Posts Tagged ‘Thomas Szasz’

A dissenting view: The myth of mental illness

Friday, August 5th, 2011

Online Opinion – August 5, 2011
by Robert Spillane

American psychiatrist Thomas Szasz argued that mental illness is a metaphor: minds can be sick only in the ways that jokes or economies can be sick. If there is no mental illness there can be no 'treatment' or 'cure' for it. Click image for more by Szasz

“No mental illness has, or ever will be, diagnosed on the basis of medical signs, for a simple reason. If people who have been diagnosed with schizophrenia are found to have a brain lesion, they are suffering from a brain illness, not a mental illness. The presence of a medical sign in people who have been labelled mentally ill proves that they are not suffering from a mental illness. Psychiatry is, therefore, that branch of medicine where diagnoses of ‘illnesses’ are made in the absence of objective evidence: they are based, not on what people have, but on what they do and say. And if they act in ways that annoy, upset or offend others, they may find themselves diagnosed as mentally ill and treated medically against their will.” – Robert Spillane

Government publications routinely announce that around 45% of Australians aged between 16 and 85 will experience a mental illness, while 20% will experience a mental illness in any given year. Australian businesses, we are told, lose over $6.5 billion each year by failing to provide early intervention and treatment for employees with mental health conditions. In 2006-7 there were 20.6 million mental health-related PBS/RPBS prescriptions which accounted for $670 million of benefits, or 10.8% of total expenditure.

Mental illness means, literally, an illness of the mind, as opposed to an illness of the brain. But can minds be ill? I argue that they cannot. Mental illness is, therefore, a myth. Since illness affects only the body and the ‘mind’ is not a bodily organ, the mind cannot be ill. ‘Mental illness’ is, therefore, an oxymoron.

In ‘The Myth of Mental Illness’, American psychiatrist Thomas Szasz argued that mental illness is a metaphor: minds can be sick only in the ways that jokes or economies can be sick. If there is no mental illness there can be no ‘treatment’ or ‘cure’ for it.

If, as many people believe, the mind is really a brain process, then mental illness is really brain illness a valid diagnosis of which must be based on objective medical signs, not on subjective communications or complaints. This is no mere semantic quibble since Australian law accepts the distinction between brain illness (e.g. multiple sclerosis) and mental illness (e.g. schizophrenia). People cannot be locked up in a hospital and treated against their will for multiple sclerosis. Similarly, people may be found not guilty of a serious crime because of their ‘paranoid schizophrenia’, but the same rules do not apply to people with brain tumours.

No mental illness has, or ever will be, diagnosed on the basis of medical signs, for a simple reason. If people who have been diagnosed with schizophrenia are found to have a brain lesion, they are suffering from a brain illness, not a mental illness. The presence of a medical sign in people who have been labelled mentally ill proves that they are not suffering from a mental illness. Psychiatry is, therefore, that branch of medicine where diagnoses of ‘illnesses’ are made in the absence of objective evidence: they are based, not on what people have, but on what they do and say. And if they act in ways that annoy, upset or offend others, they may find themselves diagnosed as mentally ill and treated medically against their will.

People change their behaviour with or without the intervention of psychiatrists or psychologists. Such intervention is nowadays called ‘treatment’ when, in some cases, it should be called ‘torture’. When these interventions produce acceptable changes in behaviour, they are called ‘cures’. The cure of mental illness, it is argued, produces a state of mental health which is universally regarded as desirable. But if mental illness is a myth, mental health is too.

Since the middle-1990s the term ‘mental health literacy’ has been used to describe people who endorse an illness ideology and so agree with biological psychiatrists who bemoan the public’s alleged ignorance. Many attempts to reduce prejudice against the ‘mentally ill’ have been based on the attempt to make the public think like biological psychiatrists. This approach is based on the assumption that if you are ill your behaviour is beyond your control and you cannot be held responsible for it. Psychologist, John Read, reports evidence from seventeen countries that reveals that citizens have steadfastly resisted this propaganda, preferring to attribute mental illness to problems in living. Biological psychiatrists, eagerly supported by pharmaceutical companies, have consistently tried to tell people that they are wrong. This ‘illness’ approach to de-stigmatisation ignores the impressive body of evidence that biological explanations actually fuel prejudice.

The authors of the psychiatric bible known as ‘The Diagnostic and Statistical Manual of Mental Disorders’ (DSM-IV-TR) admit that ‘no definition adequately specifies precise boundaries for the concept of ‘mental disorder”. Faced with the undeniable fact that mental illnesses cannot be diagnosed on objective medical grounds, DSM IV nonetheless provides more than 350 examples including: academic disorder, ADHD, expressive language disorder, gambling, gender-identity disorder, mathematics disorder, neglect of child disorder, partner-relational disorder, phase of life disorder, rumination disorder, written expression disorder and premature ejaculation. It seems that when females climax quickly it is ‘sexy’, when males climax quickly it is a mental illness!

In English there are success verbs, like ‘discover’ – one cannot discover something that does not exist. ‘Invent’ is not a success word since one can invent something that does not exist. Brain illnesses are discovered, mental illnesses are invented.

http://www.onlineopinion.com.au/view.asp?article=12427

To find out more about Dr. Thomas Szasz click here: http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

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The Illegitimacy of the “Psychiatric Bible” by Thomas Szasz, Professor of Psychiatry

Tuesday, March 29th, 2011

The Moral Liberal – March 29, 2011

by Thomas Szasz

Professor of Psychiatry Emeritus, Dr. Thomas Szasz

“Mental health experts ask: Will anyone be normal?” So read the title of a July 27 Reuters report. The “experts” warned that the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in 2013, “could mean that soon no-one will be classed as normal. . . . [M]any people previously seen as perfectly healthy could in future be told they are ill.”

This is not news. More than 200 hundred years ago Johann Wolfgang von Goethe (1749–1832) warned: “I believe that in the end humanitarianism will triumph, but I fear that, at the same time, the world will become a big hospital, each person acting as the other’s humane nurse.”

Moreover, Goethe foresaw the moral hollowness of the “humanitarian science” on which such therapeutic tyranny would rest: “I could never have known so well how paltry men are, and how little they care for really high aims, if I had not tested them by my scientific researches. Thus I saw that most men only care for science so far as they get a living by it, and that they worship even error when it affords them a subsistence.”

