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精神疾病製造商 資本社會如何剝奪你的快樂？
心衛工作者必讀的啟蒙之作，拆解精神痛苦的社會根源。【內容簡介】「罷工糾察線不見了，全都變成勞工額頭上的皺紋。」在心理疾病高度汙名化的時代，無論是職場、校園霸凌，或是工作身心創傷，我們幾乎都忘了致病的最大成分不是自己的大腦，而是社會。特別是社會貧富不均加大，有錢人不工作就可以累積財富，我們發現自己越工作越窮，最後身心俱疲。根據衛福部的最新統計，臺灣在2017年中有將近264萬人曾因精神疾患相關困擾而尋求醫療協助，比起十年前的數據大約提增三成。這是不斷提高生產率和盈利的必然結果。中國大陸富士康工廠的年輕工人自殺，世界各地的工人也在苛刻的勞動條件下掙扎求存。此外，若政府以撙節為名刪減社福預算，壓縮民眾的生存空間，孤獨和社會孤立蔓延，憂鬱症和焦慮症就更會攀升。從歷史上看，供水與汙水系統建立後，才能解決下階層的傳染病問題；同樣地，改善工作環境、增加照顧措施，也會有助於改變勞工的身心困境。英國著名的社工系教授弗格森也是社會運動者，他嘗試著將一般人不易懂的社會主義、精神分析理論，套入現代人的生活困境，於是有了這本導讀的小書。近年來臺灣爭取勞動權益的訴求越來越頻繁，這時我們更需要充實相關的知識背景。他深入精神醫學內部，一路從佛洛伊德的精神分析、連恩的反精神醫學主張，梳理到晚近的批判精神醫學以及「倖存者運動」。透過此書我們才瞭解，與其找尋不明的大腦致病原因，瞭解社會運動以及提出倡議，也是健康的重要解方。黃涵榆（臺灣師範大學英語系教授）、曾凡慈（中研院社會所助研究員） 專文推薦林宗弘、（中研院社會所研究員）、盧郁佳（作家）、萬毓澤（中山大學社會學系教授）一致好評。【作者簡介】伊恩．弗格森（Iain Ferguson）英國西蘇格蘭大學（University of the West of Scotland）社會工作與社會政策學榮譽教授，除了本書外，著作與合著有《反思福利：批判的視角》（Rethinking Welfare）、《奪回社會工作：挑戰新自由主義與促進社會公義》（Reclaiming Social Challenging Neo-liberalism and Promoting Social Justice）、《激進社會工作實務》（Radical social work in practice）等，並發表不少相關領域的學術文章。弗格森亦是英國激進左翼政黨「社會主義工人黨」（Socialist Workers Party）的資深成員。
260 pages, Kindle Edition
First published December 14, 2017
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Displaying 1 - 19 of 19 reviews
October 25, 2018
Just finished reading this book and I can confidently say it was the best book I have read this year and definitely one of the best non fiction books I’ve read of all time. If you work in social work, psychology, biology or have experienced I the mental health treatment system I’d love to hear what you think of it if you have the chance to read it.
Mental illness (or as Iain Ferguson calls it, mental distress) is prolific amongst people of all walks of life at an ever rising rate and this gave me insight into the shortcomings of our understanding of, but more importantly our services of help for people with mental illness which in my opinion is one of the most egregious unacknowledged killers of our time. 73% of people in the lowest economic bracket (under $2400 p/m) report experiencing a mental health problem in their life time as well as 59% in the highest economic bracket (over $7000 p/m). Suicide is often the second highest killer of people between the ages of 15-25 second only to car crashes.
I found the book especially moving due to losing one of my close friends when we were 17 to mental illness and from reading this book it invigorates me to believe in the fight for a better world more than ever. While I acknowledge that my friend suffered particularly badly from mental illness and that’s unavoidable for some people, I believe that in a better world - a world where schooling wouldn’t be competition based so when my friend couldn’t understand a concept she wouldn’t think it was a failure of herself, a world where schools had the appropriate and adequate health services to give support to the disturbingly large amount of mentally unwell students, a world where when she attempted suicide the first time and went to hospital, she would’ve been given real treatment and not just held until someone at a higher risk than her came along to take her spot - ...I believe in a better world Connal would still be here.
