"Madness is not necessarily a dysfunctional stratagem."    —Thomas Szasz

Most libertarians are aware that both the U.S. Libertarian Party and the broader spectrum of the movement have long advocated positions on orthodox psychiatry falling roughly within what is usually referred to ideologically as the "antipsychiatry tradition" [1]. But few are aware of many of the specifics of such critical perspectives beyond knowing, for instance, that we oppose involuntary commitment, forced drugging and electroshock, etc., as well as the legal use of "insanity" or "diminished capacity" defenses to absolve guilt when criminal intent is shown. It is also the case that prominent libertarian psychiatrists such as Thomas Szasz and Peter Breggin would be the first to admit that the term "antipsychiatry" is something of a misnomer, that neither they nor most libertarians are opposed to everything which is done in the name of psychiatry. Rather they are more specifically opposed to the widespread coercion, systemic abuse, pseudo-science and/or outright quackery inherent in the prevailing "Medical Model"—or endemic to what has come to be known as "biopsychiatry". So, while honoring the diverse elements connoted by the umbrella concept "antipsychiatry”, libertarian critics of psychiatry are careful not to allow themselves to be cast in the defamatory false-caricature "boxes" our would-be detractors like to try to "put on us" to the effect that we are being "totally negative" or somehow denying the reality of the problems which psychiatry has historically dealt with. The beauty of Dr. Ty C. Colbert's recent (1996) book, Broken Brains or Wounded Hearts—What Causes Mental Illness, is that, building on and confirming all the previous work of such libertarian giants as Szasz and Breggin, he not only gives a lucid and detailed account of all the latest research findings re the state-of-the-debate over the "Medical Model" but also gives the most sensible and clear-headed account of what is actually entailed in the phenomena of so-called mental “illness" that I have ever read.

To give some historical perspective, after having initial widespread success and significant impact in the late 60s and early 70s, the antipsychiatry movement was generally considered to have been effectively marginalized into irrelevancy for many years while the "new psychiatry"-- biopsychiatry --came to the fore. It was heralded by the likes of E. Fuller Torrey (whom top American psychiatric researcher, Loren Mosher, accurately identified as the "psychiatric god" of the American NAMI and its Canadian counterpart, The Schizophrenia Society [erstwhile "Friends" of Schizophrenics-- until the truth became too obvious; these are the people who pressured the NDP provincial government here in B.C. into ramming through the soon-to-be-infamous out-patient committal Bill 22 without any consultation from "consumers"] with their "fascistic agenda" pushed prominently by Tipper Gore and other "compassionate" left-liberals who "progressively" got over any "stigma" they may ever have had about initiating violence on behalf of multi-million dollar medical monopolists against poor and/or disabled people) and Nancy Andreason (author of The Broken Brain: The Biological Revolution in Psychiatry [2]), et al. We were told that scientific opinion based on the reductionist materialist model that worked so well for orthodox medical diseases now affirmed that so-called mental “illnesses" were identical in nature and totally explainable according to their root biological causes. Moreover, we were fed the Big Lies that neuroleptic drugs and electroshock were effective and superior "cures" compared to any previously known treatments and would enable recovery, or at least "stabilization", supposedly making deinstitutionalization possible [3]. And this was deemed to be a great humanitarian advance because no longer would the environmental or family/social factors involved in emotional trauma and problems of living be "blamed"; everyone would realize that people were not responsible, either collectively or individually, for irrational thought and behavior—this was merely due to unavoidable "diseases of the brain" or "biochemical imbalances". The only time it was legitimate to "blame" anyone was if mental patients actually tried to confute this dogma by becoming lucid counterfactual examples of successful recovery without being coerced into submitting to their "right to treatment". Then "blaming the victims" was perfectly O.K. because the biopsychiatric medical monopoly itself was clearly at stake (witness the recent desperate attempts to shore up the crumbling establishment's pretense of expertise founded on junk-science with compulsory out-patient committal legislation all across North America, the aforementioned Bill 22 just being a local instance of this general reactionary trend).

