[Marxism] Fwd: H-Net Review [H-Disability]: Beveridge on Wall, 'The British Anti-Psychiatrists: From Institutional Psychiatry to the Counter-Culture, 1960-1971'

Andrew Stewart hasc.warrior.stew at gmail.com
Sat Feb 15 20:39:05 MST 2020

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Andrew Stewart 
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> From: H-Net Staff via H-REVIEW <h-review at lists.h-net.org>
> Date: February 15, 2020 at 4:05:52 PM EST
> To: h-review at lists.h-net.org
> Cc: H-Net Staff <revhelp at mail.h-net.org>
> Subject: H-Net Review [H-Disability]:  Beveridge on Wall, 'The British Anti-Psychiatrists: From Institutional Psychiatry to the Counter-Culture, 1960-1971'
> Reply-To: h-review at lists.h-net.org
> Oisín Wall.  The British Anti-Psychiatrists: From Institutional 
> Psychiatry to the Counter-Culture, 1960-1971.  Routledge Studies in 
> Cultural History Series. New York  Routledge, 2017.  xiv + 212 pp.  
> $155.00 (cloth), ISBN 978-1-138-04856-0.
> Reviewed by Allan Beveridge (University of Edinburgh)
> Published on H-Disability (February, 2020)
> Commissioned by Iain C. Hutchison
> Over the decades, the anti-psychiatry movement of the 1960s has 
> attracted a lot of attention. Its story has been recounted in 
> memoirs, biographies, and oral histories; has received scholarly 
> scrutiny; has been examined in newspaper articles and documentaries; 
> has been portrayed in films, novels, and plays; and has been the 
> subject of a great deal of mythologizing. Its legacy has been 
> fiercely contested. For some, it represents a period when orthodox 
> psychiatry was finally exposed as an authoritarian and repressive 
> tool of the state: further, by confronting mainstream psychiatry, the 
> anti-psychiatrists, in this view, were also revealing the hypocrisies 
> and iniquities of Western society. For others, the anti-psychiatrist 
> movement was a short-lived and ineffectual protest, and very much of 
> its time. Its advocates espoused a highly romanticized view of 
> madness, which, from this opposing viewpoint, left the mentally ill 
> untreated, a stance both morally and clinically indefensible. In 
> recent years, scholars have sought to provide a more balanced picture 
> that takes account of both the idealism of the movement and its 
> shortcomings. The era, however, is still a difficult one to portray: 
> does one focus on key individuals or on wider social trends? Does one 
> concentrate on particular geographical locations or does one 
> encompass the main global theaters where anti-psychiatry was enacted: 
> the United States, the Netherlands, Italy, and the United Kingdom? 
> Does the anti-psychiatric movement represent a radical rupture in the 
> approach to the mentally ill, or are there continuities with the 
> past? And, indeed, what does the term "anti-psychiatry" mean, and did 
> all the leading players associated with the movement accept the 
> label? 
> Into this field comes Oisín Wall whose new book is based on his PhD 
> thesis. He chooses to focus on a particular geographical location, 
> the United Kingdom, or more specifically, London, and on a particular 
> period, 1960 to 1971. He also chooses to take in wider social and 
> cultural developments, rather than just focusing exclusively on 
> individual practitioners, although he does spend time examining the 
> careers of R. D. Laing and David Cooper in particular. 
> Wall begins his book by examining the state of psychiatry before the 
> advent of anti-psychiatry in the 1960s. He points out, as Nick 
> Crossley, Catherine Fussinger, Mathew Thomson, and others have before 
> him, that many of the so-called radical ideas of the 
> anti-psychiatrists had their roots in the mainstream psychiatry of 
> the mid-twentieth century, most notably the notion of the 
> "therapeutic community."[1] He looks at the therapeutic community 
> projects at Mill Hill in London run by Maxwell Jones and Northfield 
> Hospital in Birmingham run by psychoanalysts, including Wilfred Bion 
> and Sigmund Foulkes. These ventures introduced a degree of democratic 
> decision-making, looser staff-patient distinctions, educational 
> programs, and a focus on the interactions of the group as a way of 
> forging a therapeutic community. Wall observes that these same 
> practices became guiding principles in the anti-psychiatric 
> communities. 
