• Monthly
  • $25
  • $50
  • $100
  • $other
  • use PayPal

ONE WEEK TO DOUBLE YOUR DONATION!

A generous CounterPuncher has offered a $25,000 matching grant. So for this week only, whatever you can donate will be doubled up to $25,000! If you have the means, please donate! If you already have done so, thank you for your support. All contributions are tax-deductible.
FacebookTwitterRedditEmail

“Don’t Be Stupid, Be a Smarty”: Why Anti-Authoritarian Doctors Are So Rare

“Don’t be stupid, be a smarty, come and join the Nazi Party” is an intentionally obnoxious line from the hilarious “Springtime for Hitler” in Mel Brook’s The Producers. Not hilarious is the reality that doctors in Nazi Germany were “smarties” in Brook’s sardonic sense, as they joined the Nazi SS in a far higher proportion than the German general population. Also not funny is that U.S. doctors and healthcare professionals—from their “aiding torture” (description used in the CIA Inspector General’s Report) at Guantánamo Bay, Abu Ghraib, and elsewhere to the more recent drugging of detained child migrants—have served U.S. authoritarian policies.

In the Journal of Medical Ethics in 2012, Alessandra Colaianni reports “More than 7% of all German physicians became members of the Nazi SS during World War II, compared with less than 1% of the general population. . . . By 1945, half of all German physicians had joined the Nazi party, 6% before Adolf Hitler gained power.” Colaianni points out, “Physicians joined the Nazi party and the killing operations not at gunpoint, not by force, but of their own volition.”

Colaianni offers several explanations for doctors’ penchant for authoritarianism—reasons that continue to exist today. Two of her explanations are doctors’ socialization to hierarchy and their exceptional career ambitiousness. “Medical culture is,” she concludes “in many ways, a rigid hierarchy. . . . Those at the lower end of the hierarchy are used to doing what their superiors ask of them, often without understanding exactly why. . . . Questioning superiors is often uncomfortable, for fear both of negative consequences (retaliation, losing the superior’s respect) and of being wrong.” She also points out, “Becoming a doctor requires no small amount of ambition. . . .The stereotypical pre-medical student [is] ruthlessly competitive, willing to do anything to get ahead.”

“Authoritarian”is defined by the American Heritage Dictionary as “characterized by or favoring absolute obedience to authority.” Authoritarians in power demand unquestioning obedience from those with lower rank, and authoritarian subordinates comply with all demands of authorities.

I have a special interest in authoritarianism among psychiatrists and psychologists. In their schooling and training (and often beyond that), they live for many years in a world where one complies with the demands of all authorities, and so their patients who challenge authority and resist illegitimate authority appear to be “abnormal” and “mentally ill.”

In my training to become a psychologist, I discovered that students, trainees, and subordinate mental health professionals who challenged authorities routinely got labeled as having “authority issues,” which stigmatizes them in terms of career advancement. Both the selection and socialization of mental health professionals breed out most anti-authoritarians, and the handful of anti-authoritarians who manage to slither through the academic hoops to obtain their degrees have all, from my experience, paid a career price for challenging illegitimate authority. And that punishment has intimidated other mental health professionals from taking an anti-authoritarian path.

Corroborating my personal experience of the retribution heaped upon those rare anti-authoritarian psychiatrists, the journal Ethical Human Psychology and Psychiatry (in 2017) devoted an issue to dissident psychiatrists Thomas Szasz (1920-2012) and his protégé, psychiatrist Ron Leifer (1932-2017).

Perhaps the most famous anti-authoritarian psychiatrist in U.S. history is Thomas Szasz. His The Myth of Mental Illness (1961) brought the wrath of the entire psychiatric establishment against him. Szasz continues today to be widely misunderstood. “He did not deny that people suffer mentally and emotionally,” Leifer pointed out, “He was not even denying mental illnesses exist. He acknowledged that they exist, but . . . not as diseases in the same sense that diabetes or pneumonia are diseases.” Szasz argued that “mental illness” is a metaphor for emotional and behavioral problems in living. Szasz has been widely accused of being anti-psychiatry, but what he opposed was coercive psychiatry. Szasz was a fierce opponent of involuntary psychiatric treatment, believing psychiatry and psychotherapy should only be utilized when there is informed choice and consent.

