- Thomas Szasz
Thomas Stephen Szasz (pronounced /sas/; born
April 15 ,1920 inBudapest ,Hungary ) is apsychiatrist andacademic . He is Professor Emeritus ofPsychiatry at theState University of New York Health Science Center in Syracuse,New York . He is a prominent figure in theantipsychiatry movement, a well-known social critic of the moral and scientific foundations of psychiatry, and of thesocial control aims of medicine in modern society, as well as ofscientism . He is well known for his books, "The Myth of Mental Illness " (1960) and "The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement" which set out some of the arguments with which he is most associated.His views on special treatment follow from classical liberal roots which are based on the principles that each person has the right to bodily and mental
self-ownership and the right to be free from violence from others, although he criticized thefree world as well as theCommunist state s for its use of psychiatry and "drogophobia". He believes that suicide, the practice ofmedicine , use and sale of drugs and sexual relations should be private, contractual, and outside of state jurisdiction.Szasz's main arguments
Szasz is a critic of the influence of modern
medicine on society, which he considers to be thesecularisation of religion's hold on human kind. Criticizingscientism , he targets in particular psychiatry, underscoring its campaigns againstmasturbation at the end of the 19th century or the use oflobotomy to treatschizophrenia . To sum up his conception of medicine, he declared:"Since
theocracy is the rule ofGod or its priests, anddemocracy the rule of the people or of the majority, pharmacracy is therefore the rule of medicine or of doctors." [ T. Szasz, "Ceremonial Chemistry", 1974 ]He considers that:
"The struggle for definition is veritably the struggle for life itself. In the typical Western two men fight desperately for the possession of a gun that has been thrown to the ground: whoever reaches the weapon first shoots and lives; his adversary is shot and dies. In ordinary life, the struggle is not for guns but for words; whoever first defines the situation is the victor; his adversary, the victim. For example, in the family, husband and wife, mother and child do not get along; who defines whom as troublesome or mentally sick?... [the one] who first seizes the word imposes reality on the other; [the one] who defines thus dominates and lives; and [the one] who is defined is subjugated and may be killed."The Second Sin. New York: Doubleday, 1973]
His main arguments can be summarised as follows:* "The myth of mental illness": It is a medical metaphor to describe a behavioral disorder, such as
schizophrenia , as an "illness" or "disease". Szasz wrote: "If you talk to God, you are praying; If God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; If you talk to the dead, you are a schizophrenic." While people behave and think in ways that are very disturbing, this does not mean they have a disease. To Szasz, people with mental illness have a "fake disease," and these "scientific categories" are in fact used for power controls. Schizophrenia is "the sacred symbol of psychiatry" and, according to Szasz, simply does not exist. To be a true disease, the entity must somehow be capable of being approached, measured, or tested in scientific fashion. According to Szasz, disease must be found on the autopsy table and meet pathological definition instead of being voted into existence by members of theAmerican Psychiatric Association . Mental illnesses are "like a" disease, argues Szasz, putting mental illness in a semantic metaphorical language arts category. Psychiatry is apseudo-science that parodies medicine by using medical sounding words invented over the last 100 years. To be clear,heart break and heart attack belong to two completely different categories. Psychiatrists are but "soul doctors", the successors ofpriest s, who deal with the spiritual "problems in living" that have troubled people forever. Psychiatry, through various Mental Health Acts has become the secularstate religion according to Thomas Szasz. It is a social control system, which disguises itself under the claims of scientificity. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well, such asMichel Foucault in "Madness and Civilization " (1961).* "Separation of psychiatry and the state": State government by enforcing the use of shock therapy has abused Psychiatry with impunity. [Rand, Ayn "Atlas Shrugged", p.1139, Random House, 1957 ISBN 0-394-41576-0] If we accept that "
