The Place of Antipsychiatry and Radical Therapy

At least as important to feminist assessments of psychological expertise were the movements known as "antipsychiatry" and "radical therapy," which distilled general criticisms of experts as antidemocratic schemers and servants of power into specific indictments of clinical practices and professionals.^[35] Centered around the theoretical writing of Thomas Szasz and R. D. Laing, antipsychiatry erased any remaining distinctions between psychological knowledge and politics by holding that the former merely presented the latter in mystified form.^[36] Antipsychiatry suggested that psychiatry was politics—not medicine, humanitarian assistance, or anything else. Mental health and

illness were thus labels convenient for protecting existing social arrangements and shielding political repression from effective resistance.

Antipsychiatry turned the historic rhetoric of the "helping professions" entirely on its head. Instead of leaders in the cause of humanitarian progress, psychiatrists and other psychological experts were malevolent conspirators who scapegoated people unfortunate enough to be labeled socially different due to their (nonwhite) race, (female) gender, (homo) sexual orientation, or (impoverished) economic status. Instead of an enviable state of health, sanity designated a pitiful state of adjustment to the alienated conditions of modern existence. Instead of helpless and tormented sufferers, patients were people whose social circumstances placed them at odds with the status quo. However socially unacceptable and personally calamitous, "freaking out" was a way of speaking out.

Indistinguishable from deviance, mental anguish evaporated as a reality and became, in Szasz's famous phrase, a "myth." Much of this critique rested on a conventional, severe distinction between body and mind, between medicine and the healing of souls. Szasz, for example, held that psychiatric work bore no resemblance at all to that of other physicians, who treated actual bodily illnesses. In sharp contrast to the medical challenges of genuine disease, psychiatric clinicians encountered rage, fear, stupidity, poverty, and a variety of other problems in living. Confusing existential quandaries with sickness disguised moral and ethical dilemmas as medical problems and undermined personal responsibility by leading people to believe that they did not control their own behavior when, to a large degree, they did, at least according to Szasz. "It behooves us," he wrote, "to discriminate intelligently and to describe honestly the things doctors do to cure the sick and the things they do to control the deviant."^[37]

Szasz was unequivocally hostile to all forms of involuntary intervention (i.e., commitment procedures) and to the growing power of psychiatry in the legal system (i.e., insanity pleas). He warned that measures equating criminality with mental illness would "convert our society from a political democracy to a psychiatric autocracy."^[38] Such views led him to oppose all welfare state programs on the grounds that they eroded individual freedoms. For example, Szasz called the policy of community mental health "moral Fascism" and argued that liberty was an absolute value, whereas mental health (whatever it was) was not.^[39] Except for these libertarian strands of his thought, which en-

deared him to right-wing ideologues and organizations, much of Szasz's critique was shared by leftists, and it was on the Left that most of antipsychiatry's support was located.

In the view of British countercultural psychiatrist R. D. Laing, psychiatry appeared to be as controlling as it was for Szasz, but madness was much less wicked. In fact, breakdown dissolved into breakthrough in the more extreme statements of Laing's antipsychiatric position toward the end of the 1960s. Early in the decade, he had claimed that psychosis resulted from two things: first, a rupture between self and social (especially familial) context and, second, a perception of the resulting abnormality by a psychiatric expert assumed to be capable of making such judgments. "Sanity or psychosis is tested by the degree of conjunction or disjunction between two persons where the one is sane by common consent."^[40] In spite of his desire to offer a theoretical explanation for schizophrenia, Laing stressed the ultimate incomprehensibility of madness, the lonely gulf necessarily separating the experience of one human being from the next. By the end of the decade, Laing turned away from the effort to grasp what was really a tragic existential distinctiveness and instead promoted a highly romanticized version of that difference in subjective experience. The reinterpretation converted schizophrenia into a mode of prophetic transcendence and healing in a society gone haywire, "one of the forms in which, often through quite ordinary people, the light began to break through the cracks in our all-too-closed minds."^[41]

The central theoretical works of antipsychiatry were not intended as feminist statements and all of the movement's major thinkers were men. It is nevertheless easy to see the exquisite fit between feminist denunciations of conventional gender expectations and the antipsychiatric assumption that what passed for mental anguish was a product of exploitation and alienation.^[42] The emerging outlines of feminist social thought dovetailed neatly with the core propositions of antipsychiatry: that the medical establishment had inappropriately usurped authority over vital social issues, including gender and sexuality; that psychotherapeutic practice harmed women by teaching that their problems were personal and intrapsychic rather than social and relational; that the neutral language of testing, diagnosis, and treatment concealed clinicians' complicity with male domination and their determination to make women adjust to sexism; that "mental health" was nothing but shorthand for gender conformity; that faith in experts (especially male ex-

perts) was counterproductive because experience—not expertise—imparted deserved authority. Only women could liberate themselves.

Radical therapy was an activist analogue to antipsychiatric theory. It consisted of a loose alliance between Left-leaning professionals, former mental patients, and radicals interested in psychotherapy. It appealed to large numbers of women (just as conventional psychotherapy had) and frequently addressed issues being debated within feminist circles, from sexuality to self-defense.^[43] It emphasized that while mental disturbance was fictive, sexism, and other types of oppression, were quite genuine. In his 1969 "Radical Psychiatry Manifesto," Claude Steiner wrote,

PARANOIA IS A STATE OF HEIGHTENED AWARENSS. MOST PEOPLE ARE PERSECUTED BEYOND THEIR WILDEST DELUSIONS. THOSE WHO ARE AT EASE ARE INSENSITIVE.^[44]

Based on a thoroughly negative appraisal of psychotherapy's political function and worth, radical therapy nevertheless retained a kernel of hope that therapeutic practice could, if revolutionized, expedite both personal liberation and social change.^[45] This coincided with the majority view among feminist critics, such as Bart and Chesler, that while psychotherapy as it existed was bad, abolishing it entirely might be worse.^[46] "Feminist therapy," they agreed, was preferable, even if it was difficult to define beyond the obvious: it would be emptied of objectionable sexist biases but still capable of offering help and insight to women in pain.