Enrique González Duro
El Viejo Topo, Extra / 7 (especially on social control) - June-August 1979
institutional psychiatry has been presented as a medical science neutral aseptic, which aims to study and treatment of so-called mentally ill. But in fact, rather than its subject, has defined its objectives in social praxis. For example, psychiatry in the Nazi era proposed "scientifically" the mass extermination of some three hundred thousand "lives devoid of value and unworthy of being lived," which constituted a "foreign body to human society." This will "fix" the problem of the mentally ill in Germany and met Hitler dictates State hygienists. But that was not very unusual nonsense, but a measure that led to its ultimate social objectives consequences of a doctrine, almost universally accepted that the mentally ill conceived it as a potential danger to the public, of which the company "healthy" had to defend themselves. And this work of animal health has always made institutional psychiatry, by delegation and to serve the order. Therefore, it is not surprising that even today, many patients are "treated" by force and by force, by the psychiatric unit, which has always had excellent means of repression. (The patient is well aware that, for example, deprivation of liberty (in the asylum) is due to altered others, and not to be really sick. Why not have "disease awareness", which, paradoxically, is interpreted as an unequivocal sign of illness).
treatment of the mentally ill has been nothing but a pretext to cover medical ethical-political function of control of certain "deviant" social psychiatry that exercised for the good of the establishment. Actually, psychiatry acts as a structure of power-knowledge, which defines, conceptualizes, classifies, monitors and corrects the follies of weak and marginalized people, according to the interests and values \u200b\u200bof a "normalized" and "normalizing" values corresponding to the dominant ideology. Historically, all his strength comes from the asylum (where he was born), a segregated institution is still the mainstay in the organization of public psychiatric care, at least in this country. But the asylum should not be conceptualized as a "thing in itself" because their reality also includes the role it plays in the consciousness and the collective unconscious of all people, signifying a desire for exclusion or treatment of the irrational . It is a magical, mythical, where they are deposited and conjure all the follies of society, and everyone fears. Because not only holds the madhouse those who go crazy over, but also acts on the population imagination, coercing a precaution to anyone freak out more than necessary, so that everyone is self-control and behave in a responsible and prudent. In this sense, similarity and complementarity with imprisonment is evident.
The mental hospital (not the hospital for those suffering mental disorders, but the place of enforcement of certain "deviations" of human behavior) was, and remains, the institutional response of the modern state and bourgeois to his need to detain and control a growing number of marginalized people (economically useless, socially irrelevant and politically ineffective), mainly from proletarianized classes who, by their conduct allegedly abnormal and irrational, may disturb the social order and unsettle the rest of the people framed "normally" in that order. From the beginning, the asylum was a repressive institution and prison (and sometimes worse), but immediately became a "doctor costume, apparently becoming a healthcare setting. And the doctors of the institution, later upheld by the University, developed a theory and psychiatric practice came to justify "scientifically" repression of insanity, now converted into mental illness, an abstract entity of alleged domestic or endogenous origin, and completely disconnected from the social circumstances that incubate and produce insanity. Thus, bourgeois society was desrresponsabilizada the contradiction posed by the presence within it of the insane, now regarded as patients suffering from mysterious ailments that doctors would find and "cure." Under the guise of medical treatment, any form of psychiatric repression (from the prison to leucotomy) can exert on the "abnormal" repression that ultimately is just exaggerated and grotesque reproduction repressive control is usually performed on "normal" in the family, school, factory, army, etc.
psychiatric expansion
Chartered as scientific doctrine, psychiatry from the asylum will be out soon and go, as praxis and ideology, acting gradually over most of the social body, whose members are increasingly more unbalanced by the "pace of modern life" and taking more subtle forms of social control and manipulation. And they strive to be more understanding and less segregated, especially when attempting to wealthy patients, always less crazy than the poor, or when you try to reinstate workers to the productive system useful. But the ultimate goal of institutional psychiatry will be introduced at all levels of society in all spheres of human life, trying to make each individual sees himself and others, from a psychiatric perspective. It is, at present, to extend the "look" almost all psychiatric social body and generalize the most of the division between normal and pathological, whose border is no longer the wall of the asylum. (All human conflicts, family and social, and posts may be psiquiatrizados in the hands of experts who will provide appropriate technical solutions).
Madness, once largely the heritage of the poorer classes, now largely has been democratized and extended to other classes in the form of neurosis. Today we are all more or less neurotic, which requires greater political intervention in psychiatry, since surveillance for the neurotic is the last trick of power to control the whole society. Consequently, it is necessary to monitor every corner of everyday life (from simple misspellings of a child, to the use of a harmless joint), and prevent possible failures or deviations of individuals in their adaptation "normalizing" the social system, but without question at all. It is better to prevent or monitor, than cure. Only be used to "cure" when it fails repressive surveillance, and madness is made too obvious: for that institutional psychiatry retains its punitive methods (the mental hospital, electroshock, insulin coma, leucotomy, etc.).
Already in the last century reformer Morel urged psychiatrists to make a general prophylaxis for all social sectors and public authorities to implement a health policy that would preserve their interests. It was the best prevention against possible rebellion of the oppressed and suffering. I did not indifference. But modern, it seems to have understood well some elitist and bourgeois intellectuals, strongly influenced by psychoanalysis (filing of its subversive edge primitives): Enough of politics, discover the unconscious drives, the desire to liberate, we open the key of dreams or signifiers [1] . Certainly, if the subject speaks all his desires and is credited with a certain capacity for enjoyment, through consumerism above all, be more consistent, and need not change the reality. Therefore, monitoring and mental health care for all citizens will be the best means of achieving social integration, the union of all and the end of the class struggle. To do this, the psychiatrist is asked, from society, a social function much wider and deeper, so that its power will increase, although that will not correspond with increased knowledge.
