Break On Through: Radical Psychiatry and the American Counterculture

by Lucas Richert

“Antipsychiatry,” Esalen, psychedelics, and DSM Radical challenges to psychiatry and the conventional treatment of mental health in the 1970s. The upheavals of the 1960s gave way to a decade of disruptions in the 1970s, and among the rattled fixtures of American society was mainstream psychiatry. A “Radical Caucus” formed within the psychiatric profession and the “antipsychiatry” movement arose. Critics charged that the mental health establishment was complicit with the military-industrial complex, patients were released from mental institutions, and powerful antipsychotic drugs became available. Meanwhile, practitioners and patients experimented with new approaches to mental health, from primal screaming and the therapeutic use of psychedelics to a new reliance on quantification. In Break on Through , Lucas Richert investigates the radical challenges to psychiatry and to the conventional treatment of mental health that emerged in the 1970s and the lessons they offer for current debates. Drawing on archives and government documents, medical journals, and interviews, and interweaving references to pop (counter)culture into his account, Richert offers fascinating stories of the decade's radical mental health practices. He discusses anti–Vietnam War activism and the new diagnosis of post–traumatic stress disorder given to some veterans; the radical psychiatrists who fought the system (and each other); the entry of New Age–style therapies, including Esalen's Human Potential Movement, into the laissez-faire therapeutic marketplace of the 1970s; the development of DSM III; and the use of LSD, cannabis, and MDMA. Many of these issues have resonance today. Debates over medical marijuana and microdoses of psychedelics echo debates of the 1970s. With rising rates of such disorders as anxiety and depression, practitioners and patients continue to search for therapeutic breakthroughs.

Genres: Psychiatry

224 pages, Hardcover

Published October 8, 2019

Reviews

[Durakov · Rating 4 out of 5]

I was very surprised by this. Looking at the cover and title, I was expecting a loose guiding thread of that nebulous category "counterculture" connecting projects and figures and a bunch of disparate drug practices to the psy-fields in the 60s/70s. There are a few points that fit that description and since I have never really been interested in hippy subcultures, Ken Kesey, "far out" stuff, or whatever, these were the least interesting parts for me. With the exception of a few paragraphs, Richert avoids a good deal of the cheesy cliches and romantic tropes that abound in works on the era.

However, I was pleasantly surprised to find that Richert is more interested in the relays and exchanges between the countercultural subcultures and establishment psychiatry and all the ways in which, despite their best attempts to differentiate themselves from often vaguely conceived authority figures, many "radicals" become venture capitalists and gurus of a dizzying array of alt-therapies, accelerated the spread of social psychiatric programs into regions previously untouched, helped clarify the biopsychiatric mission of the DSM-III, and progenitors of the very American brand of "positive" pop-psychology fads. I don't know if he intended it this way, but, with the exception of a few projects, the stories recounted here read more like warnings for what alternative subcultures might inadvertently be producing and supporting in their beliefs around producing outside of the normal sphere (of psychiatry, but also generally).

A good example is "transactional analysis," conceived of in the midst of similar eclectic therapeutic models in the Bay area as an explicit rejection or alteration of Freudian psychoanalysis by Eric Berne. Among its various tenets are the notions that we are born mentally whole and healthy, that positive reinforcement helps to bolster a holistic sense of self, that all interpersonal and emotional problems are curable. Further, he ends up shifting the focus from internal conflicts and splits to what he calls "transactions," in the hopes of identifying those which strengthen and those which threaten the ego. Surely I'm simplifying it, but one can rightly situate such a theory in the turn towards communication, cybernetics, and new age philosophy around identity and distress. In 2021, it seems especially difficult to argue that cybernetics or positive ego psychology could possibly represent a progressive turn away from "establishment" Freudianism or something. For all the problems with the latter, at least we have a vantage point that highlights conflicts, distances, difficulties, and the like over a cheap though seductive "positivity," which doesn't so much solve these problems as turn them into business opportunities.

Hopefully Richert's book will be read widely by radicals, because such failures need to be teased out in more detail: what conditions lead to movements becoming businesses, bolstering existing institutions, or simply becoming a wing of them?

[Dylan Bean · Rating 4 out of 5]

Well you know the day destroys the night, the night divides the day.