Thomas Szasz

Essay on mutual relations between mental illness, social opression, genius, art and creativity. Contains references to ideas of Hans Prinzhorn, Cesare Lombroso, Michel Foucault and Thomas Szasz, as well as works of Paul Klee, Andre Masson, Adolf Wölfli, Jean Dubuffet and the like.

PSYCHIATRY AGAINT ITSELF:
Radicals, Rebels, Reformers, and Revolutionaries

A Philosophical Archaeology


Abstract

This essay inverts the logic of anti-psychiatry to describe various movements critical of the profession as psychiatry against itself. Like Alain Badiou’s contrast of philosophers with anti-philosophers, anti-psychiatrists compel the established tradition of psychiatry to confront fresh problems with new perspectives to renew psychiatric thought. The dual themes that emerge from this study are: tradition vs. innovation and negation vs. affirmation.

This thesis is threefold: (1) What is intriguing about the psychiatrists associated with the anti-psychiatry movement and what unites them is negation. In each case, their work proceeds by a key critical negation, to the point that the defining characteristic of anti-psychiatric psychiatrists is precisely negation. (2) Each negation and how it was practised made each anti-psychiatrist, depending on his temperament and circumstances, into a rebel, a radical, a reformer or a revolutionary anti-psychiatrist. (3) Each anti-psychiatrist wielded an instrument for change that I have coined Badiou’s sickle. Based on a key critical negation, each anti-psychiatrist resisted the suturing of psychiatry to a given subdiscipline, regional practice, or dominant ideology by separating it gently or more forcefully with Badiou’s scalpel, scissors, shears, scythe or sickle to liberate psychiatry as a general theory and practice and return it to its originary task. 

Four key 20th century Western psychiatrists who were critical of their field are examined through their basic attitudes and contributions to the redefinition of psychiatry. Scotsman Ronald David Laing (1927-1989) was a radical psychiatrist-psychoanalyst, returning psychiatry to its clinical roots, with his trenchant critiques of Ludwig Binswanger’s existential analysis and psychiatric practice generally, calling for social phenomenology, negating the mystification of mental illness by placing the suffering of the self in social, family, and political context. The French Jacques Lacan (1901-1981) was both a subversive psychoanalyst and a psychiatric rebel, affirming the centrality of Freud in his construction of psychoanalysis while rebelling against both the psychoanalytic and psychiatric establishment, negating the institutionalization of psychoanalytic practice, whether in the academy or in psychoanalytic institutes. Italian psychiatrist Franco Basaglia (1924-1980) was a reformer who instigated psychiatric deinstitutionalization around the world with his key text, L’Istituzione negata, “The Institution Negated” (1968) and by joining the Radical Party in the Italian Parliament that reformed Italy’s mental health legislation. As a psychiatrist, philosopher and revolutionary, Martinican Frantz Fanon (1925-1961) negated nothing less than the claim of European psychiatry to universalism in his radical critiques of the psychology of colonization and identity formation, offering a more humane psychology on which to found psychiatry in a revolutionary program for a new society. Fanon’s critiques were far more trenchant than other anti-psychiatrists, with far-reaching impacts on critical theory, post-colonial studies and Marxist political theory, yet his project remained unfulfilled when he died all-too-young, bequeathing us psychiatry’s unfinished revolution.

Two other critical thinkers are examined to complete this study. One is Hungarian-American Thomas Szasz (1920–2012) whom I characterize as a reactionary psychiatrist in the guise of a progressive who negated the reality of psychiatric disorders. Szasz trivialized mental and relational suffering as mere “problems in living,” arguing against the majority of psychiatric disorders having biomedical origins, thus promoting the medical model in its most reductive form. In contrast with the other anti-psychiatrists, Szasz’s negation was destructive, leading the way to greater stigmatization of mental illness and diminished resources and services. Finally, the work of French psychologist and philosopher Michel Foucault (1926-1984) overshadows the entire discourse of anti-psychiatry, just as he informs and impels us to reorder medical perceptions and psychiatric thought, upending the very “order of things.” Foucault’s negation was the most disturbing to psychiatric thought because he questioned the very basis for imagining madness and reason/unreason.