Nowadays, this several decades old fashionable presumption of the definitive/"inevitable" triumph of biopsychiatry is fast fading and the antipsychiatry movement is back big time with a host of new literature attacking every aspect of the Medical/Disease Model and its attendant institutionalized coercion [4]. The book that probably really turned the corner was Peter Breggin's 1991 bestseller, Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the “New Psychiatry”. And, of course, Thomas Szasz has steadfastly continued to prolifically plant vital thought-seeds in the Implicate Order which, after a seemingly delayed gestation period, are now experiencing a dynamic existential outing in the Explicate all over the place (apologies for the borrowed allusion to David Bohm and his Wholeness and the Implicate Order, 1980). The upshot being that the whole question of whether or not this "thing" we call the "mind" is or is not ontologically distinct from this "thing" we call the "brain"-- or whether or not the medical categories "health" and "illness" can be meaningfully nosologically (i.e., in terms of the scientific classification of diseases) legitimately applied to "mind" --remains as much an open and pertinent question as it was back in 1961 when Szasz first stunned the medical world by positing it in his classic The Myth of Mental Illness. (Tim Leary called it "the most important book in the history of psychiatry" back then—a contextual assessment which, for its day, is looking more and more "right on" all the time). What has seemingly been missing from the overall anti-biopsychiatry critique, however, to make its scientific revolution complete, has been a dynamic, coherently articulated, alternative paradigm around which to galvanize the re-emergent revolt against the Medical/Disease Model. We now have this with Dr. Colbert's wonderful explication in Broken Brains or Wounded Hearts of his Emotional Pain Model—which not only offers meaningful insight into the origin of psychological disorders and/or unwanted aberrant behavior far surpassing failed biopsychiatry, but also bids fair to replace the current orthodoxy with safe and effective treatment options.

Space does not permit more than just the briefest sketch of the theoretical substance of Broken Brains or Wounded Hearts, but hopefully this will serve to give a useful impression of its vital significance. The book consists of three sections outlined in a little over 300 pages. The first deals with an overview of, and update on, the latest research pertaining to the Medical Model (the truth about psychiatric medication [5], twin and adoptive inheritance studies, the search for defective genes, and brain imaging studies, etc.). The second explains The Emotional Pain Model and its applications for understanding multiple personalities, addictions and compulsions, hate and self-hate, violence toward self and others—and much more. And the third points to "A New Direction" toward non-drug community-based centers, feeling-level therapies, consumer-run self-help organizations, and low-cost alternative treatment clinics or psychosocial approaches to recovery. To give just one illustrative instance of this last, Dr. Colbert relates how, at the San Joaquin Psychotherapy Center, in five years of serving even formerly considered "untreatable" 20 to 30 year veterans who biopsychiatry had failed to help-- in an unlocked facility, without medication, shock, restraint, or seclusion --the hospital readmission rate was zero. And there were no suicides or assaults. Addresses for other relevant organizations, source materials, and a referral service to non-drug, feeling-level therapists are listed as well.

Dr. Colbert's most relevant conclusion with respect to the Medical Model is that "...the truth is that researches have never discovered a single defective gene or accurately identified any chemical imbalance that has caused an emotional disorder; nor have they ever proven that brain abnormalities are responsible for even one emotional disorder." Furthermore, he quotes prominent psychiatrist, Ken Barney, to the effect that "The idea that 'schizophrenia' is a hidden disease entity, with a soon-to-be-discovered biogenetic 'cause' has been thoroughly debunked." Some additional substantiating quotes, which also give a brief capsule summary of the latest research findings, are:

"...the psychiatric community itself openly admits that no real biological cause for these disorders has ever been proven."

"To date, however, not one proven biological cause for mental illness has been found. Even though biological psychiatry assumes a physiological cause for all major emotional disorders, there is still no proven cause-and-effect relationship between any specific disorder and any specific physical defect."

