A Profession Without Reason: The Crisis of Contemporary Psychiatry Untangled and Solved by Spinoza, Freethinking, and Radical Enlightenment

by Bruce E. Levine

There is today a crisis in psychiatry. Even the former director of the National Institute of Mental Health, Thomas Insel, has said: “Whatever we’ve been doing for five decades, it ain’t working.” The field requires a completely fresh look, and clinical psychologist Bruce Levine—a man often at odds with his profession—enlists the early Enlightenment philosopher Baruch de Spinoza to help work through the problem. Readers unfamiliar with Spinoza will be intrigued by the modern relevance of his radical philosophical, psychological, and political ideas. Levine compares the radical/moderate divide among Enlightenment thinkers to a similar divergence between contemporary critics of psychiatry, siding historically with Spinoza in order to bring an equivalent intellectual force to bear upon our modern crisis and calling for new forms of free and enlightened thinking.

Genres: Psychology, Nonfiction, Psychiatry

270 pages, Paperback

Published May 24, 2022

About the author

Bruce E. Levine writes and speaks widely on how society, culture, politics and psychology intersect. His latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite (2011). Earlier books include Surviving America’s Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (2007) and Commonsense Rebellion: Taking Back Your Life from Drugs, Shrinks, Corporations, and a World Gone Crazy (2003).

A practicing clinical psychologist often at odds with the mainstream of his profession, he is a regular contributor to the Huffington Post, CounterPunch, AlterNet, and Z Magazine. His articles and interviews have been published in Adbusters, Truthout, The Ecologist, High Times, and numerous other magazines, and he has contributed chapters to Writing without Formula (2009), Perspectives on Diseases and Disorders: Depression (2009), and Alternatives beyond Psychiatry (2007).

Dr. Levine is on the editorial advisory board of the journal Ethical Human Psychology and Psychiatry, and he is an editorial advisor for the Icarus Project/Freedom Center Harm Reduction Guide to Coming off Psychiatric Drugs. A longtime activist in the mental health treatment reform movement, he is a member of the International Society for Ethical Psychology & Psychiatry as well as MindFreedom. Dr. Levine has presented talks and workshops to diverse organizations throughout North America.

Bruce E. Levine was born in 1956, grew up in Rockaway in New York City, graduated from Queens College of the City University, and received his PhD in clinical psychology from the University of Cincinnati. He currently lives in Cincinnati with his wife, Bon.

Reviews

[David Wineberg · Rating 5 out of 5]

Global fraud and noble lie: psychiatrists lead all the worst lists

From worst outcomes to receiving the most gifts, psychiatrists top the bottom of the lists. Their patients have the worst results in healthcare. Suicides are up 35% and continue to increase. Antidepressant use is up 400% and depression is everywhere. People with mental health disorders can expect a 10–25 year shorter lifespan. Its practitioners accept the most tainted money from Big Pharma to push its drugs. The drugs it prescribes not only don’t work, but long term they make things worse. Brain disorders are bogus inventions, unbacked, untested, unproven. Psychiatry is as corrupt a calling as there is.

And for all this failure, psychiatry is the only branch of medicine where patients are forced to take meds by law and can be forcibly confined to institutions where they will be pumped full of them until they die (AOT, or Assisted Outpatient Treatment). Psychiatric conditions are so ill- and inaccurately defined that they are continually added or dropped from the catalog, confusing everyone — including doctors. It’s hard to say worst of all, but psychiatry is in the throes of describing almost everyone as mentally ill, and putting them on drugs for life, right from childhood. In A Profession Without Reason, Psychiatrist Bruce E. Levine lays out a horror story of confusion and abuse that outside of medicine would be considered criminal.

