On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz


I presented the following comparison of the philosophic psychiatry of Thomas Szasz to the psychiatric philosophy of Epicurus in May 2014 at the 167th annual meeting of the American Psychiatric Association in New York City.   Because Szasz had died late in 2012 I assumed it would be merely one of several retrospectives of his thought and influence.  In the event, mine was the only paper to mention him, and the circumstances afforded me for presenting it proved challenging.  I was assigned to the last slot on the last of the five-day conference, to a session titled “Topics of Interest Rarely Presented.”  (The first presentation discussed psychiatric patients’ self-assessments of body weight, while the third dealt with psychiatric morbidity among Bangladeshi women in rural and slum populations.)  The audience was predictably small, but the paper was quite a hit among them.  It has continued to garner favorable remarks in private circulation.  Since the second anniversary of Szasz’ death on September 8 is now approaching, it seems a suitable occasion to publish it to a wider audience.

When the American psychiatrist Thomas Szasz killed himself a year and a half ago at the age of 92, I thought there would be a global outpouring in psychiatric circles of sympathy or scorn.1 Instead, his death was largely met with silence, a silence as deafening as the one that attended the second half of his long, prolific, and polemical career. Szasz’ name didn’t show up at all in the APA program last year, and this presentation of mine is apparently the only one to mention him this year. This silent treatment has, ironically enough, and surely against his will, forced him to fulfill the ancient Epicurean ambition to live and die unnoticed (in Greek, lathe biosas, ‘shun the limelight as you pass through life’).

Who Was Thomas Szasz?

I am not sure I need to tell you, but perhaps I do.

From the 1960s through the 1980s, Dr. Thomas Szasz (1920-2012) was the most famous psychiatrist on earth. Born in Budapest, he emigrated to the United States with his family as a teenager and graduated as valedictorian of his class at the University of Cincinnati Medical school. In 1961 he published The Myth of Mental Illness. It was an international bestseller. In it he argued the simple proposition that personal distress and behavioral eccentricity were being wrongly interpreted as medical illnesses, and that attempts to treat such behaviors by medical or surgical means were forever doomed to fail.

Szasz was fond of comparing psychiatry to the Inquisition, psychiatrists to witches, the mental hospital to the Church, and the medieval Age of Faith to what he called the modern Age of Madness.2 He saw psychiatry as the secular successor to the medieval practice of persecuting witches and heretics: it was, he argued, merely a change of name and rationale, rather than a change of substance, in man’s eternal quest to dominate man.3

Szasz’ interpretation seems to present us with a simple binary distinction between supernatural-religious and atheistic-materialist explanations of the world,1 much like the familiar (and ancient) debate between creationism and evolution.4 In rejecting the brain-disease explanation of mental illness, he might seem to be advocating a return to supernatural explanations. Nothing could be further from the truth, however; Szasz routinely referred to God and religion as transparent fictions, tout court. In my view, his focus on the coercive element of institutional psychiatry as the successor of mad-doctoring explains his failure to articulate the position he was advocating as clearly as he might or should have. And that in turn explains why his attempts to repeal psychiatry have failed. A comparison with the ancient Greek approach to mental illness, and especially the philosophy known as Epicureanism, will make my view clear.

First, however, since these issues tend to be fraught with emotional involvement — I imagine some of you are angry or aghast at what I’ve said already — let me now state clearly that I have no professional competence in psychiatry to endorse or reject Szasz’ ideas. My aim is merely to describe and compare them to a system of thought that flourished worldwide in an era that I do know quite a bit about.

Like vegetarianism vs. eating meat, competing explanations for the cause of mental illness are one of those social-ethical fashions that mankind rediscovers every few generations as if it has hit upon a brand new, progressive idea, and to which it goes back and forth. So too are the changing treatments. But contrary to the impression you might get from Szasz’ constant opposition of scientific psychiatry to religious witchcraft, there are not just two, but three ways of explaining so-called mental illnesses. The competition among them in the crucible of classical Greece some 25 centuries ago shows how.

From time immemorial, popular thought in Greece and Rome attributed mental abnormality, as inferred from behavioral deviance, to divine intervention. People believed in possession by supernatural forces, such as gods or demons, and sought to expiate it through the shamanistic sacrifice of animals. Jesus himself was a firm believer in demons and regularly cast them out of people. Amid the Ecclesiastical State of the European middle ages and early modern period, this belief reemerged and prevailed. According to it, the Church held that witches, possession by Satan, and Jews and heretics were responsible for mental abnormality as inferred from behavioral deviance. The sacred symbol of this view is its emblematic treatment, exorcism, or shamanic ritual.

In 5th-century BC Greece, Hippocrates introduced a new explanation—the medical model, which attributed mental abnormality, again as inferred from behavioral deviance, exclusively to natural bodily causes. Hippocratic healers believed in humoral imbalances in the brain, and sought to correct them through the use of neuroleptic drugs, forcibly administered if need be, and confinement in the clinic.5 With the dawn of the Scientific state of the European Enlightenment, this belief reemerged and has come to prevail. Because few people today really believe in demons, witches, or Satanic possession, they, and their governments, hold that chemical imbalances in the brain are responsible for mental abnormality or personal distress as inferred from behavioral deviance. The sacred symbol of this view is its emblematic treatment, excision, of parts of the brain through surgery, electroshock, or neuroleptic chemicals.

The opposition of these two approaches is well known, and figures in every history of psychiatry. What is less familiar today is that in 4th-century BC Greece, yet another view was on offer—the Epicurean model, which attributed mental abnormality, as inferred from behavioral deviance or self-report, to spiritual anguish. The Epicurean model held that man’s universal fear of death was responsible for his mental anguish, which caused and resulted from his poor choices and failure to understand the relationship between his appetites and his responsibility. The sacred symbol of the Epicurean view is its emblematic treatment, talk therapy or exercise, both mental and physical.

The competition among three different models of mental anguish—the shamanic, the medical, and the Epicurean—is hard to map onto today’s context. In part this is because the Epicurean model runs counter to modern scientific thinking. It interpreted the spirit or mind (psyche, soul), not as something immortal and God-given, but as a purely mortal and material product of natural evolution; so it may seem counterintuitive. Since most people today, and especially non-Christians, believe either that the soul does not really exist, or that the mind is just a function of the brain, they have a hard time understanding this approach. For an atheist to say we have a spirit, and to refer to “spiritual well being” (as Szasz does), may strike you as funny. Most unreligious people today would deny that human beings have a spirit. For them, humans are organic compounds of atoms, molecules, electrochemical processes, and no more. There is no room in this picture for a spirit, a word that smacks of religion, superstition, or supernaturalism. Furthermore, today psychoanalysis (talk therapy) and pharmacophysical treatment (lobotomy, electroshock, drugs) are both subsumed under the name psychiatry; whereas in antiquity, the two were in direct competition. The medical model was the province of the Hippocratic healers, or doctors. The Epicurean model was the province of the philosophers and their students. Each group explained distress differently. The philosophers, like psychoanalysts, thought the patient’s psyche was disturbed; whereas the psychiatrists, like the Hippocratics, thought the brain’s chemistry (or humors) were out of balance. (In antiquity, the shamanic model was only believed in by the lower classes and because it is obsolete today, it does not interest us here.)

It is the Epicurean model, I suggest, that Szasz himself hit upon and developed independently—though he was apparently unaware that he was reactivating a view that was not only ancient, but that had once been massively influential on civilized man, and for seven centuries.

Who Was Epicurus, and What Was His Philosophy?

Born in Samos (Greece) in 341BC, he emigrated to Athens and founded a philosophic school at his private residence, the Garden. Epicureanism soon became the largest of the three main schools of Hellenistic philosophy, overtaking Skepticism and Stoicism. In the wake of Alexander the Great’s conquest of the Mediterranean, the Middle East, and beyond, it soon spread to become a world philosophy. It was dogmatic and missionary, transmitted not only by one person to the next but especially through books — books of aphorisms, a manifesto (the tetrapharmakon), and graded textbooks. It met with opposition, first from rival philosophies (Platonism, Stoicism), then from religions (Judaism, Christianity).6 After Epicurus’ death in 270 BC, adherents of his philosophy could be found across all of Europe, North Africa, the Middle East, and India. It was especially popular with the middle or bourgeois classes in the vast Roman Empire. It thrived for seven centuries, dying out in the 4th century AD, when it was swamped by Neoplatonism and Christianity (belief in which became legally mandatory in 381 AD). Thereafter, it slumbered for some 12 centuries. In the Renaissance, it revived and gave the chief impetus to the Enlightenment. Thomas Jefferson is only one of several famous self-affirming Epicureans of modern times.

What tenets did Epicureanism hold? Epicurus preached a materialist philosophy. It was rooted in recent scientific speculation about the physical world. He believed everything in the universe was made up exclusively of atoms and empty space, or void, for the atoms to move through. As they moved, the atoms collided at random to form compounds, like water, air, trees, people, planets, and so on. He thought human and animal life arose purely through evolutionary processes; that is, no god created it, no god looked out for it, and no god was preparing rewards or punishments for life after death, because the soul or mind, which was just another collection of atoms, did not survive death – nothing did. Because there was no life after death, there was no heaven and no hell, and the gods, though they did exist, did not care what we humans did or did not do to one another.

This physical outlook necessitated a new moral outlook on human conduct. Epicurus preached that all social arrangements, such as justice, were simply convention. The highest aim of his philosophy was therefore individual pleasure – by which he meant, not binging on food, drink, or sex, but simply acquiring the minimum pleasure necessary to avoid pain. In short, he preached freedom from fear — the fear of death, which he considered the source of human anxiety. The goal was to achieve mental health (ataraxia, tranquility of the mind or soul) by realizing that there is no life after death, and hence nothing to fear from dying. You will surely recognize this as the forerunner of the contemporary secular humanist lifestyle.

His philosophy was, in other words, psychiatric. Talk therapies were explicitly meant to heal the soul and relieve its anguish. If you had told Epicurus you could “fix” a man’s disordered thoughts by shocking or lobotomizing his chest (wherein he thought the soul resided), he would have laughed or cried or tried to talk you out of it. So too, I suspect, with neuroleptic drugs. Epicurus would surely have agreed that disrupting or destroying your body’s material substructure will cause you to think differently, but he would not have agreed that such means could relieve you of your fear of death. While he and other philosophers were trying to reason people into correct opinions, do recall, the Hippocratic soul healers were trying to cure insanity with hellebore, the neuroleptic drug par excellence of antiquity; and the regular folk were still using shamanistic expiations.

Epicurus made no effort (to our knowledge) to oppose the Hippocratic healers, but he certainly opposed religious expiations as pointless and evil. For Lucretius, his great missionary in Rome, the sacred symbol of evil done in the name of traditional piety was a human sacrifice – specifically, the deliberate sacrifice of Iphigenia, the eldest daughter of King Agamemnon in Greek mythology, when he found his political ambitions blocked. For Szasz, the sacred symbol of evil done in the name of psychiatric piety was also a human sacrifice – specifically, the willing sacrifice (as he put it) of Rosemary Kennedy, the eldest daughter of Joe Kennedy, U.S. ambassador to Britain in 1938 and father of U.S. President John F. Kennedy. In Szasz’s account,7 Joe agreed to lobotomize his own daughter when he found his political ambitions blocked.

Another feature distinguishes Epicurus’ philosophy from that of his rivals and makes it resemble Szasz’ philosophy. That is that he was metaphysically a libertarian:

that is, he believed above all in free will. For him, the soul was certainly a bodily organ (located in the chest), but in his view free will and reasoning emerged from this material substrate, enabling man to break the deterministic chains of Fate and become a moral agent. By persuading a man to reason his way out of irrational fears, such as that of death, man could in turn act upon his atomic makeup, his body, and achieve inner peace. “Human nature is not to be coerced but persuaded,” said Epicurus (Vatican Saying 21, trans. DeWitt). The maxim could have come verbatim from Szasz’ pen.

In fact, mutatis mutandis, everything I have just said of Epicurus is also true of Szasz’ thought. It can be illustrated in almost any of his books.

This view of the soul or mind stands in contrast, by the way, to that championed by Stoics in antiquity and by psychiatry coursework today. Many people suppose that if our thinking occurs in our brains, and is not directed or controlled by gods, then we are foreordained to behave as we do. The Stoics called such determinism, or causes (rather than reasons), to Fate; whereas today we attribute it to genes or chemical imbalances in our broken brains.

Szasz and Epicurus would both have opposed such thinking as simplistic and overly reductive. What does that mean? Let me illustrate the point with a cartoon. Here is a “Dilbert” cartoon from June 4, 2000, that puts the matter simply.

DILBERT © 2000 Scott Adams. Used By permission of UNIVERSAL UCLICK. All rights reserved.

My interest is in the first four panels. In them Dilbert is caught with risqué photographs on his computer at work. What is his defense? That the pictures are “really” just strings of ones and zeros—that is to say, just binary code. Mutatis mutandis, Szasz or Epicurus would say, those who believe that people behave oddly because their brains are misfiring, instead of acting as they do for reasons they themselves deem appropriate, cannot see the pornographic motives behind strings of binary code.

If their philosophies were indeed similar, why did Epicureanism flourish where Szaszianism has failed? I ask because although he suggested and advocated many, Szasz cannot be credited with implementing any psychiatric, social, political, or legal reforms, save perhaps deinstitutionalization. His philosophy, and especially his chief claim that mental illness is not a medical disease, has not spread throughout the world; rather, it is psychiatry that has flourished and grown worldwide, and has spread throughout all classes in the West.

It cannot be just that Szasz was wrong, if you believe him to be so. Wrong ideas win all the time.

It also cannot be because of their principal tactics of persuasion. Both men liked and employed satire, aphorisms, dogma, candor, and arguing from the excluded middle. Both wrote in the global lingua franca (Greek, English), enjoyed translations, and enjoyed easy access to disseminating their ideas in print.

Clip from “The Last Interview of Thomas Szasz,” a film by Philip Singer, Ph.D
(Trailer below)

There are, to be sure, some signal differences. Epicurus founded a school and named it for himself. He demanded loyalty pledges of his students. He wanted, and became, the Greek messiah. By contrast, Szasz worked at a school. He demanded loyalty pledges of no one. He had no interest in becoming, and did not become, the psychiatric messiah. He believed too firmly in autonomy and individualism for that.

One possibility is that Szasz’ opponents reinterpreted his ideal, autonomy, to mean selfishness, just as Epicurus’ opponents twisted his ideal, pleasure, to mean hedonism. No one wants to be called a glutton or selfish; but I don’t think this explains his failure.

Rather, it seems Epicureanism spread because its endpoint was popular. People wanted to believe there was no (horrible) life after death because its physicalist-atheist underpinnings made sense to them and because believing in it freed them to pursue pleasure, however they defined that word for themselves.

Szaszianism also preached freedom—not from the fear of death, but from coercion. His highest aim, autonomy, sounds pleasant, but it is not. Framed as freedom, autonomy sounds grand. Framed as personal responsibility—accountability, answerability, paying the price, failing—it is exceedingly unpleasant. Therein lies the difference. Pleasure and personal responsibility are not merely different; they are often polar opposites, as we can see when manifested in the case of, say, obesity or alcoholism, and the various treatments of them.

In short, Szasz failed not because he was wrong but because he championed an ideal, personal responsibility, that few want to accept. As he knew and said, responsibility is something man is forever hoping to avoid and displace onto another; hence his attribution to Satan or illness as the agent “really” responsible for his poor choices. It is more pleasant to blame his failings on demons, witches, his genes, or his metabolism for his gaining weight—anything but himself. The fact that bariatric surgeries, and the unending quest for a weight-loss pill, are on the rise suggests that in the short term, Szaszianism will never succeed.

The other reason Szaszianism has failed is because—on my evidence— psychiatrists do not know what philosophers have to say about the mind or soul. They are committed to the Hippocratic, reductionist-materialist view that it’s just the brain. They aren’t taught that other views are out there. Perhaps they should be.

* * * * *

Download the handout for the talk at the APA here.

The Last Interview of Thomas Szasz,” a film by Philip Singer, Ph.D, is a documentary exploring the controversy & beliefs of anti-psychiatry psychiatrist Dr. Thomas Szasz. For more information please go to Witness Films.


(For undocumented statements about Epicurus and Epicureanism, see De Witt, O’Keefe, and Warren.)

De Witt, Norman. 1954. Epicurus and his Philosophy. Minneapolis, MN: University of Minnesota Press.

Fontaine, Michael. 2013. ‘On Being Sane in an Insane Place—the Laboratory of Plautus’ Epidamnus,’ Current Psychology 32.4 (2013), 348-365.

O’Keefe, Tim. 2010. Epicureanism. Berkeley: University of California Press.
Szasz, Thomas S. 1973. The Age of Madness: The History of Involuntary Mental

Hospitalization Presented in Selected Texts. Garden City, New York: Doubleday Anchor. —. 1988. The Theology of Medicine: The Political-Philosophical Foundations of Medical

Ethics. Syracuse: Syracuse University Press. (Original work published 1977.)

—. 1997. The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement. Syracuse: Syracuse University Press. (Original work published 1970.)

—. 2007. Coercion as Cure: A Critical History of Psychiatry. New Brunswick, NJ: Transaction Publishers, 2007.

—. 2010. The myth of mental illness: Foundations of a theory of personal conduct. New York: Harper Perennial. (Original work published 1961.)

Warren, James. 2007. The Cambridge Companion to Epicureanism. Cambridge, UK: Cambridge University Press.page8image18056 page8image18216


1. Szasz committed suicide at home on September 8, 2012. His 855-word New York Times obituary is found here. Jeffrey Schaler’s more informative obituary (“Kaddish for Thomas Szasz”) is found here.
2. The Age of Madness, introduction, and The Manufacture of Madness.
3. The Manufacture of Madness.
4. Epicurus, like many other ancient thinkers, believed in evolution.
5. For evidence and references, see Fontaine 2013.
6. In Rabbinic Hebrew, Epicurus’ name became the word for “infidel,” “heretic,” “unbeliever”.
7. Coercion as Cure, pp 152-3.
8. The Theology of Medicine.

* * * * *



Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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    • Agreed this is too much bs and also with the kudos to Szasz.

      In fact, a much more accurate description of his legacy is can be found here,


      The bottom line is this: Szasz’s message that no label listed in the DSM has been shown to be a brain disease won over both the NIMH and, at least partially, the APA.

      Mainstream psychiatrists are just too proud to admit the obvious. For those of us who have no dog in the fight of who gets what federal dollars, it is patently clear that the current crisis in psychiatry was caused by Szasz.

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        • I would like to add to Emmeline’s comment that if Mad in America is to be taken seriously, it will involve more thoughtful discussion than “this is bs.”

          I am excited to have such a thoughtful piece as this on MiA. I know that Mr. Fontaine has put considerable thought and time into it, including time spent with Thomas Szasz.

          When Szasz died I was appalled at the lack of coverage and, where there was any (the New York Times), it was clearly unappreciative and uncomprehending of his true message. I tried at the time to solicit some articles to try to fill the gap a little, to some success. But when this article showed up, I was very excited at the depth of information, thought, and appreciation reflected in it.

          These days, unfortunately, aligning oneself with Szasz is a risky thing to do; one gets too easily tarred with various unfair labels, all missing the point. If MiA is to move the conversation forward, it will require expanding the conversation around these issues, not shrinking it, until people can see that the concerns we write about on MiA actually do have meaningful connections to all of human life. A piece like this, taking its inspiration from the ancient history, written by a classics scholar, is the kind of article that expands the range and depth of the dialogue, and we are lucky for it.

          But having the first comment be “this is bs” sends a message to the world about who MiA readers are and, unfortunately, people draw conclusions about what MiA’s mission is. Those who would wish to dismiss us are given all the ammunition they need with such careless comments. No matter how many reasoned, thoughtful pieces we publish, people conclude – or are allowed to continue to believe – from such offhand comments that this is the true spirit of MiA; this fact has severely limited the pool of authors we can draw from, and the range and quality of the discussion we can have.

          On the other hand, MiA considers it a profound responsibility to be as unrestricted a forum as possible, because we feel a profound obligation to people whose voices have not been heard. We like to think we offer a unique forum that has not existed, for people who have been harmed to speak to those who are at least a little open to hearing and changing the dialogue.

          So, Emmeline has properly chosen to let these comments stand. But I am saddened that articles that offer such a unique contribution to the conversation would be met, first, with such uncomprehending, dismissive comments. The article may not be your cup of tea, but comments such as these have the effect of dampening the pleasure others find in it. I think that if you look deeply in the article, you find an elegance of thought that can be applied far beyond these relatively circumscribed conversations. It is articles like this that help people realize that we are trying to do more here than thrash out past grievances; we are trying to reconnect conversations about human struggle, which have been made paltry and irrelevant by the false promises of a medicalized solution, to discussions that can encompass human aspiration as well as the beauty and joy to be found by transcending our material being rather than surrendering to it.

          That is what a return to the classics can help us appreciate in a unique way, and why I was thrilled to be able to post this article. I hope that the conversation proceeds in a more meaningful and inspiring – or at least appreciative and polite – way from here forward.

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          • Emmeline/Kermit,

            More later today then. The summary of what my critique will be is this: the author is pulling a straw man. Thomas Szasz was not in the business of religion or providing world views to people. It’s the other co-founders of CCHR who were/are.

            Thomas Szasz true legacy is more similar to Martin Luther King’s than to Martin Luther the monk.

            I will detail this when I have the time later.

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          • Yeah I understand all the concerns about propriety etc.; I made my comment anyway and hope that my deliberate provocativeness will help infuse some passion into what some apparently feel should be an emotionless la-de-da tea-time debate.

            Lives are at stake here. Szasz’s deconstruction of the semantic obfuscation of psychiatry has set the intellectual foundation for our liberation, and many of us don’t take kindly to these sorts of hit pieces framed in the trappings of reasoned discourse .

            Unless subsequent posters make it unnecessary for me to do so I also plan a more polite response after I’ve had the chance to draw in a few more deep breaths.

            E & K I know you’re in a difficult position here, just trying to do my job as you are yours. 🙂

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    • Why bs? I don’t agree with every statement the author wrote but it’s a nice reminder that the ideas have been around for hundreds of years. As for whether Szasz succeeded or not and – well, that’s the point where I disagree with the author, mainly on the reasons why current psychiatric model is so popular.

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    • I agree. Not fair to pick on DR. THOMAS SZASZ,just because he had died.

      I heard he’d lost a lawsuit (foolishly filed by a family whose member was on lithium and committed suicide). SZASZ tried to get the guy OFF lithium. SZASZ was NOT discredited;he was OVERPOWERED and that’s a different matter.

      Who will succeed SZASZ? Dr. Jeffrey Schaler? Dr. Peter Breggin? SZASZ left some mighty big shoes to fill. CCHR keeps SZASZ’ memory alive.

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  1. In my view, his focus on the coercive element of institutional psychiatry as the successor of mad-doctoring explains his failure to articulate the position he was advocating as clearly as he might or should have.

    Excuse me, institutional psychiatry (imprisonment in mental hospitals) is the successor of mad-doctoring (i.e. the trade in lunacy [or imprisonment in private lunatic asylums]), both are coercive.

    Slavery is another coercive practice that Szasz compared with coercive psychiatry. It might be too easy to miss the success of Szasz for the failure of Epicurus. (Seems his school has been out of session for some time now.) If John Brown was instrumental in launching the war that freed people of color from the bondage of chattel slavery, well, there you go. I wouldn’t be too quick to dismiss Dr. Szasz as an abject failure. (Sure, I’m partial in making this little leap of faith, or is it judgment.)

    I have a big problem with this blind spot that psychiatry has regarding the harm that it sows. This harm comes directly out of its “coercive element” to put the matter altogether too mildly. Coercion (and the various forms of violence and torture that go with it) should not be trivialized as mere subjects for academic discussion.

    Degrading people into statistics may have its rewards, but I would hope we can find some punishments for it myself.

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    • You are certainly right about psychiatrists not understanding philosophy. I’m not trying to bash Epicurus. (Isn’t the Epicurean motto: moderation in excess?) Thomas Szasz objected to coercive psychiatry on moral grounds. It denies moral agency to those whom it labels, studies, and mistreats. It does so on would-be medical grounds, but those medical grounds are a fantasy. Psychiatry would deal with magical thinking through its own form of magical thinking, and what you don’t get out of compounding magical thinking with magical thinking is realism. If a person were to seek a guide in a hospital, what would they get out of the effort? Probably a pill. Problem is, the pill won’t lead to a good place, quite the reverse. Especially when the pill has an actual adverse effect on the physical body. The mental body can take it. Robbing people of the opportunities that were promised them is no way to “heal” them, call it what you will.

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      • “Isn’t the Epicurean motto: moderation in excess?”

        I’m not familiar with this formulation but it sounds like a spoof or caricature of the Epicurean ideal. Epicurus advocated moderation as the ideal way to live. The expression “the golden mean” is one ancient expression of that ideal, and Epicurean poets in antiquity — Horace, Virgil, probably Catullus — celebrated it repeatedly. Like the Epicurean ideal of pleasure, however, it was easily caricatured by his opponents. That is why the name Epicurean today typically conjures up associations with eating deliciously or excessively.

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    • I agree with Uprising and Frank (above)
      I appreciate your efforts Michael to think creatively about Szasz, but your analysis, although erudite and eloquent, strikes me as naïve. First of all, let me clarify a possible misunderstanding that I fear may create the wrong impression , that may be interpreted as an expression of defeat or despair by Thomas Szasz. You start by saying Szasz “killed himself.” While technically true anyone who has read Jeffrey Schaler’s account knows that this was not an act of desperation but a reasoned decision based on considerations of health at 92. And of course Szasz had written prolifically on suicide as a right and a rational decision. Just to clear that up, Michael–for those who do not know.

      You write
      “In my view, his focus on the coercive element of institutional psychiatry as the successor of mad-doctoring explains his failure to articulate the position he was advocating as clearly as he might or should have. And that in turn explains why his attempts to repeal psychiatry have failed.”
      And you write:
      “In short, Szasz failed not because he was wrong but because he championed an ideal, personal responsibility, that few want to accept. As he knew and said, responsibility is something man is forever hoping to avoid and displace onto another; hence his attribution to Satan or illness as the agent “really” responsible for his poor choices. It is more pleasant to blame his failings on demons, witches, his genes, or his metabolism for his gaining weight—anything but himself.”