The suffering and the sick role
In modern Western societies, the psychological suffering in its various forms is a problem that affects most people, especially the lower classes , living situations of conflict and have fewer resources and options for overcoming them. While that suffering is almost always hidden, kept within the "privacy" (a value characteristic of bourgeois ideology), lived shamefully and quietly, and, therefore, be manipulated by the dominant ideology (which exalts the individual sacrifice) and its institutions, including psychology and psychiatry. However, hidden fault that suffering often breaks own resistance "normalizing" of the individual and bursts lead to more or less dislocated. Then it can be described as mental illness and "treated" as such. In a society alienated and dehumanized, the risk of psychiatric solution of human problems is increasing for everyone, more or less normal, which is in a critical situation. The system creates in all its expressive potential members of madness, that most people are usually repressed and self-controlled, but in particularly adverse conditions can get out and show out. At that time, the person may be psiquiatrizada, but refuses to do so, anyway because he would be forcibly "treated." You may find it more convenient to submit "voluntarily" to control the psychiatric unit. This is what has been called "voluntary servitude" of the patient to medical power.
The accelerated to an urban society, industrialized, capitalist, as initiated in Spain in the early sixties has led to sharp changes in social structure, with serious consequences of maladjustment, uprooting, family disintegration, acculturation, etc. All these influences have affected the individual, especially in the lower strata, causing all kinds of suffering, discomfort, disorders and psychological disorders, and even major or minor changes in their behavior, subject, moreover, a continuous pressure "normalizing ". At the same time decreased their social and family tolerance threshold, which implies a greater rejection of altered or atypical behavior of the subject, soon to be perceived by those around him as incomprehensible and unpredictable in the context in which it occurs, so that may be "denounced" the psychiatrist, who easily diagnose a disease and prescribe the "treatment" right, which in extreme cases will the psychiatric. If they are people of low social returns (elderly, adults oligophrenic, etc.) Detention shall be final. Thus, what originally appeared as a conflict micro (family, school, work, etc..) Technically is neutralized and converted into a subject's mental disorder, in which consideration ignores all the suffering psychological motivations or behavior atypical. To psychiatric diagnosis, the subject is invalidated as sick, and even more so if it's been a madhouse. Suffering psychic
become susceptible to disease is only a technical answer, which is not always positive for the patient, but may benefit others, is suffering not shared by others, and therefore attracts no caring attitudes of others possibly also suffering, against oppressive structures and generating multiple ailments at all, especially among the most exploited class. The "sick" do not join with other beings "deviant" and suffering to form an alternative subsystem or opposite the central social system, but each relates, voluntarily or not, with a group of non-ill (family, doctors and therapists), which will help us control. Thus, the mental patient is deprived of the possibility of forming a supportive community, and this is much less dangerous to the stability of social roles other deviants, such as the criminal, the rebel, the political dissident, etc. . It is therefore logical that the "establishment" to show their preference for any type of deviant behavior is channeled to the sick role and be psiquiatrizada [2] .
Allocation status of a deviant social ill involves the assertion that it must "take care of you", which provides a fulcrum for social control to be exercised by the family and / or psychiatric medicine. If someone acts aggressively provocative or in certain circumstances and is considered irresponsible for having a disease, then increase social controls, which puts him in a situation of dependency, forced or not, other people, relatives or doctors, who will legitimate because they "help" and not punished, but sometimes that help is extremely punitive. If the subject is adapted to medical prescriptions, and assists in all, will be a "good patient" con lo que obtendrá ciertas ventajas: exención de responsabilidades y de exigencias sociales, apoyo, trato benevolente, etc. De ahí que actualmente mucha gente acepte y se instale cómodamente en el rol de enfermo, aunque interiormente no se reconozca como tal, y a pesar de que esto le suponga sometimiento a otros, pérdida de autonomía y una cierta opresión terapéutica. Y va siendo cada vez más frecuente que sean los propios pacientes los que demanden al médico dosis crecientes de psicofármacos, que ocultan sus propios problemas, los que en muchos casos no son sino conflictos psicosociales más o menos interiorizados. Por el contrario, si el sujeto no se reconoce como enfermo psíquico, no acepta el control doctor and not working in their treatment and healing, will be branded as "sick rebel" serious and even dangerous, in which it can use more coercive methods.
Today, given the increasing demand for psychiatric care (which does not always come from the patient), treatment is not always exclusionary and segregationist, including mental hospitals because they are more than full. Rather seek the rehabilitation of the "deviant" and their early return to economic output circuit. Therefore the treatment can be more readily acceptable to the patient. This treatment involves the administration of psychotropic drugs for patients of the working class, or psychotherapy for the more privileged classes, but in both cases he developed a healing process based on the medical unit, in subjecting the patient to a psychiatrist. And if the mental patient is no cure, is also the danger averted, because the subject is invalidated socially irresponsible, stigmatized by a diagnosis, localized and controlled or controllable at any time. So, although no "cure" institutional psychiatry continues to fulfill its function of social control of deviant behavior. In a society like ours, with high unemployment rate, the system demand psychiatry to cure and rehabilitate the patient socially, to achieve its objective social rehabilitation, as the system is unable to insert directly into the production-consumption process. Just their subjective rehabilitation with the attainment of a homogenization of the "assisted" with respect to the rules of mainstream values, so that it perceives as "good" anything that fits the standard and "bad" what not enter into it. It is, therefore, that the patient can self-controlled, though that did not report a social benefit (work, family acceptance, etc.), And this can be achieved by your agency to a psychiatrist, or institution psychiatric, always able to exercise tight control over him outside, with the threat if it does not behave well. It is therefore understandable that psychiatry in our country remains grossly repressive, especially in public assistance, although private assistance takes increasingly more subtle and smooth, without ceasing to be controlling.
