It may be for any number of personal or professional reasons, including that one of my relatives was involuntarily hospitalized repeatedly for paranoid schizophrenia during my younger years, that I was drawn to the work of Thomas Szasz a long long time ago, even before I became a therapist. A psychiatrist and academic who wrote prolifically about the rights of those with “mental illness,” a term he rejected famously in his classic 1961 book The Myth of Mental Illness, Szasz died this week at the age of 92.
Mental illness is a metaphor (metaphorical disease). The word ‘disease’ denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term ‘mental illness’ refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. As the whale is not a fish, mental illness is not a disease. Individuals with brain diseases (bad brains) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad behaviors), like societies with economic diseases (bad fiscal policies), are metaphorically sick. The classification of (mis)behavior as illness provides an ideological justification for state-sponsored social control as medical treatment.
He was against not only involuntary mental hospitalization but also “psychiatric slavery” and the insanity defense. He was for the separation of psychiatry and state as well as the presumption of competence of psychiatric “defendants.” For more detail on any of these, click on the above Manifesto link.
Although Thomas Szasz continued to write throughout his life, A Lexicon of Lunacy (1993) is the most recent book I have of his. In it, he talks about the misuse of psychiatric language and states that “the entire vocabulary of psychiatry is pseudoscientific slang.”
Yes, I did stop keeping up with his writing—but his views on the words we use as well as his efforts against psychiatric coercion and the over-medicalizing of mental issues (or what he called “problems in living“) always stay with me.
The truth about mental health and psychiatry, I believe, is somewhere between Szasz and the current medical model. Jeffrey Oliver wrote an article called “The Myth of Thomas Szasz” that appeared in The New Atlantis in 2006. Interestingly, when asked to reflect on his legacy, Szasz tells the journalist that he really didn’t expect to have a significant impact on the field of psychiatry. He certainly knew, moreover, that conventional psychiatry had pushed him aside a long time ago. States Oliver:
Although Szasz’s critique often became a caricature, his intuition about the limits and deformations of modern psychiatry cannot be ignored. Many sick people have surely benefited from psychiatric treatment, both ‘talk therapy’ and pharmacotherapy. But psychiatry’s long history of error — from snake pits to ice baths to spinning chairs to electroshock to lobotomy — should give us pause. Skepticism is not backwardness, even if Szasz often took his skepticism to rhetorical extremes…
After forty years of comparing psychiatrists to the scum of the earth, Szasz now stands as one of the biggest obstacles to his own ideas. It is simply too easy to dismiss him as an axe-grinding zealot, a ‘musician who does not like music,’ as one critic put it. ‘The atheist who cannot stop speaking about God.’ But perhaps a new generation of critics will arise — aware of psychiatry’s achievements but also its limits, leading us not to extremes but to a much-needed reformation of psychiatry from within, and a much-needed de-medicalization of human life in the culture as a whole.
MORE THOMAS SZASZ (QUOTES)
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 God talks to you, you are a schizophrenic.
Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic.
Doubt is to certainty as neurosis is to psychosis. The neurotic is in doubt and has fears about persons and things; the psychotic has convictions and makes claims about them. In short, the neurotic has problems, the psychotic has solutions.
The concept of disease is fast replacing the concept of responsibility. With increasing zeal Americans use and interpret the assertion “I am sick” as equivalent to the assertion “I am not responsible”: Smokers say they are not responsible for smoking, drinkers that they are not responsible for drinking, gamblers that they are not responsible for gambling, and mothers who murder their infants that they are not responsible for killing. To prove their point — and to capitalize on their self-destructive and destructive behavior — smokers, drinkers, gamblers, and insanity acquitees are suing tobacco companies, liquor companies, gambling casinos, and physicians.
Suicide is a fundamental human right. This does not mean that it is desirable. It only means that society does not have the moral right to interfere, by force, with a person’s decision to commit this act. The result is a far-reaching infantilization and dehumanization of the suicidal person.
He who does not accept and respect those who want to reject life does not truly accept and respect life itself.
It is easier to do one’s duty to others than to one’s self. If you do your duty to others, you are considered reliable. If you do your duty to yourself, you are considered selfish.