Lieberman’s Intellectual Cowardice in His Critique of Szasz, or: What to Do About Page 113?

Joseph Tarantolo, MD
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Why did I read Jeffrey A. Lieberman’s new book, “Shrinks: The Untold Story of Psychiatry”? Frankly, I have been befuddled by my profession. I am a psychiatrist — Board Certified, as they say, these past 37 years – for a long time. So finally, I thought, if I read this book, the pieces of the story would fall into place, right? I would be “told” that which has been “untold.” And evidently Siddartha Mukherjee, a talented oncologist and author of “The Emperor of All Maladies,”  found Lieberman’s book “Astonishing.”

Indeed, I was astonished! I did not recognize the profession that this former president of the American Psychiatric Association described. He does a nice job of describing some of our ugly, tortuous and nutty roots. You know what I mean: lobotomies and purges, chains and seizure-induction, bleeding, dunking, spinning, gassing, and beating. But now he tells us we psychiatrists have put this sadistic craziness behind us and are on a path of enlightened science, primarily with effective drugs that treat brain diseases. If you need help sorting out fact from fiction, I recommend reading two reviews, one by Robert Whitaker and the other by the author of “The Book of Woe,” Gary Greenberg.

I wish only to address here a few lines that forced me to put the book down and pace the floor for an hour.

Lieberman wishes to defang two monsters that have sullied the reputation of his beloved biological psychiatry: psychoanalysis and the “anti-psychiatry” movement.  His disgust with these culprits is evident. “As someone who has worked with thousands of schizophrenic patients, I can assure you that they are just as likely to be talked out of their illness as they are to be bled or purged out of it” (Page 82). I found this attack interesting in that the patients I have seen who have had a bad psychotherapeutic experience usually complain that the analyst did not talk enough! But it is the second “monster” I wish to address here, his vitriolic critique of a colleague, the late Dr. Thomas Szasz.

On page 113 Lieberman devotes a full paragraph to a quote from another biological psychiatrist, E. Fuller Torrey. Torrey and Szasz have vociferously debated in person and in writing the nature of schizophrenia, Torrey sticking to the position that schizophrenia is a brain disease which often must be “treated” with drugs and involuntary hospitalization, and Szasz taking the position that schizophrenia is an arbitrary construct, not a brain disease, which psychiatrists use to justify control and incarceration, in violation of the principles of a free society. Not to mention: bad science.

So when I read Torrey’s quote:

“… Laing’s convictions were eventually put to the test when his own daughter developed schizophrenia. After that, he became disillusioned with his own ideas. People who knew Laing told me that he became a guy asking for money by giving lectures on ideas he no longer believed in. Same with Szasz, who I met several times. He made it pretty clear he understood that schizophrenia qualified as a true brain disease, but he was never going to say so publicly.” (Italics and bolding are mine.)

I had to put the book down. There is nothing sacred about Szasz’s views but this did not make sense. I checked it out with a half dozen other colleagues who knew Szasz quite well. They were non-plussed, so used to criticisms of Szasz’s work as they were.  Jeffery Schaler and Robert Whitaker, however, were incensed. I had to probe further. I contacted Torrey by email:

From: Joseph Tarantolo [mailto:[email protected]]

Sent: Monday, April 06, 2015 8:23 AM

To: Fuller Torrey

Subject: “SHRINKS”/Szasz

Dear Dr Torrey,

We met several years ago, perhaps at a book signing, or we may have overlapped at the NIMH (I was a clinical associate 1970-72).

Although I disagree with many of your tenets about the biological origins of schizophrenia, I admire much of your work, particularly as a champion for the mentally ill and your critique of the need for a humane “asylum” policy.

I know you debated Tom Szasz and you respected him and spoke well of him after his death. Therefore I was taken aback by the quote by Jeff A Lieberman in his new book “Shrinks” on page 113. Lieberman quotes you as saying: “… Same[comparing Szasz to Laing] with Szasz, who I met several times. He made it pretty clear he understood that schizophrenia qualified as a true brain disease, but he was never going to say so publicly.”

I never knew Szasz to shy away from saying publicly what he believed privately so I want to check the veracity of this quote.

I can imagine Tom saying that whether Schizophrenia was “organic” or not, still no one should be locked up unless they broke the law.

The schizophrenics I have treated have seemingly had brain disease but they have been maintained on neuroleptics for decades so how might I distinguish iatrogenic damage from primary disease damage. I believe the jury is still out!

If Tom made the above statement to you, so be it. It just doesn’t sound true. Please enlighten me.

Thanks.

Sincerely,

Joe Tarantolo, M.D.
202-543 5290
908 Pa Ave, Se
Wash, DC 20003

Several days later he replied:

From: Fuller Torrey <[email protected]>

Sent: Apr 20, 2015 9:44 AM

To: Joseph Tarantolo <[email protected]>

Subject: RE: “SHRINKS”/Szasz

Dear Dr. Tarantolo,

Periodically in recent years I sent Tom articles such as the attached.[see below]  In fact now there are over 200 such studies.  I had lunch with him a year prior to his death and urged him to acknowledge what has become overwhelmingly obvious–that schizophrenia is a disease of the brain.  He just smiled his enigmatic smile.  Tom was an honest man but also a stubborn man and there was nothing in it for him to recant at the age of 90.  After Tom’s death I had a similar conversation with Dr. Mantosh Dewan, on the faculty at Syracuse and one of Tom’s closest friends there.  Mantosh agreed with me that Tom realized that schizophrenia is a brain disease but was not going to say so publicly. Thus my statement to Jeff Leiberman.

Best wishes,

Fuller Torrey, MD

So now I knew that what was said in Lieberman’s book, that Szasz made these comments directly to Torrey was false, they were alleged second hand, but it still left hanging whether there was any truth to Szasz’s self-repudiation. Next I contacted Mantosh Dewan:

Dear Dr Dewan,

I am a psychiatrist in DC. I am an admirer of Tom Szasz and got to know him late in his life. I had the honor of introducing him at the ISEPP conference in LA 3 years ago where he gave perhaps his last significant public talk. Knowing his views about schizophrenia, then, I was taken aback when I read in Jeffrey A. Lieberman’s new book, ” Shrinks”: on page 113. Lieberman quotes E Fuller Torrey as saying:”.Same [comparing Szasz to Laing] with Szasz, who I met several times.He made it pretty clear he understood that schizophrenia qualified as a true brain disease, but he was never going to say so publicly.”

