In Pharmakon We Trust

Christina and her husband, Sonny, separated in July of 2013. During a visit on December 18th,—his daughter’s birthday—Sonny strangled his 14 year-old son and then hung himself.  Sonny and Gunnar’s bodies were found in his apartment by Sonny’s girlfriend.  On December 19th Christina kept a previously scheduled appointment with a psychiatrist who she had been seeing for a couple of weeks.

BEFORE her appointment at the University Health Center, Christina’s doctor had placed the University of Vermont police on standby to take her into custody if she refused to admit herself to the psych unit in Fletcher Allen, the UV affiliated medical center. She did decline, so she was detained. A UVM police report showed that there was a delay of several hours before the officers could transport Christina to Fletcher Allen because the mental health staff didn’t have the proper paperwork to legally transport her! Five weeks later, Christina was finally released.

Justina Pelletier suffers with a rare disorder—mitochondrial disease. In February of 2013, at the recommendation of her doctor, she was taken to Boston Children’s Hospital by her mother.  Justina’s gastroenterologist had recently moved there from Tufts. The team at Children’s disputed the mitochondrial disease diagnosis and concluded Justina suffered from somatoform disorder—a psychiatric disorder in which symptoms are real, but have no underlying cause. Some reports indicated this re-diagnosis was first made within a matter of hours or minutes of Justina’s arrival at Children’s and was done without consultation with her treating physicians.

When her parents tried to have her discharged from Boston Children’s, the hospital contacted DCF, who took custody of Justina and accused her parents of medical child abuse. Justina remained a ward of the state until June 18, 2014. Most of that time she spent on a locked psychiatric ward. While in state custody, Justina only saw her family once per week for a supervised hour of visitation and spoke with them once a week on the phone.

In his essay, “Strategies of Psychiatric Coercion,” Jeffrey Schaler commented that treatment providers forcibly “treat” people they consider to be a danger to themselves or others in the name of compassion and care. In effect, psychiatrists and mental health professionals empowered by the state to commit someone involuntarily to a psychiatric hospital argue that the person is a child. Although not literally a child, he is a metaphoric child. “He does not, in their opinion, exercise responsibility for himself because he cannot do so.”

The coercion is supposedly done to protect him from himself. He “needs” to be deprived of his constitutional rights in the name of treating his “mental” illness. And the more a person objects to being coerced into treatment, “the more likely he is to be diagnosed with serious mental illness.”

Los Angeles recently decided to expand a pilot program from 20 to 300 slots that will allow a family member, treatment provider or law enforcement officer to pursue court-ordered outpatient treatment for individuals with serious mental illness. “Those who don’t comply can be taken into custody on a 72-hour psychiatric hold. Patients can’t be forced to take medication under law, but there are other mechanisms for court-ordered medication.”

In his 1963 book, Law, Liberty and Psychiatry, Thomas Szasz predicted the birth of what he called the therapeutic state: “Although we may not know it, we have, in our day, witnessed the birth of the Therapeutic State. This is perhaps the major implication of psychiatry as an institution of social control.” He even went further and coined a new term for this union of psychiatry and the state: pharmacracy.

Inasmuch as we have words to describe medicine as a healing art,  but have none to describe it as a method of social control or political rule, we must first give it a name. I propose that we call it pharmacracy, from the Greek roots pharmakon, for ‘medicine’ or ‘drug,’ and kratein, for ‘to rule’ or ‘to control.’ … As theocracy is rule by God or priests, and democracy is rule by the people or the majority, so pharmacracy is rule by medicine or physicians.

I don’t think we are a therapeutic state … yet. We aren’t a pharmacracy … yet. But I do think we need to be aware of the warnings given by Thomas Szasz. If you need more information before you decide whether the United States is in danger of becoming a therapeutic state, spend some time on the following websites:


Mad in America


By the way, a UN report thinks that forced psychiatric treatment is torture:

Deprivation of liberty on grounds of mental illness is unjustified. Under the European Convention on Human Rights, mental disorder must be of a certain severity in order to justify detention. I believe that the severity of the mental illness cannot justify detention nor can it be justified by a motivation to protect the safety of the person or of others. Furthermore, deprivation of liberty that is based on the grounds of a disability and that inflicts severe pain or suffering falls under the scope of the Convention against Torture.

Do you think we are in danger of becoming a therapeutic state?