Debemos tener en cuenta que cuando hablamos sobre creencias ya estamos hablando de una percepción diferente de lo real, adentrándonos en el terreno de la fe, que en ciertos casos, sirve para justificar acciones irracionales en una obediencia ciega a una autoridad divina.
La religión como enfermedad mental. Reflexiones marginales. Revista virtual. Universidad Nacional Autónoma de México. Año 6. Número 34.
Agosto-Septiembre 2016
Estética de la mirada. ISSN 2007-8501. Disponible en: http://reflexionesmarginales.com/3.0/la-religion-como-enfermedad-mental/

Psychiatry against itself: Radicals, rebels, reformers & revolutionaries. A philosophical archaeology

Journal of The International Association of Transdisciplinary Psychology, December 2015, 4(1): 1-18.

Abstract

This essay inverts the logic of antipsychiatry to describe various movements critical of the profession as psychiatry against itself. Like Alain Badiou’s contrast of philosophers with anti-philosophers, anti-psychiatrists compel the established tradition of psychiatry to confront fresh problems with new perspectives to renew psychiatric thought. The dual themes that emerge from this study are: tradition vs. innovation and negation vs. affirmation.

This thesis is threefold: (1) What is intriguing about the psychiatrists associated with the anti-psychiatry movement and what unites them is negation. In each case, their work proceeds by a key critical negation, to the point that the defining characteristic of antipsychiatric psychiatrists is precisely negation. (2) Each negation and how it was practised made each anti-psychiatrist, depending on his temperament and circumstances, into a rebel, a radical, a reformer or a revolutionary antipsychiatrist. (3) Each anti-psychiatrist wielded an instrument for change that I have coined Badiou’s sickle. Based on a key critical negation, each anti-psychiatrist resisted the suturing of psychiatry to a given subdiscipline, regional practice, or dominant ideology by separating it gently or more forcefully with Badiou’s scalpel, scissors, shears, scythe or sickle to liberate psychiatry as a general theory and practice and return it to its originary task. Four key 20th century Western psychiatrists who were critical of their field are examined through their basic attitudes and contributions to the redefinition of psychiatry.

Scotsman Ronald David Laing (1927-1989) was a radical psychiatrist-psychoanalyst, returning psychiatry to its clinical roots, with his trenchant critiques of Ludwig Binswanger’s existential analysis and psychiatric practice generally, calling for social phenomenology, negating the mystification of mental illness by placing the suffering of the self in social, family, and political context. The French Jacques Lacan (1901-1981) was both a subversive psychoanalyst and a psychiatric rebel, affirming the centrality of Freud in his construction of psychoanalysis while rebelling against both the psychoanalytic and psychiatric establishment, negating the institutionalization of psychoanalytic practice, whether in the academy or in psychoanalytic institutes. Italian psychiatrist Franco Basaglia (1924-1980) was a reformer who instigated psychiatric deinstitutionalization around the world with his key text, L’Istituzione negata, “The Institution Negated” (1968) and by joining the Radical Party in the Italian Parliament that reformed Italy’s mental health legislation. As a psychiatrist, philosopher and revolutionary, Martinican Frantz Fanon (1925-1961) negated nothing less than the claim of European psychiatry to universalism in his radical critiques of the psychology of colonization and identity formation, offering a more humane psychology on which to found psychiatry in a revolutionary program for a new society. Fanon’s critiques were far more trenchant than other anti-psychiatrists, with far-reaching impacts on critical theory, post-colonial studies and Marxist political theory, yet his project remained unfulfilled when he died all-too-young, bequeathing us psychiatry’s unfinished revolution.

Two other critical thinkers are examined to complete this study. One is Hungarian-American Thomas Szasz (1920–2012) whom I characterize as a reactionary psychiatrist in the guise of a progressive who negated the reality of psychiatric disorders. Szasz trivialized mental and relational suffering as mere “problems in living,” arguing against the majority of psychiatric disorders having biomedical origins, thus promoting the medical model in its most reductive form. In contrast with the other antipsychiatrists, Szasz’s negation was destructive, leading the way to greater stigmatization of mental illness and diminished resources and services.

Finally, the work of French psychologist and philosopher Michel Foucault (1926-1984) overshadows the entire discourse of anti-psychiatry, just as he informs and impels us to reorder medical perceptions and psychiatric thought, upending the very “order of things.” Foucault’s negation was the most disturbing to psychiatric thought because he questioned the very basis for imagining madness and reason/unreason.