mental illness " is a euphemism for behaviours that are disapproved of, then the state has no right to force psychiatric "treatment" on these individuals. Similarly, the state should not be able to interfere in mental health practices between consenting adults (for example, by legally controlling the supply ofpsychotropic drug s or psychiatric medication). The medicalization of government produces a "therapeutic state," designating someone as "insane" or as a "drug addict". In "Ceremonial Chemistry" (1973), he argued that the samepersecution which has targeted Witches,Jews , Gypsies or homosexuals now targets "drug addicts" and "insane" people. Szasz argued that all these categories of people were taken asscapegoat s of the community inritual ceremonies. To underscore this continuation of religion through medicine, he even takes as exampleobesity : instead of concentrating onjunk food (ill-nutrition), physicians denounced hypernutrition. According to Szasz, despite their scientific appearance, the diets imposed were a moral substitute to the former fasts, and the social injunction "not to be overweight" is to be considered as a moral order, not as a scientific advice as it claims to be. As with those thought bad (insane people), those who took the wrong drugs (drug-addicts), medicine created a category for those who had the wrong weight (obeses). Szasz argued that psychiatrics were created in the 17th century to study and control those who erred from the medical norms of social behavior; a new specialization, "drogophobia", was created in the 20th century to study and control those who erred from the medical norms of drug consumption; and then, in the 1960s, another specialization, "bariatrics ", was created to deal with those who erred from the medical norms concerning the weight which the body should have. Thus, he underscores that in 1970, the American Society of Bariatic Physicians (from the Greek "baros", weight) had 30 members, and already 450 two years later.* "Presumption of competence": Just as legal systems work on the presumption that a person is innocent until proven guilty, individuals accused of crimes should not be presumed incompetent simply because a doctor or psychiatrist labels them as such. Mental incompetence should be assessed like any other form of incompetence, i.e., by purely legal and judicial means with the right of representation and appeal by the accused.
* "Death control": In an analogy to
birth control , Szasz argues that individuals should be able to choose when to die without interference from medicine or the state, just as they are able to choose when to conceive without outside interference. He considerssuicide to be among the most fundamental rights, but he opposes state-sanctionedeuthanasia . In his 2006 book aboutVirginia Woolf he stated that she put an end to her life by a conscious and deliberate act, her suicide being an expression of her freedom of choice. [ [http://www.szasz.com/woolf.html My Madness Saved Me: The Madness And Marriage of Virginia Woolf ] ] ["The Nazis sought to prevent Jewish suicides. Wherever Jews tried to kill themselves - in their homes, in hospitals, on the deportation trains, in the concentration camps - the Nazi authorities would invariably intervene in order to save the Jews' lives, wait for them to recover, and then send them to their prescribed deaths."66 [http://www.werkblatt.at/archiv/39PytellE.htm] quotation from Kwiet, K.: "Suicide in the Jewish Community," in Leo Baeck Yearbook, vol. 38. 1993.]* "Abolition of the
insanity defense ": Szasz believes that testimony about the mental competence of a defendant should not be admissible in trials. Psychiatrist testifying about the mental state of an accused person's mind have about as much business as a priest testifying about the religious state of a person's soul in our courts. Insanity was a legal tactic invented to circumvent the punishments of the Church, which, at the time included confiscation of the property of those who committed suicide, which often left widows and orphans destitute. Only an insane person would do such a thing to his widow and children, it was successfully argued. Legal mercy masquerading as medicine, said Szasz.* "Abolition of involuntary hospitalization": No one should be deprived of liberty unless he is found guilty of a criminal offense. Depriving a person of liberty for what is said to be his own good is immoral. Just as a person suffering from terminal cancer may refuse treatment, so should a person be able to refuse psychiatric treatment.
