Liberty and/or Psychiatry?
40 Years After
the Myth of Mental Illness
A Symposium in Honor of
Thomas S. Szasz on his 80th Birthday
April
15, 2000, 9:00 A.M. to 4:30 P.M, Weiskotten Auditorium
Dear
Friends and Colleagues:
We welcome you to this historic celebration
of Thomas S. Szasz’s life and work, especially on the occasion of his 80th
birthday! Dr. Thomas Szasz has done
more throughout his life to help us comprehend the relationship between liberty
and responsibility than many people have done over the past two hundred
years. His writing, teaching, speeches,
and mentoring continue to influence and change the way we think about psychiatry,
medicine, disease, mind, behavior, law, liberty, justice, responsibility,
psychotherapy, philosophy, suicide, drug policy, addiction, economics, and the
seemingly endless manifestations of the “Therapeutic State.” By exposing the difference between literal
and metaphorical disease when he wrote The Myth of Mental Illness in
1961, Professor Szasz threw psychiatrists and psychotherapists into an ethical
identity crisis: Since mental illness
is a myth, it cannot be treated!
Law, Liberty, and Psychiatry, published in 1963, changed the relationship
between psychiatry and the state forever.
As Thomas Szasz accurately predicted:
“Although we may not know it, we have, in our day, witnessed the birth
of the Therapeutic State. This is
perhaps the major implication of psychiatry as an institution of social
control.” Despite his extensive
writings since then on how the union of medicine and state came to replace the
union of church and state, many people today use the term the “therapeutic
state” with little comprehension of its origin and meaning. The idea of mental illness persists as legal
fiction. It is used to justify
declaring guilty persons innocent of crimes they committed and innocent persons
guilty of crimes they didn’t commit.
The insanity defense and the involuntary commitment of persons to
prisons called mental hospitals continues to be justified in the name of
compassion and science. Dr. Szasz is
still blamed for the “problem” of the “homeless mentally ill” because he dared
to point out how those labeled “mentally ill” are first and foremost persons,
not a separate species from “mentally healthy” persons. Thomas Szasz exposed the myth of addiction
as a disease a long time ago. He argued
for the repeal of drug prohibition long before it was fashionable to do
so.
Has Thomas Szasz’s work made a difference
in the world since he wrote The Myth of Mental Illness forty years ago,
or are we to live the rest of our lives‑as may our children and
grandchildren‑ as pawns and chattel of the Therapeutic State? Our distinguished panel of speakers will
address the significance of this question.
They represent only a few of the people throughout the world committed
to the truthfulness of Thomas Szasz’s ideas.
This is a meeting of minds to
remember. It is a time to listen and to
speak, to make new friends and reconnect with old ones, and it is a time to
renew your confidence in what you know is right. It is a time of heroism, courage, and rebellion.
Twenty years ago, the late Professor M.E
Grenander, Director of the Institute for Humanistic Studies at SUNY Albany,
organized a special symposium entitled “Asclepius at Syracuse,” Thomas Szasz,
Libertarian Humanist.” At the very
heading of the symposium’s compiled proceedings Dr. Grenander quoted Dr. Szasz
as follows: “Respect for the individual and its choices forms the backbone of
my moral and political position.” Twenty years after “Asclepius at Syracuse,”
we are gathered to pay tribute to Thomas Szasz for his magnificent intellect,
moral integrity, physical and spiritual strength, and love for his fellow homo
sapiens.
It is most gratifying to see the tremendous
response from those of you in the academic community and general public to our
invitation to celebrate the life and work of Thomas Szasz on his 80th
birthday. May the presentations, conversations,
and our presence here at this Symposium constitute further proof that Thomas
Szasz’s contributions to society are alive and well as is Dr. Szasz
himself!
HAPPY 80th BIRTHDAY DR. THOMAS
S. SZASZ!
Nelson Borelli, MD Jeffrey A. Schaler, PhD
Symposium Co-Chairs
—9:00 AM—
GREETINGS
FROM THE
DEPARTMENT
OF PSYCHIATRY,
SUNY
HEALTH SCIENCE CENTER/SYRACUSE
Mantosh Dewan, MD, Chair,
Eugene Kaplan, MD, Past Chair,
Chaitanya Haldipur, MD, Professor
FORTY YEARS OF CONSEQUENCES
THE STATE OF THE THERAPEUTIC
STATE
AFTER THE MYTH IS DISPELLED:
WHAT THEN?