Enter Spinoza

The word Reason in the book title brings in the savior of this otherwise horrendous and hellish tale that amounts to a global fraud. Levine is a big fan of the Dutch philosopher Baruch (Bento) De Spinoza, whose whole focus seems to have been the power of reason in dealing with the foibles of humanity. There is constant back and forth about Spinoza’s short but remarkably prolific and fruitful thoughts, and the miasma of psychiatry today. It keeps the book moving at a really brisk pace. Everything wrong with psychiatry today seems to have been dealt with conclusively by Spinoza in the 1670s. We have not advanced from there at all.

Spinoza was sharp. Rejecting his own religion, Judaism, he taunted the rabbi who threatened to have him excommunicated. He offered to help him do it. Outcast, Spinoza made his living grinding lenses for microscopes and telescopes, and developed a large circle of immensely supportive friends, the intelligentsia of The Netherlands. Free speech was generous in Holland, but not that generous. Spinoza played his cards cagily, pushing the limits right up to point where he could have been incarcerated and declared insane himself. It happened to a close friend of his. He realized his magnum opus was unpublishable, so he locked it away in a desk that he willed to friends to get it out of the country. They curated, translated and published it. It was banned all over, which increased the demand for it worldwide. Spinoza had played it correctly.

The stigma and the pain

Meanwhile in psychology, people were being declared insane and imprisoned. It set a baseline of fear that has never been broken. People are afraid of those who don’t conform to prescribed behavior. They might turn violent. They might harm themselves. They might get into trouble. So unlike any other medical condition, mental health problems can be dealt with by third parties — having other people committed to institutions — or by the courts, the aforementioned AOT. Uniquely, the patient has no say in these matters. So quite naturally, patients are afraid to reveal their issues. The more one tells a doctor, the more one puts oneself at risk in the psychiatry world. It could be a life sentence, without any trial, or even charges.

It might not be so bad except that the institutions never cure anyone; they make them worse. People with schizophrenia, for example, are told outright they have a brain disease that is incurable. This has the immediate effect of inducing crippling depression in them. The meds they are given do not cure anything at all. Short term, some have been shown to relieve some symptoms, but barely more than placebos do. Long term, they damage the brain, ensuring their mental health will deteriorate and their symptoms become visibly worse. Unfortunately, psychiatry considers giving placebos unethical, so it keeps pumping proven ineffective but harmful drugs into patients instead. This is a new form of ethics Spinoza would not recognize.

Peer to peer beats professionals

Levine shows that just as Spinoza said, community is what helps. Schizophrenics in an open and safe community of like suffers actually get better. Many never have another episode again. In a peer-to-peer environment, without doctors, pills or regulations, they help each other, and the glow from making a difference in another sufferer’s life does wonders for them.

Schizophrenia is not a death sentence; most often, it eventually goes away. Unless of course the patient is imprisoned in an institution or jail, forced to take endless damaging meds, and treated like — well, a mental case. Levine says “the greater the tension, fear and anger that an individual who is considered to be mentally ill creates, the more serious their mental illness is considered to be.” Testing and measurement don’t enter into it. The simple truth is schizophrenics who refuse to continue their antipsychotic medications have the best outcomes.

The insane brain isn’t

Calling mental health issues brain disease is flat out wrong, and psychiatry is in denial over it. Nothing has ever been shown to be different in the brains of schizophrenics than in healthy people, including twins. Pills to treat these diseases have no basis, but they produce increasing damage themselves.

But psychiatry is in denial for a really good reason. The drug companies pay them millions every year to prescribe these drugs for life. And doctors do, by the billions of dollars’ worth annually. Levine says 75% of the nearly 32,000 psychiatrists in the USA are on the take from Big Pharma.

Incredibly, psychiatrists think this is fine, as long as they admit it. Admitting being on the take absolves them of criticism in advance. Levine calls it the normalization of corruption. It is not even controversial anymore.

Sane vs insane. You decide.