Psychiatry, control checks
technocratic industrial societies are undergoing a dramatic shift recently: the traditional customs are relaxed, the domains of daily life (sexuality, aggression, etc.) Gradually released and occur multiple marginalizations produced by population growth and economic development. The State with its coercive apparatus (police, justice, etc..) Seems unable to maintain an adequate social control. The so-called "ideological state apparatus" (family, school, business, church) are insufficient for the perfect socialization and "normalization" of the individual. But there is no chaos. Social cohesion now tends to be consensual and is achieved more easily with other instruments of surveillance, prevention and handling, managed by a multitude of actors and technicians (communication, information, health, etc.), which are not directly linked to the state but are vehicles for transmitting power and an ideology of "one-dimensional." We are not oppressed dam, or we are less than before, but we are subtly manipulated and controlled. Are new forms of oppression, multifaceted and not cumulative, that even produce a certain enjoyment in the social body (television, consumer, entertainment, planned, etc..), So they are relatively easily accepted by almost everyone.
In institutional psychiatry in modern society, you will gradually attributing the mission control "controls" [3] within general system of monitoring and manipulation that is under the individual. Although the family, school, factory, church, jail, etc., Institutions still control the "establishment" often gives a psychological boost medical or psychiatric condition, which ultimately assesses "scientifically" individual behavior and punished in one way or another. Therefore, its field of intervention is widening. If an individual has a conflict in the family, at school, at work or on the street may not be considered normal enough to be having problems or disorders which depend on the medical treatment. When the child escapes from family control and rebel against parental impositions, when urinating in bed, when it is "difficult," he repeatedly disobeyed or not studied enough, it can be taken to the psychiatrist, who will correct their behavior and restore harmony family. Nowadays children who run away from home, even for one or more days, may be considered ill: the American Psychiatric Association defines the disease as "flight reaction of childhood or adolescence" [4] . Moreover, in some countries begs for preventive psychiatry acting on children and adolescents, "Before it's too late." Thus, among other things, aims to solve the problem of juvenile delinquency, forgetting all social, economic and cultural factors affecting this problem. And many schools already have psychological services, which classify students ready and clumsy, who are stranded, and eliminate those that show excessive disruptive behavior, sending them to a psychiatrist. In short, it is "helping" the children to adapt better to the educational system, although this is very bad, and better understood with the teachers, but not vice versa.
It even reduce absenteeism labor strikes or street violence to simple psychological disturbances. Psychiatry lends itself to it and label as a weak social behavior of individuals and politically weak people disrupting social and politically strong. Therefore, it has to invent new disease entities, such as "antisocial personality", the "passive-aggressive personality," the "cold and emotionally insensitive psychopath", the "psychopath disarmed", etc. In some developed countries even thought about psychiatric solutions to poverty: "In the United States have proposed solutions to social workers who treat poor irrecoverable were aimed at gradually improving the living standards and promote their assimilation of the middle class. Where possible, it has been suggested psychiatric treatment " [5] . In less developed countries do not apply such solutions, because psychiatrists are concerned mainly with middle-class individuals. Therefore, poor countries might seek revolutionary solutions, though, as the author of these paragraphs, no revolution would get away with poverty. Either way, it becomes clear how psychiatry, with its ideology and its praxis adaptive, might try to stop the revolutionary impulses. Not surprisingly, they have never missed psychiatrists have dubbed the leaders and revolutionaries as genuine mental illness. In the same manner now psiquiatriza political dissidents in the Soviet Union and other Western countries.
Psychiatry has also explained the scientific and medical alleged causes of homosexuality, alcoholism, prostitution, or crime, identified as a disease. And psychiatrists are penetrating and in prisons, to apply to prisoners and adaptive coercive treatment: electric shocks, behavioral therapy, leucotomy, psychotropic drugs and therapies to group. Its mission is to bring the prisoner to the prison system [6] .
Control
social marginalization
social system produces all kinds of deviant or socially excluded, those who can not, do not know or not to rehabilitate, but maximum control, inducing them to do so, to assume roles clearly defined and differentiated. The system must "preserve", properly identified and "placed" to their misleading, even if it is so that, by contrast, clearly set social standards which apply to all "normal", which they deposited their impulses deviants. To the extent that the institutions created for the deviants (prisons, mental hospitals, etc.), Do not cure nor reformed, but on the contrary, confirms its role or social status. Could be many examples. Occurs not too interested in fully reintegrate into society when diverted or marginalized. Care more quickly discover, isolate, neutralize, to confirm that we (the healthy, normal), which is the social organization that produces contradictions.
But this is a pure contradiction that seriously questions the validity of integrity and fairness of the system, and suggests, as a solution, a revolutionary change in the structures social. To prevent the oppressed classes, from which arise most marginalized labeled, aware, solidarity with them and encourage this revolutionary change, the system will deny the contradiction. And the disguise with psychiatric ideology that explains everything "scientifically" by reducing the social problem of deviant and marginalized individual problem of each of them is always prone to be solved technically. This concludes that the marginalized are mentally ill, theoretically curable or rehabilitated.
