The purpose of this page is to bring to the visitor an introduction to the writings of Dr David Cooper, his discoveries and criticisms in and of the field of Mental Health. It was David Cooper who coined the term Anti-Psychiatry and who first outlined the Psycho-Dynamics of Schizophrenia.
This page should not be treated as a substitute to reading the original works but rather as an online outline to his work. His writings include: "Reason & Violence" with R. D. Lang, "Psychiatry Anti-Psychiatry" "The Death of the Family", "The Grammar of Living" and "The Language of Madness"
To understand Anti-Psychiatry one has to first understand Psychiatry. Psychiatry is primarily a social institution which removes from society the "mentally ill and attempts to subdue their symptoms using drugs. Patients are diagnosed, labeled and drugged. Emphasis is on "Normalization". The suppression of difference, originality and vision - Conformism - making obedient robots that do not create anxiety in others.
Anti-Psychiatry emphasis is on making the individual whole. Diagnosis and analysis are replaced by uncritical listening. Labeling is replaced by witnessing the individual as an individual. Anti psychiatry tries to reverse the rules of the Psychiatric game.
David Coopers key discovery was that the Schizophrenic condition is the result of a "significant inward voyage". By this he means the individual looking inwards - searching for what is wrong with himself or why he is the way he is. In 1974 L.R. Hubbard used the term introspection for this.
In 1925 Sigmund Freud discovered the other dynamic involved - regression. Regression can be defined as returning to a former state. In fact regression is not limited to this life but includes past lives. While regressed the individual re-experiences past memories as if they are now and reacts to current impulses as he would of then. Personality development is reversed.
These two dynamics work together like this. The individual is excessively introspecting. He or she then begins to regress. The regression results in a progressive deterioration in personality. A progressive detachment with what we agree is reality as he or she returns to earlier times. As the condition progresses the introspection gets more frantic as the subject becomes more desperate to find the cause/solution of/to his or her progressively worsening condition which in turn results in further introspection, regression and worsening.
As the regression progresses the more severe symptoms of Schizophrenia are released from the unconscious mind and the subject is gradually overwhelmed by the contents of this mind.
To reverse the disabling effects of Schizophrenia by reversing introspection and regression, and to facilitate personality development which enables the individual to be someone.
APPROACH.
"All you need is a witness is a central anti-psychiatry concept." By this David Cooper means that the patient needs someone who is listening to them and knowing them without saying anything or making an interpretation.
Listening to what subject has to say. Try and understand what is being said. Do not look for some hidden meaning or speculate on why this or that is being said. Keep it real simple. As David Cooper says "telling the truth is a symptom of mental illness." A communicative subject, while in a psychotic break, will tell anyone willing to listen what he is actually experiencing. Please do not dismiss what is said as Paranoia, delusions etc. It may well be but to the subject it is real. Telling the subject that he is wrong, deluded etc will result in shutting up the patient and pushing him further into his madness. Respond to the subject as a friend not as patient. The less said the better as what you say is liable to misinterpretation due to the regressed state. Be pleased to see the individual. Find something you like about him or her. All he or she needs one person to like/admire/appreciate themselves and then they might start to like/admire/appreciate themselves. Be a friend.
Here is an Interview with Molly by Al Siebert PhD. An excellent example of uncritical listening.
When the nurse introduced us, Molly glanced quickly at me. She didn't say anything, even though I could feel her attention on me. She seemed frightened and lonely.
I seated her at the end of a table and I sat at the side. Instead of trying to talk with her, I put her to work copying Bender-Gestalt designs onto sheets of paper. She cooperated and did what I asked.
I wasn't especially interested in how well she could draw; I just wanted her to become comfortable with me. I sat relaxed and quiet. When she finished a drawing I'd say, "Good," or "That's fine," or "Okay, here's the next one."
When she finished the drawings, I started her on the Wechsler block design test. She followed instructions accurately and worked at a good speed. I could see that she was not depressed and had no obvious neurological problems.
She gradually warmed up to me and relaxed as we proceeded. After about 15 minutes she peeked out from under her hair and looked cautiously into my eyes.
At the first moment of good eye contact, I smiled and said "Hello." She blushed and ducked her head.
I felt a rapport with her and felt that I could start a conversation. It went like this:
A.S.: "Molly?...(she looks up at me)...I am curious about something. Why are you here in a psychiatric hospital?"
Molly: "God spoke to me and said I was going to give birth to the second Savior."
A.S.: "That may be, but why are you here in this hospital.?"
A.S.: "Did you decide when God spoke to you that you were crazy?"
