Appendix 45 - Szasz

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

Love Affair

Psychiatrist Thomas Szasz has led an attack against the mental health system for over 40 years and has challenged the very concept of mental illness.[488] Szasz has become the icon of a movement which aims to destroy the power of psychiatrists to hospitalize anyone involuntarily[489],[490] In his words, "The blurring of the distinction between voluntary and involuntary patients threatens the intellectual foundations and moral integrity of psychiatry."[491]

Ironically, according to A Pictorial History of Psychology, Philippe Pinel, the great psychiatric reformer at the turn of the 19th century, was himself considered mad by his contemporaries - for he, "released the patients from their chains, opened their windows, fed them nourishing food, and treated them with kindness."[492]

From an article about Szasz published in the journal Psychiatry:

[Szasz fears] the psychiatrist can become a 'social manipulator of human material,' punishing, coercing, and influencing people to play certain games.... In general, Szasz believes persons are committed because they serve as an annoyance to other members of society and there is no other legal manner to get rid of them. Indicative of this attitude is the fact that the vast majority of the commitments occur among the lower socioeconomic classes; the rich 'eccentrics' remain immune.[493]

But what about those that are dangerous to themselves? Szasz asks why we don't commit race car drivers or astronauts. Dangerous to others? We don't commit drunk drivers. "In Szasz's opinion the psychiatrist provides society with a system of paralegal penitentiaries to dispose of socially deviant citizens, often for life."[494]

One commentator describes Szasz's concept of mental illness as facilitating a kind of moral slight-of-hand by which the true function of psychiatry (social control) is disguised as beneficence towards the sick.[495] Szasz writes, "Psychiatrists have always had, and continue to have, a veritable love affair with practicing coercion, which they equate with and then peddle as compassion...."[496]


I hold that while the proper aim of the study of things [in the physical sciences] is to increase our understanding of them, the better to be able to control them, the proper aim of the study of men [in the social sciences] must be to increase our understanding of them, the better to be able to leave them alone![497]

So intimate are the connections between psychiatry and coercion that noncoercive psychiatry, like noncoercive slavery, is an oxymoron.[498]

Nothing Better to Do

Quoting from the American Journal of Psychiatry, "Szasz makes an impassioned appeal for a new Humanistic psychiatry which will rethink its social obligations." Not all his colleagues are similarly impassioned. The editor of the Journal of Clinical Psychology opens a vicious attack on what he calls, "Szasz's role as an idealistic liberal reformer" with the statement, "public confidence in psychiatry has been seriously undermined by Dr. Szasz's... extremist [arguments]...."

The concluding two sentences of the editor's attack:

I suppose if nobody had anything with higher priority to do, one half of society could devote all its time to taking care of the less fortunate. Unfortunately, the work of the world must be done before such surplus resources as are available can be allocated to underprivileged groups, of which the psychiatrically disabled are only one.[499]



[488] Davidson, GC and JM Neale. Abnormal Psychology New York: John Wiley and Sons, 1974:58.

[489] Moss, GR. "Szasz." Psychiatry 31(1968):184-194.

[490] Chodoff, P and R Peele. "The Psychiatric Will of Dr. Szasz." Hastings Center Report 1983(April):11-13.

[491] Szasz, TS. "An 'Unscrewtape' Letter." American Journal of Psychiatry 125(1969):138-140.

[492] Bringmann, WG. A Pictorial History of Psychology. Carol Stream: Quintessence Publishing Company, Incorporated, 1997:454.

[493] Moss, GR. "Szasz." Psychiatry 31(1968):184-194.

[494] Ibid.

[495] Bentail, RP and D Pilgrim. "Thomas Szasz, Crazy Talk and the Myth of Mental Illness." Journal of Medical Education 66(1993):69-76.

[496] Szasz, T. "Psychiatric justice." British Journal Psychiatry 154(1989):864-869.

[497] Szasz, TS. "An 'Unscrewtape' Letter." American Journal of Psychiatry 125(1969):138-140.

[498] Szasz, T. "Law and Psychiatry." Journal of Mind and Behavior 11(1990):557-564.

[499] Thorne, FC "An Analysis of Szasz..." American Journal of Psychiatry 123(1966):652-656.



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