Psychiatric Disability and Rhetoricity: Refiguring Rhetoric and Composition Studies in the 21St Century
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Soteria – a Treatment Model and a Reform Movement in Psychiatry
1 Soteria – a treatment model and a reform movement in psychiatry By Volkmar Aderhold - Translated by Peter Stastny - September 2006 In honour of Loren Mosher “Everyone is much more simply human than otherwise” H.S.Sullivan - The interpersonal theory of psychiatry Introduction The Soteria treatment model was originated by the American Psychiatrist Loren Mosher during the early 1970s. As director of the Schizophrenia Branch at the National Institute Mental Health (1968-1980) he developed two federally-funded research demonstration projects: “Soteria” (1971-1983) and “Emanon” (1974-1980). The aim was to investigate the effects of a supportive milieu therapy (“being with”) for individuals diagnosed with “schizophrenia” (DSM-II), who were experiencing acute psychotic episodes for the first or second time in their lives. In these programs neuroleptics were either completely avoided, or given in low dosages only. Since the founding of Soteria Bern by Luc Ciompi in 1984, similar programs have been developed in Europe, mostly in the form of residential facilities situated in proximity to psychiatric hospitals. Initiatives to promote such programs are currently active around the world. Due to the expectation that neuroleptics would be used selectively, in acute as well as long-term situations, the program’s challenge to the medical model of “schizophrenia,” and the wide acceptance of inpatient treatment provided by mental health professionals (Mosher & Hendrix 2004, p. 282), the Soteria model has been consistently marginalized in psychiatric discourse and largely ignored in the scientific literature. On the other hand, during the past twenty years the Soteria approach has become quite influential within the debate about the optimal therapeutic methods and the development of state-of-the-art acute inpatient services. -
Mental Health
BRITISH JOURNAL OF PSYCH IAT RY ( 1007). 191 ( s upp l. 50 ), 171 -177. d ol: I0 .1191/ b j p . 191.5 0 .s71 REVIEW ARTICLE Schizophrenia outcome measures in the wider including clinical symptoms and their im provement, and social functioning, espe cially the ability to relate to people and international community performance at work (including employ ment, housework and tasks). Cognitive MOHAN ISAAC , PRABHAT CHAND and PRAT I MA MURT HY function, family burden and quality of life are other outcome measures. Outcome is also influenced by the course of schizo phrenia. The possible contribution of fac tors to the good prognosis observed in low- and middle-income countries is shown in the Appendix. Background Outcome of Schizophrenia may have a better outcome schizophrenia has been described as in low- and middle-income countries. The initial evidence for this came from the Inter Clinical symptoms favourable in low- and middle-income national Pilot Study of Schizophrenia (!PSS; The Present State Examination-9 (PSE-9; countries. Recently. researchers have World Health Organization, 1979) and was Wing et al, 1974) has been used as the mea questioned these findings. further strengthened by rwo subsequent sure of clinical symptoms at baseline and studies, the Determinants of Outcome of during follow-up in almost all long-term Aims To examine the outcome studies Severe Mental Disorders (DoSMED; studies from low- and middle-income coun carried out in different countries Jablensky et al, 1992) and the recently con tries. The PSE-9 assesses 140 symptoms specifically looking at those from low- and cluded International Study on Schizo grouped into 36 syndromes and measures phrenia (ISoS; Harrison et al, 2001). -
BREAKDOWN Phoebe Sengers
Document generated on 09/27/2021 8:55 p.m. Surfaces BREAKDOWN Phoebe Sengers SUR LA PUBLICATION ÉLECTRONIQUE Article abstract ON ELECTRONIC PUBLICATION The psychiatric institution mechanizes the patient. Absorbed into the workings Volume 4, 1994 of the psychiatric machine, the patient is reduced to a sign. Breakdown: the machine exceeds its own logic and the patient exceeds the institution's URI: https://id.erudit.org/iderudit/1064953ar totalizing grasp. Primary references to Deleuze and Guattari, Blanchot and DOI: https://doi.org/10.7202/1064953ar Goffman. See table of contents Publisher(s) Les Presses de l’Université de Montréal ISSN 1188-2492 (print) 1200-5320 (digital) Explore this journal Cite this article Sengers, P. (1994). BREAKDOWN. Surfaces, 4. https://doi.org/10.7202/1064953ar Copyright © Phoebe Sengers, 1994 This document is protected by copyright law. Use of the services of Érudit (including reproduction) is subject to its terms and conditions, which can be viewed online. https://apropos.erudit.org/en/users/policy-on-use/ This article is disseminated and preserved by Érudit. Érudit is a non-profit inter-university consortium of the Université de Montréal, Université Laval, and the Université du Québec à Montréal. Its mission is to promote and disseminate research. https://www.erudit.org/en/ BREAKDOWN Phoebe Sengers ABSTRACT The psychiatric institution mechanizes the patient. Absorbed into the workings of the psychiatric machine, the patient is reduced to a sign. Breakdown: the machine exceeds its own logic and the patient exceeds the institution's totalizing grasp. Primary references to Deleuze and Guattari, Blanchot and Goffman. RÉSUMÉ L'institution psychiatrique mécanise le patient. -