I still miss Connal as I’m sure all the people that knew her do and I will never stop blaming the barbarity of capitalism’s profit motive for the lack of help she should’ve received.
Mental illness (or as Iain Ferguson calls it, mental distress) is prolific amongst people of all walks of life at an ever rising rate and this gave me insight into the shortcomings of our understanding of, but more importantly our services of help for people with mental illness which in my opinion is one of the most egregious unacknowledged killers of our time. 73% of people in the lowest economic bracket (under $2400 p/m) report experiencing a mental health problem in their life time as well as 59% in the highest economic bracket (over $7000 p/m). Suicide is often the second highest killer of people between the ages of 15-25 second only to car crashes.
I found the book especially moving due to losing one of my close friends when we were 17 to mental illness and from reading this book it invigorates me to believe in the fight for a better world more than ever. While I acknowledge that my friend suffered particularly badly from mental illness and that’s unavoidable for some people, I believe that in a better world - a world where schooling wouldn’t be competition based so when my friend couldn’t understand a concept she wouldn’t think it was a failure of herself, a world where schools had the appropriate and adequate health services to give support to the disturbingly large amount of mentally unwell students, a world where when she attempted suicide the first time and went to hospital, she would’ve been given real treatment and not just held until someone at a higher risk than her came along to take her spot - ...I believe in a better world Connal would still be here.
I still miss Connal as I’m sure all the people that knew her do and I will never stop blaming the barbarity of capitalism’s profit motive for the lack of help she should’ve received.
January 30, 2025
An absolutely indispensable analysis of mental distress from a Marxist framework. Anti-Psychiatry is a field I am very knowledgeable about and reading his critique of that field has helped shape my perspective.
I only wish this book was available to other people in the United States, as I had to transport this book back from London with me when I was there in order to get a copy of it.
I only wish this book was available to other people in the United States, as I had to transport this book back from London with me when I was there in order to get a copy of it.
June 13, 2024
***3.5 rounded up to a 4***
This book provides a concise analysis of mental distress from a Marxist perspective. It critically examines the psycho-pharmaceutical motivations behind the DSM (The Diagnostic and Statistical Manual of Mental Disorders), discusses Freud and his ideological pitfalls/incompatibility with Marxism, and briefly summarizes historical approaches and perspectives on psychotherapy, psychiatry, and anti-psychiatry.
My favourite part of this book was the critical examination of how the DSM was largely influenced and curated with the interests of psycho-pharmaceutical companies in mind. At the same time, the DSM deliberately ignores the socio-cultural causes of mental distress, essentially denying capitalism's influence on worsening mental health. Moreover, I enjoyed the conversation on how depression and anxiety shouldn't be strictly viewed as an individual biomedical/genetic deviation, but rather a sane/typical reaction to the ever worsening conditions under neoliberal capitalism.
I found this book to be a great intro to this topic, however, it came across as a bit dull at times. As a Psychology major, I didn't mind the deep dives into different thinkers/concepts. However, you'd need to have an interest in the topic since the book is largely focused on summarizing theoretical concepts, which can make it a bit slow.
This book provides a concise analysis of mental distress from a Marxist perspective. It critically examines the psycho-pharmaceutical motivations behind the DSM (The Diagnostic and Statistical Manual of Mental Disorders), discusses Freud and his ideological pitfalls/incompatibility with Marxism, and briefly summarizes historical approaches and perspectives on psychotherapy, psychiatry, and anti-psychiatry.
My favourite part of this book was the critical examination of how the DSM was largely influenced and curated with the interests of psycho-pharmaceutical companies in mind. At the same time, the DSM deliberately ignores the socio-cultural causes of mental distress, essentially denying capitalism's influence on worsening mental health. Moreover, I enjoyed the conversation on how depression and anxiety shouldn't be strictly viewed as an individual biomedical/genetic deviation, but rather a sane/typical reaction to the ever worsening conditions under neoliberal capitalism.
I found this book to be a great intro to this topic, however, it came across as a bit dull at times. As a Psychology major, I didn't mind the deep dives into different thinkers/concepts. However, you'd need to have an interest in the topic since the book is largely focused on summarizing theoretical concepts, which can make it a bit slow.
May 18, 2024
finished reading this book at 2 am on a random sunday and started crying.