Molly: "Oh. No. They told me I was crazy."
A.S.: "Do you believe you are crazy?"
Molly: "No, but I am, aren't I." (dejected)
A.S.: "If you will put that in the form of a question, I'll answer you."
Molly: (slightly puzzled, pauses to think) "Do you think I am crazy?"
A.S.: "No."
Molly: "But that couldn't have happened, could it?"
A.S.: "As far as I am concerned, you are the only person who knows what happens in your mind. Did it seem real at the time?"
Molly: "Oh yes!"
A.S.: "Tell me what you did after God spoke to you."
Molly: "What do you mean?"
A.S.: "Did you start knitting booties and sweaters and things?"
Molly: (laughs) "No, but I did pack my clothes and wait by the door several times."
A.S.: "Why?"
Molly: "I felt like I would be taken someplace."
A.S.: "It wasn't where you expected, was it!"
Molly: (laughing) "No!"
A.S.: "One thing I'm curious about."
Molly: "What?"
A.S.: "Why is it that of all women in the world, God chose you to be the mother of the second Savior?"
Molly: (breaks into a big grin) "You know, I've been trying to figure that out myself!"
A.S.: "I'm curious. What things happened in your life before God spoke to you?"
It took about 30 minutes to draw out her story. Molly was an only child who had tried unsuccessfully to earn love and praise from her parents. They only gave her a little love once in a while, just enough to give her hope she could get more. She voluntarily did many things around the house such as cooking and cleaning. Her father had been a musician so she joined the school orchestra. She thought this would please him. She practiced hard and the day she was promoted to first chair in the clarinet section, she ran home from school to tell her father. She expected him to be very proud of her, but his reaction was to smash her clarinet across the kitchen table and tell her, "You'll never amount to anything."
After graduation from high school, Molly entered nursing school. She chose nursing because she believed that in the hospital the patients would appreciate the nice things she would do for them. She was eager and excited about her first clinical assignment, but it turned into a shattering experience. The two women patients she was assigned to criticized her. She couldn't do anything right for them. She felt "like the world fell in." She ran away from school and took a bus to the town where her high school boyfriend was in college. She went to see him, but he told her to go home and write to him. He said they could still be friends, but he wanted to date other girls.
A.S.: "How did you feel after that?"
Molly: "Awful lonely."
A.S.: "So your dad and mom didn't love you, the patients were critical and didn't like you, and your boyfriend just wanted to be friends. That made you feel very sad and lonely."
Molly: (head down, dejected) "Yes, there didn't seem to be anyone in the whole world who cared for me at all."
A.S.: "And then God spoke to you."
Molly: "Yes." (quietly)
A.S.: "How did you feel after God gave you the good news?"
Molly: (looks up, smiles warmly at me) "I felt like the most special person in the whole world."
A.S.: "That's a nice feeling, isn't it?"
Molly: "Yes, it is."
(The kitchen crew came into the dining room to set up for lunch.)
A.S.: "I must go now."
Molly: "Please don't tell them what we've been talking about. No one seems to understand."
A.S.: "I know what you mean. I promise not to tell if you won't."
Molly: "I promise."
Two days later I was walking through the locked ward to see another patient. When Molly saw me she walked over and stopped me by putting her hand on my arm. "I've been thinking about what we talked about," she said. "I've been wondering. Do you think I imagined God's voice to make myself feel better?"
She surprised me. I didn't intend to do therapy, but she seemed to see the connection. I paused. I thought to myself "maybe so, but if there is an old-fashioned God who does things like this, then He is watching! I didn't care what the other doctors and nurses do, I am not going to give her a rough time. I am going to be her friend!" I shrugged my shoulders. I said, "perhaps" and smiled at her. She smiled back with good eye contact, then turned and walked away.
At staff rounds the head nurse reported a dramatic improvement in Molly. She was now a cheerful, talkative teen-ager. She spoke easily with her doctor, the nurses, and other patients. She started participating in patient activities. She brushed and combed her hair, put on make-up, and asked for nicer looking dresses.
At rounds a week later Dr. Bostian described her amazing recovery as "a case of spontaneous remission." The plans to commit her were dropped. A few days later she was transferred to the open ward and she did so well the doctors and nurses expected her to be discharged soon. I left the hospital soon after, so I was not able to follow-up. What would have happened to her if I had not taken time to listen to her with an open mind and affirm her reality? The psychiatric staff's prediction that she was destined to spend many years in the back ward of the state hospital would, most likely, have been validated.
All patients' names in this article are pseudonyms.