What was establishment psychiatry’s reaction to Szasz? Psychologist Chuck Ruby reports, “Starting immediately on his open revolt, Szasz’s colleagues ridiculed him, and they considered him a traitor to the profession of psychiatry.” Ruby, the Executive Director of the International Society for Ethical Psychology and Psychiatry, notes, “There were unsuccessful attempts by New York state officials to remove him as a professor at SUNY Upstate Medical University at Syracuse, and his superiors at the university attempted to goad him into quitting.” Szasz was a full professor with tenure; but the chairman of the Department of Psychiatry, David Robinson, according to Leifer, “tried to drive Szasz into insubordination so he could fire him.” Szasz ultimately had to hire a lawyer to defend and protect his tenured appointment.

Ron Leifer, lacking tenure, was far more vulnerable to a career “hit.” Leifer reported that he was “excommunicated” from academic psychiatry in 1966, “fired [by Robinson] in retaliation for publishing a book that was interpreted to be criticism of psychiatry.” Leifer recounted, “I applied at other departments of psychiatry . . . but was rejected because of my association with Szasz. So much for the free expression of ideas in academic psychiatry!”

Then there is the case of Loren Mosher (1933–2004), the psychiatrist perhaps most respected by ex-patients who have become activists fighting for human rights. In 1968, Mosher became the National Institute of Mental Health’s Chief of the Center for Schizophrenia Research. In 1971, he launched an alternative approach for people
diagnosed with schizophrenia, opening the first Soteria House in Santa Clara, California. Soteria House was an egalitarian and non-coercive psychosocial milieu employing nonprofessional caregivers. The results showed that people do far better with the Soteria approach than with standard psychiatric treatment, and that people can in fact recover with little or no use of antipsychotic drugs. Mosher’s success embarrassed establishment psychiatry and displeased the pharmaceutical industry. Not surprisingly, the National Institute of Mental Health choked off Soteria House funding, and Mosher was fired from NIMH in 1980.

Dissident psychiatrists are a rare breed, and those whom I have known tell me that the attempted hit on Szasz and the successful hits on Leifer and Mosher were as predictable as any hit by La Cosa Nostra (“our thing”)—as the psychiatry establishment is also not exactly tolerant of any challenges to “their thing.”

Anti-authoritarian patients should be especially concerned with psychiatrists and psychologists—even more so than with other doctors. While an authoritarian cardiothoracic surgeon may be an abusive jerk for a nursing staff, that surgeon can still effectively perform a necessary artery bypass for an anti-authoritarian patient. However, authoritarian psychiatrists and psychologists will always do damage to their anti-authoritarian patients.

Psychiatrists and psychologists are often unaware of the magnitude of their obedience, and so the anti-authoritarianism of their patients can create enormous anxiety and even shame for them with regard to their own excessive compliance. This anxiety and shame can fuel their psycho-pathologizing of any noncompliance that creates significant tension. Such tension includes an anti-authoritarian patient’s incensed reaction to illegitimate authority.

Anti-authoritarian helpers—far more commonly found in peer support—understand angry reactions to illegitimate authority, empathize with the pain fueling those reactions, and genuinely care about that pain. Having one’s behavior understood and pain cared about opens one up to dialogue as to how best to deal with one’s pain. Because anti-authoritarian mental health professionals are rare, angry anti-authoritarian patients will likely be “treated” by an authority who creates even more pain, which results in more self-destructiveness and violence.

It is certainly no accident that anti-authoritarian psychiatrists and psychologists are rare. Mainstream psychiatry and psychology meet the needs of the ruling power structure by pathologizing anger and depoliticizing malaise so as to maintain the status quo. In contrast, anti-authoritarians model and validate resisting illegitimate authority, and so anti-authoritarian professionals—be they teachers, clergy, psychiatrists, or psychologists—are not viewed kindly by the ruling power structure.