"...neuroleptics have no specific therapeutic effect on people diagnosed as a schizophrenic because schizophrenia is not a brain disease."

"Twin studies can be misused in attempts to substantiate the medical model. The simple truth is that these studies, when correctly analyzed, firmly support an environmental model, not a genetic model."

"...there is absolutely no scientific evidence that the so-called psychiatric disorders of schizophrenia, depression, mania, ADD, obsessive/compulsive disorders, sociopathic behavior, or any others are inherited."

"Psychiatric medication does not correct a chemical imbalance; it works to disable the emotional-cognitive aspects of the human mind."

"Obviously there are thousands of individuals whose emotional condition has been stabilized with the help of medication. We now know, however, that these drugs do not stabilize or cure a mental or emotional 'disease', but actually stabilize a person's emotional life by disabling it, often permanently."

"In their massive 20-page journal article titled 'Schizophrenia—A Brain Disease?’ Chua and McKenna not only summarize all the brain imaging studies, but also give us a great summary of the biological model. In their opening paragraph in reference to schizophrenia, they state: 'There has been no identification of any underlying causal pathology.' (British Journal of Psychiatry, Vol. 166, 1995. p. 563)."

Several quotes, which give the essential idea of The Emotional Pain Model, are as follows:

"In fact, I believe that even the most so-called severe mental illnesses-- schizophrenia, depression, and mania --are not biologically based, but a reflection of a person's emotional woundedness. These symptoms are defenses and strategies developed by a person to cope with emotional pain."

"It is most important to realize that when overloaded with emotional pain, the mind begins to act 'crazy' in the process of splitting off that pain."

"All emotional or so-called 'mental' disorders, whether they be schizophrenia, depression, mania, panic attacks, or compulsive behaviors, are defense mechanisms that the mind creates to deal with an overload of pain. This is the central difference between the medical model and the emotional pain model. The medical model presents the brain as broken or defective. The emotional pain model declares that nothing is wrong with the brain and, in fact, shows that the brain is often working brilliantly as it helps create strategies to deal with the emotional pain of an investing heart."

In addition to this key concept of "the protective subconscious", Dr. Colbert elucidates his very innovative concept of a forced choice. He writes: "The choice [of reaction to emotional violations—B.F.] is not always a conscious one; it may be a choice forced upon us by our subconscious, but there will still be some element of choice involved. It is important that we understand and accept this element... with proper emotional strength, [we] can become consciously aware of this behavior and choose to change it." This, of course, parallels the notion recently popularized-- notably by Oprah Winfrey --that: "When you knew better, you did better." [6] But the important point re "mental patients" not allowing themselves to be defined as powerless is that others’ misguided attempts to classify them as "non-responsible" are not necessarily doing them any favors. As Dr. Colbert writes further, "...we can see that the emotional pain model does not lay the blame on the individual, but eventually opens the door for him to take charge of his own life and set of choices. The medical model, on the other hand, suggests that the person has no choice of possible behaviors because of some biochemical defect. While this idea may initially be freeing and relieve guilt, it ultimately becomes incapacitating because the person never deals with the root cause of the emotional disorder and because the treatment methods generally employed by medical practitioners (medication, ECT, forced hospitalization) limit the person's ability to function without solving the person's emotional problems."

With respect to therapy, the following will indicate his general orientation:

"...developing the strength to correctly identify and share our deepest feelings, is the first building block for true emotional health."

"When people are able to verbalize such perceptions and understand the pain and their feelings behind them, they often find that their distorted glimpses of reality begin to make sense..." (N.B.: Carl Jung stated, in this connection, "As a neurosis starts from a fragmentary state of human consciousness, it can only be cured by an approximate totality of the human being...[a] world of wholeness in which fragments can be gathered and put together again. Such a cure cannot be effected by pills and injections.")