      Let’s take this: “In my view, his focus on the coercive element of institutional psychiatry as the successor of mad-doctoring explains his failure to articulate the position he was advocating as clearly as he might or should have. And that in turn explains why his attempts to repeal psychiatry have failed.” In the first place I strongly disagree with you. I read at least 15 books and many articles by Tom and I think he very strongly and very clearly advocated his belief in autonomy.(You are right that autonomy was probably his primary value.) Second, and more importantly, separating his commitment to autonomy from the oppression of mental patients would have made Szasz an armchair philosopher and not a prophetic advocate, at best an academic mediocrity if not a hypocrite. (I expect you will disagree–so I’ll return to this issue later.) Finally your own explanation for his “failure” overlooks much of Szasz’s argument, which I think explains BEST why his “failure” was almost inevitable– at least in the short run.

      Your argument is like saying there is a plutocracy in America because Americans were not willing to accept the idea of equality. You completely overlook the will to power that Szasz finds at the basis of modern psychiatry. This put Szasz in the same boat, to his chagrin, with leftists psychiatrist R. D Laing (who was, contrary to your assertion, the most famous psychiatrist in the 1970s and 80s–more so than Szasz) and philosopher Foucault whose deconstruction of the Panopticon is too often overlooked. One must examine the dialectic of domination in psychiatry and the ideological ruses it assumes which make it appear as a medical enterprise undertaken for the benefit of patients. You cannot understand history if you assume the Masters and the slaves have equal access to knowledge–are equally powerful, have equal means to propagate their ideas. You write as if you assume the best ideas will “win” in the marketplace of ideas as long as they are CLEARLY articulated. My God, read Thomas Kuhn, Noam Chomsky, liberation theology, Anabaptist John Howard Yoder, Marx, Weber, Gramsci, Mills, Breggin (on the psychiatric-pharmaceutical complex), Healy, Whitaker, and Laing.

      I included religious thinkers because the Marxist notion that religious ideas are inevitably reactionary is very wrong. There are two modes of Western religion–Constantinian and anti-Constantinian.The former is religion in the service of economic elites and the State and the later is religion in the service of equality, in the service of all beings. It is Constantinian religion –of which I claim psychiatry is a secular expression— which help explain why Szasz “failed.” I make this point in all of my books. At any rate,to reiterate, the success you claim eluded Szasz would have been inconsequential for humanity. It would have excluded the “severely mentally ill”–those for whom Tom was a vigorous advocate. It is better that his ideas live on–even as a thorn in humanity’s flesh, a goad to create a more equal world in the future.

      To quote Marx,“The ruling ideas of an epoch are the ideas of its ruling class.” That is not always true but it is the reality every revolutionary(and I do not necessarily mean Marxists) must confront in “normal” times. Tom’s greatest insight–and he shared this with Laing, even though Tom would not acknowledge Laing– was that psychiatrists were the secular priesthood of the current social order.They sanctified it–they defined “reality.” (Tom’s idea were hobbled by his economic Libertarianism which became more pronounced and stingy as he got older.For example his opposition to any Soteria type asylum.)

      Why do you think Szasz compared Psychiatry to the Inquisition? The priesthood legitimizes and sanctifies the power of the dominant elites. And like the priesthood Psychiatry maintains social control. BTW Tom’s antipathy toward Laing abated ephemerally in the early 90s after Laing’s premature death, and Szasz wrote the Foreword to my first book, despite its quasi Laingian spiritual argument, Madness, Heresy and the Rumor of Angels: The Revolt against the Mental Health System. Ron Leifer,a dissident psychiatrist and Buddhist, was a protégé and friend of Szasz (and later of mine) whom I interviewed for that book–- Ron did not go along with Tom’s unfortunate opposition to any equalizing role for Government.

      Szasz’s point was Psychiatry like the Inquisition (see,The Manufacture of Madness) was not really concerned with the cure of souls but the persecution and control of social deviants (“witches,” Tom argued, were not “mentally ill” –the revisionist Psychiatric position–but indigenous local healers, usually female, who competed with priests as healers) including heretics. Leifer, a psychiatric heretic, had lost his job at the University–(SUNY-Rochester) when he defended the tenured Szasz whom the University was trying to silence. Szasz lost his classes and Ron lost his job. AS did Ernest Becker who also defended Szasz. You overlook the fact that Szasz repeatedly claimed that the real goal of Psychiatry was not cure of souls, but social control–a point made by powerfully by Leifer in In the Name of Mental Health.

      In Szasz’s book on the Inquisition he predicted coercive psychiatry would continue until humanity gave up its tendency toward “existential cannabalism”–that is until the powerful repudiated the will to power.

      You write,”In short, Szasz failed not because he was wrong but because he championed an ideal, personal responsibility, that few want to accept.” Again you are over-simplifying. Szasz’s work gave rise to the mental patients’ liberation movement–and that movement ought not be lightly dismissed.(You do not even mention it.) Despite complaints about its own under-emphasis on responsibility, it accepted personal responsibility(which includes the right of freedom and autonomy) in principle and it made the achievement of full citizenship rights and responsibilities part of its program, albeit unachieved. Thus it became a social force that embraced and symbolized the ideal of personal responsibility-–among the lowest caste of “schizophrenics” no less. He could not have done THAT had he adopted your Epicurean strategy–and that would have been an ineffable loss.

      But you keep conflating the Master and the Slave. It’s like saying slavery was supported in America because Americans could not accept the idea of equality. Blacks did support equality and by the civil war most abolitionists did as well. Those who had a financial interest in slavery did not accept equality. And they had the economic means to promulgate their ideas.(Only a minority in the South had actually owned slaves.) Remember psychiatrists had a diagnosis for slaves who ran away from slavery—a pathological condition termed “drapetomania” (cited by Szasz) described by physician Samuel Cartwright in Diseases and Peculiarities of the Negro Race.

      No your study of Szasz is creative and noble but your idea that he should have abandoned his advocacy for “the mentally ill” and thus presumably been more acceptable is misguided. Perhaps you think he would have gotten psychotics in the master’s house that way through the back door.AS someone who worked in these clinics in the 1980s, before and after I got my PhD, I can tell you it doesn’t work that way. The idea that psychotics were “severely and incurably disabled” was an intractable self fulfilling prophecy. Szasz greatest accomplishment may well have been that his ideas empowered the oppressed –the “schizophrenics”–and gave rise to a movement that proved the psychiatric narrative was wrong.

      I must admit in my current writings I reject the secularism of the Szaszian narrative. I argue it is time to go beyond the Szaszian phase, the Enlightenment phase, of the survivors’ movement –without abandoning it– onto a second phase of the movement,by explicitly affirming the spirituality of the Mad, by emphasizing the gifts of the Mad, by helping the mad to complete their initiation as prophets, poets and visionaries of humanity. That was the theme of my article published here shortly after Tom died.
      http://www.madinamerica.com/2012/11/szasz-and-beyondthe-spiritual-promise-of-the-mad-pride-movement . My newest book of the Mad Pride movement is called The Spiritual Gift of Madness…
      Thanks for your contribution.
      Best, Seth
      Seth Farber, Ph.D.

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      • Thank you for your reply, Dr. Farber. Let me address some of your points in the same order you did.

        I published my thoughts on Dr. Szasz’ suicide in a letter just uploaded to Szasz.com. In choosing the time and means of his death I believe he was self-consciously acting in the tradition of Socrates. You can find my reasoning here: http://www.szasz.com/szaszfesttwo.pdf.

        In the second instance you object to the same sentence that an earlier commenter did, which I agree was badly worded (and which I replied to above). You write, “I read at least 15 books and many articles by Tom and I think he very strongly and very clearly advocated his belief in autonomy”. You raise a good point. Did Szasz value autonomy or freedom more highly? Are the two words simply synonymous, the one Greek and the other Saxon? It would be helpful to find a statement from him on the matter.

        From your description of “Constantinian religion”, a notion with which I’m familiar only from your comment here, as well as the sweeping Marxian analysis of history and notion of “the Mad” that you offer, I will respectfully disagree. Of course power is at stake, as I thought I made clear — insufficiently so, evidently.

        On your final point, I didn’t suggest, nor meant to suggest, that Szasz ever did or should have abandoned his advocacy. As I make clear in the letter linked to above, I believe his suicide was the final act of his lifelong advocacy.

        I thank you again for your critique.

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        • Well I’m afraid I misunderstood you to mean Szasz’s FOCUS was the problem.
          Well if not you have attributed Szasz “lack of success” to two contradictory causes. On the one hand, Szasz you claim is unclear about autonomy. His lack of clarity is why he has not been able to “repeal psychiatry.” On the other hand, you tell us his account is rejected because it is unappealing because people do not want to be autonomous because that is to be held accountable.. If the latter is true than his lack of clarity is irrelevant.If anything it should only make his account more appealing.

          Certainly Szasz’s account could be both unclear and unappealing. But you cannot invoke contradictory ideas to explain his “lack of success.”
          On the one hand you say he failed because he did not make himself clear to psychiatrists. On the other hand to the extent that he made himself clear you say
          his model alienated people.

          You do not even address the problem Szasz considered central: The mental health system destroys and dehumanizes those it claims to help. You don’t present a solution. You treat that problem–integral to Szasz’s ouevre–as if it is parenthetical. Szasz deals with human suffering.

          Second you certainly did NOT deal adequately with the issue of power. You say “power is at stake” But your model completely ignores power. You mention it but you don’t include it in your explanatory schema. Virtually everything Szasz wrote was based on the idea that psychiatrists’ goals conflicted with the goal of those citizens who are deemed mentally ill. You completely ignore this and seem to imply that Szasz would agree with you that had he been clearer and had his account not frightened people with talk of accountability(a contradictory position, I repeat) then Szasz would have been “successful.” But that is nonsense because Tom knew that the interests of psychiatrists and that of “mental patients” conflicted.

          The former wanted to exercise social control–that is their social role for which they are remunerated. The latter do not want to be controlled (under the guise of being helped), they want the rights of citizens, they want the abolition of forced treatment–they want them even at the cost of being held accountable, of bearing the burden of freedom because this is what it means to be human.

          Your piece is based on the canard that Szasz could have appealed equally to mental patients or psychiatric survivors AND to psychiatrists—and been “successful.”. Szasz’s model is based on conflict. And because psychiatrists and the State–and I would add the billion dollar drug companies– have more power they will win–in the short run. You write,” His philosophy, and especially his chief claim that mental illness is not a medical disease, has not spread throughout the world; rather, it is psychiatry that has flourished and grown worldwide, and has spread throughout all classes in the West.” You are not judging Szasz by the standards of Epicurus–you are judging him by the standards of Batman! Captain Marvel. Napoleon. It’s an unfair and meaningless comparison.

          Your model is based on the idea of a harmony of interests between mental patients and psychiatrists.That is in fact the verdict of consensual reality: Psychiatrists treat patients. You don’t seem aware that Szasz deconstructed this myth of harmony, this ideology of doctor and patient. His accomplishments were intellectual and moral. But you don’t understand that because you’re oblivious to the suffering of people n the mental health system–or if not you’re not letting readers in on your awareness.

          But you have no solution. You tell us that if Szasz was only less confusing he would have repealed psychiatry. This would be like telling Trotsky if his writing were less rhetorical he would have convinced the capitalists to stop exploiting the workers, and there would not have been a need for a Russian revolution!! I am not a Trotskyist–I use this as an analogy to emphasize your failure to grasp the conflictual nature of Szasz’s model, the conflictual nature of human society.

          There is only one way to get around this problem. The only place I recall Szasz discussing it explicitly was in The Manufacture of Madness, published in 1970.In this book Szasz appeals to humanity to give up “existential cannabalism.” By existential cannabalism Szasz means e.g.,the psychiatrist enhances his own status by destroying the meaning other people–his patients–give to their lives. In this book Szasz posits that humanity will evolve spirituality so that enough of us will give up cannabalism to transcend the conditions that threaten to destroy all of humanity.

          In his other books Szasz is not explicit. He appeals to human beings’ sense of morality. Whether he thinks he will be successful or not is unclear. But Szasz at least had a criterion of success. It would be ending exploitation in the mental health field.Of course he knew one person or 1000 persons could not achieve that goal. (Furthermore that is only one domain.) I don’t know whether Szasz thought his work advanced that goal.

          Epicurus, you say, was “successful” because he had lots of followers. And Szasz didn ‘t.There is another criteria you present of success. But you tell us Epicurus had a lot of followers because he avoided dealing with the issues that disturbed people. In other words he was evasive. So what is the point of the comparison? The Moonies have many followers. The Scientologists have many followers. The Hari Krishnas had more followers than Szasz. That does not make them more “successful.” Szasz did not want followers. You picked a catchy title but it seems to me to be an unfair and meaningless comparison.

          Seth Farber, PhD

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      • Seth: You note that masters have more information than the slaves. This was especially true when I was institutionalized. I was certainly given no contravailing information, like the works of Laing, Szasz, or Foucault, so as to give me the autonomy to decide for myself. This was 1989′ only about five years after the “Mental Patient” Liberation’s successful demonstration at the psychiatric conference.

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    • Thanks for your comment, Mr. Blankenship. Regarding the relationship of mad-doctoring to coercive institutional psychiatry (your first sentence), I believe we are saying the same thing, though I now see I may have worded my statement poorly. I simply meant that his focus on the coercions inherent in institutional psychiatry tended to draw attention away from the real-world implications of just what “freedom” means (since freedom and responsibility are the “positions,” or rather ideals, that he advocated). Szasz certainly did say that freedom won’t necessarily make you happy; he only said so much less often than he might have.

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      • I haven’t met many descendants of slaves who want a return to the practice of slavery. Not being a slave, I’d say freedom and responsibility are less ideals than they are realities, and if they’ve become ideals, unreachable goals, basically illusory, as some suggest, we’ve got a problem. I don’t think they are illusory. I think we can say with more certainty that freedom is more likely to make a person happy than slavery. Additionally, I think we can safely say that slavery is more likely to make a person miserable than freedom. Were happiness the highest aim, and I question that assumption, I am certain that the way to it is not going to be through bondage to the will, whimsy, desire and demands of other people who imagine themselves to be superior. We can pretend that free people are slaves but, all the same, they are free people, and as such, they are free to engage in any such pretense they choose. Coercion, let me state, is no way to happiness either, at least, in so far as the coerced are concerned. The problem I have, Mr. Fontaine, with your post and presentation is the abstractness, and the distance, from your subject matter that you seem to maintain. Epicurus was a contemporary of slavery; Thomas Szasz of coercive psychiatry. One thing Szasz had in his day, over Epicurus in his, was the example of the abolitionists. Slavery ran its course, and coercive psychiatry will run its course. It is a course that will not be run by keeping people in bondage. It is a course that will be run when they are liberated from bondage. The poet Robert Bly once wrote a poem about casualties from the Vietnam war reduced to figures on newsprint. This is what I see in your post, too. Given the great man theory, the life of Napoleon was taken to be more valuable than the lives of thousands of other men. How many patients’ lives, for instance, is the life of any one psychiatrist worth? That’s a pretty unsettling question, isn’t it? I guess you knew your audience. I don’t think it’s the kind of question that would have gone over at an APA convention.

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    • I’ve always wanted to bring childhood up in the context of ‘nature versus nurture’ arguments. We don’t have one here, but how appropriate anyway.

      In primitive cultures, the dividing line between adulthood and childhood was something like reaching the age of 12. In more modern cultures, it is around the age of 18, or by extension, 21.

      Mental health law would retract age of consent laws, and thus some major leaps of judgment have been made about the perceived, or the impugned, childishness (always unproven beyond a reasonable doubt in any court of law) of certain adult individuals. Mental health law, in my view, is illegal or unconstitutional law.

      Implicit in the freedom to bear children is the responsibility for their welfare. Reneging on this responsibility can result in removal of the child, if the evasion is caught, or punishment, if the child is injured or dies. Here, as you can see, I don’t think the someone you refer to has put their autonomy second. I think that someone has put autonomy first, and here sacrifices come out of the autonomous decisions made for the sake of delayed and/or immaterial rewards.

      A baby left to its own devices will perish. The innate survival (thrival or whatever) gene must be entirely lacking at such an early age. Explain that one.

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      • “authority, unless justified, is inherently illegitimate and that the burden of proof is on those in authority. If this burden can’t be met, the authority in question should be dismantled.” N. Chomsky
        A toddler is not able to express substantial autonomy but a 9yr old can and a teen definitely can.

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  2. I must say that I found this post offensive because it seems that Michael was/is trying to be very provocative about Dr. Szasz in his presentation when he is writing for a critical or even antipsychiatry group who tend to admire those few heroes who exposed the truth about psychiatry and the so called mental “health” system at huge cost to themselves.

    The following article shows that psychiatry has not survived due to its great helping/healing capacity, but rather, due to the fact they sold out to Big Pharma and together made billions that helped buy politicians, the legal system and all the power for themselves that money can buy based on lies and fraud. Thus, this fascist psychiatry industrial complex or the therapeutic state that Dr. Szasz so brilliantly defined and exposed has nothing to do with health and everything to do with supporting the current 1% robber barons at the horrific expense of the majority subjected to the worst kinds of social control, brain/body destruction in the guise of health/help and the violation/robbery of all human, civil and constitutional rights.


    I don’t think it was necessary to make such a big deal of Dr. Szasz’ suicide for those of us who did not know because doing so creates the type of circus that has gone on with the death of Robin Williams while the decision to end one’s life can be based on very rational, well thought out reasons based on the pros and cons and not the so called “mental illness” the mental death profession pretends so they can impose their own form or torture/murder instead for profit and power with the pretense of concern and help. But, I think Szasz did pretty well in the media when he died and the fact his many books stay in print and keep selling shows that people brainwashed, deceived and horribly betrayed by modern biopsychiatry and its bogus, invalid stigmas and useless, poison drugs are grateful for support and validation from these noble old timers with a conscience like Dr. Szasz, Dr. Peter Breggin, Dr. Loren Mosher, Dr. Paula Caplan, Dr. Stuart Kirk, Dr. David Cohen and many others when they begin to see through this arrogant fraud. Dr. Fred Baughman, Neurologist, says all DSM stigmas voted in by consensus like ADHD and bipolar are 100% fraud to push the latest lethal, lucrative drugs and other forms of lobotomy on patent. Dr. Baughman claims that such actions by psychiatry constitute the worst medical crimes against humanity ever since children have become the major targets for this vile brain damage demolition enterprise. Psychiatry instigated the Nazi Holocaust with its horrific eugenics agenda they continue today in the guise of genetics research to blame the victims for social oppression, greed induced poverty, growing inequality, racism, sexism and many other environmental and social ills. As practice for the Holocaust psychiatry gassed to death those they stigmatized as “mentally ill” or otherwise useless eaters BEFORE Hitler came to power. In fact, Hitler praised psychiatry’s eugenics theories in his infamous book, Mein Kampf before he got involved in politics! It was psychiatry that persuaded Hitler to move the gassing apparatus from mental hospitals to the concentration camps with such “doctors” making selections for work or immediate death and even more horrific “scientific” experiments on twins like those of Mengele just as is done today in the guise of science and “mental health.” Also, psychiatry kept killing patients even after the war ended until they were forced to stop doing it openly by the Nuremburg Trials, Catholics and others opposing their psychopathy and malignant narcissism. Experts who conducted the Nuremburg Trials acknowledged that without psychiatry, the Holocaust would never have happened. So, obviously, people never learn when it comes to “snakes in suits” or demons tempting us in different guises/disguises.

    So, when a dubious field like psychiatry has the whole power of a corrupt industry like Big Pharma with their billions and equally corrupt politicians and regulatory agencies with the foxes guarding the hen houses with revolving doors, I don’t think that psychiatry’s supposed success can be attributed to Szasz’ failure. Anyone challenging this Goliath is attacked and discredited viciously as a Scientologist and other garbage with tons of Big Pharma money to destroy careers and terrorize others into silence just as they do with their so called “patients” on behalf of their fellow abusers in power. Psychiatry also plays the role of enabling the outer pretense of a democracy while using the bogus DSM stigmas to attack, discredit, isolate, terrorize, institutionalize, lobotomize and all their other horrors in the guise of mental health just like Soviet Russia and other fascist states pretending to be democracies. So, when Dr. Szasz advocates for freedom while psychiatry’s role is to violate any citizen’s every individual, human, democratic civil right using their fraudulent biopsychiatry paradigm as a cover while also helping Big Pharma and others to make billions, it isn’t hard to see who would/will “win,” but I guess that depends on what one sees as “winning.” Though one may “win” in this rat race, the winner is still a rat. As Guns ‘n Roses sang, “welcome to the jungle….”

    I think Dr. Szasz did win and succeed because he left his brilliant thoughts behind in his books and other work and all the lives he touched and saved like Dr. Peter Breggin, the conscience of psychiatry, with their great thoughts, compassion, wisdom and exposure of “psychiatry: the science of lies” and “toxic psychiatry” to help victims to unbrainwash themselves and become survivors/escapees of this horrific plague on humanity! Bob Whitaker’s books have been life savers for many as well as he exposed the truth about the epidemic psychiatry created rather than healing anything.

    There is the story of a young boy throwing star fish back into the sea that he finds on the beach. An old man comes along and chastises him on such a futile enterprise since the boy can’t save the huge number of starfish there. The boy responds that it matters to the starfish he is able to save. The same mentality can be applied to those saved from the Holocaust or whenever a human being decides to do the decent thing rather than the evil or expedient thing. Sadly, with the decline of the best of religion, many people have never even learned the basic ethics of the golden rule and other necessities for a decent civilization. I agree with Seth Farber that there is the hijacked Constantinian Christianity and that of Jesus and his followers which is another version of the therapeutic state versus freedom, compassion, wisdom and enlightenment.

    I have said elsewhere that I used to feel somewhat grateful that I wasn’t born during the Nazi Holocaust and other horrible times when in reality the fact that psychiatry sold out to Big Pharma in the 1980’s when they decided to “dance with the devil” as one APA president with lots of lucrative Big Pharma ties said to justify the destruction of so called patients makes me realize that psychiatry just continues its usual horrific crimes against humanity unabated in one guise or another whether it is state enforced witch hunts, Inquisitions and other fascist abuses just as Dr. Szasz wisely exposed, so he reminds us to beware of wolves in sheep’s clothing and other Trojan horses pretending to help during all these “times that try our souls.”

    Thank you for posting here, but again, I am offended by some of your post due to my great admiration and respect for Dr. Thomas Szasz. I think you could have been a bit more sensitive and respectful of your readers and I am still not sure I get your message or overall point other than to discredit Dr. Szasz, which I think failed miserably because you are comparing apples and oranges or using a rigged system with the so called “winner” already all too well established to tolerate any competitors or critics.

    I appreciate your writing here because your piece gave me much food for thought. Based on what you have added in your comments, perhaps I have misunderstood your analysis of Szasz. I agree with much of what Seth Farber says in that the power elite get to create the accepted version of the so called “truth” or “reality” they wish to prevail just like the winners get to write the history books. It doesn’t make it so!

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  3. A superb critique of psychiatry’s Big Pharma/DSM sellout by another conscientious objector!

