Other groups among anti-psychiatrists have motivations which Szasz may not have shared (he wasnt a Scientologist), but he shared their goals. But before outlining my various misgivings, please note that I share Szaszs contempt for the vulgar misconception that . He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University in Syracuse, New York. Szasz traces psychiatry's origins to the widespread use of private madhouses in England, where relatives would send their unwanted family members (see Parry-Jones's ( The Trade in Lunacy ). The Medicalization of Everyday Life offers a no-nonsense perspective on contemporary dogma. Moreover, to the best of my knowledge, Laing never committed anyone to a mental hospital after The Divided Self was published in 1960. It is worth noting though that one can be materialist without being eliminative. That's not what diseases are." Or a cardiologist who claims that there is no heart disease. Admittedly, Szaszs way of framing things has a stark Manichean verve and simplicity that appeals to radical individualists and libertarians. Dr. Szasz is psychiatrist/psychoanalyst, is he not? 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. Existential-integrative psychotherapy, developed by Kirk Schneider(2008), is a relatively new development within humanistic and existential therapy. Today, protecting the mental patient from himself the anorexic from starving to death, the depressed from killing himself, the manic from spending his money is regarded as one of the foremost duties of anyone categorized as a mental health professional, psychoanalysis included. (p.6). 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. We have no right to impugn the mental health of people who take their lives voluntarily in such circumstances, rather than impoverish and inconvenience their families, or placate the kinds of medical professionals who have convinced themselves that they know better than their terminal patients what is good for them, etc., but lack the decency and insight to let them be. Wolf's discussion of the work of Thomas Szasz and its relation to existential analysis. The Medicalization of Everyday Life offers a no-nonsense perspective on contemporary dogma. 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. Szasz consistently paid attention to the power of language in the establishment and maintenance of the social order, both in small interpersonal and in wider social, economic, and/or political spheres: The struggle for definition is veritably the struggle for life itself. Contributions are invited in areas of philosophical and psychological . If they do, it is because of his mental illness. Admittedly, mental illness, can provoke, prolong or intensify existing conflicts, and even add new ones to a patients life. Consequently, in The Wing of Madness: The Life and Work of R.D. And I am not the first to say so, of course. I know there are many pro-Szasz ideologues out there, especially among some strident anti-psychiatry groups. 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. There is a plenty of muddle in the middle, on which reasonable people are likely to disagree. This is simple postmodernism, held by Foucault most famously, among others, at the same time as Szasz came of age. For more than half a century, Thomas Szasz has devoted much of his career to a radical critique of psychiatry. 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. So was Laings (more or less contemporaneous) abuse of his erstwhile friend and collaborator, Aaron Esterson, with whom he co-authored Sanity, Madness and the Family, and who, in due course, became Dr. Szaszs dear friend. Well, as anyone familiar with his life knows, Laing was no saint. Similarly, the state should not be able to interfere in mental health practices between consenting adults (for example, by legally controlling the supply of psychotropic drugs or psychiatric medication). (Pies trained under Szasz but developed an independent critical position of Szasz' views, while holding him in esteem personally). This is self-congratulation concealing personal and professional self-aggrandizement. In that line of thinking, schizophrenia becomes not the name of a disease entity but a judgment of extreme psychiatric and social disapprobation. One of his patients, himself a psychiatrist, committed suicide 6 months after beginning treatment with Szasz, who stopped the patients lithium for manic-depressive illness. Being a mental health professional, even a very famous one, confers no special insight or immunity when it comes to the averting the anguish, conflict and confusion that engulf so many families. The Hungarian-American psychiatrist and writer Thomas Szasz, who has died aged 92, was regarded by many as the leading 20th- and 21st-century moral philosopher of psychiatry and psychotherapy.. And since my early twenties, I have researched the marital and family lives of Freud, Jung, Klein, Erikson and others research which confirms my initial impressions a hundred fold. People whose lives are full of harmonious co-operation with others do no seek and are not subjected to mental health services (p. 7). He was, however, criticised by existential analysts for his ideological convictions and unwillingness to declare himself an existentialist (Hetherington, 2002; Wolf, 2002). Another personal aspect to Szasz life that is mentioned rarely is that his first wife likely had a psychiatric disease. "[13]:85 He maintained that, while people behave and think in disturbing ways, and those ways may resemble a disease process (pain, deterioration, response to various interventions), this does not mean they actually have a disease. It is published biannually. But they held that some people have psychiatric diseases. [9], Szasz first presented his attack on "mental illness" as a legal term in 1958 in the Columbia Law Review. Mental health clinicians are trained to navigate discussions about self-harm. For Szasz, given his personal biography, such differences may have been difficult to distinguish. Perhaps not . An analysis of the conceptual dichotomy between 'mental illness' and 'brain disorder' that exists in the work of Thomas Szasz, and how this dichotomy relates to the concept of mental . 