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Psychiatrists themselves acknowledge that their profession often smacks of modern alchemy—full of jargon, obfuscation and mystification, but precious little real knowledge. The Patty Hearst trial was a typical embarrassment—one battery of distinguished psychiatrists neatly explained that Hearst was ill, another insisted that she was not. To radicals, feminists and homosexuals, psychiatry is just one more villainous agent of the status quo. More than a century ago, an antebellum psychiatrist blithely explained that slaves who tried to escape from their masters were suffering from "dromomania," the runaway disease. How does the public know that 20th century psychiatry is not still retailing dromomania in more sophisticated guises?
As always, psychiatrists are their own severest critics. Thomas Szasz, long the most outspoken gadfly of his profession, insists that there is really no such thing as mental illness, only normal problems of living. E. Fuller Torrey, another antipsychiatry psychiatrist, is willing to concede that there are a few brain diseases, like schizophrenia, but says they can be treated with only a handful of drugs that could be administered by general practitioners or internists. He writes: "The psychiatrist has become expendable; he is left standing between the people who have problems in living and those who have brain disease, holding an empty bag." By contrast, the Scottish psychiatrist and poet R.D. Laing is sure that schizophrenia is real—and that it is good for you. Explains Laing: it is a kind of psychedelic epiphany, far superior to normal experience.
Even mainline practitioners are uncertain that psychiatry can tell the insane from the sane. In one experiment, Stanford's D.L. Rosenhan planted eight sane volunteers, one of them a psychiatrist, in public and private psychiatric wards scattered across the country and told them to behave normally. Many inmates quickly realized that the eight impostors were sane because the would-be patients kept taking notes. But the staff psychiatrists never did. Says Rosenhan: "Any diagnostic process that lends itself so readily to massive errors of this sort cannot be a very reliable one."
As is all too plain, psychiatry, especially analysis, is now suffering a bad case of mid-life blues. Whatever else the Freudian movement accomplished, it raised hopes dramatically, set the stage for the narcissistic excesses of today's Me Decade, and propagated the notion that mind science was on the brink of blowing away all mental ills. "Psychiatry was overtouted," says Psychiatrist and Author Robert Coles. "Then there was the disenchantment, not only of patients, but also, of course, professionals " Adds Robert Michels, head of Cornell Medical Center's Payne Whitney Hospital and Clinic: "The public's enthusiasm for psychiatry 20 years ago was based on an insane interpretation of psychiatry."