The biggest obstacle to treatment is what David Cooper calls the paranoia of madness. The most common manifestation of this is "there must be something wrong with him or her as they have been mentally ill". Of course what is really being said is "there must be something wrong with him or her otherwise why am I not mentally ill. Mental illness has nothing to do with who or what the individual is. Any failings of the subject real or imagined are not the cause of the mental illness. Psychoanalysis is counter indicated in the treatment of schizophrenia - it makes the condition worse. Non Analytical Analysis - the analysis of patients by people who are not trained in psycho-analysis and who do not use transference, free association, word association or dream analysis but do go on about what is wrong with subject or why they behave the way they do - as often practiced by members of the psychiatric profession and wannabees will exacerbate the condition as will psycho-babble. As David Cooper says "obsessive projectionists, compulsive interpreters are very parano-genetic. Here he is talking about the practice of Non-Analytical Analysis by Psychiatric Professionals or wannabees.
The second most common manifestation of the paranoia of madness is the reaction to the recovery of the mentally ill. Often people recovering from mental illness become more outgoing, less introverted and more communicative. This is interpreted as a relapse.
David Cooper's solutions for these problems is for the Psychiatric Professionals to work through their paranoia of madness and training ex-patients as therapists.
The following all document successes in the treatment of Schizophrenia. They all concentrate on making the individual more able or physically better rather than focusing on the "illness" or the symptoms and instilling in the patient the hope that they can be better
New Hope for people with schizophrenia. Abstract from "Monitor on Psychology Vol 31, #2 Feb 2000".
Long-term studies show people do get past mental illness. Data shows that rates as high as 68% recovery/significant improvement without need of medication are possible. A small but growing number of psychologists are rejecting old treatment models that viewed patients as hopeless cases but rather use a recovery model that instead of focusing on the disease or pathological aspect of schizophrenia concentrates on the potential for growth. Harding's study of 269 patients who were released between 1955-1965 from Vermont State Hospital after a rehabilitation program whose goal was self-sufficiency. Her study showed that 62-68% of these former backward patients showed no signs at all of schizophrenia. She also studied same number of patients from Augusta Maine who were released at the same time but whose rehabilitation program was based on medication. 48% showed a recover/significant improvement and were all of medication.
Harding says what they all had in common was that they were all out of the hospital and had someone who believed in them, someone who had told them that they had a chance to get better.
Ronald Bassman PhD. Diagnosed with schizophrenia as a young man, recovered, earned his doctorate and is involved in patient empowerment programs in the New York state office of mental health says:- "It's miraculous how people come back. If you talk to someone who is doing better he or she will tell that someone - a friend, a family member, a pastor, a therapist - reached out with warmth, gentleness and kindness. This is not what is typically done in the Mental Health System."
The authors of the above article do subscribe to a "Brain" model of mental illness so cannot explain their findings.
Once the subject is no longer in an acute psychotic break ask him or her to Help. Help
making beds, washing dishes, pulling weeds anything to extrovert subjects and make them
feel useful. This help is not the giving out of chores but rather a request for help in
sharing your burden. The more normal you treat the mentally ill individual the better the
chances are of recovery. Rather than looking for symptoms or the negative aspects of mental
illness, focus on the positive aspects of the individual.
David Cooper does not actually mentioning the use of help in the treatment of mental
illness. The idea came to me from my mother whose friend suffered from mental illness for
twenty years. What finally brought her out of her illness was one of the attendants complaining
that her back was hurting and asking my mother's friend to help her make the beds.
This was in the early 1950"s before the use of modern medications. After many months
she was well enough to leave the asylum and became a Nurses aide. Most children love being
given the opportunity to help parents and siblings. This is a great learning tool and also
raises self esteem as the child is allowed to contribute.
Humane Treatment
Humane treatment is the key to success. The less the patient is treated like a mental patient who has to be "cured" the better the prognosis. It is not the symptoms that need to be diagnosed or labeled but rather the individual needs a friend. Encouragement in any activity without criticism or judgment facilitates personality development.
See the Dr. Giorgio Antonucci Story:-
Dr. Giorgio Antonucci used communication, physical exams and standard medical treatment to help schizophrenic and “incurable” patients who had been cruelly restrained for decades at Imola psychiatric asylum in Italy. He taught his patients living skills and organized concerts and trips to Rome as part of their therapy. Subsequently, many were discharged from Imola to lead successful lives.
Against tremendous opposition from his peers, and without the use of drugs or coercion, Dr. Antonucci salvaged the lives of hundreds of patients deemed incurable and institutional cases. Today, many of his patients continue to live and work in the community. He is an inspiration to medicine.