Szasz’s legacy involves two issues in current psychiatry: First, he criticized the concept of mental illness. The DSM-5 debate shows that psychiatry still suffers from unresolved conceptual problems. The definition of the general concept of mental disorder remains unclear. Specific classificatory entities (e.g., autism spectrum disorder) are notoriously contested. Second, he criticized coercive psychiatric practice. Recent developments suggest an ongoing identity crisis of psychiatry as a medical institution. Psychiatry’s tasks are partly related to societal interests (e.g., dealing with dangerous persons). Two psychiatric forms of intervention are therapeutic coercion and compulsion to prevent harm to others. Whether the latter can be squared with therapeutic purposes is unclear. To justify paternalistic interventions such as therapeutic coercion is difficult. Hence, there is enormous pressure on psychiatry’s medical identity. Szasz asked the right questions, not necessarily providing the most convincing answers. Psychiatry would benefit from a thorough, less prejudiced assessment of his publications.

The purpose of this analysis is to review and critique current US dual diagnosis theories and to apply a new methodology to dual diagnosis in the practical setting of everyday nursing care.  Although the term or concept of dual diagnosis has been around since 1985, it is only recently that new models of understanding this diagnosis have developed, not being a disorder of its own.

The DSM V changes diagnostic criteria for substance use disorders, placing them on a spectrum similar to the current autistic and schizophrenia spectrum disorders.  The net has been cast wider and nurses will encounter more patients with substance use disorders.  The general nursing discipline will have limited to the new diagnostic criteria.
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Tematem niniejszej antologii nie jest obłęd rozumiany w duchu Nervala. O nim traktowała w dużej mierze książka wydana w pierwszej serii „Biblioteki Romantycznej” – Ciemne drogi szaleństwa Aliny Kowalczykowej. Autorami tekstów zamieszczonych tutaj są wyłącznie ci, którzy „posługują się tym słowem «choroba»”. Najczęściej lekarze – twórcy rozpraw naukowych, opisów przypadków, ocen sądowych. Ale nie tylko. To również urzędnicy państwowi, autorzy ustaw dotyczących funkcjonowania szpitali publicznych, a także zarządcy szpitali prywatnych. Chciałam uwzględnić w ten sposób różne sposoby funkcjonowania i wykorzystania wiedzy medycznej – pokazać, jak stawiano diagnozy, jak przebiegało przyjmowanie obłąkanych do szpitala, jak ich tam traktowano i na podstawie czego orzekano o niepoczytalności. Psychiatrię jednak chciałam potraktować jako jeden z języków służących projektowaniu i podtrzymywaniu społecznego ładu.

April 2020 marks what would have been the hundredth birthday of Professor Thomas
Stephen Szasz, who passed away in 2012. This year was also the 60th anniversary of the first publication of his iconoclastic thesis on the “myth of mental illness.” In the present paper, Szasz’s main views on mental illness and modern psychiatry are summarized. By showing the origins of Szasz’s ideas in particular, it describes the following topics: Szasz’s distinction between bodily disease and mental illness, his preoccupation with the progressive medicalization of everyday life, his description of psychiatry as an institution of social control, his critique of the therapeutic state, i.e., the alliance between psychiatry and the state, and his deliberations on liberty, personal freedom and responsibility. While addressing Szasz’s main critics, the paper attempts to show the influence of Szasz’s concept on today’s psychiatry and stresses that despite well-deserved criticism he expressed some of the epistemological and ethical problems of modern psychiatry better than anyone else, which makes his legacy still important for the mental health practitioners of today.

Szasz’s proposed solution  to the “epistemological confusion psychiatry has stumbled upon” (1968, p.14), means that we are left with millions of people who have been misdiagnosed, medicated, categorized and labelled. I aim to show that there must be an ethical non-negotiable commitment within the medical community for keeping the concept of mental illness within its concern, even if it is not, as Hanna Pickard (1999) shows, a natural kind.

In this paper I examine Thomas Szasz’s claim that mental illness is only metaphorically an illness, not literally one.  In doing so I consider the crucial distinction between the literal and metaphorical uses of language.  I pay special attention to the various uses of the word ‘mental’ and how each affects our conception of what we mean by ‘mental illness.’  Finally, I offer a defence of Szasz’s position by way of arguments which differ  from those offered by Szasz himself.