November 26, 2025
mental distress, the way that it is today, with how widespread it is and how severe its symptoms are, is not something that just happens to happen to people and it is, like many other struggles in our daily life, a product of capitalism. Also pharmaceutical companies gain profit from our suffering. These are all facts, but facts I think we were all already aware of. This book does a very good job of explaining these issues, also expanding on the anti-psychiatry movement and the mental health user movement (which I find very interesting in its own right and will be reading a book about at some point). But at the end of the day, I didn't get the straight forward answer that I wanted to my questions: why do some people get fucked in the head and some others don't, in a way that doesn't seem to be related to how we relate to the system, and what the fuck should we do about it if medication and hospitalisation are subject to oh so much criticism.
overall I think it is a good starting place for someone who has read nothing about the entanglement of the mental and the social. it proves many an interesting point and weaves thinkers like Marx and Freud into it pretty naturally.
overall I think it is a good starting place for someone who has read nothing about the entanglement of the mental and the social. it proves many an interesting point and weaves thinkers like Marx and Freud into it pretty naturally.
May 16, 2024
Um texto breve sobre política e saúde mental, a partir de um viés marxista e de uma crítica da "captura neoliberal" de conceitos da antipsiquiatria e da psiquiatria crítica. Provê uma análise interessante da relação entre alienação e loucura, bem como uma análise crítica da psicanálise. Apresenta uma defesa da expansão do financiamento dos serviços de saúde mental, bem como de um aprofundamento do "jogo de contradições" que subjaz o que, no Brasil, chamamos de "luta antimanicomial". Para quem vê no Estado a única via para sustentar a saúde mental, é um texto indispensável, ainda que outras alternativas menos reativas precisam também ser pensadas.
February 2, 2021
Almost excellent ....
February 10, 2021
This book succinctly encapsulates my views regarding the staggering extent to which mental health issues today are treated through a framework that roots their causes mostly on biology and the workings of the brain. Of course, lip-service is paid to sociological causes and life events but they are subservient to that of biology in that "genetic precursors of" or "underlying susceptibility to" developing mental illness is said to be triggered by certain life events in particular individuals causing "chemical imbalances" in the brain that result in mental distress. The rise of this phenomena has also meant that medication along with certain types of "band-aid" therapies are prescribed to an alarmingly high number of people in an effort to treat mental illness.
In a way, that the mental health service providers arrived at this approach towards mental health is not surprising. Whatever radical undercurrents in psychiatry existed in the 60's and 70's have been exhausted and wiped out under the current regime of neoliberal capitalism. Psychiatry having abandoned any hope of even imagining let alone working towards a society without the brutal demands that neoliberalism and capitalism place on the majority of people, the fallback option is to just put a band-aid on it, patch up the worker and get them out being a "productive" member of society.
This book serves as a good introduction to the critique of the current paradigm in psychiatry and mental health services as it currently exists and sketches out an outline of some of the history of the stages that psychiatry underwent with a particular focus on the works of Freud, R D Laing, Sedgwick, and a little bit of Zsasz, Fromm and Reich. The significantly short length of the book means that this overview is largely cursory and summary. The book is also largely based on the conditions in the UK with some references made to those of the US.
The book argues for a dialectical historical materialist framework for placing mental illnesses, seeing them as brought on largely by people's life experiences, events, and conditions rather than on a biological deterministic model or one that pays lip-service to sociological factors but largely privileges the biological ones. The book argues for a paradigm shift in our understanding of mental illnesses, their etiology, and their treatment models by advocating for:
Some interesting things to note:
- The appropriation of the language of progressive buzzwords such as "community", "recovery" etc to mask the growing depletion of public services and resources that cater to the mentally ill. This is of particular note in the context of the UK where the NHS has weathered several successive governments advocating for and implementing budget cuts and hollowing out of the NHS.
- A sizeable chunk of this book delves into schizophrenia along with depression and anxiety. My understanding of schizophrenia largely comes from what the DSM-V has to say and I did not really know the contentions that the conception of schizophrenia as an illness generated historically. I still can't say that I have understood the crux of the issue (politically and philosophically) from this book but it is a topic that may be worth exploring.
