[In the late 1960s and throughout the 1970s, radical psychologists
and psychoanalysts sought to transform their profession. This book
shows how those efforts intersected with the radical cultural and
political movements of the day.] [[link removed]]

PORTSIDE CULTURE

UNSTABLE HISTORIES  
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Steffan Blayney
April 1, 2020
Radical Philosophy
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_ In the late 1960s and throughout the 1970s, radical psychologists
and psychoanalysts sought to transform their profession. This book
shows how those efforts intersected with the radical cultural and
political movements of the day. _

,

 

_Break On Through
Radical Psychiatry and the American Counterculture_
Lucas Richert
The MIT Press
ISBN: 9780262042826

In May 1969, in the plush surroundings of Miami’s Americana Hotel,
the ordinarily staid annual meeting of the American Psychiatric
Association (APA) became the flashpoint for a standoff which had been
brewing within the profession for a number of years. The newly-formed
Radical Caucus of the APA issued a defiant challenge to the
association’s leadership, and to the profession as a whole. No
longer content with ‘hiding behind the couch’, its spokespersons
argued, it was time for psychiatrists to take a principled stand
against the social, political and economic injustices that divided the
US. Members distributed pamphlets condemning the medical
establishment’s endemic racism and sexism, and attacking
psychiatrists for their complicity with the American military. They
denounced the Vietnam War, called for the decriminalisation of drugs
and of abortion, and supported gay rights protestors calling for the
declassification of homosexuality as a psychiatric disorder.

_Break on Through_ by historian Lucas Richert seeks to offer ‘a
reinterpretation of medical and mental health knowledge in American
society in the 1970s’. This was a decade (give or take a few months)
which opened with the formation of the Radical Caucus, and closed with
the publication, in 1980, of the third edition of the APA’s
_Diagnostic and Statistical Manual of Mental Disorders_ (DSM-III), now
widely seen as signalling the triumph of a narrowly biomedical
psychiatry. In reality, Richert’s book encompasses a longer period,
stretching from the late 1950s to the early 1980s, and taking in a
wide range of challenges to mental health orthodoxy. As well as
critiques from within American psychiatry, and from the international
anti-psychiatry movement, he covers scientific explorations of
parapsychology and of psychoactive substances, the development of
alternative therapies and grass-roots health activism, and the take-up
of mental health issues by various political constituencies.

This was a period which saw both a politicisation of psychology and a
psychologisation of politics. Radicals in the ‘psy-’ professions
argued that the problems described as ‘mental illnesses’ should
not be seen in purely medical terms, but instead as the psychological
effects of unjust socioeconomic relations. Neither the talking cure of
psychoanalysis nor the scientific pretensions of behaviourism, they
claimed, were adequate to deal with the challenges posed by
contemporary American life. Rather, mental and emotional wellbeing
could only be achieved through social transformation. ‘Therapy means
political change’, as one enigmatic slogan of the Radical Caucus put
it, ‘not peanut butter.’

At the same time, the language of psychiatry – of madness,
alienation and paranoia – was infiltrating Cold War discourse in the
United States and Europe at a variety of levels. For an iconoclastic
new left in the 1960s, the irrationality of a ‘sick society’ was
evident in everything from racial segregation to the Cuban Missile
Crisis. What was the ‘delusion’ of a psychiatric patient who
believed the atom bomb to be inside of her, asked the Scottish
anti-psychiatrist R.D. Laing, compared to the madness of political
leaders willing to trigger nuclear apocalypse? At the same time –
perhaps paradoxically – a romanticised idea of madness could also
represent the possibility of liberation from society’s repressive
norms: the ‘half-chosen, half-compelled’ rebellion that Laing’s
associate David Cooper identified in the schizophrenic, the
‘psychopathic personality’ of Norman Mailer’s hipster, or the
‘systematic derangement of the senses’ pursued by the followers of
William Burroughs.

This was a complex and unstable exchange, and neither appropriation of
psychological vocabulary nor condemnation of orthodox psychiatry were
limited to the political left. Probably the best known ‘radical
psychiatrist’ in twentieth-century America, Thomas Szasz, was a
fervent right-wing libertarian. Szasz argued – with increasing
vitriol over his career – that medical psychiatry and ‘the
therapeutic state’ functioned to pathologise undesirable behaviours,
preventing individuals from accepting responsibility for their own
actions and creating dependency. Other prominent critics of psychiatry
in the post-war period would include the anti-communist John Birch
Society – for whom the psy-disciplines represented a Soviet-Zionist
conspiracy – and L. Ron Hubbard’s Church of Scientology. At times,
_Break on Through_ struggles to contain these contradictions, and
Richert’s impulse to treat ‘radical psychiatry’ as a consistent
or discrete phenomenon risks flattening out some of the complexities
inherent in the era’s volatile psychopolitics. While it is
undoubtedly the case that a wide range of people came to criticise
psychiatry and its institutions in the 1960s and 1970s, whether as a
group they shared much else in common, politically or culturally, is
less clear.