2, https://en.wikipedia.org/w/index.php?title=Thomas_Szasz&oldid=1152649769. His wife, Rosine, died in 1971. 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. In Szasz's view, people who are said by themselves or others to have a mental illness can only have, at best, "problems in living". Required reading for all professionals in health care fields, and all those who are subject to their unwitting prejudices. But at the end of the day, Szasz and Laing are not cut from the same cloth. Even if a disease existed though, whether. Dr. Thomas Szasz 19202012. Thomas Szasz has publicly challenged the excesses that obscure reason. If existentialism has been used as a pretext to violate human dignity, we can (and should) protest. The figure of the psychotic or schizophrenic person to psychiatric experts and authorities, according to Szasz, is analogous with the figure of the heretic or blasphemer to theological experts and authorities. But this is not one of them. Depression wasnt a reflection of not-good-enough early childhood experiences, as they speculated. As to the solutions for its errors, better guides have existed, like Jaspers and Frankl and Havens. He would have to revise his claims so as to admit that schizophrenia and manic-depressive illness are medical diseases. Insanity was a legal tactic invented to circumvent the punishments of the Church, which at the time included confiscation of the property of those who committed suicide, often leaving widows and orphans destitute. Depression: Goodbye Serotonin, Hello Stress and Inflammation, How Blame and Shame Can Fuel Depression in Rape Victims, Getting More Hugs Is Linked to Fewer Symptoms of Depression, Interacting With Outgroup Members Reduces Prejudice, You Can't Control Your Teen, But You Can Influence Them. 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. Diagnoses of "mental illness" or "mental disorder" (the latter expression called by Szasz a "weasel term" for mental illness) are passed off as "scientific categories" but they remain merely judgments (judgments of disdain) to support certain uses of power by psychiatric authorities. "Mental illnesses" are really problems in living. In short, not one, but both of the tacit assumptions embedded in the term mental illness are tendentious, and at variance with one another. 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. Enfant terrible of psychiatry and widely known as one of its most indefatigable as well as iconoclastic critics, Thomas Szasz (1961-2012) had a prolific writing career that extended some 51. It would be to easy to say that both perspectives are partly correct, though they likely are. O ne place to begin such a reconsideration is by returning to a minor New York county courthouse in May 1962. 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. Szasz admits as much when he writes: The psychoanalysts job is to help his client live as honestly and responsibly, and hence as freely, as he can or wants to. Perhaps the most charitable thing one can say on behalf of Szaszs case against Laing is to render the old Scottish verdict: Not proven. Thomas Szasz is professor emeritus of psychiatry at the State University of New York Upstate Medical University, Syracuse, New York. 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. 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. Psychiatry's main methods are assessment, medication, conversation or rhetoric and incarceration. This broad definition of the therapists task could apply with equal validity to the services of a prostitute or a hired assassin, and therefore stands in stark contrast to Szaszs repeated insistence that the analytic dialogue is an ethical one. But a disciplined and reasoned critique of psychiatry today cannot rest on the same viewpoints Szasz put forward half a century ago. Request Permissions. Bipolar disorders have a high rate of misdiagnosis; ultra-rapid cycling adds another layer of misdiagnosis potential. In the end, Szasz life and work reflect the vagaries of the psychiatric profession itself, as it has lunged from error to error, to the glee of its critics. 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. How Does Ketamine Work Differently from Other Psychedelics. Thomas Szasz obituary | Mental health | The Guardian 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. [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. 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]. Szasz is a libertarian, Laing an existentialist, and despite their similarities on important points, libertarians and existentialists also diverge on a number of issues, as I hope to show in the pages that follow. A collection of essays by one of the most influential and original thinkers of our generation. After I wrote the foreword, the editors rejected it. These two cases, different as they are, are relatively clear cut, while many others we could mention occupy an intermediate position, and are anything but clear. Many cannot weep because they do not feel anything. Szasz is quite right that psychotherapy ceases to be psychotherapy when an element of coercion however benignly intended enters into it. 