In a way, that the mental health service providers arrived at this approach towards mental health is not surprising. Whatever radical undercurrents in psychiatry existed in the 60's and 70's have been exhausted and wiped out under the current regime of neoliberal capitalism. Psychiatry having abandoned any hope of even imagining let alone working towards a society without the brutal demands that neoliberalism and capitalism place on the majority of people, the fallback option is to just put a band-aid on it, patch up the worker and get them out being a "productive" member of society.
This book serves as a good introduction to the critique of the current paradigm in psychiatry and mental health services as it currently exists and sketches out an outline of some of the history of the stages that psychiatry underwent with a particular focus on the works of Freud, R D Laing, Sedgwick, and a little bit of Zsasz, Fromm and Reich. The significantly short length of the book means that this overview is largely cursory and summary. The book is also largely based on the conditions in the UK with some references made to those of the US.
The book argues for a dialectical historical materialist framework for placing mental illnesses, seeing them as brought on largely by people's life experiences, events, and conditions rather than on a biological deterministic model or one that pays lip-service to sociological factors but largely privileges the biological ones. The book argues for a paradigm shift in our understanding of mental illnesses, their etiology, and their treatment models by advocating for:
services based on the premise that the origins of mental distress are largely social—in other words, a social model of mental distress; services based on people’s own descriptions of their problems rather than on psychiatric diagnoses; greatly reduced, and more pragmatic, use of medication; services individualised to people’s needs; and much less use of coercionOf course, the length of the book prevents the author from more elaboration on and specificity regarding what this will entail.
Some interesting things to note:
- The appropriation of the language of progressive buzzwords such as "community", "recovery" etc to mask the growing depletion of public services and resources that cater to the mentally ill. This is of particular note in the context of the UK where the NHS has weathered several successive governments advocating for and implementing budget cuts and hollowing out of the NHS.
- A sizeable chunk of this book delves into schizophrenia along with depression and anxiety. My understanding of schizophrenia largely comes from what the DSM-V has to say and I did not really know the contentions that the conception of schizophrenia as an illness generated historically. I still can't say that I have understood the crux of the issue (politically and philosophically) from this book but it is a topic that may be worth exploring.
February 16, 2025
Ferguson surveys the different ways in which mental illness have been conceptualised and explained throughout history, focussing in on the medical model of mental illness and various critiques of it: psychoanalysis, anti-psychiatry and the unnamed "new paradigm" which combines trauma, dissociation, attachment theory and neuroscience. Ferguson is no fan of the mental institutions which housed those who faced mental illness in prison-like conditions before the 1950s, but the declining rate of profit in more recent decades has produced solutions which are no less faulty and can place the burden of caring for the mentally ill on families. The medical model is savaged as failing to provide much proof either that mental illness is biologically/genetically determined or that drugs help, and accused of servicing the incredibly profitable pharmaceutical industry. Psychoanalysis marks an important break in locating the root of mental illness in social relations and the Oedipal complex, but particularly in its more conservative forms can overvalue the "rational" ego and the role of repression in complex social phenomena. Anti-psychiatry provides an important corrective in showcasing how insanity comes from an insane world, but can valorise and mysticise often painful mental illnesses. The new paradigm is social and provides important analyses of the mental health issues facing minority groups due to oppression, but a social paradigm can still lay the blame for mental illness on individuals rather than systems and can justify neoliberalism, child abductions etc. Finally, Ferguson outlines a Marxist model for mental illness, rooted in alienation, and uses it to argue that patient control (importantly distinct from self-reliance) must be at the heart of responses to mental health.
The book is not just a good summary of the Marxist view of mental health but also an overview of the most important debates in modern psychology and psychiatry, full of inspiration for further reading. The area covered which I know most about would have to be psychoanalysis, and while the overview of psychoanalysis was of necessity simplistic, some of Ferguson's evaluation, such as that Freud's theories were usefully materialist while Lacan's irredemably idealist, strike me as basically correct. I only wish it were longer. I wish also that the book explored the way in which the new model of mental illness has morphed into a kind of identity politics, particularly on university campuses, where anything uncomfortable or challenging is labelled potentially traumatic in a way which serves to further atomise and fragment the student body. But this may well be a very recent development, and not common in Ferguson's line of work.