The depths to which such men would happily sink when worshiping error brings them fame and fortune became obvious only in the twentieth century.

Joaquim Maria Machado de Assis (1839–1908), the great Brazilian novelist and playwright, advanced the prescient literary satirization of the dark art of psychiatric diagnosis and the engine that drives it: the phony expert’s insatiable vanity and thirst for controlling his fellow man. His short story “O alienista” (1882, “The psychiatrist”) is a fable of a celebrated doctor retiring to a small town to pursue his scientific investigation of the human mind, gradually finding more and more of the townsfolk insane and needing to be incarcerated in his private asylum. Eventually he alone is left at liberty. As soon as modern psychiatry became a legitimate branch of medicine, Machado de Assis recognized and exposed its quintessentially unscientific-sadistic character.

It remained for the French playwright Jules Romains (1885–1972) to call public attention to the corruption of modern medicine by political power. “It’s a matter of principle with me,” declares his protagonist, “Dr. Knock” (1923), “to regard the entire population as our patients. . . . ‘Health’ is a word we could just as well erase from our vocabularies. . . . If you think it over, you’ll be struck by its relation to the admirable concept of the nation in arms, a concept from which our modern states derive their strength.”

Sigmund Freud (1856–1939), too, has played an important part in persuading people that health is an abnormal state. This old joke is illustrative: “If the patient is early for his appointment, he is anxious; if he is on time, he is obsessive-compulsive; if he is late, he is hostile.”

Particular psychiatric diagnoses have not escaped professional criticism. Wishing to make a name for themselves as psychiatrists, “critics” object to one or another diagnosis (homosexuality)—or to “overdiagnosis” (ADHD)—but continue to respect the American Psychiatric Association (APA) as a scientific organization and regard the various incarnations of the DSM as respectable legitimating documents. This is dishonest. Confronted with the DSM, the challenge we face is to delegitimize the authenticators, the APA and DSM, not distract attention from their fundamental phoniness by ridiculing one or another “diagnosis” and trying to remove it from the magical list.

I have consistently rejected this piecemeal approach. In my essay “The Myth of Mental Illness,” published in 1960, and in my book with the same title that appeared a year later, I stated my view forthrightly. I proposed that we view the phenomena conventionally called “mental diseases” as behaviors that disturb others (or sometimes the self), reject the image of “mental patients” as helpless victims of patho-biological events outside their control, and refuse to participate in coercive psychiatric practices as incompatible with the foundational moral ideals of free societies. In short, I rejected the authority of the APA as a legitimating organization and of the DSM as a legitimating document. I believe nothing less can undo the mischief wrought by the successive editions of the “psychiatric bible.”

Settled by Political Power

But times have changed. Fifty years ago it made sense to assert that mental illnesses are not diseases. It makes no sense to do so today. Professional debate about what counts as mental illness has been replaced by political-judicial decree. The controversy about the nature of so-called mental diseases/disorders has been settled by the holders of political power: They have decreed that “mental illness is a disease like any other.” Political power and professional self-interest have united in turning false beliefs into lying facts: “Mental illness can be accurately diagnosed, successfully treated, just as physical illness” (President William Clinton, 1999). “Just as things go wrong with the heart and kidneys and liver, so things go wrong with the brain” (Surgeon General David Satcher, 1999).

The claim that “mental illnesses are diagnosable disorders of the brain” is not based on scientific research; it is a deception and perhaps self-deception. My claim that mental illnesses are fictitious illnesses is also not based on scientific research; it rests on the pathologist’s materialist-scientific definition of illness as the structural or functional alteration of cells, tissues, and organs. If we accept this definition of disease, then it follows that mental illness is a metaphor, and asserting that view is stating an analytic truth not subject to empirical falsification.

For centuries the theocratic State exercised authority and used force in the name of God. The Founders sought to protect the American people from the religious tyranny of the State. They did not anticipate, and could not have anticipated, that one day medicine would become a religion and that the alliance between medicine and the State would then threaten personal liberty and responsibility exactly as they had been threatened by the alliance between church and State.

The Founders faced the challenge of separating the cure of souls by priests from the control of people by politicians. Today the therapeutic State exercises authority and uses force in the name of health. We face the challenge of separating the consensual treatment of patients by medical doctors from the coercive control of persons by agents of the State pretending to be healers.

When psychiatry was in its infancy the belief that all human “dysfunctions” are manifestations of brain diseases was a naive error. In its maturity the mistake was treated as a valid scientific theory and the justification for a powerful ideology and the powerful institutions based on it.

Today, in its senescence, psychiatry is deceit and self-deceit—coercion concealed as objective science (“medical diagnosis”) and benevolent help (“medical treatment”). As a result, paraphrasing Orwell, telling the truth becomes “a revolutionary act.”

http://www.themoralliberal.com/2010/12/20/the-illegitimacy-of-the-%E2%80%9Cpsychiatric-bible%E2%80%9D/

Dr. Thomas Szasz is a Professor of Psychiatry Emeritus at the State University of New York, Adjunct Scholar at the Cato Institute and a Lifetime Fellow of the American Psychiatric Association. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Szasz has authored more than 35 books on the subject, the first being The Myth of Mental Illness, a book which rocked the foundations of psychiatry upon its release more than 50 years ago.  Read more here: http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

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Psychiatry’s Billing Bible, the DSM: The Debate over Diagnosis

Monday, March 21st, 2011

Montreal Gazette
By Donna Nebenzahl

Psychiatric disorders are not discovered in labs, they are voted into existence by the American Psychiatric Association

Expected to be published in May 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – the bible of the American Psychiatric Association – has created a firestorm of controversy in its suggested treatment of individuals who have gender identity issues.

According to the manual, an individual questioning gender identity and meeting certain criteria suffers from gender identity disorder, which is therefore considered a mental disorder. And the new edition, whose revisions have been in the works for more than a decade, is likely to once again disappoint the vocal community that has been arguing for years that being transgendered is not a mental illness. (Preliminary revisions for DSM-5 are available for review at www.DSM5.org.)

Many medical practitioners and activists argue that the inclusion of gender identity disorder, even in its likely DSM-5 configuration as gender incongruence, “pathologizes a normal variant of human sexuality,” as Fordham University researcher Sarah Kamens wrote recently in the magazine of the Society for Humanistic Psychology.