    Commentary: Against Biologic Psychiatry December 01, 1996 | Bipolar Disorder, Cultural Psychiatry, Major Depressive Disorder

    By David Kaiser, MD

    As a practicing psychiatrist, I have watched with growing dismay and outrage the rise and triumph of the hegemony known as biologic psychiatry. Within the general field of modern psychiatry, biologism now completely dominates the discourse on the causes and treatment of mental illness, and in my view this has been a catastrophe with far-reaching effects on individual patients and the cultural psyche at large. It has occurred to me with forcible irony that psychiatry has quite literally lost its mind, and along with it the minds of the patients they are presumably supposed to care for. Even a cursory glance at any major psychiatric journal is enough to convince me that the field has gone far down the road into a kind of delusion, whose main tenets consist of a particularly pernicious biologic determinism and a pseudo-scientific understanding of human nature and mental illness. The purpose of this piece is not to attempt a full critique or history of this occurrence, but to merely present some of the glaring problems of this movement, as I believe significant harm is being done to patients under the guise of modern psychiatric treatment. I am a psychiatrist trained in the late 1980s and early 1990s, and I use both psychotherapy and medications in my approach to patients. I state these facts to make it clear that this is not an antipsychiatry tract, and I am speaking from within the field of psychiatry, although I find it increasingly impossible to identify with this profession, for reasons which will become clear below. Biologic psychiatrists as a whole are unapologetic in their view that they have found the road to the truth, namely that mental illnesses for the most part are genetic in origin and should be treated with biologic manipulations, i.e., psychoactive medications, electroconvulsive treatment (which has made an astounding comeback), and in some cases psychosurgery. Although they admit a role for environmental and social factors, these are usually relegated to a secondary status. Their unquestioning confidence in their biologic paradigms of mental illness is truly staggering. In my opinion, this modern version of the ideology of biologic/genetic determinism is a powerful force that demands a response. And when I use the word ideology here, I mean it in it’s most pernicious form, i.e., as a discourse and practice of power whose true motivations and sources are hidden to the public and even to the practitioners themselves, and which causes real harm to the patients at the receiving end. Biologic psychiatry as it exists today is a dogma that urgently needs to be unmasked. One of the surest signs that dogmatists are at work here is that they rarely question or attempt to problemitize their basic assumptions. In fact, they seem blissfully unaware that there is a problem here. They act in seeming unawareness that they are caught up in larger historical and cultural forces that underwrite their entire “scientific” edifice. These forces include the medicalization of all public discourse on how to live our lives, a growing cultural denial of psychic pain as inherent in living as human beings, the well-known American mixture of ahistoricism and belief in limitless scientific progress, and the growing power of the pharmaceutical and managed care industries. These self-proclaimed visionaries, oblivious to all of this, boast of real scientific progress over what they consider to be the dogma of psychoanalysis, which had up until recently reigned as psychiatry’s premier paradigm. Now, it is not my intention to defend psychoanalysis, which had its own unfortunate excesses, although I do use psychoanalytic principles in the kind of psychotherapy I do. However, it is quite clear to me that the grandiose claims of biologic psychiatry are wildly overstated, unproved and essentially self-serving. Biologic psychiatry has had its successes, particularly with recent antidepressants like Prozac and newer antipsychotic medications such as Clozaril. Medications can effectively improve depression, relieve severe anxiety, stabilize serious mood swings and lessen psychotic symptoms. These successes are real in that they improve the quality of life of patients who are genuinely suffering. But in reality, i.e., the reality of treating patients, medications have profound limitations. I know that if the only tool I had in treatment was a prescription pad, I would be a poor psychiatrist. The center of treatment will always need to be listening to and speaking with the patients coming to me. This means listening seriously to what they say about their lives and history as a whole, not merely listening for which symptoms might respond to medications. Although it seems astounding that I would have to state this, biologic psychiatrists as a whole really only listen to that portion of the patient’s discourse that corresponds to their biologic paradigms of mental illness. It is the nature of dogma that its practitioners hear only what they want to hear. So what are the limitations of biologic psychiatry? First of all, medications lessen symptoms, they do not treat mental illness per se. This distinction is crucial. Symptoms by definition are the surface presentation of a deeper process. This is self-evident. However, there has been a vast and largely unacknowledged effort on the part of modern (i.e., biologic) psychiatry to equate symptoms with mental illness. For example the “illness” major depression is defined by its set of specific symptoms. The underlying “cause” is presumed to be a biologic/genetic disturbance, even though this has never been proven in the case of depression. The errors in logic here are clear. A set of symptoms is given a name such as “major depression,” which defines it as an “illness,” which is then “treated” with a medication, despite the fact that the underlying cause of the symptoms remains completely unknown and essentially untreated. I have seen repeatedly that, for example, in the case of depression, once medications lessen the symptoms, I am still sitting across from a suffering patient who wants to talk about his unhappiness. This process of equating symptoms with illnesses has been repeated with every diagnostic category, culminating in perhaps one of the greatest sophistries psychiatry has pulled off in its illustrious history of sophistries, namely the creation of the Diagnostic and Statistical Manual (currently in its fourth incarnation under the name DSM-IV), the bible of modern psychiatry. In it are listed all known “mental disorders,” defined individually by their respective symptom lists. Thus mental illnesses are equated with symptoms. The surface is all there is. The perverse beauty of this scheme is that if you take away a patient’s symptoms, the disorder is gone. For those who do serious work with patients, this manual is useless, because for me it is simply irrelevant what name you give to a particular set of symptoms. It is an absolute myth created by modern psychiatry that these “disorders” actually exist as discrete entities that have a cause and treatment. This is essentially a pseudo-scientific enterprise that grew out of modern psychiatry’s desire to emulate modern medical science, despite the very real possibility that psychic pain, because of its existential nature, may always elude the capture of modern medical discourse and practice. Despite its obvious limitations, the DSM-IV has become the basis for psychiatric training and research. Its proponents claim it is a purely phenomenological document stripped of judgments and prejudices about the causes of mental illness. What in fact it has done is the defining and shaping of a vast industry of research designed to validate the existing diagnostic categories and to find ways to lessen symptoms, which basically has meant biologic research. Virtually all of the major psychiatric journals are now about this, and as such I find them useless to help me deal with real patients. Patients are suffering from far more than symptoms. Symptoms are the signs and clues to direct us to the real issues. If you take away the symptoms too quickly with medications or suggestion, you lose the opportunity to help a patient in a more profound way. As an aside, modern psychiatrists, because they have forgotten or dismissed the real power of transference, vastly underestimate the extent to which symptom reduction is caused by mere suggestion. Not that patients should be left to suffer needlessly from what are often crippling symptoms. Relief from symptoms is a part of treatment. Modern psychiatry would have us believe that this is all treatment should be. Meaning, desire, loss and death are no longer the province of the psychiatrist. In this process patients are reduced to something less than fully human, as they become an abstract collection of symptoms without meaning to be “managed” by technicians called psychiatrists. This is in the service of medical progress and enlightened scientific thought. The biologic psychiatrist will not make the mistake of imposing their value systems on patients like in the bad old psychoanalytic days. This is, of course, a sham. Modern psychiatry now foists on patients the view that their deepest and most private ills are now medical problems to be managed by physician-psychiatrists who will take away their symptoms and return them to “normal functioning.” This is more than a bit malignant. One of the dominant discourses that runs through the DSM-IV and modern psychiatry in general is the equating of mental health with “normal” functioning and adaptation. There is a barely concealed strain of a specific form of Utopianism here which blithely announces that our psychic ills are primarily biologic and can be removed from our lives without difficulty, leaving us better adapted and more productive. What is left completely out, of course, are any notions that our psychic ills are a reflection of cultural pathology. In fact, this new biologic psychiatry can only exist to the extent it can deny not only the truths of psychoanalysis, but also the truths of any serious cultural criticism. It is then no surprise that this psychiatry thrives in this country presently, where such denials are rampant and deeply embedded. I am constantly amazed by how many patients who come to see me believe or want to believe that their difficulties are biologic and can be relieved by a pill. This is despite the fact that modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness. However, this does not stop psychiatry from making essentially unproven claims that depression, bipolar illness, anxiety disorders, alcoholism and a host of other disorders are in fact primarily biologic and probably genetic in origin, and that it is only a matter of time until all this is proven. This kind of faith in science and progress is staggering, not to mention naive and perhaps delusional. As in any dogma, there is no perspective within biologic psychiatry that can effectively question its own motives, basic beliefs and potential blind spots. And thus, as in any dogma, there is no way for the field to curb its own excesses, or to see how it might be acting out certain specific cultural fantasies and wishes. The rise and fall of biologic determinism in a culture likely has complicated and interesting causes, which are beyond the scope of this paper. A few comments will have to suffice. This is a culture increasingly obsessed with medical science and medical health as a sign of virtue. It is not surprising that our psychic ills would be pulled into this dominant medical discourse, essentially medicalizing our specific forms of psychic pain. It seems to me that modern psychiatry, in step with a culture which created it, assumes any suffering to be unequivocally bad, an impediment to the “good life” of progress, productivity and progress. It is now almost heresy in psychiatry to say that perhaps suffering can teach us something, deepen our experience, or point us to different possibilities. Now, if you are depressed or anxious, it has no real meaning, because as a biologic illness similar to say diabetes, it is separate from the world of meaning and merely is. Now any thoughtful person knows that something as fundamental as depression has meanings such as loss, facing mortality, unlived desires, lack of power or control, etc., and that these meanings will continue to exist even if Prozac makes us feel better. There is much more to life than feeling better or living without pain, and only a superficial and pathologic culture would need to deny this. Yet conclusions such as “depression is a chemical imbalance” are created out of nothing more than semantics and the wishful thinking of scientist/psychiatrists and a public who will believe anything now that has the stamp of approval of medical science. It seems to me that modern psychiatry is acting out a cultural fantasy having to do with the wish for an omniscient authority who, armed with modern science, will magically take away the suffering and pain inherent in existing as human beings, and that rather than refusing this projection (which psychoanalysts were better able to do), modern psychiatry has embraced the role wholeheartedly, reveling in its new-found power and cultural legitimacy. I would be remiss if I left out the obvious economic factors in psychiatry’s movement toward the biologic. Pharmaceutical corporations now contribute heavily to psychiatric research and are increasingly present and a part of psychiatric academic conferences. There has been little resistance in the field to this, with the exception of occasional token protest, despite its obvious corrosive and corrupting effects. It is as if psychiatry, long marginalized by science and the rest of medicine because of its “soft” quality, is now rejoicing in its new found legitimacy, and thus does not have the will to resist its own degradation. The fact that drug companies embrace and fund this new psychiatry is cause enough for alarm. Equally telling is a similar embrace by the managed care industry, which obviously likes its quick-fix approach and simplistic approach to complicated clinical problems. When I talk to a managed care representative about the care of one of my patients, they invariably want to know what medications I am using and little else, and there is often an implication that I am not medicating aggressively enough. There is now a growing cottage industry within psychiatry in advocating ways to work with managed care, despite the obvious fact that managed care has little interest in quality care and realistic treatment approaches to real patients. This financial pressure by managed care contributes added pressure for psychiatry to go down a biologic road and to avoid more realistic treatment approaches. What this means in real terms is that psychotherapy is left out. There has thus been a triple partnership created between this new psychiatry, drug companies and managed care, each part supporting and reinforcing the other in the pursuit of profits and legitimacy. What this means to the patients caught in this squeeze is that they are increasingly overmedicated, denied access to psychotherapy and diagnosed with fictitious disorders, leaving them probably worse off in the long run. It is quite depressing to listen to the discourse of modern psychiatry. In fact, it has become embarrassing to me. One gets the strong impression that patients have become abstractions, black boxes of biologic symptoms, disconnected from the narratives of their current and past lives. This pseudo-scientific discourse is shot through with insecurity and pretension, creating the illusion of objectivity, an inevitable march of progress beyond the hopeless subjectivity of psychoanalysis. Psychotherapy is dismissed and relegated to nonmedical therapists. I actually have no objections to real science in the field, if, for example, it can help me make better medication decisions or develop newer and better medications. But in general biologic psychiatry has not delivered on its grandiose and utopian claims, as today’s collection of medications are woefully inadequate to address the complicated clinical issues that come before me every day. This is all not terribly surprising given what I have outlined in this piece. There will be no substitute for the difficult work of engaging with patients at the level of their lived experience, of helping patients piece together meaning and understanding in the place of their pain, fragmentation and confusion. Patients these days are not suffering from “biologic illnesses.” What I generally see is patients suffering from current or past violence, traumatic loss, loss of power or control over their lives and the effects of cultural fragmentation, isolation and impoverishment that are specific to this culture at this time. How this manifests in any individual is absolutely specific; therefore, one should resist any attempt to generalize or classify, as science forces us to do. Once you go down the route of generalization, you have ceased listening to the patient and the richness of their lived experience. Unfortunately what I also see these days are the casualties of this new biologic psychiatry, as patients often come to me with many years of past treatment. Patients having been diagnosed with “chemical imbalances” despite the fact that no test exists to support such a claim, and that there is no real conception of what a correct chemical balance would look like. Patients with years of medication trials which have done nothing except reify in them an identity as a chronic patient with a bad brain. This identification as a biologically-impaired patient is one of the most destructive effects of biologic psychiatry. Modern psychiatrists seem unaware of what psychoanalysts know well, namely how powerful are the words that a patient hears from an authority figure like a psychiatrist. The opportunity here for suggestion, coercion and manipulation are quite real. Patients are often looking to psychiatrists for answers and definitions as they struggle with questions such as who am I or what is happening to me. Of course we all struggle with these questions, and the human condition is such that there are no definitive answers, and anyone who comes along claiming they have answers is essentially a fraud. Biologic psychiatry promises easy answers to a public hungry for them. To give a patient nothing but a diagnosis and a pill demonstrates arrogance, laziness and bad faith on the part of the psychiatrist. Any psychiatrist needs to be continually aware of the very real possibility that they are or can easily become agents of social control and coercion. The way to resist this is to refuse to take on the role assigned through cultural fantasy, namely the role of omniscient dispenser of magical potions. As a whole modern biologic psychiatry has enacted this role with particular vigor and enthusiasm. At the level of individual patients this means a growing number of overdiagnosed, overmedicated and disarticulated people less able to define and control their own identities and lives. At the level of our culture this has meant an impoverishment of the discourse around such questions as what is wrong with us, as “scientific” answers replace more potentially fruitful and truthful psychological and cultural questioning. If psychiatry is to regain any semblance of legitimacy and integrity, it must strip itself of false and hubristic scientific claims and humbly submit itself to the urgent task of listening to individual patients with patience and intelligence. Only then can we have any real sense of what to say back to them. The sole philosophic basis for this new psychiatry is the championing of empiricism above all other measures of truth. Something is valid only if it can be demonstrated through experimental method, otherwise it is disregarded or relegated to “subjective” experience, which is presumed to be inferior. Now, of course, this dominance of empiricism is not limited to psychiatry, and one can easily trace the invasion of the experimental method of the “hard” sciences into the “soft” or social sciences. On a larger cultural level this can be detected in the public’s infatuation with “studies,” statistics and so on. This hegemony of empiricism over other ways of thinking and knowing represents an unprecedented modern achievement which has thoroughly infiltrated the cultural psyche, to the point now where the average person believes easily the claims of the biologic psychiatrist. Now as is clear from my views already expressed, a social science dominated by empiricism is a vulgar science, and there is a vast tradition in philosophy from Plato to Nietzsche which in my view irrefutably demonstrates this. However this is well beyond the scope of this piece. Suffice it to say that modern psychiatrists, like all “scientists” these days, have no time for the basic philosophic questions that have engaged the most brilliant minds of the past. Who needs questions about virtue when there is important data to collect? These biologic psychiatrists never think to ask themselves whether their own precious methods are perhaps standing on very shaky ground, say their own disavowed prejudices about what constitutes the good life. Empiricism is one way of knowing, but certainly not the only or best way. Biologic psychiatrists often use the standards of empiricism to answer their critics, in effect saying that their claims are scientifically “proven” and thus unassailable, clearly a tautological argument. I would further add that in my view many of the claims of biologic psychiatry do not even hold up to their own standards of empirical science, for example their claims about the biologic and genetic basis of many mental illnesses. In my view, the methods of experimental science are inappropriate and misplaced when it comes to understanding the complexity of the human psyche, as they can only objectify the mind and remove subjectivity from the heart of human experience, thus creating an abstract entity in place of a human mind. It is no wonder that psychiatry declared the 1980s the decade of the brain instead of the decade of the mind. In their pursuit of the human brain they have quite literally lost their minds. One way to unmask the dogma that is biologic psychiatry is to ask the question what kind of human being is being posited as desirable, “normal,” or not disordered. Judging by the DSM-IV, it would be a person not depressed or anxious, without perversions or sexual “dysfunction,” in touch with “reality,” not alienated from society, adapted to their work, not prone to excessive feeling states and generally productive in their life pursuits. This is, of course, the bourgeois ideal of modern culture. We will all fit in, produce and consume and be happy about it. Anyone who dissents by choice or nature slips into the realm of the disordered or pathologic, is then located as such by medical science and is then subject to social management and control. Now, psychiatry has always provided this social function, as admirably shown by Foucault and others. I would submit, however, that modern psychiatry, under the guise of medical and “scientific” authority and legitimacy, has surpassed all past attempts by psychiatry to identify and control dissent and individual difference. It has done this by infiltrating the cultural psyche, a psyche already vulnerable to any kind of medical discourse, to the point where it is a generally accepted cultural notion now that, say, depression is an illness caused by a chemical imbalance. Now when a person becomes depressed, for example, they are less able to read it or interpret it as a sign that there may be a problem in their life that needs to be looked at or addressed. They are less able to question their life choices, or question for example the institutions that surround them. They are less able to fashion their own personal or cultural critique which could potentially lead them to more fruitful directions. Instead they identify themselves as ill and submit to the correction of a psychiatrist, who promises to take away the depression so they can get back to their lives as they are. In short, the very meanings of unhappiness are being redefined as illness. In my view this is a dismaying cultural catastrophe. I do not mean to suggest that psychiatry is solely to blame for this, given how wide a cultural shift this is. However, I do think that psychiatry has not only not resisted its role here, but actually has fulfilled it with considerable hubris. Thus in my view the whole phenomenon of biologic psychiatry is itself a symptom or acting out of a larger, underlying cultural process. Unhappiness and suffering are not seen as resulting from real cultural conditions; for example, the collapse of traditional institutions and the ever increasing hegemony of rampant consumerism in American culture. Nor is suffering seen in the context of what it means to exist as a human being in any historical period. Historical and existential discourse about unhappiness is increasingly supplanted by medical discourse, and biologic psychiatry has served as one of the major mouthpieces for this kind of pseudo-scientific and frankly pathetic medical discourse about what ails us. I am increasingly astonished about how unable the average patient is now to articulate reasons for their unhappiness, and how readily they will accept a “medical” diagnosis and solution if given one by a narrow-minded psychiatrist. This is a cultural pathologic dependence on medical authority. Granted, there are patients who do fight this kind of definition and continue to search for better explanations for themselves which are less infantilizing, but in my experience this is not common. There is a frightening choking off of the possibility for dissent and creative questioning here, a silencing of very basic questions such as “what is this pain?” or “what is my purpose?” Modern psychiatry has unconscionably participated in this pathology for its own gain and power. It is a moral, not scientific issue at stake here, and in my view this is why many astute Americans rightfully distrust this new psychiatry and its Utopian claims about happiness through medical progress. So what kind of psychiatry am I advocating here? First of all, I think it is unclear whether the field can extricate itself from its current infatuation with technology and its own power to use it. When one reads psychiatric journals now, one senses a dangerous giddiness about the field’s “discoveries” and “progress,” which in my view are wildly and irresponsibly overstated. All the momentum, which is mainly economically driven, is pushing psychiatry toward further biologism. Having said this, what I am advocating is a psychiatry which devotes itself humbly to the task of listening to patients in a way that other medical practitioners cannot. This means paying close attention to a patient’s current and past narrative without attempting to control, manipulate or define it. From this position a psychiatrist can then assist the patient in raising relevant questions about their lives and pain. The temptation to provide answers or false solutions should be absolutely avoided here. Medications are used judiciously for lowering painful symptoms, with considerable attention paid to the psychological effects of medication treatment. Diagnosis should play a secondary and small role here, given that little is known about what these diagnoses actually mean. Above all suggestion, coercion, normalization and control need to be assiduously guarded against, as these are natural temptations that arise out of the dynamics of power that exist between psychiatrist and patient. A more humane psychiatry, if it is even possible in today’s cultural climate, must recognize the powerful potential of the uses and abuses of power if it is not to become a tool of social control and normalization. As I have outlined in this piece, these abuses of power are by no means always obvious and self-evident, and their recognition requires rigorous thought and self-examination. The psychiatrist plays a particular role in cultural and individual fantasies, and an intelligent psychiatrist must be aware of the complexity of these fantasies if he is to act in a position outside these projections and fantasies. This requires real moral awareness on the part of a psychiatrist who wishes to act intelligently. What I am advocating for in outline form as stated previously are the minimal requirements necessary for the field of psychiatry to reverse its current degradation. What is essential at this time is for psychiatrists and other clinicians to speak out against the ideology known as biologic psychiatry.

    – See more at: http://www.psychiatrictimes.com/articles/commentary-against-biologic-psychiatry#sthash.c2hMQzJ7.dpuf

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      • Wileywitch,

        You’re right that the article is difficult to read like that. I copied this from Psychiatric Times to make it more easily available for MIA people and in the process the paragraph divisions seem to have disappeared.

        You can access the article via the link at the end of my post and if you aren’t registered for this magazine, you can sign up and access such articles free.

        This is a great, inspiring article by a psychiatrist writing in 1996 who is horrified at the bogus biological paradigm hijacking psychiatry. He says it is/was psychiatry losing its mind and not the patients.

        Take care.

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    • A wonderful text. Thank you.
      “This is, of course, the bourgeois ideal of modern culture. We will all fit in, produce and consume and be happy about it.”
      That was the thing which took me a considerable amount of time and confusion to formulate. The disagreement with the major societal narrative about the normal and the appropriate. I was told opinions as facts over and over by everyone and it still felt wrong.

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  4. I would like to point out that Dr. Kaiser’s article was written in 1996 before the drugs he thinks work well were/are exposed to be useless but deadly like SSRI antidepressants as exposed in Kirsch’s The Emperor’s New Drugs and the horrific brain damaging/disabling neuroleptics that cause so much harm to the brain and body, those conned or forced to take them suffer many horrible physical ailments including obesity, metabolic syndrome, diabetes, heart problems, eye damage, kidney damage and tons of others along with a chemically lobotomized brain resulting in early death by an average of 25 years after living a destroyed, miserable life. As Robert Whitaker shows in his book, Anatomy of an Epidemic, the very rare cases of so called manic depression and many with schizophrenia went on to recover after one episode to lead normal lives. But, now that the psychiatry/Big Pharma cartel has expanded these bogus stigmas to assault just about everyone on the planet from babies in utero to the elderly in nursing homes with women and children the main victims of these cowards, there is a growing epidemic of permanent disability and misery with SSI foisted on us tax payers so this oligarchy can continue to make its billions by destroying our lives and forcing us to pay for the damages as well in a true Orwellian Cowardly New World!

    But, except for such dated drug information, Dr. Kaiser’s protest against the biological psychiatry eugenics ideology that persists with Dr. Thomas Insel, Head of the NIMH, and his cohorts, is right on the mark when he exposes that it’s all about money and power to keep this vile, self serving gravy train goind.

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  5. Thank you for this piece Michael. Since I am not much of a philosopher some of it is a bit difficult for me to understand but I really like the point you make about there being not two, but three ways to explain mental illness.

    I have never been happy with the dichotomy created by those who say mental illness is always caused by biology or always caused by trauma. Neither of these explanations could explain my son’s illness. Perhaps, there are several causes and combinations of causes that result in what is known as mental illness. I believe that what Szasz said about personal choices is definitely part of the explanation of mental illness. In my son’s case I think that his choice to eat only junk and self-medicate with drugs caused the physical problems that led to his breakdown. There were probably genetic factors and environmental factors as well. So the explanation for mental illness is much more complicated than some would have you believe. I have read only one book by Szasz but although he had some great insights I also believe that he over-simplified the causes of mental illness.

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    • Szasz’s aim was not to find “causes” for “mental illness.” What he did was demonstrate that the very notion of mental illness is based on a semantic and logical non-sequitur, and that those who seek to end to their emotional suffering by defining it as “disease” and discovering a medical “cure” are barking up the wrong tree.

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    • You read one book by Szasz and conclude he “over-simplified” the causes of “mental illness!
      But as oldhead points out Szasz did not believe in mental illness and thus to look for its causes was misleading–and I would add it exacerbates, reifies and perpetuates the original presenting problem. Had you read Szasz more carefully MadinCanada you might have understood what you were reading. And learned from it.
      But this is a good way to handle our great prophets and iconoclasts, men and women who would have us reexamine our most comfortable myths., Read superficially a tiny fraction of their work and then dismiss them as simpletons who don’t understand the complexity of life. Thus Isaiah and Jesus, Dorothy Day and the Berrigan brothers could be dismissed as ieewalists who don’t understand the reality of politics and the necessity of war. Laing was dismissed as a romantic who would not face the reality of mental illness. Read a few pages of Chomsky and dismiss him as an unpatriotic ideologue. So much easier than actually making the effort to understand him.And it spares all that cognitive dissonance. Or dismiss Whitaker as an anti-drug fanatic. In his day Martin Luther King Jr was also dismissed by those who never read his work. Today his subversive ideas on imperialism and class warfare (similar to Occupy Wall St but more caustic) have been disappeared and he has been transformed into a vapid purveyor of sentimental clichés–a vapid icon celebrated by both corporate parties.
      This strategy obviates the need to look within, to see the root of our problems in our own societies or psyches. We need not exert the intellectual discipline it requires to understand a Szasz or a Chomsky or Foucault who prophesized the omniscient totalitarian national security state AND the Therapeutic State. It’s so much easier to read a few pages and dismiss them as simpletons than it would be to actually seek to understand them. But at what social cost?
      Seth Farber, Ph.D.

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    • MadinCanada you read one book by Szasz which you read too superficially to understand–as Oldhead points out Szasz did not believe in mental illness so to seeks its causes is misleading –and I would add exacerbates, reifies and perpetuates the presenting problem. That was Szasz’s point and his writing can be extremely empowering to people like your son. He was not interested in what caused “mental illness” but in what kept
      people as chronic patients. But you need to read him carefully to benefit from his work.
      To dismiss him as a simpleton is an indication that you have not understood his project. If you want a book on the causes of distress etc read Peter Breggin’s Toxic Psychiatry. Or the causes of madness read my first book, Madness, Heresy and the Rumor of Angels…

      It is easier to dismiss our prophets and iconoclasts as simpletons than to exert the discipline and tolerate the cognitive dissonance they cause. For exampleit’s easy to read a few pages by Chomsky and dismiss him as an unpatriotic ideologue. Read a little Isaiah, Jesus, Dorothy Day and the Berrigan brothers and dismiss them as idealists who did not understand war is allegedly necessary and politics requires compromising principles. Martin Luther King Jr was a critic of American military power and domestic class warfare (like Occupy Wall St) but today he is celebrated by our political elites as a sort of black Santa Claus who uttered vapid clichés and posed no threat to corporate America. Laing was dismissed as a romantic who did not understand the realities of schizophrenic. If you don’t make an effort to read and focus you will just parrot the received wisdom of our culture. But at what social cost? At what cost to your own individual growth?

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  6. “Szasz was fond of comparing psychiatry to the Inquisition, psychiatrists to witches, the mental hospital to the Church, and the medieval Age of Faith to what he called the modern Age of Madness.2”

    Psychiatrists to witches? Do you mean inquisitors?

    As far as the silence following Szasz’ death, the ‘boycott’ is the hiding place of those who have no case to offer in response, thus ignoring what they can not answer, and hope to stop the spread of the unpleasant truth so dangerous to their cause.

    Deep article for me Michael, might have to come back to it to take it all in.

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    • “Psychiatrists to witches? Do you mean inquisitors?”

      No. Surprising as it may seem, in Manufacture of Madness Szasz argues that psychiatrists correspond to witches, whereas mental patients correspond to the bewitched. It’s certainly a counterintuitive argument, so I invite you to read the book for yourself.

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      • Michael, I have read the book at least three times–although not in a while.
        It’s a counter-intuitive argument alright –and it is not true.
        What What kind of game are you playing with us? To what end????
        Boans you are correct/
        Michael, You do not know what you are talking about. Szasz compares mental patients to witches and psychiatrists
        to witch- hunters. That is the analogy on which this book–his greatest IMO–is based.Now there may be one parenthesis in the book where he reverses it for some reason but in the book the psychiatrists are the Inquisitors. I don’t bet money but if you do not believe me I’ll make you a “gentleman’s bet.”
        I don’t know what kind of game you are playing here but it is really incredible.
        You have invented an entirely different book. To what end? Did you think there is no one here who read it? What is your motive?
        Szasz wrote the Foreword to my first book.Madness. Heresy and the Rumor of Angels. Look on Amazon if you don’t believe me. Do you think I have not read TMM, his second most famous book? Is this a deliberate lie, or have you imagined this?.!!!
        Leszt someone accuse me of unfair play I’ll be right back with the description of the book.

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        • OK
          Here is the first reader from Amazon . I could also quote from a joiurnal review. But they all say the same thing. Michael has imagined or invented
          a book Szasz never wrote. Micael Fontaine writes above”…, in Manufacture of Madness Szasz argues that psychiatrists correspond to witches, whereas mental patients correspond to the bewitched. It’s certainly a counterintuitive argument, so I invite you to read the book for yourself.” I read the book 3 times so I know Michael either lied or
          imagined this.
          Here is the description on AmazOn

          The Manufacture of Madness is a fine historical analysis of psychiatry and the mental health movement, drawing comparisons between the medical establishment’s treatment of deviants as mental patients and the Inquisition’s treatment of deviants as witches. Radical, perhaps, although it must have seemed much more radical in 1970, when first published. Dr. Szasz knew his material well, having worked for twenty years as a psychiatrist in this country prior to writing the book.
          His views were considered heretical by his colleagues (an irony that he makes much of) because he argued, quite strongly, that institutional psychiatry is dehumanizing both to patients and society as a whole because it deprives these people of all rights, treats them as objects to be repaired, and submits them to cruel tortures in the name of therapy. He went on to declare that mental illness itself is a myth; there has never been a scientific basis for treating social and behavioral deviance as stemming from the same causes as physical illnesses, nor reason to try to cure it. His central thesis is that institutional psychiatry fills the same role in modern times as the Inquisition did until only a few hundred years ago–a system of control and suppression of social deviants.