I never knew Szasz to shy away from saying publicly what he believed privately so I checked the veracity of this quote with Dr Torre[y].

I told him Torrey’s response.

Dr. Dewan got back to me within a day:

From: Mantosh Dewan <[email protected]> [Edit Address Book]

To: Joseph Tarantolo <[email protected]>

Subject: Re: Szasz/”Shrinks”

Date: Apr 21, 2015 10:00 PM

Attachments: The psychology of schiz.docx

Dear Dr Tarantolo,

 

Tom was not merely brilliant but also capable of unusually sophisticated thinking; thinking that “schizophrenia qualified as a true brain disease” is entirely too simplistic. Tom would not agree to this statement in the way it is written- and I certainly did not say or mean in any way to say [italics mine] “Tom realized that schizophrenia is a brain disease but was not going to say so publicly.”

Tom wrote an amazing paper, The psychology of schizophrenia, in which he describes the deficits in object relations/developmental terms. Later, when biological findings were being reported, he wrote a superb paper, “Schizophrenia: the sacred symbol of psychiatry” in the British J Psychiatry. I published a dozen articles on CT scan findings and discussed this with him. His view:

  • isolated findings in some persons is not necessarily meaningful since these findings are also found in other conditions. eg poverty runs in families, and has many biological stigmata [shorter, lower IQ, etc].
  • Schizophrenia is a consequence of poverty of internal objects. [his more challenging notion was that people make up voices and pithy quotes such as : “If you talk to God, it is prayer; if God talks to you, it is schizophrenia’]
  • in persons who have a brain disease [which are known to cause psychosis, delirium, etc] and [not] ‘schizophrenia’, it is a neurological disease and therefore not a psychiatric disease[like schizophrenia] to be treated under coercive ‘mental health laws.’

He continued to believe that the essential facts are: the state or majority will always subjugate the unwanted social groups and that ‘mental illness’ including schizophrenia is a fiction that is manufactured to justify this oppression.

Personally, I do not care whether folks agree or disagree with Tom. I just hope they do not dismiss him by calling him ‘like Laing’ [a major disservice; Szasz thought Laing so bad he wrote a book about it: “Antipsychiatry, Quackery Squared”, 2009, Syracuse Press] or as ‘antipsychiatry’ without giving his views thoughtful consideration – and sometimes even without ever reading him.

I presented the “Clinical wisdom of Thomas Szasz” at a celebration of his life that the Department held last year and have built on his ideas on the psychology of schizophrenia in a paper recently submitted. I have attached it in case it is of interest.

Warm regards

Mantosh

 

So there you have it. In Whitaker’s book review he says tersely about “Shrinks…,” “This is not a serious book.” I think, however, we should take seriously the egregious nature of a former president of the APA attempting to tarnish the reputation of a legitimate critic. Yes, I understand that any of us can get careless in our private conversations. I still don’t know what actually went on between Torrey and Dewan. Whatever was said, however, pales before the corpus of Szasz’s work: 30 published books, hundreds of articles in dozens of journals, countless lectures and speeches. I am not calling Lieberman a liar, but I do think his besmirching of Szasz’s psycho-philosophical-political views was intellectually cowardly.

Addendum:

I did read Torrey’s paper “proving” that schizophrenia is a brain disease. (“Studies of individuals with schizophrenia never treated with antipsychotic medications: a review” in Schizophrenia Research 58 (2002) 101-115). It is a good review but it proves only that we should be much more humble when trying to explain madness using medical language. I shared with Torrey the following:

Date: Apr 21, 2015 4:53 PM

Thanks for the article, well written, I’m still studying it.

I am agnostic about the issue: brain or Mind. Off the top here are some thoughts that concern me: (Note: I made some minor editorial changes for this article)

1) There is no diagnostic organic test to diagnose schizophrenia, only clinical impression.

2) All the physical findings described are non specific. The papers are awash with statistical probabilities, nothing definitive.

3) What comes first: schizophrenia symptoms or organic disease. (abnormal MRI’s, etc)?

4) I’d prefer not to make a radical distinction bet/psychological and biological: psychosomatic AND somatopsychic are both legitimate notions. Body impacts mind. Mind impacts body.

5) Contrary to organic diseases, madness takes different forms in different cultures. Culture defines madness, not physiology.

6) Contrary to your view that schizophrenia is like Parkinson’s disease and Multiple Sclerosis, we can make an autopsy/biopsy diagnosis in Parkinsons and Multiple Sclerosis, but not in schizophrenia.

7) Isolation of lab rodents will lead to brain changes. i.e. psychosocial factors lead to brain changes. Brain changes are pertinent but psycho-social factors may produce the brain changes. In other words we don’t know cause or effect.

8) Madness has taken different forms over the ages. Not true of organic diseases.

9) Organic disease is profoundly influenced by psychological factors. (see Dean Ornish “Love and Survival”)

10) Charles B Dunlap’s 1924 autopsies (American Journal of Psychiatry Vol.3 page 403) showed no difference in brains of Schizophrenics and “normals.”

11) There really is a “dementia praecox” (i.e.chronically institutionalized/dysfunctional people who never get better) but is that the same illness as the significant % of schizophrenics that do get better. Does the so called brain disease heal?

12) If Schizophrenia is first and foremost a brain disease, then all treatments that damage the brain (ECT, lobotomy and neuroleptics) should be contraindicated. Why would one want to damage an already damaged brain?

13) Virtually all the “risk factors” are psychosocial not humoral, immunological, morphological, or genetic.

Best,  joe t

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62 COMMENTS

  1. I appreciate your efforts, as well as so many others, to bring clarity to these issues of what is and is not mental illness, as well as, perhaps, what mental illness is and is not.