“In the DSM that’s currently in use, it’s classified the same way homosexuality was 30 years ago,” says Dr. Shuvo Ghosh, who treats children with gender identity issues at the Montreal Children’s Hospital.

“The diagnosis stigmatizes trans people; it makes it look like they’re mentally ill, and they’re not,” says Françoise Susset, psychologist and president-elect of the Canadian Professional Association for Transgender Health. “Many of the people I see are very high functioning and have no mental illness whatsoever.”

“It’s being called a disorder and treated as a disorder, and I would say it should stay there,” argues Dr. Pierre Assalian, head of the human sexuality unit at the Montreal General Hospital. “I would say that until we find something biological that explains why somebody feels wrong in their body, I would have to consider it as a disorder.”

The research on biological underpinnings of gender identity issues is being carried out around the world, but in the meantime the American Psychiatric Association’s manual, considered the No. 1 source of diagnostic categories, maintains the condition’s psychiatric listing – with some troubling inclusions. One group of professionals proposed online that new indicators in the DSM-5 such as “strong preference for toys and games of the other gender . and playmates of the other gender” should be struck from the forthcoming manual, since preference for play and playmates, they argue, have “no place in diagnostic criteria for a psychiatric disorder.” http://www.montrealgazette.com/health/Debate+over+Diagnosis/4469318/story.html#ixzz1HFmnUm00

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Shrinks on the couch as they ponder who is and is not crazy

Thursday, March 17th, 2011

Business Day – March 17, 2011

by Marika Sboros

At the heart of this matter is a nasty predilection some psychiatrists have for medicalising normality

Diagnosis is a slippery slope. It involves concepts that are virtually impossible to define precisely with bright lines at the boundaries

SOME psychiatrists — the ones who don’t believe they are godlike creatures — are in a bit of a tizz these days. They are worried about all the damage they might have unwittingly done by misdiagnosing mental illness.

Libyan leader Colonel Muammar Gaddafi could help to ease their furrowed brows.

Some background, before I explain that apparent non-sequitur: In a soul-searching analysis of his profession in Wired magazine recently, US psychiatrist Dr Allen Frances declares that mental disorders “can’t be defined”, and it’s “bull—-” to suggest otherwise.

Frances is lead editor of the DSM-IV, the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual. It’s a publication that has been described as “the bible” and “the imperial doctrine” of psychiatrists.

It’s what shrinks use, in their godlike wisdom, to decide whether or not you are mentally ill — and then to prescribe powerful, dangerous drugs, and other treatments that can turn you into a shadow of your former self.

In the gut-wrenching Wired article, Frances says: “We psychiatrists have made mistakes that had terrible consequences.”

In particular, he believes the manual has inadvertently facilitated the massive increase in recent years of diagnoses of autism, attention deficit disorders and bipolar depression — that used to be called manic depression, because of the manic swings in mood that characterise the condition.

He believes psychiatrists largely bear the responsibility for a massive increase in child bipolar diagnoses, and an epidemic of prescriptions for dangerous, antipsychotic drugs for very young children — below the age of five.

At the heart of this matter is a nasty predilection some psychiatrists have for medicalising normality, or as Wired writer Gary Greenberg says of the DSM, “to chalk up life’s difficulties to mental illness, and then treat them with psychiatric drugs”.

After all, it’s one thing to be thought of as having the blues after a protracted period of difficulty in your life. It’s quite another to be diagnosed as nuts. Mental illness is a serious diagnosis, aggravated by the burden of stigma that weighs down those deemed to have it. It wreaks havoc on lives, families, reputations and careers.

Yet diagnosis is a slippery slope. It involves concepts that “are virtually impossible to define precisely with bright lines at the boundaries”, says Frances.

He has accused colleagues “not just of bad science, but of bad faith, hubris, and blindness, of making diseases out of everyday suffering and, as a result, padding the bottom lines of drug companies”, as Greenberg so eloquently puts it.

Frances has joined forces with Dr Robert Spitzer, editor of the previous edition DSM-III, to prevent the current DSM-V from bulldozing its way down the same damaging path.

That’s a battle they look unlikely to win, given the power of the vested interests involved. And while this may all seem a little in-medical-house, it has implications for the many at the mercy of psychiatrists.

Frances fears the DSM will continue the “wholesale imperial medicalisation of normality”. It may create yet another bonanza for the pharmaceutical industry with a proposed, new “pre-psychotic disorder” — as if the manual doesn’t contain enough disorders from which pharmaceutical companies can make massive profits.

Of course, there’s nothing new about the idea that psychiatry is unscientific. The most famous proponent of that is US psychiatrist Dr Thomas Szaz, professor emeritus of psychiatry at the State University of New York Health Science Centre since 1990.

Szaz put his iconoclastic views forward in his books, The Myth of Mental Illness, published in 1960, and 10 years later in The Manufacture of Madness: A comparative study of the inquisition and the mental health movement.

These are damning critiques from a fine mind on psychiatry’s moral and scientific foundations — and mania for social control.

But what, you might ask, has this to do with Gaddafi?

Well, the Libyan leader is nothing if not a fascinating specimen, psychiatrically speaking, and an argument for the existence of mental illness. After all, if something looks like a duck, acts like a duck, walks like a duck, sounds like a duck, it’s a duck.

Gaddafi looks, acts, sounds and struts around like a madman. He provides a veritable smorgasbord of disorders guaranteed to titillate the mental tastebuds of orthodox psychiatrists, and have them reaching for their prescription pads in a flash.

Gaddafi, according to DSM specifications, could be diagnosed with borderline personality disorder — psychobabble psychiatrists have dreamt up to pigeonhole people who don’t or won’t do as others expect them to do.

He’s more likely to be diagnosed with into-the-abyss megalomania, paranoia, psychopathy, with a hint of schizophrenia.

Szaz might argue that Gaddafi’s madness is manufactured, a product of the toxic environment he created over the 42 years of his rule, wallowing in the absolute power that corrupts body and mind absolutely.

His bloated, puffy, sallow complexion suggests bad diet, and other unhealthy lifestyle habits that may contribute to the misfiring of neurons in his grey matter. Yet I doubt even the humane and holistic treatment methods Szaz advocates could bring Gaddafi back from the mad brink to anything resembling rational, normal, decent behaviour.