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        • Seth, respectfully, I think your argument could have been made without the accusations of lying and game playing, which are personal attacks. Like it says in our posting guidelines, please respond to and criticize ideas, not character.

          To everyone: I understand that this piece is controversial and that many of us have strong feelings about Szasz and his work, but let’s keep it civil please.

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          • That is what I thought
            I wasn’t trying to be insulting
            I know the book well–I read it at least 3 times. I was astonished.
            Evidently he based his description of the book on a cryptic description by Foucault.

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      • Let me revisit the point Szasz made about witches/psychiatrists/patients briefly. In Anti-Psychiatry: Quackery Squared (2009, p. 130) he quotes Foucault’s endorsement of his argument in Manufacture of Madness:

        “What’s strong and important in Szasz’s work is to have shown that the historical continuity doesn’t go from witches to madness, but from the institution of witches to the one of psychiatrists.”

        The fact that Szasz does not comment on or correct Foucault’s statement suggests to me he agreed with it. This matches my recollection of the argument of the book. As I recall (though I don’t have the book nearby to check) in Manufacture of Madness Szasz disputed Zilboorg’s traditional interpretation that the mental patients of today were identical with the witches of the early modern period.

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        • I’ll have to look for that book later.(I have it–it’s rare for Szasz to quote Foucault whom he disliked.) But clearly you have not read The Manufacture of Madness. What you write here is true:”Szasz disputed Zilboorg’s traditional interpretation that the mental patients of today were identical with the witches of the early modern period.” That doesn’t mean the analogy does not equate witches with mental patients. THe Psychiatric revisionist account posits–as I said above already–that witches were mentally ill. That the Church persecuted the mentally ill. Szasz disputes this as he denies the existence of mental illness! AS I said the witches were indigenous healers persecuted by the priests.Just as witches and heretics were formerly persecuted by the Church, the Inquisition, in our era deviants are persecuted by Psychiatry. So of course Szasz does not agree with the Psychiatric view of Zilboorg. He claims–I repeat–that witches were really mentally ill people who were misconstrued as “witches” by the Church and persecuted.” This is Psychiatric Whiggery. Szasz argues –correctly –that there is no such thing as mental illness. THe witches neither had sex with the Devil(as the priests claimed) nor showed any “symptoms” of “psychosis.” as Psychiatry claims. They were for the most part indigenous healers.
          Now if you hold that in mind you can see the scandal that continues today. Just as social deviants were persecuted as “witches” by the Church so today social deviants are persecuted by the Mental Health movement. The construct witch is a fiction invented by the Church. And the construct “schizophrenic” is fiction invented by Psychiatry. Now in order to establish its hegemony the Psychiatric “historians” rewrite history and claim the heretics persecuted by the Church were really mentally ill.. There is neither mental illness or witchcraft. Both are inventions of the powerful. Seth (TO BE CONTINUED)

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          • Zilboorg clkaims, I mean,–I repeat–that witches were really mentally ill people who were misconstrued as “witches” by the Church and persecuted. Szasz does not claim that witches have any continuity with schizophrenics. That is psychiatric propaganda–an effort to take on the role of the Church. It is the PROCESS that is tyhe same. On the one hands you have the manufacture of withcraft–woimen who sealed their pact with the Devil through
            sodomy. On the other hand you have the manufacture of madness.
            The later derives it legitimacy through the former which it replaces.
            Now Later I’ll look for that Szasz book. What Foucault may have been saying is that the women who were indigenous authentic healers were replaced by psychiatric charlatans.“What’s strong and important in Szasz’s work is to have shown that the historical continuity doesn’t go from witches to madness, but from the institution of witches to the one of psychiatrists.” This is an illegitimate usurpation.
            But this is not the main theme of Szasz book which is “the manufacture of madness.” Usually Szasz is critical of leftists like Foucault–but Foucault had greaT respect for Szasz–and passed that on to his buddy Laing. SF

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        • I’m not sure you get anywhere by quoting another author in another book without giving fresh meaning to hearsay.

          The gist of Zilboorg’s thesis is that most witches were mentally ill. Instead of their illness being correctly identified, it was misinterpreted as a sign of witchcraft.

          The Manufacture of Madness, pg. 75. P 3.

          Zilboorg apparently believed in something called “mental illness”, and he believed, as well, that women burned at the stake as witches had it. I imagine the institution involved to be the inquisition as I don’t think there was much organized witchcraft back then. Take the notion of heresy, and stretch it, and you’ve got a witch.

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  7. It seems to me from a moral standpoint, the burden of proof should be on the person who claims that another is responsible for his actions. Most people clearly are irresponsible most of the time. True responsibility must be learned. Most people don’t learn it, not really. They merely acquiesce to legalistic subjection. That is not really responsibility, just conformity to a social norm. Arbitrary claims of responsibility like Dr. Szazs’s are just another form of social control. A necessary one, perhaps, but still just social control.

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    • We are all responsible for our actions. As Seth F pointed out Szasz’s “economic libertarianism” may have brought with it some conflict between his notions of personal responsibility and progressive ones of collective responsibility, but in reality there is no conflict, just a dialectic manifesting on different levels. And as Steve below points out, shills for the corporate state manipulate the concept to hold people “responsible” for their own oppression.

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        • I’m not one to sing praises for the irresponsibility of man, beast, or child. I wonder if the issue for you is freedom versus determinism, and are you saying humanity is not free? Otherwise, I don’t get it. Responsibility goes along with freedom. That’s why we’ve got the dog pound for those people who are irresponsible, and disrespect the freedom of others. If we are only cows or lemmings, figuratively speaking, alright then. So goes one theory.

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          • It was just something to ponder that might make us think about what we are doing.

            “Responsibility goes along with freedom.” Does this mean anything other than “A requirement for obedience goes along with freedom”?

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          • Certainly not. Freedom makes disobedience one option among many. Responsibility could, in fact, demand disobedience rather than obedience. An element of morality is at work here, just the kind of thing that was absent from, say, NAZI Germany, or is absent on Wall Street. You have the freedom to pursue your own version of “king on the mountain” at the world’s expense if you want to do so, or you could pursue a more egalitarian state for all. Good and bad are choices, but choosing good is more responsible than choosing bad. Choosing poorly, well, of course that’s irresponsible, too.

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  8. “In antiquity, the shamanic model was only believed in by the lower classes and because it is obsolete today, it does not interest us here.”

    What?!?! Sorry, but “shamanic” model is not only “obsolete”, but actually is in the process of rebirth – due to successes of academic parapsychology, transpersonal psychology and near-death studies. Whether one like it or not, there is a lot of hardcore scientific evidence pointing to something that can be called “non-local consciousness” – e.g., consciousness which transcend brain and body (as well as space and time, and “physical reality” in general).

    Yes, such statements may seem outrageous for some, but this is just the fact. If you want to look at the topic in more detail, you can start here:




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  9. Thanks for this article – I learned a lot! I find myself being sympathetic to the Epicurian viewpoint overall, though I had no idea of the history. I now understand why “epicurian” has been diverted to mean something much smaller – the “psychiatrists” of the time needed to demonize the movement in order to snuff it out, much as modern psychiatry has had to demonize Szaz.

    I have to say, though, I think you missed the main reason why Szaz’s influence waned as he got older. It’s very clear that Psychiatry (the religion) made a monumental effort to re-define “mental illness” starting in the late 70s and early 80s with the development of the DSM-III. This effort was massively funded by the pharmaceutical industry, but also fit very nicely into the Reagan-Thatcher era push toward “individual responsibility,” meaning an increasing desire to deny the impact of social forces on individuals and free reign toward blaming all individuals for their own circumstances or conditions, including poverty, unemployment, racial discrimination, and so forth.

    So there was a HUGE push toward denying that mental illness could be caused by circumstances a person is confronted with, not because it was philosophically believed to be so, but because it was economically and socially beneficial to those in positions of power to forward this belief.

    Sadly, Szaz was indeed correct in his assumption that too many individuals will do almost anything imaginable to avoid real responsibility and instead cast blame somewhere else. This also leads to the desire for magical cures, and psychiatry has been all too happy to provide them, for a considerable fee, of course. The DSM and pills let EVERYONE off the hook – parents aren’t responsible for their kids’ behavior problems or emotional states, teachers don’t need to think about creating better structures or learning environments (after all, it’s the CHILD that has the problem!), therapist don’t have to actually listen to or feel what their client is experiencing, social institutions don’t have to examine their role in perpetuating prejudice and oppression – nobody’s done anything wrong, and nobody has to change anything, it’s all genetics. Even the client is off the hook – you’re emotions have nothing to do with you, it’s all your brain’s fault. So kids don’t need to learn to behave better, adults don’t need to learn to manage their lives better, teachers don’t need to learn how to teach better – we put a label on and give a drug and the problem is solved! And even if it isn’t, we blame the “disease” – if my efforts don’t work, he has “treatment-resistant depression.” It’s not because I am a crappy therapist. It’s that darned “depression” that just refuses to yield!

    This viewpoint, however unsupported by actual facts, had great appeal to the masses, as well as to the monied elites who create policy and control the media. So Szaz and Laing and Mosher and Breggin and Paolo Friere and anyone who had the temerity to disagree with the “new world order” were systematically and rather easily dismissed as a crank or “antiscientific” or a “Scientologist” or whatever ad hominem attacks were effective, because these people (the psychiatric big brass and their allies) were never interested in the truth or in helping people, they were interested in dominating and making money. And they have done a great job of it, much to the detriment of those they claim to want to help.

    This is the reality we’re up against, but Szaz was no politician. He was just stating what he saw. I have the greatest respect for the guy, who put his reputation on the line for the truth. If we had more like him, even if I disagreed with them, we’d be in a better place. The problem isn’t that psychiatry (the Church of Psychiatry, not all the individuals who may practice it) is wrong, its that it doesn’t care if it’s right or wrong, as long as it can hold onto it’s position of domination.

    — Steve

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  10. Someone, please send the following memo to the great psychiatrists of the APA… RE: Michael Fontaine’s “…comparison of the philosophic psychiatry of Thomas Szasz to the psychiatric philosophy of Epicurus in May 2014 at the 167th annual meeting of the American Psychiatric Association in New York City. Because Szasz had died late in 2012…”

    If, since the time of Szasz’s passing, that talk (by Fontaine) has been the one and only talk, that the APA has, thus far, scheduled, on the topic of Szasz’s body of work, then shame on you all.

    That talk concludes with phrases such as, “In short, Szasz failed…” and “The other reason Szaszianism has failed is because…” (Those are the leading lines in each of Fontaine’s last two paragraphs.)


    No one should read Mr. Fontaine’s address (which, according to its title and on its face seems designed only to compare and contrast Szasz and the ancient Greek philosopher, Epicurus) and presume that the speaker was not editorializing, in major ways, to essentially bolster the status quo APA party-line, on Szasz.

    His first line begins, “When the American psychiatrist Thomas Szasz killed himself a year and a half ago…” — which could, of course, easily be heard (and read), as suggesting, that Szasz died a defeated man.

    (I see at least one commenter before me — Seth Farber — has raised this issue. And, in response, Michael Fontaine has explained, briefly, that he actually views Szasz’s death as being akin to that of the death of Socrates. Surely, that’s a positively flattering take on Szasz’s ultimate choice, to have expedited his own death; however, there is every reason to believe, that Szasz was choosing to die for practical reasons; he was suffering physically in ways; and, no such comparison, to Socrates, appears in the address that Fontaine offered the APA.)

    In fact, there is nothing but seeming failure, that Fontaine paints, in his APA address, on Szasz’s and Epicurus…

    His first paragraph begins,

    “When the American psychiatrist Thomas Szasz killed himself a year and a half ago at the age of 92, I thought there would be a global outpouring in psychiatric circles of sympathy or scorn. Instead, his death was largely met with silence, a silence as deafening as the one that attended the second half of his long, prolific, and polemical career.”

    Deafening silence?

    Please, just Google the following line of words: death of thomas szasz obit obituary

    When I do that, Google does a search offering 146,000 results. Surely, that’s not deafening silence.

    Fontaine continues,

    “Szasz’ name didn’t show up at all in the APA program last year, and this presentation of mine is apparently the only one to mention him this year. This silent treatment has, ironically enough, and surely against his will, forced him to fulfill the ancient Epicurean ambition to live and die unnoticed…”

    Szasz lived and died unnoticed?


    Thomas Szasz certainly did not live and die unnoticed.

    Of course, Fontaine know that — which is probably why he continues (barely two or three sentences later) by explaining, that,

    “From the 1960s through the 1980s, Dr. Thomas Szasz (1920-2012) was the most famous psychiatrist on earth.”

    Szasz was a literally a giant — in the realm of modern philosophy, as it pertains to freedom and free will and medical ethics.

    For generations to come, he will be carefully studied by academics and others — but, most especially, by countless psychiatric survivors, as his legacy only continues to spread…

    The APA, meanwhile, is a perfect authoritarian echo chamber — the ultimate bastion of psychiatric abusers. (Just look how that organization continues to use a bust of Benjamin Rush as their masthead. http://psychiatry.org/ Szasz pointed out, that Rush, who is widely considered “The Father of American Psychiatry,” believed that, a tendency to bear false witness — to lie — and/or a tendency to believe everything that one is told, …is basically a kind of disease.)

    So, there’s really no wonder, that an invited speaker could get away with giving an address, at the APA, which so entirely suggests that Szasz died a virtual nobody.



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    • The following passage is from the writings of Benjamin Rush (the ‘Father of American Psychiatry,’ whose bust is pictured on the masthead of the American Psychiatric Association):

      “A propensity to believe every report which reaches the ear, whether true or false, probable or improbable, our author denominates a “disease in the principle faith.” Whether our readers will concur in regarding this state of mind as a real disease or not, they can entertain no doubt as to its existence, nor will they deny that it frequently operates as a public nuisance. The following is an excellent description of it.

      Persons affected with this disease in the principle of faith, as far as relates to human testimony, believe and report every thing they hear. They are incapable of comparing dates and circumstances, and tell stories of the most improbable and incongruous nature. Sometimes they propogate stories that are probable, but false; and thus deceive their friends and the public. There is scarcely a village or city, that does not contain one or more persons affected with this disease. Horace describes a man of that character in Rome, of the name of Apella. The predisposition of such persons to believe what is neither true, nor probable, is often sported with by their acquaintances, by which means their stories often gain a currency through whole communities.

      It is probable the confinement of persons afflicted with this malady, immediately after they hear any thing new, might cure them. Perhaps ridicule might assist this remedy. I think I once saw it effectual in an old quidnune during the revolutionary war.”

      Source: http://deila.dickinson.edu/theirownwords/reviews/0034.htm

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    • I think you have misinterpreted what Michael meant when he stated; “Szasz failed”. The meaning was not that Dr. Szasz failed, but society has failed to listen and understand what Dr. Szasz was pointing out. Tom was a close and dear friend. Dr. Szasz and I had many conversations about this. Dr. Szasz said he knew that what he rationally showed would never be completely accepted. In a conversation just two weeks before he passed, he said. ‘Even if every psychiatrist agreed with me, it still would not change’. I responded, ‘yes, because society wants it’. He said “Exactly!” “Psychiatric Coercion serves a role society will always desire to have access to.” Tom did not see this at all as some sort of defeat, just the sad reality of today’s society. He was an honest man, courageous and a true hero.

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      • Interesting. Dr. Szasz’s comment about “society” may be a bit culture-bound in my estimation and I would see it more in terms of the interests of those who control a given society, and who manipulate public opinion and perception. But I agree that his success or failure can never be predicated on others’ reactions, only on the validity of his insights.

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        • If one’s objective is merely to be ‘right’, then perhaps you are right, although the decision of what is right is usually ultimately intersubjective. If one’s object is persuading others to one’s point of view, then success or failure in persuasion is surely measured by their reaction.

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      • RK,

        Thanks much for your feedback on my comment. It’s quite meaningful; and, though I never had the honor of meeting Thomas Szasz, I feel I ‘know’ him well enough, by reading his writings and through listening to and watching him, in various online media, that I can trust, from what you’re saying, you really did know him personally, for what you’re saying about his views matches my sense of his message, as I’ve gathered it over the years…

        And, from what I ‘know’ of him, I fully agree with your assessment of his character. (Indeed, you say “He was an honest man, courageous and a true hero.” Yes, he was.) But, I’m still inclined to feel ultimately negative about Michael Fontaine’s use of the concluding phrases “Szasz failed” and “Szaszianism has failed.” That is because, to whatever small extent that I can actually well fathom the life of Szasz (and his message), as it’s conveyed through his career, as a writer (i.e., to the extent that I’ve understood his work, from the roughly half dozen books that I’ve read by him and by the videos of his talks that I’ve watched and the podcasts I’ve listened to and from many of the essays he wrote and from interviews with him, which were transcribed), the way I see the legacy of work left behind, by Szasz, no way did he fail in any considerable sense whatsoever. Not at all.

        He was an extremely successful teacher.

        He left what is virtually a library of wisdom behind, that is literally priceless. It has already saved and enriched the lives of countless souls (including myself); it will continue doing so, endlessly, on into future…

        In my opinion, Michael Fontaine does not ‘get’ Szasz (the way you clearly do).

        Otherwise, he would not have repeatedly indicated, that Szasz supposedly failed.

        Again, thanks very much for your comment reply, and I do sincerley hope to find that you’ll continue commenting here, on this website, especially when there are conversations on Szasz.



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        • “Whose failure is Michael actually talking about?”


          Let’s see if I can field your question…

          As mentioned in my previous comments (above), Michael begins by informing his APA listeners, that Szasz killed himself, and he offers no further words about that. Then, he suggests that Szasz lived and died unnoticed (even though he admits afterward, that Szasz was once the most famous psychiatrist in the world). And, finally, his two concluding paragraphs begin by stating “Szasz failed” and “Szaszianism has failed.”

          Oh, and let’s not forget, that the title of his address is: “On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz.”

          (Yes, the fact is, the last five words in Michael’s title are “the Failure of Thomas Szasz.”)

          Of course, you can feel free to disagree with me (maybe I’m just jumping to conclusions or, perhaps, being too literal in my interpretations); perhaps, you think maybe he’s being ironic when he paints Szasz a failure? I don’t know.

          But, to be quite honest, I don’t think there’s even a hint of irony in his tone.

          In fact, I must say, my only way to answer your question, is by simply pointing to those facts, which I’ve pointed out, above…

          From those fact, I can’t help but conclude: Without a doubt, Michael is talking about what he believes was “the failure of Thomas Szasz ” (and, yes, this is what the prevailing, status quo mindset, at the APA likes to hear).

          Again, no need to agree with me; and, admittedly, I could be completely missing some coded (‘contrary’ or ‘counterculture’) message in the body of his text, that you are detecting.

          Maybe he can tell us if that’s the case.



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          • Okay, so you have correctly pointed out the instances where “Szasz” and “failure” appear together in the text.

            Here’s another way to look at it:

            Szasz espoused the idea that so-called “mental illness” is not a medical disease. This idea has (thus far) failed to flourish and become the predominant view or to bring about significant change to the practice of psychiatry, let alone repeal it. Three possible explanations are offered for this:

            1. Psychiatrists failed to take the mind or the soul into account, focusing instead on a reductionist-materialist view of the brain.

            2. The public failed to embrace a school of thought that would require them to take personal responsibility, preferring also a reductionist-materialist view that lets them off the hook.

            3. Szasz failed to articulate his ideas as clearly as he could have (in other words, in a way that people with vested interests in not hearing it could manage to understand and accept).

            Maybe Michael is saying (perhaps too subtly) that Szasz was right, but that the wrong ideas won anyway, as they so often do. Maybe he said this as subtly as he did because he was saying it directly to the faces of the APA — the very champions of those wrong ideas.

            I can understand why people might react to any hint of implication that a man they greatly admire (and perhaps in some sense even owe their life to) had “failed” in any way. I admire him too and would not want to see his work dismissed or impugned. But let’s be real — while Szasz’s ideas have certainly had strong influence, if they had in fact taken root and flourished and changed the game we all wouldn’t be here, Mad In America would not even exist because psychiatry would already have been rethought. It’s not an insult to Szasz or his legacy to acknowledge this. I don’t think this piece paints him as an abject failure as some have suggested. I think it largely points the finger elsewhere.

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          • I think your interpretation may be correct, but what does that mean, in terms of readers’ reactions? Has this possibility been lost on many because they are so devoted to the memory of Szasz that they were unable to appreciate the author’s subtlety, or has it been lost on many because it is simply not clear from merely reading the article?

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          • while Szasz’s ideas have certainly had strong influence, if they had in fact taken root and flourished and changed the game we all wouldn’t be here, Mad In America would not even exist because psychiatry would already have been rethought

            No, no, no — it is a mistake to assume that because correct ideas are not adopted that there is something wrong with the way they are being articulated. This ignores the whole role of power. Ideas which are threatening to any ruling establishment are generally repressed.

            Szasz’s ideas are taking root right here, btw. It takes time before critical mass is achieved but eventually the absurd pretensions of psychiatry will be a matter for mass ridicule.

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        • It must be remembered that this man came up with this presentation to present before a whole room full of gentlemen with a kind of two faced attitude towards Szasz.

          This presents us with another question. Unlike Laing, Szasz wasn’t associated with a coterie of like minded psychiatrists. How can Szaszianism fail when it has never been tried?

          If Szaszianism means abolition of forced psychiatry, I think it high time we tried it.

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          • Frank,

            Excellent points you’re making about the intended audience for Michael’s address; and, from me, here’s a resounding ‘Yes!’ to your conclusion.

            (It deserves serious far more serious consideration than it gets from Michael, in his address; and, it certainly bears repeating…)

            “If Szaszianism means abolition of forced psychiatry, I think it high time we tried it.”)




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          • Ronald Pies wrote a piece recently where first he goes after anti-psychiatry, the bug-a-boo of psychiatry, and then he goes after Humanistic Existentialism, using Thomas Szasz as an example. He actually accused Szasz of being too logical. I can’t bring up the article anymore. I’m not a subscriber. I wish I could. I’d love to be able to congratulate Pies on his illogic.

            Have you seen the Thomas Szasz Wikipedia page? Szasz’s Wikipedia page is like no other page in Wikipedia. A great portion of it is devoted to 3 separate shrinks offering their refutation of his views. If that isn’t bullying, well, let’s not go there. Nowhere on Wikipedia that I know of are opposing views given so much space. I think that’s what conventional biological model psychiatrists liked about Szasz. He provided somebody they could safely disagree with.

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  11. medicine has a long and venerable tradition that stretches back to the time of the Greek philosophers…..psychiatry was born in the asylum….. it has no such tradition.

    The asylums have largely closed…. society has changed. What has not changed is psychiatry. The truth is that psychiatry as Szasz is scientifically worthless and socially harmful. This is why long term society will do away with it. It might be hard to see that sometimes as the institution still has a lot of power but the institution itself is in crisis as a recent lancet article reviewed here on MIA attests to.

    When psychiatry was born women didn’t even have the vote. Mainly psychiatry preyed on the weak and vulnerable. Now anyone…. even people with social capital can get caught up in its dragnet…… this more than anything mitigates against it.

    What does society harm human society gets rid of …… eventually. The internet is changing everything….. ideas spread faster than ever….. the internet will play its part….. psychiatry is divisive at its root. Humans don’t like that…… modern humans hate it infact. divisive psychiatry has no future. There will be no coup de gra for psychiatry …… humanity will simply smudge it out….eventually and szasz will have played his part.

    Btw critical psychiatrists like MonCrief quote Szasz all the time. His ideas live on.

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  12. The author of this MIA post seems to have confused the well understood distinction between freedom from and freedom to……..

    The whole post seems predicated on this basic misunderstanding and its premise that szasz was flawed and therefore somehow “wrong” is entirely erroneous as a consequence of this basic misunderstanding.

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  13. Anyway the logic of philosophy isn’t required to prove the worth or otherwise of psychiatry. Humans are not rational beings….. trying to conceptualise them as such is a waste of time. Watch the news any evening for five minutes to prove this is the case. So much for academic philosophy 🙂

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  14. Interesting article, Michael. I never knew that Hippocrates used black hellebore as an anti psychotic. ‘Seems against the Hippocratic Oath which states, “First do no harm”.

    However, I’ve read the article, scanned the comments, gone to the article that you say tells of his “suicide”, and STILL haven’t found anything that definitely says that Dr. Szasz willfully killed himself. All I saw was that he died after a fall, not that he jumped.

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    • The official account of Szasz’s death is contained in the following piece: “Kaddish for Thomas Szasz by Jeff Schaler” from the Szasz site. http://www.szasz.com/szaszdeath.htm

      Briefly, after a fall at home in which he broke his 10th thoracic vertebra — very painful — he had no medical option other than surgery with propsects of a long and painful recovery. The man was 92 years old. How much more do we need to kmow? Suffice it to say it was not a “suicide” so much as the only permanent pain control available.

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  15. Michael,

    Here is what I should have said earlier, instead of dismissing your article as bs.

    I want to start by explaining what brought me to Mad In America . My story can be found here http://www.madinamerica.com/2013/01/ny-times-invites-readers-to-a-dialogue-on-forced-treatment/#comment-19770 (comment by cannotsay).

    I didn’t come to Mad In America or to Thomas Szasz searching for “meaning”, so from my point of view, your article, and your address, start with an straw man, namely that Thomas Szasz was some sort of prophet for a worldview that conflicted with psychiatry’s worldview.

    While I do think that psychiatry is a worldview (which I will define later), I do not think that Thomas Szasz was primarily motivated by promoting his own, but rather he used his own training as a psychiatrist to denounce psychiatry’s excesses and abuses.

    The way I see it, psychiatry’s worldview is this: MD degree holders have a “God given right” to determine behavioral orthodoxy for the rest of society as they see fit, and then promote the use of biological interventions (lobotomy, ECT, insulin therapy, drugging, you name it) in order to take those who deviate from that behavioral orthodoxy into compliance (by force if necessary in the case of forced treatment).