In the film classic Blade Runner, the story explores the notion of personal identity through that of carefully crafted androids. Can an android have a personality; can androids be persons? The title of the original story by Philip K. Dick is Do Androids Dream of Electric Sheep? The story suggests that our sense of being a person depends on our having memories that connect us with our childhood. In the movie, the androids are only a couple of years old, but have adult bodies. To complete them as persons they are given simulated memories of childhood. Some psychiatrists have decided that even humans dream only of electric sheep. I explore how Popper’s world 3 can help to defend a notion of personhood that can be used to criticise the thesis that persons are simply complex physical processes and that all their serious life-problems can be conceptualised as a form of physical illness.

I highly recommend this book by Thomas Szasz (1920-2012).
Szasz, Thomas (1996).  The Meaning of Mind:  Language, Morality, and Neuroscience.  Westport, Connecticut:  PRAEGER.
Szasz's argumentation is irresistible and he certainly gives a compelling alternative view to the now popular materialist view of mind = brain.

The publication in 1960 of Thomas Szasz’s The Myth of Mental Illnes, subtitled Foundations of a Theory of Personal Conduct was received with hostility by members of the psychiatric establishment . One of his central claims is that psychiatrists such as Sigmund Freud and Emile Kraepelin, unable to find any genuine organic disturbances, played an “epistemological trick” on us by transferring the naturalistic concept of disease from “abnormal bodily structure” to “abnormal personal behaviour” (1979, p.12). What Szasz calls “problems in living” (ibid, p.45) have been misdiagnosed as diseases of the mind. I propose that an endorsement of Szasz’s position is inconsistent with the most standard bioethical principles of medical practice. Secondly, by means of an analogy with racial categories, I argue that the ontological status of mental illness should not change our medical attitude to the mentally ill. Lastly, I advance a virtual case study that would leave the most ardent critic of psychiatry with no solid grounds for denying a person mental health treatment

In a pair of articles in the Journal of Humanistic Psychology, E. Fuller Torrey’s psychiatry is castigated by Thomas Szasz. In return, Torrey dismisses Szasz’ criticism as “increasingly anachronistic.”  The current exchange clarifies the early ties between the two and their subsequent unraveling.  Apparently at opposite ends of the psychiatric spectrum, Szasz and Torrey in fact have much in common and share foundational assumptions about mind and body, the definition of “disease,” the nature of medical practice and the nature of medical science.  Their presuppositions, all readily challenged, are problematic for all of medicine including psychiatry.  Physicians treat persons not diseases; people go to the doctor with ailments and illnesses and not with diseases; mental illnesses are not necessarily diseases; medicine is a social response to human need and not a pure science; medical science is a practical not a pure science.  What is true for medicine in general is of course also true for psychiatry.

A humorous, fictional but academic conversation between two of psychiatry's giants Sigmund Freud and Thomas Szasz. Or is it a dream? Through their animated dialogue and critique of each other's theories is elicited a contrasting exploration of their conceptual differences. The dialogue canvases: the origins of psychiatry; the medical-scientific approach to mental illness and the medicalization of the language of psychiatry; psychiatry as science vs. the social construction of mental illness; hysteria; the causes of mental illness; patients' social responsibility vs. illness; the unconscious mind; sublimation of individual freedom vs. metarules of society and coercion vs. treatment. The conversation demonstrates the sharp contrasts between the seminal works of both theorists; on the one hand Szasz's The myth of mental illness: Foundations of a Theory of Personal Conduct and Freud's Studies in hysteria (with Breuer) and Civilization and its discontents.