But in practice, institutional psychiatry does not cure or rehabilitate just about anyone. What Not surprisingly, given that ignores all socioeconomic contradictions that affect social exclusion. But not only does not cure the deviant, sick, but stigmatizes them with a scientific diagnosis that makes them socially unacceptable, or to accept them hypocritically and with many reservations. For example, when a mentally ill man allegedly cured returns to its normal environment, following a psychiatric hospitalization, chooses to withdraw, for being docile and avoid any confrontation with others, because his senses that any action may find it dissonant minimally interpreted as a symptom of disease. Who has a psychiatric stigma it requires exemplary behavior, almost perfect, because it is easily recognizable, is in poor condition and can not, that in case of conflict, the other to act against him and lead him back to the psychiatrist. People around him are not treated as equals, do not trust him, will monitor and control, which leads to self-exaggeration, to avoid the "relapse" and psychiatric repression. It is the view that psychiatric controls: the former patients living on probation, supervised by the family, social worker, doctor, neighbors and the psychiatrist who reviewed periodically. Will have to undergo such monitoring unless you want to avoid greater evils. Is a process of psychiatrization, which will each internalized the ideology of repressive psychiatry and become your own psychiatrist, and others, watching and controlling their own folly and that of others. Occurs, thus extending the distance mental control, more subtle and less expensive than direct psychiatric repression, which act only in extreme cases.
Thus, institutional psychiatry does not need to cure or rehabilitate many people astray. You just have to tame wild eliminating symptoms of the deviant-ill, stigmatized and remote control. Invalidates it as a person, so the state can repress when it suits them peacefully and with the consensus of the normal population. But it is precisely this practice with the marginalized which invalidates the entire psychiatric ideology critically, unmasking it as cover for controlling and repressive order.
Towards a popular psychiatry
addition repressive apparatus of control of certain deviant behaviors, institutional psychiatry, while teaching and practice, constitutes an efficient "ideological state apparatus, which reproduces compliance with the individual to rules of order and submission to the dominant ideology, and that helps, "through knowledge", the maintenance of this ideology and its handling by the agents of repression. Indeed, psychiatry assesses individual behaviors, classifying them as normal or abnormal, "is" only abnormal, but a priori denying its historicity and its possible connections with the social and production relations. Rejects "scientific" psychological suffering, or that it has something to do with power, the oppression or exploitation of man by man. Any response to an alleged mental illness, from internal or intrapsychic, which can appear almost mysteriously in any individual, unrelated to their specific circumstances. Only doctors can cure with methods rigorously "scientific." It is, therefore, an ideology that is often accepted uncritically by the entire social body as a medical science, with almost absolute value. The working class, on the institutional psychiatry operates in a more oppressive, not easily aware of ideological manipulation that is the subject for the benefit of the ruling class. Hence there has been subjected to a critical ideologies, as if it has done with other "devices ideological "such as school or religion.
But if you understand the ideology behind psychiatry, it can become a place of class struggle, because through psychiatry "resistance of the exploited classes may find the means and opportunity to make their voices heard either using the existing contradictions within it, is winning the fight battle stations "in it (Althusser). This is starting to happen: many technicians (psychiatrists, psychologists, etc.) Are rejecting its role as "servants of consensus", with its guarantee not to legitimize discrimination and violence inflicted on social deviants, and considering alternative solutions. And on the other hand, some nuclei of the working classes, as potential users of psychiatric services, begin to sensitize and to claim their participation in their management, to become genuine public services that address the psychological needs suffering population. In fact, attempts are emerging popular psychiatry, which denies the madhouse, seeking therapeutic resources in the community, which seeks to socialize the knowledge, developing mental health plans with the participation of more people and to the maximum despsiquiatrizar problems human and social, to be solved transforming simultaneously the social reality.
psychiatry is still necessary, because the mental suffering of the population constantly growing. But we must fight for a new psychiatry, which no press release and that is not in the service of power but to alleviate the suffering of the people. This requires ideologize traditional psychiatric discourse and transform it into a discourse of emancipation, dialogue popular. And this will be achieved by removing the discourse of the medical field that is still and taking it to the political-social. Then demonstrate the futility of current psychiatric knowledge and the power of nudity the psychiatrist, and may open an avenue for alternative psychiatry.
Footnotes
page
La Guardia, Jaen, 1939. University professor and psychiatrist.
has worked for over thirty years on public assistance, having been one of the leaders of the anti-psychiatric movement of 1970. Launched in 1973 the first Day Hospital in Spain. In 1981 he took charge of the psychiatric reform in the province of Jaén. Currently working in the hospital Gregorio Maranon de Madrid. Regular contributor to newspapers, radio and television. Author of psychiatric care in Spain (ed. M. Fernández and Co., 1975), sexual repression, social domination (ed. Akal, 1976), Psychiatry and authoritarian society (Akal, 1978), Distance to the madness: Theory and Practice of Hospital Day (ed. Fundamentals, 1982), History of Psychiatry (ed. Libertarian-Prodhufi, 1987), Report of a madhouse (ed. Libertarian-Prodhufi, 1992), The neurosis of the housewife (ed. Universidad Complutense de Madrid, 1990), Paranoia (ed. Temas de Hoy, 1991), Psychological Biography Felipe González (Ed. Temas de Hoy, 1996), powerful mask (Libertarian-Prodhufi ed., 1999), Women separate (Thelassa Editions, 1999), Franco, a psychological biography (Ed. Temas de Hoy, 2000), Juan internal Biography Ramón Jiménez (ed. Libertarian-Prodhufi, 2002), Fear in postwar (ed. Oberon, 2003), Demons in the convent (ed. Oberon, 2004), risk of living: new XXI century addiction (Ed. Temas de Hoy, 2005), Shadow of the General (ed. Debate, 2005), Fernando VII: Felon King (ed. Oberon, 2006) and fear Biography (ed. Debate, 2007).