Putting things in perspective, Levine cites conditions that are considered mental health problems, versus what is sane. For example, hearing voices inside the head is a sure sign of brain disorder, unless of course, it is the voice of God. That’s OK. At the same time, being a miser and never spending a cent in the compulsive pursuit of the most money possible is not a disorder of the brain. Believing people are chasing you indicates brain disorder, but believing in miracles like stopping the sun is rational. Levine gives the example of Opposition Defiant Disorder (ODD) that requires tranquilizers to make the patient conform. It is an extreme diagnosis, but at the other extreme, he says, there is no such condition as Submissive Compliant Disorder. Because submissive compliance is what human life is all about. It is the basis of all organization and religion. It also enables parental abuse and authoritarian leadership, for example, and that is what society willingly accepts. It is only Opposition that is insane.

On religion

Spinoza was all over the irrational beliefs espoused by religion. He could not accept that the bible was the word of God. It was clearly made up and edited by men. Instructive stories perhaps, but nothing like truth. He could not justify an all-knowing God who had specific and minute plans for everything in his Creation down to the bacteria in Spinoza’s microscope trays, suddenly bending physics and stopping Nature at the request of a single human’s prayer to accommodate their wish. It’s insulting to God. Yet this is where psychiatry is today.

The infamous DSM

The DSM — the bible of brain diseases — is continually updated. Those whose disease is dropped from the latest edition because it cannot be shown to be real — are therefore suddenly cured. They no longer have a mental health disorder! And the stunning number of brain disorders on the books mean that about one person in four has one. Pretty much anyone can be nailed with the damning label of mentally ill.

And yet, Levine says no major study has ever supported the reliability of the disorders listed in the DSM. He says Spinoza would have viewed its authors “as having no aptitude as scientists, philosophers or storytellers … The behavioral classification system of the DSM would likely provide no intellectual stimulation for him.” Unfortunately, it provides today’s doctors with unimpeachable authority to declare mental illness.

Homosexuality was a brain disorder until recently. Homosexuality meant you were not sane. You were mentally ill. Then suddenly, it was dropped from the DSM and all those people were instantly cured.

Even the chairman of the DSM’s fourth edition (2010) admitted: “There is no definition of a mental disorder. It’s bullshit. You just can’t define it.” At the same time, he called those diagnoses a “noble lie” that might help some patients “cope with life.” So psychiatry is built on a lie.

A real disease?

The facts are that western societies diagnose mental disorders far more than less developed societies. While mental disorders are so common in the West, they hardly affect life elsewhere. This also makes Levine’s point about even calling them diseases. There has never been proof that (the current fashion of) biochemical imbalance has any connection whatsoever with mental disorders. The Editor in Chief Emeritus of Psychiatric Times calls biochemical imbalances “urban legend.” All the prescriptions for supplements have been baseless. No mental disorders show up in brain scans. The brains of the mentally ill are no different than average. Treating them for life with meds that cause more issues than they correct is criminal.

The same holds true for genetics. There is no gene or combination of genes that trigger or express mental illness. Mental illness cannot be treated with gene therapy today. Levine describes Nazi Germany where schizophrenics were systematically put to death. At least three quarters of them. Yet far from eliminating their nefarious genes, there are far more schizophrenics in Germany today than in the 1930s and 40s.

For Levine, citing Spinoza, it used to be that clergy declared sanity or insanity based solely on their own opinion. Today, psychiatrists declare sanity or insanity based solely on their own opinion, because there are no valid tests. And psychiatrists do that far more often than even clergy did.

Tapping the child market

The latest fashion is to get children in on brain diseases. Attention deficit disorder, opposition defiant disorder — there all kinds of flavors psychiatrists can label children with and put them on anti-psychotics for life. Foster children are famously all suffering from brain disease. They are loaded with anti-psychotics and tranquilizers to keep them from any thoughts of independence, rebellion or justice. Then they have to add anti-convulsives to deal with the antipsychotics built up in their bodies, and psychiatrists have created a drug-addled mental case out of a foster child.

However, people addicted to prescription opioids are not considered mental cases. They are instead victims. They may turn to violent crime to feed their craving, but that’s to be pitied, not feared. They are not mentally ill. But a bored child is.

