Headcase - The Wacky Mental Health Biz

Psychology and its allied medical field, psychiatry, have been in the news a good bit lately. And most of what's happened hasn't cast the mental health field in a positive light. If outright failures haven't been the subject of discussion, the ongoing debate about whether psychotherapy is a science or an art has grown more heated.

The death of Charles Socarides, a psychiatrist and psychoanalyst, precipitated a lot of reflection on the Internet about the way definitions of mental illness have long been used to enforce moral, religious and social codes. Socarides was one of the founders, in 1992, of the National Association for Research and Therapy of Homosexuality. The organization is infamous for rejecting the 1973 decision of the American Psychiatric Association to rescind its definition of homosexuality as a mental illness.

Socarides, in an avalanche of books, articles and public appearances, fought against public acceptance of homosexuality as a valid expression of love. He proposed that it was possible for gay people to become heterosexual and that NARTH's main job was to provide therapy and information in that undertaking.

Socarides has been described in much of the media as an anomaly in a time when growing numbers of people believe homosexuality is a genetic predisposition. But his theories were not unique, nor are they far from dead. He adhered to the notion that homosexuality in men is a "neurotic adaptation" caused by growing up with an absent father and identifying with an overly doting mother.

That idea, widespread in the psychoanalytical community in the '50s and '60s, is often attributed to Freud and still has remarkable currency with many psychologists. In reality, Freud proposed that theory only as speculation and later said it was just as likely that homosexuality in males is caused by over-identification with the father instead of the mother. In the end, he refused to pathologize homosexuality at all, encouraging a mother to accept her son as he was in a letter widely ignored by psychoanalysts of the last century.

Nonetheless, Socarides and his colleagues have kept the myth alive and actively campaigned against the culture's growing acceptance of gay people. With almost predictable irony, it turned out, of course, that Socarides' own son Richard is gay. In fact, he's a nationally prominent activist. Whether Socarides publicly declared that he was an absent father or that any of his three wives were overly doting mothers, I don't know.

Meanwhile, 9,000 people in the mental health field gathered a few weeks ago in Anaheim, Calif., for the Evolution of Psychotherapy Conference, which is held every five years. Surprisingly, little was reported in the media about the conference, but the New York Times did run a story, focusing on how therapists are increasingly divided between "the cool logic of science or a spirit of humanistic activism."

Indeed, one participant, Dr. Marsha Linehan of the University of Washington, advocated prosecution of therapists who use unstandardized methods of treatment with some clients. The Times story does not mention that Linehan's own method draws heavily on Zen and other mindfulness traditions of Eastern religion. Nor does it explain how one develops effective, new standards of treatment without deviating from the standards.

Nor does the Times article question just how "scientific" the work of those claiming such an orientation — principally cognitive-behavioral therapists — really is. The guru of so-called positive psychology, Martin Seligman, repeatedly makes that claim for his therapy, which, like 12-step programs, emphasizes gratitude, living in the present moment and cultivating personal strengths. It is hard to imagine how one scientifically measures the outcome of a therapy that demands optimism in order to work.

Of course, the best known recent attacks on the field have been launched by Tom Cruise, the actor and member of the Church of Scientology, which has conducted a long battle to discredit psychiatry. Cruise, for example, attacked Brooke Shields for taking antidepressant medications.

Scientologists certainly go over the top in their criticism, but the fact is that much of what they have documented is true and convincing enough to attract people like Thomas Szasz, a psychiatrist at the State University of New York who is an infamous critic of his own profession (and was a presenter at the Evolution of Psychotherapy Conference).

The church and Szasz created the Citizens Commission on Human Rights in 1969 to "expose psychiatric violations of human rights." Besides documenting outright harm, like the incidence of death during electroshock therapy, the organization produces articles about the way psychiatry continues to reinforce cultural norms by pathologizing deviancy, the way it once did with homosexuality. The gross over-diagnosis of attention deficit disorder among children and the use of drugs like Ritalin is an example.

How compelling is the case against psychiatry? About 2,500 people showed up last month when the CCHR opened a museum in Los Angeles devoted to the subject. The

Psychiatry: An Industry of Death Museum is doubtlessly nonobjective, with its displays of scary electroshock machines and pictures of psychosurgery, but its existence leaves no doubt that the mental health field is at a turning point.

cliff.bostock@creativeloafing.com

Cliff Bostock holds a Ph.D. in depth psychology.