El Viejo Topo, Extra / 7 (especially on social control) - June-August 1979
institutional psychiatry has been presented as a medical science neutral aseptic, which aims to study and treatment of so-called mentally ill. But in fact, rather than its subject, has defined its objectives in social praxis. For example, psychiatry in the Nazi era proposed "scientifically" the mass extermination of some three hundred thousand "lives devoid of value and unworthy of being lived," which constituted a "foreign body to human society." This will "fix" the problem of the mentally ill in Germany and met Hitler dictates State hygienists. But that was not very unusual nonsense, but a measure that led to its ultimate social objectives consequences of a doctrine, almost universally accepted that the mentally ill conceived it as a potential danger to the public, of which the company "healthy" had to defend themselves. And this work of animal health has always made institutional psychiatry, by delegation and to serve the order. Therefore, it is not surprising that even today, many patients are "treated" by force and by force, by the psychiatric unit, which has always had excellent means of repression. (The patient is well aware that, for example, deprivation of liberty (in the asylum) is due to altered others, and not to be really sick. Why not have "disease awareness", which, paradoxically, is interpreted as an unequivocal sign of illness).
treatment of the mentally ill has been nothing but a pretext to cover medical ethical-political function of control of certain "deviant" social psychiatry that exercised for the good of the establishment. Actually, psychiatry acts as a structure of power-knowledge, which defines, conceptualizes, classifies, monitors and corrects the follies of weak and marginalized people, according to the interests and values \u200b\u200bof a "normalized" and "normalizing" values corresponding to the dominant ideology. Historically, all his strength comes from the asylum (where he was born), a segregated institution is still the mainstay in the organization of public psychiatric care, at least in this country. But the asylum should not be conceptualized as a "thing in itself" because their reality also includes the role it plays in the consciousness and the collective unconscious of all people, signifying a desire for exclusion or treatment of the irrational . It is a magical, mythical, where they are deposited and conjure all the follies of society, and everyone fears. Because not only holds the madhouse those who go crazy over, but also acts on the population imagination, coercing a precaution to anyone freak out more than necessary, so that everyone is self-control and behave in a responsible and prudent. In this sense, similarity and complementarity with imprisonment is evident.
The mental hospital (not the hospital for those suffering mental disorders, but the place of enforcement of certain "deviations" of human behavior) was, and remains, the institutional response of the modern state and bourgeois to his need to detain and control a growing number of marginalized people (economically useless, socially irrelevant and politically ineffective), mainly from proletarianized classes who, by their conduct allegedly abnormal and irrational, may disturb the social order and unsettle the rest of the people framed "normally" in that order. From the beginning, the asylum was a repressive institution and prison (and sometimes worse), but immediately became a "doctor costume, apparently becoming a healthcare setting. And the doctors of the institution, later upheld by the University, developed a theory and psychiatric practice came to justify "scientifically" repression of insanity, now converted into mental illness, an abstract entity of alleged domestic or endogenous origin, and completely disconnected from the social circumstances that incubate and produce insanity. Thus, bourgeois society was desrresponsabilizada the contradiction posed by the presence within it of the insane, now regarded as patients suffering from mysterious ailments that doctors would find and "cure." Under the guise of medical treatment, any form of psychiatric repression (from the prison to leucotomy) can exert on the "abnormal" repression that ultimately is just exaggerated and grotesque reproduction repressive control is usually performed on "normal" in the family, school, factory, army, etc.
psychiatric expansion
Chartered as scientific doctrine, psychiatry from the asylum will be out soon and go, as praxis and ideology, acting gradually over most of the social body, whose members are increasingly more unbalanced by the "pace of modern life" and taking more subtle forms of social control and manipulation. And they strive to be more understanding and less segregated, especially when attempting to wealthy patients, always less crazy than the poor, or when you try to reinstate workers to the productive system useful. But the ultimate goal of institutional psychiatry will be introduced at all levels of society in all spheres of human life, trying to make each individual sees himself and others, from a psychiatric perspective. It is, at present, to extend the "look" almost all psychiatric social body and generalize the most of the division between normal and pathological, whose border is no longer the wall of the asylum. (All human conflicts, family and social, and posts may be psiquiatrizados in the hands of experts who will provide appropriate technical solutions).
Madness, once largely the heritage of the poorer classes, now largely has been democratized and extended to other classes in the form of neurosis. Today we are all more or less neurotic, which requires greater political intervention in psychiatry, since surveillance for the neurotic is the last trick of power to control the whole society. Consequently, it is necessary to monitor every corner of everyday life (from simple misspellings of a child, to the use of a harmless joint), and prevent possible failures or deviations of individuals in their adaptation "normalizing" the social system, but without question at all. It is better to prevent or monitor, than cure. Only be used to "cure" when it fails repressive surveillance, and madness is made too obvious: for that institutional psychiatry retains its punitive methods (the mental hospital, electroshock, insulin coma, leucotomy, etc.).
Already in the last century reformer Morel urged psychiatrists to make a general prophylaxis for all social sectors and public authorities to implement a health policy that would preserve their interests. It was the best prevention against possible rebellion of the oppressed and suffering. I did not indifference. But modern, it seems to have understood well some elitist and bourgeois intellectuals, strongly influenced by psychoanalysis (filing of its subversive edge primitives): Enough of politics, discover the unconscious drives, the desire to liberate, we open the key of dreams or signifiers [1] . Certainly, if the subject speaks all his desires and is credited with a certain capacity for enjoyment, through consumerism above all, be more consistent, and need not change the reality. Therefore, monitoring and mental health care for all citizens will be the best means of achieving social integration, the union of all and the end of the class struggle. To do this, the psychiatrist is asked, from society, a social function much wider and deeper, so that its power will increase, although that will not correspond with increased knowledge.