Even the armed forces aren’t safe from psychiatrists, who have put one of every six soldiers on antipsychotic meds. In nursing homes, it is 20%. America is way overmedicated for phantom disease.

Attacking the source

Levine goes after his peers with a machete. He says “a suicide expert who conducted an in-depth assessment of risk factors would predict a patient’s future suicidal thoughts and behaviors with the same degree of accuracy as someone with no knowledge of the patient, who predicted based on a coin flip.” Those judgments, he adds, tell us more about the doctor than the patient. Three hundred fifty years ago, Spinoza said what Paul says about Peter tells us more about Paul than about Peter. Or as every child knows about name-calling: it takes one to know one.

American original

This has a long, glorious history in America. Levine points to Benjamin Rush, a signer of the Declaration of Independence, who is considered the father of American psychiatry. He called runaway slaves mentally ill for the act of trying to escape. To him, it demonstrated clear brain disease, because they would not play the game. Similarly, anyone protesting the federalism of the new republic was insane. He called this particular disease anarchia.

It’s always been about control. Any threat to authority is a clear case of mental illness. Limit people’s range. Curb their enthusiasm. Don’t let them step out of line. This has always been the mantra of power.

Grim future

Psychiatry is in a tough place. Levine points out that if brain disorders could be measured and treated, patients and families would want a trained professional to treat and cure the condition. Unfortunately for psychiatrists, “that specialty is not psychiatry. It is neurology.” Psychiatrists are in a direct conflict of interest, milking it for all they can while it lasts.

Levine ends the book with a massive fireworks display of what Spinoza would say about psychiatric issues today, based directly on what he did say in the 1670s. From conflicts of interest to tolerance to reason to suicide to consensus reality to conceptualization to madness to resistance to fear to resentment to freedom and stunningly much more, Levine sends roman candle after roman candle up to explode before readers’ eyes. It is a lovely and powerful conclusion. Perfect, really.

Spinoza died at 44. It cannot even be imagined where his mind would have led us had he lived even a normal lifespan.

This book could have been a simple damning indictment of psychiatry, filled with tables and statistics. Instead, it is a brilliant illumination of its subject. The interweaving of the modern with the philosophical assessments of Spinoza is a masterstroke, making it far easier, not to mention exciting, to digest both. It is a fine accomplishment by Levine. For psychiatry to have yet to catch up to a young philosopher 350 years ago should be controversial enough. But A Profession Without Reason has made it far more.

David Wineberg

[Corvus · Rating 4 out of 5]

It would be impossible to review Bruce E Levine’s A Profession without Reason without acknowledging my own relevant life experiences. This is going to be a long review not as tailored to the shorter attention span of review sites and blurbs. In an attempt to keep a long and complex history at least mildly reasonable in length, I will try to be as general as I can and keep the personal history in italics in case you want to skip ahead. I am also going to analyze much more of the book in specifics, which also adds length:

I have had a personal relationship with psychiatry since age 9, an educational relationship since age 17, and a professional relationship since age 24. The latter two ended years back due to worsening disabilities, but my personal relationship remains ongoing. I am 39 years old.

Many of my friendships, most of my romantic partnerships, and both sides of my blood-related family are riddled with suffering through drug and other addictions and/or multiple mental health struggles. I have also been part of radical mental health and psychiatry-critical (a term I am using to differentiate from anti-psychiatry like that of scientology) movements in big ways due to abuses and failures I have endured off and on since childhood. In adulthood, I was forced to reexamine my views when my closest family member began suffering from severe psychosis, rife with terrifying delusions, hallucinations, and other hellish experiences, which eventually involved the authorities being called multiple times and forced hospitalization, no matter how hard I personally tried to avoid that. I was previously hard-line against these coercive methods. I was forced to reexamine those reexaminations when the coercion didn’t work either, causing even more fear and mistrust, leading that person to disappear from my life for a period of years. However, I cannot look back and see any other way things could have gone in those moments. Not long after that, unrelated to this, another immediate family member took his own life.

