Critical Analysis of the Medical Institution With Special Focus on Madness

In this online version of a paper written as a part of a Masters course at Queen Margaret University I have used visual screengrabs from the original texts. For the purposes of review and education I have chosen to integrate excerpts from each cited reference inline to assist the reader in learning more deeply the arguments which are being laid out.  The reader is encouraged to work through all the reference texts as each one offers a series of nuances important for unpacking the complex issues being dealt with.

All the excerpts are placed inside the grey boxes with their details inline following the narrative text which has drawn on the reference. An example can be found below with Alison Jaggar’s paper.  The aim of this typesetting practice is to emphasise that the references are the means for developing deep understanding to facilitate analytical conversation rather than offered as a reductive paperwork of proofs.

 

The practice of providing a bibliography of references is to provide access to the original knowledge in context which has been used to synthesise the main narrative. Anyone serious about the subject will give over significant enough time to exploring diverse authors and perspectives investigating the subject field.  As a result they will gain benefits from this investment and be more able to understand their subject of study having taken time to take in what is contained in the language.


 

Introduction

“Speaking requires a language but dominant vocabularies may lack the resources necessary to express perspectives of subordinated groups…Because language is essentially public creating new vocabularies is necessarily a collective rather than an individual project” – (Jaggar, 1998)

JAGGAR, A., (2000), Feminism in ethics Moral justification in Fricker, M. (Ed) The Cambridge companion to feminism in philosophy. https://doi.org/10.1017/CCOL0521624517. Page 238


JAGGAR, A. M. (1998). Globalizing Feminist Ethics. Hypatia, 13(2), 7–31. Http://Www.Jstor.Org/Stable/3810635 (supplementary reference not cited in the text of the paper)

 

Bosch Hieronymus The Garden of Earthly Delights
Bosch Hieronymus The Garden of Earthly Delights

 

The marketisation of society (Bakan, 2019; Bakan, 2021) has given rise to an industrial-medical complex (Magee, 2020; Perkins, 2004) that acts as a catch all for a range of phenomena which ultimately impact on mood, cognition and behaviour – the effects of these phenomena are given the identities of ‘madness’ and other epithets (American Psychiatric Association, 2017; Frances & Boehmer, 2017).

 

BAKAN, J. (2019). Corporation The Pathological Pursuit Of Profit And Power. New York, Penguin Canada. Http://Public.Eblib.Com/Choice/Publicfullrecord.Aspx?P=6813467. Page 25


BAKAN, J. (2021). The New Corporation: How “good” Corporations Are Bad For Democracy. Introduction


MAGEE, M. (2020). Code Blue: Inside America’s Medical Industrial Complex. Afterword


PERKINS, B. B. (2004). The Medical Delivery Business Health Reform, Childbirth, And The Economic Order. New Brunswick, N.J., Rutgers University Press. Page 1


AMERICAN PSYCHIATRIC ASSOCIATION. (2017). Diagnostic And Statistical Manual Of Mental Disorders: Dsm-5. Arlington, Va, American Psychiatric Association.  Preface


FRANCES, A., & BOEHMER, P. (2017). Saving Normal: An Insider’s Revolt Against Out-Of-Control Psychiatric Diagnosis, Dsm-5, Big Pharma, And The Medicalization Of Ordinary Life. Old Saybrook, Conn, Tantor Media. Https://Www.Overdrive.Com/Search?Q=A88f16ff-A3bc-4e19-Ac59-Df3419d2687f.

 

This results in a fallacy of category similar to a modernisation of ‘metaphysics’ esoterising heterogeneous phenomena preventing understandings from developing. The fallacies of category of mental health happen where misunderstood psychological phenomena get bundled into a single identity similar to the way that the curation of Aristotle’s work gave rise to a portmanteau subject which he had not intended.

 

The term metaphysics has been associated with Aristotle however he never used the term. It was coined by a first century C.E. Editor to denote a collection of Aristotle’s smaller works brought into a single treatise. It was named according to its place in the curated volumes which he had chosen; ‘metaphysics’ meaning literally ‘after the Physics’ (Cohen, 2022).

 

COHEN, S. MARC. (2022)”Aristotle’s Metaphysics”. Stanford Encyclopedia Of Philosophy. The Metaphysics Research Lab Center For The Study Of Language And Information Stanford University Stanford, Ca. Retrieved 14 May 2022.

 

This communicates what I mean by relating a modernisation of metaphysics to creating of psychiatric identity. Mental health has become an agglomerating identity for psychological and behavioural phenomena which do not easily fit, and therefore challenge, the cultural rubrics for perceiving the world and people which are in common usage.

 

In this essay I explore some of the problems of how madness is perceived, medicalised and how the medical model of privilege has shaped the discourse. I explore possible anthropological roots for cultural perceptions surrounding mental illness. I argue from this that the subject of Mad Studies has emerged as a part of a constellation of critical philosophical and epistemological correctives in response to structural power imbalances forged in old and dominant political myths which alienate people from human rights and agency. I suggest that these political myths are hindering the progress and evolution of medicine and society in ways which prevent contributions to the tackling of complex problems ultimately factoring into their recreation.

 

In the first section I offer a general account of ‘madness’ and introduce how medicalised identities are misidentifications of bundled disparate phenomena. I go on to discuss how the lack of cohesive logic esoterises the unknown bringing about experiences of dehumanization, disadvantage and injustice. In the subsequent section I suggest how material and non-material forms of mental illness interrelate feeding into each other as positive feedback loops. I then scrutinize how the paradigm of privilege and impunity in medicine and examine how power imbalances lead to iatrogenic harms.


 

Miscellaneous is not a category it is a collection of things which do not fit the categorical schemes which humans have made or inherited
Miscellaneous is not a category it is a collection of things which do not fit the categorical schemes which humans have made or inherited

 

The Conflation of Ideas in Madness and Hermeneutical Disadvantage

I frame the word ‘madness’ as a conflation of ideas brought to spaces of common ‘unknownness’. Foucault in his Madness and Civilisation speaks to this idea: “this liberation derives from a proliferation of meaning, from a self-multiplication of significance weaving relationships so numerous, so intertwined, so rich, that they can no longer be deciphered except in the esotericism of knowledge. Things become so burdened with attributes, signs, allusions that they finally lose their own form. Meaning is no longer read in an immediate perception, the figure no longer speaks for itself.” (Foucault, 1967)

 

FOUCAULT, M. (1967). Madness And Civilisation. London, Tavistock. P. 19

 

Madness is multivalent; it has so many meanings and is so heavily invested with values that it becomes unmoored from the individual superseding them in the world with an idea. For me madness is both expression of emotion – I am mad at the way I have been and am treated – and what I call a vacuum concept. What I mean by a vacuum concept is a situation in which a vacuum exists where a cohesive idea should be which is related to as something of substance holding an internal logic; a vacuum of understanding draws people to project exoticising hopes (Nieto & Bode, 2018) and demonising fears onto the unknown, as people do with darkness and experience of otherness (Staszak, 2011).

 

NIETO, S., & BODE, P. (2018). Adapting Curriculum For Multicultural Classrooms in Affirming Diversity: The Sociopolitical Context Of Multicultural Education. P368


STASZAK J. F. (2011). Other/Otherness In International Encyclopedia Of Human Geography. Eds Kitchin, R., & Thrift, N. J. Amsterdam [Netherlands], Elsevier. Http://Www.Credoreference.Com/Book/Esthg.

 

In effect I argue that madness is a concept without concrete identity, it is an idea which becomes imbued with the purposes of the user; in many ways a medium for superstition (Vyse, 2014). Individuals who experience ails related to mood, cognition and behaviour – and who, as a result, require support, are simultaneously bound to culturally encountering primitive hostile responses of human beings to the unknown. As a result they experience various forms of injustice perceived as an ‘other’.

 

VYSE, S. A. (2014). Believing In Magic: The Psychology Of Superstition. New York, Oxford University Press, USA. Page 252

 

The war-like nature of humans is intimately associated with processes of dehumanization which are common and everyday, both inside and outside of professional spaces (Haslam, 2006; Cahill, 2012; Bastian & Haslam, 2011). These processes of dehumanization lead to justifications of moral disengagement resulting in injustices perpetrated on the targets (Bandura, 1999). What is especially problematic about the psychiatric support/need juncture is that medicine has incorporated and normalised forms of dehumanisation within its institutional practice (Haque & Waytz, 2012) beyond frank devaluation (Capozza, Falvo, Boin, & Colledani, 2016).

 

HASLAM, N. (2006) ‘Dehumanization: An Integrative Review’, Personality And Social Psychology Review, 10(3), Pp. 252–264. Doi: 10.1207/S15327957pspr1003_4.


