Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice

319 Pages·2000·1.56 MB·English

by  Lucy Johnstone

Users and Abusers of
Psychiatry
Users and Abusers of Psychiatry is a radically different, critical
account of the day-to-day practice of psychiatry. Using real-life
examples and her own experience as a clinical psychologist, Lucy
Johnstone argues that the traditional way of treating mental
breakdown can often exacerbate people’s original difficulties leaving
them powerless, disabled and even more distressed.
In this completely revised and updated second edition, she draws on
a range of evidence to present a very different understanding of
psychiatric breakdown than that found in standard medical textbooks.
Users and Abusers of Psychiatry is a challenging but ultimately
inspiring read for all who are involved in mental health – whether as
professionals, students, service users, relatives or interested lay people.
Lucy Johnstone is a Senior Lecturer in Clinical Psychology and
Counselling at University of the West of England, Bristol. She is a
chartered clinical psychologist and chartered counselling psychologist
and spent eleven years working in the NHS before moving to her
present post. She has lectured and published widely in the area of
critical approaches to mental health.

Users and Abusers
of Psychiatry
A critical look at psychiatric
practice
Second edition
Lucy Johnstone
London and Philadelphia
First edition published 1989
Second edition published 2000
by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Taylor & Francis inc
325 Chestnut Street, 8th Floor, Philadelphia PA 19106
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2006.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”
© 2000 Lucy Johnstone
The right of Lucy Johnstone to be identified as the Author of this
Work has been asserted by her in accordance with the Copyright,
Designs and Patents Act 1988
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from
the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloguing in Publication Data
Johnstone, Lucy.
Users and abusers of psychiatry : a critical look at psychiatric practice /
Lucy Johnstone.–2nd ed.
p. cm.
Includes bibliographical references and index.
1. Psychiatry–Great Britain. 2. Psychiatric hospital care–Great
Britain–Case studies. 3. Pharmaceutical industry–Great Britain. I. Title.
RC450.G7 J58 2000
616.89’00941–dc21 99-086275
ISBN 0-203-12963-6 Master e-book ISBN
ISBN 0-203-17667-7 (Adobe eReader Format)
ISBN 0-415-21155-7 (hbk)
ISBN 0-415-21156-5 (pbk)
In memory of Roy and Mary McKay

Contents
Foreword ix
Acknowledgements xvii
Glossary xix
1 The story of a depressed housewife 1
2 The Rescue Game 17
3 The sick role 40
4 The treatment barrier 65
5 Women’s and men’s role problems and psychiatry 100
6 The professionals and their training 130
7 A brief history of psychiatry 145
8 Physical treatments and the role of the drug industry166
9 Resistance in the system 201
10 Psychiatry and wider society 219
11 Pointers to the future 257
Notes 267
Index 293

Foreword
Lucy Johnstone’s Users and Abusers of Psychiatry was first published
in 1989. A second edition is very much needed to show us what is
happening in the psychiatric system today.
Nowadays, if I were talking to a psychiatrist and referred to what
Lucy had written or to any of my experiences of working in the
psychiatric system from 1968 to 1986, the psychiatrist might respond
to any criticism I made of the system by saying, ‘It has all changed now’,
and go on to talk about multidisciplinary teams, community care,
modern psychiatric units in place of large asylums, new, improved drugs
based on scientific research, training for psychiatrists and psychiatric
nurses in psychotherapy and cognitive therapy, and the plethora of other
disciplines – clinical psychologists, art and drama therapists,
occupational therapists, aromatherapists and so on – working in the
multidisciplinary teams. This would be all very impressive, just as long
as you did not actually encounter the modern psychiatric system.
As that wily observer Talleyrand, who had seen the government of
France go from monarchy to revolution to dictatorship, once remarked,
‘The more things change the more they remain the same.’ The
psychiatric system might have changed, but what remains the same is
the purpose of the system. In Lucy Johnstone’s words, psychiatry is
required to be the agent of society while purporting to be the agent of
the individual; and its main function is not treatment but social control.
What Lucy Johnstone shows is that every aspect of the psychiatric system
– the way problems are formulated; the way the participants’ roles are
defined; the way patients are perceived by the participants in the system;
the way the professionals are trained; the way the history of the
psychiatric system is told; and the way its treatments are decided on
and given – reflects and is shaped by the conflict between what psychiatry
purports to be and what it actually does.