I eventually found the formerly mentioned family member and she is again part of my life, but still suffers today and refuses all medical treatment despite desperately needing it for physical health problems.I remain in various forms of treatment and out of work due to both physical and mental health problems. I cannot take psych meds due to lack of improvement (with every class of drug under the sun) coupled with extreme and often dangerous side effects and usually have to assertively defend this boundary with every clinician. I do not have a solution or answer to any of these problems, but there have been small improvements that have come from both inside and outside mainstream clinical psychology. There is much much more.

I am not super fond of writing all of that on the internet, though it is not the first time. The reason I am doing so is to share an account of something that is real life- not the often touted polar opposites on some ridiculous spectrum of “mainstream psychiatry is the god emperor and you are crazy and ignorant for refusing to go along with it” or “psychiatry is all horrible authoritarians who just want to poison your beautiful freedom and creativity so they can make big pharma money.”

When I first started this book of Levine’s, I worried that it was leaning too hard into the latter. Because I have seen what anti-psychiatry without other solutions in place can do, and how it can often lead to the same places as authoritarian psychiatry in the end or worse, I felt myself resisting hard against Levine’s criticisms and discussions. Because I have read that, for people suffering psychosis in particular, the longer they go without treatment, the poorer their recovery will be, I fear the criticism of psychiatry that I use to hold close and have no trouble agreeing with. While I agree that psychiatry has not made very good progress, that many larger messages about psychiatry and medication’s effectiveness are either myths or sales pitches for drug companies, and that many professionals are afraid (just like I am) to trust their patients or themselves over the system, I also worried at times that he was cherry picking data or being way too general in his claims. He has a ton of citations, but at first they seemed to only come from a few of the same books sharing his message. (This changed later in the text.) I found myself saying, “ah yes, I remember when I saw through rose colored glasses and believed this sort of thing, but what pray tell are you supposed to do when someone is truly in danger, is endangering others, is living in a persecutory hell, and who thinks all of that is real? Is that really freedom?” I dug my nails in and stuck with Levine and I would recommend that any other reader do the same if they end up feeling the same uneasiness that I was. He was pushing the buttons that I would have loved someone to push years ago before life had beaten me down this much. I am glad I held on, because honestly, he won me over by the end. I think this book should be critical reading for pretty much anyone, especially those in educational, clinical, and/or research psych* and neuro* fields. Even if you aren’t persuaded like I was, you should welcome the challenge and exercise in open-mindedness.

I won’t spend much time with the parts about Spinoza in this review, even though they are a huge part of the book. This is in part, because it’s just not that interesting to me aside from saying, yes, this dude had some liberating ideas for SOME European MEN way back in the day. I left myself asking all throughout the book, “yes, but where are the women- especially non-European, white women- in Spinoza’s equation?” only to discover on the last two pages that he did not believe they deserved equality. Levine is a little critical of this glaring flaw, but is also obviously sweet on Spinoza, so he tries to save his #problematicfave by acknowledging the time period and saying that, if Spinoza were to meet his female scholars of today, perhaps he would have changed his mind. I am sorry, did smart women not exist until today? And should a man this apparently brilliant and free thinking only find himself able to see women as human when they praise his own work? Levine definitely speaks to his own blind spots in this, and it honestly irked me , but I will leave it at that because you could easily remove all of the parts about Spinoza from this book and still have an interesting piece on psychiatry and alternative ways of thinking.

Now, onto the nut-meat and potatoes of these arguments: Levine discusses several studies in which treatment outcomes were poorer in wealthier nations with higher hospitalization and psychiatric medication uses than they were in less wealthy nations with less medication use. He also talks about how, even though psychiatry has progressed in its development of many new drugs and treatments, mental illness is on the rise and the DSM continues to be expanded upon to (what I agree is) a ridiculous extent- pathologizing any deviation from the norm. Correlation does not imply causation, he acknowledges. But, this is an interesting thing I have seen brought up regularly by people critiquing psychiatry and medication. When my brain was pushing back, it was saying, “yes, and stigma may have also been reduced, healthcare access increased, and thus due to accessibility more people sought care and increased the amount of illness in statistics even though people have been struggling all along in silence. There are a number of reasons these events could have taken place this way.”