The suffering and the sick role
In modern Western societies, the psychological suffering in its various forms is a problem that affects most people, especially the lower classes , living situations of conflict and have fewer resources and options for overcoming them. While that suffering is almost always hidden, kept within the "privacy" (a value characteristic of bourgeois ideology), lived shamefully and quietly, and, therefore, be manipulated by the dominant ideology (which exalts the individual sacrifice) and its institutions, including psychology and psychiatry. However, hidden fault that suffering often breaks own resistance "normalizing" of the individual and bursts lead to more or less dislocated. Then it can be described as mental illness and "treated" as such. In a society alienated and dehumanized, the risk of psychiatric solution of human problems is increasing for everyone, more or less normal, which is in a critical situation. The system creates in all its expressive potential members of madness, that most people are usually repressed and self-controlled, but in particularly adverse conditions can get out and show out. At that time, the person may be psiquiatrizada, but refuses to do so, anyway because he would be forcibly "treated." You may find it more convenient to submit "voluntarily" to control the psychiatric unit. This is what has been called "voluntary servitude" of the patient to medical power.
The accelerated to an urban society, industrialized, capitalist, as initiated in Spain in the early sixties has led to sharp changes in social structure, with serious consequences of maladjustment, uprooting, family disintegration, acculturation, etc. All these influences have affected the individual, especially in the lower strata, causing all kinds of suffering, discomfort, disorders and psychological disorders, and even major or minor changes in their behavior, subject, moreover, a continuous pressure "normalizing ". At the same time decreased their social and family tolerance threshold, which implies a greater rejection of altered or atypical behavior of the subject, soon to be perceived by those around him as incomprehensible and unpredictable in the context in which it occurs, so that may be "denounced" the psychiatrist, who easily diagnose a disease and prescribe the "treatment" right, which in extreme cases will the psychiatric. If they are people of low social returns (elderly, adults oligophrenic, etc.) Detention shall be final. Thus, what originally appeared as a conflict micro (family, school, work, etc..) Technically is neutralized and converted into a subject's mental disorder, in which consideration ignores all the suffering psychological motivations or behavior atypical. To psychiatric diagnosis, the subject is invalidated as sick, and even more so if it's been a madhouse. Suffering psychic
become susceptible to disease is only a technical answer, which is not always positive for the patient, but may benefit others, is suffering not shared by others, and therefore attracts no caring attitudes of others possibly also suffering, against oppressive structures and generating multiple ailments at all, especially among the most exploited class. The "sick" do not join with other beings "deviant" and suffering to form an alternative subsystem or opposite the central social system, but each relates, voluntarily or not, with a group of non-ill (family, doctors and therapists), which will help us control. Thus, the mental patient is deprived of the possibility of forming a supportive community, and this is much less dangerous to the stability of social roles other deviants, such as the criminal, the rebel, the political dissident, etc. . It is therefore logical that the "establishment" to show their preference for any type of deviant behavior is channeled to the sick role and be psiquiatrizada [2] .
Allocation status of a deviant social ill involves the assertion that it must "take care of you", which provides a fulcrum for social control to be exercised by the family and / or psychiatric medicine. If someone acts aggressively provocative or in certain circumstances and is considered irresponsible for having a disease, then increase social controls, which puts him in a situation of dependency, forced or not, other people, relatives or doctors, who will legitimate because they "help" and not punished, but sometimes that help is extremely punitive. If the subject is adapted to medical prescriptions, and assists in all, will be a "good patient" con lo que obtendrá ciertas ventajas: exención de responsabilidades y de exigencias sociales, apoyo, trato benevolente, etc. De ahí que actualmente mucha gente acepte y se instale cómodamente en el rol de enfermo, aunque interiormente no se reconozca como tal, y a pesar de que esto le suponga sometimiento a otros, pérdida de autonomía y una cierta opresión terapéutica. Y va siendo cada vez más frecuente que sean los propios pacientes los que demanden al médico dosis crecientes de psicofármacos, que ocultan sus propios problemas, los que en muchos casos no son sino conflictos psicosociales más o menos interiorizados. Por el contrario, si el sujeto no se reconoce como enfermo psíquico, no acepta el control doctor and not working in their treatment and healing, will be branded as "sick rebel" serious and even dangerous, in which it can use more coercive methods.
Today, given the increasing demand for psychiatric care (which does not always come from the patient), treatment is not always exclusionary and segregationist, including mental hospitals because they are more than full. Rather seek the rehabilitation of the "deviant" and their early return to economic output circuit. Therefore the treatment can be more readily acceptable to the patient. This treatment involves the administration of psychotropic drugs for patients of the working class, or psychotherapy for the more privileged classes, but in both cases he developed a healing process based on the medical unit, in subjecting the patient to a psychiatrist. And if the mental patient is no cure, is also the danger averted, because the subject is invalidated socially irresponsible, stigmatized by a diagnosis, localized and controlled or controllable at any time. So, although no "cure" institutional psychiatry continues to fulfill its function of social control of deviant behavior. In a society like ours, with high unemployment rate, the system demand psychiatry to cure and rehabilitate the patient socially, to achieve its objective social rehabilitation, as the system is unable to insert directly into the production-consumption process. Just their subjective rehabilitation with the attainment of a homogenization of the "assisted" with respect to the rules of mainstream values, so that it perceives as "good" anything that fits the standard and "bad" what not enter into it. It is, therefore, that the patient can self-controlled, though that did not report a social benefit (work, family acceptance, etc.), And this can be achieved by your agency to a psychiatrist, or institution psychiatric, always able to exercise tight control over him outside, with the threat if it does not behave well. It is therefore understandable that psychiatry in our country remains grossly repressive, especially in public assistance, although private assistance takes increasingly more subtle and smooth, without ceasing to be controlling.
