“If you identify yourself with something for so long, and suddenly you think of yourself as not that thing, it leaves a bit of space.” - Paul Haggis, quoted in Going Clear, p. 362Truthout features an interview with Robert Whitaker and Lisa Cosgrove, authors of the new book Psychiatry under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform (which has recently been added to my list of recommended readings in psychiatry, skepticism, and social justice). Bruce Levine asks the two about the possibilities of reform coming from within psychiatry, in light of the depth of the institutional corruption, the cognitive dissonance it entails, and the tendency among psychiatrists in response to “construct a narrative that protects their self-image.” They both answer that the chances seem slim.
I share their pessimism (which isn’t a general pessimism, I should emphasize, but specifically skepticism about moves for reform coming from within the institution itself – they do believe change can come from outside). The quotes by past presidents of the American Psychiatric Association at annual meetings that Whitaker and Cosgrove provide late in the book struck me as well, especially because I read it around the same time as I read Lawrence Wright’s Going Clear: Scientology, Hollywood, and the Prison of Belief (2013). The quotes all evince an effort to construct a particular narrative and collective self-image, to cast off doubts and criticisms. Two that stood out:
Herbert Pardes in 1990:
Psychiatry in 1990 is at the height of its powers. We have had a spectacular decade… Psychiatry works, psychiatry is respected for it, and we can hold our heads high.Jeffrey Lieberman in 2014:
We have been waiting, many of us our whole lives, for the chance to change the way the world thinks of psychiatry and the way we think of ourselves as psychiatrists. Let’s use the momentum we have to plunge ahead into the next year with our confidence brimming, our energy renewed, and our sights set high…this is our opportunity to change the practice and perception of psychiatry for the better and as never before. Last year, standing on the stage in San Francisco, I told you that ‘our time has come’. Today, I say to you that our future is now!These speeches remind me of little as much as the meetings and rallies shown in Alex Gibney’s documentary version of Going Clear. I don’t believe the similarity is entirely superficial, and there’s a tragic element in both cases. How difficult it must be to have dedicated years of your life to an institution; to realize it’s corrupt, built on a harmful mythology, and has led you to act unethically; and to face up to that knowledge. What a struggle not to let yourself continue to be seduced by the self-serving narrative that would put your mind and conscience at ease. And how rare are the people like Haggis who can bring themselves to do it.