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 . Robert Evan Kendell presents (in Schaler, 2005[38]) a critique of Szasz's conception of disease and the contention that mental illness is "mythical" as presented in The Myth of Mental Illness. The Existential-Humanist Perspective . If it were not so dismally commonplace, one might infer that its use is indicative of a thought disorder. [9] Open Forum: Evolution of the Antipsychiatry Movement Into Mental Health Psychiatrists are the successors of "soul doctors", priests who dealt and deal with the spiritual conundrums, dilemmas, and vexations the "problems in living" that have troubled people forever. Of course not! In Ceremonial Chemistry (1973), he argued that the same persecution that targeted witches, Jews, gypsies, and homosexuals now targets "drug addicts" and "insane" people. The question then emerges: why does Szasz dredge up these sad tales of familial discord, and harp about Laings drinking, and other outbursts or excesses? Men have long been silent and stoic about their inner lives, but theres every reason for them to open up emotionallyand their partners are helping. 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. Szasz called schizophrenia "the sacred symbol of psychiatry" because those so labeled have long provided and continue to provide justification for psychiatric theories, treatments, abuses, and reforms. But there are many instances where breaking confidentiality will likely result in an involuntary commitment, or indeed, in criminal charges, with the result that people other than the therapist deprive the client of his liberty, with the result that the clients trust in the therapist is irrevocably shattered. Even if a disease existed though, whether psychiatric or not, he argued for a libertarian approach to practice. Pop culture's most prominent depiction of OCD was among its worst. Set against our anxiety-avoidant times, life-enhancing anxiety enables us to live with and make the best of the depth and mystery of existence.. Why? That line reads: When I certify someone insane, I am not equivocating when I write that he is of unsound mind, and may be dangerous to himself and others, and requires care and attention in a mental hospital. The human body is subject to illnesses and disabilities expressed through somatic signs (like paralysis, convulsions, etc.) 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. Existential-Humanistic Institute, Inc. A California Benefit Corp, Musings on Being an Existential Psychotherapist, Track 1: Existential Therapy Foundations Certificate, Track 2: Experiential Training Course (Retreat Only), About Existential Therapy Training Retreat. In a 2009 interview aired by the Australian Broadcasting Corporation, Szasz explained his reason for collaborating with CCHR and lack of involvement with Scientology: Well I got affiliated with an organisation long after I was established as a critic of psychiatry, called Citizens Commission for Human Rights, because they were then the only organisation and they still are the only organisation who had money and had some access to lawyers and were active in trying to free mental patients who were incarcerated in mental hospitals with whom there was nothing wrong, who had committed no crimes, who wanted to get out of the hospital. One could still use psychological concepts even though one realizes that such notions are based in the brain. OUP is the world's largest university press with the widest global presence. For instance, as some authors note, Szasz held a humanistic approach to work with patients. If a public figure claims to have a psychiatric condition, then clinicians can discuss the topic. ); the second root can be found into cultural factors."[16]. New research examines emerging trait-based approaches to personality disorder. ", 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? According to Szasz, to understand the metaphorical nature of the term "disease" in psychiatry, one must first understand its literal meaning in the rest of medicine. His books include Law, Liberty, and Psychiatry, The Manufacture of Madness, Ideology and Insanity, Our Right to Drugs, The Myth of Psychotherapy, and Pharmacracy, all published by Syracuse University Press. because the greatest obstacle to success may be success. The state, searching for a way to exclude nonconformists and dissidents, legitimized psychiatry's coercive practices. Laing, whose life and work I have studied in some detail. Research reveals how therapists have to use themselves to do the work. Mental illness: Fact or myth? Revisiting the debate between Albert Recommended Article Julie Falk of SHP has conversations with six psychologists who represent a broad range of humanistic flavors, including (but not limited to) existential-humanistic, phenomenological, human science, constructivist, and transpersonal. Admittedly, by valuing life above the principle of confidentiality, we are making an ethical judgment the wrong one, in Szaszs view; the right one, in mine. While largely unknown outside of the academic community, Szasz's name inadvertently inspired those of two DC Comics characters: private investigator and crimefighter Charles "Question" Szasz and Batman foe Victor Zsasz. Of course not , even if you disapproved of your colleagues previous behavior toward his distressed child (as you should). Szasz's arguments have provoked considerable controversy over the past five decades. Thomas Szasz: The uncompromising rebel and critic of psychiatry It is based on a general philosophy of knowledge and science advanced by Heidegger in the 1920s and 1930s, with a foundation in the works of Nietzsche in the 19th century. 