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Psychiatry and the Family: A Historical Perspective
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13157 |
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Section : |
MODERN THOUGHT
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| Issue
Date : |
11 / 1987 |
5,997 Words |
| Author
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Ian Dowbiggin
Ian Dowbiggin is professor of the faculty of education at the
University of Western Ontario. |
During the last quarter-century many writers have begun to challenge the legitimacy of the medical profession in general, and psychiatry in particular. Among these are thinkers such as Ivan Illich, Christopher Lasch, Michael Foucault, R.D. Laing, and Thomas Szasz. Although they disagree on some points, they all agree that the medicalization of society in the last 150 years has not improved public health. They concur that Western nation-states have given physicians unwarranted political, social, and moral authority to intervene in our personal lives and the lives of our families. They further maintain that with its growing influence and power, medicine has steadily eroded our autonomy and self-reliance, encouraging us to depend on supposed experts to organize and manage our lives. This dependence on state-employed professionals has left the public vulnerable to state control of those elements in society deemed to be dangerous to the political order and established elites. Critics like Lasch, Illich, Foucault, and Jacques Donzelot conclude that medicine--and especially psychiatry--has been less concerned with the cure of disease than with political control.
This thesis regarding psychiatry's social role appears confirmed by historical evidence. Historians of medicine since the 1960s have increasingly focused on psychiatry's past, discovering that state-backed psychiatrists have urged families to obey them, although their professional claims to expert knowledge about family heath have often been questionable. In fact, the social mandate granted to psychiatry by the state ahs expanded. This has largely come about because psychiatrists have tried to depict themselves as indispensable in the ongoing struggle to reduce the incidence of mental disease. Because psychiatrists have rarely been able to cure their patients, the task of convincing powerful and influential people that they can improve mental health has never been easy. On the whole, however, they have succeeded in this endeavor, mainly because they were able to depict the elimination of madness as a politically desirable goal. One example of their success was the experience of French psychiatry in the final third of the nineteenth century. During these years French psychiatrists--or "alienists," as they called themselves--successfully convinced the French government that public calls for the de-institutionalization of the national asylum system were foolhardy and would lead to crime, social chaos, and national decline. These psychiatrists maintained that if their medical advice were heeded the family origins of mental illness would disappear as would the causes of social deviance and political instability. This argument was an effort to disguise the fact threat their attempts to cure their hospitalized patients had been shown to be futile. Psychiatry's
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