The Criteria of What Works and for Whom Part I
by Sue Poole

 "There are many ways of practicing existential cannibalism. In our society, the most popular form of its is to give one's 'beneficiary' a psychiatric diagnosis and impose on him a psychiatric treatment, neither of which he wants. This enables the 'benefactor' to claim he is helping and strengthening his 'beneficiary,' while in fact he is harming him and is rendering him more powerless." - Thomas Szasz in "Madness, Heresy and Rumor of Angels: The Revolt Against the Mental Health System" by Seth Farber

"One need not be a member of a mental health profession to participate in its study and shape. Clinicians can claim special expertise ONLY OVER THE PRAGMATICS OF HELPING." - Robert Fancher in "Cultures of Healing: Correcting the Image of the American Mental Health System"

Thomas Szasz is a celebrated dissident psychiatrist advocating revolt against the barbarisms of a mental health system practicing social control and feeding its own self-interests under the guise of treating people who are experiencing problems in life.

Robert Fancher's insights are startling because he is a mainstream psychologist with impeccable credentials and has dared to critique the unilateral judgments of his own colleagues.

"We have probably also conflated many types of suffering under the metaphor {author's note: Fancher does not refer to suffering as a disease} of mental illness," Fancher observes. "Some of the problems of the troubled sane probably do reflect impairment in basic human functions, but many probably do not. We do not know very well which are which."

Within those prickly parameters, Fancher acknowledges that psychiatry is fallible, misdirected, fraudulent and dangerous to human beings who get ensnared by it. He is not advocating outright revolt, but he is disgusted by the arrogance of his colleagues who presume to determine values and exert social control based on their own reflections, like Narcissus, who became enamored of his own image, got lost in the inventory of his assets and ceased to relate humanly to his environment or fellow beings.

Fancher is proposing a new paradigm and vigorous reform of a mental health system that is hell-bent on insinuating its spurious dogmas and psychobabble into every segment of society, using false claims and scientific pretensions to lull the general public into the delusion that the mental health professions are altruistic, avuncular and innocuous.

They are none of these things. Psychiatry is an industry with a vested interest in broadening its power base by declaring most of society mentally ill and in need of "management" with mind-numbing drugs, incarcerations of the harmlessly aberrant or electrical therapies that traumatize the brain.

Psychiatrists reserve and protect their power to advise judges and attorneys about definitions of mental illness, to give expert testimony exonerating criminals of the consequences of their violence, to shut away people who become annoying to their families or friends, to administer drugs that destroy the nervous system and to run lightnings through the brains of the non-consenting elderly...all in the paternalistic name of what is best for the struggling, protesting, noncomplying, terrified, reluctant, involuntary patient.

Fancher endorses the mental health professional as an ancillary mind rather than a god-like authority wielding absolute and unchecked power to label, permanently categorize and institutionally persecute the afflicted and the harmlessly deviant.

"An argument could be made," he says, "that elitist notions of what constitutes adequate beliefs have infected mental health care. Perhaps an adequate belief is whatever works in the judgment of whomever it works for."

Fancher's style is not as passionate as Peter Breggin's or as painstakingingly sardonic as Szasz's, but he, too, is fed up with psychiatry's missionary zeal to stamp out the flamboyant, the odd, the quaint, the zany, the humorous, the witty, the peculiar, the engaging and the eccentric by pathologizing every imaginable gesture and manifestation of human behavior as a mental disorder needing aggressive, radical interventions.

Fancher argues for circumscribing, in the interests of a common humanity, the unchecked hegemony psychiatrists have long enjoyed as arbiters of sanity for society, as determiners of normality and judges of functionality and fitness. Fancher also contends that psychiatry defrauds society by pretending to apply scientific facts about human behavior to people's problems in life.

The primary criteria for decent psychiatric care, Fancher suggests, may very well be what works for the person for whom it works.

"Certainly, this is not the worst possible conclusion, since a great deal of life is like this," Fancher remarks with understated bitterness. Like Szasz and Breggin and Farber, he is scunnered with psychiatric press releases heralding the advent of miracle drugs that eliminate releases that omit mention of other effects like permanent impairment of the liver, the kidneys, the nervous system; sexual dysfunctions; hair loss; incapitating nausea; incontinence; toxic and paradoxical reactions; impairment of coordination; tolerance and addiction; and myriad other possible bad consequences of neuroleptic and psychotropic drugs.

Fancher further suggests that psychiatric views about patients are artifacts of culture...the lunatic as helpless, irresponsible, demon-possessed, inferior, defective, unlearned, useless...and not facts about the world.

He also acknowledges that creating a true culture of healing means threatening exposure of the abuses and false advertising of the present system, which is operating in a sort of twilight zone detached from the actual needs, demands, personalities, beliefs and hopes of the victims it dares to call clients and consumers.

Mental health professionals, in the interests of preserving, defending and expanding their turf, have been traditionally unwilling to fulfill the function of ancillary mind, choosing instead to pose as scientific authorities whose absolute subjective judgments brook no challenge or questionings, particularly not from patients, who are perceived as mindless children in need of management by drugs or torture in confinement.

"The scientific image of mental health care needs to be supplanted by an image of pragmatic efforts to solve a variety of problems posed by life," Fancher writes. "The scientific image is mostly a matter of public relations, but the mental health professions have made the egregious error of believing their own press releases."

Thus, the mental health professionals, by plain fraud, have appropriated unchecked power to categorize, negate, neglect, ignore, mistreat, isolate, drug, shock, dehumanize, abuse, punish and exploit the subjects...some suffering, others quite content to be eccentric...they purportedly are serving and helping.

They have assumed this power and are perpetrating this fraud in the interests of ensuring themselves an ever-expanding patient population to plunder by exerting absolute control over diagnosis and treatments, both subjective and imprecise at best in the welterworld of psychiatric domination.

Unilateral psychiatric judgments, augmented by involuntary interventions, support the system's growth and expansion at the expense of the self-esteem and social acceptability of its so-called clients and to the detriment of a broader society in critical need of diversity and tolerance for differences.