This book encourages a revolt against “institutional
mental health” and “institutional society”. It sees itself in the tradition of
a genre of publications, such as Thomas Szasz’s The Myth of Mental Illness and
Eric Fromm’s The Sane Society, which challenged the assumptions of
psychiatry and questioned the nature of society. It argues that at one time it
was possible to be more open about adopting such a stance, but what is required
now is a rebellion against the impersonal and coercive nature of society and
psychiatry.

The author, Bruce Levine, is a clinical psychologist
in private practice in the United States. He is on the advisory council of the
International Center for the Study of Psychiatry and Psychology (ICSPP), a
network associated with Peter Breggin, author of Toxic Psychiatry. A current particular concern of the Center is the
impact of biological psychiatry on children, such as the prescription of
Ritalin for Attention Deficit Hyperactivity Disorder (ADHD).

Commonsense Rebellion directs attention to the
need for autonomy, community and humanity. Organizations should be
"convivial" and not promote institutionalization. Symptoms of mental
disorder and institutions interact in what is called the Institutional Illness
Web (IIW), seen as another web besides the World Wide Web of the Internet.
There is a chapter heading beginning with each letter of the alphabet – Attention Deficit Disorder, Bad boys, Chemical dependency, Depression
and so on. The author acknowledges that the connections he makes are not
comprehensive. The A to Z format means that each chapter does not
need to be read consecutively.

The institutional view of mental health problems and
treatments is contrasted with a commonsense view. There are focuses on various
aspects of the Institutional Illness Web in each chapter. Specific suggestions
for self-help are made.

I enjoyed this book. It was a little repetitive, but
the feelings of boredom created were not enough to give me what Commonsense Rebellion calls one of
society’s mental illnesses. I found it generally refreshing and energizing, and
it therefore succeeded in its aim of giving me direction for rehumanizing my
life. My appreciation of the book arises out of my own sense of rebellion, and
other people who may not have the same critical sense may be less supportive.

For example, I can tolerate the conclusion of Commonsense Rebellion that institutional
mental health’s diagnoses are unreliable and invalid, even if I do not totally
agree with this statement as it stands. The book may go too far in reframing
all individual symptoms as social alienation, but I too maintain that it is
important to understand the context of individual presentations and to recognize
the inevitable uncertainty of mental health practice.

I can also go along with most of the self-help
suggestions being seen as commonsense. The author acknowledges that they are
"stimulants rather than recipes for success". However, there is a
danger of replacing one ideology with another dogma. For example, Commonsense Rebellion is very
anti-television. This may be understandable in a book primarily aimed at the
United States market, which is generally acknowledged to have a poor quality of
television output. Moreover, the book does not recommend getting rid of
television altogether, but minimizing its use. Still, it is difficult to avoid
a moralizing tone, which should be Commonsense
Rebellion‘s aim. I am not necessarily defending television, merely emphasizing
the inevitable biases of perspective that the word "commonsense"
cannot avoid.

This book encouraged me to think again about institutionalization
and I was drawn to Russell Barton’s book Institutional
Neurosis. We have now moved on from the large, locked asylum, with the
consequent effects on behavior that Barton described in those institutions.
However, bureaucratic modes of existence still have their effects in society. I
am writing from the UK where Peter Mandelson, member of parliament, usually
seen as the architect of the New Labour government, has recently suggested that
New Labour mark one has been too controlling in how it has tried to run the
country and should be replaced by New New Labour. We continually need to be
reminded about the benefits of promoting independence. Taking risks is an
opportunity as well as a threat. Commonsense
Rebellion is of value in reminding us of the need for a spirited sense of change.
As the book notes, Thomas Paine in 1776 entitled his public appeal for American
independence Common Sense.

The book is also of value in scrutinizing the role
of psychotropic medication and the pharmaceutical industry. Society is
generally overmedicated, whereas institutional mental health is likely to
continue to increase the amount of psychiatric treatment. My wish would be that
this book could help to encourage doctors to obtain more understanding before
being ready to write a prescription for mental health problems.

The quote that ends the chapter Z of the A to Z
format is "It’s an easy matter to diagnose that which disturbs us as a disease, isn’t it?" Those who
appreciate this quote will like this book.

© 2002 Duncan Double

Duncan Double, Consultant Psychiatrist and Honorary
Senior Lecturer, Norfolk Mental Health Care Trust and University of East
Anglia, UK; Website Editor, Critical
Psychiatry Network.

Categories: Ethics, MentalHealth