* "Our right to drugs":
Drug addiction is not a "disease" to be cured through legal drugs (Methadone instead ofheroin ; which forgets that heroin was created in the first place to be a substitute toopium ), but a social "habit". Szasz also argues in favor of a drugs free-market. He criticized the "war on drugs ", arguing that using drugs was in fact avictimless crime . Prohibition itself constituted the crime. He shows how the "war on drugs" lead states to do things that would have never been considered half a century before, such as prohibiting a person from ingesting certain substances or interfering in other countries to impede the production of certain plants (e.g.coca eradication plans, or the campaigns againstopium ; both are traditional plants opposed by theWestern world ). Although Szasz is skeptical about the merits of psychotropic medications, he favors the repeal ofdrug prohibition . "Because we have a free market in food, we can buy all the bacon, eggs, and ice cream we want and can afford. If we had a free market in drugs, we could similarly buy all the barbiturates, chloral hydrate, and morphine we want and could afford." Szasz argued that theprohibition and other legal restrictions on drugs are enforced not because of their lethality, but in aritual istic aim (he quotesMary Douglas 's studies of rituals). He also recalls that "pharmakos ", the Greek root ofpharmacology , originally meant "scapegoat". Szasz dubbed pharmacology "pharmacomythology" because of its inclusion of social practices in its studies, in particular through the inclusion of the category of "addictiveness" in its programs. "Addictiveness" is a social category, argued Szasz, and the use of drugs should be apprehended as a social ritual rather than exclusively as the act of ingesting a chemical substance. There are many ways of ingesting a chemical substance, or "drug" (which comes from "pharmakos"), just as there are many different cultural ways of eating or drinking. Thus, some cultures prohibit certain types of substances, which they call "taboo ", while they make use of others in various types of ceremonies.Szasz has been associated with the
anti-psychiatry movement of the 1960s and 1970s, although he has resisted being identified as an anti-psychiatrist. He is not opposed to the practice of psychiatry if it is non-coercive. He maintains that psychiatry should be a contractual service between consenting adults with no state involvement. In a 2006 documentary film called "" released on DVD Szasz stated that involuntary mental hospitalization is a crime against humanity. Szasz also believes that, if unopposed, involuntary hospitalization will expand into "pharmacratic" dictatorship.Relationship to Citizens Commission on Human Rights
Together with the
Church of Scientology , Szasz co-founded theCitizens Commission on Human Rights (CCHR), in 1969, to help clean up the field of human rights abuses. He remains on CCHR's Board of Advisors as Founding Commissioner, [cite web | url = http://www.cchr.org/index.cfm/7075 | title = CCHR's Board of Advisors | work = Citizens Commission on Human Rights (CCHR) | accessdate = 2006-07-29 ] and continues to provide content for the CCHR. [ [http://www.cchr.org/index.cfm/11112 An interview with Dr. Thomas Szasz - Citizens Commission on Human Rights ] ] In the keynote address at the 25th anniversary of CCHR, Szasz stated: "We should all honor CCHR because it is really the organization that for the first time in human history has organized a politically, socially, internationally significant voice to combat psychiatry. This has never been done in human history before." [ [http://www.scientology.org/en_US/news-media/faq/pg037.html Scientology - Church of Scientology Official Site ] ] Szasz, himself, does not have any membership or involvement in Scientology. In 2003, the following statement, authorized by Szasz, was posted to the official Szasz web site by its owner, Jeffrey Schaler, explaining Szasz's relationship to CCHR:"Dr. Szasz co-founded CCHR in the same spirit as he had co-founded — with sociologist
Erving Goffman and law professor George Alexander — The American Association for the Abolition for Involuntary Mental Hospitalization...
