Binary Oppositions in Psychiatry: For or Against?

摘要

IN their interesting and informative paper 'From Szasz to Foucault: On the Role of Critical Psychiatry,' Pat Bracken and Phil Thomas contrast, in a clear and helpful way, some central themes in the works of Thomas Szasz and Michel Foucault. They go on to endorse a form of critical psychiatry inspired by the latter. Szasz's critique of psychiatry, they explain, is premised on binary oppositions, principally that between 'mental' and 'bodily.' Szasz begins by assuming the legitimacy of the distinction and proceeds to argue that the term 'illness' can only be legitimately applied to what is 'bodily.' According to Szasz, there are medical pathologies, which are to be understood in naturalistic, biological terms, and there are also 'problems in living,' which should not be conceived of in that way. Bracken and Thomas then show how Foucault's work challenges this kind of view, by exposing the historical contingency of the discourses, practices and ideologies in which binary oppositions such as that between 'mental' and 'bodily' are embedded. Having contrasted the two approaches, they conclude that Foucault serves as the better role model for current critical psychiatry. Psychiatry, they propose, should strive to make explicit the contingency of its concepts and practices, opening up not just new positions within an already established arena of debate but also new possibilities for debate.