Marika Sboros is Health News editor.

http://www.businessday.co.za/articles/Content.aspx?id=137544

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Psychiatric diagnoses prone to abuse

Tuesday, November 9th, 2010

Note from CCHR: The below article is short but the point made by author Richard Vatz, Professor of political rhetoric, is all to often overlooked—quite simply that psychiatric diagnoses are completely subjective and there is no known scientific or medical means by which any “psychiatric diagnosis” can be proven.  For more information see video of CCHR Co-founder, Professor Thomas Szasz, Professor of Psychiatry Emeritus, of whom Vatz has called,  “the preeminent critic of psychiatry in the world.” http://www.cchrint.org/videos/experts/thomas-szasz/

The Baltimore Sun, November 8, 2010

by Richard  E. Vatz,  Professor of political rhetoric at Towson University.

One of the few issues not thoroughly covered in Scott Calvert’s well-researched, comprehensive articles on Baltimore Behavioral Health (“Hooked on treatment,” Nov. 7 and “Sheltered addicts, strained recovery,” Nov. 8)  is why psychiatric diagnoses are particularly prone to misdiagnosis and overdiagnosis.

The reason is that psychiatric diagnosis is not based on pathological criteria. The closest the article comes to addressing this problem is the statement that “Even in the best clinical scenario, a psychiatric diagnosis is tricky, experts say; doctors have no X-rays to help apply the criteria defining a mental illness.”

In fact a diagnosis can never be indisputably ruled in or ruled out in psychiatry. All we have is testimony by differing psychiatrists, psychologists and social workers. In somatic medicine there is an array of pathological tests which often permit much greater diagnostic certainty. A biopsy of a lump in the breast will almost always tell you whether it’s benign or malignant.

The ability of professionals and patients to play the system financially and to exculpate addicts from responsibility will forever be aided by makeshift diagnoses which can neither be confirmed nor ruled out.

Richard E. Vatz

http://articles.baltimoresun.com/2010-11-08/news/bs-ed-pschiatric-diagnoses-letter-20101108_1_psychiatric-diagnoses-criteria-addicts

For more information on psychiatry as a pseudo-science,  visit CCHR’s Thomas Szasz pages http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

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1 million misdiagnosed ADHD children for $80B drug industry

Saturday, October 30th, 2010

Examiner.com
By Deborah Dupre
October 30, 2010

Two new studies published suggest something wrong with the way ADHD is diagnosed in young children in the US, confirming the need for the public to utilize Citizens Commission on Human Rights International resources for injury prevention.

One or the new studies found nearly 1 million children potentially misdiagnosed just because of being youngest in their kindergarten year, with the class youngest twice likely to be medicated with stimulant medication. The other study confirmed that whether children were born just before or just after the kindergarten cutoff date significantly affected chances of being diagnosed ADHD.

20 million children are taking psychiatric drugs according to the mental health watchdog, Citizens Commission on Human Rights International (CCHRI).

CCHR works shoulder-to-shoulder with like-minded groups and individuals who share a common purpose to restore basic inalienable human rights to the field of mental health. These rights include, but are not limited to, full informed consent regarding risks of treatments and all available medical alternatives, and the right to refuse any treatment considered harmful.

Psychiatric disorders fuels an 80 billion dollar industry, highlighted CCHTI’s new documentary online, THE STAMP: Psychiatric Disorders Fuel $80 Billion Drug Industry.

Most authors of the “official” Diagnostic Manual that sets criteria for mental “diseases” have ties to the drug industries.”

“The psychiatric/pharmaceutical industry spends billions of dollars a year to convince the public, legislators and the press that psychiatric disorders such as Bi-Polar Disorder, Depression, Attention Deficit Disorder (ADD/ADHD), Post Traumatic Stress Disorder, etc., are medical diseases on par with verifiable medical conditions such as cancer, diabetes and heart disease. Yet unlike real medical disease, there are no scientific tests to verify the medical existence of any psychiatric disorder. To counter this obvious flaw in their push to medicalize behaviors, the psychiatric industry will claim that there are certain medical conditions that do not have a verifiable test so this is why there isn’t one for “mental illness.” This is frankly a lame argument; Whereas there may be rare medical conditions that do not have a verifiable medical test, there are virtually no psychiatric disorders that can be verified medically as a physical abnormality/disease. Not one.” (CCHR)

Parents, legislators and the general public are not being given documented risks of drugs prescribed to children. CCHRI provides an easy to use search engine with complete information including warnings, studies, and adverse reactions to psychiatric drugs at www.cchrint.org/psychdrugdangers/.

No More ADHD

Dr. Mary Ann Block, Medical director of the Block Center and associated with CCHRI is an outspoken critic of children being diagnosed ADHD and put on drugs documented to cause tics, stunted growth, heart attack, stroke and sudden death.

Dr. Block describes how parents are being misinformed about the medical legitimacy of ADHD and the dangers of the drugs being prescribed to treat children. She encourages parents to have their child given a full medical examination to find underlying medical problems that are being misdiagnosed as a mental disorder.

The Citizens Commission on Human Rights (CCHR) is a mental health watchdog and non-profit organization. It has been responsible for more than 150 laws protecting individuals from abusive or coercive practices committed under the guise of mental health.

CCHR’s Board of Advisers, called Commissioners, include doctors, scientists, psychologists, lawyers, legislators, educators, business professionals, artists and civil and human rights representatives.

Co-founder of CCHR, Dr. Thomas Szasz is a Professor of Psychiatry Emeritus at the State University of New York, Adjunct Scholar at Cato Institute and Lifetime Fellow of the American Psychiatric Association. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Szasz has authored over 35 books on the subject, the first being The Myth of Mental Illness, a book that rocked the foundations of psychiatry upon its release more than 50 years ago.

Photo: CCHR International

Watch the full CCHR documentary, THE STAMP: Psychiatric Disorders Fuel $80 Billion Drug Industry, here.

