Editing Anti-psychiatry (section)

=== Normality and illness judgments ===
[[File:Samuelcartwright.jpg|thumb|A madness of civilization: the American physician Samuel A. Cartwright identified what he called drapetomania, an ailment that caused slaves to be possessed by a desire for freedom and a want to escape.]]

In 2013, psychiatrist [[Allen Frances]] said that "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests".<ref name=frana>{{Cite journal|title=The New Crisis in Confidence in Psychiatric Diagnosis |journal=Annals of Internal Medicine |volume=159 |issue=3 |pages=221–2 |author=Allen Frances |date=17 May 2013 |doi=10.7326/0003-4819-159-3-201308060-00655|pmid=23685989 |doi-access=free }}</ref>

Reasons have been put forward to doubt the [[ontic]] status of mental disorders.<ref name=Phillips>{{cite journal |last1=Phillips |first1=James |title=The Six Most Essential Questions in Psychiatric Diagnosis: A Pluralogue. Part 1: Conceptual and Definitional Issues in Psychiatric Diagnosis |journal=[[Philosophy, Ethics, and Humanities in Medicine]] |date=January 13, 2012 |volume=7 |issue=3 |pages=3 |doi=10.1186/1747-5341-7-3 |pmid=22243994 |issn=1747-5341 |pmc=3305603 |last2=Frances |first2=A |last3=Cerullo |first3=MA |last4=Chardavoyne |first4=J |last5=Decker |first5=HS |last6=First |first6=MB |last7=Ghaemi |first7=N |last8=Greenberg |first8=G |last9=Hinderliter |first9=AC |last10=Kinghorn |first10=WA |last11=LoBello |first11=SG |last12=Martin |first12=EB |last13=Mishara |first13=AL |last14=Paris |first14=J |last15=Pierre |first15=JM |last16=Pies |first16=RW |last17=Pincus |first17=HA |last18=Porter |first18=D |last19=Pouncey |first19=C |last20=Schwartz |first20=MA |last21=Szasz |first21=T |last22=Wakefield |first22=JC |last23=Waterman |first23=GS |last24=Whooley |first24=O |last25=Zachar |first25=P |display-authors=9 |doi-access=free }}</ref>{{rp|13}} Mental disorders engender [[ontological]] skepticism on three levels:
# Mental disorders are abstract entities that cannot be directly appreciated with the human senses or indirectly, as one might with macro- or microscopic objects.
# Mental disorders are not clearly natural processes whose detection is untarnished by the imposition of values, or human interpretation.
# It is unclear whether they should be [[Concept|conceived]] as abstractions that exist in the world apart from the individual persons who experience them, and thus instantiate them.<ref name=Phillips />{{rp|13}}

In the scientific and academic literature on the definition or classification of mental disorder, one extreme argues that it is entirely a matter of value judgements (including of what is [[norm (sociology)|normal]]) while another proposes that it is or could be entirely [[objectivity (science)|objective]] and [[scientific]] (including by reference to statistical norms).<ref>{{cite journal|author=Berrios G E |title=Classifications in psychiatry: a conceptual history |journal=Aust N Z J Psychiatry |volume=33 |issue=2 |pages=145–60 |date=April 1999 |pmid=10336212 |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0004-8674&date=1999&volume=33&issue=2&spage=145 |archive-url=https://archive.today/20120604144233/http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0004-8674&date=1999&volume=33&issue=2&spage=145 |url-status=dead |archive-date=2012-06-04 |doi=10.1046/j.1440-1614.1999.00555.x|s2cid=25866251 }}</ref> Common hybrid views argue that the concept of mental disorder is objective but a "fuzzy [[prototype]]" that can never be precisely defined, or alternatively that it inevitably involves a mix of scientific facts and subjective value judgments.<ref>{{cite encyclopedia |last=Perring |first=C. |year=2005 |url=http://plato.stanford.edu/entries/mental-illness/ |title=Mental Illness |encyclopedia=Stanford Encyclopedia of Philosophy |access-date=2012-01-27 |archive-date=2018-06-11 |archive-url=https://web.archive.org/web/20180611130635/https://plato.stanford.edu/entries/mental-illness/ |url-status=live }}</ref>

One remarkable example of psychiatric diagnosis being used to reinforce cultural bias and oppress dissidence is the diagnosis of [[drapetomania]]. In the US prior to the American Civil War, physicians such as [[Samuel A. Cartwright]] diagnosed some slaves with drapetomania, a mental illness in which the slave possessed an irrational desire for freedom and a tendency to try to escape.<ref>{{cite book |last=Sharkey |first=Joe |author-link=Joe Sharkey |title=Bedlam: greed, profiteering and fraud in a mental system gone crazy |publisher=St. Martin's Press |year=1994 |location=NY |page=[https://archive.org/details/bedlamgreedprofi00shar/page/n195 182] |isbn=978-0-312-10421-4 |url=https://archive.org/details/bedlamgreedprofi00shar |url-access=registration }}</ref> By classifying such a dissident mental trait as abnormal and a disease, psychiatry promoted cultural bias about normality, abnormality, health, and unhealth. This example indicates the probability for not only [[cultural bias]] but also [[confirmation bias]] and [[bias blind spot]] in psychiatric diagnosis and psychiatric beliefs.<ref>{{Cite journal |last=Whaley |first=Arthur L. |date=March 1997 |title=Ethnicity/race, paranoia, and psychiatric diagnoses: Clinician bias versus sociocultural differences |url=http://dx.doi.org/10.1007/bf02263226 |journal=Journal of Psychopathology and Behavioral Assessment |volume=19 |issue=1 |pages=1–20 |doi=10.1007/bf02263226 |s2cid=145127517 |issn=0882-2689}}</ref>

It has been argued by philosophers like Foucault that characterizations of "mental illness" are [[indeterminacy in philosophy|indeterminate]] and reflect the hierarchical structures of the societies from which they emerge rather than any precisely defined qualities that distinguish a "healthy" mind from a "sick" one. Furthermore, if a tendency toward self-harm is taken as an elementary symptom of mental illness, then humans, ''as a species'', are arguably insane in that they have tended throughout recorded history to destroy their own environments, to make war with one another, etc.<ref>{{cite book|last=Foucault |first=Michel |title=Madness and Civilization: a History of Insanity in the Age of Reason |publisher=Vintage Books |year=1988 |location=New York |isbn=978-0-394-71914-6|title-link=Madness and Civilization }}{{page needed|date=January 2014}}</ref>