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Dr. Thomas Szasz’s Critique of Psychiatry

In health on December 8, 2010 at 2:01 am

Psychiatry contrarian Thomas Szasz (Photograph by Jeffrey A. Schaler, permission granted, http://www.szasz.com)

(previously published in Suite101)

A Contrarian Frames Psychiatry as Part of Growing Therapeutic State

Since publishing his first critical book on psychiatry in 1961, The Myth of Mental Illness, Thomas Szasz has been viewed as troublesome, troubled, and for many, a hero.

Dr. Szasz has been debating the psychiatric profession for decades, calling this medical specialty a “pseudoscience.” In one of his first forays, he claimed that what we call mental illnesses are not diseases at all, but “problems in living.”

“Mental illness is a myth whose function is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations,” said Szasz.

Szasz: A Libertarian Skeptic

Thomas Szasz is Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. An outspoken critic of psychiatry, Szasz has often infuriated his peers. Although current trends in psychiatry and neuroscience appear to strengthen the theory of a biological basis for mental illness, Szasz has probably “…done more than any other man to alert the American public to the potential dangers of an excessively psychiatrized society,” according to Edwin Shurr in the Atlantic Monthly.

“The classification of (mis)behavior as illness provides an ideological justification for state-sponsored social control,” said Szasz.

The body of Szasz’s work is prodigious, and includes books and articles published over the past half century questioning the role of the state in mental health, especially its legal implications for individuals. Szasz believes the relationship between a mental health practitioner and patient should be contractual. Some of his more contentious ideas include his opposition to psychiatric coercion in mental illness, his views on assisted suicide, and his criticism of labeling and medicating children with Attention Deficit Disorder.

Biology of the Brain

In the last few decades, neuroscience has gained the upper hand in the great debate on the origins of mental illness. “Evidence of the biological basis of mental illness would seem to be so overwhelming that to doubt is akin to doubting evolution,” wrote Jeffrey Oliver of Szasz in The New Atlantis.

Psychiatry has made progess in proving that diseases of the mind arise from biological/physiological causes in the same way diseases of the body are the result of disorders of bodily organs. Many in the psychiatric profession view Szasz and others who oppose them, such as the Anti-Psychiatry movement, as irresponsible and even dangerous. Most people agree psychiatrists who use the law to coerce those deemed mentally ill do so with the best interests of the patient in mind.

Beyond the Diagnostic and Statistical Manual of Mental Disorders

Despite the medical advances made in recent years in the biology of mental illness, most of the items listed in the “Holy Bible” of the psychiatric profession, the Diagnostic and Statistical Manual of Mental Disorders, rely on behavioral observations. The danger lies in the power of the medical/psychiatric profession to define arbitrarily what behaviors are sick. The challenge is to improve patients’ legal rights to bodily and mental self-ownership and the right to be free from state violence.

Dr. Szasz, though deemed by many in his profession as a “failed revolutionary”, has provided a legal and moral framework to examine potential abuses in what he deemed to be a “Therapeutic State”.

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