Read the entire article here:  http://www.examiner.com/human-rights-in-national/1m-misdiagnosed-adhd-children-for-80b-drug-industry

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LewRockwell.com—No Excuses:The Reality Cure of Thomas Szasz—Szasz has been, for over 50 years, the gadfly of psychiatry

Wednesday, August 4th, 2010

LewRockwell.com
By Phil Barker and Poppy Buchanan-Barker
August 4, 2010

And you thought Tom Szasz was yesterday’s hero? This paper brings us up to date.

Future historians may well cast Thomas Szasz as an intrepid campaigner for the blindingly obvious: people do not have “mental illnesses” but experience a wide range of moral, interpersonal, social and political “problems in living.” All such problems concern, or have an impact on, our sense of who and what we are and could just as easily be called spiritual crises. However, despite his prodigious scholarly output, Szasz might well be written out of history, as punishment for his single-handed and persistent exposure of the greatest hoax of the modern age – the construction of the “myth of mental illness” and psychiatry’s ludicrous attempts to “treat” it.

In the best Socratic tradition Szasz has been, for over 50 years, the gadfly of psychiatry. In his classic book, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Szasz, 1961), he contended that, contrary to the professional and public opinion of the time (the late 1950s) the mind – an abstract concept – could only be considered “sick” in the same sense that a joke or a building might similarly be described. This mind metaphor functions as a powerful myth, like many fictions, offering comfort to all who embrace the idea as a way of explaining the “inexplicable.”

At the end of the 20th century religion, especially Christianity, was furiously debunked by radical secularists like Richard Dawkins, Daniel Dennett and Christopher Hitchens. They exposed not just its mythical nature but the harm and injustice associated with its practice down the ages. Ironically, their glaring sin of omission was to ignore psychiatry – by far the most potent and influential religion of the past two hundred years.

Psychiatrists might feign offense at their portrayal as “high priests,” believing that they offer a complex and compassionate form of psychological medicine, worshipping at the same altar as scientists like Dawkins. Historically, the facts tell a very different story, as Szasz’s works have vividly illustrated.

Traditional religions can hold sway over large sections of any population, and may be considered a force for good or evil. However, such “myths” are, at the very least, embraced by the faithful; who gain socially, culturally or spiritually from their allegiance; and are free to rejoin secular society whenever they wish. The same could never be said of “psychiatric patients.” The open secret of the 20th century was that modern psychiatry became a “church” founded on hocus-pocus masquerading as science, and promoted a range of means of detaining and restraining its “patient” flock. Today, as psychiatry rebrands itself as a branch of neuroscience, it seeks to colonize “developing nations,” despite its near-bankrupt status in its Western world of origin. Parallels with the Christian missionaries seem wholly apposite.

Over the past 60 years Thomas Szasz has published over 30 books and around 700 papers and articles, all focused on exposing the logical weaknesses of psychiatric thought, and the moral bankruptcy of its practice. Heidegger proposed that every great thinker thinks but one thought. Szasz’s singular, original thought concerns the moral bankruptcy of expecting (far less forcing) people to see psychiatrists; to be admitted to so-called “mental hospitals”; to take psychiatric drugs; and otherwise to comply with the capricious fashions of psychiatric religion. His diverse and remarkably accessible writings around this single proposition have led many to view him as the foremost, contemporary moral and existential philosopher of psychiatry and psychotherapy: the psychiatric equivalent of the boy obligated to point out the Emperor’s nakedness. In his 90th year, the uncompromising fury of Szasz’s scholarship shows no sign of waning as three of his latest books attest.

Coercion as Cure (Szasz 2007) has a “classic” feel providing, as its subtitle makes clear, a much-needed “critical history of psychiatry.” Szasz acknowledges that, from his first day in medical school in the early 1940s, his understanding of the physician’s role was to try to relieve the suffering of individuals who asked for, and accepted, medical help. He quickly formed the view that psychiatrists were committing a grave moral wrong by imprisoning and coercing people who neither sought nor wanted their “help.” This simple, yet profoundly humanist view became, and remains, his raison d’être.

Read entire article here:  http://www.lewrockwell.com/orig10/szasz5.1.1.html

Dr. Thomas Szasz is also the co-founder of CCHR.  For more on Thomas Szasz, including his CV, quotes, video, accolades and his relationship with CCHR, click here:  http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

And you thought Tom Szasz was yesterday’s hero? This paper brings us up to date.

Future historians may well cast Thomas Szasz as an intrepid campaigner for the blindingly obvious: people do not have “mental illnesses” but experience a wide range of moral, interpersonal, social and political “problems in living.” All such problems concern, or have an impact on, our sense of who and what we are and could just as easily be called spiritual crises. However, despite his prodigious scholarly output, Szasz might well be written out of history, as punishment for his single-handed and persistent exposure of the greatest hoax of the modern age – the construction of the “myth of mental illness” and psychiatry’s ludicrous attempts to “treat” it.

In the best Socratic tradition Szasz has been, for over 50 years, the gadfly of psychiatry. In his classic book, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Szasz, 1961), he contended that, contrary to the professional and public opinion of the time (the late 1950s) the mind – an abstract concept – could only be considered “sick” in the same sense that a joke or a building might similarly be described. This mind metaphor functions as a powerful myth, like many fictions, offering comfort to all who embrace the idea as a way of explaining the “inexplicable.”

At the end of the 20th century religion, especially Christianity, was furiously debunked by radical secularists like Richard Dawkins, Daniel Dennett and Christopher Hitchens. They exposed not just its mythical nature but the harm and injustice associated with its practice down the ages. Ironically, their glaring sin of omission was to ignore psychiatry – by far the most potent and influential religion of the past two hundred years.

Psychiatrists might feign offense at their portrayal as “high priests,” believing that they offer a complex and compassionate form of psychological medicine, worshipping at the same altar as scientists like Dawkins. Historically, the facts tell a very different story, as Szasz’s works have vividly illustrated.

Traditional religions can hold sway over large sections of any population, and may be considered a force for good or evil. However, such “myths” are, at the very least, embraced by the faithful; who gain socially, culturally or spiritually from their allegiance; and are free to rejoin secular society whenever they wish. The same could never be said of “psychiatric patients.” The open secret of the 20th century was that modern psychiatry became a “church” founded on hocus-pocus masquerading as science, and promoted a range of means of detaining and restraining its “patient” flock. Today, as psychiatry rebrands itself as a branch of neuroscience, it seeks to colonize “developing nations,” despite its near-bankrupt status in its Western world of origin. Parallels with the Christian missionaries seem wholly apposite.

