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

Frank Holloway wonders whether he has missed a subtle distinction between the constructs of post-psychiatry and critical psychiatry. ¹ Post-psychiatry 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 post-psychiatry.

Holloway also suggests that post-psychiatry 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 R.D. 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 recent issue 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.

Declaration of interest

D.B.D. is a member of the Critical Psychiatry Network.