"Because we didn't medicate her pain, she was left with a clear mind, and her pain helped lead us to exactly what needed to take place in her healing and recovery process. Because she wasn't on psychiatric drugs, which may have suppressed her symptoms, she didn't become dependent upon drugs for support."

"...simply attempting to reduce symptoms can actually lead to more emotional woundedness."

In other words, Dr. Colbert's position, virtually identical with Dr. Lars Martensson's more recent conclusion from all the latest research findings (see below)-- and stating the matter with undue brevity --is that, if you sincerely intend to help someone to overcome or cope effectively with a temporary mental disorder, the last thing in the world you want to do is to disable their ability to think and feel through a "chemical lobotomy." As Dr. Martensson says:

"Without an intact frontal-limbic system it is impossible to overcome schizophrenia. It must be emphasized that the only possible way out of schizophrenia is forward. Returning to the naiveté of previous repression is impossible. All the suffering, and everything experienced through psychotic breakdowns and expansions of consciousness, must be integrated in a further evolved organization of the personality. It is a creative endeavor that depends on the full faculty of a person's mind." (Quoted from “Should Neuroleptic Drugs Be Banned?” at p. 125 of Deprived of Our Humanity: The Case Against Neuroleptic Drugs, 1998. See Note No. 5)

Although there is much more in Dr. Colbert's book worthy of comment, I will lastly just note that a common misapprehension some consumers/survivors/ex-mental patients/ have when faced with a radical revision of themselves as not really "ill", "sick", or "diseased"-- but emotionally wounded --is that their much-needed care and/or benefits will be jeopardized if they don't submit to being "wholly-owned assets of the Psycho-Pharmaceutical Complex parroting the latest biopsychiatric party-line", as some have uncharitably put it. (One is reminded of the line from individualist-anarchist, Joseph Labadie, which Robert Anton Wilson likes to quote: "Poverty doth make cowards of us all." See further, "Neuroeconomics", The Illuminati Papers). But this need not be the case at all if we keep in mind the graphic analogy of the difference between a broken arm and a bona fide disease like diabetes. The former, though entailing no disease component, still requires adequate care and support during recovery. The Emotional Pain Model, rightly understood, is an eminently commonsensical framework for empowering us to assume responsibility (in the sense of choice-enhancing self-determination—not other-imposed guilt inducement [7]) for safely traversing our quite natural problems of living. For achieving true healing via the realization that, while we have a capacity for free will, we are not always free to exercise that capacity.

Notes

1) For an excellent overview of some of the predominant early perspectives in this genre, see: Janet Vice, From Patients to Persons: The Psychiatric Critiques of Thomas Szasz, Peter Sedgewick and R.D. Laing (New York: Peter Lang Publishing, 1992).

2) Nancy Andreason, The Broken Brain: The Biological Revolution in Psychiatry (New York: Harper & Row, 1984).

3) For the truly relevant facts, see: Seth Farber, Madness, Heresy, and the Rumor of Angels: The Revolt against the Mental Health System (Chicago: Open Court, 1993), “Appendix 2: Why Deinstitutionalization Failed", p. 245.

4) To name just 3 of the most important recent works, there are Alvin Pam and Colin Ross's Pseudoscience in Biological Psychiatry: Blaming The Body (New York: John Wiley & Sons, 1994), Peter Breggin's Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Role of the FDA (New York: Springer, 1997) and Herb Kutchins and Stuart Kirk's Making Us Crazy: DSM—The Psychiatric Bible and the Creation of Mental Disorders (New York: The Free Press/Simon & Schuster, 1997).