PSYCHIATRY ON TRIAL
RHETORIC AND SZASZIAN THEORY
EPITOMIZING
THE MYTH:
MAX
FINK AND ELECTROSHOCK
— 10:45 AM TO 11:00 AM BREAK —
THOMAS SZASZ AND
POST-MODERNISM
THE EXISTENTIAL PHILOSOPHY
OF THOMAS SZASZ
Keith
Hoeller
THOMAS SZASZ’S IMPACT
ON POLITICAL ISSUES
—12:15 TO 1:30 PM LUNCH—
PSYCHIATRY’S MORAL ANCHOR
THOMAS SZASZ’S PERSONALIST
AND ETHICAL CONCEPTION OF
THE
CAUSE AND CURE OF CHARACTER,
CONDUCT, AND CONFLICT
THE MYTH CONSTRUCTION SINCE
THE MYTH OF MENTAL ILLNESS
James C. Mancuso
ASKING SIMPLE QUESTIONS
Anthony Stadlen
GNOSIS VS. DIAGNOSIS:
SYBIL’S LAST STAND
Peter J. Swales
—3:35 PM TO 3:50 PM BREAK—
THOMAS SZASZ AND
THE LIBERTARIAN
TRANSFORMATION
OF PSYCHIATRISTS
Abraham L. Halpern
CLOSING
REMARKS
Nelson Borelli and Jeffrey A.
Schaler
—
4:30 PM —
Many of us have struggled with coercive
psychiatry, with Dr. Szasz's writings as our guide. It is evident that we have made progress. Equally clear is the fact that society will
not let people who frighten it walk the streets. Sexual predator laws illustrate the post-medical response. I will discuss why, in my judgment, the
struggle with the myth is worth waging despite that fact.
By ideologizing Szasz’s 1960 plain
scientific observation pertaining to absence of disease, the mental illness establishment
caused consequences worth twenty-four magnificent books and many papers, which
are facing us now and forever.
How a retreading Obstetrician/Gynecologist
was stunned to find out that the residency program in psychiatry was an
indoctrination, rather than an education, and rapidly found himself unable to
comply with its requirements.
Discovering and reading the works of Thomas S. Szasz, which by his own
description are nothing more than common sense, plus the good fortune of
meeting this wonderful man, enabled him to persevere through some difficult
times to establish himself as the psychiatrist of choice for people who didn’t
want a real psychiatrist.
Thomas Szasz’s depiction of persons as
human agents capable of authoring action for which they are morally
accountable, is a hallmark of his work.
He has employed this idea to generate a host of philosophical, political,
legal, and clinical questions pertaining to the intelligibility and moral
integrity of psychiatry and psychiatrists.
Does psychiatry, in principle, have a moral foundation‑even if
morally relevant features of the practices in which psychiatrists engage often
fail to reflect this principle? In
offering an account of psychiatry’s “moral anchor,” I turn to themes which Dr.
Szasz has consistently drawn attention‑agency and action, intentionality,
sanity, madness, and the community of human agents as apprehended from a moral
point-of-view.
EPITOMIZING
THE MYTH: MAX FINK AND ELECTROSHOCK
From the perspective of a practicing
neurologist, I analyze the arguments, examine the facts and rebut the claims of
Max Fink, one of the leading figures in the field of electroshock therapy.
THOMAS
SZASZ AND THE LIBERTARIAN TRANSFORMATION OF PSYCHIATRISTS
The publication
of Law, Liberty, and Psychiatry (1963) brought forth a defensive,
concerted barrage of criticism by organized psychiatry. Indoctrinated by centuries-long teachings
that involuntary hospitalization was warranted to isolate and/or treat persons
who were believed to be mentally ill, psychiatrists failed to appreciate the
primacy of freedom as a value to be prized in a democratic society. The
influence of Thomas Szasz on psychiatrists over the past 37 years has been
enormous and has led to abandonment of involuntary hospitalization of hundreds
of thousands of non-dangerous persons seeking psychological help, and to a
meaningful respect for fundamental human rights in many countries, especially
in the U.S.