Scientologists have joined Szasz's battle against institutional psychiatry. Dr. Szasz welcomes the support of Jews, Christians, Muslims, and any other religious or atheist group committed to the struggle against the Therapeutic State. Sharing this battle does not mean that Dr. Szasz supports the unrelated principles and causes of any religious or non-religious organization. This is explicit and implicit in Dr. Szasz's work. Everyone and anyone is welcome to join in the struggle for individual liberty and personal responsibility — especially as these values are threatened by psychiatric ideas and interventions." [Statement by the Owner and Producer of the Site, Thomas S. Szasz Cybercenter for Liberty and Responsibility, http://szasz.com/enemies.html, URL accessed April 9, 2007.]Criticism
While teaching at SUNY, Szasz offered private psychotherapy to individuals with "problems in living," consistent with his belief that mental illness is a myth and that drugs do not solve emotional conflicts. He did not apply psychiatric disease labels to his patients because he believes that such diseases are fictional. Szasz's critics maintain that, contrary to his views, such illnesses are now regularly "approached, measured, or tested in scientific fashion." [http://www.stanleyresearch.org/publications/neuropath.asp] The list of groups that reject his opinion that mental illness is a myth include the
American Psychiatric Association (APA) and theNational Institute of Mental Health (NIMH).The
journalist Jacob Sullum , who received a 2004 Thomas S. Szasz Award, [ [http://www.szasz.com/2004szaszaward.html 2004 Szasz Award Materials ] ] summarized some specific criticisms of Szasz's views when he noted that critics "offer various alternatives to the Szaszian perspective, which insists upon an objectively measurable bodily defect as the "sine qua non " of a true disease". If mental illness is a myth, the critics argue, so is physical illnessFact|date=October 2007, because both categories have fuzzy boundaries and are to a large extent culturally determined. Viewing mental illness as a myth, they assert, is a fiction supported by Szasz in order to maintain the integrity of psychotherapy as a moral enterprise. Critics of Szasz also contend that the distinction between mental and physical disease is misleading, since, as theAmerican Psychiatric Association puts it: Cquote|There is much that is "physical" in mental disorders and much "mental" in "physical" disorders. [ [http://www.reason.com/0505/cr.js.thomas.shtml Reason Magazine - Thomas Szasz Takes on HisCritics ] ]From a philosophical point of view, Szasz's contention that mental illness is a "myth" appears to rely on a variant of the dualistic Cartesian model of mind versus body (see
Descartes ). The modern scientific consensus is that the mind is a property or process of the brain and therefore of the physical body. The burden, critics charge, is therefore on skeptics such as Szasz to explain what special property of the mind would give it immunity to the kind of biochemical imbalances and disruptions that are known to afflict every other part of the human organism.There is also the criticism that many physical diseases were identified and even treated with at least some success decades, centuries, or millennia before their etiology was accurately identified.
Diabetes is one notable example. In the eyes of Szasz's critics, such historical facts tend to undermine his contention that mental illnesses must be "fake diseases" because their etiology in the brain is not well understood.References
See also
*
Anti-psychiatry
*Cognitive liberty
*Arguments for and against drug prohibition
*Michel Foucault
*Rat Park , experiment by Bruce K. Alexander challenging the disease model ofaddiction
*Morphological freedom Writings by Szasz
[http://www.szasz.com/publist.html Bibliography] of Szasz's writings.
Books
SUP =
Syracuse University Press .
*1973 "The Second Sin". Doubleday.
*1973 (editor). "The Age of Madness: A History of Involuntary Mental Hospitalization Presented in Selected Texts". Doubleday Anchor.
*1974 (1961). "The Myth of Mental Illness: Foundations of a Theory of Personal Conduct". Harper & Row.
*1976 "Heresies". Doubleday Anchor.
*1984 "The Therapeutic State: Psychiatry in the Mirror of Current Events". Buffalo NY: Prometheus Books.
*1985 (1976). "Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers". Holmes Beach FL: Learning Publications.
*1987 (1963). "Law, Liberty, and Psychiatry: An Inquiry into the Social Uses of Mental Health Practices". SUP.
*1988 (1965). "Psychiatric Justice". SUP.
*1988 (1965). "The Ethics of Psychoanalysis: The Theory and Method of Autonomous Psychotherapy". SUP.
*1988 (1957). "Pain and Pleasure: A Study of Bodily Feelings". SUP.
*1988 (1976). "Schizophrenia: The Sacred Symbol of Psychiatry". SUP.
*1988 (1977). "The Theology of Medicine: The Political-Philosophical Foundations of Medical Ethics". SUP.
*1988 (1978). "The Myth of Psychotherapy: Mental Healing as Religion, Rhetoric, and Repression". SUP.
*1990 (1980). "Sex by Prescription". SUP.
*1990 "The Untamed Tongue: A Dissenting Dictionary". Lasalle IL: Open Court.
