Peter Stastny / Peter Lehmann (Eds.): Alternatives Beyond Psychiatry. ISBN 978-0-9545428-1-8 / 978-0-9788399-1-8

Contributions by Volkmar Aderhold, Laurie Ahern, Birgitta Alakare, Karyn Baker, Ulrich Bartmann, Agnes Beier, Regina Bellion, Wilma Boevink, Pat Bracken, Stefan Bräunling, Ludger Bruckmann, Giuseppe Bucalo, Dorothea S. Buck-Zerchin, Sarah Carr, Tina Coldham, Bhargavi Davar, Anne Marie DiGiacomo, Constance Dollwet, Jeanne Dumont, Merinda Epstein, Sandra Escher, Jim Gottstein, Chris Hansen, Geoff Hardy, Petra Hartmann, Alfred Hausotter, Michael Herrick, Guy Holmes, Andrew Hughes, Theodor Itten, Maths Jesperson, Kristine Jones, Hannelore Klafki, Miriam Krücke, Peter Lehmann, Bruce E. Levine, Harold A. Maio, Rufus May, Shery Mead, Kate Millett, Maryse Mitchell-Brody, David Oaks, Peter Rippmann, Marius Romme, Marc Rufer, Gisela Sartori, Erich Schützendorf, Jaakko Seikkula, Andy Smith, Zoran Solomun, Peter Stastny, Chris Stevenson, Dan Taylor, Philip Thomas, Jan Wallcraft, David Webb, Uta Wehde, Scott Welsch, Salma Yasmeen, Laura Ziegler and Ursula Zingler

Translations by Christine Holzhausen, Katy E. McNally and Mary Murphy

Preface

The first question raised by a book titled "Alternatives Beyond Psychiatry" is this: Why do we need alternatives? What is wrong with the "care" that mainstream psychiatry provides? While there are many answers to that question, first and foremost we can look at one startling statistic, and that is the rise in the number of people disabled by "mental illness" over the past 50 years.

The modern drug-based paradigm of psychiatric care dates back to 1954, when chlorpromazine was introduced as the first antipsychotic medication. This, or so psychiatry would like us to believe, kicked off a great leap forward in society's care of the "mentally ill." Psychiatric researchers are said to have made great strides in understanding the biological causes of mental disorders and that has led to the development of ever better drugs for treating them. Yet, here is what all this "progress" has wrought: in the United States, the rate of the "disabled mentally ill" has increased nearly six-fold in the past 50 years, from 3.38 people per 1,000 population in 1955 to 19.69 people per 1,000 population in 2003. Since the introduction of Prozac (1) in 1987—and this was the first of the second-generation psychiatric drugs said to be so better than the first—the number of so-called disabled mentally ill in the United States has been increasing at the rate of 150,000 people per year, or 410 people newly disabled by "mental illness" every day.

Other countries that have adopted a drug-based paradigm of care, such as the U.K. and Australia, have also reported a great surge in the number of people disabled by mental disorders in the past 50 years. This interesting fact leads to only one conclusion: mainstream psychiatry's paradigm of care has failed. It has not proven to be an approach that helps people struggling with mental distress of some kind—depression, anxiety, manic thoughts, psychosis, etc.—recover and get on with their lives. Instead, it has proven to be an approach that increases the likelihood that such people will become chronically ill.

We desperately need to think of alternatives to that failed paradigm of care. That is a big challenge, and yet the contributions in this timely and much needed book all ultimately point to a common starting point: if we want to help those struggling with their minds, we can start by thinking of them—as the Quakers did when they rebelled against mainstream psychiatry in the late 1700s and early 1800s—as "brethren." Not as people with "broken brains," but simply as people who are suffering. From that conception, a whole world of "care" follows. What does everyone need to stay well? Shelter, food, friendship, and something meaningful to do with his or her time. Any society that provides such care and support, along with a message of hope—that people can recover from whatever mental distress they may be suffering—makes a good start at providing an effective alternative to psychiatry.

There are chapters in this book that tell of such programs. There are proven alternatives to psychiatry, programs that have a track record of helping people get better. And there are reports of ways of coping with madness on an individual level. This book hopefully will encourage many, many other such efforts to take root and flourish.

Robert Whitaker (2)
Cambridge, MA

(1) Antidepressant, active ingredient fluoxetine, marketed also as Auscap, Deprax, Eufor, Flexetor, Fluohexal, Fluox, Fluoxebell, Fluoxetine, FXT, Lovan, Movox, Oxactin, Plinzene, Psyquial, Sarafem, Veritina, Zactin; component of Cymbyax

(2) Robert Whitaker is a former newspaper reporter who has written widely on the pharmaceutical industry and on mental illness, and is the author of "Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill". In this riveting social and medical history of madness in America from the 17th century to today, Mr. Whitaker finds that so-called schizophrenics in this country fare worse than patients in the world's poorest countries. More about Robert Whitaker

Introduction

"Alternatives Beyond Psychiatry" is a collection of reports and approaches from non-, anti- and post-psychiatric everyday life in different countries and provides an appraisal of individual and organized alternatives and measures that point to a need for structural change in the system. This is a book of practice and ideas, more personal than generalized. It offers suggestions, highlights contradictions and problems, and shows positive examples and models but does not provide easy answers.