    Now, there is a great deal of arbitrariness in the process by which psychiatry comes up with its behavioral orthodoxy because the way it does it is by labeling “disorder” the patterns of behavior they do not like. So, when the APA was made up of a majority of WASP men, homosexuality was a “disorder”. Now that the majority of the APA are left leaning secular liberals, homosexuality is not anymore a “disorder”, in fact, the APA endorses gay marriage. Some scholar called the DSM a secular sacred text. That someone has a point, but unlike religious sacred texts that show the faithful a direct path to happiness, the DSM is about showing people a path to unhappiness: “if you behave this or that way, you are disordered, like if, under DSM-5, you are still sad two weeks after the death of a loved one”. Your spouse of 30 years or a child died? What’s wrong with you that you cannot get over it in two weeks!!

    What made Szasz such an interesting figure is that he recognized the travesty psychiatry is decades before other people, like Allen Frances, did. In fact, in an act of absolute courage and generosity towards his fellow human beings, he renounced to cozy relationships with Big Pharma, governments and their money in order to denounce the psychiatric scam.

    Donna speaks of something that is both crucial to understand Szasz and absent from your commentary: the therapeutic state. Szasz was concerned with people, through the coercive force of government, imposing certain worldviews onto other human beings. Unlike the “nanny state”, which takes care of food and shelter of its citizens, the therapeutic state is about promoting a particular version of “happiness” and legally incarcerating and abusing those who dare to challenge it. Since in a way this is what religious tribunals used to do, Szasz used the parallel to the Inquisition, not as a matter of principle but rather as a explanatory vehicle of how psychiatry is today’s manifestation of this phenomenon.

    He, more than any other anti psychiatrist, single-handedly attacked the excesses of psychiatry and never relented, even in his death. As others have explained, he was consistent in his defense of people’s right to suicide with his decision of ending his own life.

    Finally, a topic that needs to be addressed when speaking of Szasz is CCHR/Scientology which invalidates most of what this article is about.

    Thomas Szasz, despite being an atheist, was regularly attacked during his lifetime for having co-founded CCHR with Scientology. He himself was an atheist who was awarded for his efforts the Humanist of the Year award, but he never sought to impose his own worldview or Scientology’s on anybody. As he explains here https://www.youtube.com/watch?v=tY78qJNLoQ0 , the only reason he joined forced with Scientology is because he understood too well that psychiatry could not be confronted with intellectual arguments alone. For psychiatry’s abuses to be corrected, they needed to be confronted. In Scientology he found a partner willing to pay attorneys to fight against psychiatry’s most egregious abuses in order to expose them in the public view. For people like Maryanne Godboldo , https://www.youtube.com/watch?v=6hIlo7KD2L0 , CCHR’s help has meant the difference between freedom and jail and between being able to keep the custody of her daughter and having had her daughter drugged with poisonous Risperdal.

    For all these reasons, psychiatric survivors like me who see in Szasz an intellectual giant who empowered us with knowledge and information to confront our oppressors, psychiatrists, found your article very offensive: a fabricated distraction intended to keep the focus away from the abuses that organized psychiatry perpetrates each day in America.

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    • And to supplement my critique, I don’t like the emphasis on competing “worldviews” because that is one of organized psychiatry most insidious distractions, namely, to claim that those who criticize psychiatry must surely be motivated by their own worldview. Well, no. Psychiatry is an evil discipline, period. I have as much interest in people becoming Epicureans as I have in them becoming Scientologists or Muslims: it is simply not my business. My only business is to end psychiatry’s reign of terror.

      To say that one cannot oppose psychiatry without having some nefarious hidden agendas is like saying that those who fought against slavery (in my mind “anti” in anti psychiatry means the same as “anti” in anti slavery) were only motivated by bankrupting the business model of the slave owners.

      Certainly the slave owners had to adapt their business model after slavery was abolished, but bankrupting them was not the prime motivation of those who saw themselves as anti slavery.

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  16. Getting lost in all this discussion is Michael Fontaine’s excellent exposition of Epicurean ‘psychiatry’. I know nothing about Szasz, but if Fontaine is correct that his outlook parallels Epicurus, then the following difficulty with Szasz’s persuasive efforts is pertinent:

    “Framed as freedom, autonomy sounds grand. Framed as personal responsibility—accountability, answerability, paying the price, failing—it is exceedingly unpleasant.”

    This negative view of responsibility has been addressed by another philosopher who also took an alternative view to that of psychiatry, and one that I have found very valuable and pleasurable in the Epicurean sense:

    “Responsibility begins with the willingness to be cause in the matter of one’s life. Ultimately, it is a context from which one chooses to live. Responsibility is not burden, fault, praise, blame, credit, shame or guilt. In responsibility, there is no evaluation of good or bad, right or wrong. There is simply what’s so, and your stand. Being responsible starts with the willingness to deal with a situation from the view of life that you are the generator of what you do, what you have and what you are. That is not the truth. It is a place to stand. No one can make you responsible, nor can you impose responsibility on another. It is a grace you give yourself – an empowering context that leaves you with a say in the matter of life.” – Werner Erhard

    This is the revelation of the Epicurean pleasure of responsibility. The truth of responsibility does not lie in the fact that it correspondence to reality, which may or may not be the case, but in the positive consequences of embracing it as a stand. Too bad Szasz appears not to have known about either Epicurus or Erhard.


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  17. OK I’ll try not to be distracted by more dubious assumptions such as in the last sentence in the above post…

    So here’s my “responsible” criticism: though Mr. Fontaine seems to have some kind of personal appreciation for Szasz, it seems for all the sophistry he doesn’t really understand Szasz’z basic disproof of the medical model or what he means by the myth of mental illness. And as cannotsay points out, Szasz’s significance to history has nothing to do with his personal philosophy but lies in his articulation of the fact that “mental illness” is not only an incorrect but an impossibly absurd notion based on the deliberate distortion of language, i.e. the concretizing of metaphor. These insights are available to Christians, Buddhists, followers of Epicurus, ad infinitum and I would call them the essence of Szaszs’s legacy. The author doen’t seem to get this, or blatantly rejects it, as he constantly talks about competing “approaches” to “mental illness” as though “it” were a real thing.

    There is no need to comment on “why Szasz failed” because he hasn’t, unless one bases their conclusions on the opinions of those who have the most to lose by agreeing with him. History will show him to have been right — and in the present era so will the human capacity of reason.

    In closing I can’t not mention the cynical and self-serving implication that Dr. Szasz’s “suicide” was something more telling than an effort to end his unrelenting physical pain. And what’s with the snot rag — is Szasz really blowing his nose throughout the interview? If not I think this says it all.

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    • oldhead,

      I forgot who said great minds think alike but this basically summarizes my critique as well :),

      “The author doen’t seem to get this, or blatantly rejects it, as he constantly talks about competing “approaches” to “mental illness” as though “it” were a real thing.”

      Michael asked me to read his essay again, but I see nothing in his essay other than one of those comparative studies of worldviews in which one is Szasz’s, another is Epicurus’ and another psychiatry’s. The essay misses completely the point of what the core of the Szasz message is and why mainstream psychiatry wants nothing to do with it. The rejection of Szasz by mainstream psychiatry is similar to the rejection of those who made moral arguments against slavery based on “all men are created equal” by slave owners. Just as slave owners could not comprehend that “all men are created equal with certain inalienable rights” meant exactly that, psychiatrists cannot comprehend that the constructs they call “mental illness” are nothing but gratuitous institutionalized bigotry towards the behaviors they themselves do not understand.

      Similarly, as to the success or failure of Thomas Szasz, it is too early to tell, but the NIMH’s official adoption of one of Thomas Szasz’s talking points (that the DSM labels do not have a scientific basis) tells a very different story. Take Frederick Douglass and the American Anti-Slavery Society. Until the passage of the XIII-th amendment, they were perceived as losers. History, and God, have a funny way of correcting injustice, but injustice is almost always inevitably defeated. Psychiatry’s days as an oppressive endeavor are counted.

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      • I was at a meeting the other day, a cosmopolitan gathering….. a black man said that bio psychiatry was institutionally racist….. everyone just nodded. An apostate psychiatrist added that it was a racist ideology and would remain so even if it was practiced by a black person. Nods all round.

        Every idea has its time….. its not looking good for bio-psychiatry.

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        • Thomas Szasz was an author, a psychiatrist, and a teacher. Epicurus was a philosopher. Just think of the number of people who failed to start schools of philosophy. Apparently, Epicurus was not one of them.

          One thing about Szasz though, his was the thought that probably appeals to more people outside of his particular profession than people within it than any other psychiatrist around. That’s no mean feat.

          As far as Szasz goes, I don’t think he’s completely out of the picture yet. There are still those people who, like Ron W., for instance, haven’t read anything he’s written. R. D. Laing, speak of the devil, despite bio-psychiatry’s best efforts, is still routinely quoted. I don’t imagine Szasz has said his last at this point either.

          As anyone who reads these comments should be able to plainly see, he had an enormous influence on a great many psychiatric survivors. I think in that regard the legacy of Thomas Szasz is bound to last for some time to come.

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  18. I enjoyed this piece very much and also the predictable controversy stirred up surrounding anything Szasz. The part that I am having trouble with is the Western, class-centric bald assumption that the shamanic model is obsolete today. “In antiquity, the shamanic model was only believed in by the lower classes and because it is obsolete today, it does not interest us here.” Tell that to the billions of people of Africa, central Asia, Polynesia, many who continue to believe in demons and exorcism no matter what their social class or religious background. (I’ve had African Anglicans tell me in no uncertain terms about their belief in witches.) Tell that to me, a university educated, mainstream church going, fervent believer in the healing powers of shamanic practices, many practices which have been flourishing for years North American style, meaning in week-end retreats and in suburban strip malls. The world is getting smaller, and we can’t assume what we believe in Western Europe and North America applies to the majority of the world’s peoples.

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    • Thank you for articulating this point, Rossa. I too believe our culture could learn a few things from shamanic practices about how to help people navigate extreme mental states, a.k.a. psychosis/mental “illness.” I also had trouble with Mr. Fontaine’s class-centric bald assumption (great term, BTW) about shamanic traditions being supposedly obsolete. And I was amused but not surprised that your thoughtful observation was met with a snarky “Come now” from an apparent close-minded ivory tower dweller.

      In his TEDx Rainier talk on myths, shamans, and seers, Phil Borges describes how our western culture gives us little permission to explore nonrational states of consciousness. Of particular interest (to me anyway) was Phil’s interview of the State Oracle of Tibet, the Venerable Nechung Oracle, Thupten Ngodrup, who is the medium who channels the Dalai Lama’s oracle. Obsolete? I don’t think so.

      In addition to Tibet monks, Phil has interviewed shamans from all over the world. Fascinating stuff.

      Phil quotes Albert Einstein at the end of his talk:
      “We humans tend to experience ourselves as something SEPARATE from the whole we call ‘The Universe.’ This is actually an optical illusion of our consciousness. It’s LIKE A PRISON for us. Our task is to free ourselves from this prison by widening our CIRCLE OF COMPASSION to embrace all living creatures and the whole of nature in its beauty. This is the only true foundation for our INNER PEACE and SECURITY.”

      Here’s a link to Phil Borges’ talk. It’s well worth the 14 minutes to listen and watch. And Phil’s photos are STUNNING!

      Thanks again for speaking up about this topic, Rossa!

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      • Suzanne,

        Thanks for sharing the link to the TEDx talk by Phil Borges. I’ve seen the promo and outtakes from his upcoming film (“Crazywise”) and found them compelling, so I’ll surely watch the Youtube you’re recommending, as soon as i have 14 extra minutes. 🙂

        Like you and like the commenter ‘uprising’ (above), I quite appreciate what Rossa Forbes has (in her comment, on August 28, 2014 at 2:52 am) brought to this discussion, of Michael Fontaine’s address to the APA.

        For Michael to have said, parenthetically, in his address, that, “In antiquity, the shamanic model was only believed in by the lower classes and because it is obsolete today, it does not interest us here” …is somewhat outrageous, I feel.

        (It is a statement so perfectly emblematic of the precise sort of intellectual and economic elitism, that forever stinks up the halls, of that much vaunted but truly decrepit organization, the American Psychiatric Association).

        Psychiatry, which is often government-funded, has long been trampling traditional non-Western healing traditions, in the name of ‘treating’ so-called “mental illness.”

        Though I put no faith whatsoever in any government’s ‘mental health system,’ I am sympathetic with certain views of a number of activists who, as self-described ‘mh’ reformers, express themselves, their activist ideals and their professional agendas, through their blogging, on this MIA website.

        Richard D. Lewis is one such individual, who’s views I mainly appreciate. But, he is quite skeptical about talk of ‘spiritual’ healing. Therefore, not long ago, I recommended a Youtube video to him, which I will recommend here, again… for whomever might be interested.

        It is a talk, just 21 minutes long — by an ethnographer, named William Sax:


        That Youtube is titled “Healing and Psychiatry in South Asia”

        Upon recommending it to Richard, I mentioned to him: Somewhere near the middle of Sax’s talk, there is a concession that he makes to bio-psychiatry, which may be obligatory and which I think is unnecessary; but, otherwise, I find it to be an excellent and important talk.

        Perhaps, Michael Fontaine should watch it.



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  19. @oldhead Thanks! I always enjoy your thoughtful posts!

    @Rossa I agree…. their are many ways to conceptualise what it is to be a person…. its a pity that the wonky bag of chemicals model bio bio bio dominates the western initiated gulag system…… the good news is that no one other than a small band of psychiatrists actually conceive of themselves like that…..

    Ill just add that imo the bio/psycho/social/spiritual(extra-terrestrial?) model isn’t a model that explains anything….. its just some prefixes and punctuation that serves to cover up the fact that none of the professional groups agree with each other about anything….. long run that is a good thing because it indicates that anyone exercising power in a “mental health” context does so illegitimately… imo

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  20. The right of freedom from fear. From the irren offensive.

    We call on all members of the community of people who recognize our basic right to self-determination as a people who suffer from psychiatric persecution, psychiatric incarceration and psychiatric torture.
    We hereby declare that:

    1 Preamble

    Whereas recognition of the inherent dignity and of the equal and inalienable rights of all the human family is the foundation of freedom, justice and peace in the world,
    Whereas disregard and contempt for human rights have resulted in barbarous acts which satisfy the conscience of mankind with indignation, and
    has been proclaimed as that of a world in which human speech and belief and freedom from fear (consisting of the freedom from arbitrary detention, torture and killing) and enjoy freedom from want, the highest aspiration of man is true,
    since it is necessary to protect human rights through the rule of law, that the man is not compelled to have recourse, as a last resort, to rebellion against tyranny and oppression,
    we accept the atrocities of the systematic psychiatric mass murders in the gas chambers of the “Action T4”, which started in 1939 as a medical biologistic campaign in Germany, and was followed by the extermination camps in Poland, as a starting point for our following Declaration of Human Rights.
    We emphasize that the defeat of such barbaric acts, the worst case in the history of dehumanization and violations of basic social norms, 1948 after the Nuremberg trials was also the basis of the Universal Declaration of Human Rights of the United Nations.

    2 Therefore:

    A) A person is born from another man

    B) It is impossible to distinguish between the human rights of any person from those of another, no matter how extraordinary he look and think, or whatever he may express his thoughts.

    C) We emphasize that the articles of the Universal Declaration of Human Rights of the United Nations are the basis to determine the fundamental human rights

    D) We hereby declare that we the use of psychiatric terms as medical slander, as biologistically – consider racial discrimination, particularly when it comes to determine a person’s behavior as a genetic or mental “illness”

    E) We hereby declare as a kind of torture: psychiatric persecution, arbitrary psychiatric incarceration and physical psychiatric coercion to penetrate the body – treatment with drugs, electroshock, psychosurgery, fixation, etc. These measures have been since the inception of coercive psychiatry over and over again by people everywhere referred to the world as torture, regardless of whether someone was referred by medical staff as “incompetent” and the place of these measures a “medical device” called “hospital” should be.

    F) Based on the previous arguments, we hereby declare psychiatric coercion as “fear” (“Fear”), as defined in the Universal Declaration of Human Rights of the United Nations. Everyone has the right to freedom from fear.

    G) We recognize a psychiatry that is based on coercion and violence, as a crime against humanity because it deprives individuals the status of a man with his inalienable human rights by making known their soul to a bio-medical way as “sick” and of a bio-medical “mental illness” speaks, and thus legally justify all kinds of violence against them.

    H) We deny that the General Assembly of the UN has the right to exclude some of the members of the human community from being recognized as a human, by this psychiatric biologically – supports racist doctrine. Therefore we appeal to all peoples of the world to abolish the UN Resolution. 46/119 of 17 December 1991. This resolution violates the basic principles of the Universal Declaration of Human Rights of the United Nations 1948 This resolution is an attack on the human dignity of all members own the human community and their equal and inalienable rights, the basis for freedom and justice.

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  21. Thank you dear Michael for sharing your perspective. Your words have inspired a lot of folks to speak up. May the dialogue further our cause for social justice, tolerance of differences and truth telling. ” Come on people now, smile on your brother(s and sisters.) Everybody get together. Try to love one another right now…”

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    • Personally I was not “inspired” at all, more irritated than anything that so much energy had to be spent in correcting and dispelling some rather blatant misinformation and confusion. Why can’t we spend more time arguing about how to defeat this behemoth, rather than indulging in what I see as pseudo-intellectual gamesmanship?

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  22. What’s all the fuss about saying Szasz failed? Everything his supporters here are attacking psychiatry for indicates he failed to persuade the profession to change its outlook sufficiently for them, yet they take offense at the idea he failed at anything.

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    • Thomas Szasz is having a very difficult time failing right now, if by failure you mean not having a following. I’d ask him to try harder, but then where would we be. I guess what I’m trying to get it at here is that in the estimation of many people Szasz didn’t fail. As far as persuading psychiatry to become something other than itself, well, I don’t think of Szasz as being particularly naive either.

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      • If people want to talk about what Szasz succeeded at, great. But that wouldn’t make the article wrong about what he failed at. Ironically, the hyersensitivity about the word ‘failure’ rather supports Fontaine’s point about the unappealingness of the libertarian concept of personal responsibility, because people often use this concept to justify abandoning people to their fate.

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        • As I wrote previously, Ron W., you should read Thomas Szasz sometime. How can you sensibly comment on a writer with whom you are, as you stated earlier, unfamiliar? After you’ve read him, you should let what you’ve read sink in, and settle, rather than offering a more or less reflexive opinion. Once you’ve reflected on what you’ve read, then you will be at a point where your criticism might conceivably make a little bit of sense.

          What is the obligation you think libertarians are shirking? Since when are people “fated”? There are lapses in logic that I would let any person pursue to his or her heart’s content because I know reason is something that this or that person is not going to find particularly amenable. So be it. Who is abandoning anybody to his or her fate, if such a fate is freely chosen? You want to argue against freedom. Okay, an argument against freedom is an argument for fate. I’m making the opposite argument. I’m arguing for choice. We chose our “fates”. It’s a choice I, at least, can live with. I am also free to say “no” to any fate I don’t want. I’m glad I have that freedom.

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    • RonW,
      Michael claimed that Szasz failed to” repeal” the mental health system because of his lack of clarity.
      Later he seems to contradict himself and claims says Szasz “failed” to attract followers because his idea of responsibility was not appealing.
      I have been critical of many of Szasz’s ideas– for example his Libertarian argument that the government has no responsibility to redistribute money to aid people in need. So it is not a matter of people not tolerating criticism of Szasz. But the criticism of Szasz must be fair. I strongly object to Michael’s first criticism because it is absurd. I will not repeat the argument I made above but I will say it is unfair because Szasz brilliantly and clearly expressed his ideas. And it is to my mind based on the premise that had Szasz’s “failure” must have pointed to a lack of clarity as if the skewed maldistribution of power between the psychiatric-pharm complex and its critics and victims was irrelevant..

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  23. To: Frank Blankenship

    There does not seem to be a REPLY button on your post, so I am posting here in reply to:
    “Certainly not. Freedom makes disobedience one option among many. Responsibility could, in fact, demand disobedience rather than obedience. An element of morality is at work here, just the kind of thing that was absent from, say, NAZI Germany, or is absent on Wall Street. You have the freedom to pursue your own version of “king on the mountain” at the world’s expense if you want to do so, or you could pursue a more egalitarian state for all. Good and bad are choices, but choosing good is more responsible than choosing bad. Choosing poorly, well, of course that’s irresponsible, too.”

    How does this show that “Responsibilty goes along with freedom.”, let alone that humans are responsible for their actions in some way that other organisms (which we do not consider responsible) are not?

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    • I’m not saying other animals are not responsible after a fashion. I’m just saying that our evolved capacity makes us more responsible. The understanding possessed by other species is more limited than ours. Among animals, I suppose the instinct for survival plays more of a role. One has to know when, for instance, or when not to challenge an alpha member of the pack or troop. A mistake could mean banishment or death. Luck/skill at negotiating could mean dinner or alpha status. We’ve got the survival thing more or less licked. Survival for people is a choice. Of course, there’s always suicide. One could opt for death as well.

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      • Freedom without responsibility is a criminal career, for instance, that could get your freedom taken away from you. Freedom with responsibility is knowing the difference between right and wrong, and choosing the right course of action to take. Not choosing is a choice. Not knowing the difference between the two, the claim in the insanity defense, can also result in loss of freedom. People have to protect themselves somehow, and they do so by penalizing individuals who they think threaten the survival of the group as a whole. Mistakes happen, certainly, but so does conscious planning. Random chance, the throw of the dice, is not freedom. It is random chance, and there can be a slavery to that, witness so-called ‘gambling addiction’. One can control ones appetites, or one can be controlled by one’s appetites. You’ve got a choice there, and one choice is more responsible than another.

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        • I agree that responsibility would be a useful thing, if it exists. And I agree this is the regime we (try to) impose on each other. My question is, does simply declaring someone responsible make them responsible, or just intimidated into doing what society wants? And if it is just intimidation, glorifying it by calling it responsibility, as I said, is merely justifying or disguising our using the notion of responsibility to control people. Which is not to say that people don’t need to be controlled.

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          • I wasn’t saying people need to be controlled. Self-control is the premium value here. Brutality and intimidation are not in themselves responsible acts, it depends on the motivation behind them, and there it ends up being a matter of interpretation. We’re sort of dealing here in the murky terrain of ‘honor among thieves’ that a grubby handed pragmatism may get you. Voila, let’s hear it for purity instead. People are responsible for their actions regardless of whether they claim responsibility for them, it’s just a matter of the accepting responsibility for those acts.

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      • I agree it appears that humans have more awareness of themselves than animals do, and greater calculating ability, broadly defined. My question is whether any of that means they could have acted any way other than they did act. We can imagine a person acting in a way other than they may have acted, but that may say more about our imagination than reality. Our present notion of responsibility may be a recent development of individualistic Western thought. It’s not clear to me that the characters in the Iliad looked at their behavior as ‘optional’.

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        • One could always act in a different way and manner, that is what choice is all about.

          In the Iliad you’ve got Homer crafting a song, and singing about events with some root in reality. The witches, Cyclops, and sirens of the Odyssey aside, that’s an intriguing thought. One could ask whether, and/or to what extent, we may have progressed since the days of the ancient Greeks, too. They didn’t have to produce the Hellenic culture that they produced, and yet they did so. That culture is still a wonder. We might say that the hand of God was at work for them today. Then it would have been the hands of Goddesses and Gods. As some have said about of the Christian God, it takes human beings to realize his will on earth. These words are those of an avowed atheist, keep that in mind.

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          • “One could always act in a different way and manner, that is what choice is all about.”

            And exactly what I am questioning. How would one devise a controlled experiment to show this? How would you exactly replicate someone’s state of mind and circumstances at two different times and produce two different outcomes? It’s hard to see that there could be more than one outcome (barring quantum effects, which would not support the existence of free will).

            I don’t know about ‘progress’ from the time of the Iliad, though there may be less tolerance of war and cruelty, no small thing. But I’m pretty sure there’s been a paradigm shift on this responsibility/free-will thing. Today ‘the hand’ of God or the gods clearly operates via human conversation about such things as responsibility. But the modern notion of responsibility and choice may be just as mythical as Aphrodite, and even in some ways more misleading.

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          • @ RonW

            Considering your comment (on August 29, 2014 at 1:31 am), I suggest to you a paper, by Steven P.R. Rose, as food for thought:

            “Human agency in the neurocentric age”

            (Under the title, appears a very brief synopsis: “Philosophers and scientists resort to dualistic explanations to reconcile the age‐old dichotomy between determinism and ‘free will’, but agency is an integral part of human biology.”)

            Rose is emeritus Professor of Biology and Neurobiology at the Open University and Gresham College, London.

            You can access the full paper via the following link:


            In my opinion, it’s well worth reading.



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          • That’s your opinion.

            Controlled experiments are usually conducted at the expense of the notion of free will. That said, the humanities are soft sciences (too much free will, thought, error, metaphysics, whatever, too few machine parts), and psychiatry is soft science pretending it’s hard. I think about the only thing you are likely to get from such an experiment is waste of somebodies good money. There’s altogether too much junk science in the world today as is.

            We know, when it comes to determinism, better than to accept the stock answers. There are so many places where those stock answers simply don’t apply. I live in an in-deterministic universe where all sorts of things are possible. Were I the puppet of “bad” genes, maybe this wouldn’t be the case. Perhaps you live in a different sort of universe, a mechanistic universe, full of excuses. If so, that’s fine. You’ve got your answer, and I’ve got mine.

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  24. “No, no, no — it is a mistake to assume that because correct ideas are not adopted that there is something wrong with the way they are being articulated. This ignores the whole role of power. Ideas which are threatening to any ruling establishment are generally repressed.”

    This is a non sequitur, since he did not say the there is something wrong with the way they are articulated. Not in the passage you quoted, anyway.

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  25. Since I’m already on moderation I will take a chance at saying this. I don’t think it is right for a teacher, a professor, to characterize a book whose argument he does not remember. Thus when Michael was asked if he had not been careless when he said Szasz compared psychiatrists to witches he responded:

    ” ‘ Psychiatrists to witches? Do you mean inquisitors?’ No. Surprising as it may seem, in Manufacture of Madness Szasz argues that psychiatrists correspond to witches, whereas mental patients correspond to the bewitched. It’s certainly a counterintuitive argument, so I invite you to read the book for yourself.”

    This clearly implies Dr Fontaine, an authority on philosophy, had read and was familiar with the book. If I had read the above characterization and had never read Szasz I doubt I would have been inspired to read the book. I might have even wondered why the subtitle was: “A Comparative Study of the Inquisition and the Mental Health Movement.” But I would not have doubted Dr Fontaine’s expertise on this book by Szasz.