*1990 "Anti-Freud: Karl Kraus and His Criticism of Psychoanalysis and Psychiatry". SUP. First printed in 1976 as "Karl Kraus and the Soul-Doctors: A Pioneer Critic and His Criticism of Psychiatry and Psychoanalysis". Louisiana State University Press.
*1991 (1970. "Ideology and Insanity: Essays on the Psychiatric Dehumanization of Man". SUP.
*1993 "A Lexicon of Lunacy: Metaphoric Malady, Responsibility, and Psychiatry". New Brunswick NJ: Transaction Books.
*1996 (1992). "Our Right to Drugs: The Case for a Free Market". SUP.
*1996 "Cruel Compassion: Psychiatric Control of Society's Unwanted". SUP.
*1996 "The Meaning of Mind: Language, Morality, and Neuroscience". SUP.
*1997 (1987) "Insanity: The Idea and Its Consequences". SUP.
*1997 (1977). "Psychiatric Slavery: When Confinement and Coercion Masquerade as Cure". SUP.
*1997 (1970). "The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement". SUP.
*1999 (1996). "Fatal Freedom: The Ethics and Politics of Suicide". Westport CT: Praeger.
*2001 (1996). "Pharmacracy: Medicine and Politics in America". Westport CT: Praeger.
*2002 "Liberation By Oppression: A Comparative Study of Slavery and Psychiatry". New Brunswick NJ: Transaction Books.
*2004 "Words to the Wise: A Medical-Philosophical Dictionary". New Brunswick NJ: Transaction Books.
*2004 "Faith in Freedom: Libertarian Principles and Psychiatric Practices". New Brunswick NJ: Transaction Books.
*2006 " [http://www.szasz.com/woolf.html My Madness Saved Me: The Madness and Marriage of Virginia Woolf.] " Somerset NJ: Transaction Publishers.
*2007 "Coercion as Cure: A Critical History of Psychiatry". New Brunswick (USA) London (UK) Transaction Publishers
*2007 "The Medicalization of Everyday Life: Selected Essays". SUP.econdary literature
* Burston, Daniel, 2003, " [http://www.ehinstitute.org/articles/?method=display&ArticleID=1015 Szasz, Laing and Existential Psychotherapy.] " Existential-Humanist Institute.
* Powell, Jim, 2000. "The Triumph of Liberty: A 2,000 Year History Told Through the Lives of Freedom's Greatest Champions". Free Press.
* Schaler, J. A., ed., 2004. "Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics". Chicago: Open Court Publishers.
* Vatz, R. E., and Weinberg, L. S., eds., 1983. "Thomas Szasz: Primary Values and Major Contentions". Prometheus Books.External links
*"Diseases are malfunctions of the human body, of the heart, the liver , the kidney, the brain." [http://www.youtube.com/watch?v=f4Gr4OIkums Audio on youtube]
* [http://www.szasz.com/ The Thomas S. Szasz Cybercenter for Liberty and Responsibility]
* [http://www.iatrogenic.org/library/case.html The Case Against Psychiatric Coercion, by Thomas S. Szasz]
* [http://www.szasz.com/usatoday.html Mental Disorders are not Diseases, by Thomas S. Szasz]
* [http://reason.com/0007/fe.js.curing.shtml Interview: Curing the Therapeutic State]
* [http://www.brainyquote.com/quotes/authors/t/thomas_szasz.html Thomas Szasz Quotes]
* [http://thomas-szasz.oism.info/english.htm Thomas Szasz's OISM Honorary Membership Website]
* [http://www.szasz.com/manifesto.html Thomas Szasz's Manifesto]
* [http://www.cato.org/events/030925f.html RealPlayer Video (or chose audio only) of Thomas Szasz]
* YouTube Szasz interview 26:44 audio ( [http://www.youtube.com/watch?v=mojxtnm3fA4 Part 1] , [http://www.youtube.com/watch?v=X_FVMvDDuDU Part 2] , [http://www.youtube.com/watch?v=x7ct9qVF73U Part 3] )
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