Szasz's initial exposure to philosophy was
to analytic philosophy and the philosophy of language, which he used to offer
an alternative to the medical model in his game-language model. In the early 1960s, Szasz became familiar
with existential philosophy, and began to use its moral principles as a basis
for an alternative to the medical model.
I will point out similarities between the principles of existentialism
and many of Szasz’s ideas.
In May of 1998, standing in for Dr. Szasz,
I served as prosecutor at the “Foucault Tribunal: Psychiatry on Trial,” which
was held in Berlin, Germany. I will
present a summary of the charges made against psychiatry at that Tribunal.
THOMAS
SZASZ’S PERSONALIST AND ETHICAL CONCEPTION OF THE CAUSE AND CURE OF CHARACTER,
CONDUCT, AND CONFLICT
The subtitle of Szasz’s book, The Myth
of Mental Illness: Foundations of a
Theory of Personal Conduct, is my focus here. Szasz did not mean theory qua hypostasis but theory in the
sense of method. He meant the
foundations of a method for the understanding of and coping with personal
conduct and ethical choices. The central concept in this method is: "No
man is an Island, entire of it self," that it takes two to tango,
or, in my preferred terms, that it takes one person to have pneumonia, the
monadic model of observation and epistemology, but it takes two to develop
paranoia, the dyadic model of observation and epistemology.
THE MYTH CONSTRUCTION SINCE THE MYTH OF
MENTAL ILLNESS
When Thomas Szasz wrote The Myth Of
Mental Illness, he produced a landmark text which promoted a focus on the
construction labeled myth and the involvement of that construction in our
personal and scientific endeavors. By
promoting a focus on the functions of the myth construction, Szasz helped to
resurrect an interest in the ways in which our story-making processes intercede
in our creation of our personal and scientific realities. His deconstruction of the mental illness
myth continues to inform major reconsiderations of what and how we, both as
persons and as scientists, create and maintain the "realities" that guide
our interactions with what we take to be our surrounding world.
At the present time we are confronted
through the postmodern surge with a fundamental challenge to all of the canons
that underlie western culture. Such concepts as freedom, truth and morality
have been brought into question and subjected not just to re-consideration, but
to deconstruction. What this means is that any theory, be it in physics,
medicine or law, is subject to a radicalized relativism opposed to the idea of
any fundamental verities. How does the thought of Thomas Szasz stand up to this
sort of critique and what does Szasz have to tell us about this way of
thinking?
The Myth of Mental Illness
paved the way to Law, Liberty and Psychiatry (1963), in which Thomas
Szasz first exposed the dangers of Therapeutic State. Today, institutional
psychiatry still undermines personal liberty (involuntary commitment) and
justice (the insanity defense). The
idea of insanity still undermines the rule of law. The public health movement undermines personal responsibility and
the free market economy. The literal
war on people escalates daily as a metaphorical “war on drugs.” People still regard themselves as things and
things as people. Most people prefer
paternalism and obedience to authority over autonomy and individualism. They always have and likely always will.
Thomas Szasz's eightieth birthday, 15 April
2000, is also the first anniversary of the death of his British friend and
colleague Aaron Esterson. The heart of
their method is asking simple questions.
Their work inspires psychotherapy where the therapist learns to ask, and
learns to let his client learn to ask, simple questions. The therapist learns to refrain, and learns
to let his client learn to refrain, from asking and answering seductive
questions. I explain how the method
informs Szasz's and Esterson's work on 'schizophrenia' and my own research on:
(1) the paradigm cases of Freud, Jungians, Boss and others; (2) the techniques
the Nazis developed to mystify and deceive their victims in the Holocaust.
Had Thomas Szasz only had available to him
in 1958, when conceiving and composing The Myth of Mental Illness, a
letter written by the famous “Sybil” to her shrink, Dr. Cornelia Wilbur, then
he would surely have wanted to add an Appendix to his magnus opus. Oh well, better late than never . . . .
