Abstract

By Andrew Klein 

Introduction: From Healing to Social Control

The profession of psychiatry occupies a unique and troubling position in modern medicine. Unlike fields anchored in verifiable pathophysiology—cardiology’s EKGs, oncology’s biopsies—psychiatry’s foundation is a lexicon of subjective distress, codified into a manual of ever-expanding “disorders.” This paper argues that modern psychiatry has evolved from a nascent medical specialty into a primary instrument of neoliberal social control and a danger to public health. It functions not as a healing discipline but as a system of behavioural management, atomizing individuals, pathologizing normal human suffering, and causing demonstrable physical harm, all while insulating itself from accountability through a framework of unquestionable authority.

I. The Shaky Foundations: A Science Built on Shifting Sand

The DSM: A Bible of Subjectivity

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is not a scientific document discovered in nature, but a social construct voted into existence. Its evolution reveals a pattern of diagnostic inflation. Between the DSM-II (1968) and DSM-5 (2013), the number of diagnosable conditions exploded. “Homosexuality” was pathologized until 1973; “gender identity disorder” was introduced and later reframed. As critic Allan V. Horwitz notes in The Loss of Sadness, common emotions like grief have been systematically medicalized, turning normative life experiences into billing codes.

The Freudian Legacy: Pathologizing the Victim

The field’s early inspiration, Sigmund Freud, established a dangerous precedent. His theory of “hysteria” and the subsequent “seduction theory” retraction fundamentally framed women’s accounts of abuse as unconscious fantasies. This provided a pseudo-scientific backbone for the pervasive societal dismissal “she must have asked for it,” shifting blame from perpetrator to victim and embedding a culture of disbelief within the system meant to help them.

II. The Neoliberal Handmaiden: From Patient to Consumer

Psychiatry has become perfectly adapted to late capitalism. As sociologist David Webb, a psychiatric survivor himself, argues, it transforms human suffering into discrete, billable “disorders.” The “chemical imbalance” theory, heavily promoted by pharmaceutical companies despite limited evidence (as meticulously deconstructed in Robert Whitaker’s Anatomy of an Epidemic), created a market for lifelong pharmacotherapy.

The system produces customers, not cures. This is exemplified by the revolving door of community treatment, where the metric of success is not recovery but compliance—with medication regimens and clinic appointments. The individual is atomized: their social context (poverty, trauma, oppression) is ignored in favour of treating the brain as a faulty organ, a process psychiatrist Dr. Bruce E. Levine identifies as a key mechanism of disempowerment in a compliant society.

III. The Architecture of Coercion and Harm

The Power to Captivate and Restrain

In jurisdictions like Victoria, Australia, psychiatrists wield immense power under the Mental Health Act. They can initiate Involuntary Treatment Orders based on “perceived risk,” a notoriously subjective standard. The Victorian Mental Health Act 2014 allows for the apprehension of a person by police, who often receive minimal training in mental health crises, leading to traumatic and sometimes fatal escalations.

The system operates on a profound asymmetry of verification. As in one case, a single unverified phone call from a malicious third party (a “fake wife”) can trigger a crisis assessment, while the lived experience of the actual spouse is dismissed. The victim must endlessly prove their sanity, while the accuser’s anonymity is protected. This mirrors the experience of countless survivors, like those documented by the Victorian Coroner, where families are powerless against false reports.

Case Studies in Systemic Failure

1. The Coroner’s Inquest into the Death of “Ms. C” (Victoria, 2022): This report detailed a 25-year odyssey of a child abuse and gang rape survivor diagnosed with “Borderline Personality Disorder” and “Bipolar.” Her trauma-based responses were treated as pathology. Only after decades was Complex PTSD considered. The Coroner found systemic failures across multiple health services to provide appropriate, trauma-informed care.

2. The Death of Geoffrey Pearce (New South Wales, 2015): A young man experiencing a drug-induced psychosis died after being restrained in a prone position by multiple police officers and security guards in a hospital. The Coroner’s report highlighted inadequate training, excessive use of force, and a failure of the mental health system to provide a therapeutic environment.

3. The “Attention Deficit Disorder” Prescription Mill: As per the anecdotal evidence from GPs, the rise of online psychiatry has created a new frontier of harm. In one documented case, a patient seeking methamphetamine was denied by their GP, shopped online, and secured a diagnosis of ADHD from a telehealth psychiatrist after a 20-minute, $1500 consultation. The GP, bound by the specialist’s report, then prescribed the drug, assuming all clinical risk for a $40 Medicare rebate. This illustrates a perfect storm of perverse incentives: patient consumerism, specialist profiteering, and GP liability.

IV. The Psychopathic System: A Diagnosis of the Institution Itself

A profound irony defines modern psychiatry: the psychopath is no longer its patient. Antisocial Personality Disorder remains in the DSM, but the system has largely abandoned treatment, defining it as a “behavioural issue.” Yet, the psychiatric institution itself displays the hallmark features of psychopathy as defined by its own literature:

· Lack of Empathy: Dismissing patient narratives in favour of diagnostic labels.

· Grandiosity: Claiming authority over the human mind and soul.

· Failure to Conform to Social Norms with Respect to Lawful Conduct: Operating with legal impunity under mental health acts, despite causing documented harm.

· Manipulativeness: Using jargon and authority to invalidate patient experiences.

· Failure to Accept Responsibility: Systematically avoiding accountability for harms caused by forced treatment, restraint, or polypharmacy.

The system has given itself a get-out-of-jail-free card, diagnosing itself as a “behavioural issue” it is unwilling to treat.

V. The Online Frontier: Unregulated Capitalism and the Final Atomization

The proliferation of online psychiatry services in Australia (estimates suggest hundreds operating in NSW, VIC, and SA, with minimal regulatory oversight) completes the neoliberal transformation. The patient is now a true consumer, shopping for a diagnosis. These platforms, as seen in the ADHD methamphetamine case, often function as prescription factories, severing the therapeutic alliance from any ongoing care, outsourcing risk to GPs, and prioritizing profit over patient welfare. It is vulture capitalism applied directly to human suffering.

Conclusion: A Costly Threat to Individuals and Society

Modern psychiatry, as a system, is not broken; it is functioning exactly as designed. It was engineered not to heal, but to manage, categorize, and pacify. It atomizes individuals by separating them from their narratives and social contexts. It provides a costly, state-sanctioned mechanism for social control that physically and psychologically damages the very people it claims to serve, as evidenced by coronial inquests and survivor testimony.

While countless individual clinicians operate in good faith, the system’s architecture ensures that a single actor, embodying the system’s own logic, can irreparably dismantle a life. Society becomes lesser for each person it captures. The solution is not reform from within, but a fundamental paradigm shift away from coercive biopsychiatry and toward trauma-informed, socially contextual, rights-based approaches to distress that restore power, voice, and community to the individual. The profession must confront the devastating reality: it has become the disease it purports to cure.