Thankfully, Levine did not make the same mistake others who cited these studies in brief passing have. He told me the same thing a (human) neuroscientist friend of mine did when I asked his thoughts about it. Said friend once worked in a schizophrenia lab and learned that in China there were better outcomes regarding schizophrenia because family and community were more important in the collectivist culture being studied and thus, people took care of their loved ones during psychotic episodes instead of being driven by fear and assuming only psychiatrists and hospitals could deal with them. This resulted in better recovery times and little to no reliance on forced hospitalization and medication.

Levine talks extensively about how community support and financial aid are far more critical in terms of recovery than medication or hospitalization. But, my mind was still pushing back when he seemed to claim that drug companies had a hand in skewing many studies, almost seeming to suggest that no studies existed showing that psych meds work. I think this may have just been poor organization, because as the book progresses, he directly addresses some studies in which antidepressants, antipsychotics, and other drugs are deemed effective. A flaw of many of them that he points out is that the effect is not much more than placebo, even if it is statistically significant. This is relevant because, as anyone who has been on a plethora of psych meds knows, the side effects can be life changing and life threatening at times. Those factors combined with the possibly long term reduction in recovery rates mean that a mildly significant result doesn’t mean much at all in the grander scheme of things. If you’re going to get 10% better from the drug but feel 65% worse physically, that’s not really a success story. When I was told- even by folks on the icarus project boards who had dealt with psychosis- that forced hospitalization and meds were all that worked for them when their symptoms were severe, I took their word for it thinking I had been stupid for trying to find other ways to help my aforementioned family member. In hindsight, was that what worked because in western countries where most of us were from, that’s often all there is aside from wandering the streets alone or ending up in prison?

Further along in the book, he discusses research that reported a favorable drug result. But, the discussion of the results (which are rarely if ever reported in mainstream media or clickbait titles with paywalls) showed a more complex reality. The people achieving success were also receiving housing and other forms of assistance. It is a no brainer (pun maybe intended?) to say that, having stable housing vs houselessness or incarceration is likely going to foster more stability in one’s mental health. Other predicting factors for good mental health outcomes are safety from abuse and violence, financial security, work or other fulfilling responsibilities, friend/family support, and so on. All of these things make perfect sense, but as Levine states, "While psychiatry claims to have a "biological-psychological-social" model, the flow of dollars dictates bio-bio-bio research and treatment. Psychological, social, cultural, and political causes...receive significantly less consideration. By paying scant attention to societal and political causes, the societal status quo is maintained, which benefits those at the top of the societal hierarchy."

Levine makes a comparison between the pathologizing of LGBQ people- homosexuality in particular- and people suffering psychosis. I found this offensive. Not because oh psychosis bad, gay good, or because there’s never any overlap, but because comparisons like these do a disservice to the unique experiences of both LGBQ people (we did not even discuss the T, yet) and people dealing with psychosis and related experiences. To be frank, someone I know believing the government is giving them brain damage by projecting microwaves into their head because of the poetry they write on their personal computer is not anything like the experience of someone being attracted to or falling in love with the same gender. The latter is pretty damned simple to figure out and, when acted on with consent of all parties, is not dangerous. The former caused the person I am referencing to be unable to drive safely, have a conversation with a stranger, or even sleep or eat. I understand the drive to make comparisons in order to draw people to one’s side or to make a point, but I can speak from experience making the same mistakes in a variety of ways: it usually obscures the real issues and turns off the reader.

