On March 10th, 2018, Jon spoke at the International Family Therapy Association’s (IFTA) World Therapy Congress in Bangkok, Thailand. Entitled The Rise and Fall of Psychiatry (And What It Means For Psychotherapy), Jon’s speech chronicles the rise of psychiatry, summarises its present state, and discusses it and psychotherapy’s future. The speech was followed by a Q&A period, and can be viewed, below.
Summary
It has been decades since the ideological battle to define ‘abnormality’ was won by psychiatry. Today, being diagnosed ‘mentally ill’ is now ‘the norm, not the exception’ (Schaefer et al., 2017, p. 220). How did this happen? And why did a recent UN (2017) report advocate abandoning the prevailing bio-medical paradigm?
Full Description
It has been decades since the ideological battle to define ‘abnormality’ was won by psychiatry (Kirk, Gomory, & Cohen, 2013). In the past, psychiatrists utilized psychotherapeutic interventions more frequently and were much less reliant on pharmacological solutions to their clients’ complex problems. However, as a result of psychiatry’s medicalization of everyday life (Frances, 2014), only ten percent of psychiatrists now offer therapy to all of their clients, and this decline has coincided with an increase in the prescription of medications (Mojtabai & Olfson, 2008). Moore (2016) reported that one in six Americans now consume at least one psychiatric drug, with one in eight consuming an antidepressant. The dangers and lack of efficacy of these drugs have been expounded, repeatedly (Breggin, 2013; Moncrieff, 2008; Gøtzsche, 2015). In addition, the attempt by the DSM-IV’s Task Force Chair to ‘save normal’ (Frances, 2014) appears to have failed. According to Schaefer et al. (2017), receiving a psychiatric diagnosis is now ‘the norm, not the exception’ (p. 220).
Despite the proliferation of psychiatry’s mantra that ‘mental illness is an illness like any other’ (Read & Dillon, 2013), fewer and fewer students are entering the profession (Balon, Coverdale, & Roberts, 2011; Katschnig, 2010). A survey asking UK medical students why they decided to leave the field of psychiatry cited reasons that included a lack of evidence supporting psychiatric diagnoses and treatments (Lambert, Turner, Fazel, & Goldacre, 2006). These concerns are consistent with a recent UN (2017) report which stated: ‘A growing research base has produced evidence indicating that the status quo, preoccupied with biomedical interventions, including psychotropic medications and non-consensual measures, is no longer defensible in the context of improving mental health (p. 4).’ The UN’s call for a paradigm-shift may represent a watershed moment, regarding psychiatry’s future. The lack of empirical support for psychiatry’s foundations (Davies, 2013), it’s poor treatment outcomes (Whitaker, 2010), and the decline in professional interest in the field (Katschnig, 2010), represent an opportunity for psychotherapeutic community to reassert its usefulness to the public and emphasize the importance of context (Watzlawick, Bavelas, & Jackson, 2011) in addressing psychological distress within families.
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Gøtzsche, P. C. (2015). Deadly psychiatry and organised denial. Copenhagen: People’s Press.
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Kirk, S. A., Gomory, T., & Cohen, D. (2013). Mad science: psychiatric coercion, diagnosis, and drugs. New Brunswick: Transaction.
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Moncrieff, J. (2008). The myth of the chemical cure. New York: Palgrave Macmillan.
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Watzlawick, P., Bavelas, J. B., & Jackson, D. D. (2011). Pragmatics of human communication: A study of interactional patterns, pathologies, and paradoxes. New York: W.W. Norton & Company.
Whitaker, R. (2010). Anatomy of an epidemic. New York: Crown.