For the majority of the book, Richert’s focus is on militancy within
the psy-professions – those ‘agitators and radicals’ who
challenged the assumptions of their disciplines and put forward
revolutionary new models of mental disorder and its treatment. Yet one
of the more striking aspects of the story told in _Break on Through_
is the extent of productive exchange and interaction between this
‘radical fringe’ and the ostensible mainstream. The pioneers of
‘humanistic psychology’, Carl Rogers and Abraham Maslow, managed
to challenge orthodoxies while at same time holding numerous
prestigious professional appointments, while facilities such as the
Esalen Institute – the California birthplace of the ‘human
potential’ movement – provided a lively interface between the
countercultural avant-garde and the scientific establishment.
Exploration of the therapeutic effects of psychoactive substances such
as LSD and MDMA, in treatments of schizophrenia and in end-of-life
care for geriatric patients, was a serious research enterprise rather
than a crank pseudoscience, and its legitimacy was threatened more by
the political climate of Nixon’s ‘War on Drugs’ than by any
opposition within the psychiatric profession.

While the APA’s Radical Caucus undoubtedly styled themselves as
renegades and trailblazers, many of the positions they advanced in the
1970s actually had a much longer pedigree. The thrust of much recent
scholarship on anti-psychiatry movements has been to stress the extent
of continuity between the politicised, social models of mental health
of the kind explored in _Break on Through_, and an already-established
liberal tradition within the psychiatric profession. In the US, the
Group for the Advancement of Psychiatry (GAP), founded in 1946, was
typical of this approach, eschewing political neutrality and espousing
a variety of social causes. Two decades before the Radical Caucus’s
emergence, a 1950 statement by GAP on the ‘social responsibility of
psychiatry’ had made clear the Group’s ‘conscious and deliberate
wish to foster those social developments which could promote mental
health on a community-wide scale.’ Similarly, the origins of the
democratically-run ‘therapeutic community’ were not to be found at
Esalen, or in the radical circles around Laing and Cooper in 1960s
London, but in experiments taking place in British military hospitals
during the Second World War.

Arguably the more interesting problem for historians is not the
prevalence of these ideas in the 1960s or 1970s, but the reasons for
their ultimate co-option or defeat by the 1980s. The reassertion of a
biological and hereditarian essentialism in psychiatry, assisted by
the lobbying power of the pharmaceutical industry and codified in
DSM-III, is one aspect of this story. Another is the corporate,
business school co-option of concepts and techniques – human
potential, mindfulness, the encounter group – which had once held
utopian promise for a generation of radicals as a means to transform
both interpersonal and societal relationships. While it is tempting to
see such projects as corrupted from the start – naïve in their
prizing of immediate experience, nascently individualistic in their
focus on personal growth, orientalist in their selective appropriation
of Eastern philosophy and religion – it is also worth considering
the emancipatory ways of thinking that their eclipse may have shut
down. In this view, the decline of radical psychiatry begins to look
like just one aspect of a greater exorcism of that spectral freedom
which Mark Fisher identified in sixties radicalism more broadly –
the process of reclamation through which ‘those aspects of the
counterculture which could be appropriated have been repurposed as
precursors of the “new spirit of capitalism”, while those which
were incompatible with a world of overwork have been condemned to so
many idle doodles.’

Some of the most illuminating sections of _Break on Through_ are the
short passages which look at the emergence of what is now called the
psychiatric survivor movement (Richert’s claim that such groups have
been well-served by existing historiography is puzzling). Grassroots
demands for ‘mad liberation’ from patients and ex-patients both
exposed tensions within radical psychiatry and generated new
contradictions of their own. While often inspired by the
anti-psychiatric writing of figures like Szasz and Laing, activists in
groups such as the Insane Liberation Front and the Network Against
Psychiatric Assault questioned the possibilities for genuine
emancipation within a movement dominated by a few ‘hip
professionals’, most of whom continued to work within the
psychiatric system. While some groups campaigned for a more humane and
democratic approach to treatment – demanding an end to involuntary
hospitalisation, electroshock therapy and psychosurgery – others
questioned whether the existence of any kind of therapeutic
intervention at all was compatible with liberation. The demand for a
transformed psychiatry co-existed uneasily with convictions that only
a wider, revolutionary, social transformation could address the
problems that psychiatrists claimed to treat. Ultimately, from the
1980s onwards, the more radical elements of patient-led activism also
proved co-optable. Demands for greater democracy in treatment could be
subsumed within a commercialised model of user feedback and consumer
rights, collective self-empowerment diverted into privatised
self-help, while more militant groups struggled for resources in the
face of cuts to public funding.

