From Socialist Worker, 11 March 1972. (letter)
Transcribed by Ted Crawford.
Marked up by Einde O’Callaghan for the Marxists’ Internet Archive.
I should like to reply to objections raised to my review of the film Family Life.
I am asked by Alan Phipps of Horne (Socialist Worker, 19 February) what I mean by ‘successful’ results in psychiatry, do I believe that ‘there is such a thing as treatment, cure and rehabilitation’?
The answer to this depends on whether one believes that mental illness is a serviceable and truthful idea.
I believe that thousands and thousands of people are mentally ill: that many of them can be made much more ill by psychiatry (including crackpot analysis of the Laingian type as well as inhuman doctoring of the worst NHS type), and that many of them can improve their condition to a state nearer to that of mental health (which can never, in one person, be a final, finished state) through humane and scientific doctoring which need not be carried on by doctors or nurses.
Whether we call the improvement of mental illness ‘treatment’ or not is a matter of terminology: I prefer to it ‘treatment’.
However, the bulk of mental illness will only be treated when we have not only individual psychiatry with patients but also social surgery against capitalism.
‘Rehabilitation’ of course means that the patient is re-equipped to work in the frightful conditions of capitalist industry. I see no objection to providing facilities for ‘rehabilitating’ sick people in this sense, the working class seeks the right to work even under capitalism.
Indeed, the alternative to rehabilitation, is for most workers, starvation and poverty for themselves and their families.
Bob Carter of Leicester says it is not a revolutionary demand to have ‘palaces of mental health based on existing methods of treatment’.
What other methods are there than the existing ones? We cannot frame the political demands around methods which do not exist.
Like Celia Deacon of London N16, I have visited mental hospitals, but have been more fortunate in some of the institutions I encountered.
The best alternative at present lies in the psychiatric ward situated inside the ordinary general hospital. Ideally physical and mental illnesses should be treated at the same hospital, even in the same ward, certainly in the same occupational industrial therapy centres, so that standards of care can be encouraged.
There also seems to have been some objection to my endorsement of shock therapy when properly administered.
In many or perhaps most cases it is badly administered and overused, like all mass-production methods of treatment in conditions of inadequate staffing. Unlike some left-wing critics of psychiatry I not prepared to state that ECT should never be used.
Large numbers of mental patients make serious attempts at suicide, and continue to be severe suicidal risks even when resuscitated. ECT, with proper education of the patient in what to expect and with humane attention in the phase of mental confusion that follows its administration, can save lives, and in other cases can bring very withdrawn patients into a condition where they can respond to the human relationships that are genuinely therapeutic.
In other words, ECT, like tranquillisers, can be used as an aid to social treatment. The fact that it is nowadays used as a substitute for such treatment is once again an indictment of the low expenditure which capitalism provides for the professional care of the mentally ill.
I must admit to a personal revulsion from the prospect of ECT, bit I am prepared to regard this feeling, like an aversion from vasectomy, as something which is almost entirely irrational.
Finally, may I say that although Socialist Worker received an unprecedented flood of angry letters at attacking my article, one correspondent has rallied to my support.
The relative of a severely mentally disturbed patient writes: ‘It was criticism of the film that I have read that wrote most clearly and with great understanding of the feel of a family with a schizophrenic member. Have you had schizophrenia’?.
Peter Sedgwick, York
This correspondence is now concluded. Ed.
Last updated on 5.12.2004