WASHINGTON — WASHINGTON - Recent reports of the misuse and abuse of psychiatry in China have been chilling, but they serve as a steadying cautionary tale for those of us practicing psychiatry in the West.
Chinese psychiatrists have apparently been actively colluding with the Beijing government's efforts to discredit the Falun Gong spiritual movement by forcibly hospitalizing and medicating hundreds of defiant followers.
According to a report in the Columbia Journal of Asian Law, other political protesters are sent to psychiatric facilities where they undergo electroshock therapy for bogus mental illnesses. Indeed, the willingness and ability of the Chinese leadership to import Western ideas like Marxism and Western psychiatric practices - and to corrupt these ideas while ignoring their own remarkable intellectual traditions - are absolutely astounding.
One insight we have learned in the United States and from abuses of psychiatry in the former Soviet Union is that mandated treatment, when overused, does immense harm to the public health. In fact, mandated treatments are invariably perceived as punitive.
Accordingly, thousands of people who could potentially benefit from psychological treatments make every effort to avoid mental health professionals.
Understandably, they begin to perceive that their supposedly friendly local mental health professional is really Hannibal Lecter in disguise. The impact on the emotional and psychological health of the community can be extraordinary: People would rather die, often by suicide, than see a psychiatrist.
Mandated treatments generally do not help the designated patient, except in the case of some alcohol and drug problems. FBI experts have told me of serial rapists who have been remanded, after prison-terms, to outpatient psychiatric care. Their presumably capable psychiatrists had reported impressive progress in the psychological evolution of these former criminals, while in the meantime the patients had continued to commit serial rapes. One committed serial killings while reporting remarkable progress to his psychiatrist.
One knows intuitively that many Falun Gong devotees in Chinese mental hospitals are outwardly disavowing their religious practices while at the same time secretly maintaining their strongly held beliefs despite electroconvulsive treatments and medications. The Spanish Inquisition was certainly unable to stop Marranos from surreptitiously continuing their religious practices.
In college psychiatry - the one remaining domain where we in the West can look at a community's true mental health - we can recognize the paramount value of a non-punitive approach to psychiatric intervention.
In the past year, Harvard University has belatedly changed its longstanding house-advisers system. Previously, students were reluctant to turn to faculty who were living in the student houses because students understandably worried that an acknowledgment of their distress would interfere with a possible recommendation for career opportunities and graduate school applications.
The professors, serving essentially as residence hall advisers, were perceived as potentially punitive, even if a student's distress would not have affected the student's future recommendations. As a remedy, Harvard administrators have put older students in the position of hall advisers.
In my 24 years of providing psychiatric care to college students at four universities, there were two students I have had to involuntarily hospitalize.
Involuntary hospitalization is an essential tool for any psychiatrist attempting to serve a large population, to be used rarely in situations in which a person is genuinely a threat to himself or others or when his inability to care for himself becomes life-threatening.
Most of the time, people's survival instincts allow them to choose to come into the haven of a hospital voluntarily or family members can prevail upon a loved one to seek such care.
In China, however, hospitals are not at all havens. Indeed, from all indications, family members are working overtime to keep their loved ones out of hospitals and away from psychiatrists.
In a world where governments and religions can be felt as all-too-punitive, it is extraordinarily disturbing to hear of psychiatrists in China joining this punitive bandwagon.
Somehow, they have lost track of the simple wisdom of Lao-tse, that remarkable master of paradox, who once pointed out, "To realize that our knowledge is ignorance, this is a noble insight. To regard our ignorance as knowledge, this is sick-mindedness."
The psychiatrists of China have indeed become sick-minded. And Chinese society, not unlike Russian society in its past dealings with psychiatric abuses, will be paying an unbearably high price for these sick-minded interventions for decades to come.
Paul Steinberg, M.D., is associate director of the Georgetown University Counseling and Psychiatric Service.