5) See also especially the important chapter by Canadian psychiatric researcher, Dr. David Cohen, "A Critique of the Use of Neuroleptic Drugs in Psychiatry”, in From Placebo to Panacea: Putting Psychiatric Drugs to the Test (New York: Wiley, 1997), edited by Seymour Fisher and Roger P. Greenberg. As well: David H. Jacobs, "Psychiatric Drugging: Forty Years of Pseudo-Science, Self-Interest, and Indifference to Harm", The Journal of Mind and Behavior 16 (1995), pp. 421-470. And: Lars Martensson, M.D., Deprived of Our Humanity: The Case Against Neuroleptic Drugs (Geneva: The Voiceless Movement, C.P. 235, CH- 1211 GENEVA 17, Switzerland. 224 pages. Can be ordered with a 7 Pound money order).

6) The implication here-- not at all particularly new to either psychology or psychiatry –being, of course, that operational knowledge-"premises" controlling behavior and/or producing "dissociative" states are anything but representative of a single conscious self acting much of the time. For a very instructive related discussion, see: Ernest R. Hilgard's Divided Consciousness: Multiple Controls in Human Thought and Action (New York: John Wiley & Sons, 1977). Also highly pertinent are the following excerpts from the subsection titled "Unconscious Perception Experiments" in physicist Amit Goswami's The Self-Aware Universe—How Consciousness Creates the Material World (New York: Tarcher/Putnam, 1993), pp. 109-112:

"...new data in the cognitive laboratory point toward a distinction between the two concepts—perception and awareness... Clearly, there was perception... but there was no conscious awareness of that perception... So in unconscious perception, we are talking about events that we perceive (that is, events that are taken in as stimuli and processed) but that we are not aware of perceiving... The phenomenon of unconscious perception raises a crucial question. Are any of the three common concomitants of conscious experience (thought, feeling, and choice) absent in unconscious perception? The experiment...suggests that thought is present... Obviously, we go right on thinking even in our unconscious, and unconscious thoughts affect our conscious thoughts.... feeling is also present during unconscious perception, and an unconscious feeling can produce an unexplainable conscious feeling... Finally, we ask, does choice, too, occur in unconscious perception? ... Apparently, choice is a concomitant of conscious experience but not of unconscious perception. Our subject-consciousness arises when there is a choice made: We choose, therefore we are.... It fits. When we do not choose, we do not own up to our perceptions." It is "knowledge" in this last sense, which Oprah is referring to as the sine qua non of any meaningful change for the better. And yet we see that both thought and feeling at the unconscious level significantly affect or motivate our conscious or ego-self thought and behavior so, paradoxically, our total being must consist of both intentional and non-intentional (or "unintentional") acting components-- of free subject-consciousness and unfree object-consciousness, as it were --as criminal law has long recognized. Dr. Colbert's concept of a "forced choice" as a non-consciously intended reaction to overwhelming emotional pain which is characteristic of so much purportedly criminal activity ("I just found myself doing it" is the most commonplace explanation repeatedly given by violent offenders) and/or psychologically deviant behavior precisely captures the essence of the reality of this oft ill-defined ambiguity. And it seems plain that not only are purposeful actions caused by conscious free will by-passing motives and non-chosen/automatic thoughts from the realms of the personal unconscious but that they are also caused by non-ego "other"—or transpersonal --components of Collective Consciousness often held to be aspects of discrete individuality, which are not so at all. What we have not consciously chosen, we therefore are not (-- and therefore are not “guilty”/not “responsible”/ for!).

7) See especially, in this regard, Chapter 10 of Peter Breggin’s The Psychology of Freedom: Liberty and Love as a Way of Life (Buffalo, New York: Prometheus, 1980), "Guilt Is an Unethical Emotion"--: “The guilty, ashamed, or anxious person is rendered less able to pursue rational self-criticism and is greatly impeded in finding a self-determined method of pursuing self-interest. Guilt, shame, and anxiety have no place in a rational, self-determined life.", p. 128.

First published in West Coast Libertarian, September 1999.

(Broken Brains or Wounded Hearts is available from Support Coalition International, P.O. Box 11284, Eugene, OR 97440, U.S.A. or at www.mindfreedom.org.