    As a survivor of psychiatric madness, myself–far behind me at this point, so I have clarity about what happened to me–I have my own personal perspective about all of this, a perspective which led to my ability to heal and move on to create my life my way and enjoy it, once and for all. I no longer have any attachment to the mental health world, other than to post on here for my own deeper understanding of humanity, amid these relevant issues.

    However, I’m fairly certain that were I to know absolutely nothing about these issues and I or someone I knew were experiencing mental confusion and distress, I’d be pulling my hair out trying to get clarity about where to turn. There are so many REALLY STRONG opinions and perspectives, and more than that, there is incessant conflict and argument about them. It’s hard to tell where the personalities end and the issues begin.

    As someone outside the fold now, with all due respect, that, alone, would motivate me to look for a less distressing and argument-ridden community for support and guidance.

    • Alex:’Actually knowing that people have successfully exited from psychiatry is quite a relief and empowering. As we speak, author Jon Ronson is on In depth on CSPAN BookTV right now. One of his books is the Psychopathology test which is being made into a movie with Scarlet Johansen. He is quite critical of some of the psychiatric labeling that is taking place. His newest book deals with the social media practice of shaming, which I believe is the main function of psychiatry. Social media shaming is a cathartic substitute for social justice. Psychiatric is a misplaced form of “help” whose real purpose is the creation of otherness.

      • chrisreed, thanks for this. Many of us have successfully exited. I made a real life film about it, where we are all at different stages of this in our healing. Exiting the system is often a complex process, so indeed, I agree with you. We don’t need Hollywood to tell our stories, nor anyone else. Not only is it not real, professionals are actually arguing about what is real for OTHER people. That makes absolutely no sense to me, and will only lead to more confusion, rather than the clarity we crave.

        We exit the system by owning and refining our own stories.

        Here’s a 10 minute clip from the film I made in 2011, when I was speaking per an advocacy agency (which turned out to be bogus in the end, but I got this film out of it, which changed my life, led to family healing, as well as successfully calling out corruption). If it piques your interest, the complete film is on YouTube. This is REAL, and from what I’ve been told, both inspiring and encouraging, straight from the mouths of psychiatric survivors and a couple of our spouses. We are our own experts–

        https://www.youtube.com/watch?v=LN0-m6nhUIE

      • It’s my truth, jt. I’m being direct, clear, and coming from my heart. Going through the system is PLENTY humbling, and I’ve internalized that for life. I find it ironic when a psychiatrist asks humility from a psychiatric survivor when in dialogue. This is from where the phrase, “Physician heal thyself,” comes, and I don’t mean any more disrespect toward you than you offer me.

        I’m entitled to my certainty, based on my experience in life so far, which has been exhaustive with these issues, I’ve lived them inside and out, on all sides of the fence, which is what my life work is about and I’m fully in practice.

        Have you been through the system as a client? Through toxic medication Dr. prescribed overdose and then treacherous withdrawal? Have you had to crawl out of disability and sabotaging stigma in the face of being demeaned and pushed to the margins of society, for no good reason other than to preserve their narcissistic power? I have. And this was after I had received my graduate education and training in psychology, so I got to experience this from a critical perspective, as well as experiential. That’s a lot of life lessons, believe me.

        And I landed just fine, no thanks to anything about the mental health world. I found my healing and guidance elsewhere, and it was clean, not laden with all of this conflict and uncertainty. Certainty is a healing energy.

        My perspective is never etched in stone, however, I’m always open to discussing anything and considering other opinions, but calling my truth ‘too strong’ is relative and subjective, and more a reflection of how my truth affects others than a reflection on me. What I express here is hardly as strong as it could be. I use kid gloves around here.

        Thank you for your honest reflection. Felt good to say this. It is so my truth at this time, most directly and authentically. In fact, give me a bit of closure to it all.

        • One last thing I want to express as clearly and directly as I can, and then I believe I will be super complete with this particular aspect of my journey through the mental health world.

          I really feel that anyone at all dealing with people who have been labeled as ‘mentally ill’ or ‘mentally disabled’–however you want to put it, but referring to those who have been diagnosed and at least at one point on ‘psych drugs,’ and who are currently taking steps and are obviously on a path to becoming more clear and self-empowered after having slipped into some kind of personal mental or emotional malaise– should really check themselves and their emotional responses to peoples’ words and actions. This goes for psychiatrists, psychotherapists, social workers, advocates, activists, and trainers.

          I have had numerous dealings with people in each of these categories over decades, including grad school therapist/professors, and what I keep noticing as the most consistent dynamic is the continuous power plays that are enacted, on the part of the ‘professional class.’ I’ve never seen such unfair, unjust, and uneven boundaries in my life. Talk about indoctrination!

          You don’t like what I say, so you criticize me. Big deal, that’s transparent to me. So many have attempted to shame, intimidate, gaslight, and demean me, all simply for asserting my truth, when it is not even hostile but reasonably critical. That merits dialogue, not shaming. How on earth is that productive, other than to appease your ego?

          Seems that the ‘mental health professional class’ feels it has some kind of authority over people, which of course, is a crock. But man-0-man, you folks really go at it with all guns when you’re triggered. This is how vulnerable unsuspecting clients end up carrying the ills of society, including the ills of their so-called ‘support.’

          To the ‘mental health professional class:’ own your issues, feelings and reactions to other, please! That way, you will have much less compulsion to medicate, force treat, or unjustly mistreat, because the secret is: really, these are YOUR issues!

          Please, please grow your tolerance for diverse energies. That takes personal growth, self-reflection, and ownership. Many of us survivors have done this already and continue to do so, that’s how we have survived, and can now thrive. It’s your turn to own your stuff.

          No disrespect at all intended, but it is hard truth to some. I think it’s valuable to at least consider this. To me, it would solve a lot of the problems with which we tend to go in circles, because you will be demonstrating much needed self-responsibility. As it is now, you are over-burdening your clients, that’s why they are not healing.

          It’s about self-ownership, on everyone’s part. That crosses all class boundaries.

          Thank you. I am complete!