Thomas Szasz's work broke new political
ground, of which the starting point is the abolition of "mental
patients" laws. This is a report on two examples of how we are
incorporating his guidelines in our political struggle against psychiatric
coercion in Germany‑First, by using a particular form of authorization
for custody in order to exclude civil commitment, and second, by using an
initiative for a (Bertrand) Russell Tribunal on Human Rights in
Psychiatry. I will outline the
political issues involved.
In “The Myth of the Rhetorical Situation” (Philosophy
and Rhetoric, 1973), I argued that the rhetoric one employs does not merely
reflect reality or truth for relevant audiences, but creates reality or truth
for such audiences. This is
particularly true, as Thomas Szasz has pointed out, in conventional psychiatric
study and persuasion. Thus, mental health
professionals define normalcy for a variety of reasons and create the false
reality of “mental illness,” a “reality” for which the definer must assume
moral responsibility. Thomas Szasz has
consistently emphasized rhetoric as a central, but unacknowledged, concern of
psychiatry. It is through such a
perspective that the base rhetoric of psychiatric persuaders can best be
understood.
*Paper submission
Most
of the presentations will appear as papers in a forthcoming edited
anthology.
Watch
for the announcement regarding this at http://www.szasz.com
SPEAKER
BIOGRAPHIES
George
J. Alexander, JD, JSD, is Elizabeth H. and John A.
Sutro Professor of Law and Director of the Institute of International and
Comparative Law at Santa Clara University in California.
Nelson
Borelli, MD is an Assistant Professor in the
Department of Psychiatry and Behavioral Sciences at Northwestern University
Medical School in Chicago, Illinois. He has been practicing psychiatry for forty-five
years. He has treated people with all kinds of psychiatric syndromes. He has used all therapeutic modalities, from
electric shock, Metrazol, insulin coma and ACTH in the 1950’s to the
contemporary psychotropic drugs. He has read and studied all of Dr. Szasz’s
books and most of his papers and in the last thirty years he has utilized Dr.
Szasz’s principles and techniques, successfully and gratifyingly, in assisting
people who consulted with him professionally.
Doctor Borelli recognizes Thomas S. Szasz as one of the most, if not the
most, lucid, honest, articulate and courageous writers of the second
millennium.
Donal T.
Conley, MD, is a psychiatrist at the V.A.
Outpatient Clinic Daytona Beach in Florida.
Robert
W. Daly, MD is Professor of Psychiatry and Medical
Humanities and Director of the Program in Medical Humanities at the SUNY
Upstate Medical University in Syracuse.
He is the founding chair of the Ethics Committee of University Hospital
and teaches graduate courses in bioethics and the philosophy of medicine. In the practice of psychiatry and a
consultant to institutions for thirty years, Dr. Daly is President of the
Institute for Ethics in Health Care and past Chair of the National Association
of the Directors of Humanities Programs in the Health Profession.
John
Mark Friedberg, MD, is a board certified neurologist in
private practice in Berkeley, Ca., since 1979.
He is a member of the American Academy of Neurology, the American
Academy of Electrodiagnostic Medicine, and the California Medical
Association. Dr. Friedberg has given
expert neurologic testimony in courts and legislatures leading to the
restriction of shock treatment in California, Texas, and Oregon, and to the
abolition of cyanide execution as unconstitutionally cruel and unusual.
Abraham
L. Halpern, MD is Professor Emeritus of Psychiatry,
New York Medical College; Past President of The American Academy of Psychiatry
and the Law; Past President of The International Academy of Law and Mental
Health; and former Commissioner of Mental Health, Syracuse (1962-1967). Dr. Halpern is the recipient of the American
Psychiatric Association’s 2000 Human Rights Award.
Keith
Hoeller, PhD, is editor of the Review of
Existential Psychology & Psychiatry, and the book series Studies in
Existential Psychology and Thomas Szasz: Moral Philosopher of Psychiatry. He lives in Seattle, WA, where he teaches
philosophy and psychology in the community colleges.
Ron
Leifer, MD, trained under Dr. Szasz at Syracuse
from 1958-1961. He has been a critic of psychiatry for forty years. He is now
in private practice in Ithaca, New York. His first book, In the Name of
Mental Health: The Social Functions of Psychiatry, was published in 1969.