Análise do conceito psicopatia como ilustração da natureza dos termos que estão subsumidos no diagnóstico psiquiátrico, à luz das teorias críticas da regulamentação dos comportamentos indesejados e da filosofia da psiquiatria. Nossa questão principal foi procurar saber qual o significado de um diagnóstico psiquiátrico. Fundamentamos nossa pesquisa no fato de que a psiquiatria nasceu vinculada à filosofia, que sempre teceu críticas sobre os conceitos usados pelos médicos alienistas, bem como sobre os fundamentos epistemológicos dessa ciência. A própria fusão dos tratados de psiquiatria como médicos e filosóficos atesta essa relação, o que tem deixado a filosofia da psiquiatria muito à vontade para questionar e contribuir com a psiquiatria ao longo de sua história. Uma dessas críticas tem sido direcionada à função social da psiquiatria como órgão de controle contra os comportamentos indesejados. A acusação é a de que os termos psiquiátricos são fabricações literárias sem respaldo médico tradicional ou comprovação empírica, com o intuito de justificar as ações morais contra os indesejados ou divergentes. No tocante à psicopatia, isso pode ser mais facilmente observado: ao longo dos anos foram surgindo diversas propostas para a composição de um significado desse termo, algumas das quais inconciliáveis, cujo propósito tem sido o de interditar um tipo de personagem conceitual classificado como o que há de pior na humanidade. Nossa proposta analisou essa construção por meio da análise do conceito em sua historicidade, composição, consistência, relação com outros conceitos e seu caráter fragmentado. Coletamos informações sobre esse processo nas mais importantes tradições psiquiátricas e documentos oficiais para a regulação da atividade psiquiátrica. Verificamos as ferramentas e as propostas metodológicas para a elaboração de um diagnóstico diferenciado de psicopatia. Nossas análises nos levaram a reforçar a tese de que os termos psiquiátricos, pelo menos os usados no diagnóstico da psicopatia, são livremente usados, forjados dentro de um processo de trocas de influências e manipulação midiática, não por descobertas médicas. Isso pode ter feito com que o termo tenha migrado da área médica para a criminal, conquanto não tenha abandonado parte da ritualística médica tradicional e ainda se valha das três maiores ferramentas psiquiátricas: a compaixão, o diagnóstico e a interdição. Outras possibilidades de leitura das condições subsumidas sob oconceito psicopatia existem, como as do homem amoral ou do homem sereno, mas isso pressupõe outra forma de abordagem moral dos comportamentos: de uma visão moral excludente a uma moralidade que reconhece a diversidade como legítima.

We can study pain, chronic diseases and death from different angles to the biomedical model, to the perspectives and models of psychology, to palliative and terminal care, and even more, to the branch of medicine that scientifically studies pain and its treatment, algology. ES | Abstract: Podemos estudiar el dolor, las enfermedades crónicas y la muerte desde ángulos distintos al modelo biomédico, a las perspectivas y modelos de la psicología, a los cuidados paliativos y los cuidados terminales, y más aún, a la rama de la medicina que estudia de forma científica el dolor y su tratamiento, la algología.

Abstract: Podemos estudiar el dolor, las enfermedades crónicas y la muerte desde ángulos distintos al modelo biomédico, a las perspectivas y modelos de la psicología, a los cuidados paliativos y los cuidados terminales, y más aún, a la rama de la medicina que estudia de forma científica el dolor y su tratamiento, la algología. EN | Abstract: We can study pain, chronic diseases and death from different angles to the biomedical model, to the perspectives and models of psychology, to palliative and terminal care, and even more, to the branch of medicine that scientifically studies pain and its treatment, algology.

Thomas Szasz. Texto de J.C. Ruiz Franco1. Tradução2: Ezequias Nogueira3. Publicação em Espanhol: Thomas Szasz, el psiquiatra libertário. Site: www.academia.edu. pág.1-2. Em 8 de setembro de 2012, morreu em Manlius, Nova York, uma das figuras máximas da cultura atual, o doutor Thomas Szasz, Psiquiatra, escritor e, por cima de tudo, grande defensor das liberdades individuais e do consumo de sustâncias psicoativas. "Se você fala com Deus, está orando. Se Deus fala com você, é porque você tem esquizofrenia "(Thomas Szasz) O falecido psiquiatra anti-psiquiatra, foi o médico que se atreveu usar a voz para denunciar os erros epistemológicos e metodológicos da disciplina médica dedicada aos pacientes com doenças mentais, assim como toda violação moral e social que causava. BIOGRAFIA: De família Judia, Nascido em 15 de Abril de 1920, em Budapest (Hungría), Szasz viaja a Paris para estudar Medicina. Mas os planos de sua família tiveram que mudar, uma vez que a doutrina nazista se expandiam pela Europa central. 1 Licenciado em Filosofia pela Universidade Complutense de Madrid (1989) < https:// ucm.academia.edu/JCRuizFranco/CurriculumVitae> Acesso: 17-11-2019. 2 Ouve algumas modificações para melhor compreensão do leitor. 3 Apenas mais um na fila do pão.