        • Alex – Here, let me put a good word in for Dr. Tarantolo, in the manner of benefit of the doubt about innuendos and such. He can say if I’ve talked out of turn…of course. That little reflection he’s offered you sounds like a reflection of his credo for himself, as you probably noticed, and that makes it seem from where I sit, that intention is just–like for the drift of any meaningful encounter–letting you keep with your truth and bouncing the idea off you. Your story update (life narrative work, after all) that you completed here was great. I loved it, so don’t be done. More people need your visions and tales of apprenticeship in this world here on MIA than me–and I also wouldn’t be alone in missing your voice if it came to Ciao. As for our rowdiness, backbiting, definitely “dis-embodying our calm”, I’ve kept that in mind since Ted spoke up about it several weeks ago on one of Bonnie Burstow’s blogs. We’re doing OK, is my assessment, so then if you want to go into a bit more with sharing your more original ideas about constructive energy, and get a forum started in the Community designations, I”d be right there for that, too. Dialogue, criticism, emotional reaction–any focus you thought best for clarity and effectiveness to become more evident in our engagements and disputes here.

          • Well, if that’s the case, then I am certainly humbled and apologetic! Although the sparseness of the reflection did allow me to at least project my truth about the matter, in general, and I stand by that. Although I’ll recant anything directed at the good doctor if what you say is true, along with my apologies for misinterpreting so reactively. Live and learn.

            I’m certainly accustomed to being called to humility when I speak my truth about healing, but I never feel it is really sound because it feels more strategic than actual feedback, one of those very familiar projections used to throw people. Obviously, it works if I mistakenly projected, but I can own it humbly.

            Although I will say, that’s certainly the voice of having been chronically demeaned and stigmatized, I’m sure other recognize it as such. From expressing this, however, I’ve healed just a bit more of it, thank God.

            Thanks for your sensitive feedback, travailler-vous, even if it is speculative. I’ll consider the other, even though I’m getting really busy now with my next show and film. I appreciate your validation, here.

        • Hi Alex,
          I hesitate to chime in here, but it appears to me that Dr. Tarantolo is responding to your very first comment. I think he is actually agreeing with you that within the community that should be facilitating emotional healing, there is instead too much certainty and strong opinion and not enough humility. That’s the way I’m seeing it. Just trying to be a peacemaker here. Of course, I could be wrong . . .

          • I responded to that, if that were the case, that I had misunderstood. But lack of transparency on the dr’s part is enough answer for me.

            This is the problem, vagueness for the purpose of confusing others. It’s an old trick, hackneyed really. But ironically, it’s certainly effective in providing clarity for those of us on the outside of it, who can tag it as such. Thank you.

      • What happened to primum non nocere? . . . “doc?” Could it be your self-satisfied (and vitriolic I add) projection of what are YOUR issues onto this lovely being who escaped the clutches of the likes of YOU! What comes through here is who is “healthy” and who is . . . not! But you knew that. Take a deep breath and . . . look . . . within! xox from Zurich

    • I agree with you assertion that more “clarity” is needed regarding mental illness.
      As my layman’s research of mental illness progresses, I’m becoming quite convinced that the bio-psychiatry gang are deliberately muddying the waters, while the growing anti-psychiatry crowd are trying desperately to clear the waters.

  2. Thank you so much for this article.

    Imagine how different things could be if the psychiatric profession as a whole would speak out loudly for the necessity of informed consent to treatment, given the inconclusive evidence about whether long term drug treatment is helpful or harmful. Or if at least all the psychiatrists who realize they don’t know who will be helped by drug treatment in the long run, would speak loudly about the need to separate ‘forced safety’ from ‘forced psychotropic drug treatment’ in the case of serious mental illness, and would talk loudly about the need to conduct long term studies that compared medicated to non-medicated recovery.

    Really the change to the current system wouldn’t have to be more costly – simple having choices of ‘outpatient’ support that involved either medication, or a more open dialogue/umbrella approaches, having the choices of being on psychotropic medication in inpatient or sanctuary type settings, and most importantly providing safe care while clients and their families have ‘time’ to think through the different options and research before starting on such a serious drug treatment.

    Once choice is given, then it would be so easy to find the patients to conduct the research that is so necessary to see when and where, for how long and for who psychotropic medication is helpful.

    I know…I know…..people will be thinking ‘what planet am I from to suggest something such as this……

  3. Thanks for this carefully written article. It is pretty shocking and intellectually dishonest for Lieberman to brazenly misrepresent Szasz in this way. It is essentially peddling a falsehood, although Lieberman may have deceived himself and come to believe that what he was doing was somehow acceptable.

    When I was reading it I had an amusing image come into my mind of Lieberman being made to read the 50+ long case reports of former “schizophrenics” who recovered to become essentially healthy, contained in these books:

    Murray Jackson – Weathering the Storms, and Unimaginable Storms
    Ira Steinman – Treating the Untreatable
    Vamik Volkan – The Infantile Psychotic Self and Its Fates
    Bryce Boyer – The Regressed Patient
    Paris Williams – Rethinking Madness
    Gaetano Benedetti – Psychotherapy of Schizophrenia
    Evelyn Liegner – The Hates that Cures: The Psychological Reversibility of Schizophrenia

    It was through reading these casebooks of “schizophrenics” in long-term psychotherapy – which can still be found used on Amazon – and hearing the former “schizophrenics” in their own words that I became convinced that schizophrenia as a unitary illness is a sham, and that psychotic breakdowns are fully reversible with sufficient help. Hopefully when Lieberman goes to purgatory or worse, he will be made to read these over and over!

    One can guess what Lieberman would say: “But these people were never “schizophrenic” to begin with!” (a statement which would be a bunch of BS given how crazy and out of contact with reality these people initially were, although the statement (never “schizophrenic”) would also ironically be true, but not in the sense that Lieberman thought 🙂 ).

    One therapist (Bert Karon) who helped many formerly psychotic people to get well said it best: “If you understand absolutely nothing about schizophrenia, you say that it’s a brain disease.” There we have Lieberman and Torrey in a nutshell.

  4. Appreciate your blog and your through search.
    I had been a person of psychiatric interest to psychiatrists and psychiatry for more years then you have been a psychiatrist. I’m free now and thankful but I’m 68 years old, “Frankie Frankie I could of been somebody , I could a been a contender .”
    You wean people off neuroleptics , surely a nobel necessary service.