Psychiatry, control checks
technocratic industrial societies are undergoing a dramatic shift recently: the traditional customs are relaxed, the domains of daily life (sexuality, aggression, etc.) Gradually released and occur multiple marginalizations produced by population growth and economic development. The State with its coercive apparatus (police, justice, etc..) Seems unable to maintain an adequate social control. The so-called "ideological state apparatus" (family, school, business, church) are insufficient for the perfect socialization and "normalization" of the individual. But there is no chaos. Social cohesion now tends to be consensual and is achieved more easily with other instruments of surveillance, prevention and handling, managed by a multitude of actors and technicians (communication, information, health, etc.), which are not directly linked to the state but are vehicles for transmitting power and an ideology of "one-dimensional." We are not oppressed dam, or we are less than before, but we are subtly manipulated and controlled. Are new forms of oppression, multifaceted and not cumulative, that even produce a certain enjoyment in the social body (television, consumer, entertainment, planned, etc..), So they are relatively easily accepted by almost everyone.
In institutional psychiatry in modern society, you will gradually attributing the mission control "controls" [3] within general system of monitoring and manipulation that is under the individual. Although the family, school, factory, church, jail, etc., Institutions still control the "establishment" often gives a psychological boost medical or psychiatric condition, which ultimately assesses "scientifically" individual behavior and punished in one way or another. Therefore, its field of intervention is widening. If an individual has a conflict in the family, at school, at work or on the street may not be considered normal enough to be having problems or disorders which depend on the medical treatment. When the child escapes from family control and rebel against parental impositions, when urinating in bed, when it is "difficult," he repeatedly disobeyed or not studied enough, it can be taken to the psychiatrist, who will correct their behavior and restore harmony family. Nowadays children who run away from home, even for one or more days, may be considered ill: the American Psychiatric Association defines the disease as "flight reaction of childhood or adolescence" [4] . Moreover, in some countries begs for preventive psychiatry acting on children and adolescents, "Before it's too late." Thus, among other things, aims to solve the problem of juvenile delinquency, forgetting all social, economic and cultural factors affecting this problem. And many schools already have psychological services, which classify students ready and clumsy, who are stranded, and eliminate those that show excessive disruptive behavior, sending them to a psychiatrist. In short, it is "helping" the children to adapt better to the educational system, although this is very bad, and better understood with the teachers, but not vice versa.
It even reduce absenteeism labor strikes or street violence to simple psychological disturbances. Psychiatry lends itself to it and label as a weak social behavior of individuals and politically weak people disrupting social and politically strong. Therefore, it has to invent new disease entities, such as "antisocial personality", the "passive-aggressive personality," the "cold and emotionally insensitive psychopath", the "psychopath disarmed", etc. In some developed countries even thought about psychiatric solutions to poverty: "In the United States have proposed solutions to social workers who treat poor irrecoverable were aimed at gradually improving the living standards and promote their assimilation of the middle class. Where possible, it has been suggested psychiatric treatment " [5] . In less developed countries do not apply such solutions, because psychiatrists are concerned mainly with middle-class individuals. Therefore, poor countries might seek revolutionary solutions, though, as the author of these paragraphs, no revolution would get away with poverty. Either way, it becomes clear how psychiatry, with its ideology and its praxis adaptive, might try to stop the revolutionary impulses. Not surprisingly, they have never missed psychiatrists have dubbed the leaders and revolutionaries as genuine mental illness. In the same manner now psiquiatriza political dissidents in the Soviet Union and other Western countries.
Psychiatry has also explained the scientific and medical alleged causes of homosexuality, alcoholism, prostitution, or crime, identified as a disease. And psychiatrists are penetrating and in prisons, to apply to prisoners and adaptive coercive treatment: electric shocks, behavioral therapy, leucotomy, psychotropic drugs and therapies to group. Its mission is to bring the prisoner to the prison system [6] .
Control
social marginalization
social system produces all kinds of deviant or socially excluded, those who can not, do not know or not to rehabilitate, but maximum control, inducing them to do so, to assume roles clearly defined and differentiated. The system must "preserve", properly identified and "placed" to their misleading, even if it is so that, by contrast, clearly set social standards which apply to all "normal", which they deposited their impulses deviants. To the extent that the institutions created for the deviants (prisons, mental hospitals, etc.), Do not cure nor reformed, but on the contrary, confirms its role or social status. Could be many examples. Occurs not too interested in fully reintegrate into society when diverted or marginalized. Care more quickly discover, isolate, neutralize, to confirm that we (the healthy, normal), which is the social organization that produces contradictions.
But this is a pure contradiction that seriously questions the validity of integrity and fairness of the system, and suggests, as a solution, a revolutionary change in the structures social. To prevent the oppressed classes, from which arise most marginalized labeled, aware, solidarity with them and encourage this revolutionary change, the system will deny the contradiction. And the disguise with psychiatric ideology that explains everything "scientifically" by reducing the social problem of deviant and marginalized individual problem of each of them is always prone to be solved technically. This concludes that the marginalized are mentally ill, theoretically curable or rehabilitated.
But in practice, institutional psychiatry does not cure or rehabilitate just about anyone. What Not surprisingly, given that ignores all socioeconomic contradictions that affect social exclusion. But not only does not cure the deviant, sick, but stigmatizes them with a scientific diagnosis that makes them socially unacceptable, or to accept them hypocritically and with many reservations. For example, when a mentally ill man allegedly cured returns to its normal environment, following a psychiatric hospitalization, chooses to withdraw, for being docile and avoid any confrontation with others, because his senses that any action may find it dissonant minimally interpreted as a symptom of disease. Who has a psychiatric stigma it requires exemplary behavior, almost perfect, because it is easily recognizable, is in poor condition and can not, that in case of conflict, the other to act against him and lead him back to the psychiatrist. People around him are not treated as equals, do not trust him, will monitor and control, which leads to self-exaggeration, to avoid the "relapse" and psychiatric repression. It is the view that psychiatric controls: the former patients living on probation, supervised by the family, social worker, doctor, neighbors and the psychiatrist who reviewed periodically. Will have to undergo such monitoring unless you want to avoid greater evils. Is a process of psychiatrization, which will each internalized the ideology of repressive psychiatry and become your own psychiatrist, and others, watching and controlling their own folly and that of others. Occurs, thus extending the distance mental control, more subtle and less expensive than direct psychiatric repression, which act only in extreme cases.