Educate subject into the condition, the mind, life and work skills.
Medication.
Will not cure condition but does minimize symptoms, makes patients more controllable and
more accessible. Unfortunately they do have severe side effects, can cause neurological damage and may prevent full recovery. Certainly over medication will prevent proper treatment and recovery.
Medication should not be viewed as a treatment but rather an aid when required.
The following Quote is from an article originally published in the New York Times on Sunday, March 10, 2002, in response to the release of the film A Beautiful Mind.
Beautiful Minds Can Be Recovered
by Courtenay M. Harding, Ph.D.
Senior Director
Center for Psychiatric Rehabilitation
Sargent College of Health and Rehabilitation Science
Boston University
The film "A Beautiful Mind," about the Nobel Prize-winning mathematician John F. Nash Jr., portrays his recovery from schizophrenia as hard-won, awe-inspiring and unusual. What most Americans and even many psychiatrists do not realize is that many people with schizophrenia -- perhaps more than half -- do significantly improve or recover. That is, they can function socially, work, relate well to others and live in the larger community. Many can be symptom-free without medication.
I started out to understand Schizophrenia not to find someone to blame.
There is no such thing as a perfect parent and certainly there is no perfect child.
There are parents who are so bad that the State will take their children from them and the
majority of these children are affected some way by their parents, a few escape
relatively un-scathed. at the opposite end of the spectrum most of the offspring of good
parents grow up fine while a few are seriously effected. About 1% of the population becomes
Schizophrenic. This figure is pretty universal which points to a genetically based
predisposition. However, the key to understanding mental aberrations is the individual's reaction to:
trauma, whatever happened to them, what they witnessed or what they themselves did.
Is Mental Illness a learned reaction to an insane world?
No. Normality is the learned reaction to an insane world and to the insanity buried in
the psyche. Schizophrenia is a failure of the maturation process. In fact the process is
thrown into reverse.
Is Schizophrenia one Disease or many?
There are many similar disorders which are the result of physical illness, poisons tumors etc. That is why the mentally ill should be first be examined by a medical doctor to eliminate these. Schizophrenia is a mental or if you prefer a spiritual disorder. The root of the disorder will be found 6-9 months before its first observation. What sends the individual into obsessive introspection and regression varies from individual to individual and the results of this are different for each individual. The spectrum of mental phenomenon that then results from this underlying mechanism gives rise to the appearance of more than one disorder. There are common things buried in each of our Psyches and these are often seen in patients, further there are unique things in each of our Psyches.
Why do you disagree with the Medical Model?
People with disorders like Schizophrenia, Bi-Polar and Depression all respond to placebo medicine, all occasion spontaneous remissions and a percentage all recover from conventional treatment. People with true organic illness like Alzheimer's and Parkinson's do not exhibit any of the above. 25% of Schizophrenics recover with conventional treatment but this figure can be boosted to nearly 60% if the patients are treated with vitamins by medical staffs that believe that the condition is caused by a vitamin deficiency. Placebos work on the mind or on the spirit.
Successful Schizophrenia A critical Psychiatry site which provides information on what is wrong with Psychiatry and case histories supporting the case for humane treatment of the mentally ill.
Overcoming Schizophrenia Ronald Bassman, PhD., a Psychologist, the tale of his battle with Schizophrenia.
Are Psychiatrists betraying their Patients Letters and articles by Loren R. Mosher M.D., former Chief of the Center for Studies of Schizophrenia, National Institutes of Mental Health.
Mind Freedom Campaign for human rights in the mental health system.
Critical Psychiatry Web site British Psychiatric site which is critical of current Psychiatric Treatments, Training & Philosophy.
The Experience of Schizophrenia Ian Chouls', who suffers from Schizophrenia, home page. This is a very extensive site that includes Ian's own story and many links to conventional sites dealing with Schizophrenia. It does however adopt the medical model for Schizophrenia but it is still well worth a visit.
R. D. Laing List of links to pages dealing with R. D. Laing.
First I would like to thank the patients and staff of Springfield Hospital, Tooting,
London who helped me understand what David Cooper was saying. I trained there as a
Psychiatric nurse from 1978 to 1981.
Second I would like to thank the staff of Scripts Hospital, Encinitas,
California who look after me while I had an operation for gallstones.
It was during this time that I first wrote this page.
If you have any comments or questions please press the mail button.
Eric Setz wrote this page 18th June 2003. Last modified 15th October 2006.
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