Richert is surely right in seeking to situate the battles over
American psychology within a wider cultural field. In many ways
‘radical psychiatry’ and ‘American counterculture’ were
inseparable. As well as Rogers and Maslow, Esalen could count among
its guests and residents the likes of Ken Kesey, Buckminster Fuller,
George Harrison, Joni Mitchell and Bob Dylan. The patients’
liberation movement exploited the networks of the underground press
and drew on a repertoire of activist and protest techniques – such
as the consciousness-raising group and the sit-in – developed in
civil rights and women’s liberation movements. Yet the definition of
‘counterculture’ offered by Richert – ‘theological, political,
attitudinal, or material positions that departed from common or
accepted standards’ – is so capacious as to be almost evacuated of
any analytical utility. Too often, cultural historical detail is
deployed as mere background colour, the superficial set-dressing for a
nostalgic period drama set in a television producer’s idea of the
sixties and seventies – a time of hippies and punks, lava lamps,
roller skates and disco. At certain points, this appears as
unintentionally comic non-sequitur, crowbarred in like clumsy
expositional dialogue. The pioneer of LSD therapy Ronald Sandison
writes to R.D. Laing in June 1970, we’re told, ‘a moment when the
Beatles “The Long and Winding Road” and Jerry Mungo’s [sic]
“In the Summertime” were wafting over the airwaves and _Myra
Breckinridge_ and _Catch-22_ were showing in theaters.’ The somewhat
rushed feeling these insertions give to the book is not helped by an
accumulation of minor factual or typographical errors: the opening of
Laing’s community at Kingsley Hall is wrongly dated to 1964 rather
than 1965; a takeover of mental health facilities by workers at
Lincoln Hospital in the South Bronx also has the wrong date (it was
1969, not 1968), and is erroneously attributed to the Black Panthers
(perhaps being confused with a later action at the hospital led by the
Puerto Rican Young Lords); the important newspaper of the early
survivor movement, _Madness Network News_, is referred to as _Madness
News Network_ throughout.

The countercultural engagement with psychiatry the United States and
in Europe – was wide-ranging, often ambivalent and politically
confused. 1969 special edition of the London underground newspaper
_International Times_, for example, placed side-by-side an interview
with R.D. Laing, an article on the unorthodox early twentieth-century
psychologist Georg Groddeck (interspersed with quotations from Laing,
the I Ching, Shakespeare and Jimi Hendrix), an extract from L. Ron
Hubbard’s _Dianetics_, and a call to action from the
activist-therapy collective People Not Psychiatry. A more sustained
and serious engagement with these broader anti-psychiatric networks
might have allowed Richert more fully to come to terms with the
tangled web of contradictory impulses, inconsistencies and reflexive
critiques which in many ways defined the psychiatric radicalism of the
period.

Half a century on, radicals in the mental health field are confronted
with a much-changed system. While the Victorian asylums which
dominated mid-century psychiatric care have largely been emptied, the
reality of deinstitutionalisation in the US and the UK has been an
abandonment by the state of those who most need assistance.
‘Community care’ – always largely euphemistic as a policy
proposal – has left people isolated in the absence of properly
funded support, and decarceration has in many cases meant emancipation
into addiction, homelessness and the criminal justice system.
Prescriptions for psychiatric medications (in particular
antidepressants) have increased exponentially, as have the profits of
pharmaceutical companies, while biomedical hegemony has been
consolidated. In the context of relentless cuts to mental health
provision, the instincts of the left have often, understandably, been
defensive – to fight to keep the services we have, and to expand
them to more people. Revisiting the liberatory experiments of the
1960s and 1970s can allow us to think again about how our communities
might be served not just by an extension of medical psychiatry, but by
a fundamentally transformed conception of illness and what it means to
be well. For today’s radicals and activists, at a time when mental
health and illness are becoming newly politicised once more, it will
be equally important to learn from their failures.

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