CAHILL, A. J. (2012). Overcoming Objectification: A Carnal Ethics, Page xi


BROCK BASTIAN & NICK HASLAM (2011) Experiencing Dehumanization: Cognitive And Emotional Effects Of Everyday Dehumanization, Basic And Applied Social Psychology, 33:4, 295-303, Doi: 10.1080/01973533.2011.614132


BANDURA, A. (1999). Moral Disengagement In The Perpetration Of Inhumanities. Personality And Social Psychology Review. [Special Issue On Evil And Violence], 3, 193-209.


HAQUE, O. S. AND WAYTZ, A. (2012) ‘Dehumanization In Medicine: Causes, Solutions, And Functions’, Perspectives On Psychological Science, 7(2), Pp. 176–186. Doi: 10.1177/1745691611429706.


CAPOZZA, D., FALVO, R., BOIN, J., & COLLEDANI, D. (2016). Dehumanization In Medical Contexts: An Expanding Research Field. Tpm-Testing, Psychometrics, Methodology In Applied Psychology, 23(4), 545–559.

 

Ailing people who are at a disadvantage must negotiate and absorb the injustices engrained and/or embedded in the psychology and structures of society. From the outset individuals are overwhelmingly at a ‘hermeneutical disadvantage’ which Miranda Fricker describes in the following terms:

 

“If, for instance, someone has a medical condition affecting their social behaviour at a historical moment at which that condition is still misunderstood and largely undiagnosed, then they may suffer a hermeneutical disadvantage that is, while collective, especially damaging to them in particular. They are unable to render their experiences intelligible by reference to the idea that they have a disorder, and so they are personally in the dark, and may also suffer seriously negative consequences from others’ non-comprehension of their condition.” (Fricker, 2011)

 

FRICKER, M. (2011). Epistemic Injustice: Power And The Ethics Of Knowing. Oxford, Oxford University Press. Pp 151


 

Material and Non-material Harm, and the Paradigm of Privilege

In this section I discuss material and non-material causes of mental ailment. I then suggest a scheme of how they reinforce and lead to each other generating positive feedback loops which Hofstadter describes as tangled hierarchies (Hofstadter, 2006). I go onto critically discuss how the medical approach is flawed, bringing about significant iatrogenic harms. Finally I identify key issues with the institution of medicine and how it is protected from vitally needed change.

 

HOFSTADTER, D. R. (2006). Gödel, Escher, Bach: An Eternal Golden Braid. New York, Basic Books. Pp 686

 

Material Causes of Mental Illness

To flesh out the notion of material causes of mental illness I offer some examples that offer clarity due to their now well documented nature. The neurological and psychological effects of a range of chemicals which the population are exposed to may not be recognised or acknowledged (Salinger, 2013).

 

SALINGER, L. M. (2013). Encyclopedia Of White-Collar And Corporate Crime. Los Angeles, Sage. P 30

 

Three examples are the exposure of people to cholinesterase inhibiting pesticides and herbicides (Bradwell, 1994; Takahashi & Hashizume, 2014), the impacts of ethyl mercury as an excipient in once widely used medicines (Huang et al, 2014; Dorea, Farina, & Rocha, 2013) and the impacts of heavy metals in mercury-silver amalgam (Siblerud, Motl, & Kienholz, 1994; Siblerud et al, 2019; Siblerud, R. Mutter, J. (2021).

 

BRADWELL, R. H. (1994) Psychiatric Sequelae Of Organophosphorous Poisoning: A Case Study And Review Of The Literature Behavioural Neurology / Volume 7 |Article Id 683275 | Https://Doi.Org/10.3233/Ben-1994-73-402


TAKAHASHI N, HASHIZUME M. (2014) A Systematic Review Of The Influence Of Occupational Organophosphate Pesticides Exposure On Neurological Impairment. Bmj Open;4:E004798. Doi:10.1136/Bmjopen-2014- 004798


 

HUANG X, LAW S, LI D, YU X, LI B. (2014) Mercury Poisoning: A Case Of A Complex Neuropsychiatric Illness. Am J Psychiatry. Dec 1;171(12):1253-6. Doi: 10.1176/Appi.Ajp.2013.12101266. Pmid: 25756767.


DOREA, G., FARINA, M., & ROCHA, B. T. (2013). Toxicity Of Ethylmercury (and Thimerosal): A Comparison With Methylmercury. Journal Of Applied Toxicology, 33(8), 700-711. Doi:10.1002/Jat.2855


SIBLERUD RL, MOTL J, KIENHOLZ E. (1994) Psychometric Evidence That Mercury From Silver Dental Fillings May Be An Etiological Factor In Depression, Excessive Anger, And Anxiety. Psychol Rep. Feb;74(1):67-80. Doi: 10.2466/Pr0.1994.74.1.67. Pmid: 8153237.


SIBLERUD R, MUTTER J, MOORE E, NAUMANN J, WALACH H. (2019) A Hypothesis And Evidence That Mercury May Be An Etiological Factor In Alzheimer’s Disease. Int J Environ Res Public Health. Dec 17;16(24):5152. Doi: 10.3390/Ijerph16245152. Pmid: 31861093; Pmcid: Pmc6950077.


SIBLERUD R, MUTTER J. (2021), A Hypothesis and Additional Evidence that Mercury May be an Etiological Factor in Schizophrenia, Clin Schizophr Relat Psychoses Clinical Schizophrenia & Related Psychoses Volume 15s:1

 

Each represents a large evidence base for physical factors that have distinct ramifications on mental health but which are culturally silenced through evoked controversy (Gillam, 2019) protecting the industry and the institution of medicine; therefore they represent examples of agents involved in hermeneutical disadvantage.

 

Page 127
Page 172
Page 234

GILLAM, C. (2019). Whitewash: The Story Of A Weed Killer, Cancer, And The Corruption Of Science. Pages 127, 172 and 234

 


 

Non-material Causes of Mental Illness

Acting as compliment to the material harms of mental health there are a range of sociological harms which can be visited upon an individual by themselves, by others, by cultures, communities and/or by structural violence. These kinds of non-material cause result in mental illness which can be understood as responses to psychological trauma (which are physiologically measurable) (Cohen, Janicki-Deverts, & Miller, 2007; Slavich et al, 2019).

 

COHEN S, JANICKI-DEVERTS D, MILLER GE. ( 2007) Psychological Stress And Disease. Jama. Oct 10;298(14):1685-7. Doi: 10.1001/Jama.298.14.1685. Pmid: 17925521.


SLAVICH, G. M., STEWART, J. G., ESPOSITO, E. C., SHIELDS, G. S., & AUERBACH, R. P. (2019). The Stress An Adversity Inventory For Adolescents (Adolescent Strain ): Associations With Mental And Physical Health, Risky Behaviors, And Psychiatric Diagnoses In Youth Seeking Treatment. Journal Of Child Psychology And Psychiatry. Doi:10.1111/Jcpp.13038

 

These sociological phenomena are esoterised as collectively demarcated forms of mental illness (psychiatric labels) and treated dominantly as biochemical imbalances of the brain (Cohen & Cohen, 1986) with powerful, and sometimes disabling, life shortening drugs (Breggin, 2011; Harris & Barraclough, 1998; Jones, Howard, & Thornicroft, 2008).

 

COHEN, D., & COHEN, H. (1986). Biological Theories, Drug Treatments, And Schizophrenia: A Critical Assessment. The Journal Of Mind And Behavior, 7(1), 11–35. Http://Www.Jstor.Org/Stable/43853201


BREGGIN PR. ( 2011) Psychiatric Drug-Induced Chronic Brain Impairment (CBI): Implications For Long-Term Treatment With Psychiatric Medication. Int J Risk Saf Med. 23(4):193-200. Doi: 10.3233/Jrs-2011-0542. Pmid: 22156084.


HARRIS, C., & BARRACLOUGH, B. (1998). Excess Mortality Of Mental Disorder. British Journal Of Psychiatry, 173(1), 11-53. Doi:10.1192/Bjp.173.1.11


JONES S, HOWARD L, THORNICROFT G. (2008) ‘Diagnostic Overshadowing’: Worse Physical Health Care For People With Mental Illness. Acta Psychiatr Scand. Sep;118(3):169-71. Doi: 10.1111/J.1600-0447.2008.01211.X. Pmid: 18699951.

 

This speaks to cultural deficits in publicly recognising sublegal forms of violence which may ultimately manifest as biochemical differences in the brain brought about by specific sociological configurations and actions – to illustrate this I suggest the example of gaslighting (Sweet, 2019). In context, psychological abuse by a partner or family member can generate large releases of adrenal hormones (Bremner, 2005), cortisol (Kandhalu, 2013) and opiates (McCubbin, Surwit & Williams, 1985) as a response to the trauma affecting how the individual apprehends, feels and acts in the world.