The book is not just a good summary of the Marxist view of mental health but also an overview of the most important debates in modern psychology and psychiatry, full of inspiration for further reading. The area covered which I know most about would have to be psychoanalysis, and while the overview of psychoanalysis was of necessity simplistic, some of Ferguson's evaluation, such as that Freud's theories were usefully materialist while Lacan's irredemably idealist, strike me as basically correct. I only wish it were longer. I wish also that the book explored the way in which the new model of mental illness has morphed into a kind of identity politics, particularly on university campuses, where anything uncomfortable or challenging is labelled potentially traumatic in a way which serves to further atomise and fragment the student body. But this may well be a very recent development, and not common in Ferguson's line of work.
November 25, 2020
3.5
This is a good, approachable summary of the medicalization and social attitudes towards madness and mental distress in the 20th and 21st century. It’s strongest point is this clear summary. While there is a definite critical edge that derives from a Marxist angle, actual critique on the basis of Marxism takes up very little of the text. This is not a book with strong analysis. I agree with it generally, but would have liked to see the sections connecting concepts in Marxist terms expanded, since there is more there that is left unexplored.
This is a good, approachable summary of the medicalization and social attitudes towards madness and mental distress in the 20th and 21st century. It’s strongest point is this clear summary. While there is a definite critical edge that derives from a Marxist angle, actual critique on the basis of Marxism takes up very little of the text. This is not a book with strong analysis. I agree with it generally, but would have liked to see the sections connecting concepts in Marxist terms expanded, since there is more there that is left unexplored.
September 21, 2023
Fantastically nuanced take on the pathologisation of human behaviour during the background of capitalism. Really, it's a lot more balanced than you might expect and has definitely altered the way I look at mental health. Like, should grief really be classed as a mental illness? Should we really put so much stock in attachment theory when its own creator has distanced himself from it? Really eye-opening to see the domino effect of psychological theories that were created to help people turning into tools with which to discriminate against people.
February 15, 2021
Great overview of psychopolitics and also overviews of the big names (Laing, Freud, etc) but I wish there was more Marxist critique on mental health provision and what this might look like
This books a gateway drug to lots of others.
This books a gateway drug to lots of others.
Read
February 23, 2021More historical and less analytical than I was expecting
February 27, 2023
Psychology, psychiatry and related issues aren't a personal strength but this was a good intro to a number of debates, and presented a nuanced Marxist approach.
June 3, 2024
A good analysis of mental health and distress under capitalism using a Marxist lens
December 6, 2024
An incisive and eye-opening analysis of mental health under capitalism, really shifted my perception of it
December 16, 2024
This analysis will have fresh insight for those familiar with Marxist theory and/or anti/critical psychiatry, while remaining accessible for those with neither.
October 14, 2021
This is a nice little volume. Unlike Peter Sedgwick's Psychopolitics, which is a lengthy polemic disguised as a summary (important to read, don't get me wrong), it actually offers a solid overview of the critique of psychiatry from the left from Freud to present-day peer organizations. I would absolutely recommend this to someone who wants a rundown of leftist social psychiatry. Ferguson is fair to everyone he treats, though one could argue he falls into the common trap of using the major figureheads as a stand-in for whole movements (so Freud is invoked as an avatar for psychoanalysis, Laing for antipsychiatry). There's benefits to this (helps trace developments more easily, can embed concepts in specific social contexts), but what's lost are all the deviations of those movements, especially because these figureheads are often among the more well-situated and comfy in such movements. It probably couldn't really be avoided in a text like this, but, all the same, I am tired of reading about Laing all the time.
My main issue is that it is lighter than I wanted on delving into the Marxist concepts that was promised by the title. Still, Ferguson illuminates very promising paths for such a critique, and, unlike Bruce Cohen's Psychiatric Hegemony, which Ferguson rightly notes appears more indebted to the popular mixture of labeling theory and Foucault, Ferguson does base his critique in Marx's understanding of capitalist alienation and our social capacity to transform the world.
My main issue is that it is lighter than I wanted on delving into the Marxist concepts that was promised by the title. Still, Ferguson illuminates very promising paths for such a critique, and, unlike Bruce Cohen's Psychiatric Hegemony, which Ferguson rightly notes appears more indebted to the popular mixture of labeling theory and Foucault, Ferguson does base his critique in Marx's understanding of capitalist alienation and our social capacity to transform the world.
October 9, 2018
Very good
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