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Postpsychiatry's Challenge to the Chemical Treatment of Mental Distress

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Postpsychiatry's Challenge to the Chemical Treatment of Mental Distress DEPARTMENT OF PSYCHOLOGY UNIVERSITY OF COPENHAGEN Postpsychiatry's Challenge to the Chemical Treatment of Mental Distress When we name you a ‘schizophrenic’, we take away your speech and your ability to name yourself, we The reduction of peoples distressing life experiences obliterate you. The moral position that we must adopt is into a diagnosis of schizophrenia means that they are one in which we bear witness and resistance. To bear condemned to lives dulled by drugs and blighted by stigma and offered no opportunity to make sense of witness means accepting the reality of lives harmed and damaged by many things, including psychiatry. We can their experiences. no longer deny this. Jacqui Dillon Chair of the UK Hearing Voices Network P. Bracken and P. Thomas Postpsychiatry It is open to question whether schizophrenic patients, with their lack of insight into their illness and their cognitive deficiencies, are able to assess their own situation and to evaluate and describe their psychic state and the positive/negative effects of the medication given to them. E. B. Larsen & Jes Gerlach Former Chair of Psykiatrifonden Olga Runciman Master’s Thesis Academic advisor: Morten Nissen Submitted: 11/08/13 Postpsychiatry | Olga Runciman Number of pages 79.9 Number of letters 191772 TABLE OF CONTENTS Abstract ....................................................................................................................... 3 Introduction ................................................................................................................. 4 Problem Formulation .......................................................................................................................................... 9 The Approach ............................................................................................................... 9 How do I want to express myself through this work? ........................................................... 9 Methodological Structure .............................................................................................. 10 Method chosen ...................................................................................................................... 11 Review of the Research Literature .................................................................................. 11 My review of the literature ................................................................................................................................. 12 A counter History of Psychopharmacology ....................................................................... 13 Chlorpromazine ........................................................................................................... 13 Chlorpromazine in use ............................................................................................................ 16 Theoretical Introduction ................................................................................................ 21 Antipsychiatry ....................................................................................................................... 21 Antipsychiatry .................................................................................................................................................... 21 Critical Psychiatry and Postpsychiatry ...................................................................................... 22 Critical psychiatry .............................................................................................................................................. 22 Postpsychiatry ................................................................................................................................................... 23 The Hearing Voices Network ................................................................................................... 26 Introduction to the Seven Interviewees ........................................................................... 28 Context of Medicine ..................................................................................................... 29 Accept Medication ....................................................................................................... 29 Lou ....................................................................................................................................... 29 Ben ....................................................................................................................................... 32 Zac ........................................................................................................................................ 33 Doubt medication ......................................................................................................... 39 Mia ........................................................................................................................................ 39 Page 1 of 80 Postpsychiatry | Olga Runciman Pat ........................................................................................................................................ 43 Off medication ............................................................................................................. 47 Joe ........................................................................................................................................ 47 Leo........................................................................................................................................ 51 Context of Trauma ....................................................................................................... 56 Reflections on Trauma ..................................................................................................62 Conclusion and Closing Discussion ................................................................................. 66 EndNotes ................................................................................................................... 68 Bibliography..............................................................................................................................72 A very special thanK you to all my interviewees who participated and who shared their experiences with me. Page 2 of 80 Postpsychiatry | Olga Runciman ABSTRACT People who taKe psychiatric medication often have a very different view and experience of their medication than those who prescribe it. This thesis explores the discrepancies between the experiences of users and prescribers in an attempt to find out how we deal with these differences. It does this from a postpsychiatric perspective, which is critical of contemporary psychiatry, not as an opponent, but with the viewpoint of moving beyond current practices. In exploring these discrepancies, this thesis gives voice to those who are normally silenced by the current medical model of psychiatry, which insists that those diagnosed as schizophrenic suffer from a brain disorder and/or chemical imbalance. A search through the research literature spanning five databases from 1950 to 2012 was performed looKing for research focusing on the subjective medical experiences of those labeled schizophrenic. The research literature provides tangible evidence that the subjective experience of psychiatric medication from those labelled schizophrenic plays a small role in that only 14 articles were found. A counter history of psychopharmacology is also introduced in an attempt to counterbalance the gaps left out by the dominant discourse. The counter history shows that when psychiatric drugs first appeared, psychiatrists initially experienced the way these drugs worked as being in agreement with how service users experience them, including the seven interviewees here. The counter history also indicates that the pharmaceutical industry played a major role in transforming psychiatry's initial medical narrative into the one we recognize today. For this thesis, seven people labeled schizophrenic participated in qualitative interviews, giving voice to their experience of taking psychiatric medication. Three accept medication, two doubt its efficacy, and two are off medication completely. The voices of the interviewees introduce a world of context, meaning and understanding and show that madness is multifaceted and complex but understandable. The narratives of their medication experiences challenge the current psychiatric belief system. The voices of the seven interviewees show that their medication experiences cannot be removed from the context of their lives. But this challenges psychiatry’s current discourse, which tends to symptomize or downplay the experiences of service users. Depending on how they themselves experienced the dominant medical discourse, the service users dealt with its variation from their own experiences in a variety of ways. The narratives of the interviews indicate finally that there is a gap in the production of Knowledge, and that if we are to move beyond the current psychiatric paradigm as proposed by postpsychiatry, we cannot continue to ignore the voices and thereby the rights of those whom psychiatry treats. Page 3 of 80 Postpsychiatry | Olga Runciman POSTPSYCHIATRY'S CHALLENGE TO THE CHEMICAL TREATMENT OF MENTAL DISTRESS INTRODUCTION One of the most contentious debates in the field of mental health is whether mental distress is biogenetic or whether it results from traumatic lived experiences. Some might argue that it does not matter, but anyone who has ever received
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