    Your right I could of been talked out of the S word diagnosis if someone took enough time and there were a humane supportive place for me to be while I worked things out . Had I been examined and found to be mercury poisoned early on . Had I had available something to help me sleep at times instead of neuroleptics ,electric shock and other tortures. And had I read Edwin Blacks book “War Against the Weak” in 1963 instead of 2003 which is when it was written. Also if I had had a spiritual teacher with broad experience earlier on. All these and I could a come out from under it in less then 4 months instead of 4 decades.
    Instead I was set upon by the psychiatric juggernaut. I was fed upon like a stalk of wheat attacked by a locust swarm .Had I not escaped 6 times from mental institutions I’m sure I would have perished or been wishing I would have.
    We need people like you so rare ,maybe, what 5 out of a thousand or less to start to be brave enough to stand up for us and with us and move to help increase the visibility of anti-psychiatry at the same time to help eliminate at least the Practice of DSM Coercive Psychiatry. And to march and demonstrate and do civil disobedience along side us with survivors in charge, otherwise they might grab us and torture us further. Help there be funding and support for psychiatry free non- coercive first do no harm modalities, respites, Sotera , open dialog etc. all without psychiatrists in charge .

    Appreciate your calling out the intellectually cowardly Lieberman and bringing out insights into Dr. Thomas Szasz and his thinking especially for those of us who have not read his books yet like myself.
    Do you know any practitioners like your self near Eugene someone close to me needs their help and protection from the system ,as its trying to grind her down. Thank You.

  5. Funny how Lieberman’s thinking works: apparently he thinks that if he can show that some authority has changed his mind that necessarily means that the ideas were wrong to begin with. Apparently he has never heard about “argument from authority” fallacy.

    Even if Szasz did change his mind it would mean absolutely nothing – his ideas stand on their own and there are plenty of others who have a lot to say to back them up and plenty of data to support them. We don’t need Szasz or anyone else to find the truth. It’s only someone who puts blind faith into one or the other authority figure whose world will crumble if that person flips. Which of course is not even the case since he’s lying – but it’s an interesting lie that says a lot about the liar and his assumptions. It reminds me about some church people doing this trick against atheists – “oh, he converted on his death bed”. Of course there’s no one to corroborate the story and the dead guy can’t defend himself but you can push your ideology as the only right one anyway. It’s pretty despicable.

  6. I’m very glad Schaler and Whitaker pressed you on this matter. The media has given Lieberman, as an ex-president of the APA, something of a free ride. Lieberman is taking potshots at those he sees as adversaries on the basis of hearsay. The victims of his attack, when he isn’t attacking the living, as he did in the case of Robert Whitaker, are conveniently no longer around to defend themselves. Thomas Szasz would certainly be taken aback to find that he had been lumped, after his own defense, with R. D. Laing and “antipsychiatry”. I would imagine that the statement made about Laing and, again, based upon hearsay, equally fictitious. Had I words for Jeffrey Lieberman, I imagine I would have to say, no, Dr. Lieberman, critical thought regarding your profession does not equal antipsychiatry, and it is exactly this desire to suppress opinions that contrast with the predominant view that I find troubling. That the evidence supporting the predominant view is flimsy at best I would call anything but astonishing.

    Lieberman shouldn’t be allowed to get away with this kind of slander Scot free. It’s good that there is somebody out there to catch the deception regardless of whether it is self-deception or an intentional obscuring of the facts. I think I had read Torrey once make the same claim in another place. Now we know the truth. Apparently (Duh!) Thomas Szasz was not a secret believer, in contrast to everything he ever published, in the theory that so-called “mental illness” was brain disease after all.

  7. Dr. Tarantolo,
    I understand that the point of this blog was to address a misrepresentation in Lieberman’s book and I appreciate your efforts at debunking. At the same time, I wonder about the dualistic nature of your view. Do you think it is possible that the experience of let’s say hearing voices reflects some alteration in brain functioning while at the same time is amenable to so-called social or psychological interventions? I wonder if this is what Dr. Dewan was getting at when he said that Szacz would not have even thought in terms such as “schizophrenia qualified as a true brain disease” because that is such an unsophisticated way of thinking about this. It seems that this unintended dualism creates unnecessary arguments and distracts us from more central concerns. So maybe there are changes in the brain that are truly independent of drug effects. Fine.that really tells us very little about causality (stress and trauma later the brain) or what types of interaction and interventions will and will not be helpful.
    I know there are true dualists – those who believe deeply in spirit and non-organic effects and that is one type of discourse. But much of the time, there seems to be an unnecessary debate on whether or not brain changes are part of alterations in cognition, feeling, and perceptual experiences. It is as if by involving the brain we automatically imply that genetic contributions are paramount or that biological treatments are required. This is an unnecessary and unfounded assumption.

    • I really agree with this – if I am understanding it correctly). I would love to see discussion/debate/arguments focus on supporting the search for which types of interaction and interventions will and will not be helpful.

    • Hi Sandra – If I understand you right, I believe you should put your views on approaches to schizophrenia into your next post, or sometime soon. But I hope it is minus the speculations about how you see the significance of your ideas mattering for the mind-body problem. The best philosophers of mind are dissatisfied themselves still with the formulation of the problem from the outset. Few lay people are consistent materialists, dualists, etc., simply (emphasis on simply) because they reify/hypostasize a lot, as psychiatrists do in suggesting a detectable substance called schizophrenia. Suggesting interaction between mind (insubstantial but real) and brain (good to have, but not independently agential) by itself is not signalling classical dualism, however. I believe your feel for the parameters of getting “mental illness” understood and discussed are right, and that your concerns for Dr. T’s somewhat rambling mentions of his theoretical commitments are warranted, nonetheless. Both warranted and thoroughly to the point, actually–so I absolutely appreciate that you ask him to steer clear of suggesting hypostasizations of fictitious disease entities and determinable sources of communication between the spirit world and the material world. We would still need him to do that if he were a Plantingan dualist, because he seems to court arguments that omit recognition of the slippery slopes involved for any conjecture based on his statements at any given point. But he needs to focus on tightening up his descriptions instead of working out his metaphysics and his ontological commitments. Maybe spelling out the theoretical take on diagnosis and then explaining the indications for treatment modalities atheoretically can give his communications that natural feel that we all like next time.