More articles by:

Bruce E. Levine, a practicing clinical psychologist often at odds with the mainstream of his profession, writes and speaks about how society, culture, politics and psychology intersect. His most recent book is Resisting Illegitimate Authority: A Thinking Person’s Guide to Being an Anti-Authoritarian―Strategies, Tools, and Models (AK Press, September, 2018). His Web site is brucelevine.net

bernie-the-sandernistas-cover-344x550
October 16, 2019
Patrick Cockburn
How Turkey’s Invasion of Syria Backfired on Erdogan
Chitrangada Choudhury – Aniket Aga
How Cotton Became a Headache in the Age of Climate Chaos
Jack Rasmus
US-China Mini-Trade Deal: Trump Takes the Money and Runs
Michael Welton
Communist Dictatorship in Our Midst
Robert Hunziker
Extinction Rebellion Sweeps the World
Peter A. Coclanis
Donald Trump as Artist
Chris Floyd
Byzantium Now: Time-Warping From Justinian to Trump
Steve Klinger
In For a Dime, in For a Dollar
Gary Leupp
The Maria Ramirez Story
Kim C. Domenico
It Serves Us Right To Suffer: Breaking Down Neoliberal Complacency
Kiley Blackman
Wildlife Killing Contests are Unethical
Colin Todhunter
Bayer Shareholders: Put Health and Nature First and Stop Funding This Company!
Andrés Castro
Looking Normal in Kew Gardens
October 15, 2019
Victor Grossman
The Berlin Wall, Thirty Years Later
Raouf Halaby
Kurdish Massacres: One of Britain’s Many Original Sins
Robert Fisk
Trump and Erdogan have Much in Common – and the Kurds will be the Tragic Victims of Their Idiocy
Ron Jacobs
Betrayal in the Levant
Wilma Salgado
Ecuador: Lenin Moreno’s Government Sacrifices the Poor to Satisfy the IMF
Ralph Nader
The Congress Has to Draw the Line
William A. Cohn
The Don Fought the Law…
John W. Whitehead
One Man Against the Monster: John Lennon vs. the Deep State
Lara Merling – Leo Baunach
Sovereign Debt Restructuring: Not Falling Prey to Vultures
Norman Solomon
The More Joe Biden Stumbles, the More Corporate Democrats Freak Out
Jim Britell
The Problem With Partnerships and Roundtables
Howard Lisnoff
More Incitement to Violence by Trump’s Fellow Travelers
Binoy Kampmark
University Woes: the Managerial Class Gets Uppity
Joe Emersberger
Media Smears, Political Persecution Set the Stage for Austerity and the Backlash Against It in Ecuador
Thomas Mountain
Ethiopia’s Abiy Ahmed Wins Nobel Peace Prize, But It Takes Two to Make Peace
Wim Laven
Citizens Must Remove Trump From Office
October 14, 2019
Ann Robertson - Bill Leumer
Class Struggle is Still the Issue
Mike Miller
Global Climate Strike: From Protest To Power?
Patrick Cockburn
As Turkey Prepares to Slice Through Syria, the US has Cleared a New Breeding Ground for Isis
John Feffer
Trump’s Undeclared State of Emergency
Dean Baker
The Economics and Politics of Financial Transactions Taxes and Wealth Taxes
Jonah Raskin
What Evil Empire?
Nino Pagliccia
The Apotheosis of Emperors
Evaggelos Vallianatos
A Passion for Writing
Basav Sen
The Oil Despots
Brett Wilkins
‘No Friend But the Mountains’: A History of US Betrayal of the Kurds
John Kendall Hawkins
Assange: Enema of the State
Scott Owen
Truth, Justice and Life
Thomas Knapp
“The Grid” is the Problem, Not the Solution
Rob Kall
Republicans Are Going to Remove Trump Soon
Cesar Chelala
Lebanon, Dreamland
Weekend Edition
October 11, 2019
Friday - Sunday
Becky Grant
CounterPunch in Peril?
FacebookTwitterRedditEmail