Letter: Marxism and psychiatry

Proletarian writers

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Proletarian writers

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The letter below was sent by a party member to the editors of the Oxford Handbook of Psychiatry in response to an outrageous and gratuitous slander against Marxism Leninism that was included under the handbook’s ‘anti-psychiatry’ entry.

The letter’s author is a supporter of the Critical Psychiatry Network (CPN), a group of psychiatrists working within the NHS who are opposed to the mainstream psychopharmacological orthodoxy. The CPN critiques the unholy trinity of the pharmaceutical industry, the psychiatric profession, and the capitalist state, whose shared interests have, they believe, resulted in the dominance of a wrong-headed conception of mental illness.

One of the leading figures in the CPN, Dr Joanna Moncrieff, has written a book called The Myth of the Chemical Cure, which is highly recommended to Proletarian readers interested to know more about the debate.

Dear doctors

I am a CT1 psychiatry trainee currently working in Greater Manchester.

First of all, I would like to congratulate you on your second edition of the Oxford Handbook of Psychiatry, which I find to be an essential aid in day-to-day psychiatric practice.

However, I would like to take issue with something you say on page 21, in your brief section on ‘Anti-Psychiatry’. You say that it was (note the past tense): “fatally flawed by … an association with half-baked political theory of the Marxist-Leninist strain”.

Quite aside from such a curiously emotive wording in a medical textbook, I was wondering where on earth you got your evidence to suggest that Marxist-Leninist political theory is ‘half-baked’? The Cuban healthcare system is based on Marxist-Leninist principles, and consistently achieves healthcare outcomes that are the envy of many a developed country, never mind the innumerable third-world countries suffering under the systematised immiseration of neoliberal imperialist domination.[sup]1[/sup]

You imply that Marxist-Leninist theory is flawed by a rejection of empiricism. On the contrary, Marxism Leninism has always made the most rigorous and appropriate use of empirical data. This approach enabled the Soviet Union to achieve the fastest economic growth rates ever witnessed, shoulder 80 percent of the military burden in ridding the world of the scourge of nazism, and send the first human being into space.

Karl Marx’s legendary compiling of an unparalleled quantity of economic data from the British Library enabled him to pen what even bourgeois commentators are now prepared to concede was – and remains – the most comprehensive and accurate analysis of the workings of the capitalist system ever written.

What Marxism Leninism has never done is to fetishise the empiricist method to the extent that all creative thought is stifled. Yet this is exactly what has happened to medical practice in the western capitalist countries in recent years with the advent of so-called ‘evidence-based medicine’. Quite correctly referred to as “empiricist quackery” by GP and medical commentator Dr Michael Fitzpatrick, its real purpose does indeed seem to be to serve as a tool “to health economists, policymakers and managers, to whom it appears useful for monitoring performance and rationing resources”.[sup]2[/sup]

Fitzpatrick might also have added that EBM’s narrow assertion of the randomised controlled trial as the be-all-and-end-all of everything seems tailor-made for the demands of the pharmaceutical industry; so to give an antidepressant or not to give an antidepressant is easily quantifiable and easily RCT-able, whereas having a long chat with a patient about life is not (even though it might, and invariably does, make much more of a positive difference to the patient’s mood).

Let’s not forget that it was not half-baked Marxist-Leninist political theory, but rather the scientifically pristine traditions of bourgeois psychiatry that brought us, for example: insulin-induced coma therapy for schizophrenia, the CIA’s brainwashing experiments of the 1950s, prefrontal lobotomy as panacea, and some of the more fanciful theoretical meanderings of Dr Freud.

Yours sincerely



1. ‘Review – Health in Cuba ’ by Richard S Cooper, Joan F Kennelly and Pedro Orduñez-Garcia, International Journal of Epidemiology, 4 May 2006

2. ‘Taking a political placebo’ by Michael Fitzpatrick, Spiked Online, 13 June 2008