 

SWEET, P. L. (2019) ‘The Sociology Of Gaslighting’, American Sociological Review, 84(5), Pp. 851–875. Doi: 10.1177/0003122419874843.


BREMNER D. J., (2005) Effects Of Traumatic Stress On Brain Structure And Function: Relevance To Early Responses To Trauma, Journal Of Trauma & Dissociation, 6:2, 51-68, Doi: 10.1300/J229v06n02_06


KANDHALU, P. (2013). Effects Of Cortisol On Physical And Psychological Aspects Of The Body And Effective Ways By Which One Can Reduce Stress. Berkeley Scientific Journal, 18.


MCCUBBIN JA, SURWIT RS, WILLIAMS RB JR. (1985) Endogenous Opiate Peptides, Stress Reactivity, And Risk For Hypertension. Hypertension. Sep-Oct;7(5):808-11. Doi: 10.1161/01.Hyp.7.5.808. Pmid: 4030048.

 

This material response to the social stimulus acts as a medium for tautological/self-referential accounts of mental illness in the medical model used as justification for prescription of psychoactive drugs. Relatedly, disadvantaging bureaucratic and legal double binds (Bateson, Jackson, Haley, & Weakland, 1956) can produce similar psychological and neurological changes in an individual through mechanisms such as learned helplessness (Maier & Seligman, 2016; Tennen & Affleck, 1998).

 

BATESON, G., JACKSON, D. D., HALEY, J. & WEAKLAND, J., (1956), Toward A Theory Of Schizophrenia.Behavioral Science, Vol. 1, 251–264


MAIER, S. F., & SELIGMAN, M. E. (2016). Learned Helplessness At Fifty: Insights From Neuroscience. Psychological Review, 123(4), 349–367. Https://Doi.Org/10.1037/Rev0000033


TENNEN, H., & AFFLECK, G. (1998). Three Compulsions Of Stress And Coping Research: A Systems Framework Cure? Psychological Inquiry, 9(2), 164–168. Http://Www.Jstor.Org/Stable/1449114

 

Large and small cultures of double bind can result in a person dehumanising and harming themselves through a range of means; for example, a man may come to despise himself in the image of ‘patriarchy’ resulting in his engaging in problem drug use and self harm as means of dissociation.


 

The Interaction Between Material and Non-material Causes of Mental Illness

The interrelationship of material and non-material causes of mental illness is largely unacknowledged. It is essential to understand that the material and non-material courses of psychological ailment are inextricably linked leading to each other (Akiskal, 1985). If a person experiences the toxic effects of a psychology-affecting substance their behaviour will change and they will be treated differently sociologically as a result. Once medicalised, they may be overshadowed by their label and its associated rubric having the person they were known by displaced (Reiss, Levitan & Szyszko, 1982; Bradley & Hollins, 2006).

 

AKISKAL, H. S. (1985). Interaction Of Biologic And Psychologic Factors In The Origin Of Depressive Disorders. Acta Psychiatrica Scandinavica, 71(319), 131–139. Https://Doi.Org/10.1111/J.1600-0447.1985.Tb08529.X


REISS S, LEVITAN GW, SZYSZKO J. ( 1982) Emotional Disturbance And Mental Retardation: Diagnostic Overshadowing. Am J Ment Defic. ;86(6):567-74. Pmid: 7102729.


BRADLEY, E. A., HOLLINS, S., (2006) In Psychiatric Clinical Skills,  In Assessment Of Patients With Intellectual Disabilities, Psychiatric Clinical Skills. Philadelphia, Pa, Elsevier Mosby. Http://Www.Sciencedirect.Com/Science/Book/9780323031233. P 241

 

If the person receives a label which dehumanizes them (Fiske, 2012) they will be further traumatised having their behaviour affected on a second order level; if a person is chronically or acutely brutalised sociologically the physiological responses to trauma will change their behaviour as the psycho-physiological responses alter their perception, capability and mode of interacting in the world.

 

FISKE S. T. (2012). Warmth And Competence: Stereotype Content Issues For Clinicians And Researchers. Canadian Psychology = Psychologie Canadienne, 53(1), 14–20. Https://Doi.Org/10.1037/A0026054

 

What is set up here is a positive feedback loop which penultimately sets up information which can be used to evoke the societal response of prescribing mind altering drugs leading ultimately to social reactions to these altered states of mind. The lack of comprehension and understanding of the cause of ailment underlines particular demands on medicine as a science – namely the need to expand its borders of involvement and interests and to reality check its values base.


 

Signs and Symptoms in the Privileged Model of Medicine

An explicit core of the privileged model of medicine can be seen by analysing and comparing the tenets and the practice of medical diagnosis. It is helpful to use the framing of Principal-Agent theory developed by Jensen and Meckling (1976) and others to clarify the positions and roles in the power juncture which are experienced. They describe “an agency relationship as a contract under which one or more persons (the principal(s)[patient] engage another person (the agent)[medic] to perform some service on their behalf which involves delegating some decision making authority to the agent”.

 

JENSEN, M. C., & MECKLING, W. H. (1976). Theory Of Firm: Managerial Behavior, Agency Costs And Ownership Structure. Journal Of Financial Economics, 3(4), 305-360.

 

In medical science the understanding of a problem generally requires the confluence of two sources of information through which an identification of malady and corresponding appropriate therapeutic avenue is forged. It is the combination of signs (observable by the agent/medic) with the information of the symptoms (observed by the principal/patient) which inform the identification of ailment and subsequently appropriate attempts at remedy (Nessa, 1996). To abandon one is to compromise the other. Thus the abandonment of patient knowledge we find in the privileged model of medicine are key contradictions anathema to the foundational philosophy and science of medicine.

 

NESSA, J. (1996) About Signs And Symptoms: Can Semiotics Expand The View Of Clinical Medicine?. Theor Med Bioeth 17, 363–377. Https://Doi.Org/10.1007/Bf00489681

 

In medicine and professional support in general, the concentration of power in the agent/medic with institutional in impunity results in ‘moral hazard’. Moral hazard describes a situation where an agent/medic has an incentive to increase the principal/patients exposure to risk because the agent/medic does not bear the full costs of that risk (Dembe & Boden, 2000). An exploration of the roots of medical and institutional impunity will be explored later in the writing. Power corrupts the capacity for self criticality and obscures the needed opportunities for professionals to be critiqued by their citizen peers as principals of their own health management.

 

DEMBE, A. E. AND BODEN, L. I. (2000) ‘Moral Hazard: A Question Of Morality?’, New Solutions: A Journal Of Environmental And Occupational Health Policy, 10(3), Pp. 257–279. Doi: 10.2190/1gu8-Eqn8-02j6-2rxk.


 

Medical Dehumanisation, Dementalisation and Iatrogenic Harms

In this power imbalance Medical Dehumanisation is trained into the agent/medic (Leyens, 2014) effectively negating the principal/patient as knowledgable and cognate beings, especially in the psychiatric realm, where doubt about the capacity and mind sits central to consideration of the agent and their circumstances. This is known as dementalisation and it typically accompanies dehumanisation processes (Haslam & Loughnan, 2014).

 

LEYENS, J.-P. (2014). Humanity Forever In Medical Dehumanization. In P. G. Bain, J. Vaes, & J.-P. Leyens (Eds.), Humanness And Dehumanization (pp. 167–185). Psychology Press.


HASLAM, N., & LOUGHNAN, S. (2014). Dehumanization And Infrahumanization. Annual Review Of Psychology, 65(1), 399–423. Doi:10.1146/Annurev-Psych-010213-115045

 

The combination of dehumanized perception and alienation of rights reinforced in this juncture results in a dementalization of the principal/patient on the back of which extraordinary alienation of rights and recognition take place. The result of this is the occurrence of moral hazard in the support/need juncture which produces iatrogenic impacts on people who exist under the psychiatric gaze (Fava & Rafanelli, 2019).

 

FAVA, G., RAFANELLI C. (2019) Iatrogenic Factors In Psychopathology. Psychother Psychosom. 2019;88(3):129-140. Doi: 10.1159/000500151. Epub May 14. Pmid: 31085917.

 

The tautological/self-referential medical model(s) of psychiatry represent a species of flawed theory related to solipsism. The prevailing paradigms provide status to medical/care actors which is heavily invested in by institutions and cultures partly because people have their identity and cultural status based on the knowledge.

 

This is typical of the institutionalisation of any area and also not typical to our age, for example we can see a similar investment in ‘phlogiston’ like theories of medicine in the age of Vesalius who battled with the hierarchical medical cultures over-invested in the outdated conceptions of Galen (Siraisi, 1997; Nuland, 2005).

 

SIRAISI, N. G. (1997). Vesalius And The Reading Of Galen’s Teleology. Renaissance Quarterly, 50(1), 1–37. Https://Doi.Org/10.2307/3039327


NULAND, S. B. (2005). Doctors: The History Of Scientific Medicine Revealed Through Biography.

 

The non-engagement of medics (and those working from the auspices of the medical model) in discussion of the science and evidence bases underlying treatment rationales is a problem for medicine, care and support. Significant insights needed for advancement of understanding are located outside of the gate-kept habitas of the medical orthodoxy. The medical model and institutionalisation of power suffers considerably from the Streetlight effect – observational bias expressed as when people only search for something where they can easily see (Freedman, 2010).

 

FREEDMAN, D. H., (2010). “The Streetlight Effect”. Discover. Retrieved 16.05.2022

 

Iatrogenic illness literally means illness that is ‘induced by the physician’ and it has come to be recognized as a significant source of patient risk (Sharpe & Faden, 2009). It is not uncommon that symptoms are treated rather than causes, and the treatments which are used to treat the symptoms are themselves not uncommonly iatrogenic in nature – that is, they cause pathologies which get misidentified and mystified as the psychiatric diagnosis; the idea replaces the person and it then is responded to as their cultural identity. A chief example of this is the production of tardive dyskinesia by medicines and the cultural misidentification of symptoms of tardive dyskinesia as the original mental illness (Bahiya & Sujith, 2017; Narsi Reddy et al, 2010).

 

SHARPE, V. A., & FADEN, A. I. (2009). Medical Harm: Historical, Conceptual And Ethical Dimensions Of Iatrogenic Illness. Cambridge, Gbr, Cambridge University Press. Http://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=4638246. P 1


BAHIYA S, SUJITH O. (2017) Drug Induced Parkinsonism: An Overview. Open Access J Neurol Neurosurg.; 3(4): 555620. Doi: 10.19080/Oajnn.2017.03.555620


NARSI REDDY, K., BANJI, D., BANJI, O.J., REDDY, J.A., & SWETHA, M. (2010). An Overview Of Tardive Dyskinesia. International Journal Of Pharmaceutical Sciences Review And Research, Volume 4, Issue 3, September – October 2010; Article 019 Issn 0976 – 044x

 

The level of iatrogenesis involved in the area of psychiatry is exceptional (Meadows et al, 2019; Mulder, Rucklidge & Wilkinson, 2017) due to the alienating nature of medical privilege and the extreme devaluation of the principal/agent knowledge. On top of this it gets placed behind a veil of invulnerability due to the protected nature of medicine as an institution (Finnis, 2011).

 

MEADOWS GN, PRODAN A, PATTEN S, SHAWYER F, FRANCIS S, ENTICOTT J, ROSENBERG S, ATKINSON JA, FOSSEY E, KAKUMA R. (2019 ) Resolving The Paradox Of Increased Mental Health Expenditure And Stable Prevalence. Aust N Z J Psychiatry. ;53(9):844-850. Doi: 10.1177/0004867419857821. Epub 2019 Jun 25. Pmid: 31238699; Pmcid: Pmc6724452.


MULDER R, RUCKLIDGE J AND WILKINSON S (2017) Why Has Increased Provision Of Psychiatric Treatment Not Reduced The Prevalence Of Mental Disorder? Australian And New Zealand Journal Of Psychiatry 51: 1176–1177.


FINNIS, J. (2011). Natural Law And Natural Rights (Clarendon Law Series). Oxford University Press. Page 361

 

In the later part of this writing I offer an analysis of the construction of protected professions relating this to old lineages of alienation and cultural dominance. In this I also suggest potential accounts for the semiotic patterning of the social model of mental illness. The protected profession of medicine has become a medium to modernise various mythologies surrounding people who have become ‘other’ as cultural targets of malevolent behaviours (Warnock, 2019).

 

WARNOCK, A., (2019) “The Dehumanization Of Immigrants And Refugees: A Comparison Of Dehumanizing Rhetoric By All Candidates In Three U.S. Presidential Elections” . Purdue Undergraduate Research Conference. 5. Https://Docs.Lib.Purdue.Edu/Purc/2019/Oral_Presentations/5

 

We can see the impacts of the othering of individuals and groups by examining the patterns of diagnosis in social groups who are excluded and displaced from the socio-economic institutions of society and who are, as a result, denied their voices in the body politic (social groups also known as the subaltern). The name subaltern derives from the work of Italian theorist Antonio Gramsci. The original Italian usage, ‘subalterno’ translates as ‘subordinate’. The term carries in it class analysis with Gramsci originally referring to peasants and the lower working classes; over time it has expanded in use to designate the general attribute of subordination (Lehner, 2014).

 

LEHNER, S. (2014). Subaltern Ethics In Contemporary Scottish And Irish Literature: Tracing Counter-Histories. Place Of Publication Not Identified: Palgrave Macmillan. Page 8

 

Typical examples include intersecting realities of gender (Richards, Sayres & Van Niel, 2017), race (Bignall et al, 2019), and sexuality (The Trevor Project, 2019) but necessarily must also include ideological targets of societal extreme out groups – that is, drug users (Drugscope, 2015), homeless populations (Local Government Association, 2017), people caught in the criminal justice system (Duncan, 2016), and emigrants (Pumariega, Rothe & Pumariega, 2005). Susan Fiske identifies extreme outgroups (Harris & Fiske, 2006) as encountering dehumanized perception three orders of magnitude greater than other cultural outgroups. Her work indicates this includes psychiatric labels like Schizophrenia (Fiske, 2012).

 

RICHARDS, M.D., SAYRES M, VAN NIEL, M.D, (2017), Mental Health Disparities: Women’s American Psychiatric Association, Mental Health, Division Of Diversity And Health Equity And The Council On Minority Mental Health And Health Disparities. Available From: Https://Www.Psychiatry.Org/File%20library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-For-Women.Pdf


BIGNALL, T., JERAJ, S., HELSBY E., AND BUTT, J., (2019), Racial Disparities In Mental Health: Literature And Evidence Review, Race Equality Foundation, Available From: Https://Raceequalityfoundation.Org.Uk/Wp-Content/Uploads/2020/03/Mental-Health-Report-V5-2.Pdf


THE TREVOR PROJECT. (2019). National Survey On Lgbtq Mental Health. New York, New York: The Trevor Project. Available From: Https://Www.Thetrevorproject.Org/Wp-Content/Uploads/2019/06/The-Trevor-Project-National-Survey-Results-2019.Pdf


DRUGSCOPE, (2015), Mental Health And Substance Misuse, On Behalf Of The Recovery Partnership, Available From: Https://Www.Drugwise.Org.Uk/Wp-Content/Uploads/Coexisitingmhandsmfull.Pdf


LOCAL GOVERNMENT ASSOCIATION, (2017), The Impact Of Homelessness On Health A Guide For Local Authorities, Available From: https://local.gov.uk/impact-health-homelessness-guide-local-authorities


DUNCAN, G., (2016), Mental Health And Criminal Justice, Views From Consultations Across England & Wales, Centre For Mental Health, Available From: Https://Www.Centreformentalhealth.Org.Uk/Sites/Default/Files/2018-09/Centre_For_Mental_Health_Mh_And_Criminal_Justice_Pdf.Pdf


PUMARIEGA AJ, ROTHE E, PUMARIEGA JB. (2005) Mental Health Of Immigrants And Refugees. Community Ment Health J. ;41(5):581-97. Doi: 10.1007/S10597-005-6363-1. Pmid: 16142540.


LASANA T. HARRIS AND SUSAN T. FISKE, (2006) “Dehumanizing The Lowest Of The Low: Neuroimaging Responses To Extreme Out-Groups,” Psychological Science 17, No. 10 : 847–53.


FISKE S. T. (2012). Warmth And Competence: Stereotype Content Issues For Clinicians And Researchers. Canadian Psychology = Psychologie Canadienne, 53(1), 14–20. Https://Doi.Org/10.1037/A0026054

 


 

Critique of Medicine as an Institution and Body Politic

Medicine as a body politic imposes itself as the privileged convenor of subordinate groups using tautological/self referential accounts of mind, feeling and behaviour reasoned as biochemical imbalances whilst disregarding its duty of candour to acknowledge and address environmental, toxicological, financial and social causes of mental illness.

 

A duty of candour refers to statutory governance which states if something goes wrong with your treatment or care, health and social care organisations have a duty to you or the person acting on your behalf to: apologise; be open and honest; involve you in a review of what happened; let you know how they will learn from what has happened (UK Statutory Instruments, 2014).

 

UK STATUTORY INSTRUMENTS, (2014) No. 2936, Part 3, Section 2, Regulation 20, The Health And Social Care Act 2008 (Regulated Activities) Regulations 2014

 

This mystification of identifying the causes of measurable harms is negligence of duty of care (Goldberg, 2021) as it plainly involves avoiding confrontation of inconvenient societal issues such as toxic exposure to chemicals, psychological brutalisation in families, workplaces and in institutions; intervening in the stark exploitation and deliberate political production of poverty related harms in societal groups. In tort law, a duty of care is a legal obligation which is imposed on an individual, requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others (Steele, 2020).

 

GOLDBERG, J. C. P., KENDRICK, L., SEBOK, A. J., & ZIPURSKY, B. C. (2021). Tort Law: Responsibilities And Redress. P. 118


STEELE, J. (2020). Tort Law: Text, Cases, And Materials. Oxford, Oxford University Press. Page 151

 

Due to the privilege and power it claims, medicine must necessarily be political when society wide issues are causing health problems which in turn necessarily involves critiquing other protected professions such as the criminal justice and law. In the context of corporate parenthood government and the protected institutions such as medicine must be held to account for their actions and omissions of action in relation to public health if they are to evolve beyond their mistakes and be effective in meeting their claimed remits (Scottish Government, 2015; Cockett, 2016; Access All Areas, 2017; Llywodraeth Cymru, Welsh Government, 2009).

 

SCOTTISH GOVERNMENT, (2015). Guidance Section 56: Corporate Parents. Retrieved 30.4.2018 Http://Www.Gov.Scot/Publications/2015/08/5260/5


COCKETT, C., (2016), ‘Corporate Parenting: What Can The Westminster Government Do Better?’, Huffington Post Published 14/12/2016 14:28 Gmt, Updated 15/12/2017 10:12 Gmt. Retrieved From Internet 30.3.2018: Https://Www.Huffingtonpost.Co.Uk/Chloe-Cockett/Corporate-Parenting-What-_B_13624084.Html


ACCESS ALL AREAS (NI), (2017), ‘Access All Areas Northern Ireland: Supporting Corporate Parents To Improve Young People’s Journey From Care To Adulthood’. Available At: https://www.barnardos.org.uk/sites/default/files/uploads/Access%20All%20Areas%20Northern%20Ireland%20-%20Supporting%20corporate%20parents%20to%20improve%20young%20people%27s%20journey%20from%20care%20to%20adulthood%202017.pdf


LLYWODRAETH CYMRU, WELSH GOVERNMENT, (2009), ‘If This Were My Child: A Councillor’s Guide To Being A Good Corporate Parent To Children In Care And Care Leavers’, Retrieved From Internet 14.6.2022: https://tinyurl.com/wpu2wn23


 

Alienation of Human Rights in The Political Construction of Protected Professions

A significant part of the problems in psychiatry and medicine are related to the impunity they enjoy and the resistance these institutions have to ‘outsider’ involvement and change. To understand this cultural configuration it is important is to make an examination of how and why people have been alienated from the discussion of medical science and evidence bases in relation to healthcare, especially psychiatry. For this I am examining the role of alienation in political myths which structure and shape our society. Over centuries and millennia people have become increasingly alienated from ancient means of subsistence and existence (Dunedin, 2021).

 

DUNEDIN (2021), The Tragedy Of The Commons People, Presentation At The 2nd International Working Class Academics Conference, Retreived 18.5.2022: Https://Raggeduniversity.Co.Uk/2021/06/07/The-Tragedy-Of-The-Commons-People-A-Marmot-Overview/

 

No longer is it possible to independently draw shelter or subsistence farm, land having become significantly enclosed by the privileged elite since the 11th century in Britain, and the practice acutely intensifying from the 16th century onwards, exemplified in the lowland (Aitchison & Cassell, 2019) and highland clearances of Scotland (Devine, 1999; Devine, 2011). This alienation from land was paralleled by an alienation from human capabilities – that is, the opportunities to exercise skills, practices and trades.

 

AITCHISON, P., & CASSELL, A. (2019). The Lowland Clearances: Scotland’s Silent Revolution, 1760-1830.


DEVINE, T. M. (2011). Clearance And Improvement: Land, Power And People In Scotland, 1700-1900. Edinburgh: John Donald. Page 4

 

An instrumental moment in this was the introduction of Labour Law of 1563 put into place by William Cecil in the Statute of Artificers (Heckscher, 1994). Amongst other mandates this law imposed the reservation of superior trades for the sons of the better off and the control of entry into the class of skilled workmen via compulsory seven year apprenticeship (Atiyah, 2003); note the altogether exclusion of women who were chattel (property) under the laws of Coverture having their human rights subsumed by men.

 

HECKSCHER, E. F. (1994). Mercantilism. Routledge: Taylor And Francis, Page 226


ATIYAH, P. S. (2003). The Rise And Fall Of Freedom Of Contract. Oxford: Clarendon Press. Page 67

 

This had the effect of crystallising privilege into a hierarchy which enclosed and protected professions such as medicine and law. It was from this that we see an expanded cultural dominance of the patriarchal aristocracy on human capabilities. The result has been that the world views of aristocratic patriarchs have overbearingly shaped who and what was/is deemed to be mad – or of ‘unsound mind and character’ – by dint of medical orthodoxy. The conflation of character and the relationship of mental health with carceral and prison systems requires scrutinization parallel to the critical examination of the mental health system as they are intimately related (Sapolsky, 2017; Kupers, 2017).

 

SAPOLSKY. R. M. (2017). Behave. Vintage Digital. Https://Bibliotecacomplutense.Odilotk.Es/Opac?Id=00200915.


TERRY A. KUPERS (2017) The Asylum, The Prison, And The Future Of Community Mental Health In Community Mental Health Edition 3rd Edition, Ed. Jessica Rosenberg, Samuel Rosenberg, Routledge, Ebook Isbn 9781315690346

 

I argue the convergence of the privileged profession of medicine with financialism driven by ideologies such as ‘shareholder democracy’ acts to transform a relationship based in public value (healthcare) to one of cost effectiveness calculations of utilitarianism and profit we see dominating the professional management of wellbeing. Legacies of Hobbesian Authoritarianism rooted in mythologies of monarchist patriarchalism (Tully & Skinner, 2009) pattern the management of expectations in the medical support/need juncture with behaviours of martial imperial colonialism.

 

TULLY, J., & SKINNER, Q. (2009). Approach To Political Philosophy. Cambridge, Gbr, Cambridge University Press. Http://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=4638354. P 29

 

In political language this represents a long history of alienating people from their human rights to autonomy and agency. Over time this has embodied shifting baselines of attitudes to wellbeing manifesting large cultures of adaptive preference and growing populations experiencing psychological harms from structural violence. Adaptive preference describes damaged or maladaptive responses to oppressive circumstances affecting individuals’ sense of who they are and what they can be and do (Mackenzie, 2014).

 

MACKENZIE, C., (2014), ‘Three Dimensions Of Autonomy: A Relational Analysis’, In Veltman, A., & Piper, M., (Eds.) ‘Autonomy, Oppression, And Gender’, Oxford University Press. P 30 Https://Www.Oxfordscholarship.Com/View/10.1093/Acprof:Oso/9780199969104.001.0001/Acprof-9780199969104-Chapter-2

 

In the work of Thomas Hobbes we see the political mythology of patriarchalism repackaged into social contract theory as a diachronic form of the divine right of kings (Hobbes, 2021). Arguably the most famous rendering of this is that of Robert Filmer’s book Patriarcha in 1680 (Filmer, 2008). Filmer, a barrister, argued the government of a family by the father is the basic archetype of all government. Hobbes argued that human rights are alienated to an absolute monarch who has complete impunity in ruling; he privileges males by arguing it is fathers not mothers who have founded societies. Thomas Hobbes and Robert Filmer were the same age, being born in 1588, and both went to the privileged colleges of Cambridge University.

 

 

Page 368

HOBBES, T. (2021). Leviathan. La Vergne, True Sign Publishing House. Https://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=6881154. Page 128


FILMER, R. (2008). Patriarcha: Or, The Natural Power Of Kings. London, Printed For R. Chiswell. Http://Oll.Libertyfund.Org/Title/221. Page 57

 

I suggest that the power invested in the structure of psychiatry is representative of the unusual privilege of patriarchal monarchism which pervades all so called protected professions and as a result reinforces an exclusionary imperialism characteristic of an archaic archetype. Anthropological examination of these political myths can be explored through Frazer’s Golden Bough which exemplify vertical dominance structures in the king myths (Frazer, 2009).

 

FRAZER, J. G. (2009). The Golden Bough A Study In Magic And Religion. First Published In 1890. Isbn 978-1-775410-56-0 © 2009 The Floating Press. P 13

 

‘Those whom the gods wish to destroy they first make mad’ is an anonymous ancient proverb, wrongly attributed to Euripides that holds a motif reiterated throughout the ages about madness. This offers some testimony to what madness is in one cultural aspect; the response of the dissident mind to harms inflicted by violence – structural or otherwise.

 

This semiotic places dominance through display of strength at the apex of societal structure and forges alternative qualities as othered weakness; as disability subservient to the functioning prime. This configuration offers a semiotic basis for the social model of mental illness (Beresford, 2002), one that illustrates myths of supremacy that act as charters for action (Malinowski & Redfield, 2013) but also create pathogenic culture through the traumas of dominance customs.

 

BERESFORD, P. (2002) Thinking About ‘mental Health’: Towards A Social Model, Journal Of Mental Health, 11:6, Pp. 581 -584. Thinking About ‘mental Health’: Towards A Social Model: Journal Of Mental Health: Vol 11, No 6 (tandfonline.com)


MALINOWSKI, B., & REDFIELD, R. (2013). Magic, Science And Religion: And Other Essays. Page 120

 

This anthropological look at dominance customs can offer accounts which are helpful in viewing both the intersecting disadvantages in peoples lives and how the realities of these traumas are theoretically erased in the dominant cultures accounting of other existence; non-privileged existence (Crenshaw, 1989).

 

CRENSHAW, K., (1989) “Demarginalizing The Intersection Of Race And Sex: A Black Feminist Critique Of Antidiscrimination Doctrine, Feminist Theory And Antiracist Politics,” University Of Chicago Legal Forum: Vol 1989: Iss. 1, Article 8.

 

A trauma model of mental illness may reconcile and unite siloed accounts of ailment which affect mood behaviour and capability. It may integrate personal violence, structural violence and environmental, cultural and existential violence. A trauma model of mental illness is capable of tangibly implicating a range of stressors in negatively impacting someone’s psychological wellbeing and offers practical insights for therapeutic action. Take, for examples, the effects of an abusive partner, the impacts of hostile city planning, the depletive actions of drugs/chemicals, exploitation by employers, the prejudice of a community.

 

The intersecting traumas can be seen to compound and overwhelm an individual’s capacity to cope. The fact that stressors aggregate and interact and the way that people are dealt with through categorical lenses amount to the erasure of the whole person in the their sociological setting. Psychiatry as a line managed professional specialism exemplifies this kind of erasure and alienation of a person negating the human rights of the subject (Alexander, 1997).

 

ALEXANDER, G. J., (1997), International Human Rights Protection Against Psychiatric Political Abuses, 37 Santa Clara L. Rev. 387 . Available At: Http://Digitalcommons.Law.Scu.Edu/Lawreview/Vol37/Iss2/3


 

 

 

Summary Conclusion

I have argued that madness and forms of mental illness are diverse heterogeneous phenomena which get homogeneously categorised as medical tautological/self-referential identities. I argue that madness is something of ‘unknownness’, a concept which lacks substance and as a result is culturally projected onto. Its misunderstood nature places people at a disadvantage where they are dehumanised and dementalised.

 

I contend that mental illness is caused by material (physiological harms) and non-material (sociological harms) which interact in positive feedback loops that get responded to dominantly by psychoactive drugs with mystifying tautological rationales. In the support/need juncture the medic/agent significantly discounts the knowledge and involvement of the patient/principal exposing them to risks through an asymmetry of power and as a result iatrogenic harms come about. The iatrogenic harms further displace the individual caught in the psychiatric gaze as their psychology, behaviour and mood are further affected via positive feedback.

 

To understand the alienation of individuals from their principality of their own healthcare I argue that over-investment in the status of the medical institution has anthropological roots which confer political myths of impunity subordinating people to damaging ideologies. The greater the subordination, the greater the dehumanisation and harms brought upon the people who have been erased from the discourse through alienating theories. Finally I put forward that the institution of medicine embodies a dereliction of duty of candour and duty of care, like other protected professions, to dealing with society wide issues which show up as forms of madness.


 

References:

ACCESS ALL AREAS (NI), (2017), ‘Access All Areas Northern Ireland: Supporting Corporate Parents To Improve Young People’s Journey From Care To Adulthood’. Available At: Http://Www.Barnardos.Org.Uk/Accessallareas_Report_Web.Pdf

AITCHISON, P., & CASSELL, A. (2019). The Lowland Clearances: Scotland’s Silent Revolution, 1760-1830.

AKISKAL, H. S. (1985). Interaction Of Biologic And Psychologic Factors In The Origin Of Depressive Disorders. Acta Psychiatrica Scandinavica, 71(319), 131–139. Https://Doi.Org/10.1111/J.1600-0447.1985.Tb08529.X

ALEXANDER, G. J., (1997), International Human Rights Protection Against Psychiatric Political Abuses, 37 Santa Clara L. Rev. 387 . Available At: Http://Digitalcommons.Law.Scu.Edu/Lawreview/Vol37/Iss2/3

AMERICAN PSYCHIATRIC ASSOCIATION. (2017). Diagnostic And Statistical Manual Of Mental Disorders: Dsm-5. Arlington, Va, American Psychiatric Association.

ATIYAH, P. S. (2003). The Rise And Fall Of Freedom Of Contract. Oxford: Clarendon Press. Page 67

BAHIYA S, SUJITH O. (2017) Drug Induced Parkinsonism: An Overview. Open Access J Neurol Neurosurg.; 3(4): 555620. Doi: 10.19080/Oajnn.2017.03.555620

BAKAN, J. (2019). Corporation The Pathological Pursuit Of Profit And Power. New York, Penguin Canada. Http://Public.Eblib.Com/Choice/Publicfullrecord.Aspx?P=6813467.

BAKAN, J. (2021). The New Corporation: How “good” Corporations Are Bad For Democracy.

BANDURA, A. (1999). Moral Disengagement In The Perpetration Of Inhumanities. Personality And Social Psychology Review. [Special Issue On Evil And Violence], 3, 193-209.

BATESON, G., JACKSON, D. D., HALEY, J. & WEAKLAND, J., (1956), Toward A Theory Of Schizophrenia.Behavioral Science, Vol. 1, 251–264

BERESFORD, P. (2002) Thinking About ‘mental Health’: Towards A Social Model, Journal Of Mental Health, 11:6, Pp. 581 -584. Thinking About ‘mental Health’: Towards A Social Model: Journal Of Mental Health: Vol 11, No 6 (tandfonline.com)

BIGNALL, T., JERAJ, S., HELSBY E., AND BUTT, J., (2019), Racial Disparities In Mental Health: Literature And Evidence Review, Race Equality Foundation, Available From: Https://Raceequalityfoundation.Org.Uk/Wp-Content/Uploads/2020/03/Mental-Health-Report-V5-2.Pdf

BRADLEY, E. A., HOLLINS, S., (2006) In Psychiatric Clinical Skills, . In Assessment Of Patients With Intellectual Disabilities, Psychiatric Clinical Skills. Philadelphia, Pa, Elsevier Mosby. Http://Www.Sciencedirect.Com/Science/Book/9780323031233. P 241

BRADWELL, R. H. (1994) Psychiatric Sequelae Of Organophosphorous Poisoning: A Case Study And Review Of The Literature Behavioural Neurology / Volume 7 |Article Id 683275 | Https://Doi.Org/10.3233/Ben-1994-73-402

BREGGIN PR. ( 2011) Psychiatric Drug-Induced Chronic Brain Impairment (CBI): Implications For Long-Term Treatment With Psychiatric Medication. Int J Risk Saf Med. 23(4):193-200. Doi: 10.3233/Jrs-2011-0542. Pmid: 22156084.

BREMNER D. J., (2005) Effects Of Traumatic Stress On Brain Structure And Function: Relevance To Early Responses To Trauma, Journal Of Trauma & Dissociation, 6:2, 51-68, Doi: 10.1300/J229v06n02_06

BROCK BASTIAN & NICK HASLAM (2011) Experiencing Dehumanization: Cognitive And Emotional Effects Of Everyday Dehumanization, Basic And Applied Social Psychology, 33:4, 295-303, Doi: 10.1080/01973533.2011.614132

CAHILL, A. J. (2012). Overcoming Objectification: A Carnal Ethics

CAPOZZA, D., FALVO, R., BOIN, J., & COLLEDANI, D. (2016). Dehumanization In Medical Contexts: An Expanding Research Field. Tpm-Testing, Psychometrics, Methodology In Applied Psychology, 23(4), 545–559.

COCKETT, C., (2016), ‘Corporate Parenting: What Can The Westminster Government Do Better?’, Huffington Post Published 14/12/2016 14:28 Gmt, Updated 15/12/2017 10:12 Gmt. Retrieved From Internet 30.3.2018: Https://Www.Huffingtonpost.Co.Uk/Chloe-Cockett/Corporate-Parenting-What-_B_13624084.Html

COHEN, D., & COHEN, H. (1986). Biological Theories, Drug Treatments, And Schizophrenia: A Critical Assessment. The Journal Of Mind And Behavior, 7(1), 11–35. Http://Www.Jstor.Org/Stable/43853201

COHEN, S. MARC. (2022)”Aristotle’s Metaphysics”. Stanford Encyclopedia Of Philosophy. The Metaphysics Research Lab Center For The Study Of Language And Information Stanford University Stanford, Ca. Retrieved 14 May 2022.

COHEN S, JANICKI-DEVERTS D, MILLER GE. ( 2007) Psychological Stress And Disease. Jama. Oct 10;298(14):1685-7. Doi: 10.1001/Jama.298.14.1685. Pmid: 17925521.

CRENSHAW, K., (1989) “Demarginalizing The Intersection Of Race And Sex: A Black Feminist Critique Of Antidiscrimination Doctrine, Feminist Theory And Antiracist Politics,” University Of Chicago Legal Forum: Vol 1989: Iss. 1, Article 8.

DEMBE, A. E. AND BODEN, L. I. (2000) ‘Moral Hazard: A Question Of Morality?’, New Solutions: A Journal Of Environmental And Occupational Health Policy, 10(3), Pp. 257–279. Doi: 10.2190/1gu8-Eqn8-02j6-2rxk.

DEVINE, T. M. (1999). The Scottish Nation: A History, 1700-2000. New York: Viking.

DEVINE, T. M. (2011). Clearance And Improvement: Land, Power And People In Scotland, 1700-1900. Edinburgh: John Donald.

DOREA, G., FARINA, M., & ROCHA, B. T. (2013). Toxicity Of Ethylmercury (and Thimerosal): A Comparison With Methylmercury. Journal Of Applied Toxicology, 33(8), 700-711. Doi:10.1002/Jat.2855

DUNEDIN (2021), The Tragedy Of The Commons People, Presentation At The 2nd International Working Class Academics Conference, Retreived 18.5.2022: Https://Raggeduniversity.Co.Uk/2021/06/07/The-Tragedy-Of-The-Commons-People-A-Marmot-Overview/

DRUGSCOPE, (2015), Mental Health And Substance Misuse, On Behalf Of The Recovery Partnership, Available From: Https://Www.Drugwise.Org.Uk/Wp-Content/Uploads/Coexisitingmhandsmfull.Pdf

DUNCAN, G., (2016), Mental Health And Criminal Justice, Views From Consultations Across England & Wales, Centre For Mental Health, Available From: Https://Www.Centreformentalhealth.Org.Uk/Sites/Default/Files/2018-09/Centre_For_Mental_Health_Mh_And_Criminal_Justice_Pdf.Pdf

FAVA, G., RAFANELLI C. (2019) Iatrogenic Factors In Psychopathology. Psychother Psychosom. 2019;88(3):129-140. Doi: 10.1159/000500151. Epub May 14. Pmid: 31085917.

FILMER, R. (2008). Patriarcha: Or, The Natural Power Of Kings. London, Printed For R. Chiswell. Http://Oll.Libertyfund.Org/Title/221.

FINNIS, J. (2011). Natural Law And Natural Rights (Clarendon Law Series). Oxford University Press. Page 361

FISKE S. T. (2012). Warmth And Competence: Stereotype Content Issues For Clinicians And Researchers. Canadian Psychology = Psychologie Canadienne, 53(1), 14–20. Https://Doi.Org/10.1037/A0026054

FOUCAULT, M. (1967). Madness And Civilisation. London, Tavistock. P. 19

FRANCES, A., & BOEHMER, P. (2017). Saving Normal: An Insider’s Revolt Against Out-Of-Control Psychiatric Diagnosis, Dsm-5, Big Pharma, And The Medicalization Of Ordinary Life. Old Saybrook, Conn, Tantor Media. Https://Www.Overdrive.Com/Search?Q=A88f16ff-A3bc-4e19-Ac59-Df3419d2687f.

FRAZER, J. G. (2009). The Golden Bough A Study In Magic And Religion. First Published In 1890. Isbn 978-1-775410-56-0 © 2009 The Floating Press. P 13

FREEDMAN, D. H., (2010). “The Streetlight Effect”. Discover. Retrieved 16.05.2022

FRICKER, M. (2011). Epistemic Injustice: Power And The Ethics Of Knowing. Oxford, Oxford University Press. Pp 152

GILLAM, C. (2019). Whitewash: The Story Of A Weed Killer, Cancer, And The Corruption Of Science.

GOLDBERG, J. C. P., KENDRICK, L., SEBOK, A. J., & ZIPURSKY, B. C. (2021). Tort Law: Responsibilities And Redress. P. 118

HAQUE, O. S. AND WAYTZ, A. (2012) ‘Dehumanization In Medicine: Causes, Solutions, And Functions’, Perspectives On Psychological Science, 7(2), Pp. 176–186. Doi: 10.1177/1745691611429706.

HARRIS, C., & BARRACLOUGH, B. (1998). Excess Mortality Of Mental Disorder. British Journal Of Psychiatry, 173(1), 11-53. Doi:10.1192/Bjp.173.1.11

HASLAM, N. (2006) ‘Dehumanization: An Integrative Review’, Personality And Social Psychology Review, 10(3), Pp. 252–264. Doi: 10.1207/S15327957pspr1003_4.

HASLAM, N., & LOUGHNAN, S. (2014). Dehumanization And Infrahumanization. Annual Review Of Psychology, 65(1), 399–423. Doi:10.1146/Annurev-Psych-010213-115045

HECKSCHER, E. F. (1994). Mercantilism. Routledge: Taylor And Francis, Page 226

HOBBES, T. (2021). Leviathan. La Vergne, True Sign Publishing House. Https://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=6881154.

LLYWODRAETH CYMRU, WELSH GOVERNMENT, (2009), ‘If This Were My Child: A Councillor’s Guide To Being A Good Corporate Parent To Children In Care And Care Leavers’, Retrieved From Internet 30.3.2018: Http://Gov.Wales/Topics/Health/Publications/Socialcare/Guidance1/Corporateparent/?Lang=En

HOFSTADTER, D. R. (2006). Gödel, Escher, Bach: An Eternal Golden Braid. New York, Basic Books. Pp 686

HUANG X, LAW S, LI D, YU X, LI B. (2014) Mercury Poisoning: A Case Of A Complex Neuropsychiatric Illness. Am J Psychiatry. Dec 1;171(12):1253-6. Doi: 10.1176/Appi.Ajp.2013.12101266. Pmid: 25756767.

JAGGAR, A. M. (1998). Globalizing Feminist Ethics. Hypatia, 13(2), 7–31. Http://Www.Jstor.Org/Stable/3810635

JENSEN, M. C., & MECKLING, W. H. (1976). Theory Of Firm: Managerial Behavior, Agency Costs And Ownership Structure. Journal Of Financial Economics, 3(4), 305-360.

JONES S, HOWARD L, THORNICROFT G. (2008) ‘Diagnostic Overshadowing’: Worse Physical Health Care For People With Mental Illness. Acta Psychiatr Scand. Sep;118(3):169-71. Doi: 10.1111/J.1600-0447.2008.01211.X. Pmid: 18699951.

KANDHALU, P. (2013). Effects Of Cortisol On Physical And Psychological Aspects Of The Body And Effective Ways By Which One Can Reduce Stress. Berkeley Scientific Journal, 18.

LASANA T. HARRIS AND SUSAN T. FISKE, (2006) “Dehumanizing The Lowest Of The Low: Neuroimaging Responses To Extreme Out-Groups,” Psychological Science 17, No. 10 : 847–53.

LEHNER, S. (2014). Subaltern Ethics In Contemporary Scottish And Irish Literature: Tracing Counter-Histories. Place Of Publication Not Identified: Palgrave Macmillan. Page 8

LEYENS, J.-P. (2014). Humanity Forever In Medical Dehumanization. In P. G. Bain, J. Vaes, & J.-P. Leyens (Eds.), Humanness And Dehumanization (pp. 167–185). Psychology Press.

LOCAL GOVERNMENT ASSOCIATION, (2017), The Impact Of Homelessness On Health A Guide For Local Authorities, Available From: Https://Www.Local.Gov.Uk/Sites/Default/Files/Documents/22.7%20health%20and%20homelessness_V08_Web_0.Pdf

MACKENZIE, C., (2014), ‘Three Dimensions Of Autonomy: A Relational Analysis’, In Veltman, A., & Piper, M., (Eds.) ‘Autonomy, Oppression, And Gender’, Oxford University Press. P 30 Https://Www.Oxfordscholarship.Com/View/10.1093/Acprof:Oso/9780199969104.001.0001/Acprof-9780199969104-Chapter-2

MAGEE, M. (2020). Code Blue: Inside America’s Medical Industrial Complex.

MAIER, S. F., & SELIGMAN, M. E. (2016). Learned Helplessness At Fifty: Insights From Neuroscience. Psychological Review, 123(4), 349–367. Https://Doi.Org/10.1037/Rev0000033

MALINOWSKI, B., & REDFIELD, R. (2013). Magic, Science And Religion: And Other Essays. Page 120

MCCUBBIN JA, SURWIT RS, WILLIAMS RB JR. (1985) Endogenous Opiate Peptides, Stress Reactivity, And Risk For Hypertension. Hypertension. Sep-Oct;7(5):808-11. Doi: 10.1161/01.Hyp.7.5.808. Pmid: 4030048.

MEADOWS GN, PRODAN A, PATTEN S, SHAWYER F, FRANCIS S, ENTICOTT J, ROSENBERG S, ATKINSON JA, FOSSEY E, KAKUMA R. (2019 ) Resolving The Paradox Of Increased Mental Health Expenditure And Stable Prevalence. Aust N Z J Psychiatry. ;53(9):844-850. Doi: 10.1177/0004867419857821. Epub 2019 Jun 25. Pmid: 31238699; Pmcid: Pmc6724452.

MULDER R, RUCKLIDGE J AND WILKINSON S (2017) Why Has Increased Provision Of Psychiatric Treatment Not Reduced The Prevalence Of Mental Disorder? Australian And New Zealand Journal Of Psychiatry 51: 1176–1177.

NARSI REDDY, K., BANJI, D., BANJI, O.J., REDDY, J.A., & SWETHA, M. (2010). An Overview Of Tardive Dyskinesia. International Journal Of Pharmaceutical Sciences Review And Research, Volume 4, Issue 3, September – October 2010; Article 019 Issn 0976 – 044x

NESSA, J. (1996) About Signs And Symptoms: Can Semiotics Expand The View Of Clinical Medicine?. Theor Med Bioeth 17, 363–377. Https://Doi.Org/10.1007/Bf00489681

NIETO, S., & BODE, P. (2018). Adapting Curriculum For Multicultural Classrooms in Affirming Diversity: The Sociopolitical Context Of Multicultural Education. P368

NULAND, S. B. (2005). Doctors: The History Of Scientific Medicine Revealed Through Biography.

PERKINS, B. B. (2004). The Medical Delivery Business Health Reform, Childbirth, And The Economic Order. New Brunswick, N.J., Rutgers University Press.

PUMARIEGA AJ, ROTHE E, PUMARIEGA JB. (2005) Mental Health Of Immigrants And Refugees. Community Ment Health J. ;41(5):581-97. Doi: 10.1007/S10597-005-6363-1. Pmid: 16142540.

REISS S, LEVITAN GW, SZYSZKO J. ( 1982) Emotional Disturbance And Mental Retardation: Diagnostic Overshadowing. Am J Ment Defic. ;86(6):567-74. Pmid: 7102729.

RICHARDS, M.D., SAYRES M, VAN NIEL, M.D, (2017), Mental Health Disparities: Women’s American Psychiatric Association, Mental Health, Division Of Diversity And Health Equity And The Council On Minority Mental Health And Health Disparities. Available From: Https://Www.Psychiatry.Org/File%20library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-For-Women.Pdf

SALINGER, L. M. (2013). Encyclopedia Of White-Collar And Corporate Crime. Los Angeles, Sage. P 30

SAPOLSKY. R. M. (2017). Behave. Vintage Digital. Https://Bibliotecacomplutense.Odilotk.Es/Opac?Id=00200915.

SCOTTISH GOVERNMENT, (2015). Guidance Section 56: Corporate Parents. Retrieved 30.4.2018 Http://Www.Gov.Scot/Publications/2015/08/5260/5

SIBLERUD RL, MOTL J, KIENHOLZ E. (1994) Psychometric Evidence That Mercury From Silver Dental Fillings May Be An Etiological Factor In Depression, Excessive Anger, And Anxiety. Psychol Rep. Feb;74(1):67-80. Doi: 10.2466/Pr0.1994.74.1.67. Pmid: 8153237.

SIBLERUD R, MUTTER J, MOORE E, NAUMANN J, WALACH H. (2019) A Hypothesis And Evidence That Mercury May Be An Etiological Factor In Alzheimer’s Disease. Int J Environ Res Public Health. Dec 17;16(24):5152. Doi: 10.3390/Ijerph16245152. Pmid: 31861093; Pmcid: Pmc6950077.

SIBLERUD R, MUTTER J. (2021), A Hypothesis and Additional Evidence that Mercury May be an Etiological Factor in Schizophrenia, Clin Schizophr Relat Psychoses Clinical Schizophrenia & Related Psychoses Volume 15s:1

SIRAISI, N. G. (1997). Vesalius And The Reading Of Galen’s Teleology. Renaissance Quarterly, 50(1), 1–37. Https://Doi.Org/10.2307/3039327

SHARPE, V. A., & FADEN, A. I. (2009). Medical Harm: Historical, Conceptual And Ethical Dimensions Of Iatrogenic Illness. Cambridge, Gbr, Cambridge University Press. Http://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=4638246. P 1

SLAVICH, G. M., STEWART, J. G., ESPOSITO, E. C., SHIELDS, G. S., & AUERBACH, R. P. (2019). The Stress An Adversity Inventory For Adolescents (Adolescent Strain ): Associations With Mental And Physical Health, Risky Behaviors, And Psychiatric Diagnoses In Youth Seeking Treatment. Journal Of Child Psychology And Psychiatry. Doi:10.1111/Jcpp.13038

STASZAK J. F. (2011). Other/Otherness In International Encyclopedia Of Human Geography. Eds Kitchin, R., & Thrift, N. J. Amsterdam [Netherlands], Elsevier. Http://Www.Credoreference.Com/Book/Esthg.

STEELE, J. (2020). Tort Law: Text, Cases, And Materials. Oxford, Oxford University Press.

Doi: 10.1093/He/9780199671403.003.0003 (p. 111)

SWEET, P. L. (2019) ‘The Sociology Of Gaslighting’, American Sociological Review, 84(5), Pp. 851–875. Doi: 10.1177/0003122419874843.

TAKAHASHI N, HASHIZUME M. (2014) A Systematic Review Of The Influence Of Occupational Organophosphate Pesticides Exposure On Neurological Impairment. Bmj Open;4:E004798. Doi:10.1136/Bmjopen-2014- 004798

TENNEN, H., & AFFLECK, G. (1998). Three Compulsions Of Stress And Coping Research: A Systems Framework Cure? Psychological Inquiry, 9(2), 164–168. Http://Www.Jstor.Org/Stable/1449114

TERRY A. KUPERS (2017) The Asylum, The Prison, And The Future Of Community Mental Health In Community Mental Health Edition 3rd Edition, Ed. Jessica Rosenberg, Samuel Rosenberg, Routledge, Ebook Isbn 9781315690346

THE TREVOR PROJECT. (2019). National Survey On Lgbtq Mental Health. New York, New York: The Trevor Project. Available From: Https://Www.Thetrevorproject.Org/Wp-Content/Uploads/2019/06/The-Trevor-Project-National-Survey-Results-2019.Pdf

TULLY, J., & SKINNER, Q. (2009). Approach To Political Philosophy. Cambridge, Gbr, Cambridge University Press. Http://Public.Ebookcentral.Proquest.Com/Choice/Publicfullrecord.Aspx?P=4638354. P 29

UK STATUTORY INSTRUMENTS, (2014) No. 2936, Part 3, Section 2, Regulation 20, The Health And Social Care Act 2008 (Regulated Activities) Regulations 2014

VYSE, S. A. (2014). Believing In Magic: The Psychology Of Superstition. New York, Oxford University Press, Usa.

WARNOCK, A., (2019) “The Dehumanization Of Immigrants And Refugees: A Comparison Of Dehumanizing Rhetoric By All Candidates In Three U.S. Presidential Elections” . Purdue Undergraduate Research Conference. 5. Https://Docs.Lib.Purdue.Edu/Purc/2019/Oral_Presentations/5


 

by Alex Dunedin