I have stumbled upon Smail through a lecture by critical theorist Mark Fisher and if you are familiar with Fishers work, you will recognize a lot of his positions on the mental health industry in this book.
Honestly, I don't understand how this book manages to stay on the fringes of psychological and critical theory. Smail really grasps and exposes the ideological function of the whole field of psychiatry/ psychology, namely: to shift the burden of responsibility for psychological pain onto the victim, who is actually rather a victim of societal forces, which he has essentially no control over. Through artificially narrowing the theoretical scope which therapy works with, namely on the individual and his immediate relationships, it excludes the larger societal, cultural and economic context in which he or she has been brought up, formed and which he or she is required to navigate. Smail goes even further than that and tries to - in my opinion quite convincingly - redefine what a personality actually is; namely, a personality, Smail argues, i s to a large extent nothing more than the accepted modes of conduct, language, beliefs, etc ... of the environment he happens to live in.
Smail is preoccupied with power in this book. He sees society as a deterministic matrix of individuals who are mere "mediators" of power; the more distal the powers, the stronger they usually are and the more they influence (read: determine) our behaviour, belief and desire on a more proximal level. What he achieves thereby is to enable the sufferers of "mental illness", family dysfunction, poverty, etc ... to stop blaming themselves for their misery, to stop looking within themselves or to their immediate circumstances for the causes of their problems and to start considering them as epiphenomena of bigger societal powers such as business interests, politics, indeed, class warfare.
His outlook can definitely seem discouraging. He does away with the notion that any form of therapy which doesn't actually enable the "patient", or rather the person, to gain some leverage in the larger context of the societal power struggle to capitalize on, as essentially nothing more than providing comfort (and thus, nothing a good friend couldn't provide). But his sober analysis also, at least to me, seems closer to the truth of the matter and importantly, it denies the basic tenets of many forms of therapy and of psychiatry, which are in essence nothing more than an instrument for the powers that be, which are so often felt as invalidating and as a form of victim blaming.