Psychiatry: beautiful lady or old hag?

There is a famous optical illusion called the young lady and the old hag.

The drawing illustrates how one’s perception of an object can suddenly flip, and in a sense, the dueling histories [of psychiatry]… have that same curious quality.  There is the “young woman” picture of the psychopharmacology era that most of American society believes in, which tells of a revolutionary advance in the treatment of mental disorders, and then there is the “old hag” picture… which tells of a form of care that has lead to an epidemic of disabling mental illness.

… If you think of the [psychotropic] drugs as “anti-disease” agents and focus on short-term outcomes, the young lady springs into sight.  If you think of the drugs as “chemical imbalancers” and focus on long-term outcomes, the old hag appears.  You can see either image, depending on where you direct your gaze.

Robert Whitaker, Anatomy of an Epidemic

I took that quote from altmentalities blog where the author tells a story to highlight the nature of this illusion in psychiatry. To read her post go here: Psychiatry-as-usual: beautiful lady or old hag?

I felt moved to share it, too today, as I had a run in with someone I greatly respect who doesn’t seem to understand the dangers of the hag. It gets tiresome doing this work quite often. Tiresome and painful both. Those who’ve not perceived the great damage that psychiatry can incur continue to see only the lady. Not that my friend is 100% blinded to the harm psychiatry can cause but many don’t understand how often the old hag rules. And that we have a human rights crisis on our hands. Really the old hag metaphor breaks down for me at this point. Psychiatry can be dangerous. Plain and simple. An old hag isn’t so dangerous, really. It’s really not hyperbole to speak of the dangers of psychiatry and sometimes trying to sound reasonable in the face of that fact to those who don’t understand the harm that is caused just seems impossible.

I wrote an email to my friend today about this topic too. I will include an edited version here:

I want to remind you about the film That’s Crazy:


see more about that film HERE

I mention spiritual emergence because those who understand spiritual emergence, and there are psychologists who do now, at least to some degree, largely fail to recognize that many who get labeled with psychotic disorders are also having such emergencies. It’s all too easy for people to dismiss the folks that are unlucky enough to get sucked up into psychiatry as different…really sick. This issue is also brought up in this post where I do a little review of Rethinking Madness, the book:  More on “Rethinking Madness: Towards a Paradigm Shift in our Understanding and Treatment of Psychosis”

The fact that people like the young man in this film are quite often having spiritual emergence (or a psyche generated healing crisis and process) rather than any sort of pathological process, is kind of lost, because, well, they’re too busy fighting to survive and to simply get their basic human rights returned to them. Yes, human rights are violated all the time in psychiatry.

And this film depicts only the far end of the coercion spectrum that happens. Coercion, often somewhat subtle, is implicit in almost all psychiatric care as practiced today. When one is vulnerable as people are in any sort of crisis of the psyche, people’s lives are often destroyed.

I could go on and on really. For example many drugs begin a process of iatrogenic decline and mental illness and the people prescribing them are dangerously out of touch with the reality of this. It’s like a domino effect. See my story for graphic illustration:  Recap: 6 drugs 6 years of withdrawal…before that 39 drugs total: A portrait of poly psychopharmacology (and I’m a lucky one because I escaped!)

It’s so easy to dismiss this when one is far far away from where it happens…but again…it can happen to pretty much anyone and it happens rampantly in all social service agencies all across the country…public and private…it happened to me and I’ve seen it happen to 1000s of others…I’ve been on the listening end of far more tragic stories than I wish to know and frankly I often wish I didn’t know what I know…but alas I do and so this is part of my work…

If one is not aware of this grave and frequent risk one cannot safely refer to psychiatrists…in the interest of informed consent one must know what psychiatry is capable of before sending innocents to get “help.”

I never tell anyone what to do and certainly getting medicated on occasion is necessary (mostly because alternative intensive supports are not available) and I would never stop someone from pursuing that line of care and in crisis would make whatever recommendation seemed necessary and support what the person wanted…that doesn’t change the fact that most psychiatrists are dangerous at this time and not even aware of how they harm.

 Also, I’m aware that there are many people and professionals too who are beginning to be aware of this stuff, but to randomly tell someone to get help within the current system means it’s likely they’ll find someone who is clueless. These facts seem lost on most people who are not intimately familiar with the system.

So at the very least people who are forced to get care that is risky at best should know that they need not be locked in forever and that the doctor may not know anything at all about healing and recovery. Once one is aware of the limitations of a doctor one can cautiously utilize them in spite of their limitations if need be.

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters