“Your recent book, Cracked, has provoked a lot of interest and comment. For those who haven’t read it, how would you summarise the argument?
In a nutshell, I argue that psychiatry over the past 40 years, under the dominance of the medical or ‘technological’ model, has done a lot of harm in the name of helping vulnerable people. Not intentionally, I hasten to add, but as an outcome of taking the medical model too far. Your readers will be familiar with the arguments: psychiatry has medicalised more and more natural, albeit painful, responses to the difficulties of living; it has become wedded to medications of questionable value (for many people) and whose long-term effects are still uncertain; it has allowed itself to be compromised by pharmaceutical ties; it has stigmatised people through labels and has sold itself as closer to the rest of medicine than it is. All this has led to a situation in which the integrity and efficacy of the profession is now under serious scrutiny.
What led you to write the book?
My experience of working with people in the NHS who had been adversely affected by psychiatric diagnoses and drugs that were, in my view, often entirely unnecessary. It takes relatively little time to assign a descriptive label, but it takes many months to really understand a person and why they suffer. Yet most psychiatrists have little time for the latter, which is why I’d so often encounter understandable human experience, even necessary experience, being medicalised and medicated to the detriment of the patient. In many cases the diagnoses were leading to little other than the illusion of understanding, for doctors, and stigma and selfstigma for patients. The medications themselves, although helpful for some of the more severely distressed in the short term, ended up confusing us all: what experience was drug induced and what the product of the ‘person’ or the ‘condition’? After some time nobody would really know any more, patient, psychologist or doctor.