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Common sense, nonsense and the new culture wars within psychiatry. Invited commentary on … Beyond consultation

  • Frank Holloway (a1)
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Abstract
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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1 Bracken, P, Thomas, P. Beyond consultation: the challenge of working with user/survivor and carer groups. Psychiatric Bull 2009, 33, 241–3.
2 Bracken, P, Thomas, P. Post-psychiatry: Mental health in a Postmodern World. Oxford University Press, 2005.
3 Bracken, P, Thomas, P. Post-psychiatry: a new direction for mental heath. BMJ 2001; 322: 724–7.
4 Thomas, P, Bracken, P. Critical psychiatry in practice. Advan Psychiatr Treat 2004; 10: 361–70.
5 Department of Health. Standards for Better Health. Department of Health, 2004 (http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4086665).
6 Healthcare Commission. Criteria for Assessing Core Standards in 2008/ 2009 – Mental Health and Learning Disability Trusts. Healthcare Commission, 2008 (http://www.cqc.org.uk/_db/_documents/Criteria_for_assessing_core_standards_08-09_for_MHLD_trusts_200903194404.pdf).
7 General Medical Council. Consent: Patients and Doctors Making Decisions Together. GMC, 2008.
8 Kuhn, TS. The Structure of Scientific Revolutions (2nd edn). University of Chicago Press, 1970.
9 Tyrer, P. From the Editors' desk. Br J Psychiatry 2008; 192; 482.
10 Davidson, L. Living Outside Mental Illness. Qualitative Studies of Recovery in Schizophrenia. New York University Press, 2003.
11 Craddock, N, Antebi, D, Attenburrow, M-J, Bailey, A, Carson, A, Cowen, P, et al. Wake-up call for British psychiatry. Br J Psychiatry 2008; 193: 69.
12 Clare, A. Psychiatry in Dissent. Tavistock Publications, 1977.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Common sense, nonsense and the new culture wars within psychiatry. Invited commentary on … Beyond consultation

  • Frank Holloway (a1)
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eLetters

Critical psychiatry seeks to avoid the polarisation engendered by anti-psychiatry

D B Double, Consultant Psychiatrist
10 July 2009

Frank Holloway wonders whether he has missed a subtle distinction between the constructs of postpsychiatry and critical psychiatry.1 Postpsychiatry is one form of critical psychiatry, perhaps the best articulated.2 Critical psychiatry covers a broad range of opinion. A fundamental debate within critical psychiatry is about how much can be achieved within psychiatry. Critical psychiatry is not necessarily tied to postmodernism, as is postpsychiatry.Holloway also suggests that postpsychiatry is “strikingly similar to the anti-psychiatry movement of the 1970s”, but does not explain in what way. Indeed there are links between anti-psychiatry and critical psychiatry, which critical psychiatry has not been afraid to hide.3 However, it should be remembered that both RD Laing and Thomas Szasz, perhaps the two psychiatrists most commonly associated with the term, disowned the use of it of themselves. Moreover, there are significant differences between the views of Laing and Szasz, which are frequently glossed over. Essentially, ‘anti-psychiatry’ has been used by the mainstream to disparage any opposition. I worry that Holloway is also using the term in this way when he talks about the new culture war between critical psychiatry and academic psychiatry.Holloway expresses concern that the casualties of this war will include most mental health professionals who take an eclectic approach to their work. True, eclecticism was the compromise outcome of the anti-psychiatry debate, perhaps best represented by Anthony Clare’s book Psychiatry in dissent, which Holloway quotes.4 Clare eschewed a well-defined basis for practice. In the same month’s edition of the British Journal of Psychiatry, Nassir Ghaemi argues for the need to move beyond such eclecticism.5 Critical psychiatry is a potential way forward.1. Holloway F. Comon sense, nonsense and the new culture wars within psychiatry. Invited commentary on … beyond consultation. Psychiatric Bulletin 2009, 33: 243-42. Double DB (ed) Critical psychiatry: The limits of madness. Basingstoke, Palgrave Macmillan, 20063. Double DB. Historical perspectives on anti-psychiatry. In: Double DB (ed) Critical psychiatry: The limits of madness. Basingstoke, Palgrave Macmillan, 2006: 19-39 www.dbdouble.freeuk.com/Chapter2DBD.htm 4. Clare A. Psychiatry in dissent. Tavistock Publications, 19775. Ghaemi SN. The rise and fall of the biopsychosocial model. Br J Psychiat 2009, 195: 3-4. ... More

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