    • Dear Dr Steingard,
      Thank you for your commentary.
      I think we are in agreement. But I must do some “splitting” to convey the issues.Who we are is not equal to our body and our body does not equal who we are. Let’s not be too concrete. Who we are affects our body and our body affects who we are.
      Reading Dr Dunlap’s study from 1923 I was struck by how little the debate has changed . Dementia Praecox and Schizophrenia were invented a hundred years ago. Madness, however, has been with us for thousands of years.
      William Allanson White, in the commentary about Dunlap’s study points out that there were many things wrong with the “Schizophrenic” patients in his hospital, St Elizabeths: malnutrition, thyroid and adrenal problems, various toxins, poverty etc. So even then we knew calling it all a “brain disease” was silly.It has been said that in the WW2 concentration camps, psychosis was 100%! Cruelty breeds madness. But that is only one example.
      I just did a phone consultation: A 25 year old “mad”person has done his best after 6 years of madness only after spending 3 weeks in jail: free of psychiatric intervention and held accountable for his behavior. Where’s the lesson in that?
      Sometimes, with careful study, one might understand an individual. We dare not, I think, jump to the conclusion that we can understand a whole class of people. Politicians for example,like to say “Americans deserve good government!” Well, I have a hunch not all Americans deserve good government.
      jt

      • “We dare not, I think , jump to the conclusion that we can understand a whole class of people .”
        ” It has been said that in the WW2 concentration camps psychosis was 100%!’ ” Cruelty breeds madness.” ” But that is only one example. ”

        My mother survived the Lodz Ghetto and Auschwitz . She survived 14 selections . For one of those she was so weak that her friends hid her and one of them went through the selection process twice once as herself and once as my mother. My mom said they all looked alike , bald headed skeletons . She spoke of dividing even a small morsel of bread with her friend and her friend with her . My mother experienced being separated from her mother her last surviving relative in Europe who was gassed and cremated upon arrival in Auschwitz. My mother was told by another veteran prisoner ” Do you know where your mother is ?… that’s her coming out of the chimney right now , there ” as she pointed up toward the rising smoke . My mother said that no one who was not there will ever understand it. That spending 5 minutes in Auschwitz was like 5 years of life . She was a prisoner of the nazis for 5 years most of the time in the Lodz Ghetto . While there she risked her life to save her mothers life a number of times. Also sneaking out of the Ghetto to get eggs for her sick father . My mother was once in a roomful of people where all perished from typhoid except her. Maybe because she rubbed her body with a piece of ice when she could. She said there was no sense about what the nazis did. One place she was sent if she wanted to live she was chained to a machine and forced to make bullets . Another to fill buckets with pieces of coal. Another to knit stuff for a nazi guard. People starving , consumed potato peels and machine oil.

        When my mother met my dad Henry Abbe after the war and married I was their first born son . There was a photo I saw of me as a baby being held up in the extended upward arms and hands of my mother Mira and her best friend Hela who shared crumbs of bread with each other in Auschwitz . It reminded me of the TV series Roots when newborn Chicken George was held high by his father. Hela married and ended up emigrating to Israel my mother to the USA. Every few years my mother flew to Israel to meet with the handful of woman who survived Auschwitz with her. Talk about real friends .
        Actually my mother spoke very little about her experience and did not know how or why she survived . She did give up at times in those years . She didn’t believe anyone who was not there could ever understand it . She was there and couldn’t understand it.
        During the last year of her life still sharp as a tack, even under chemo treatment aged 85 while at my youngest sisters house my mother asked me , ” Fred where do you think I have to go when I want to be with my mother ?”
        My Mama was the real deal Yiddishe Mama . She loved and was loved by her family and friends. Never had any need for psychiatrist or therapist . What could they possibly be qualified to tell her ?

        • Dear Fred,
          Most did not survive Auschwitz. Mira did! Why?
          When determinists explain “madness”, e.g. Freud and Biological psychiatrists they miss because there is no understanding of the human will. Except it is. Madness or whatever you want to call it, call it psychosis or schizophrenia, just names ,is a way, a very human way of coping with painful life. Mira , it seems, did not retreat. She willed herself to survive, whatever it took. Nothing is determined except death but we have something to say about when.
          Thanks for sharing Mira with me.
          best
          joe t m.d.

          • Does it seem so “insane” that a person abandoned to an insane situation would have to adapt to survive? I have always been fascinated by how a simple question of what to wear can cause me to panic in indecision, but if you drop me into a situation where all the “sane” people have lost any grasp of control and chaos reigns supreme, and I become decisive, self assured, and a natural leader. There’s no science to support my theory, but I believe the idea that mental illness is a means for a person to deal with an insane and traumatic situation makes a lot more sense than the idea that it is sometimes genetic, sometimes completely unknown to the patient, and always a brain defect although never able to be established with any consistency. While I completely deny any actual medicine in the medical model, I will say… sane thinking never can grasp “insane” thinking. I do believe the difference exists. I also do not believe I would have survived my life with “sane” thinking. It’s funny to come to a point in your life where you are thankful for the same diagnosis that has taken so much from you.

          • “I believe the idea that mental illness is a means for a person to deal with an insane and traumatic situation makes a lot more sense than the idea that it is sometimes genetic, sometimes completely unknown to the patient, and always a brain defect ”

            Well, if 25-50% of people have a “mental illness” then sure as hell it’s adaptive. Evolution does not allow for almost everyone to have a serious pathology, it’s bs on its face. We have emotions for a reason and why we need them is best exemplified by the amount of carnage, physical or psychological a single psychopath can inflict. Psychiatry is in the business of protecting the abusive system hence a necessity to label everyone who does not fit a sick person.

          • Well said, B, as usual. I agree with acidpop – we adapt as we need to, and there’s nothing “crazy” about coming up with creative ways to survive an oppressive environment!

            —- Steve

    • Dr. Steingard,

      A few years ago I started to wonder whether a “schizophrenic” who is hallucinating, and talking to what s/he hears or sees, might actually be asleep and dreaming. I would describe it as the opposite of a hypnagogic hallucination. It’s also not unlike a lucid dream except the body is moving around in “reality” rather than lying motionless and seeing a dreamscape.