Over the past 60 years Thomas Szasz has published over 30 books and around 700 papers and articles, all focused on exposing the logical weaknesses of psychiatric thought, and the moral bankruptcy of its practice. Heidegger proposed that every great thinker thinks but one thought. Szasz’s singular, original thought concerns the moral bankruptcy of expecting (far less forcing) people to see psychiatrists; to be admitted to so-called “mental hospitals”; to take psychiatric drugs; and otherwise to comply with the capricious fashions of psychiatric religion. His diverse and remarkably accessible writings around this single proposition have led many to view him as the foremost, contemporary moral and existential philosopher of psychiatry and psychotherapy: the psychiatric equivalent of the boy obligated to point out the Emperor’s nakedness. In his 90th year, the uncompromising fury of Szasz’s scholarship shows no sign of waning as three of his latest books attest.

Coercion as Cure (Szasz 2007) has a “classic” feel providing, as its subtitle makes clear, a much-needed “critical history of psychiatry.” Szasz acknowledges that, from his first day in medical school in the early 1940s, his understanding of the physician’s role was to try to relieve the suffering of individuals who asked for, and accepted, medical help. He quickly formed the view that psychiatrists were committing a grave moral wrong by imprisoning and coercing people who neither sought nor wanted their “help.” This simple, yet profoundly humanist view became, and remains, his raison d’être.

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The Psychologist, UK: Madness, Myth and Medicine—the continuing relevance of Thomas Szasz, now in his 91st year

Monday, August 2nd, 2010

The Psychologist

by Ron Roberts

Only after we abandon the pretense that mind is brain and that mental disease is brain disease can we begin the honest study of human behaviour and the means people use to help themselves and others cope with the demands of living (Szasz, 2007a, p.149).

Fifty years ago American Psychologist published a seminal article by the Hungarian-born psychoanalyst and psychiatrist Thomas Szasz, “The myth of mental illness” (Szasz, 1960). The thesis was elaborated at length in a book of the same name a year later (Szasz, 1961).

As the decade got into full swing, Szasz’s critique of psychiatric theory and practice was herded into the same conceptual basket as the musings of Scottish psychiatrist R.D. Laing, and his erstwhile friend and collaborator David Cooper. The quite different ideas of these men came to be bracketed inappropriately under the rubric of “anti-psychiatry”—an expression coined by Cooper though disclaimed by Laing and rejected outright by Szasz.

Since then biological psychiatry has developed a stranglehold on research, teaching and practice in the field of “mental health,” and Szasz’s opposition to psychiatry and the basis for it has been mislocated in the art and culture of the day, its relevance for today denied. Szasz’s view has become viewed by many as a supposed child of its time—a component in the social manufacture of the so-called anti-establishment Swinging Sixties. To let such misapprehension pass unchallenged into the history of the behavioural sciences would be a serious error, and Szasz for his part has constantly endeavoured to set the record straight.

First it must be said that Szasz’s insights into the shortcomings of conventional psychiatry pre-date the 1960s by some considerable margin. In a brief autobiographical sketch Szasz makes clear that the absurdity of psychiatric fictions had dawned on him long before Fellini’s masterpiece was highlighting the shallowness of La Dolce Vita: “Everything I had learned and thought about mental illness, psychiatry, and psychoanalysis—from my teenage years, through medical school, and my psychiatric and psychoanalytic training—confirmed my view that mental illness is a fiction; that psychiatry, resting on force and fraud is social control, and that psychoanalysis—properly conceived—has nothing to do with illness or medicine or treatment.” (2004, p.22)

Szasz graduated in medicine in 1944, having migrated to the US from his native Hungary in 1938, a fugitive from the looming menace of Nazism. He undertook a psychiatric residency and trained in psychoanalysis. The appeal of psychoanalysis, besides its intellectual and interpersonal attractions, lay in its ostensibly consensual and contractual nature. Less well known than his other works, his dissection of power in psychoanalytic relationships—published as The Ethics of Psychoanalysis (Szasz, 1965)—is central to his thinking and stands complementary to the assertions that mental illness is a myth. In this Szasz effectively provides a practical guide on how to ensure a level playing field in psychotherapeutic relationships, to the benefit of both parties. He is honest and open enough to explicitly explore the role that money may play in distorting therapeutic means and ends. As such, it not only stands the test of time but stands squarely against the numerous vested interests, both pharmaceutical-financial and professional, which dominate the mental health industry past and present

Anti-psychiatry or pro-consent?
Szasz is not “anti”-psychiatry. He advocates the right to agree consensual contractual relations of any kind, including consensual psychiatry if that is what suitably informed people want. He has proposed, for example, the use of advanced psychiatric directives whereby people could agree to accept or refuse specific interventions to be made “on their behalf” in the event of their becoming extremely distressed and “irrational” in future. Such ideas have unfortunately been rejected outright by leading figures in both psychiatry and medical ethics, and accordingly Szasz sees little possibility of any kind of consensual psychiatry until the use of coercion, whether explicit or tacit, is relinquished.

As psychiatry continues to function for the most part as an extension of the criminal justice system, Szasz asserts that psychiatry in its current form must be abolished. This would require a concerted challenge to its support structures, premised as they are on the notions of behaviour as disease, the fear of dangerousness and the necessity for medical treatment under the guise of protecting the individual from his or herself. The championing of the latter notion in particular owes much to an ignorance of its origins. A careful reading of Szasz’s historical analysis of the origins of the insanity defence in 17th-century England goes some way to clarifying where behavioural scientists got the idea from that people of “unsound mind” were not responsible for their actions and could not be held accountable for them. In Coercion as Cure, he writes

With suicide defined as a species of murder, the persons sitting in judgment of self killers had the duty to punish them. Since punishing suicide required doing injustice to innocent parties… the wives and minor children of the deceased—eventually the task proved to be an intolerable burden. In the seventeenth century, men sitting on coroners’ juries began to recoil against desecrating the corpse and dispossessing the suicide’s dependants of their means of support. However, their religious beliefs precluded repeal of the laws punishing the crime. Their only recourse was to evade the laws; The doctrine that the self-slayer is non compos mentis and hence not responsible for his act accomplished this task (Szasz, 2007a, p.99)

And so a social practice became reified into an imaginary biological disease process ravaging through the brains of its unfortunate victims, necessitating psychiatric intervention!