    If you have read The Manufacture of Madness and do not remember that psychiatrists are compared to the Inquisitors who tormented and murdered “witches,” the book has not made a profound or lasting impression on you. I believe it is unethical to authoritatively characterize an author’s argument that you only vaguely remember. Michael says he read the book so I will assume he has. As I showed above this is an egregious mischaracterization of what I consider one of the 3 greatest books on the “mental health system” — and one of the greatest books on the human condition. I also am somewhat of a feminist. Thus I take offense to claiming Szasz equated one of our most powerful and destructive elites to a poor group of harmless women who did not hurt anyone but were the victims of authority. Just as “mental patients” are today. I think Szasz would have objected also.

    PS There is nothing wrong with saying, “I think so but I don’t remember the book well enough to discuss it.”

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    • From the article: “He saw psychiatry as the secular successor to the medieval practice of persecuting witches and heretics.”

      So, insofar as Fonatine said what you quote, he has apparently become momentarily confused. I have no doubt he will agree with you when he has gathered his thoughts. As someone rapidly creeping up on senility, I have a lot of sympathy for such lapses.

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  26. @Jonah Thanks. This is a good overview of the situation, but his conclusion, as always, fails to avoid dualism. He finds the dualism (which he does not admit to, however) necessary because it is the basis of all our notions of morality and justice. But what if those are all based on a misconception? What if appeals to ‘morality’ and ‘justice’ and ‘free will’ are simply humanity’s way of justifying punishing those it wants to punish? Not that we shouldn’t try to justify punishment, but do we really need the notion of ‘free will’ to justify to ourselves punishing someone, or is that just a dodge to avoid responsibility ourselves for the act of punishing? The ancients didn’t seem to have this problem. To oversimplify, their attitude was “We’re going to punish you for this behavior because this is behavior that prompts us to punish people, period.” with no real consideration of whether the person could help themselves or not. This strikes me as more honest, whatever judicial shortcomings may have been involved.

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    • “With no real consideration of whether the person can help themselves or not”? Helplessness defines childhood more than it does adulthood. Weaned is, in a word, weaned. Ingenuity is getting out of dire straits. It comes with time. At least, I imagine it does. We have different expectations for children than we do for adults. The fledgling isn’t ready to fly. I don’t see this as a problem. You could reverse your equation. “What if ‘free will'” is “simply humanities way of justifying” rewarding “those it wants to” reward? So much for innate worth, as for earned worth, that’s another thing altogether. We bring value to the world. Value that doesn’t exist in the world prior to our bringing it there. Gold we may value, and some do value it to excess. Morality and justice we may value as well, and woe be unto the person who dismisses their value. Morality and justice exist to keep people from being punished undeservedly, that is, for nothing, or for doing good.

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  27. @Frank Blankenship
    Any form of psychiatry that misses how determined people are, or, more precisely, in what ways they are determined and in what ways they are not, is doomed to fail. I agree there are fatal limits to scientism here as well, however. Some of the most useful experiments we might conduct cannot be scientifically controlled. The whole history of autonomy is an uncontrolled experiment and could not be otherwise. The key is to recognize it as an experiment and all of us as subjects as well as flawed experimenters.

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    • I notice this from the preface of The Myth of Mental Illness:

      “Although my thesis is that mental illness is a myth, this book is not an attempt to ‘debunk psychiatry’… although I consider the concept of mental illness to be unserviceable, I believe that psychiatry could be a science. I also believe that psychotherapy is an effective method of helping people—not to recover from an ‘illness,’ but rather to learn about themselves, others, and life.”

      This seems to strike a different tone than his supporters here. Did he change his outlook after that book?

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      • Thomas Szasz was a psychiatrist who was very critical of the way psychiatry was practiced. He was thoroughly opposed to coercive psychiatry. Psychiatrist Thomas Szasz, psychiatrist R. D. Laing, philosopher Michel Foucault and other people have been associated with what has been called the anti-psychiatry movement in the public mind and by the media. The word itself was coined by David Cooper, a colleague of R. D. Laing. R. D. Laing himself came to distance himself from the term. Thomas Szasz himself didn’t like the word used in reference to himself, and wouldn’t use it, for one thing, because of his own issues with R. D. Laing and associates. There are people who identify with anti-psychiatry nonetheless, and who oppose the abuses and excesses of that profession. Many of them are indebted to Szasz and others for their critique of, and differing approaches to, the profession of psychiatry. For more background info on anti-psychiatry, you might find the Wikipedia page on the subject helpful.


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        • Thanks. I think I am getting a little better picture from this. I honestly thought that coercive psychiatry had been largely curtailed, thanks in part to Szasz, though there no doubt are still problems with that. There is also a problem around psych drugs, and of course the medicalization of human suffering generally, which I definitely suspect could better be alleviated through educating people in personal autonomy if such education were available – which brings us back to Epicurus. Although some people interpret Epicurus to have considered himself a healer of sorts, I don’t think that is how I would characterize his teachings today. But I digress.

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  28. A brilliant article: the arguments often presented on this website (that psychiatry is based on a false premise, that mental distress is due to the way people think, not faulty brains, genes, humors) are centuries old, that Epicurus stressed the pleasant side of this (relief from stress and worry) and Szasz stressed the hard side (taking personal responsibility) and that Epicurus formed a school and demanded loyalty where as Szasz was a solitary but brilliant figure.

    Avoiding our responsibilities is one of human beings favorite activities, but carrots are often better motivators than sticks.

    Organizing and working together is usually more effective in achieving social change than working alone.

    All of these are themes reflected every week in this website.

    Nice to see the historical perspective.

    I take issue that Shamanic model is not relevant though. I was looking at the Paranoia Network’s website recently and they were recommending visualization of a healing, protective light as tool to help people who thought they were possessed by an alien spirit, or at risk of alien abduction. A friend was exorcised by a Christian, had a Sikh holy man hit him on the bottom with the flat side of the blade of his sword and had other rituals performed, all paid for by his parents, to try to remove the voices he was hearing. It didn’t work, but it was a lot less damaging than the psychiatric drugs he is now on. So some communities are actively using contemporary Shamanic models to address madness. An interesting area for future exploration and debate perhaps?

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    • Brilliant is not the word that I would use to describe Michael Fontaine’s piece. Disingenuous perhaps. I don’t consider Dr. Szasz a failure. This is kind of like talk during the cold war about a politician of the “enemy” camp. Few people at an APA convention are going to be singing praises for Dr. Szasz, and they were not praising him here. Instead, a distance was established to his ideas, and those ideas were distorted. Epicurius, on the other hand, conveniently ancient, in putting pleasure first, made a negative comparison easy. You’ve got something like the psychiatrists’ (and the pharmacologists’) buddy here, positive psychology. All that’s missing is the Woolworth smiley. Who is Fontaine’s modern equivalent to Epicurus? Martin Seligman, Joseph Lieberman, Nancy Andreasen, Allen Frances, Thomas Insel, E. Fuller Torrey, etc.? He didn’t say, and if he had said, it would only be one out of a number of trendy theoretical models. Come on. We can buck the fashion, too. Thomas Szasz has scarcely been buried 2 years now. Spread the ideas found in his manifesto, and abolish coercive psychiatry. Long live Thomas Szasz!


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  29. Professor Fontaine,
    I am very pleased to see this thoughtful and instructive essay posted here. I agree that psychiatrists – and all of us – could benefit from a more rigorous philosophical training (and I include myself in this assessment). I will now add you to my list of teachers.

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  30. Michael (and the others),

    My final thought on this discussion is this. I am not a big fan of using pop culture artifacts as explanatory vehicles for complex matters since most of the times they miss the subtleties involved. I think that I can make an exception with this issue.

    In the late nineties, there was an Italian movie titled “Life Is Beautiful” that was very successful both in the US and in the Europe. It went on to make 230 million dollars worldwide, including 57 million dollars in the United States. It also won 3 academy awards (including best actor and best movie in a foreign language). For those who haven’t heard about this movie, here comes a detailed study guide http://www.gradesaver.com/life-is-beautiful/ .

    Reading this essay I could not avoid feeling like Guido in the scene in which Doctor Lessing tells him he has something very important to talk to him about.

    Guido, whose most important worry was to get his son and himself out of the concentration camp, thinks that Lessing is going to use his Nazi connections help them escape their misery. Instead, the good doctor wants help solving one of the riddles that has been bothering him for a long time.

    The concern of most survivors who read Mad In America is to equip ourselves with knowledge and tools to confront our oppressors who have the legal upper hand (just as Nazi Germany had the legal upper hand over Guido in the movie and Guido’s main concern was how to get safely out of the camp).

    Your major concern is probably to solve “scholar riddles” about worldviews and philosophy.

    While I can say that I respect your work, it is a bit naive to pretend that an audience primarily concerned with having their civil rights abused every day (explicitly and in very subtle ways http://www.antipsychiatry.org/stigma.htm ) is going to find it interesting.

    Further, when you speak that one of your intellectual heroes, Thomas Szasz – who has helped us make sense of our circumstances and in many cases keeps up alive given that most of us voluntarily stopped the poisonous drugs we were on after reading/listening to him-, we feel rightly offended.

    I wish you good luck with your work and hopefully we will see more of you in MIA, but please, next time spare us from “scholar riddles” most of us couldn’t care less about.

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  31. Thanks Michael, for a thoughtful article. I hope you aren’t put off by all the critical remarks! Obviously there are lots of fans of Szaz here, and I think they may be talking too literally your assertion that Szaz “failed.” Obviously if he had completely failed in having his voice heard you wouldn’t be writing about him here – he wouldn’t be important enough to pay attention to.

    While I have found Szaz helpful at points, and I agree especially with his point that mental conditions should not be assumed to be medical in the absence of good evidence that this is the case (like a stroke or Alzheimer’s) I also think Szaz might have been more helpful had he been a little more Epicurean, and striven to be more moderate.

    For example, I met Szaz only once, while I was staffing a booth alongside David Oaks. The two of them began a conversation, and one thing I recall from that is that Szaz had little respect for the Hearing Voices Movement. In general I have seen that kind of thing as a flaw in the way Szaz approached things – all the emphasis seemed to be on critiquing how our society deals with confused and distressed people, with little attention to what might work better.

    I know that those who have been seriously hurt by the existing system, many of whom are commenters here, often see eliminating the power of that system as a first priority, and so would have no problem with Szaz’ critical emphasis. The problem with that though is that there are way more people worried about what to do about distressed and confused people than there are people worried about how the existing system has flaws and often hurts people, so unless we can address both issues at once, we aren’t likely to get the broad support we need to really change things.

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    • A thoughtful piece, that gives us food for thought. Michael, thank you for posting it. At the same time, let me suggest that Szasz did not fail. He gave birth of a foundational critique of psychiatry that will continue long after this death. And while he himself was skeptical of it (see Quakery Squared) he likewise laid the foundation for the antipsychiatry movement. What he did not do–nor was this his mission–is have a huge impact on psychiatrists. How could he? For them to take seriously his critique undermines their entire project. Correspondingly, leaving aside the issue of impact on his colleagues, insofar as he persuaded only some people and not others, let me suggest that connects not so much with the nuances of his philosophy as with the issue of power. By virtue of the very fact that he took on psychiatry in a foundational way, Szasz was up against a a mammoth industry, with huge money behind it, moreover, a profession upheld by the state. As indeed are the rest of us. So we take our victories where we can.

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    • “…I also think Szaz might have been more helpful had he been a little more Epicurean, and striven to be more moderate.”

      Epicurus was pretty tough on the spiritualistic charlatans of his day. I think the difference is that he focused on providing an attractive, effective, transformative alternative to the supernaturalists that the average person could comprehend, which is what he is remembered for.

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    • Regarding Ron Ungers comment:

      For what it`s worth I think Szasz addressed his perspective on this in the following excerpt from one of his speeches ( youtube, unsure of exact clip link):

      “It`s not necessary to propose an alternative, it would be easy to do so. In my writings for almost 40 years, I have used the analogy which I think is very valid, to slavery. Slavery is an unqualified evil. Now it existed for thousands of years of human history and there came a point that slavery was abolished. Abolishing slavery does not require that one propose an alternative as to what to do with these people. Once involuntary psychiatry, once it would be abolished, society would develop different ways of dealing with different problems, because so called mental illness is many different problems one cannot make a single solution.“ (excerpt of Thomas Szasz speaking, youtube clip)

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      • I think there are real problems with the comparison to slavery. Slavery of course existed entirely for the benefit of the slave holders, and was obviously harmful to the slaves. Psychiatry is much more mixed.

        It is not difficult to find people who are sure they have been helped by psychiatry, even by forced treatment. In some cases we could argue they only thought they were being helped while really they were being hurt, but in other cases we might find that people do seem to have gotten real benefit.

        In any case, I don’t think we get anywhere by being oblivious to the ways psychiatry is unlike slavery in that it usually is at least trying to help, and we need to be much more overt about proposing meaningful alternatives to current psychiatric practices before we can expect much momentum behind any efforts at change.

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        • There were many slaves who felt, or at least later said they felt, that slavery was just fine. They remembered their owners affectionately. Does that mean that slavery was just fine? Is it somehow disrespectful to these individuals to say that chattel slavery is an abomination?


          In psychiatry, as in slavery, you have one arbitrarily delineated class of human beings wielding absolute power over another arbitrarily delineated class of human beings. There is no escaping this truth.

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          • I have made this exact point to Michael Guy Thompson below.

            That is a simple truth that the “Szasz offered no alternatives” crwod has not confronted in a meaningful way. This crowd seems to be either accepting that this delineation will always exist and therefure the only reasonable fight is to control it in a way that causes the least harm possible or that the delineation is necessary for civl society and that while psychiatry’s version is not a good one, perhaps there is another one can be contruscted that serves the common good better.

            Szasz’s point is that said delineation is not only arbitrary but harmful to both the individuals affected by it and society at large. All human beings should be given exactly the same rights regardless of whatever a bunch of MD degree holders think of who deserves more or less rights. In fact, this is what the XIV-th amendment is all about. 150 years later, psychiatrists have not yet accepted the implications of the equal protection clause.

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        • I think the slavery comparison very apt. If mental health law, continually updated with contra-constitutional reformist revisions, is to be some people’s portal into second or third class citizenship, and subhuman maltreatment, (re: slaves 3/5 of a human being status in antebellum America) I don’t see how you can’t see the parallels.

          Before the Civil War, you could find slaves that were alright with slavery, too. They didn’t know anything else. They didn’t see anything wrong with it It was their lot in life so to speak. The slave owner, much like society vis a vis the mental patient, was out to destroy links to their heritage, as a means of insuring their fraction of a human status. You get the same thing in lunatic asylums where people are reduced to numbers, and a treatment records. If the slave, like the mental patient, hated him or herself, well, he or she had a great deal of encouragement, if not reason.

          Psychiatry began with institutionalization, forced treatment. It began with the trade in lunacy, and the first lunatic asylums. You didn’t have psychiatrists back then, but you did have specialist doctors, mad doctors in the popular press. It was never, to my way of thinking, out to help people. It was always, much the same as today, out to protect society from it’s members deemed ‘out of control’ and thought to be a threat. It was what is still is today, the looney bin, a trash receptacle for unwanted humanity.

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          • I think a key difference is that freed slaves tend to do quite well on their own, absent active sources of oppression like the KKK, while people with severe “mental health” issues commonly have serious problems in their lives even before psychiatry intervenes, problems which can easily result in terrible outcomes all by themselves.

            If we fail to make note of such things, we may feel more adept at making statements of condemnation toward psychiatry, but we will also be seen as totally out of touch by the general public, which won’t exactly help our movement.

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        • Actually, Abe Lincoln’s plan, if the southern states had been amenable, would have had slavery around until at least the 1950s. Distaste in the south for the Republican agenda and, even more so, war put an end to that continuance plan. Part of the question is what do you mean by ‘alternative’ here? Slavery in less labor intensive occupations? That’s really where psychiatry is at. Damage people’s economy, chemistry, and autonomy, and then throw them a bone so they won’t revolt, or so that they can feign contentment. I can see the similarities, if I see the differences, too, between the happy darkies on the plantation, and poor pathetic “sick” people “helped” by psychiatry, especially when that “help” means torture and imprisonment.

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  32. I knew Tom, a little bit from my work. He sure reached a lot of people, and comparing the DSM to the Malleus Maleficarum is not just a metaphor, it is accurate. I have a copy of that book MM a few feet away and it is still very chilling to me.

    I would like to make a brief comment about the word “failure.” A few years ago, when I directed MindFreedom, in fact just before its name changed when we were called Support Coalition, we directly addressed that topic. For three years in a row, we hand invited about forty folks based on diversity and working well together, realized we had to limit the numbers because our purpose was that we could all talk together directly in a circle. As I said for three years we met annually for a few days and they were very helpful for me and very supportive. We did this because as we said we knew that we were facing a huge tsunami of oppression. What strategy do you take in the face of such a juggernaut?

    Two of the three times we met at the Highlander Center, which is where MLK and Rosa Parks among other people in the poor south civil rights movement met. Though the center itself moved a bit from those days, the spirit is still the same. For example, I was delighted to hear that apparently when the song “We shall overcome” produces royalties, that is apparently where the royalties go. They actually helped produce that song, even if the story about royalties proves an exaggeration. Until then I kind of thought the song came from thin air!

    If you want to see one of the results from these gatherings, here is a link to the second year statement:


    My point is this: a few years ago I saw a black congressman respond to the many people who bitterly pointed out that obviously the civil rights movement has a long way to go, so was it a failure? But he ticked off many wins including the fact that there are now hundreds of black elected leaders in the south.

    A few years ago, I realized that we need to do the same thing when our people feel a little down and negative. Failure? Over the years I have head many bitter people talk about failure. But I remember years of phone calls from Ray Sandford of Minnesota to me. He would say that he had jokingly not gotten forced electroshock, about every time we had a phone call. If you google his name with the phrase forced electroshock, you will see that he got many forced shocks, but we at MindFreedom stopped those! His psychiatrist said that he would never make it! But years later after the forced shock he was still doing well, and may still today.

    So, yes, in a way right now our whole movement and everybody who works to peacefully overthrow psychiatry is having a “failure.” After all, today there are people in solitary confinement in psychiatric facilities getting forced drugs, as I once did.

    But for Ray Sandford, is it a failure? Every Wednesday morning, they told him in his group home that he could not have any food, because a court order required him to get a forced shock at the hospital every Wednesday morning. But our social change movement came to his aid, and Ray is a hero who impacts many people.

    By the way, my last lock up in 1977, the MAD movement came to my aid, helped me get out of the institution, and helped me get over the trauma of forced psychiatry. Failure? The MAD movement did not fail me, either.

    Let us remember the folks who are still there, but if we are truly serious about revolution in mental health, let us remember the many successes!

    I also remember that it took 75 years or up there abouts for US women to get the right to vote. Some struggles are multi-generational.

    And one more thing: MLK said over and over “Beware the paralysis of analysis!”

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  33. I share many of the same reservations about Szasz that Ron Unger articulates so well, but likewise remain very sensible to the incredible impact of his life and legacy. In this respect I really appreciate Professor Fontaine’s work on this article – it’s erudite, bold, creative and exactly the right side of provocative! It’s always a pleasure to see these types of pieces on MiA, and is what contributes to making the website so special.

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  34. This comment is more geared to those participating in the discussion, rather than so much to Professor Fontaine. I read this article not having any idea what to expect, and kind of excited to actually learn something new (I know most nothing about philosophy). Professor Fontaine also prefaced the entire thing by saying this was a speech given to the APA…so, I also had my guard up as I read through. Like many of you, I found some things offensive, but I also found many others enlightening. The thing I was most impressed by was this man, who is not even a mental health professional, had the courage to give a presentation about a figure whom is most reviled by the very people Fontaine is addressing, and he did so in a room and time slot that really is quite insulting and humiliating. He attempted to bring to light an issue that those in power were ignoring, and asked his audience to take a moment and reflect. There are very few, very few indeed, who have the courage that Professor Fontaine does to do this at an APA convention.

    Professor Fontaine may not be aware of the extent of the issues discussed on this site or that people have first-hand experiencing. And, yes, his speech has many errors in it due to using secondary resources or no resources at all (shamanism), and his tone is, at times, terse and dismissive. But, it is clear from his exploration and the questions he asks that he is curious and skeptical of the mainstream mental health practices and stigma that so many people must deal with. And there were very interesting historical and philosophical ideas that he explores that could really inform us from a “let’s learn from the past” kind of place. For that alone, he deserves respect, not an attack. There is a lot of anger around here, certainly justified in many respects, but to lash out at someone and accuse them of wrong doing without listening to his stated intentions is itself abusive and oppressive. This is what happens in the cycle of violence.

    There is another author on this site, who I will not mention, who is consistently offensive and has made it very clear that he doesn’t care what anybody thinks. Perhaps he deserves the anger and backlash that is rampant here. But, Professor Fontaine has admirably responded and tried to dialogue in spite of the attacks. Maybe we can give him the benefit of the doubt and discuss the problems in his narrative from a place of respect? And, perhaps we can also acknowledge that there were many interesting and important things within the narrative that are very much in line with the thinking of most at this site. There is constant discussion about “how do we instill change?” Personally, I believe that the first step is to not push away those who are curious about and sympathetic to what we might have to say. It’s not always easy to do, but we still must try to be aware and not react out of anger.

    Oh, and just as an FYI, I’m speaking as a person who is talking to myself just as much as anybody else right now….

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    • “There is a lot of anger around here, certainly justified in many respects, but to lash out at someone and accuse them of wrong doing without listening to his stated intentions is itself abusive and oppressive. This is what happens in the cycle of violence.”

      I have another comment waiting for moderation that addresses in a more “pop culture” way the reasons many like me were upset by the tone of this piece.

      That said, I think that your innuendo that people cannot be upset, and very upset, without positioning themselves to what you call a “cycle of violence” is preposterous.

      I have, here and elsewhere, advocated for exclusively peaceful and legal ways. Not only because I am a non violent person but also because from a pragmatic point of view, peace and legality need to be present if we aim at achieving long lasting and meaningful change.

      That said, you can be peaceful promoting exclusively legal means and still be very upset. The two are not mutually exclusive. Our politicians are a good example of people who are very upset and angry most of the time all while writing our laws. Republican lawmakers have called Obama all sorts of names. Obama has returned the favor, to the point that a conservative author called him “The Abuser in Chief” http://www.americanthinker.com/2011/11/the_abuser_in_chief.html .

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    • to lash out at someone and accuse them of wrong doing without listening to his stated intentions is itself abusive and oppressive. This is what happens in the cycle of violence

      Wow, that’s pretty manipulative thinking. Which “stated intentions” do you contend are being ignored? And “violence” — exactly what are you accusing whom of saying/doing? And what’s with this un-nameable writer at MIA you are accusimg of being nasty?

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      • Oldhead,

        I have been moderated for quite some time. I do not agree to abide with the rule of “always being nice to shrinks”, so MIA moderates my comments. In a way that is good, I let the MIA moderator decide what is “not nice”. For the almost one year that I have been moderated, I have only had 2-3 comments rejected, it’s only that they take time to show up.

        With respect to the violence innuendo, it is just a “shutting down the debate” tactic.

        During the campaign to free Justina Pelletier, both Boston Children’s Hospital and DCF claimed to have received threats. They made sure the press echoed their false victim accusations.

        The fact is that nobody was arrested or charged for having made a criminal threat to either institution (the NSA disclosures should convince anybody that if these institutions had received anything remotely close to a criminal threat, the people responsible for them would have been arrested and charged). Many in the Free Justina movement felt that the “threats” thing was an innuendo campaign on the side od BCH and DCF to scare the peaceful and legal supporters that kept calling MA and CT government offices.

        Recently, Fox CT published the result of a FOIA request they submitted to CT’s DCF on the matter (you can see all the emails here http://foxct.com/2014/08/06/ct-dcf-commissioner-pelletier-circus-about-parents-not-justina-2/ ).

        While the emails do not show that CT DCF made up accusations of violence, they clearly show that they were more concerned about the damage the whole thing was doing to the agency reputation than what they were willing to admit publicly, to the point that they people answered the phone for CT DCF admitted that what the were telling the callers that CT had no jurisdiction was just a talking point whose accuracy they were not sure about and that they needed further guidance.

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        • First, I want to start with apologizing for perceived “innuendos” that left anybody feeling like I was admonishing them harshly. It genuinely saddens me to think that I might have upset people who I consider my (virtual) allies, even if we don’t know one another. If you see the final sentence of my comment, it states very clearly that I am talking to myself just as much as anybody else. That is because I am used to being in the position of being told that I am “attacking” when I become impassioned and upset at what I perceive as an affront to my very being…which is also as a “survivor”. I get it. My comment was a plea for reflection, particularly in relation to someone who is willing to dialogue, not an accusation.

          Second, I want to reiterate the point to my comment that everything else was centered around…that is, how do we get people to listen and really help change to happen? My suggestion was that in order to get people to listen we have to be willing to welcome those who may not fully understand but yet are curious and open. And by welcoming, it requires giving someone a little bit of the benefit of the doubt.

          Lastly, nothing of what I said was to shut down the debate. I actually learned quite a bit from some of the comments correcting the mistakes found in the original post and some of the personal anecdotes that went with it. Rather, I am pleading for, yes, a less violent approach to doing so. Perhaps my choice of words were harsh without my tone and context being apparent (and perhaps that is the case for others on here as well!). It’s just that there are more respectful ways of debating that don’t lead to humiliation of a person trying to honor a leading figure of this movement (even if his efforts were clumsy in some ways).

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          • Noel,

            The comment was going fine until you said,

            “Rather, I am pleading for, yes, a less violent approach to doing so”

            What violence are you talking about, might I ask? You must not watch TV at all because what was said here was mild in comparison with the epithets that our politicians throw at each other all the time. Again, this is innuendo.

            Violence is being involuntarily committed and forcibly drugged. Violence is destroying property, physical assaults, battery or threats of doing the same.

            None of the comments that I read, even those that were later moderated, amounted to anything that I would call “violent”. The proof: the majority of commnets expressing strong disagreement with the essay were not moderated.

            The reason you should be careful with labelling “violent” something that objectively is not is because, as I said, that is a very well known technique to shut down debate. Even in this comment where you are trying to explain yourself you are still falling for the trap.

            If you see something “violent”, file a police report or whatever, but do not use the word lightly in cases where it objectively does not apply.

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          • Emmeline,

            Charlton Heston famously said that “political correctness is tyranny with manners”.

            That’s how that characterization of “violent communication” sounds to me. Violence has a clear meaning in American criminal law. You can be charged with a crime and put in jail if you act violently against somebody or threaten somebody with violence.