Our alternatives beyond psychiatry are far removed from the academic remains of the '68 generation; nor are they a reform-oriented variant of Italian psychiatry, social psychiatry or community extensions of psychiatric institutions. Instead, alternatives beyond psychiatry are truly innovative, initiated and carried out by critical professionals and independent (ex-)users and survivors of psychiatry, the real experts in the psychiatric domain, dedicated to the right of self-determination, physical inviolability and social support.

Alternatives beyond psychiatry originate from an undogmatic and humanistic movement. Accordingly, the texts in this book are filled with a contrarian spirit and the fundamental conviction that (1) psychiatry, as a scientific discipline, cannot do justice to the expectation of solving mental problems that are largely of a social nature, (2) its propensity and practice to use force constitutes a threat, and (3) its diagnostic methods obstruct the view of the real problems of individuals.

Furthermore, the texts in this volume describe a commitment to (1) developing adequate and effective assistance for people in emotional difficulties, (2) safeguarding civil rights in treatment on a par with 'normal' patients, (3) joining forces in cooperation with other human rights and self-help groups, (4) use of alternative and less toxic psychotropic substances and a ban of electroshock, (5) new ways of living with madness and being different—with as much independence from institutions as possible, and (6) tolerance, respect and appreciation of diversity at all levels of life.

This book has been published without any financial support from sponsors. We have no connection to the pharmaceutical industry and to organizations that are dependent on them, nor to Scientology or other sects and dogmatists of whatever color. Beyond health, nothing is more valuable than freedom and independence.

We would like to express our heartfelt thanks to the many supporters who have provided valuable ideas, translated, corrected, and illustrated, in particular Arno Hessling, Christine Holzhausen, Craig Newnes, Darby Penney, David Oaks, Katy E. McNally, Kerstin Kempker, Martin Urban, Mary Murphy, Paula Kempker, Pia Kempker, Rainer Kolenda, Reinhard Wojke and Tricia R. Owsley.

Peter Stastny and Peter Lehmann

About the editors

Photo from Peter Lehmann and Peter Stastny Peter Stastny

Peter Stastny (right) was born in Vienna, Austria, where he graduated from medical school in 1976. Since 1978 he has been working and residing in New York City. He is Associate Professor of Psychiatry at the Albert Einstein College of Medicine in the Bronx and has conducted several publically funded research projects in the area of vocational rehabilitation, social support and self-help, in collaboration with individuals who had survived personal crises and psychiatric interventions. Currently, Dr. Stastny is working on the development of alternative services that obviate psychiatric intervention and offer autonomous paths towards recovery and full integration. These activities have engendered a close collaboration with the user-survivor movement, as manifested by joint research projects, publications, service demonstrations, and community work. He is a founding member of the International Network Toward Alternatives and Recovery (INTAR). More about Peter Stastny

Peter Lehmann (left). Born in Calw, Black Forest (Germany). Education as a social-pedagogist. Living in Berlin. Founder and editor, Peter Lehmann Publishing. From 1994 to 2000, board-member of the German organization of (ex-)Users and Survivors of Psychiatry. From 1997 to 2000, member of the Executive Committee of Mental Health Europe, the European section of the World Federation for Mental Health. From 1997 to 1999, Chair of the European Network of (ex-)Users and Survivors of Psychiatry (ENUSP), since 2002—2004 Interim secretary of ENUSP, since 2004, ENUSP board member. Book publications include Der chemische Knebel – Warum Psychiater Neuroleptika verabreichen (The Chemical Gag: Why Psychiatrists Administer Neuroleptics), 1986, reprint 2005; Schöne neue Psychiatrie (Brave New Psychiatry), 1996; Vol. 1: Wie Chemie und Strom auf Geist und Psyche wirken (The Effects of Chemistry and Electricity on the Human Mind and Psyche), Vol. 2: Wie Psychopharmaka den Körper verändern (How Psychiatric Drugs Change the Body); Psychopharmaka absetzen. Erfolgreiches Absetzen von Neuroleptika, Antidepressiva, Lithium, Carbamazepin und Tranquilizern (2rd ed. 2002; English edition: Coming off Psychiatric Drugs: Successful Withdrawal from Neuroleptics, Antidepressants, Lithium, Carbamazepine and Tranquilizers [2004]; Italien edit. Liberarsi dagli psicofarmaci. Riuscire con pieno successo a liberarsi da neurolettici, antidepressivi, stabilizzante dell'umore, Ritalin e tranquillanti and Βγαίνοντας από τα ψυχοφάρμακa: Εμπειρίες επιτυχημένης διακοπής νευροληπτικών, αντικαταθλιπτικών, λιθίου, καρβαμαζεπίνης και αγχολυτικών [both in preparation for 2008]. More about Peter Lehmann

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