A Hunger Strike to Challenge International Domination by Biopsychiatry
A Hunger Strike to Challenge International Domination by Biopsychiatry This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to "first do no harm." Psychiatrists are able with impunity to: *** Incarcerate citizens who have committed crimes against neither persons nor property. *** Impose diagnostic labels on people that stigmatize and defame them. *** Induce proven neurological damage by force and coercion with powerful psychotropic drugs. *** Stimulate violence and suicide with drugs promoted as able to control these activities. *** Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy) *** Employ restraint and solitary confinement - which frequently cause severe emotional trauma, humiliation, physical harm, and even death - in preference to patience and understanding. *** Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public. WHY WE FAST There are many different ways to help people experiencing severe mental and emotional crises. People labeled with a psychiatric disability deserve to be able to choose from a wide variety of these empowering alternatives. Self-determination is important to achieve real recovery. However, choice in the mental health field is severely limited. -
Epistemic Injustice in Cases of Compulsory Psychiatric Treatment
Epistemic Injustice in Cases of Compulsory Psychiatric Treatment Antonia Smyth ORCID: 0000-0001-6843-1753 A Thesis Submitted in Partial Fulfilment of the Requirements for the Degree of Master of Arts (Advanced Seminar & Shorter Thesis) Philosophy Department School of Historical and Philosophical Studies Faculty of Arts The University of Melbourne June 2021 Abstract There is a growing body of philosophical research into epistemic injustice in the psychiatric context; this thesis examines the impact of this distinct form of injustice on people in compulsory psychiatric treatment specifically, that is, on people receiving treatment without their consent. Epistemic injustice poses an intrinsic harm to those who experience it, but it can result in secondary practical consequences. In the case of compulsory psychiatric treatment, these consequences can be severe, including the infringement of peoples’ rights to liberty and autonomy. I begin with a focus on testimonial injustice, as described by Miranda Fricker. I will show that compulsory treatment cases provide fertile ground for this form of injustice, and explore the idea that testimonial injustice functions at an institutional level in this context. To demonstrate this I use a case study, the Victorian Mental Health Act 2014, focusing particularly on the role of capacity assessments, which I will argue constitute a formal credibility judgment. Fricker’s proposed remedy for testimonial injustice is the cultivation of the virtue of testimonial justice, however, I argue that on its own, this will not be sufficient for combatting institutional testimonial injustice. Examining solutions to this problem, I argue for structural solutions in the form of proposals for legislative and policy changes. -
Coercion: the Only Constant in Psychiatric Practice? Tomi Gomory, David Cohen, and Stuart A
Florida State University Libraries Faculty Publications College of Social Work 2013 Coercion: The Only Constant In Psychiatric Practice? Tomi Gomory, David Cohen, and Stuart A. Kirk Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected] Coercion 1 Coercion: The Only Constant In Psychiatric Practice? Tomi Gomory, Associate Professor, Florida State University1 David Cohen, Professor, Florida International University Stuart A. Kirk, Professor Emeritus, University of California, Los Angeles To allow every maniac liberty consistent with safety; to proportion the degree of coercion to the … extravagance of behavior; … that bland art of conciliation, or the tone of irresistible authority pronouncing an irreversible mandate … are laws of fundamental importance … to the … successful management of all lunatic institutions. Philippe Pinel (1806) Introduction In the Western world, since at least the 15th century, state-sanctioned force has been employed to control those who disturb others by their violent or existentially destabilizing behaviors such as threatening or inflicting self-harm. Coercing the mad into madhouses, separating and detaining them from the rest of society, and forcing them to comply with their keepers’ wishes, occurred before physicians became involved in theorizing about the meaning or origins of madness, and it continues to distinguish psychiatric practice to this day. It is widely recognized that the mad used to be confined, beaten, tied, shocked or whirled into submission, but it seems less appreciated today by 1 Co-authors of Mad Science: The Disorders of American Psychiatry (Transaction Publishers, due in March 2013). Coercion 2 scholars, practitioners, and the general public that the physical control of “dangerous” mental patients remains a central function, and perhaps the only constant function, of public mental health systems. -
The Case Against Antipsychotic Drugs: a 50-Year Record of Doing More Harm Than Goodq