> Wall then considers Cooper's attempt to run a therapeutic community 
> at Villa 21 at Shenley Hospital in Hertfordshire. Cooper went further 
> than the earlier proponents of the therapeutic community: in Villa 
> 21, the staff did not wear uniforms and they ate from the same plates 
> as the patients. Wall has been resourceful, and indeed fortunate, in 
> tracing two former residents of Villa 21 whom he calls "Adam" and 
> "Ben." Their testimony helps to bring alive the day-to-day reality of 
> Villa 21. Interestingly, they have opposing views of the place. Adam 
> found Dr. Cooper caring and thought his stay had improved his mental 
> health, whereas Ben felt he survived his time in Villa 21 _in spite 
> of _his treatment, rather than _because_ of it. Both agreed that 
> patients were expected to "perform" madness, especially if there were 
> visitors to the unit. Indeed, Adam became a "star" patient. As Wall 
> astutely observes: "In many ways this left the residents in a classic 
> double-bind position: on the one hand they were at the hall to work 
> through their madness, with the intention of emerging on the far 
> side; but on the other hand they had been granted access to this 
> exciting community by virtue of their overt craziness and there was 
> the constant threat that they might, in Clancy Sigal's words, 'go 
> down and come up straight'" (p. 81). (Sigal was an American writer 
> who gave a comic account of his experiences as a resident in Kingsley 
> Hall in his 1976 novel, _Zone of the Interior_.) 
> Wall goes on to consider the aforementioned Kingsley Hall, which was 
> another therapeutic community, located in East London and presided 
> over by Cooper's colleague, Laing. He judges that it differed from 
> Villa 21 in that it did not have such direct anti-institutional 
> aspirations and did not threaten or confront mainstream psychiatry. 
> He writes: "It did not directly challenge any pre-existing 
> institution. Indeed, in some ways the hall served the exact opposite 
> purpose to Villa 21" (p. 82).  However, one could argue that the very 
> existence of Kingsley Hall provided an example of how the mentally 
> ill could be cared for in a different way to that of the standard 
> psychiatric hospital, and, in that sense, it represented a challenge 
> to orthodox psychiatry. 
> Wall then examines the counterculture of the 1960s. Drawing on his 
> own archival research and the work of such commentators as Jeff 
> Nuttall and Barry Miles, who were involved in the counterculture 
> scene at the time, he evokes the heady atmosphere of the period, 
> which combined radicalism, internationalism, hedonism, and just plain 
> silliness. He also shows how anti-psychiatrists became involved with 
> the counterculture, and how this contributed to their increasingly 
> extravagant and apocalyptic claims. Where once they concentrated on 
> the individual psychiatric patient, they now moved on to what they 
> saw as the repressive role of the family and the evils of the West. 
> They maintained that Western intervention in the third world was a 
> function of the mapping of repressed sexual and murderous desires on 
> to entire peoples, transforming them into the "other." They declared 
> that the Nazi concentration camps were a model for the methods 
> employed by modern-day institutions, such as mental hospitals and 
> schools, to dehumanize its population. 
> The anti-psychiatrists believed that institutions behaved like 
> families in order to exercise power over people. Wall devotes a whole 
> chapter to the anti-psychiatrists' view of the family. They claimed 
> that it was only through liberation on a _micro_-political level--at 
> the level of the family--that society could be changed on a 
> _macro_-political level. By escaping the oppressive power of social 
> institutions, one became truly "authentic." Wall discusses Cooper's 
> 1971 book, _The_ _Death of the Family_, which he judges brought the 
> different strands of the anti-psychiatric view of the family together 
> and has been unjustly neglected and underrated. 
> Wall contends that the decline and fall of anti-psychiatry was 
> intricately linked to the demise of the counterculture. As he writes: 
> "By the mid-1970s, the novelty of the synthesis between the 
> counter-culture and psychiatry, which had once attracted attention on 
> all sides, was wearing off. For psychiatrists, the 
> anti-psychiatrists' theories and practices were no longer seen as 
> sufficiently therapeutically focused, and for the counter-culture 
> their politics either did not go far enough or were not developed 
> enough" (p. 180). Elsewhere, he lays responsibility for the demise of 
> anti-psychiatry at the door of Laing and Cooper, whom he considers 
> were charismatic but also manipulative and abusive. This caused 
> problems in sustaining the support and cooperation of others. David 
> Ingleby had made this point some years before in _Critical 
> Psychiatry: The Politics of Mental Health_ (1980). 