      Today I came across Bertram Kratan again (I’d forgotten his name but not his humanity) and he’s got the same idea. I might well have internalized it in college 30 years ago, and begun to think it was mine.

      Kratan also believed that schizophrenic people, during episodes, were in a states of terror (Nightmares?).

      Finally, I was reminded yesterday that congenital blindness and schizophrenia rarely co-occur. (A handful of known cases, ever.) That somehow ties back to sleep/wake issues, as well.

      Below are two non-contiguous paragraphs byt Dr. Kratan.

      http://healingwithdrcraig.com/video-films-radio/schizophrenia-is-a-chronic-terror-syndrome-not-genetic-dr-bertram-karons-acceptance-speech-for-empathic-therapist-award/

      “Schizophrenia is a chronic terror syndrome. All of the symptoms of schizophrenia are either manifestations of the terror or defenses against it. Chronic terror blanches out most other emotions, which led Eugen Bleuler to the erroneous conclusion that schizophrenics have no affect. Many patients are helped by being told in the first or second session that you will not let anyone kill them.

      Hallucinations are basically waking dreams, and can be readily understood with Freud’s theory of dreams, with minor alterations. There are no universal symbols but there are frequently used symbols. Schizophrenic hallucinations may occur in any sensory modality, but auditory hallucinations are most frequent because schizophrenia is an interpersonal disorder, and speech is a communication between people. As with dreams, if the patient associates to the hallucination, the two of you will eventually figure out what the hallucination is about. Patients don’t like being told they hallucinate, but they readily discuss voices and other experiences.”

      Whether any of these sleep-like phenomena really are variants of regular sleep is beyond me. What I like about a sleep theory is that it doesn’t put the patient so far away from everyone else. Some of us sleepwalk, and others lucid-dream and sleep-hallucinate. Maybe in the process of waking up or becoming tired, something small goes awry, maybe out of sync.

      If you have any thoughts on Kratan’s ideas I’d be interested to know them.

      C

      • clc ,
        As someone who has been diagnosed for over 40 years by psychiatry, in succession as a certified Schizophrenic plus unremembered designations , then Manic Depressive then Bipolar and had psychiatry’s , entire inhumane arsenal and then some fired at me (except for old school physical lobotomy and insulin shock treatments) since 1963 {been free of psychiatry since 2007 ( Any further of their treatments that is) } including ECT and ones hardly anyone ever heard of (experimentation) really. Fortunately my survival instinct helped me escape 6 times from mental institutions and I always stopped or lowered the dose of ” meds “myself whenever possible . I never told any psychiatrists social workers or employees of mental hospitals the truth after the first 2 initial months of torture when I was 16.
        Most all psychiatrists don’t know anything compared to a survivor . Their profession is pseudo science itself besides most everybody lies to them in order to survive the coercive blind power and authority they are facing.
        So yeah Kratan’s ideas are spot on .
        fred

        • clc,
          I agree with Fred that people who have experienced what I call psychosis,are in a much better position to describe it and respond than a non-experiencer like me can ever be. But in an attempt to respond to your question, I would say that attempts to link the experiences of someone experiencing what I call psychosis to other kinds of experiences others have is worthwhile. Is all of “schizophrenia” a chronic terror syndrome? Whom am I to say? In general, however, I resist unifying explanations be there the dopamine hypothesis, genetics, or terror syndromes.

  10. There is not a psychiatrist alive who knows any more about so-called “schizophrenia” than the average Joe or Jane on the street.

    There are can be many etiological conditions that cause these symptoms, but there is no stand-alone disease present. There never has been.

    The day “schizophrenia” dies, so does psychiatry. Which is why it is on artificial life support.

    Duane

      • It is the only way that shamans ever become shamans in other cultures. I am First Nations (commonly called Native American by White people) and people who experienced this kind of distress were the ones who were called upon by the community to become the healers and the spiritual leaders of the community. They were respected, not reviled, and no one tried to control their behavior and thinking all the time while they were experiencing the distress.

  12. Joseph,

    I personally dealt with what an ethical subsequent pastor confessed was “the dirty little secret of the two original educated professions.” Basically, I was drugged and defamed with a “mental illness” to cover up a “bad fix” on a broken bone, by a PCP who was paranoid of a non-existant potential malpractice suit, and the medical evidence of the sexual abuse of my small child, based upon medically documented lies and gossip from the alleged child abusers themselves (including a prior pastor).

    And, of course, I had to research medicine myself, since no doctors actually confess to this “dirty little secret.” Well, once you medically explain it to subsequent doctors, they do at least take the stigmatization off your medical records. But I came across some interesting information in my research, likely the most common cause of schizophrenia.

    John Read’s research into schizophrenia and adverse childhood experiences / child abuse shows evidence that the most common trait of all schizophrenics is adverse childhood experiences. His research shows that child abuse victims are claimed to be psychotic at a rate of 77%, while non-abused children only receive a diagnosis of psychosis at a rate of 10%, if I recall correctly. His theory, from my understanding is child abuse causes schizophrenia, which may be true. I’m not personally certain of that.

    But according to my medical records, I had my concerns of the abuse of my child (I was in denial at the time) wrongly claimed to be psychosis. And I was made psychotic on a child’s dose of Risperdal, .5mg. This was medically claimed to be a “Foul up.” But since I was dealing with unethical and paranoid doctors in the first place, unbeknownst to me at the time, I ended up having the symptoms of schizophrenia created via the central symptoms of anticholinergic intoxication syndrome – it was called “bipolar” at the time, however. From drugs.com:

    “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    Since a grown adult can actually be made psychotic on a child’s dose of Risperdal. And so many children who’ve been abused are also likely being misdiagnosed as psychotic, because of course doctors don’t want to deal with the potential legal ramifications of an issue such as child abuse, especially if they can profit off another’s misfortune. And covering up child abuse for the religions with psychiatric stigmatization and torture is “the dirty little secret of the two original educated professions.”

