Showing posts from 2020

Understanding Depression: A Pluralistic Approach

Depression is a common human experience characterized by feelings such as unhappiness, despondency, dejection, sadness, despair, or misery. However, the depression that is the subject of our discussion, the depression that comes to the attention of clinical professionals, and the depression that is characterized as a “mental disorder” is not entirely the same as this commonplace understanding of depression. This notion of depression as a clinical entity is continuous with the more ordinary understanding of depression, but also differs from it in important ways. One of the ways in which depression as a clinical entity (“clinical depression”) differs from our commonplace understanding is that clinical depression is understood as a constellation of related problems. These problems include experiences such as inability to experience joy, changes in appetite, changes in sleep, low energy, slowed movements, guilt, difficulty thinking and concentrating, and thoughts of death or suicide. Tha

The Users and Abusers of Psychiatric Criticism

This post continues the dialogue between James Barnes and me on the topic of criticisms of psychiatry. See last post by Barnes here . I am going to respond to some of the specific points raised by Barnes, but in order for this exchange to be more meaningful, I want to do so in the context of some larger theses about the common ways in which criticisms of psychiatry can be problematic. In line with my previous post, the intention is not to shut down or suppress criticisms, but rather to encourage more thoughtful and more nuanced criticisms.  1) On analysis, many (certainly not all) criticisms about psychiatry are actually about the current system of mental health care, but these criticisms are often directed at psychiatry as a medical specialty . By conflating the two, critics often ignore or downplay the “market forces” and systemic influences in shaping contemporary practice. 2) Many criticisms that apply to psychiatry also apply to psychology, but psychiatry is typically single

Critics and Their Psychiatry

This is a guest post by James Barnes , who offers a response here to my earlier blog post Psychiatry and its Critics . Your response-blog was much appreciated and clarifying. I wanted to respond in kind to some of what you said, partly to explore certain misunderstandings and identify differences, but also to highlight degrees of agreement. I do want to just say, though, that I disagree with your premise. I do not think this should be characterized as a conversation that is being had “over and over again.” The implication is that what is/has been missing is some sort of better appreciation of a set of facts about what psychiatry actually is or does. I think that is a serious underestimation of what is going on. Ultimately, this debate concerns a clash of ‘world views.’ Similar themes can of course be traced back to the “antipsychiatrists” of the 1960’s — though they are not simply regurgitations of those arguments — but that movement itself can and should be located within the p

Psychiatry and its Critics

This blogpost is in response to a blogpost by James Barnes on Mad in the UK : Are critics of psychiatry stranded in a ‘Jurassic world?’ I am not interested in framing my response as a refutation . I am not interested in any claims of victory or proclamations along the lines of “Hah! Arguments by critics of psychiatry have been refuted!” That would be the wrong way to think about this. I think there are many valid criticisms of psychiatry to be made, and it is important and essential to engage with criticisms. As I explain below, any framing that frames this discussion in terms of psychiatry vs its critics is problematic in my view. Refutations and counter-refutations are neither the best way to advance a debate nor the best way to learn from each other. My hope, in offering this as a response, is that we can move away from having the same arguments over and over again . 1) Psychiatry and the Critics of Psychiatry First thing I want to note is the framing of debate, the way the ti