The psychiatry that Szasz railed against in his most famous book was full of myths and was mostly false. In short, Laings intention was to impress upon the reader that he did not minimize the severity of distress or the potential harm entailed in a psychotic episode, but that he did not rate the sanity of normal (i.e. 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. Szasz was born to Jewish parents Gyula and Lily Szsz on April 15, 1920, in Budapest, Hungary. This paper attempts to clarify Szasz's own political perspective. 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. 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. Required reading for all professionals in health care fields, and all those who are subject to their unwitting prejudices." from the same university in 1944. Judging from the testimony of Dr. Richard Gelfer, whom I interviewed in 1992, and who roomed with Laing and his family from 1957 to 1961, Laing probably composed these lines sometime in 1958 perhaps as late as 1959. By Thomas S Szasz Christina Richards Creative Inspiration and Existential Coaching 79 . From 1951 to 1953, Laing did his psychiatric training in the British Army, where he differentiated (to the best of his ability) between malingerers and those who were genuinely deranged, and therefore incapable of fighting in the Korean war. His main arguments can be summarized as follows: "Mental illness" is an expression, a metaphor that describes an offending, disturbing, shocking, or vexing conduct, action, or pattern of behavior, such as packaged under the wide-ranging term schizophrenia, as an "illness" or "disease". They agreed that many people seek help from psychiatrists for problems of living, not diseases. 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. Because in an ethical dialogue, the therapist must be able to take some critical distance from the interests of the client, as the client defines them, and help the client to do the same, if and when the clients perceived interests do not coincide with their deeper, human interests. Therapists should stick to their proper role and function, and not usurp the legal or medical professions practices or prerogatives. He accepted the existence of medical disease; he just denied such status to psychiatric diagnoses. 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. According to Szasz, many people fake their presentation of mental illness, i.e., they are malingering. If a public figure claims to have a psychiatric condition, then clinicians can discuss the topic. The effects of early trauma are increasingly proposed as the primary cause of later mental health problems. 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? EHI offers courses on the principles of existential-humanistic philosophy and practice, the inner search process, presence, subjectivity and encounter, the therapeutic relationship, and the responsibility of the therapist. . 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. Their opinions truly were myths. 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. 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. Second, to be confirmed as a disease, a condition must demonstrate pathology at the cellular or molecular level. 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. 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. [11]:22. 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, as Ronald Pies describes well, it wasnt false for the reasons Szasz thought it was false. 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. OUP is the world's largest university press with the widest global presence. The Nazis spoke of having a "Jewish problem". [6] Szasz completed his residency requirement at the Cincinnati General Hospital, then worked at the Chicago Institute for Psychoanalysis from 195156, and then for the next five years was a member of its staff taking 24 months out for duty with the U.S. 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. Two decades later, however, Gartnavel was under new management, and Laing had earned a reputation as the pre-eminent critic of mainstream psychiatry. Szasz's arguments have provoked considerable controversy over the past five decades. The problem is not the psychiatry is not medical enough, as Szasz argued; in fact today, there are plenty of pathological abnormalities in the brain that are connected to schizophrenia (like ventricular enlargement) and manic-depressive illness (like amygdala enlargement in mania and hippocampal atrophy with depression). Even if a disease existed though, whether psychiatric or not, he argued for a libertarian approach to practice. Szasz famously declared mental illness a "myth" and a "metaphor," arguing that psychiatry's diagnostic categories are only temporary stops on the road to "real" and "legitimate" bodily diseases. And like Szasz, I confess, I am thoroughly sick and tired of that simple-minded refrain. The medicalization of government produces a "therapeutic state", designating someone as, for example, "insane" or as a "drug addict". The iconic figures behind psychiatry's most consequential ideas. But as Erich Fromm was apt to point out, inner and interpersonal conflicts can also be symptomatic of health the manifest expressions of an intact and vibrant social conscience, of a desire for rational self-assertion, or a need to puncture the pretences and illusions that more complacent or conformist souls habitually mistake for truth (Burston, 1991). So these remarks, striking as they are, do not reflect his professional activities at the time. Szasz is quite right that psychotherapy ceases to be psychotherapy when an element of coercion however benignly intended enters into it. It is only one of several interpretive possibilities, and a pretty hostile one at that. Wolf's discussion of the work of Thomas Szasz and its relation to existential analysis. Award for Greatest Public Service Benefiting the Disadvantaged (1974), Szasz's conception of disease exclusively in terms of "lesion", i.e. This item is part of a JSTOR Collection. The good that men do may be interred with their bones, as Shakespeare's Marc Antony famously intoned over Caesar, but it also is true that the evil men do lives after them. ); the second root can be found into cultural factors."[16]. Just as a person suffering from terminal cancer may refuse treatment, so should a person be able to refuse psychiatric treatment. Donald Polkinghorne. Yet, they disagreed about the facts of mental illness. Szasz seems to engage in what philosophers call eliminative materialism, which is the view that once we have sufficient scientific knowledge, the language of the ordinary world (folk psychology) will be replaced by a scientific language. If it were not so dismally commonplace, one might infer that its use is indicative of a thought disorder. Confidentiality has limits, and the priest/confession analogy, which Szasz cites repeatedly, does too. [13]:85. He would have to revise his claims so as to admit that schizophrenia and manic-depressive illness are medical diseases. But the full meaning of this statement only becomes clear when it is juxtaposed with a subsequent (and equally emphatic) statement to the effect that many sane people, who are deemed competent by their peers (and prevailing community standards) pose a much greater threat to the safety and well-being of others than the average mental patient. The fantasy that it is or should be otherwise is just that a fantasy for which there is no logical or empirical justification. Thomas Stephen Szasz (/ss/ SAHSS; Hungarian: Szsz Tams Istvn [sas]; 15 April 1920 8 September 2012) was a Hungarian-American academic and psychiatrist. [33] In the keynote address at the 25th anniversary of CCHR, Szasz stated, "We should all honor CCHR because it is really the organization that for the first time in human history has organized a politically, socially, internationally significant voice to combat psychiatry. Why? 