            To say that constitutionally protected speech is “violent” just because you don’t like that your opponent is expressing his/her point of view in, for lack of a better word, “uncivil ways”, is just an attempt to shutdown your opponent’s point of view by way of making the false connection to violence because most people repudiate violence.

            Now, I am not saying that Mad In America has to abide by what the US Supreme Court has consistently considered constitutionally protected speech -regardless of the political composition of the court- since MIA is a private enterprise and we all agree to abide by its terms of service when we comment. However, the distortion of language is one of the well known tactics employed by those of a totalitarian frame of mind and MIA should resist it. That’s the infamous https://en.wikipedia.org/wiki/Newspeak contained in Orwell’s 1984.

            Freedom of speech, as the US Supreme Court has consistently protected it, is without a doubt the right I am most thankful for of all rights that come with American citizenship. I rather be free to say what I please and be homeless than be a servant of the nanny state paying for my living expenses. In fact, that’s what Europe offers in the context of so called “mental health”: we’ll pay your expenses for life as a “disabled person” as long as you abide to be a compliant “mental patient”. Thanks, but not thanks.

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    • I don’t really get the idea the man presenting was any kinder to his subject than his audience. That is, if the subject was Thomas Szasz. Epicurus could take it. Michael is a professor of classical studies, and this was his way of finding relevance. It was also a much smaller world back then with many more or less important personages magnified in retrospect.

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  35. Michael, I want to thank you for a most thoughtful and erudite article comparing Szasz with the Epicureans. I agree with your assessment of the three traditions of conceptualizing “mental illness,” and thought you summarized the similarities between Epicurus and Szasz brilliantly.

    I also agree that, though Szasz has been very influential with a small number of critics of psychiatry, most of whom, I suspect, belong to MIA, his message has fallen on deaf ears in the world of psychiatry, the media, and the popular culture, despite the correctness of his message. It is a pity that some of the readers of this blog misunderstood your article as an attack on Szasz. Perhaps putting the word Szasz and failure in the same sentence was apparently too much for some of his followers to entertain?

    You raise some excellent points, in an admittedly provocative way, that warrants serious consideration. I find interesting, for example, the point you raise about Szasz’s views on freedom and whether this is the same as autonomy. Szasz was a Libertarian and detested communism and anything even remotely smacking of liberal politics. This is a pity because it severely limited his influence, since it is preciely those liberals who are most invested in more humanitarian treatment of people wrongly diagnosed as mentall ill. Szasz’s notion that we are all responsible for our actions, as well as our mental states, is also problematic. Yes, we are all responsbile for who we are and the sense we make of the world, but we don’t all act in a responsible manner. Some people need help, but that was not Szazs’s strong suit. He was more invested in dismantling psychiatry than in cresting humane ways of helping people in dire straights.

    That seems to me to be his greatest failing – dare I usse that word? Many of Szszs’s views about psychiatry are similar to those or R. D. Laing, with whom I worked for many years in London. Despite all of Laing’s efforts to fight the encroachment of instituional psychaitry into our lives, he also failed to accomplish what many of his followers had hoped for, a realistic alternative to psychiatry. It is a sober activity to look upone those whom we see as our champions and recognize they, too, have feet of clay, and that there are important reasons why “good” ideas sometimes “fail” – or at any rate do not succeed as quickly as we would hope.

    Both Szasz and Laing went out of their way to offend people. Neither were very likable human beings. That is their right. They took no prisoners and devoted their lives to helping people who are the real victims in our society, those who are temporarily so vulnerable that they are at the mercy of the ultimate authorities in our culture, for lack of a viable alternative. The principal weakness of Szasz’s message was that he did not really offer an alternative to the system currently in place. When Italy decided to close down all their mental hospitals without an alternative to replace them with, they were suddenly confronted by thousands of people in mental distress that had nowhere to go to for help. The state ultimately set up “traveling hospitals” that went to the homes of those in acute distress and adminstered ECT to them in their homes! Hardly an improvement over what they had before.

    To me this is the main reason Szasz has had little impact on mainstream society. The other reason is the one you so astutely explain, that also explains Laing’s marginal impact, that for the most part very few people want to take responsibility for their lives and prefer to blame their problems on “sufferng from mental illness,” for which they can be medicated out of their senses. To forgo medication is not a fun experience and requires weathering unvelievable anxiety until such feelings abate or can be accepted. It may also require psychotherapy, an expensive alternative. Given the choice, most people opt for psychiatric treatment. The scandal in our culture is that we don’t offer alternative, Soteria-like places for people to go to, IF that is their choice which, for most, would not be.

    Thank you for your beautifully written, though-provoking article. I hope it encourages more of the same from this readership.

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    • “The principal weakness of Szasz’s message was that he did not really offer an alternative to the system currently in place. ”

      Sorry, but I think that this is not a valid argument, in the sense that is strikingly similar to this other argument,


      “This theory supposes that there must be, and supposedly always has been, a lower class for the upper classes to rest upon: the metaphor of a mudsill theory being that the lowest threshold (mudsill) supports the foundation for a building.”

      “Southern pro-slavery theorists asserted that slavery eliminated this problem by elevating all free people to the status of “citizen”, and removing the landless poor (the “mudsill”) from the political process entirely by means of enslavement. Thus, those who would most threaten economic stability and political harmony were not allowed to undermine a democratic society, because they were not allowed to participate in it. So, in the mindset of pro-slavery men, slavery was for protecting the common good of slaves, masters, and society as a whole”

      This argument appears from time to time in different forms. In the first half of the XX-th century it took the shape of “eugenics”, by which people deemed “unfit” needed to be prevented from procreating (original argument) if not completely eliminated (what Nazi Germany did).

      Bob Whitaker has written and talked about how eugenic thinking impacts the thinkging of mainstream psychiatry today,


      To those who claim that Szasz offered no alternative, might I ask why is an enteprise with the aims and goals of psychiatry necessary in the first place? Why is it that there needs to be a group of “self appointed”, “unaccountable”, mind guardians issuing certificates of abnormality -or “subhumanity” if you will- to the people they dislike?

      The issue of “no alternative” is a straw man designed to avoid to deal with the issue that mainstream psychiatry is this day and age’s incarnation of institutional bigotry.

      Unless those who seek “an alternative” believe that institutional bigotry will always be with us (or that it is even necessary for a civil society), I don’t get why the fact that Szasz was first and foremost insterested in rendering psychiatrists unemployed is problematic.

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  36. Ron writes,
    ” The problem with that though is that there are way more people worried about what to do about distressed and confused people than there are people worried about how the existing system has flaws and often hurts people, so unless we can address both issues at once, we aren’t likely to get the broad support we need.”

    You express the premise that is the problem. There is a solution to the first–social control disguised as mental health. Because this solution worked, the” mind police” (who are well remunerated) had no need to look for a different solution.
    Those worried about the destructiveness of the system were viewed as problems–social control was not working.

    Michael keeps insisting that the social control agents had no conflict of interests with survivor-activists and heretics.

    As if had Szasz been more clear he could have convinced the former group.

    Those who spoke up for Szasz lost their tenure, e.g. Ron Leifer.
    The authorities thought that to criticize the flaws in the social control system
    made one a problem for the social controllers.

    The solution for problems in living created a problem for social control.

    You cannot eliminate the social control problem AND solve the problem in living by fostering autonomy. It is a zero-sum game.

    The only way Szasz could have succeeded is if he built an enormous movement of radical mental patients. (For that you m need money.)
    It seems neither of you understand that. Szasz did.
    Although he might have slightly more effective
    Had he joined with Mosher and demanded more Soteria Projects.

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  37. Hi Michael,

    Thanks enormously for posting this article. I find historical perspectives to be extremely valuable in understanding where and why we are today and so I appreciate your contribution in that regard. I’ve read some of Kurt Danziger’s books about the historical development of concepts in psychology and they were just as illuminating as your article.

    Your ideas were so interesting I read some paragraphs a few times just to let your suggestions roll around in my mind. I’ve been a fan of Szasz’s for a long time so I really appreciate the perspective you’re offering in your post. I was intrigued that Epicurean philosophy could accommodate the idea of a spirit but not as a God-given entity. I’ll need to mull that one over for a while. It’s counter-intuitive but appealing and provocative all at the same time.

    Your article has helped me think about my own work and the work of the movement generally that is working towards a different understanding of mental health and its treatment and the extent to which it’s important to think about how messages are received by others. I can understand why the idea of personal responsibility might not be a tune that all would want to hum along to but it’s there nevertheless.

    Thanks again,


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  38. Thanks for a thoughtful article, Michael, as well as for participating in a (probably overly) heated discussion.

    However (and now I’m speaking to a broader audience), before we dismiss commenters for their occasionally bitter, sometimes unkind comments, we should remember that these comments are the product of a very specific context. In the days after Szasz’s death, the New York Times’ obituary emphasized Szasz’s points of agreement with the Church of Scientology, and eulogized him with a disparaging quote from E. Fuller Torrey, all the while straining to avoid mentioning any of Szasz’s ideas. When Szasz could no longer defend himself, there was a rush to bury his ideas as surely as the man himself.

    In this context– where ideas critical of psychiatry are constantly smeared and always under attack– reading a phrase like “the failure of Thomas Szasz” can arouse some strong feelings. But we should have empathy for commenters who are triggered by seeing phrases that, at first look, appear very much like attacks on those who dare to oppose the hegemonic dominance of psychiatry. These are people with whom we probably fundamentally agree. The severity and tenor of their comments is probably a reflection of this context, rather than any particular animosity toward the author. We would do well to remember this before judging too harshly any particular commenter.

    But all of us, commenters and authors (which is a fairly porous line– one of the prime reasons I enjoying writing for MiA) would be best served by keeping in mind that we’re a self-selecting group. All of us are here for the same reason. We all hope to ameliorate the suffering exacerbated (or sometimes even caused) by the medical establishment in persons diagnosed with mental illness. It is this hope that binds us together as a community.

    Except in extraordinary circumstances (such as investigative journalism), MiA does not pay authors. This means that every author who writes for MiA has only one intention– to share something with the community. Every MiA author devotes his/her time and energy, and exposes him/herself to considerable professional risk simply to share something with this community.

    As a community, we should assume that others– commenters and authors– in our community are acting with the best of intentions. If commenters speak harshly, it is because they care too much, and we owe them our understanding. If authors seem to be speaking against our beliefs, we owe them a careful reading before we speak against them.

    The editors of MiA put a lot of time and energy into soliciting and editing pieces, and to watch a community turn on itself over arguments of tone or moderation is heartbreaking. It undermines the purpose of their work, which is to build a community like this one. Even if we strongly disagree with a particular author or commenter, it is for the sake of the community that we are obliged to be civil, read carefully, assume the good intentions of others, and occasionally, forgive one another for harsh words written in haste.

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    • Read carefully…are you saying we’re missing something? I’m only marginally concerned about “good intentions” — you know the saying i’m sure. Are we aupposed to ignore blatant misiinformation rather than expose it?

      before we dismiss commenters for their occasionally bitter, sometimes unkind comments

      Who is this “we” that presumes it can decide whether or not to “dismiss” us?

      And speaking of unkind what about the snot rag? No one seems to notice, hmmm…

      Also the survivor community here is tighter than ever, so I don’t see anything “heartbreaking” about us forcing the issue when needed.

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      • Hi oldhead–

        I think this article ultimately champions Szasz’s work. I could be wrong about this, but I believe that the author wrote with the intention of celebrating Szasz and his ideas, not blaming Szasz for his failure to overturn psychiatry as a guild. (By that metric, we’re all failures.)

        I left that comment with the hopes of reconciling both the commenters who seemed very angry at this piece, and other commenters who were angry at the first group of commenters, apparently for their anger. I hoped that a reminder of why we’re all commenting on MiA in the first place would serve to soothe the tempers that had been inflamed.

        You’re more than welcome to take my plea to heart or not (and it is a plea– not advice or an admonishment– simply a plea), but I would hope that everyone here can recognize the good intentions behind putting time and effort into writing a piece for MiA. The author isn’t trying to deceive you– there’s nothing to “expose.” If there are errors, most authors I know would welcome a correction. (I certainly would.) Just be nice. We’re all working together toward a common goal. 🙂


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        • Well, many of us are, I think that may be overly optimistic.

          I think people are too afraid of anger, it’s one of the most healing emotions there is, and when there is cause for anger (i.e. one feels it) it sometimes needs to be expressed. Anger is not “violence” as alluded to earlier here; nor should we be consumed by i and i don’t see that happening here.

          If you check back btw, Seth Farber very thoroughly corrected a number of glaring factual errors and seems to have been disciplined for it. Meanwhile you say to “be nice,” but i still want to know about the snot rag. What was the nice purpose of that? Anyway, you don’t have to be nice to me (not that you haven’t been), just be genuine.

          As for your original thought, if you don’t know for sure whether or not he intends to “ultimately” champion Szasz or not, i guess he hasn’t made himself ckear, huh? Why doesn’t he just say what he means? If he has to speak in code to “reach” the APA maybe he should have rewritten it in plain English for MIA.

          This is not directed specifically at you, Christian, but I’m really getting bored with all this talk about people “attacking” others when they are simply responding to their printed words. No one attacked Mr. Fontaine personally that I recall. This is a discussion & debate forum, folks, and we’re passionate people; hopefully we can all accept and value this.

          Anyway, thanks for responding, good to hear from you.

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          • Oldhead, this is a discussion and debate forum with clearly stated guidelines for participation: https://www.madinamerica.com/posting-guidelines/. You don’t have to personally agree with the guidelines, but abiding by them is a condition of posting here.

            No one has been moderated for correcting factual errors, and no one ever will be. What has been moderated are personal attacks. To give some examples of what that means, comments that mock or belittle a person or make disparaging assertions about their character are personal attacks. It’s entirely possible to express anger or disagreement without taking digs at a person and I don’t think that’s too much to ask. Play the ball and not the player, as the saying goes.

            As I mentioned before, discussion of moderation in a blog comment thread is considered off-topic and derailing to the conversation — that’s in the guidelines too. If you want to talk about moderation policy you can contact me or any other MIA staffers via email or the contact page, or start a discussion in the feedback forum. Any further comments about it in this already-very-lengthy thread will likely be removed.

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  39. I think the inherent flaw in this essay is that the best argument doesn’t necessarily win. A scholar from before-christ times didn’t have to contend with a profession, industry, marketing machine that benefits from their argument.

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  40. Hi Michael,

    Thanks for your thoughtful essay and for presenting this to the APA. I am not strongly familiar with Epicurian philosophy so this was an interesting read.

    I do want to mention that I felt like your thesis didn’t ring completely true for me in terms of the three schools of thought. You mention (and dismiss) the shamanic/tribal approach as obsolete- though that is an incredibly common way of interacting with “mental illness” throughout the world to this day. But I think you also discuss the Hippocratic model of mental illness somewhat poorly. You say…

    “In 5th-century BC Greece, Hippocrates introduced a new explanation—the medical model, which attributed mental abnormality, again as inferred from behavioral deviance, exclusively to natural bodily causes. Hippocratic healers believed in humoral imbalances in the brain, and sought to correct them through the use of neuroleptic drugs, forcibly administered if need be, and confinement in the clinic.”

    Like most traditional systems of healing- including Ayurvedic, Unani-Tibb and Traditional Chiniese Medicine, emotional distress is often described in terms of elemental or humoral imbalance. However, none of these systems- including ancient Greek, generally promote correcting them through “neuroleptic drugs, forcibly administered if need ne, and in confinement in the clinic.”

    Hippocrates actually promoted the idea of vix medicatrix naturae…the idea that man, if given proper nourishment, rest and a healthy environment, will naturally return to a state of balance. Herbs and foods were often offered to help remedy imbalance and bring someone back to a greater state of emotional and physical health. The notion of “dis-ease” was seen by the ancient Greeks and most other traditional societies as a temporary condition that could be essentially alleviated by proper nourishment.

    This is really quite opposite to the modern “disease-model” which posits that strong drugs fix underlying permanent illnesses that are rooted in genetics. One posits nourishment and gently encouraging the body’s own healing processes and one posits allopathic intervention with strong neurleptics that supplant the body’s own natural ability to heal.

    Though Szasz rightly focused strongly on the inherent flaws in the modern day disease model of mental illness, I think we would do well to look at how the ancient Greeks and traditional societies often tend to work with people in emotional distress- primarily through the model of nourishment and not dramatic intervention.

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  41. Its an irony that moderation comes up in a discussion about someone who spoke about social control.

    For all the ways that unique people with unique circumatances could be helped if our current system, that grew out of the asylum system was proposed today……. ie lets build mini prisons in every town in the land and lets pass some antidemocratic legislation to lock up and drug people into a stupor even though they have committed no crime and that this system would be at the core of the system of help…..you would be treated with howls of derision. In todays world you couldn’t begin to get the system off the ground. No one would go along with it.

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    • Looks like psychiatry helped add to this violence definition so that they could falsely accuse everyone they fraudulently stigmatized as “mentally ill,” the most vicious, vile, violent speech of all, as the violent ones! The pot calling the kettle black!

      I think there comes a point when moral relativity goes too far. That is another problem with psychiatry in that supposedly no one has the right to judge whether things/people’s actions are good or evil, but rather, they are stigmatized as “mental illness.” And who is psychiatry kidding? They have vilified, stigmatized, tortured and falsely accused those they label as “mentally ill” on a par with Satan himself with all their vicious lies and false accusations of dangerousness, violence, psychotic and others against many trauma victims who are not any of these so they can profit from their suffering.

      I guess this could be considered violent speech, but I think cloaking evil, cruel agendas of social control, intraspecies predation and profiting by destroying others’ lives is the worst form of violence even if bogus pseudoscience language like the DSM and other junk science is used as a veneer for such evil.

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      • I know almost nothing about the mental health system, so this may be off the wall, but I can imagine a scenario where a psychiatrist looks at someone and says, “Either I take this person’s freedom away from them, at least temporarily, or else some policeman is liable to take his life away in a violent confrontation.” Given that there are already possibly thousands of people killed by police every year (the statistics are woefully incomplete), this seems a plausible thought process. I’m not saying this is right, or that it wouldn’t/doesn’t lead to the sort of abuses and corruption being discussed, but it makes me wonder whether a laissez-faire alternative would be workable.

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        • Except that as Jeffrey Swanson, a medical sociologist from Duke University who studies the intersection of guns and mental illness, explains here,


          “The ability of mental health professionals to pick out who’s going to be violent, it’s not much better than a coin toss. It’s a needle in a haystack,”

          You are basically describing the sort of “pre crime” societies that exist in totalitarian regimes. Another great libertarian thinker, FoxNews’ judge Napolitano, explains theses issues here with Szasz’s clarity https://www.youtube.com/watch?v=Lg468Wjk4AI .

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        • Police murder, oh, excuse me, justifiable homicide, or imprisonment? Actually, when the police beat a person to death, I don’t think any amount of drugging is going to prevent them from doing so. It makes a good argument though, doesn’t it? Why don’t we blame the victim? He or she is dead meat anyway. Prosecuting police officers? There you go. That might work. If only the police really would police the police.

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          • I’m thinking of a work colleague and friend who, unknown to us, was on psychiatric medication. One day at work, after he had stopped taking his medications, he suddenly went missing from work. Another colleague/friend must have suspected a problem and went looking for him. He caught up with the guy running around the village making what we laymen call paranoid statements about the FBI and CIA being after him and he had a weapon of some sort on him. Fortunately colleague #2 was able to get colleague #1’s father on the scene before the small-town cops got wind of anything. Nothing bad happened, but although my colleague who found him was reluctant to share many details, he was pretty shaken up and it is clear it was pretty tense out there on the street. Colleague #1 went back to the drug and has been fine ever since. I don’t know what the drug is, but that drug seems to be helpful whatever it is. Would I have blamed my colleague if he had threatened a cop and been killed? Of course not. I’m sorry if this experience biases me, but I really can’t help that.

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          • Clearly RonW had internalized psychiatric ideology before he concluded his friend went crazy because he stopped taking his “medications.” We don’t know how long his friend was off his ” meds.” but let’s assume it was long enough to have an effect. Anyway who has read any of the critics of psychiatric drugs, say Dr Peter Breggin, knows that anyone who stops taking the drug abruptly is almost certain to have withdrawal effects. This is why all the critics urge patients to go gradually, slowly. You will never hear a psychiatrist (other than the dozen critics) utter the word “withdrawal effects”, let alone addiction. But the best way you can be a friend is to warn him of the long- term effects of the drugs he was on, and probably still is–certainly a neuroleptic (i.e., “anti-psychotic”) azd probably a SSRI–common effects include tardive dyskinesia, diabetes, cardiovascular problems, Parkinson, obesity,mania etc.

            You’re on Bob Whitaker blog yet you tell the standard psychiatric story- propaganda: The illness came back as a result of his not taking his “meds.” Even if you had no skepticism about psychiatry, a scientist doesn’t just ignore the many other variables involved. You write: “Colleague #1 went back to the drug and has been fine ever since. I don’t know what the drug is, but that drug seems to be helpful whatever it is” That is a nice little fairy tale but there is not going to be a happy ending. Not unless you or your friend actually read the articles or books by some of the posters here–I don’t mean Dr Fontaine. I mean Bob Whitaker’s last book, Dr Joanna Moncrieff, Laura Delano(survivor) , And Dr Breggin latest book on how to get off psych drugs–or my first book, Madness, Heresy and the Rumor of Angels, with stories of people–‘psychotics’– who got off drugs–‘meds.’. Then–if it’s not too late–you have a chance of getting him off those poisons before they kill him–they actually shorten life expectancy by 20 –30 years in addition to all the other ways they incapacitate one.
            Seth Farber, Ph.D.

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  42. @Emmeline

    “What constitutes violence is more subjective than objective, really. If the principles of NVC were our guidelines for the site, many more of the comments would have been moderated.”

    While I realize that discussion of moderation is off topic, just wanted to say thanks for making me aware of NVC. Good stuff. I intend to apply most if not all of those principles to my internet commenting from here on out.

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  43. I want to thank Michael for an article that taught me so much and to comment on the concept of failure as a positive.

    As a mother and a teacher I have spent my life promoting the idea that failure is one of our greatest achievements. I have never seen failure as something to be afraid of but rather something to be celebrated. I don’t think it makes us any less worthy of admiration or respect, takes away from our successes or defines us as anything other than brave, forward-thinking and ambitious. Small people set achievable goals, heroes like Thomas Szasz set huge ‘not achievable in my lifetime’ goals and analysis of why they are not achieved overnight and meet so much resistance teaches those to whom the torch is passed how to get closer to success. Failure is our greatest teacher and thanks to Thomas we are all wiser and closer to achieving the change he wanted to see in the world.

    I personally have learned far more from failing to reach an ambitious goal than from succeeding in smaller ones. If I’m not failing regularly, I suspect I am being complacent and not challenging myself enough. I relish failure as presenting me with opportunities and sometimes inspiring more successful efforts in others.

    Of course Thomas Szasz failed. My child would not have been told he had a chemical imbalance, given drugs to fix it and violently killed himself because of those drugs, had Thomas succeeded. I would not have been thrown into a psychiatric institution following his death against my wishes. Had Thomas succeeded, none of us would be here on MIA. Does that make his achievements any less worthy of recognition? Of course not. He failed because he promoted ways of thinking and behaving that will change the world, benefit the masses and undermine the privileged. He failed because he was great and had a vision beyond his peers. As Michael points out, his failure says little about him but speaks volumes about his detractors, our society and what is needed to achieve lasting and effective change. Is changing the world ever achieved in one person’s lifetime or do the big humanity-changing goals have a longer timeframe before they are truly bedded in?

    My goal is to eradicate suicide. I will be remembered as a failure. On the back of my failure though, lasting rather than superficial, short-lived change may be made and as such my failure and my success are intertwined. I’m no Thomas Szasz and no one will write such a thoughtful, thought provoking article when I die as Michael has but if someone talks about my failures, I’ll feel like I’ve succeeded because my work and ideas will have outlived me.

    I think it is imperative that we recognize that as a movement aimed at ending coercive psychiatry we are failing. Yes we need to celebrate our successes and acknowledge our heroes but if we are afraid of admitting that we are not achieving the change we seek or critically appraise the efforts of our leaders, then I don’t think we’ll ever get there. Let’s not delude ourselves or be afraid to honestly evaluate progress towards our goals. Being afraid to acknowledge that we have not yet succeeded would, in my view, be our biggest failure.

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    • I’m not one to encourage enslavement and subhuman mistreatment, even if that enslavement goes under the name coercive mental health treatment, your phoney care. I’m not going to encourage people to enslave, imprison, and torture other people in the name of “mental health”. Our forefather’s fought a war of independence so that this country could be free of foreign domination. This being the case, I am going to argue for criminal law, and against mental health law. I would argue for the constitution, and against loopholes in that constitution. Win or lose, sink or swim, I think mental health law should be repealed. Sorry, psychiatric oppression is not my forte’. I’m not any keener on oppressing myself, and I don’t need to collude with others in that kind oppression. I’m not a turncoat, and I’m not a collaborator with the enemy.

      I don’t think Thomas Szasz failed. I don’t think anyone could expect to end 400 + years of coercive psychiatry overnight. I will until my dying breathe continue to battle coercion, control, and other dehumanizing forms of enslavement and torture. Admittedly, it’s an uphill battle, but as far as I’m concerned, it’s a long ways from being over, and it will always be worth it.

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  44. Michael, thank you for bringing Szasz into the conversation. Thank you also for bringing Epicurus and Hippocrates into the conversation. Thank you to others who have invited Foucault and Laing into the conversation. Thank you, as well, to those who have invited Breggin and Whitaker into the conversation.

    We rightfully call upon many muses to make our points, but too seldom invoke the mind of Socrates or the Spirit of Christ. There is a clear philosophical critique of psychiatry that can be traced back to Socrates (and perhaps to the pre-Socratics), the original ostrakon, the famous pharmakos. There is also a clear Christian critique of psychiatry. Ancient psychiatry and its modern iterations may have “succeeded” temporarily, but this is not because Socrates, Jesus and Szasz were wrong. Good eventually triumphs over evil, right over wrong, truth over falsehood, light over darkness, love over hate, and persuasion over coercion.

    I don’t mean to imply that there were no flaws in Szasz’ thinking, but he was correct to champion freedom based on responsibility. He was correct, in Socratic fashion, to raise the question: “WHAT IS MENTAL ILLNESS?” and he was correct in his conclusion that MENTAL ILLNESS IS A MYTH. Mental illness is as illusory as the accusations that were leveled against Socrates. Just as Socrates was not guilty of impiety or corrupting the youth, the modern psychiatric patient is not mentally ill. What the gadfly Szasz accomplished was to raise questions that had been suppressed or dismissed, and then, for the most part, answer them correctly.

