This collection of essays provides a springboard from which mental health professionals may respond to the dramatic social, economic and political worldwide transformations that have taken place over the last century. Here, the liberatory character of psychiatry refers to its role in rendering persons ‘free from’ physical, social or psychological oppression and ‘free to’ pursue what they can be and lead self-directed lives. Provocative, and at times radical, expositions from 22 international contributors illustrate the growing demand for debate and reconceptualization of psychiatric theory and practice that arises from within the field itself. This book will be of interest to the mental health professional, practitioner and researcher, and anyone with an interest in philosophy, politics and mental health.
Progressive psychology goes beyond the view that science is separate from the objects of its enquiry since it deals with real people in real social relationships. Similarly, post-psychiatry is a post-modern psychiatry that appreciates the enmeshment of its science with social judgments, values and practices, not only relieving suffering but ultimately maintaining an appropriate public consciousness. The mature thesis is put forward, that due to psychiatry's intimate link to power, the liberation it can deliver may be viewed at best, not a single act, but as a process.
In the chapters that follow, clinical assessment is framed in the context of risk, the anxiety it creates in health professionals and the temptation to shy away from that by medicalizing mental disorder; an intriguing position. The pieces that follow call for democracy in psychiatric practice through greater involvement of its stakeholders/recipients, as well as psychology research.
Psychopolitical validity is also introduced as an evaluation criterion for a liberatory psychiatry, which ought to conceptualize symptoms as arising from unmet basic human needs, oppression and lack of freedom. The analyses of the predictive roles of structural social class on mental disorder and social capital, a young concept with conflicting implications for the mentally distressed individual, are illuminating, as is the historical account of the opposite influence: that of psychoanalysis on social change in Argentina.
Particularly striking are the accounts of frank self-reflection on the difficulties facing mental health professionals in post-colonial countries, and the essential role of culture in shaping the local narrative, the basic model of knowledge in psychiatry. The reader is reminded that reason is culturally determined and value-laden.
The transformation of the psychiatrist's social and political role as a function of neoliberal ideals and the free-market economy is addressed in chapters 9 and 12, and it is here that the present day relevance and urgency of the liberatory psychiatry project really shines through. These radical pieces address issues surrounding diagnostic instruments, psychopharmacology and the pharmaceutical industry, and the emergent notion of the chemically balanced self, which ultimately obscure the origins of mental illness.
The final question put to the reader is one that the authors ask of themselves: Can liberatory psychiatry engage in constructive dialogue with mainstream institutions without diluting its radicalism? This book is not about consensus and answers; it is about throwing down the gauntlet and kickstarting debate. It is the collective voice of mental health professionals, faced with dilemmas and responsibilities, who challenge their own practice, with sensitivity, sincerity and above all humanism. This reviewer thoroughly recommends it.
