By Mel Starkman
A review of Commonsense Rebellion, Debunking Psychiatry, Confronting Society: An A to Z Guide to rehumanizing Our lives, by Bruce E. Levine. The Continuum Publishing Group Inc., 2001 (1.22 x 9.30 x 6.29 331 pages. ISBN 0826413153, $19.57, hardcover).
Dr. Levine is a Ph.D. clinical psychologist and has been in private practice for over 15 years. He is on the Advisory Council of the International Center for the Study of Psychiatry and Psychology “which fights against the abuses and corruption of institutional mental health” (back dust jacket). In this book Levine calls for a commonsense rebellion against the tendencies in America that have made lives miserable for all but the power elite. A large part of the blame he gives to the psychiatric profession, but does show that society as a whole has sheepishly followed these pseudo scientists. He writes it in the form of a self-help guide to bring American lives back to its local, voluntarism and democratic roots, which roots he does show some belief in. This is a protest book in the tradition of citizen reformers like Paine, Thoreau, and Mumford.
“At the core of Commonsense Rebellion is the belief that heteronomous institutions promote helplessness, passivity, fear, isolation, and dehumanization” (p. 99). Heteronomous means being directed by outside forces instead of being autonomous and pulling one’s own strings. Large impersonal organizations like health maintenance organizations (HMOs) and hospitals are alienating and frightening institutions both for the ordinary mistakes they make and the reality that means and end are confused. The hospital becomes the end, not the patient. That’s where helplessness, passivity, fear, isolation and dehumanization derive from. If you don’t feel that way you are considered to fall into one of the categories of psychiatric diagnosis.
In opposition to the feelings of helplessness and so on outlined above, Levine advocates self-help featuring enthusiasm, respectful personal relationships, community, trust and confidence, empowerment, autonomy (self-direction), participatory democracy, diversity and stimulation, human pride, citizenship, and a human-scaled society (p. 6).
In 26 alphabetically titled chapters with a 27th summary chapter, this parody of popular culture self-help books covers a wide range of American domestic, internal, made in the U.S. problems that face America’s future. Included in the list of problems are the rising rate of crime, particularly among the young and the response of the government, the privatization of punishment (for example, private sector incarceration), alienating jobs, psychiatry out of touch with the community of survivors it works with, and the problems of mass society (not just the problems of corruption and abuse, which phenomena are symptoms of deeper rooted systemic problems). Levine does not deal at any length with the effects and implications of American foreign policy.
Levine’s perspective is antipsychiatry as would be expected from a non-conformist psychologist. He even states in his book that psychiatrists cause trauma to their victims out of a need to work out their own traumas. Sartre made the argument that psychiatrists are also ill. Levine pokes fun at psychiatrists, especially for their jargon and the use of psychotropic medication like Ritalin, which is prescribed so readily and has done so much harm. While he is against electroshock, he could have dealt more with the debate it has engendered within society and especially within the survivor culture.
Levine offers his arguments in the manner of a well-prepared teacher. His wisdom derived from his reading and practice as well as personal experience is there to be shared at the free choice of his reader. He has read very widely in the subject matters he covers. Most chapters follow a pattern with the exception of 23, 26 and 27. First the topic is discussed with relevant cases not gone into to any great length, but with citations from various books. Then follows two sections, The Institutional Illness Web (IIW) and The Commonsense Revolution (CR). Basically he argues that institutions foster illness rather than cure; the systems in hospital can be seen as being in entropy. Commonsense Rebellion calls for more human approaches to our problems, such as local community involvement, voluntarism and other approaches and attitudes seen above. The last part of each chapter is a series of suggestions on how to move from the IIW to the CR. The underlying problem is that corporate power underpins the IIW.
Chapter 2 is titled Bad Boys and speaks of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Low-income kids are likely to land in jail because of lack of insurance coverage. ODD kids are “brats” and CD kids are “juvenile delinquents or criminals (p.29)”. Further in the late 1990s, with insurance companies and the pharmaceutical industry influencing hospitals, there is a class and race confrontation, as of old. The white well-off spend less time in hospitals and more on recreational drugs, while the poor and non-white are in jails or prisons. Bad Boys are treated chemically whether in prisons or hospitals. As Szasz and others have argued, at least the stays in prison are determinate although it is true that release of survivors or whatever they are called are now clogging North American streets.
Addiction is a huge problem in North America and in the long run there is little choice between street drugs and medications like Ritalin which compares to cocaine or amphetamines: speed with a prescription. Sometimes the route to illegal drugs comes from first taking psychiatric medications, which are too easily dispensed. In chapter 4, dealing with depression, Levine takes on both the old neuroleptics and the new SSRIs like Prozac, Paxil and Zoloft, today’s snake oil.
There’s a too short section on ECT focusing on the Ernest Hemingway suicide case. He had been shocked and Levine quotes Peter Breggin as to the reemergence of shock. At this time it is difficult to gather statistics on the renewed prevalence of shock, especially among older women and persons of colour, different race, sexual orientation, recent immigrants and refugees. Also there is the use of shock as a social control mechanism focusing on dissidents to the accepted values of our consumer society. Even psychosurgery is back.
Under Newest Nomenclature Levine questions the value of the DSM-IV and its 400 odd categories. Are many diagnoses scientifically valid, or are they marginal or downright silly? Some silly categories include clumsiness [315.4], snoring [780.54], grammatical and punctuation errors, or disorder of written expression [315.2]; the last disorder I would personally say was iatrogenically induced by the medications.
Levine's book is a worthwhile riposte to the anaesthetizing self-help manuals that are flooding the market place and which praise the elements of the Institutional Illness Web that are critiqued by Levine. This is a consummate compendium of the nostrums that cause rather than cure the problems that Americans are particularly prone to. A review of Commonsense Rebellion, Debunking Psychiatry, Confronting Society: An A to Z Guide to rehumanizing Our lives is very well worth reading and should enlighten the public in regard to both psychiatry as well as the course of present medical practice in general.
Mel Starkman is a retired archivist from the University of Toronto and active in the anti-psychiatry movement.
(x) For more about Bruce Levine see:
LiP's Silja J. A. Talvi talks with Dr. Bruce Levine, the author of Commonsense Rebellion, about dissident psychiatry for a dysfunctional society.
Psychiatric Medications, Illicit, Drugs, & Alcohol Article by Bruce Levine in Z Magazine Commentary -- March 2002