The label of “anti-psychiatry” that continues to be attached to Szasz is one which he has been at pains to condemn (Szasz, 2009), used as it is to stultify and nullify any criticism of contemporary psychiatry. While Laing saw himself as “essentially on the same side” as Szasz (Mullan, 1995, p.202), Szasz sees considerable distance between them, for a number of reasons. Perhaps at the forefront of these Laing was known to have forcibly drugged one of his patients (Szasz, 2008) and for all his eloquence and insight into human misery his writings do not in principle condemn the forced treatment or incarceration of people against their will on psychiatric grounds. Finally whilst The Divided Self (Laing, 1960) and Sanity Madness and the Family (Laing & Esterson, 1964) amongst other outpourings proclaimed the intelligibility of going mad within a human rather than biological framework, Laing did not reject outright the notion of mental illness, which in Szasz’s view remains at best a metaphor.

Szasz has throughout his career stood firmly to his principles and steadfastly eschewed psychiatric practice in an environment where people have been deprived of their liberty. He has on occasion appeared in court both to represent individuals deprived of their liberty and to uphold the principle of criminal responsibility in murder cases where those accused have sought to evade it through the insanity defence (see Szasz, 2007b, chapter 13 in particular). Such consistent challenges to institutional psychiatry have been made at some professional cost. Szasz has not simply been the recipient of fierce criticism from the psychiatric fraternity, who feel betrayed by his actions, but has also endured attempts to limit his academic freedom. In the aftermath of the publication of The Myth of Mental Illness, for example, attempts were made to ban him from teaching at the state hospital medical school—citing his beliefs as “proof” of his “incompetence as a psychiatrist” (Schaler, 2004, p.xix).

Some confusion about Szasz’s work has arisen through the quite different political cultures within which it is interpreted, even by those who oppose institutional psychiatry in its current incarnation. His work has been claimed and repudiated by those on both the “left” and “right”—deemed a liberal in some quarters and a fascist in others—with the claims and counterclaims rooted in the predilections of the critics for different configurations of state power. European intellectual tradition on the left, for example, clings to a belief and a desire that state power can be harnessed for the good. This means that while Szasz’s attacks on psychiatric authority are applauded, his admonitions against the “therapeutic state” (Szasz, 2001, 2002), with its merging of psychiatric and state power on the one hand and private and public health on the other, are glossed over. In truth, if such a thing can be said, Szasz’s ideas belong to neither the right nor the left. His work challenges and questions all operations of organised power from the state downwards, as long as they are used to crush and oppress human freedom. His work implies unanswered questions concerning theforms of community and social organisation which people can harness for the individual and common good in order to enable them to deal elegantly with the insatiable demands of living.

Addendum
While preparing this article I encountered Philippe Petit’s (2002) wondrous account of his high-wire walk across the twin towers of the World Trade Center in 1974. Immediately after performing his “artistic crime of the century” Petit was arrested and subject to psychiatric examination. Petit was judged to be sane, but the outcome of the psychiatric interview is less revealing than the fact that psychiatrists were willing to play their part in a pseudo-medical intervention provoked by nothing more than social rule breaking of the highest imaginative order. It struck me that Petit—an imaginative, unusual and beguiling figure—exemplifies much that modern psychiatry stands in antipathy to. Petit cares not for the rules and regulations that structure and govern the lives of citizens and lives, in his terms, only to dream “projects that ripen in the clouds”(Petit, 2002, p.6). There can be little doubt that psychiatry is an enterprise that is engineered to destroy these—that it cannot tolerate idiosyncrasies of thought, whether grandiose or mundane. Petit succeeded in his outlandish and highly improbable quest—but why should one have to achieve outlandish success to be embraced by society and enjoy the right to pop one’s head in the clouds or spend the “afternoons in treetops”? Szasz’s efforts over the years can be seen in many lights, but without doubt he has toiled on behalf of the dream of human accountability and responsibility, for the freedom to be different and to take charge of one’s life, free from the machinations of state sponsored psychiatric interference.

Read the article here:  http://www.centerforindependentthought.org/Psychologist_article.html

Dr. Thomas Szasz is also the co-founder of CCHR.  For more on Thomas Szasz, including his CV, quotes, video, accolades and his relationship with CCHR, click here:

http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

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50 Years Ago Thomas Szasz Rocked The World of Psychiatry: The Difference Between A Disease and a Disorder

Thursday, March 4th, 2010

By Dr. Jeffrey Schaler
Assistant Professor of Justice, Law & Society
March, 2010

The Myth of Mental Illness by Thomas SzaszIt is fifty years now since Thomas Szasz rocked the world of psychiatry by writing The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. His work continues to have a profound impact on how we think about disease, behavior, liberty, justice, responsibility, and most important of all, what it means to be human.  Szasz has shown us how the idea of mental illness is used by the state to deprive innocent people of freedom, and guilty persons of justice.  Without the state involved, the medicalization of behavior means nothing.

He has shown us how the idea of mental illness functions as legal fiction within our legal system. In this sense, the idea of mental illness has been used much as the idea that African American slaves were considered three-fifths of a person. Persons labeled as mentally ill are now considered three-fifths of a person. It is as if there was a postscript at the bottom of the Bill of Rights that reads: “PS: For mentally healthy people only.”

The courts will not allow the idea of mental illness to be disproved, in much the same way that the idea that slaves could be three-fifths person was not allowed to be disproved. Today, mental illness as legal fiction maintains the institution of psychiatric slavery.

The Theraputic State by Thomas SzaszMental illness diagnoses have more to do with politics and science fiction, than medicine and science. Take for example the idea that people with a homosexual orientation are mentally ill. The category was excluded from the Diagnostic and Statistical Manual of Mental Disorders – our contemporary “Malleus Maleficorum,” or “Hammer of Witches” – the same way it was included, for political reasons, not scientific reasons. No one discovered that homosexuality was a disease, and no one discovered that it isn’t a disease. They pronounced it as such, in each case, because of political pressure.

