Fearless speaking about psychiatry

John Heaton has been mentioned in this blog before (eg. in a guest post by Miles Clapham). John wrote a chapter in my edited Critical psychiatry book. He used the Greek notion of parrhesia from Foucault to help explain that critical psychiatry is a practice that states frankly what one thinks about the nature of persons and psychiatry. 

In the Fall Term of 1983, Foucault gave 6 lectures in English at the University of California in Berkeley as part of a seminar entitled ‘Discourse and Truth’ devoted to the study of parrhesia. These were taped recorded and edited by Joseph Pearson and published as Fearless Speech (2001). The general objective of the seminar was to construct a genealogy of the critical attitude in Western philosophy. 

The parrhesiates is someone who uses parrhesia and opens their heart and mind completely to other people through their discourse. The parrhestiastes makes clear they are expressing their own opinion by using the most direct words and expression they can find to express what they actually believe. In a positive sense, they are telling the truth because they know it is true. They are saying something dangerous because it is different from what the majority believe. They expose themselves to harm as the truth may cause hurt or anger but they prefer to be a truth-teller rather than being false to themselves. Parrhesia is therefore a form of criticism from a less powerful position than the one with whom the parrhestiastes speak. 

Parrhesia may become a problem of truth if it is seen as mere frankness in speaking when everyone is equally entitled to give their own opinion. It actually has a relation to knowledge and education. Bad, immoral or ignorant speakers may endanger democratic organisations. Saying what people want to hear avoids the necessity of being critical and the need to attempt to change people’s understanding and will. Parrhesia, in the positive sense, is, therefore, a virtuous personal attitude and quality to speak the truth boldly. 

I’ve commonly said that psychiatry is more like a faith than a science (eg. see previous post). That implies it is not true that primary mental illness is brain disease. Challenging the claim that primary mental illness is brain disease, as does critical/relational psychiatry, is not denying the reality of mental illness. It is a necessary challenge to the power of psychiatry speaking from the position of the parrhesiastes (see recent post ‘Truth-telling in psychiatry’ on my personal blog).