    It strikes me the most common cause of schizophrenia today is likely doctors misdiagnosing child abuse victims as psychotic, then creating psychosis with the antipsychotics, via the central symptoms of neuroleptic induced anticholinergic intoxication syndrome.

    I know none of my psychiatrists claimed to be aware of the fact the antipsychotics could actually cause psychosis, are all the psychiatrists so deluded? Thankfully, I eventually ran into an oral surgeon who wasn’t so deluded.

    I highly doubt schizophrenia is a real disease either, and the “gold standard” treatment, indeed, does cause the symptoms of schizophrenia.

  13. James Davies author of Cracked may well be the last person to interview Thomas Szasz , just a month before he died.
    Page 276 – 277 in his book or 70% on a kindle edition. You can read this on Amazon.
    Perhaps , the author of Shrinks should read it too.

  15. Thanks for sharing your correspondence Joseph, it does indeed help to clarify the contours of the debate!
    In your response to Torrey’s paper you raise the following question (Point 12): Why would one want to damage an already damaged brain? One possible answer results from the “Snake Pit Theory” of psychiatry, namely, the idea from ancient times that if you threw a “normal” person into a snake pit, it would make them crazy, ergo if you throw a “crazy” person into a snake pit, it should make them normal!! This principle is perhaps the central guiding principle for most all of the brain damaging methods developed by psychiatry over the centuries.
    Thanks for a fine blog.

    • Your welcome Eugene, nice to be appreciated,
      What struck me as a psychiatric resident were the people who showed up in the Emergency Room wildly “mad” who beaome calm and “normal” as soon as they arrived at a quiet accepting ward. It was not the Snake pit that made them “normal” but rather having an asylum. The big deficit in the world of “mental illness” treatment is the lack of non coersive asylums, places to heal, to be away from that which was maddening. Must be voluntary! And that is where I disagree with Torrey and take on Szasz’s mantel of the respect for freedom of choice.
      best
      jt

      • I couldn’t agree with you more! To quote my colleague and mentor, the late psychologist and family therapy pioneer, Harry Goolishian: “By the very questions that we ask, we (professionals) are responsible for producing the ‘pathologies’ that we see. We are not like microscopes, seeking to uncover pathogens. Rather we actively co-create the persons sitting across from us… always!” If, for instance, I think of the person sitting across from me as being a potentially and uncontrollably violent chronic schizophrenic, as opposed to, say, being in a state of overstimulated or agitated panic, I am going to speak with him/her differently, relate to him or her differently, and our exchange is going to produce a very different relationship and in all probability, a very different outcome.
        So yes, let’s work on changing the meaning of the word “asylum” in our cultural vocabulary!!

      • Thank you Joe, for doing the necessary detective work to expose Lieberman’s and Torrey’s dishonesty. I’m enjoying the idea of them both reading your article, which I’m sure they have by now!
        Please check out my MIA article -“Remembering a medication free madness sanctuary” to see how a loving sanctuary is a better descriptor than asylum for the healing setting you describe. We used no diagnosis, meds or restraints on the 20 bed, open door I-Ward sanctuary I served at for several years.
        You also might enjoy my website- “What is Madness?” at michaelcornwall.com
        Best wishes,
        Michael
        Michael

  16. Lieberman rubbed me the wrong way when he claimed he had suffered under the stigma of psychiatry (simply by practicing it.) However, that just makes him rather self involved and unaware. I can’t say that it makes him a liar. Torrey, on the other hand, is blatantly dishonest. His statistics are habitually so biased that there’s no way he can have just got the numbers wrong. Both of them are so invested in the medical model at this point though that they would happily sacrifice all delusions of professional ethics in the name of brain disorders. I suppose it’s handy that Sanz is dead, and this supposed quote fully supports Torrey and Lieberman’s agenda.

  17. I don’t know if Lieberman is a chronic liar (probably is), but I think we all know that Torrey lies like a rug and is willing to swear to the truth of stuff that is known to be false. Of course, anyone who would take Torrey’s word for something is stupid. I don’t know how the guy has the slightest credibility left.

    Thanks for directly taking on the liars!

    —- Steve

  18. Psychiatry is in the business of protecting the abusive system hence a necessity to label everyone who does not fit a sick person.

    Exactly. Which is why our ability to upend that system will be impaired until our analysis of psychiatry recognizes it not primarily as a rogue branch of medicine but as a branch of the repression/law enforcement apparatus.

    Lieberman strikes me as a bit delusional and paranoid — for example, where exactly is this “anti-psychiatry movement” he speaks of?

    • If you aren’t there (where the antipsychiatry movement is), OldHead, I am.

      I think however that Jeffry Lieberman here is using antipsychiatry in the old pejorative sense of anybody with the audacity to question the legitimacy and authority of psychiatry, and I mean anybody. The profession, as a whole, doesn’t seem able to take criticism very well. Antipsychiatry movement here is only the old bug-a-boo of psychiatry, of which, as a former president of the APA, Lieberman is able to claim something approaching honcho (i.e. top-dog leadership) status.

  19. Sooo…the truth is Lieberman screams at Szasz to recant his heresy. Szasz, knows he’s dealing with a fool, refuses to argue, merely smiling instead. Ergo Szasz for his own NEFARIOUS purposes is obviously lying–though he really knows the truth.

    Consider that Lieberman’s status of psychiatrist gives him mystical clairvoyant powers to not just predict suicide/homicide before they happen but read the innermost thoughts of Szazs as well as all his vic–uh–patients.

    Mind reading and fortune telling. The science of psychiatry,folks!

    Alas, if only Szazs could have been his patient, Lieberman could easily have “cured” him of that thought crime anosognosia. Lock him up and subject him to endless rounds of electroshock and druggings till he recants.

    “He loved Big Brother.”

  20. It can’t be a disease if a person can get better through carefully not taking their “medication” and moving to “psychology”. And can explain how and why this process works.

    Carefully not taking my “medication” because these drugs have serious Rebound and Withdrawal Syndromes.

    Suitable Psychology for me would be the Psychology of Dr Wayne W Dyer + Eckhart Tolle. Buddhist Psychology also and 12 Step Fellowship….

    (..By coincidence these styles are also supported by Oprah Winnfrey .. ).

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