherent arguments. There are lots and lots of references.
The investigation into psychiatry proceeds via a formal mechanism, the institutional ethnography (and who could criticize the work if they are not familiar with that methodology?) that separates observations from bias. It relies on multiple other theories drawn from feminism, political science, social justice, phenomenology, discourse analysis, indigenous and environmental schools of thought, etc. Jargon from these disciplines is sprinkled liberally throughout.
Odd choices for a book that’s designed to appeal to the masses. But really, just the existence of the book, having the form of serious academic research, is enough. After all, if you’re reading a book or paper, do you really follow up and read the references, to see what they actually say? They sound credible; good enough.
Suppressed evidence
There are a lot of references, but almost all to the same group of works and authors you’ll find in many antipsychiatry books. Despite the dozens if not hundreds of mental health and neuroscience journals with hundreds of articles each, thousands of books, etc., you will find very few references to them here. The supporting material is specifically selected to reinforce the author’s viewpoint.
That’s not necessarily a bad thing if you’re building up a set of examples to advocate for change in a discipline. But if you’re looking to eradicate an entire discipline, a higher standard, and certainly greater attention to alternative points of view, would be in order.
Cherry-picking references in this matter, from the antipsychiatry “echo chamber” provides a nicely encapsulated, closed circle of information that appeals to the intended readers’ confirmation biases (i.e. they think psychiatry is bad, and this just confirms it). It’s one sided, and it’s used to persuade, and to remove the possibility of doubt, not to inform.
Critics are neutralized and dismissed in a pro forma manner. Practitioners are automatons so enmeshed within the dominant system that they cannot see beyond the next drug company kickback in front of them. Patients who claim they have received benefit from medications have simply been “subdued” by their medications.
This, from a book that identifies its specific contribution is that “it elucidates and ‘maps’ the institution as a whole” [italics added].
Appeal to conspiracy theories
A reasonable argument can be made (and at times is made) for various biases of psychiatrists, researchers, pharmaceutical companies. There are documented examples where psychiatry has been used as a means of punishment or coercion by state or other actors. Yet, the extent to which this appears to actually occur according to PBM is truly breathtaking (again, using specific examples, but lacking evidence of the extent to which it occurs). The terminology throughout, e.g. “regime,” or “madness industry,” only emphasizes this.
When most actors are assumed to be motivated by malicious and nefarious reasons, we’ve gone past a healthy concern for bias and into the realm of serious broad-based conspiracy theories, which of course appeals to those who are most fanatical and tend to traffic in conspiracy theories. It also weakens any doubt or resistance in terms of accepting arguments and evidence that are presented.
It’s hyperbole at best, blatant manipulation at worst. What it certainly is not is a massive all-encompassing government and/or Big Pharma conspiracy.
Logical fallacies, obscured by examples
The most obvious evidence of departure from rigorous academic work is the blatant reliance on logical fallacies to “prove” the rather more extreme positions. Or to put it another way, key arguments, intended to show the inherent flaws of psychiatry as an entire discipline, are completely bogus.
Suppressed evidence is one example of a type of fallacy carried throughout the book. The fallacies of composition and overgeneralization (i.e. one part is bad so the whole thing is bad) are frequently encountered as well, including with respect to conspiracy theories. Several rather incongruous definitions of terms form the foundation for other arguments. There are a multitude of others. The next sections will detail the flaws and fallacies of several of the key arguments, highlighting the ways in which arguments are incorrectly constructed.
It’s not surprising of course to find significant logical fallacies at the heart of claims that an entire discipline is logically flawed.
If these logical flaws stood alone, they would perhaps be more obvious. They are, however, presented in a way that is intended to obscure their simplicity. First, the incorrect logical argument is made, as a “preliminary” step, though the full intended conclusion is already contained. Then, a large number of examples, references, and explanations are appended, thematically related to the argument, to highlight the horrible practices, abuses, biases, violations, and so on (and yes, the Nazi comparison’s come quickly).
While the examples do not provide additional logical support to the argument already made, they do their best to portray psychiatry and its practitioners as horrible people committing horrible acts, to the point that the reader would believe there is no level they would not stoop to, and so have no doubts as to the veracity of the earlier argument.
Yet, painting psychiatry as “the bad guy” via a seemingly endless stream of selective examples (in effect, “induction by attrition”) does not meet the standard of logical proof that PBM has inexplicably set for itself.
Summary
If PBM, and antipsychiatry writing in general, were merely meant to inform the public about abuses and violations, it could do so without resort to the manipulative techniques I’ve outlined here. In fact, there are legitimate critics of psychiatry who stick to actual facts, do not overstate their conclusions, and are open to differing arguments, opinions, and evidence. These reasonable voices contribute to a valuable and important conversation. But that is not the antipsychiatry movement.
That such an activist movement as antipsychiatry exists I can understand, and though I disagree with it and feel it is very harmful, they have the right to express their opinions, unless they descend into e.g. hate speech. I can even (at times) understand such a movement that would not consider authentically engaging with any of its critics.
What I have great difficulty with is the notion that an extreme activist movement, spewing grandiose arguments that would embarrass a first year philosophy student, apparently unwilling to entertain open dialog and criticism, appears to have pockets well-entrenched within serious academia. That such poor scholarship (in my opinion) might gain credibility from the stature of an environment known for openness and reason is truly disappointing.
With that said, let’s move on to look at some of the arguments in detail.
