Commonsense Rebellion

by Bruce E. Levine
Continuum Publishing, 2001
Review by Duncan Double on May 25th 2002

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.

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

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