Letter

To the Editor: During the past 27 years, I have studied psychiatry and psychology as a student, as a patient, and as a professional, and since college I have written and edited published work in these areas. From this perspective, I would say that although the Open Forum by the Rissmillers, which claims to survey the "antipsychiatry" movement, aims for a worthy goal, it is weak because of its imprecision about concepts, its less-than-adequate research, and its rather stereotyping characterization of certain intellectual figures in the 1960s and 1970s and the significance of their more responsible ideas.

Perhaps the best way to undermine the authors' central apparent argument—that antipsychiatry was a golden banner that started as an intellectual game among a few radicals and then, after virtual exhaustion, was picked up by a movement among obstreperous consumers that seemed nostalgic for 1960s leftist political and intellectual styles—is to quote from Dendron, a sort of samizdat newsletter that eventually provided the basis for the organization Support Coalition International, whose name was changed last year to MindFreedom International. In a 1988 interview with none other than the renowned psychiatrist R. D. Laing by David Oaks, editor of Dendron at the time and currently director of MindFreedom, Oaks asked, "How can ex-inmates [of psychiatric wards] and progressive therapists work together?" Laing answered, "I'd have to sit down with actual people, and simply talk about it. I don't know enough about what Americans call the 'hands-on' situation to come up with a formula, some key to open up possibilities. The whole thing is: this is stitched together by personal trust [and] confidence between actual people" ( 1 ).

If he was describing how a "progressive therapist" might help the budding "psychiatric survivor" movement, Laing was also characterizing the most fundamental method of relating between doctor and patient. But if this was so, it may have been unintended and ironic because he definitely seemed surprised that Americans—with their homely "hands-on" efforts—could have a pragmatic way of organizing a pro-patient movement. In fact, his tone seems that of a musty old European doctor-patient fundamentalist.

So much for the Rissmillers' claim or suggestion that there is some substantive continuity—almost on the order of a grand, insidious historical error—between Laing, Szasz, and others and between their hermetic intellectual efforts and the more modern consumer efforts, now enabled by the Internet.

The more likely reason for the growth of the consumerist movement might be today's widespread style of practice of psychiatry and such things as the pharmaceutical industry's medical hegemony. More fundamentally, the better reason among many people involved in the movement might simply be good sense.