Thus, institutional psychiatry does not need to cure or rehabilitate many people astray. You just have to tame wild eliminating symptoms of the deviant-ill, stigmatized and remote control. Invalidates it as a person, so the state can repress when it suits them peacefully and with the consensus of the normal population. But it is precisely this practice with the marginalized which invalidates the entire psychiatric ideology critically, unmasking it as cover for controlling and repressive order.
Towards a popular psychiatry
addition repressive apparatus of control of certain deviant behaviors, institutional psychiatry, while teaching and practice, constitutes an efficient "ideological state apparatus, which reproduces compliance with the individual to rules of order and submission to the dominant ideology, and that helps, "through knowledge", the maintenance of this ideology and its handling by the agents of repression. Indeed, psychiatry assesses individual behaviors, classifying them as normal or abnormal, "is" only abnormal, but a priori denying its historicity and its possible connections with the social and production relations. Rejects "scientific" psychological suffering, or that it has something to do with power, the oppression or exploitation of man by man. Any response to an alleged mental illness, from internal or intrapsychic, which can appear almost mysteriously in any individual, unrelated to their specific circumstances. Only doctors can cure with methods rigorously "scientific." It is, therefore, an ideology that is often accepted uncritically by the entire social body as a medical science, with almost absolute value. The working class, on the institutional psychiatry operates in a more oppressive, not easily aware of ideological manipulation that is the subject for the benefit of the ruling class. Hence there has been subjected to a critical ideologies, as if it has done with other "devices ideological "such as school or religion.
But if you understand the ideology behind psychiatry, it can become a place of class struggle, because through psychiatry "resistance of the exploited classes may find the means and opportunity to make their voices heard either using the existing contradictions within it, is winning the fight battle stations "in it (Althusser). This is starting to happen: many technicians (psychiatrists, psychologists, etc.) Are rejecting its role as "servants of consensus", with its guarantee not to legitimize discrimination and violence inflicted on social deviants, and considering alternative solutions. And on the other hand, some nuclei of the working classes, as potential users of psychiatric services, begin to sensitize and to claim their participation in their management, to become genuine public services that address the psychological needs suffering population. In fact, attempts are emerging popular psychiatry, which denies the madhouse, seeking therapeutic resources in the community, which seeks to socialize the knowledge, developing mental health plans with the participation of more people and to the maximum despsiquiatrizar problems human and social, to be solved transforming simultaneously the social reality.
psychiatry is still necessary, because the mental suffering of the population constantly growing. But we must fight for a new psychiatry, which no press release and that is not in the service of power but to alleviate the suffering of the people. This requires ideologize traditional psychiatric discourse and transform it into a discourse of emancipation, dialogue popular. And this will be achieved by removing the discourse of the medical field that is still and taking it to the political-social. Then demonstrate the futility of current psychiatric knowledge and the power of nudity the psychiatrist, and may open an avenue for alternative psychiatry.
Footnotes
page
- [1] Christian Delacampagne, Psychiatry and oppression , Editorial Destino, Barcelona, \u200b\u200b1978.
[2] Talcott Parsons, social system, Editorial Revista de Occidente, Madrid, 1966.
[3] Christian Delacampagne. Op.
[4] The description of this supposed disease appeared in the "Diagnostic and Statical Manual", published by the American Psychiatric Association in 1968.
[5] The phrase Oscar Lewis is, and is quoted in his book by Basaglia Most marginalized, Editorial Laia, Barcelona, \u200b\u200b1973.
[6] Stanley Cohen, "A stage for the prison system of the future", an essay in the book peace crimes compiled by Basaglia and published by Editorial Siglo XXI, Mexico, 1977.
[7] Louis Althusser, Writings, Editorial Laia, Barcelona, \u200b\u200b1974.
La Guardia, Jaen, 1939. University professor and psychiatrist.
has worked for over thirty years on public assistance, having been one of the leaders of the anti-psychiatric movement of 1970. Launched in 1973 the first Day Hospital in Spain. In 1981 he took charge of the psychiatric reform in the province of Jaén. Currently working in the hospital Gregorio Maranon de Madrid. Regular contributor to newspapers, radio and television. Author of psychiatric care in Spain (ed. M. Fernández and Co., 1975), sexual repression, social domination (ed. Akal, 1976), Psychiatry and authoritarian society (Akal, 1978), Distance to the madness: Theory and Practice of Hospital Day (ed. Fundamentals, 1982), History of Psychiatry (ed. Libertarian-Prodhufi, 1987), Report of a madhouse (ed. Libertarian-Prodhufi, 1992), The neurosis of the housewife (ed. Universidad Complutense de Madrid, 1990), Paranoia (ed. Temas de Hoy, 1991), Psychological Biography Felipe González (Ed. Temas de Hoy, 1996), powerful mask (Libertarian-Prodhufi ed., 1999), Women separate (Thelassa Editions, 1999), Franco, a psychological biography (Ed. Temas de Hoy, 2000), Juan internal Biography Ramón Jiménez (ed. Libertarian-Prodhufi, 2002), Fear in postwar (ed. Oberon, 2003), Demons in the convent (ed. Oberon, 2004), risk of living: new XXI century addiction (Ed. Temas de Hoy, 2005), Shadow of the General (ed. Debate, 2005), Fernando VII: Felon King (ed. Oberon, 2006) and fear Biography (ed. Debate, 2007).