    Viewing Szasz through the lens of Epicurean thought is a useful enterprise, but judging the relative success or failure of either presupposes a standard by which such thinkers may be judged. What is this standard? As far as I could tell, this article attributes Szasz’ failure to his poor reception among psychiatrists and the general public… but of course the same could be said of Socrates, and much more so, of Jesus Christ. But Socrates saved Athens. Christ saved the world. Szasz, if understood correctly, has the potential to save psychiatric survivors.

    Szasz succeeds to the extent that people read and understand his work. Therein lies the problem. Szasz was no Socrates, and no Savior, but he laid the groundwork for a revolution. The torch has been passed. It is up to us to articulate more clearly, more powerfully, and more persuasively the truths that Szasz had begun to seize upon.

    Seen in this light, the truth that is rejected will eventually succeed, while commonly accepted falsehoods will ultimately fail.

    Thanks again for inviting Szasz into the conversation… just more evidence that he has succeeded after all.

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  45. A short article by T.M. Luhrmann in this past Sunday’s New York Times shouldn’t pass by this context unnoticed.

    According to the article, the British Psychological Society just released a report effectively confirming everything Szasz argued for 50 years:


    TWO months ago, the British Psychological Society released a remarkable document entitled “Understanding Psychosis and Schizophrenia.” Its authors say that hearing voices and feeling paranoid are common experiences, and are often a reaction to trauma, abuse or deprivation: “Calling them symptoms of mental illness, psychosis or schizophrenia is only one way of thinking about them, with advantages and disadvantages.”

    The report says that there is no strict dividing line between psychosis and normal experience: “Some people find it useful to think of themselves as having an illness. Others prefer to think of their problems as, for example, an aspect of their personality which sometimes gets them into trouble but which they would not want to be without.”

    The report adds that antipsychotic medications are sometimes helpful, but that “there is no evidence that it corrects an underlying biological abnormality.” It then warns about the risk of taking these drugs for years.

    It’s a pity Luhrmann didn’t bother to mention Szasz’ name. After all, those are all his ideas.

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  46. Michael – Listen, you didn’t really go anywhere with this idea that Thomas Szasz skewed his overal critique with one ceaseless beating of the dead horse of freedom. From my reading of Szasz to date, his work includes emphasis on the abrogation of civil rights more determinedly than anyone who tries to compete in the world of ideas regarding mental health, but it wasn’t the centerpiece of most of those books, and perhaps just was only in Insanity: the Idea and its Consequences and Law, Liberty, and Psychiatry. I picked the titles that mattered to me, among them The Meaning of Mind, The Myth of Psychotherapy, Schizophrenia. Only someone coming to read him who is already offended by the idea of protecting legal rights equally would find in those books that the undergirding sine qua non is his belief in personal liberty stood out above and beyond all else to make his message rest on the victory or defeat of that concept. There was an awful lot of different kinds of meat on the bones of his arguments, even if the bones were constituted by unflinching belief in freedom and dignity.

    Similarly, Szasz never aimed at freedom simpliciter–like Sartre, for instance, does in an entirely philosphical vein. For Szasz, freedom referred to self-interest. Psychiatrists haven’t got to earn there clientele while they have the means to create lifelong extra-judicial authority through their entitlement as social control agents. That’s the relevant aspect of the freedom discussion for the APA and such supporters as they have. Of course, I want my freedom, too. How is it good enough to make me rely for my legal rights on the conscience of individual clinicians and leave their authority unquestioned? The notion that the issue of psychiatrists refusing to release patients has most to do with either violence or inability of the patient to care for himself is hyper-proclaimed. What goes on most often is that psychiatrists want you to thank them or want your “friends and family” to see who’s boss, so that they will know who to call when they tire of you.

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  47. Trailller-vous,
    Of course one can’t reduce Szaszx work to one central idea. But if you look at all his books, including his more recent book Slavery and Psychiatry (2006?)it seems clear to me that the civil rights of those persons who become mental patient is a central concern of Szasz and one he argues for better than anyone else. Szasz wrote as a citizen–one who had inherited the legacy of the founders, and fought to advance and protect it.
    I was looking over Michael’s article and he says at the end that Szasz failed–a poor choice of words–because people are afraid of responsibility Erich Fromm said that all his life. This is interesting because Michael implied Szasz had a thick concept of freedom, and that it included freedom to, as well as freedom from. I agree.
    I think that was one of the weaknesses (I don’t want to say”failures”) of Szasz–unlike Fromm he never filled that in. I don’t think he ever discussed what he did with his clients, how he inspired them to embrace freedom–never includes one discussion.
    But what would success mean for Szasz?. I think Michael has defined it too high But he not completely off. It would have meant there was a large school of Szaszian psychiatrists and psychiatrists influenced by Szasz in America. (And other professionals, as a consequence.) Face it. There are almost none. Jeffrety Schaler PhD his protege is a psychologist, Ron Leifer MD was a neo-Szaszian (he is a progressive, not a libertarian but he was unable to get a job teaching and then among those who write there are about 10 professionals influenced by him. They write here and include me, David Cohen, probably Bruce Levine. Peter Breggin, MD is the only psychiatrist strongly influenced by Szasz (he was his student)–but they don’t talk to each other. MICHAEL IS RIGHT FOR THE WRONG REASONS. Szasz
    was silenced by SUNY, SYRACUSE. They would not allow him to speak publicly to med students after THe Myth of Mental Illness was published. HAD SZASZ NOT BEEN SILENCED CUNY WOULD HAVE BECOME A CENTER OF SZASZIAN THOUGHT. Hollander knew that and that is why he silenced Szasz and fired Ron Leifer and ERnest Becker. HAd Szasz not been silenced I believe there would be at least a thousand Szaszian and Szasz influenced psychiatrists today. They would be an influential minority.
    Process theology is esoteric but thanks to Claremont Institute there
    are a few thousand clergy and educators who believe in process theology.Schools of theology spread because they had a center where students went to learn, e.g., University of Chicago (Eliade), Union Theological (a range of liberal theologians often with radical political views), Princeton Theological–a center for Calvinism. (I realize the limits of the analogy but imagine thousands of med students taking Szasz’s classes at a public University! ) Michael fails to take into account that if Szasz failed it was because the establishment put a sock in his mouth and made sure his influence was restricted to those hyper- intellectuals who read his books–not medical students with a desire for another perspective. (Laing was slightly more successful since some of his students created a Laingian space at Duquesne University. I am critical of the reduction of Laing’s thought to phenomenology)
    Part of the tragedy of the mental health system stems from the fact that in the late 1970s Psychiatry willingly placed their power in the pharmaceutical companies–they changed their rules so they could accept drug money. Had Szasz not been silenced there would be a large faction fighting this, screaming when Dr Joe Biederman took millions of dollars from Johnson and Johnson to propagate a new illness: childhood(“pediatric”) bipolar disorder–and said Risperadol(made by J and J) was the best treatment.(His test was bogus.) Biederman should have gone to prison—-think of all the very active kids who are labeled bipolar and kept on drugs forever. Instead he went to teach in Florida. Harvard found him an embarrassment and fired him. As he basks on the beaches in the Florida sun I hope he thinks of the millions of kids whose lives he has ruined. If a 3 year old has a temper tantrum instead of being sent o his room, parents are taught to put her on strong drugs–Risperadol is an “anti-psychotic” and it causes diabetes, cardiovascular problems, tardive dyskinesia, and apathy. Great training for a career as a mental patient. The same kid who in 1970 would have been sent to his room.
    Michael points out that recently the British counterpart to the APA endorsed Szaszian ideas–rejected the medical model– without mentioning Szasz. This is evidence that Szasz’s ideas would have spread here among psychiatrists if he wasn’t silenced.
    Trailler writes:”The notion that the issue of psychiatrists refusing to release patients has most to do with either violence or inability of the patient to care for himself is hyper-proclaimed. What goes on most often is that psychiatrists want you to thank them or want your “friends and family” to see who’s boss, so that they will know who to call when they tire of you.” It is true that hospital psychiatrists make the decision. While the psychological factors Trailler mentions are true there is a stronger systemic factor. The patient will be kept there if there are empty beds and Medicaid will pay the bill. Then the shrinks and the staff will see danger and pathology—and money, money money.
    Seth Farber, Ph.D.

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  48. Hi Seth, As ever, kindness inevitably creeps in every available chink in your remarks after distinguishing your viewpoint along certain lines of difference to the one that is the putative object of your reply. Now, I just am seeing your post today. Not because of very profound distress, but because of enough of it, I take breaks from all sorts of the instantaneous life the Internet keeps available for us. And this change of seasons happens to coincide for me with another time of coming back to the portals. Since you bothered to submit my comment to the litmus test of your own perspective, I receive the pleasure of re-stating my case in double, because , as we see, Michael still adds to the thread. So, it’s to the point of clarifying some comments for the spotlight that puts on his original contributions… as he might benefit from eavesdropping. (I was deeply moved, too, Seth, by your article on “Gloria” and have wanted to see your continued updates to your advocacy position.)

    So, to start out, I only reread the article and your comment, and not anymore of the thread a second time and not my own remarks yet. But I will before pressing the post comment button, so that my answer’s careful enough– since it’s been awhile. Maybe my statements suggested that I thought Michael was reducing Szasz’s views to an idee fixe on Freedom, but that wasn’t how I was actually coming at it. Rather it was from the other direction, that given Szasz’s bibliography and various smatterings of tastes and predelictions, you wouldn’t automatically derive Freedom as the Prime Mover of his (little “p”) philosophy. In that observation was my excuse for pointing out the very rarefied atmosphere surrounding Michael’s discussion of Dr. Szasz’s take on “freedom”. Michael seemed to want the highest generic freedom, or some version assumed from a neutral viewpoint to serve where he was referencing Thomas Szasz in particular.He practically approached it like it was a thetic absolute, freedom as abstractly and absolutely as it could be made to order, not just for free will discussions, but for discussions of political substance between worthy pundits, whether liberal or conservative, at their level and in the context of such purposes, which more often than not bear no reference to survivor issues. If you talk at that level you keep the jingoists and new-agers from heckling, let’s say. But you don’t remind the APA how to think Szasz through.

    At any rate, my own take on Michaels’ efforts appreciate his scholastic intents fully. My first motivation is to approach this essay as a writing topic; secondly, to understand it as a convocation between a liberal academic and an anti-responsibility coalition in full regalia. If you want to keep at the ideas in the piece for another go-round, Seth, I subscribed this time. In that regard, it would be important, prior to talking about the propriety or correctness of the political drift of the language and any of its allusions to survivor issues, to acknowledge the thesis: that in tying coercive practices to the essential qualities of the early to late early modern mad-doctoring efforts Szasz’s aims at reform get bogged down.

    I think rather that it worked just as Hannah Pickard noted here–


    –that Szasz got too convoluted and verbose sometimes. But then let’s also not forget Dr. Joanna Moncrieff for seconding Szasz on this site.
    Thanks for your well thought out response, Seth.
    To recap: My impression from getting acquainted with Szasz and Szaszianism in a less then deliberate way left me with the very definite impression that Szasz’z freedom meant what it means to common sense as for most people that serves both as their philosophy of practical reason and their guidelines topsychology. Szasz honors common sense plus delivers refinements of it that can take the name of philosophical statement, no matter that it’s not Philosphical “outright”. Specifically, where Szasz left me and where I have left my reading of him to date is: freedom works to provide the ultimate foundation for incentives toward responsibility. You know that what you do, you do, and that if you see that it turns out for the good, and the good is what you get. You want more of it and deserve the opportunity to own it gain the respect of your peers. You very appropriately want to get more of what you can by your own honest efforts. Conversely, what your failures mean are what they stand for as learning opportunities in the fullest sense of the wored. Or, if they are moral failures, then they serve as cues for how others will and should make you stand to account.

    I know it’s obvious as the breakdown of libertarian choice in everyday terms, but that ‘s not a good enough reason to leave it tacit for a group like the APA, who loves to believe it engages views in rigorous manner before going ahead and issuing the right idea from its central orifice.

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  49. Thanks Trailler
    Basically I just wanted to point out that Szasz was censored by the academy. If you want to construe Szasz as a philosopher offering intellectual nostrums like Epicurus, that’s fine. That is not how the majority of people on this page, including me, see him. He was a psychiatric abolitionist– a fairly recent book was Slavery and Freedom. That sets the bar higher.
    But even so—and you ignore my main point to retreat again to a realm of abstractions–had SUNY not prevented Szasz from teaching and hsd Szasz’s supporters not been fired, I submit you would have 100s of Szaszian
    psychiatrists today fighting against coercive psychiatry and Michael would not be writing books comparing him unfavorably to Epicurus. He might have a different critique, but those on this page would agree the country would be better off.

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  50. Seth – You’re jumping to conclusions and misconstruing my actual position. Also, you seem to think that I took myself for squaring off with you and disagreeing that Szasz was censored like crazy and gets misrepresented right up to today, and I’m not disagreeing. In addition, I think there is only as much connection between Epicurus and Szasz as someone wants to see for their own purposes, and no more. And I don’t know what would have led Michael to totally different critiques.

    I don’t think Szasz was writing philosophy, I think it was Dr. F’s technique of suggesting a juxtaposition for bringing these two diverse realms of discourse in under one heading for comparison of substance rather than form. Philosophy amidst the intellectual tradition and everyman’s philosophy are continuous but not coextenxive, I think. I enjoyed the compact history lesson on Epicurus, but didn’t take it as an apt way of championing Thomas Szasz in light of the fact that to develop the context of the showdown between opposing views about psychiatry at the conference podium meant saying a bit more that is particular to Szasz. That required giving more character to the way freedom worked as a theme in his writing and thought, I said. Still, Dr. F. admirably seems to want to be present in the mode of eulogy for Thomas Szasz, wouldn’t you say?

    As far as getting abstract, the only way I feel that has to happen concerns Dr. F.’s thesis statement, which is rather refined, and is one that he then doesn’t systematically defend to convincing effect since he is busy making the colloquial treatment of Szasz’z ideas sound like something that the fully credentialed members of his audience were inherently above. If there’s too much optimism in his efforts, that’s where it is.

    I know something of the history of Szasz’s reception by his opponents and understand the counterhistory that you reel off and don’t doubt it.
    But if we don’t look at what Dr. Fontaine declares as his justification for his views, then we’re simply dismissive.

    You know how some supposed advocates of survivor rights try to dispel our natural belief that D.r Szasz was a caring soul? Well, when I read him, starting right off with The Myth of Mental Illness I see that he knows my situation front to back. Then, to his dying day he shone the spotlight on the way mainstream professionals are derisive of the mental capacity of their clients. Far from concerning themselves to assist us with our problems in living, their focus is on parading their superior intents and purposes before government power-brokers and the public at large and keeping labels working like dogtags. Don’t you think that’s what we’ve had enough of?

    Michael’s writing projects are at worst benign in that regard but I think he means to have some pro-active effects and use his perceived authority to inspire other perceived authorities to think and act self-critically. Nonetheless, maybe his actual efforts are too suggestive that being benign about human rights in the survivor debate isn’t one more face of social injustice–which it surely is. Indeed, however, I enjoyed the article and the chance to–exactly, Seth–“complain”.

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  51. Trailler
    You force me to read MF’s piece again, and it bores me!. Yes I agree his intention were benign but there is no awareness of how indignant Szasz was as an American citizen at the treatment of the mad. You can find many references in Szasz but most are to the “foundering father” of our country.

    This idea to depict Szasz as an Epicurean is a fine way to take away the teeth from Szasz’s writings. Compare him to Paine or Jefferson or Madison or Lincoln–because it is obvious that is the tradition Tom identified with. And his project was to recover the basis of American Republic. Also compare him to the abolitionists. THis is why Szasz’s writing sizzle: He is an American patriot defending our tradition. His best book in the years before he died was Slavery and Psychiatry.

    Epicurus was not a fighter standing up for the rights of man. And IF MF presented Tom that way he would have been jeered not feted. He reduced Szasz to what I consider an irrelevancy and this he threatened no one b ut he makes Szasz’s project worth no more than a footnote in history at best.

    In 1991 Tom wrote a forward to my 1973 book–oddly since the book had a Laingian theme. One of my argument was the people who escaped the system
    were having spiritual death-rebirth experience that were pathologized by Psychiatry. Szasz may have disagreed but he did not even mention it in his Foreword. What was important to him was I showed how destructive the system was. He did criticize my subjects for seeking help from Psychiatry in the first place. In my opinion both Laing and Szasz made huge contribution.

    The broader perspectives: Laing was a critic of modern society. Szasz was infuriated because he was a believer in the basic principles
    of the American republic. That is why Szasz simmers with anger whereas MF’s version of Szasz puts one to sleep. The moral indignation is gone.

    Now if you see Szasz as a subversive and citizen in the tradition of abolitionists you can understand his anger. You can also come up with a more cogent explanation for why there are so few Szaszian psychiatrists. You poo-poo it, Trailler, but it is critical. Szasz was silenced, Leifer was fired. He had tenure so they paid him his check but thery would not allow him to teach medical students.Psychiatry did not want people going around calling it bogus medicine and unAmerican in the tradition of slave-owners. Had Szasz been allowed to teach–I repeat-you’d have 100s–at least– of Szaszian psychiatrists, antibodies to the Psychiatric suppression of liberty, contractual psychiatrists who refused to become servants of the state. That is why Szasz “failed” and any other explanation is just a cover-up for Psychiatry. AS to shirking responsibility of freedom–that is why I said there would be 100s of Szaszian psychiatrists, rather than the APA would have switched to a Szaszian model.
    Seth Farber, PhD. , http://www.sethHfarber.com

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  52. Seth-I follow you and I feel you. Stay with me now a minute. You understand that Dr. F.’s up there at Cornell watching in, right? So, is that really how you are supposed to spell poo-poo? I want to know because I promise that wasn’t going on and that means it is value judgment city. By the way, in youth I was solicited (probably high math scores) by alittle accelerated program that automatically put you into Cornell’s graduate program. But something appealed to me at Vassar and I entered there to study Classics. However, I wanted to work, so I left and got into bidding and fulfilling civilian contracts on U. S. Army and ROTC bases around the country, running crews, and cashing checks. I’m hard right military and I know what I’ve got on me. I fully understand Szasz’s ethic, but don’t need to stay so polite as that. I believe completely in keeping memoryies alive. I know that I remain unstable, too. But I operate from 100% rational beliefs and look to make up for my mistakes. I like that Dr Fontaine is trying to get somewhere with his knowledge of Thomas Szasz and so-called human nature and want to see more of it and better work, too. So we have the same ultimate goal.

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  53. N.B. Seth – I am not saying that I did serve, though. That’s just an expression to make up for having no political home but the far right in military matters, hard right is. I liked Buckley and enjoy Pat Buchanan and supported Reagan until Iran-Contra. But it was not hot anywhere when it was time to decide about going in. So, regarding how my life matters in terms of freedom has meant what it did, and if civil libertarians claim Szasz as theirs for posterity, and they unofficially do, that might be what to accept as his legacy for now. But it is also true that Dr. Pickard’s updating his argument and abiding by the principles for meaningful reform according to his prescription in clever and effect ways. You have to take hope where you can get it. Different career academics will promote different interpretations of Szasz over time, and maybe Michael Fontaine wants some of them to think about it right now, but he fears a feeding frenzy of mad academic competition and so wants Szasz to be thought lacklustre unless they are already in the know. You know, no wild surprises or hullabulla until he’s got all his aces in hand. Why don’t we stay on his good side for that possible reason?

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  54. I just want to remind you that Szasz was a life-long member of the Libertarian Party. His mentors were von Mises and Von Hayek and American founders, so you are not talking about Michel Foucault. Although oddly Foucault thought Szasz’s work was important.
    You can find an affirmation of equality both on the right and left. Gordon Wood wrote The Radicalism of the American Revolution. The expansion of the welfare state represents a failure—a point made also by Christopher Lasch in The Revolt of the Elites. This is a long story but to pretend Szasz’s work has nothing to do with the rights and responsibilities of citizenship may be an interesting exercise but it turns Szasz into an armchair intellectual. It may pacify shrinks and academics but it is far more important to discuss what are–or were the unique potentialities of the American experiment–and its failures.
    I am not a conservative but I think John Dean (who turned in his boss,Nixon), a collaborator with Goldwater right before the latter’s death was correct to say in his recent books that conservatives in America are pseudo-conservatives. They don’t stand for any principles except greed. Anyway I agreed with Szasz it was far better to teach a man to fish, than to give him a fish.
    Szasz undersestimated the harm done to the country by the super wealthy elites–and he failed to note that these questions obsessed the mad who took their citizenship more seriously than most people. But he realized the harm done by psychiatric do-gooders. To put in in other terms Szasz realized that the New Classs did not serve the common good, a point even a Marxist could concede.
    Seth Farber, Ph.D.

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  55. I just want to remind you that Szasz was a life-long member of the Libertarian Party. His mentors were von Mises and Von Hayek and American founders, so you are not talking about Michel Foucault. Although oddly Foucault thought Szasz’s work was important.
    You can find an affirmation of equality both on the right and left. Gordon Wood wrote The Radicalism of the American Revolution. The expansion of the welfare state represents a failure—a point made also by Christopher Lasch in The Revolt of the Elites. This is a long story but to pretend Szasz’s work has nothing to do with the rights and responsibilities of citizenship may be an interesting exercise but it turns Szasz into an armchair intellectual. It may pacify shrinks and academics but it is far more important to discuss what are–or were the unique potentialities of the American experiment–and its failures.
    I am not a conservative but I think John Dean (who turned in his boss,Nixon), a collaborator with Goldwater right before the latter’s death was correct to say in his recent books that conservatives in America are pseudo-conservatives. They don’t stand for any principles except greed. Anyway I agreed with Szasz it was far better to teach a man to fish, than to give him a fish.
    Szasz undersestimated the harm done to the country by the super wealthy elites–and he failed to note that these questions obsessed the mad who took their citizenship more seriously than most people. But he realized the harm done by psychiatric do-gooders. To put in in other terms Szasz realized that “the New Classs” (e.g. mental health professionals in public sector) did not serve the common good, a point even a Marxist could concede.
    Seth Farber, Ph.D.

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  56. Seth – I lingered here and it wasn’t to go proxy for everything you found disagreeable in the article and of its reception in the web. I chose to dialogue because you seemed to want to come to terms with your dissatisfaction and seemed to believe something like setting the record straight on Szasz’s legacy had to be done. I respected your concerns and learned from the discussion, so let’s wrap it up. To the point of your remarks, neither am I a conservative. I just like such things as some of these great talkers thought and said who were. I extended my remarks on such meaning of freedom as I bear witness to in life, one indispensable to me for understanding which of the many “freedom”‘s Professor Fontaine was trying to specify, the one he picked for Dr. Szasz meaning something to me like “You did it. You said it. It’s on you.” Szasz had written, for instance, “Responsibility is a zero sum game.”

    Dr. F. has committed himself to some theory that I doubt is true, though, and I suspect academic license plays a part in his presenting that thesis of his as such, since while he uses it to justify the remarks that follow it, however concatenated, the later remarks don’t establish good reasons for believing it in turn. That’s why I keep calling attention to Hannah Pickard’s article “Mental Illness Is Indeed a Myth”. She shows the stronger defense that Szasz had available to him for demonstrating the mythic character of psychopathological determination of “mental illnesses” as entities that psychiatrists do medical work in terms of .

    So Seth, Do you believe Szasz and eventually most leading psychiatrists didn’t all see that he was leaving that door wide open? It’s unlikely to me that he never thought of the stronger defense, as it’s right within arm’s reach of his weakeer one. Academic license just is a kind of a way of getting along for our buddies the good psychiatrists, the folks who Dr. Fontaine rubs elbows with, people who knew Szasz as a very old man and want to have our support these days, but who still don’t want to admit that psychiatry does more harm than good and will for a long time, that the problem is not just it’s theories and culture, but the people in it and all the people who are going to be in it for many generations, and that it could go away without being missed if the right effort got backed to replace it. If Dr. Fontaine is producing scholarly literature that those less acquainted with its purposes can enjoy, as he so ably is, he also is great at giving the game away, never mind that we don’t partake in its dramas as the colleagues and peers of the hobknobbing do-gooders of psychiatry.

    Have the last word, then Seth, and let’s let Emmeline finally take a break from this and us, OK? But to make myself clear, here’s something else I know. During one of my (voluntary) hospitalizations, whoever was the lead psychiatrist on the ward decided to put the whole ward on suicide watch until further notice. For his whole week of rotation in that capacity, every inmate was asked every fifteen minutes by someone with clipboard in hand to tell them–no matter where they were or what they were doing or trying to do–if they had any plans to hurt themselves or anyone else, or if they were thinking they might commit suicide. Dozens of patients. This one thing getting done in exclusion of any other caregiver/patient contacts outside of groups. Dozens of times every shift. Never dealing with such readily available “data”, the mainstream academic critiques generated by this Academy and theirs in the clinical fields here are strictly gratuitous. But I like getting to share in their high cultural treasures as much as anyone with a good career or nice entitlement does. I promise.

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  57. I am not at scholar of Greek philosophy but it seems to me that if one were inclined to try and define, squeeze or limit Szasz’s thinking into a Greek philosophical pigeon hole Epicurean is certainly a better fit that Platonist.

    Personally, I try to avoid the pop culture tendency to see everything through Hellenistic lenses.

    I disagree with the author’s observation that “Szasz was fond of comparing” “psychiatrists to witches”.

    Did I miss something Szasz wrote or said that showed he ever considered them analogous?

    In a more accurate line up of terms used in oppressive environments, the terms for the role played by psychiatrists during the witch persecutions were “witch finder” or “witch hunter”, and “Inquisitor”.

    Psychiatrists among others have been authors of the various DSMs as clergy were its predecessor the malleus maleficarum*. Clergy might then also be used as an analogous term, but is so broad as may cause confusion.

    When Szasz protested against psychiatry he was referring I believe to those who abused their authority to coerce or force people to conform to the wishes of the prevailing authority. He was not referring to those who were considered psychiatrists but did not use that status to impose their or the state’s will upon others, but who like Szasz protested against such impositions.

    Failure to understand the distinction between persons accused of being a witch during the witch hunting era and the accuser and seeing them instead as somehow equal is a failure to differentiate predator from prey.

    Such failure does nothing to advance liberty and oppose the kind of tyranny brought by medicalizing distress caused by the programs of forced “treatment” and represented by the “mental health” movement. Szasz fought the good fight. His detractors shrink from it.

    * https://en.wikipedia.org/wiki/Heinrich_Kramer

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