The rest of Levine’s discussions about the pathologization of radical action or normal human variations of thought and behaviors were excellent, not only because they did not rely on false equivalencies. The chapter Tractatus Psychiatrico-Politicus is particularly good. I have a ton of page flags throughout the book, but ended up just flagging this entire chapter when I realized that I wanted to quote the entire thing. It is quite true that all throughout history from the beginning of any sort of attempts to understand human thought and experience, marginalized and oppressed people have been pathologized. These include but are not limited to aforementioned sexuality, “drapetomania” applied to enslaved people who escaped, the increase in diagnoses of schizophrenia among Black activists during the 1960s civil rights movements, experimentation on intellectually disabled people, Jews, and many others during the nazi era holocaust, the forced sterilization of disabled, poor, and/or people of color throughout eugenics movements, and (not mentioned in the book, but added by me,) “zoophil psychosis” applied to people who historically believed in nonhuman animal liberation. These and many other horrific histories of all forms of modern medicine- not solely psychiatry- should always be enough to cause us to keep our minds open to critiques of the system. Even today, shadows of these things remain, even inside people who find themselves horrified by these histories.

A final note: I did not realize until 90% of my way through the book that I had not had to deal with triggers regarding glorified details of nonhuman animal abuse for psych* or neuro* discovery purposes. Despite it being perfectly possible and preferable, to compose a text about human psychology without including animal abuse, many writers do so with cold detachment because they are falling in line with the norm, trying to stay on supportive terms with their colleagues, lack an understanding of human studies or the flaws with translational research, or because they just don’t care about ethics and other animals as much as they care about their citation list. We do read about horribly unethical human experimentation, but this is done in order to further support Levine’s points about how pathologization is used as a tool of oppression by governments, doctors, and scientists in supremacist cultures and movements which is very different. Levine being a “free thinking” psychologist probably served him well in these regards, though I can’t claim to know his intentions regarding a focus on human research (other than to say, because it makes the most damned sense.) I would love to be able to read more books about human (or other animals) minds without having to sit through, “wasn’t it so awesome when this brilliant science man electrocuted dogs or injected acid into rats or separated baby monkeys from their moms or induced horrifying brain injuries, etc? WHAT A GUY.”

All in all, I enjoyed this book, learned a lot, and it changed my mind about quite a few things. It also offered me a little bit of a reprieve from the guilt and pressure caused by systems expecting easy solutions to complex problems. No wonder I did not and often do not know what to do. It takes a village, and all that. I also read Levine’s previous book, Resisting Illegitimate Authority, but liked this one much better. I can see were the author has learned and grown from his last work and that is always a good thing.

This was also posted to my blog.

[David · Rating 4 out of 5]

I had some really serious reservations going into this book, I work in mental health, and also have benefitted from therapy (a very long story in itself), but after having finished it, can say that it is very well supported and mirrors my own journey. I don’t know what it will take to get it through practitioner’s head that adverse childhood experiences and trauma are the root etiology of mental illness and not so-called ‘chemical imbalances,’ and it’s even more frustrating to learn that many of these theories were disproven before I had any notion that they were! I can’t express how frustrating it is that most practitioners seem to never update their understanding of mental health diagnoses, treatment, or etiology after they get out of school. I remember learning as a nurse that we were told that ‘practices change only when the older generation retires,’ but this is just ridiculous.

I’m glad I was able to overcome my initial unease at the title, the material is overall well researched and supported and approaches real problems in the field of psychology in practical ways with a novel approach. (I now know a great deal more about Spinoza than I ever imagined I would).

[Mel · Rating 4 out of 5]

This is one of those books that added a bunch more books to my to read list. Fascinating. Disturbing. Psychiatrists are cops. Full stop. I can see why the author chose to use Spinoza as an anchor, but it sometimes felt a little clumsy and distracted. Still worth reading.

[Scout · Rating 4 out of 5]

This book has a lot of strong material for encouraging a critical understanding of psychiatry, in terms of both historical fact and conceptual approaches. The author convincingly shows the discipline to be unscientific, rife with ethical issues, and too frequently willing to prioritize the profits of pharmaceutical companies over the well-being of patients. He reframes "mental illness" as "behaviors that cause tension for others," arguing that if it was only some decades ago that homosexuality was no longer classified as a mental illness, which others in the DSM might also be there for political rather than scientific reasons?