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. For some time now, Szasz has maintained that psychotherapy is an essentially ethical enterprise a secular cure of souls analogous, in some ways, to Catholic confession even though the analysts stance toward his patient/client, by Szaszs account, is more akin to the purely voluntary association between a Jewish rabbi and a fellow Jew than between a Catholic priest and his parishioner. 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 . Tragic as it was, her confinement to hospital was neither instigated nor approved by Laing, who was in London when it occurred, and was informed of her situation only after the fact. Thomas Szasz was perhaps the most influential critic of mental illness while Albert Ellis was one of the most influential psychotherapists of the twentieth century. To be clear, heart break and heart attack, or spring fever and typhoid fever belong to two completely different logical categories, and treating one as the other constitutes a category error. "[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. Szasz wrote: "If you talk to God, you are praying; If God talks to you, you have schizophrenia. 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. Szasz presents mental health professionals with two stark alternatives: he must choose between serving the interests of the client, as the client defines them; or serving the interests of the clients family or employer or insurance company, or the interests of his profession, religion, community, or the state, as they define them. The prospect of being a double agent, as Szasz calls it, and therefore, presumably, of betraying the clients trust and confidence isnt very appealing, of course. 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. 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. Does this constitute grounds for reproach? morphological abnormality, is arbitrary and his conclusions based on this idea represent, Szasz's criticism of syndrome-based diagnoses is divorced from a consideration of the, Szasz's contention that mental illness is not associated with any morphological abnormality is uninformed by genetics, biochemistry, and current research results on the, Szasz contends that, "Strictly speaking, disease or illness can affect only the body; hence, there can be no mental illness" and this idea is foundational to Szasz's position. 2, https://en.wikipedia.org/w/index.php?title=Thomas_Szasz&oldid=1152649769. Szasz also drew analogies between the persecution of the drug-using minority and the persecution of Jewish and homosexual minorities. And that to me was a very worthwhile cause; it's still a very worthwhile cause. 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. 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. The Medicalization of Everyday Life offers . Though I am not the first to say so, of course, the phrase mental illness is actually thundering contradiction in terms, which perpetuates and inscribes the Cartesian mind/body dualism in the discourse of the mental health professions. Mental health clinicians are trained to navigate discussions about self-harm. Depression wasnt a reflection of not-good-enough early childhood experiences, as they speculated. The collection of essays in the upcoming book on Szasz ignores more than it discusses. [9] That's not what diseases are." And clearly, he meant it at the time. Sleep Deprivation Is Bad News for Bipolar Patients, Why We Think That Everything Happens for a Reason, Adult-Onset ADHD Is Usually Something Else, How Therapists Use the Self During Therapy, The True Link Between Early Trauma and Adult Mental Health, Diagnosing Obsessive-Compulsive Personality Disorder, Nasal Spray vs. IV Ketamine for Depression, The Five Most Influential Psychiatric Thinkers of All Time. Psychology Today 2023 Sussex Publishers, LLC. [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. 1980 Oxford University Press One of the most respected and widely read professional journals in today's social sciences, Social Problems presents accessible, relevant, and innovative articles that maintain critical perspectives of the highest quality. Unbeknownst to your colleague, an estranged son or daughter from his first marriage experienced a severe romantic disappointment, and was hospitalized involuntarily. Hetherington (2002: 227-228) writes about Szasz as follows: . If existentialism has been used as a pretext to violate human dignity, we can (and should) protest. This passage warrants careful scrutiny. According to Szasz, despite their scientific appearance, the diets imposed were a moral substitute to the former fasts, and the social injunction not to be overweight is to be considered as a moral order, not as a scientific advice as it claims to be. If they do, it is because of his mental illness. Between the chronically ill or elderly adult who hopes to die with dignity and the anorexic teenager whose judgment is addled there are all kinds of intermediate cases that are more difficult to judge, at least on the issue of confidentiality. He maintained that, by calling people diseased, psychiatry attempts to deny them responsibility as moral agents in order to better control them. 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. [14] He thought that psychiatry actively obscures the difference between behavior and disease in its quest to help or harm parties in conflicts. In a long lifetime, as with most human beings, he never changed his mind on this matter or any other major aspect of his psychiatric beliefs. 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. [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 is sometimes, but not always, the case. 8, The Self and Humanistic Psychology. [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. 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. 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 . Rather, it is his rigid adherence to abstract ethical principles that admit of no exceptions, and that preclude the possibility of doubt or regret. In sum, one can be quite humanistic in ones approach to psychiatry without verging into the anti-psychiatric judgments, and extreme libertarianism, that characterized Szasz work. Laing, whose life and work I have studied in some detail. In his IFPE address of November 2, 2002, Szasz stated: Psychoanalysis possesses a valuable moral core that has never been properly identified and is now virtually unrecognized: it is, or ought to be, a wholly voluntary and reliably confidential human service, initiated and controlled largely by the client who pays for it (p.2). To keep this ethical relationship intact, says Szasz, the practitioner must confine his or her role to conversing with the client in the privacy of a professional office, and to completely refrain from meddling in their life outside it. Chapt. The Center for Independent Thought established the Thomas S. Szasz Award for Outstanding Contributions to the Cause of Civil Liberties.

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