The iconic figures behind psychiatry's most consequential ideas. Existential Analysis is a Journal of note in its specialist field and is known worldwide by those interested in reflecting on existential Admittedly, he carries this off with apparent conviction and great rhetorical skill. If so, that cannot be helped. Donald Polkinghorne. They agreed that many people seek help from psychiatrists for problems of living, not diseases. Nassir Ghaemi, M.D., M.P.H., is Professor of Psychiatry at Tufts University and Lecturer in Psychiatry at Harvard Medical School. The psychiatry that Szasz railed against in his most famous book was full of myths and was mostly false. [29] Its founding was announced by Szasz in 1971 in the American Journal of Psychiatry[30] and American Journal of Public Health. That is difficult to do not only because key terms (individualism, collectivism, coercion, freedom, contract) are vague and inconsistently used, but also because his assumptions about social life and the significance of language, although somewhat like those in symbolic interactionism, seem fundamentally nonsociological. Drug addiction is not a "disease" to be cured through legal drugs but a social habit. Szasz was a biological libertarian in psychiatry. Professor Thomas Szasz, iconic champion for liberty, pioneer in the fight against coercive psychiatry and co-founder of Citizens Commission on Human Rights, has passed away at the age of 92. To be critical is not necessarily a bad thing; criticizing ideas should not be seen as personal attacks; understanding a legacy has to take the bad with the good. Recommended New Article: Voices from and about HP education, 3rd World Congress of Existential Therapy, Salon Beyond the Individual: The Situation in Therapy, Lunch and Learn Change Through Movement, Unleashing Otto Rank: From Interpretation to Experience. I think not. Szasz is quite right that psychotherapy ceases to be psychotherapy when an element of coercion however benignly intended enters into it. Szasz view was all-or-nothing, without allowing for this nuance. AB - This essay traces Thomas Szasz's intellectual development from the social behaviourism of George Herbert Mead to a dramaturgic-existentialism which he used to reinforce and extend his critique of mental illness. Szasz had two daughters. Request Permissions. "One of the smartest and most thorough defenders of autonomy and liberty of our time.". Open Forum: Evolution of the Antipsychiatry Movement Into Mental Health So if we accept that mental illnesses are social constructions, as Foucault and Szasz argue, then the psychiatric profession is a mere rationale for enforcement of societys standards. The orthodox position is that mental illness is a fact; critics argue that it is a myth. To say that someone suffers from a mental illness implies that his or her malady is mental, rather than physical in nature, when more often than not, the patients affliction entails intense bodily suffering as well. Psychiatry is a pseudoscience that parodies medicine by using medical-sounding words invented especially over the last one hundred years. In calling attention to this issue, Szasz stands shoulder to shoulder with existentialists of all shades and stripes, and in various ways, has done for several decades. Thats all very well, some say. After I wrote the foreword, the editors rejected it. This does not mean that we should jettison our critical faculties, or blunt our ethical sensibilities in the process. Sept. 11, 2012 Thomas Szasz, a psychiatrist whose 1961 book "The Myth of Mental Illness" questioned the legitimacy of his field and provided the intellectual grounding for generations of. For more than half a century, Thomas Szasz has devoted much of his career to a radical critique of psychiatry. Besides his philosophy of disease, the other central feature of Szasz thinking is his libertarianism. The fact that none of this registers in Szaszs interpretation of Laings statement strikes me as very significant, and characteristic of his whole approach to Laing. Anyone who is well informed about Laings situation at the time will appreciate that his passivity was probably the result of a (more or less) rational appraisal of the situation, in which he balanced the possible benefits to Fiona against the probable harm to himself and his first family and doubtless, to his second family, who would share his shame and frustration if his efforts to help Fiona created an embarrassing media circus. And let us imagine that, for one reason or another, your colleague feels helpless to intervene on his estranged childs behalf without potentially doing harm to himself and others in the process. This paper attempts to clarify Szasz's own political perspective. Thomas Szasz is professor emeritus of psychiatry at the State University of New York Upstate Medical University, Syracuse, New York. [32], In 1969, Szasz and the Church of Scientology co-founded the Citizens Commission on Human Rights (CCHR) to oppose involuntary psychiatric treatments. It merely means that we give someones ideas as ideas a fair and impartial hearing, whether we approve of their behavior or not. I have worked alongside Dr. Fischer at Duquesne University for more than a decade, and can attest that the kind of collaborative psychological assessment she teaches to our graduate students who authored many of the articles in this issue of The Humanistic Psychologist does not take instances of inner or interpersonal conflict to be symptomatic of mental illness per se. When you take these mundane matters into account, Szaszs lofty appeal to principles, and his claim that Laing approved of involuntary hospitalization seems opportunistic or obtuse, to say the least. He is seen by his supporters, mostly citizens who are critical of the psychiatric system, as a courageous man who spoke out against the errors and excesses of his profession. 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. Chapt. Self-help is also included in humanistic psychology: Sheila Ernst and Lucy Goodison have described using some ofthe main humanistic approaches in self-help groups. But it does not compare to Nazism and Stalinism. Once a therapist commits a client to hospital against their will and wishes, they cease to function as a therapist, and must rely on some combination of medication, coercion and old-fashioned persuasion to get results. Get EHI News, Event Announcements, and E-H Therapy insights delivered to your inbox. This is quite misleading, because his daughter Fionas first hospitalization, in 1977, followed a break-up with her current boy friend. ", State University of New York Upstate Medical University, private investigator and crimefighter Charles "Question" Szasz, "Psychiatric diagnosis, psychiatric power and psychiatric abuse", "The myth of mental illness: 50 years later", "Psychiatry and the control of dangerousness: on the apotropaic function of the term "mental illness", "Secular humanism and "scientific psychiatry", "Law and psychiatry: The problems that will not go away", "The therapeutic state: the tyranny of pharmacracy", "Psychiatry, anti-psychiatry, critical psychiatry: what do these terms mean? Likewise, women who did not bend to a man's will were said to have hysteria. Through his remaining friends and colleagues in Glasgow, Laing was still fairly current with the situation at Gartnavel, and probably knew or strongly suspected that the new brass would greet any of his overtures or representations on Fionas behalf with cold hostility. Thomas Szasz Accolades Laws are social constructions, not facts of nature. As Szasz points out: In Freuds day, it did not occur to people least of all to lawyers or psychiatrists that it was an analysts duty to protect a client from killing himself. If (for whatever reason) a client clearly plans to maim or kill someone else, and his therapist neglects to inform the clients intended victim or someone else in a position to warn or assist them, the therapist becomes an accomplice to mischief or murder. 1, Concepts and Controversies in Modern Medicine: Psychiatry and Law: How are They Related? It probably is not irrelevant that Szasz was born in Budapest and left as an 18-year-old with his Jewish family just before World War II. Mental illness, he said, was only a metaphor that described problems that people faced in their daily lives, labeled as if they were medical diseases. He accepted the existence of medical disease; he just denied such status to psychiatric diagnoses. But on reflection, we really neednt even go that far. Finally, imagine that when you consider your colleagues behavior toward his first family, you hold him at least partially responsible for creating the familial instability that led to his childs breakdown, which resulted, eventually, in (his or her) hospitalization. '"[21], The "therapeutic state" is a phrase coined by Szasz in 1963. Thomas Szasz: An Evaluation | Psychology Today South Africa Admittedly, Szaszs way of framing things has a stark Manichean verve and simplicity that appeals to radical individualists and libertarians. A genuine disease must also be found on the autopsy table (not merely in the living person) and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association. 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. This tradition took all the humane approaches to patients found in the writings of Szasz, and more, and yet it did not reject the basic concepts of mental illness or psychiatric disease in the way Szasz did. In The Secular Cure of Souls (JSEA, issue 14.2), and a talk delivered to the International Federation for Psychoanalytic Education on November 2, 2002, entitled The Cure of Souls in The Therapeutic State, Thomas Szasz goes to great lengths to differentiate between himself from R.D. Bugental And he probably reckoned correctly, I think that if Fiona were released from Gartnavel, it would be into her mothers custody, not his. In his IFPE address (Szasz, 2002), for example, Szasz wrote that. pt. "No one has exposed the oppressive medicalization of human conflict and politicization of medicine as thoroughly and radically as Thomas Szasz. He was, however, criticised by existential analysts for his ideological convictions and unwillingness to declare himself an existentialist (Hetherington, 2002; Wolf, 2002). Two decades later, however, Gartnavel was under new management, and Laing had earned a reputation as the pre-eminent critic of mainstream psychiatry. It would be to easy to say that both perspectives are partly correct, though they likely are. In short, not one, but both of the tacit assumptions embedded in the term mental illness are tendentious, and at variance with one another. (Pies trained under Szasz but developed an independent critical position of Szasz' views, while holding him in esteem personally). [26], Believing that psychiatric hospitals are like prisons not hospitals and that psychiatrists who subject others to coercion function as judges and jailers not physicians,[28] Szasz made efforts to abolish involuntary psychiatric hospitalization for over two decades, and in 1970 took a part in founding the American Association for the Abolition of Involuntary Mental Hospitalization (AAAIMH). Szasz argued throughout his career that mental illness is a metaphor for human problems in living, and that mental illnesses are not "illnesses" in the sense that physical illnesses are, and that except for a few identifiable brain diseases, there are "neither biological or chemical tests nor biopsy or necropsy findings for verifying DSM diagnoses."[5]. Either all of the best clinical research in medicine is false since it is based on randomized placebo-controlled research, or Szasz is wrong. Mental health clinicians are trained to navigate discussions about self-harm. Another personal aspect to Szasz life that is mentioned rarely is that his first wife likely had a psychiatric disease. For Szasz, given his personal biography, such differences may have been difficult to distinguish. The Nazis spoke of having a "Jewish problem". 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 (from the Greek baros, for "weight"), was created to deal with those who erred from the medical norms concerning the weight the body should have. [8] Szasz had first joined SUNY in 1956. In fairness to Szasz, of course, there are indeed many instances when an individuals right of self-determination cuts against the grain of collective common sense. Thomas Szasz Thomas Szasz Born in hungry Spend most of his time in USA He started his career as a psychiatric Very quickly realize the psychiatric system is deeply faulty Wrote his first essay in 1960 which became famous Title is "The myth of mental illness"Szasz Myth of Mental illness This is not a conventional . In framing my objections to Szaszs attack this way, I hoped that a lucid and fair-minded acknowledgement of the pertinent historical and contextual data would help to make my case. Dr. Thomas Szasz 19202012. The Medicalization of Everyday Life offers a no-nonsense perspective on contemporary dogma. [36], Szasz was a strong critic of institutional psychiatry and his publications were very widely read. Because schizophrenia demonstrated no discernible brain lesion, Szasz believed its classification as a disease was a fiction perpetrated by organized psychiatry to gain power. On reflection, there is probably no more potent method for silencing dissatisfaction, dissent and the sense of having been violated or misunderstood than by treating (inner or interpersonal) conflict per se as symptomatic of mental illness. Szasz argues that the diagnosis and treatment of mental illness stands in the same relationship to the . Whether he would want to call them mental illnesses or not is a linguistic and conceptual matter, as Pies again describes. No one should be deprived of liberty unless he is found guilty of a criminal offense. This is the postmodernist perspective, enshrined in Michel Foucaults work (also based in the psychiatry of the 1950s), of psychiatrists as policemen, mere agents of societys laws. "Throughout his long life, he did not simply fight the good fight, he . Other groups among anti-psychiatrists have motivations which Szasz may not have shared (he wasnt a Scientologist), but he shared their goals. Consequently, in The Wing of Madness: The Life and Work of R.D. Life-enhancing anxiety is the invigorating degree of anxiety needed to become passionately engaged, ethically attuned, and creatively enriched. Laing, however, consciously decided not reply to Szasz, a task taken up instead by Leon Redler on behalf of the Philadelphia Association (PA). He argued that so-called mental illnesses had no underlying physiological basis, but were unwanted and unpleasant behaviors. Szasz believed that if we accept that "mental illness" is a euphemism for behaviors that are disapproved of, then the state has no right to force psychiatric "treatment" on these individuals. The Medicalization of Everyday Life offers a no-nonsense perspective on contemporary dogma. With this superb collection, the essence of Szaszs case against the Therapeutic State is now accessible to everyone. The falsehoods of Freud were replaced by the falsehoods of DSM-III in 1980. 1950s-60s US psychiatry was to the profession as 1950s-60s Soviet orthodoxy was to communism. He had previously suffered a fall and would have had to live in chronic pain otherwise. Meanwhile, framing the whole issue in such starkly adversarial terms, as Szasz does, is quite revealing, and there are many reasonable people who would shun the services of a mental health professional whose ostensible zeal on behalf of the clients interests pits them in adversarial struggle with others from the outset, as a matter of course. [9], Szasz first presented his attack on "mental illness" as a legal term in 1958 in the Columbia Law Review. So for the sake of clarity and emphasis, let me re-state my argument in the following, hypothetical terms. This statement warrants our enthusiastic and unqualified assent. He arrived in the US as an adult, whose whole character must have been stamped by his experience of totalitarianism. In surgery, all things being equal, doctor and patient are fungible. Positivism, Humanism, and the Case for Psychiatric Diagnosis - Medscape For instance, as some authors note, Szasz held a humanistic approach to work with patients. For decades, Thomas Szasz has publicly challenged the excesses that obscure reason. [26]:496 A secularization of God and the medicalization of good resulted in the post-Enlightenment version of this view: once people agree that they have identified the one true reason, it brings about that they have to guard against the temptation to worship unreason that is, madness. This action is uncommon for an invited essay, but I probably shouldn't have been surprised. University of Melbourne Library / All Locations But that is not the issue. It is quite true, as Szasz points out, that Szasz, Laing and Foucault are often lumped together indiscriminately as anti-psychiatrists by spokesmen for the psychiatric establishment, and indeed, by its critics as well. Existential perspectives in psychology are often associated with the humanistic movement and provide somewhat of a philosophical ground for it. Thomas Szasz and the language of mental illness Hetherington (2002: 227-228) writes about Szasz as follows: . Another way of saying this is that Szaszs emphasis on honesty, responsibility and freedom puts too much emphasis on the clients relationship to himself, at the expense of his being with (and for) others. But from 1956 till 1987, when his medical license was finally revoked, Laing hospitalized no one, to my knowledge, and worked diligently to create therapeutic communities that would function as viable alternatives to mental hospitals. 8, The Self and Humanistic Psychology. In addition to contemporaries R D Laing in the UK, the Canadian sociologist Erving Goffman, and the French philosopher Michel Foucault, Szasz provided much of the high octane intellectual fuel for the genesis of the . He considered suicide to be among the most fundamental rights, but he opposed state-sanctioned euthanasia. Pop culture's most prominent depiction of OCD was among its worst. Even if a disease existed though, whether. Unfortunately, however, Szasz employs a good deal of exaggeration and distortion to achieve his purpose. Szasz's inconsistencies and nonsociological underpinnings lead to a clear political bias in his own work, as well as provide a rationale for regressive social policies. [12][pageneeded]. Hysteria wasnt a fantasy of childhood libido, but a reflection, too often, of real-life sexual trauma. [22] The collaboration between psychiatry and government leads to what Szasz calls the therapeutic state, a system in which disapproved actions, thoughts, and emotions are repressed ("cured") through pseudomedical interventions. Bipolar disorders have a high rate of misdiagnosis; ultra-rapid cycling adds another layer of misdiagnosis potential. Medicalization of Everyday Life : Selected Essays, Paperback by Szasz Well, as anyone familiar with his life knows, Laing was no saint. This would be like a surgeon who claims that cutting into bodies is wrong. Anyone acquainted with Dr Thomas Szasz's previous writings about mental disorder, the nature of its relationship to the Law and to the problems of drug dependance (Szasz, 1961, 1963, 1970, 1972, 1975) has learned to look in the first instance for the dualism, the poles of which are to be demonstrated as irreconcilable. Moreover, to the best of my knowledge, Laing never committed anyone to a mental hospital after The Divided Self was published in 1960. As has been evaluated in a previous paper, Thomas S. Szasz redoubled his attacks against R. D. Laing in a series of articles which were published in The New Review (TNR) during the 1970s. A new study finds that 95 percent of late-onset ADHD cases arent ADHD. Thomas Szasz challenged mental health practice perhaps more than any other American psychiatrist in the decades after World War 2. I will not assert that in the 1970s and 1980s, as it shifted to a more biological perspective, psychiatry got mental illness right. Having said that, however, I strongly object to Szaszs contention that Constance Fischers introduction to the double issue of The Humanistic Psychologist (2002), which he cites briefly, implies a thoughtless endorsement of this way of thinking. In his Preface to the first edition of The Myth of Mental Illness (1961), Szasz wrote that he had a twofold purpose: Presumption of competence and death control, Abolition of the insanity defense and involuntary hospitalization, American Association for the Abolition of Involuntary Mental Hospitalization, Relationship to Citizens Commission on Human Rights, "The Nazis sought to prevent Jewish suicides. He was 30 or 31 years old at the time, and not obliged indeed, not even allowed to treat certifiable patients in the course of his clinical duties. His opponents, mostly card-carrying members of the psychiatric profession, see him as a stubborn fanatic. [35], In the summer of 2001, Szasz took part in a Russell Tribunal on human rights in psychiatry held in Berlin between June 30 and July 2, 2001. A collection of essays by one of the most influential and original thinkers of our generation. Therapists should stick to their proper role and function, and not usurp the legal or medical professions practices or prerogatives. This has never been done in human history before."[34]. To say that he sanctioned or approved of Fionas hospitalization, or used it to manage his first family is to put the worst possible construction on his behavior. He criticized the war on drugs, arguing that using drugs is in fact a victimless crime. O ne place to begin such a reconsideration is by returning to a minor New York county courthouse in May 1962. Indeed, in the preface to the Pelican edition of The Divided Self, Laing went so far as to say In the context of our present pervasive madness that we call normality, sanity, freedom, all our frames of reference are ambiguous and equivocal. Required reading for all professionals in health care fields, and all those who are subject to their unwitting prejudices.-- "Jeffrey K. Zeig, Director, The Milton . Philosophical influences on Thomas Szasz To underscore this continuation of religion through medicine, he even takes as an example obesity: instead of concentrating on junk food (ill-nutrition), physicians denounced hypernutrition. Szasz also argues in favor of a free market for drugs. "Jeffrey K. Zeig, Director, The Milton Erickson Foundation. Thomas Szasz: rebel with a questionable cause - The Lancet Thomas Szasz obituary | Mental health | The Guardian Prohibition itself constituted the crime. And in this spirit, I do not dispute Szaszs right to differentiate clearly between Ronald Laing and himself, provided the evidence supports his arguments. 2, https://en.wikipedia.org/w/index.php?title=Thomas_Szasz&oldid=1152649769. If it were not so dismally commonplace, one might infer that its use is indicative of a thought disorder. Rather, it is his rigid adherence to abstract ethical principles that admit of no exceptions, and that preclude the possibility of doubt or regret. On the contrary, his duties at the Tavistock Clinic and the Institute of Psycho-Analysis in London involved him with neurotics, the walking wounded, on a voluntary, out patient basis. In his 2006 book about Virginia 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. Why? Depriving a person of liberty for what is said to be his own good is immoral. Does this constitute grounds for reproach? By Thomas S Szasz Christina Richards Creative Inspiration and Existential Coaching 79 . Unlike the elderly, chronically ill or deeply disabled person, her horizons of possibility have been constricted, not by physical hardships and limitations, but by misguided beliefs, and/or by prevailing cultural beliefs or expectations, etc. Thinking Twice About Ultra-Rapid Cycling Bipolar Disorder. Szasz was a biological libertarian in psychiatry. perspectives. Our approach will be more phenomenological if we begin with a substantial quotation, as a precaution against quoting isolated phrases or sentences out of context. There are other better concepts. . Strange as it may sound, on the face of it, suicide in such circumstances can be an act of freedom, of transcendence over the blind cruelty of circumstances, a resounding affirmation, an existential statement: I am!. Since the foreword was rejected, I have decided to publish it here, in a slightly edited version so that it can stand alone, to make it available to interested readers: It is held that one should not speak ill of the dead, as they cannot defend themselves.