The book's biggest limitation, in my reading, is an idiosyncratic interest in the philosopher Baruch de Spinoza that drives much of the framing of the text and does not feel necessary. This aspect, it seems to me, simply could have used more editing, making for a shorter and more to the point book. It often feels as if, "I am reading a book about psychiatry that also for some reason is about Spinoza, too." Many chapters start with biographical information about Spinoza or explications of his philosophy, then bring up a contemporary issue with psychiatry, and connect the two with many statements of "Therefore, here's how Spinoza would feel about this." I get the function of these frequent speculative statements within the book's structure, but they sometimes leave me thinking things like "I'm not really sure that what's important to me about involuntary commitment is what Spinoza would think of it." In perhaps the book's most disappointing moment, the chapter on Freedom, which follows the chapter on peer support, does not explore topics such as strategy for divesting from coercive psychiatric practices to shift energy toward peer support, or what freedom means to psychiatric survivors, but rather is more or less entirely dedicated to the concept of freedom in Spinoza's writings.

The strength of all the Spinoza stuff for the book is that it helps to provide a familiar and friendly conceptual framework, including Enlightenment values around rationality and freedom, in order to explore territory that might be unfamiliar or concerning for some, namely, the scrutiny toward core concepts of psychiatry that go for many as unquestioned reality. However, precisely because these concepts and values are familiar, I don't think we really need the deep dives into Spinoza's philosophy to understand them, at least for the purposes of this particular critique of psychiatry. It seems like a tighter book might have just kept the Spinoza influence largely implicit and kept closer to the subject at hand.

All that said, I quite enjoyed reading this and got a good amount from it.

[Marco · Rating 1 out of 5]

Although I mostly agree with the author's premises, this book is just so sloppy it is painful to read.

The author would benefit immensely from reading On Writing Well. I'll give you some quick (and also sloppy) examples of things that are wrong with this book. Like the author, I can't be bothered to spend much of my time or energy on writing this review:

1. Instead of owning his voice and saying what he believes, the author talks as if he were trying to guess what Spinoza would say. "Spinoza would think the DSM is bad because it is like the Bible." "Bento (he goes back and forth calling Spinoza Bento just like that) would disagree with psychiatrists today". "Spinoza never liked to eat broccolli in the mornings, and would often say that asparagus are better". This gets tiresome so fast you wouldn't believe it.

2. He indulges in the age-old mistake of trying to find synonyms for SAY: Spinoza argues that the sky is blue. Mr. Smith asserts he agrees. John states he believes that also to be true. Maria notes she too thinks that to be the case.

This needs so much editing I wonder how much of the book would remain after the elimination of repetition and mind wandering.

[Timothy Armantrout · Rating 5 out of 5]

To Think Freely

I was not very acquainted with Spinoza or his writings prior to reading this book. Being an aspiring freethinker, and having an interest in the philosophy of psychology, I thought that this book might offer some rational insights into the current state of mental health and the practice of psychiatry.

I was not disappointed. Perhaps I should say that I was thrilled, entertained, inspired, surprised, illuminated, educated, and even aghast at what (in general) passes for "professional" mental health today. (My, how we humans love to give our power away.) I especially liked the dovetailing of Spinoza's writings with insights on current psychiatric practices.

I felt like I read 2 books in one. One about Spinoza and one about Psychiatry/mental health. What a bargain!

Well-done. Thank you, Dr. Levine.

[Margo · Rating 4 out of 5]

What an interesting read. So much great information. Really enjoyed reading this book.

[Gabriel Sims-Fewer · Rating 4 out of 5]

A great book with a tonne of valuable information, even if it does read a bit like a teenager's journal, with whole pages of "Spinoza" in different fonts, surrounded by hearts.