Medical Hypotheses (2004) 62, 5–13 http://intl.elsevierhealth.com/journals/mehy The case against antipsychotic drugs: a 50-year record of doing more harm than goodq Robert Whitaker* 19 Rockingham St., Cambridge, MA 02139, USA Summary Although the standard of care in developed countries is to maintain schizophrenia patients on neuroleptics, this practice is not supported by the 50-year research record for the drugs. A critical review reveals that this paradigm of care worsens long-term outcomes, at least in the aggregate, and that 40% or more of all schizophrenia patients would fare better if they were not so medicated. Evidence-based care would require the selective use of antipsychotics, based on two principles: (a) no immediate neuroleptisation of first-episode patients; (b) every patient stabilized on neuroleptics should be given an opportunity to gradually withdraw from them. This model would dramatically increase recovery rates and decrease the percentage of patients who become chronically ill. c 2003 Elsevier Ltd. All rights reserved. Introduction which posed this question: “After fifty years of neuroleptic drugs, are we able to answer the fol- The standard of care for schizophrenia calls for lowing simple question: Are neuroleptics effective patients to be maintained indefinitely on antipsy- in treating schizophrenia?” [8] A close review of the chotic drugs. The evidence for this practice comes research literature provides a surprising answer. from research showing the drugs are effective in The preponderance of evidence shows that the treating acute psychotic symptoms and in pre- current standard of care – continual medication venting relapse [1,2]. Historians also argue that the therapy for all patients so diagnosed – does more introduction of neuroleptics in the 1950s made it harm than good. -
Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill Stephen P
Page 40 Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill Stephen P. Kliewer Melissa McNally Robyn L. Trippany Walden University Abstract Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus requiring a shift in how services are delivered and how mental health counselors need to be trained. The focus of this article is to explore the dynamics and challenges specific to deinstitution- alization, discuss implications for counselors, and identify solutions to respond to the identified challenges and resulting needs. State run psychiatric hospitals have traditionally been the primary component in the treatment of people with severe and persistent mental illness. For many years, individuals with severe mental illness (SMI) were kept out of the community setting. This isolation occurred for many reasons: a) the attitude of the public about people with mental illness, b) a belief that the mentally ill could only be helped in such settings, and c) a lack of resources at the community level (Patrick, Smith, Schleifer, Morris & McClennon, 2006). However, the institutional approach was not without its problems. A primary problem was the absence of hope and expecta- tion that patients would recover (Patrick, et al., 2006). In short, institutions seemed to become warehouses where mentally ill were kept for long periods of time with little expectation of improvement. -
Social Work 618 Systems of Recovery from Mental Illness in Adults
Social Work 618 Systems of Recovery From Mental Illness in Adults 3 Units Instructor: Marco Formigoni, LCSW Course Day: E-Mail: [email protected] Monday Office Hours: By appointment Course Location: VAC I. COURSE PREREQUISITES This advanced level practice course is only open to Mental Health Concentrations students who are working, in their current field placement, with adult clients who have been diagnosed with mental illnesses. II. CATALOGUE DESCRIPTION This advanced mental health practice course focuses on the multi-level impact of mental illness on adults and families. Evidence-based interventions promoting increased quality of life and stability are emphasized. III. COURSE DESCRIPTION This advanced-level elective course offers students the opportunity to learn about effective, leading -edge social work approaches to providing humane care for persons with mental illness, especially those clients with concomitant substance abuse, developmental disabilities and severe socioeconomic disadvantage who are commonly considered “difficult” to treat. The course offers students a comprehensive approach to social work practice with this population which includes outreach, clinical assessment; treatment planning that includes strengths orientation with client’s environment and collaboration with other systems, advocacy and program development as well as management. The contribution of discrimination and social inequalities to clients’ difficulties is considered throughout the course, including discrimination based on gender, race, ethnicity, socioeconomic status, sexual orientation, disability and diagnosis. Many different understandings related to the nature of the problem of severe mental illness are included and the required readings draw from various theoretical approaches to treatment, ranging from psychodynamic to ecological. The perspective of the course is client-centered in that the emphasis is on understanding the persons who have a severe mental illness, their strengths and the processes associated with acquiring care. -
Psychiatry and Anti-Psychiatry: History, Rhetoric and Reality
