Twilight of Liberty II: The Shadow Kingdom of Psychiatric Coercion and Oppression

Rob Wipond, David Cohen, MSW, Ph.D., Dennis Feld, J.D., and Arthur Baer, J.D., Moderator

This panel seeks to explore the social and legal infrastructures that permit and justify state sanctioned coercion, and lead to a civil system of increasing psychiatric control and oppression. Legally sanctioned coercion is a consequence of public narrative, philosophical precept, politics, economics, and professional discipline, and often premised on foundational beliefs, hidden from view, that maintain closed systems of thought and practice, which amplify orthodoxy and suppress alternative voices, voices that if heard could lead to greater dignity, liberty, and healing. This panel will explore the breadth of coercion and coercive systems, how these systems interact to transform the law and permit state sanctioned force in “treatment”, and what can be done to bring light to systems often hidden in darkness, and transform them. Objectives We will consider how political and psychiatric systems discipline those who fail to conform to their orthodoxy. How narratives shape the course of coercion. Why, for example, a lack of housing and resources are ignored as antecedents of crime, while the psychiatric history of persons involved in incidents are amplified to justify the weakening of legal standards for involuntary outpatient treatment orders, or other mechanisms of control. We will also consider how professional disciplines may create institutional constraints that adversely effect the rights of individuals. For example, treatment over objection is precluded unless the person is proven to lack capacity and the treatment is narrowly tailored. But capacity is often defined by professional paradigms, that negate the perceptions and experiences of those most effected by the proposed treatment. Its measure is the degree of agreement the person has with the view of the psychiatrist who proposes the treatment. Disagreement reflects “anosognosia” a condition said to prevent recognition of the illness, and is said to evidence a lack of insight, notwithstanding that the individual has experienced the sedation caused by the medications and the trauma cause by the electroshock administered, and best speak to its effects. We will also consider institutional structures, biases, and constraints. For example, treatment over objection is often ordered in summary proceedings which may provide less due process than a slip and fall case, and in which experts are regularly provided to one side, the proponent of the forced treatment. We hope to explore what can be done to address coercion on the broader level of the social structure that supports coercion, and narrower level of the legal structure that enforces coercion. For examples, how can paradigms that harm be exposed and those that heal be substituted; how can false or inaccurate public narratives be countered by true and accurate public narratives; how can institutional self interest and bias be exposed and rooted out; how can laws and legal processes and presumptions that are systemically unjust be brought to light, and challenged to ensure processes are fair and just. After an initial presentation using possible approaches and case examples, the panel will invite participants to share ideas about possible strategies to overcome and transform structures of coercion.