About two years after The Myth of Mental Illness was first published, Szasz published another book that has had an equally profound impact on freedom and responsibility. In Law, Liberty and Psychiatry he predicted the following:

“Although we may not know it, we have, in our day, witnessed the birth of the Therapeutic State. This is perhaps the major implication of psychiatry as an institution of social control.”

Thomas Szasz wrote that in 1963.

We live in a Therapeutic State today. Moral management now masquerades as medicine. The state dictates a “duty to be healthy.”

Seventy years ago another state, Nazi Germany, dictated a “duty to be healthy.” Back then, murder masqueraded as medicine. I think you all know what I’m referring to. We don’t need a weatherman to know which way the wind blows.

Today, good health practices have become a social responsibility. Bad health practices are viewed as socially irresponsible behavior. When health and illness are applied to the mind and behavior, this means that people must think and speak and act the right way. Otherwise, they may end up in a prison called a mental hospital.

I am one of the few college professors in the United States, if not in the world, who teaches Szasz’s ideas on a regular basis in college. And in every course, my students have always said at least two things to me: This stuff by Szasz is changing my life. And why hasn’t anyone ever taught his work in class before?

Because professors are punished for teaching Szasz; they can lose their jobs if they do so. I know. I have the scars to prove it. If you read my book, Szasz Under Fire, you will see how the same thing almost happened to Thomas Szasz. He came a hair away from being fired for teaching Thomas Szasz!

The Myth of Mental Illness and the subsequent Law, Liberty and Psychiatry are not so unsophisticated as to deny the existence of behaviors that people find disturbing. Quite to the contrary, Szasz’s writings clarify the difference between behavior and disease, description and explanations for behavior, and the consequences of labeling behavior as a disease within the arenas of law, medicine, social and public policy.

Szasz has simply pointed out what pathologists have always known: A disease refers to cellular pathology. Period. A behavior cannot be a disease. And he has also fought endlessly for the rights of persons labeled mentally ill. He will be ninety years old on April 15. He is still writing one book after another. He writes books faster than I can read them!

He has also shown us how behavior is strategic, the expression of what philosophers call moral agency. Today’s neuroscientists, psychiatrists and clinical psychologists have attempted to reduce man to the category of things. They deny the existence of moral agency. Let me give you one simple example of how this is so.

Conventional wisdom, particularly as it appears in the media, leads people to believe that brains cause behavior, as if the brain could act. Psychiatrists and the neuroscientists they aspire emulate, regard man as a machine, an incredibly complicated machine, but a machine nevertheless. Everything that is human is ultimately reducible to electrical and chemical interactions.

This is especially so when it comes to socially unacceptable, abnormal, disturbing and criminal behavior. Bad brains are said to cause bad behavior. Bad brains, in this, sense refers to problems in the structure and function of the brain.

Now if bad brains cause bad behavior, it only follows that good brains must cause good behavior. In other words, brains that work correctly, brains that are structurally and functionally healthy, cause good and admirable behaviors.

While psychiatrists try to excuse bad behaviors by ultimately blaming bad brains, they inadvertently (or perhaps intentionally) are removing personal responsibility for the good things that people do. When someone commits a heroic deed, for example, shows courage, compassion, and care for others at great personal expense and with great risk of danger, the person is then not choosing to do what is clearly important to do.

The brain, according to this way of thinking, is causing the person to do this good thing, in the same way that a bad brain causes someone to prey on others. There is no need to praise someone for his altruism, heroism, and courage, his brain made him do it.

Some psychiatrists have equated human behavior with seizure activity: An alcoholic reaching for that drink too many is having an epileptic seizure. So is the mother sacrificing her own life for the life of her child.

What is left of the person, if this is so? What is left of the person if brains cause bad and good behavior? What is that represented by the pronoun “I?” What happens to moral agency?

Nothing. From this way of thinking, human beings are reduced to the category of things. Things do not choose, they are caused. Things do not feel. Things are not alive. Things have no conscience, no values, no morality, no ethics. And most important, things do not care, for self or others.

This is the legacy of psychiatry and neuroscience today, when it comes to entertaining biological explanations for behavior. Mind is equated with brain, behavior with disease, good with bad, morality with medicine, and ethics with mechanics. In other words, there is no soul. That which we consider uniquely human is destroyed by psychiatry and neuroscience.

How does this fit into law? Through a simple equation. Liberty and responsibility are two sides of the same coin. If we increase one, we increase the other. If we decrease one, we decrease the other. The more free man is, the more responsible he must be. The more responsible man is, the more he is captain of his own ship.

What institutional psychiatry as an extension of the state would have us believe is this: The more we decrease responsibility, the more we increase freedom. In other words, the more you allow us to be in charge of your life, the more you abdicate responsibility, the more you embrace the paternalism we say is good for you, the more you will be free. For obedience to authority is the greatest political virtue.

What then must we do? Szasz has done his job, what is ours? I believe our job is this: We get psychiatry out of the courthouse. We do not need to destroy psychiatry. It will destroy itself if we sever its invisible umbilical cord to the mother-state. Once psychiatry is available to people by choice only, it will die a natural death. Very few people will seek out psychiatrists if they cannot hire and fire them at will.

Psychiatrists know this. That is why they are so afraid of Thomas Szasz.

And that is why they are so afraid of those who understand what I am saying here. As I tell my students every semester, “don’t believe a word I say. Just think about it and come to your own conclusion.” That kind of independence and autonomy scares institutional psychiatrists and those who run the therapeutic state.

It should.

Jeffrey A. Schaler is an assistant professor of justice, law, and society at American University’s School of Public Affairs in Washington, D.C. Professor Schaler’s work is focused on the “therapeutic state”—the union of medicine and state. He completed his doctoral and master’s degrees in human development at the University of Maryland College Park, where the major emphasis of his research was addiction and social policy. Dr. Schaler is particularly interested in how research in the behavioral sciences is interpreted and applied in public, social, and legal policy arenas. He writes and speaks extensively on the relationship between liberty and responsibility.

Dr. Thomas Szasz is a Professor of Psychiatry Emeritus, State University of New York. He is a well known critic of the moral and scientific foundations of psychiatry and has authored more than 30 books on the subject including the Manufacture of Madness, The Myth of Mental Illness and The Therapeutic State. He is the co-founder of the Citizens Commission on Human Rights (CCHR) and has said of the organization, “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.”

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