2 (4) 2018 DOI: 10.26319/4717 Daniel Burston, Psychology Department, Duquesne University, Pittsburgh PA [email protected] Psychiatry and Anti-psychiatry: History, Rhetoric and Reality Abstract: The term “anti-psychiatry” was coined in 1912 by Dr. Bernhard Beyer, but only popularized by Dr. David Cooper (and his critics) in the midst of a widespread cultural revolt against involuntary hospitalization and in-patient psychiatry during the 1960s and 1970s. However, with the demise of the old-fashioned mental hospital, and the rise of Big Pharma (with all its attendant evils), the term “anti-psychiatry” has outlived its usefulness. It survives merely as a term of abuse or a badge of honor, depending on the user and what rhetorical work this label is expected to perform. Those who use the term nowadays generally have a polemical axe to grind, and seldom understand the term’s origins or implications. It is time that serious scholars retire this term, or to restrict its use to R.D.Laing’s followers in the Philadelphia Associates and kindred groups that sprang up in the late 1960s and 1970s. Keywords: psychiatry, anti-psychiatry, psychoanalysis, DSM V, Big Pharma, normalization, psychopolitics On November 16, 2016, Dr. Bonnie Burstow, Associate Professor of Adult Education and Community Development at the Ontario Institute for Studies in Education, which is affiliated with the University of Toronto, launched the first (and thus far, only) scholarship in North America to support doctoral theses on the subject of “anti-psychiatry.” Predictably, this bold gesture garnered praise in some quarters, but provoked a barrage of criticism from both in and outside the university. -
Journal of Critical Psychology, Counselling and Psychotherapy Appropriate, and Have to Use Force, Which Constitutes a Threat
Winter 2010 Peter Lehmann 209 Medicalization and Peter * Lehmann Irresponsibility Through the example of an adolescent harmed by a variety of psychiatric procedures this paper concludes that bioethical and legal action (involving public discussion of human rights violations) should be taken to prevent further uninhibited unethical medicalization of problems that are largely of a social nature. Each human being loses, if even one single person allows himself to be lowered for a purpose. (Theodor Gottlieb von Hippel the Elder, 1741–1796, German enlightener) Beside imbalance and use of power, medicalization – the social definition of human problems as medical problems – is the basic flaw at the heart of the psychiatric discipline in the opinion of many social scientists, of users and survivors of psychiatry and critical psychiatrists. Like everywhere, in the discussion of medicalization there are many pros and cons as well as intermediate positions. When we discuss medicalization, we should have a very clear view, what medicalization can mean in a concrete way for an individual and which other factors are connected with medicalization; so we can move from talk to action. Medicalization and irresponsibility often go hand in hand. Psychiatry as a scientific discipline cannot do justice to the expectation of solving mental problems that are largely of a social nature. Its propensity and practice are not * Lecture, June 29, 2010, presented to the congress ‘The real person’, organized by the University of Preston (Lancashire), Institute for Philosophy, Diversity and Mental Health, in cooperation with the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP) in Manchester within the Parallel Session ‘Psychiatric Medicalization: User and Survivor Perspectives’ (together with John Sadler, Professor of Medical Ethics & Clinical Sciences at the UT Southwestern, Dallas, and Jan Verhaegh, philosopher and ENUSP board-member, Valkenburg aan de Geul, The Netherlands). -
Subverting the Narrative: Addressing Gaps in the Medical Model of Mental Health Through Expressive Arts and Critical Race Feminism Paradigms
Lesley University DigitalCommons@Lesley Graduate School of Arts and Social Sciences Expressive Therapies Capstone Theses (GSASS) Spring 5-16-2020 Subverting the Narrative: Addressing Gaps in the Medical Model of Mental Health Through Expressive Arts and Critical Race Feminism Paradigms Sofiya Kostareva [email protected] Follow this and additional works at: https://digitalcommons.lesley.edu/expressive_theses Part of the Social and Behavioral Sciences Commons Recommended Citation Kostareva, Sofiya, "Subverting the Narrative: Addressing Gaps in the Medical Model of Mental Health Through Expressive Arts and Critical Race Feminism Paradigms" (2020). Expressive Therapies Capstone Theses. 250. https://digitalcommons.lesley.edu/expressive_theses/250 This Thesis is brought to you for free and open access by the Graduate School of Arts and Social Sciences (GSASS) at DigitalCommons@Lesley. It has been accepted for inclusion in Expressive Therapies Capstone Theses by an authorized administrator of DigitalCommons@Lesley. For more information, please contact [email protected], [email protected]. SUBVERTING THE NARRATIVE 1 Subverting the Narrative: Addressing Gaps in the Medical Model of Mental Health Through Expressive Arts and Critical Race Feminism Paradigms Sofiya Kostareva Graduate School of Arts and Social Sciences, Lesley University SUBVERTING THE NARRATIVE 2 Abstract: This paper discusses the problematic theoretical underpinnings of the medical model of mental health, first examining the historical development of the mental health field. Reviewing literature on the paradigms of expressive arts therapy, critical race feminism, and the medical model of mental health, the author argues how systemic oppression in such forms as racism, classism and ableism contribute to the issues of mental health accessibility for individuals who possess historically marginalized identities in the United States.