> One of the difficulties of the book is the author's decision to talk 
> about the "British anti-psychiatrists," rather than considering each 
> one individually. While there were similarities in approach--Laing 
> and Cooper wrote _Reason and Violence_ (1964) together, and Laing 
> also jointly researched _Sanity, Madness and the Family _(1964) with 
> Aaron Esterston--there were significant differences between them. 
> Further, Joseph Berke, whom Wall awards a key role in the development 
> of anti-psychiatry, was, of course, American, while Cooper was South 
> African. Such a strategy of grouping these diverse individuals under 
> the umbrella of "the British anti-psychiatrists" gives the impression 
> that there was more unity among the anti-psychiatrists than was 
> actually the case. It is also confusing for the reader to disentangle 
> which views were unanimously accepted and which were the expression 
> of an individual anti-psychiatrist. A better title might have been, 
> "Anti-Psychiatrists Working in Britain." The term "anti-psychiatry" 
> is itself contested. Laing is on record as rejecting the term as 
> applied to himself. Wall does consider Laing's claim and argues that 
> Laing only made this claim in later years but that he seemed to 
> accept it at the height of anti-psychiatry's popularity. This is an 
> interesting observation and may well be true given Laing's penchant 
> for self-mythologizing. 
> Wall gives insufficient credit to the work of previous scholars. 
> Fussinger has written about the continuities between the approach of 
> anti-psychiatrists and the postwar psychiatric experiments with 
> therapeutic communities. David Abrahamson has compared Laing's 
> involvement with the "Rumpus Room" experiment at Gartnavel Royal 
> Hospital in Glasgow to his later work at Kingsley Hall. Thomson 
> identified that the roots of British anti-psychiatry lay in 
> mid-twentieth-century psychiatry. None of them gets cited. Crossley 
> has explored the influence of the counterculture and the New Left on 
> anti-psychiatry. He does earn a citation, but there is no extended 
> engagement with his work.[2] In my _Portrait of the Psychiatrist as a 
> Young Man_ (2011), I detail the early influences on Laing, which 
> included his clinical years in Glasgow. Laing was to describe himself 
> as a "conservative revolutionary," by which he meant he was carrying 
> on the tradition of the older Glasgow psychiatrists, such as Angus 
> MacNiven, the superintendent of Gartnavel Royal Hospital, who were 
> skeptical of the new physical treatments, such as psychosurgery and 
> medication, and who saw their role as protecting their patients from 
> harm. 
> Despite these reservations, Wall has produced a readable account of a 
> much-discussed subject and has also provided original research and 
> observations in the process.  
> Notes 
> [1]. Nick Crossley, "R. D. Laing and the British Anti-Psychiatry 
> Movement: A Socio-Historical Analysis," _Social Science and Medicine 
> _47 (1998): 877-89; Catherine Fussinger, "'Therapeutic Community', 
> Psychiatry's Reformers and Antipsychiatrists: Reconsidering Changes
> in the Field of Psychiatry after Word War II," _History of Psychiatry 
> _22 (2011): 146-63; and Mathew Thomson, "Before Anti-Psychiatry: 
> 'Mental Health' in Wartime Britain," in _Cultures of Psychiatry and 
> Mental Health Care in Postwar Britain and the Netherlands_, ed. 
> Marijke Gijswijt-Hofstra and Roy Porter (Amsterdam: Rodopi, 1998), 
> 43-60. 
> [2]. Fussinger, "'Therapeutic Community'"; David Abrahamson, "R. D. 
> Laing and Long-Stay Patients: Discrepant Accounts of the Refractory 
> Ward and 'Rumpus Room' at Gartnavel Royal Hospital," _History of 
> Psychiatry_ 18 (2007): 203-15; Thomson, "Before Anti-Psychiatry"; and 
> Crossley, "R. D. Laing and the British Anti-Psychiatry Movement. 
> Citation: Allan Beveridge. Review of Wall, Oisín, _The British 
> Anti-Psychiatrists: From Institutional Psychiatry to the 
> Counter-Culture, 1960-1971_. H-Disability, H-Net Reviews. February, 
> 2020.
> URL: https://www.h-net.org/reviews/showrev.php?id=54633
> This work is licensed under a Creative Commons 
> Attribution-Noncommercial-No Derivative Works 3.0 United States 
> License.

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