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. Philosophical Psychology, Overview | SpringerLink [29] Its founding was announced by Szasz in 1971 in the American Journal of Psychiatry[30] and American Journal of Public Health. Freud suggested that a detached expert who excises or replaces morbid tissue from the unconscious corpus of his patient represents the model for the listening and interpretive skills of someone charged with making the unconscious conscious. Szasz lives in an imaginary world where one and the same ethical principle the right to suicide, or to absolute confidentiality in all imaginable circumstances applies equally to all people, regardless of age, background and condition. 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. Thomas Szasz was one of those few and now joins the rest of those freedom fighters who belong to history.". This paper attempts to clarify Szasz's own political perspective. [11]:22. Admittedly, he carries this off with apparent conviction and great rhetorical skill. Was that judgment kind or fair? Thomas Szasz. They agreed that many people seek help from psychiatrists for problems of living, not diseases. He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University in Syracuse, New York. He accepted the existence of medical disease; he just denied such status to psychiatric diagnoses. Title: The handbook of humanistic psychology : theory, research, and practice / edited by Kirk J. Schneider, J. Fraser Pierson, James F.T. 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. I will not assert that in the 1970s and 1980s, as it shifted to a more biological perspective, psychiatry got mental illness right. . The medicalization of government produces a "therapeutic state", designating someone as, for example, "insane" or as a "drug addict". 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. In the 1970s, Szasz was claimed by existentialist psychotherapists as a fellow traveller, if not a full member of the clan (Hoeller, 1997, 2012; Stadlen, 2014). The orthodox position is that mental illness is a fact; critics argue that it is a myth. 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. We offer existential therapy certification and our yearly existential therapy training retreat for clinicians teaches E-H therapy skills to enhance therapeutic practice. For decades, Thomas Szasz has publicly challenged the excesses that obscure reason. Thomas Szasz Accolades "[25] The "nanny state" has turned into the "therapeutic state" where nanny has given way to counselor. Thomas Szasz: An Evaluation | Psychology Today Mental incompetence should be assessed like any other form of incompetence, i.e., by purely legal and judicial means with the right of representation and appeal by the accused. Hence the remark: Well, Ruskin Place or Gartnavel, whats the difference? This statement warrants our enthusiastic and unqualified assent. So these remarks, striking as they are, do not reflect his professional activities at the time. In his article he argued that mental illness was no more a fact bearing on a suspect's guilt than is possession by the devil. Let us say that you have a colleague who divorced and re-married, whose first family lives in a city several hundred miles from him. Laws are social constructions, not facts of nature. 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. The Myth of Mental Illness: Foundations of a Theory of Personal Conduct is a 1961 book by the psychiatrist Thomas Szasz, in which the author criticizes psychiatry and argues against the concept of mental illness. KW - Szasz [27] In the same vein as the separation of church and state, Szasz believes that a solid wall must exist between psychiatry and the state. His libertarian approach to life must have grown out of this painful personal experience with the Nazism which displaced him from his homeland in 1938, and the Stalinism which famously repressed his nation of origin in 1956. Verbal intercourse, especially, the psychoanalytic dialogue, entails existential intimacy, often more intense than sexual intimacy. Existential Perspectives of Psychopathy | SpringerLink [4] A distinguished lifetime fellow of the American Psychiatric Association and a life member of the American Psychoanalytic Association, he was best known as a social critic of the moral and scientific foundations of psychiatry, as what he saw as the social control aims of medicine in modern society, as well as scientism. Actually, "Jewish problem" was the name the Germans gave to their persecution of the Jews; "drug-abuse problem" is the name we give to the persecution of people who use certain drugs. If we take the pertinent historical evidence into account, this statement probably represented a vote of non-confidence in Anne Laings ability to restore her daughters emotional equilibrium, rather than an endorsement of involuntary hospitalization per se. This collection of impassioned essays, published between 1973 and 2006, chronicles Thomas Szaszs long campaign against the orthodoxies of pharmacracy, that is, the alliance of medicine and the state. And clearly, he meant it at the time. Elderly people, and those unfortunate souls who suffer from severe, chronic pain, or disabling and disfiguring diseases, who are experiencing a steady and irreversible deterioration in their quality of life, have every right to take their lives in the manner they choose, and at the time they choose, rather than leave their deaths to fate, or the impersonal ministrations of the medical profession, to decide.