His most recent book, The Happiness Project, appeared in 1999.
Zvi Lothane, MD, is Clinical Associate
Professor of Psychiatry, Mount Sinai School of Medicine in New York City, a
psychoanalyst, and a member of the American and the International
Psychoanalytic Associations. He
is the author of In
Defense of Schreber: Soul Murder and Psychiatry (1992).
James C.
Mancuso, PhD, is Emeritus Professor of Psychology
at the University at Albany SUNY in New York.
Andrea
Millen Rich is President of Laissez Faire Books and
the Center for Independent Thought in New York. She is also the creator of The Thomas S. Szasz Award for
Outstanding Contributions to the Cause of Civil Liberties, established in 1991.
Irwin
Savodnik, MD, PhD, is a psychiatrist, psychoanalyst
and professional philosopher. He is a clinical faculty member at the UCLA
School of Medicine and a member of the faculty of the Southern California
Psychoanalytic Institute. His areas of interest are in the philosophy of mind,
philosophy and medicine and political thought.
Jeffrey
A. Schaler, PhD., is a psychologist and adjunct
professor of justice, law, and society at American University’s School of
Public Affairs in Washington, D.C. He
teaches psychology at Johns Hopkins University, is the author, most recently,
of Addiction Is a Choice (Open Court, 2000), and is a recipient of the
1999 Thomas S. Szasz Award for Outstanding Contributions to the Cause of Civil
Liberties. His edited books include Drugs: Should We Legalize, Decriminalize or
Deregulate? and, Smoking: Who
Has the Right?, co-edited with Magda E. Schaler, MPH, both published by
Prometheus Books in 1998.
Anthony
Stadlen, MLCP, BCP Reg, UKCP Reg, has been in
private practice for thirty years as an existential-phenomenological
psychotherapist. He teaches and
supervises psychotherapists at Regent's College School of Psychotherapy and
Counselling; the London Centre for Psychotherapy; and elsewhere. He is a former Research Fellow of the Freud
Museum, London. For twenty years he has
investigated‑historically, philosophically, logically, scientifically,
ethically‑the paradigmatic case-studies, and analyses of dreams and
parapraxes, of Freud, some Jungians, Boss, and others. He has researched the collaboration of Boss
and Heidegger on Daseinsanalysis; and the psychological techniques used by the
Nazis to deceive and mystify their victims.
Peter J.
Swales is a well-known and controversial Freud
historian who characterizes himself as a social archaeologistalso as a
performance artist. He writes
prolifically and lectures widely on Freud, Fliess, Marilyn Monroe, William S.
Burroughs, and ‘Sybil.’ He lives and
works in New York City.
René
Talbot is a Board Member of Irren-Offensive
(Lunatic Offensive), a lecturer at the "Chair for Madness" at the
Freie University Berlin, and Secretary of the planned Russell Tribunal.
Richard
E. Vatz, PhD, is a tenured full Professor of
Rhetoric and Communication at Towson University. He won four outstanding teaching awards at Towson. He was the 1994 winner of the Thomas Szasz
Award. He has written over 250 articles
and reviews, including: Thomas
Szasz: Primary Values and Major
Contentions (Prometheus Books, 1983) and a chapter, “Thomas Szasz and the
Rhetorical Paradigm of Psychiatry” in Discovering the History of Psychiatry
(Oxford University Press, 1994).
A special thank you to
Eugene
Kaplan, MD, Mantosh Dewan, MD, and Chaitanya Haldipur, MD,
of the Department of Psychiatry, SUNY Health
Science Center/Syracuse,
for
their critical support in making this Symposium possible;
To
Margot
Szasz Peters, Susan Szasz Palmer, Renee Royak-Schaler, and Magda E. Schaler
for
their important assistance with the planning of this Symposium;
And
to several anonymous donors.
|
George J. Alexander, JD, JSD Santa Clara University School of Law Santa Clara, CA 95053 408.554.4053 |
Nelson Borelli, MD 680 N. Lake Shore Dr. Suite 801 Chicago, IL 60611-4402 312.649.9270 |
Donal T. Conley, MD 5442 AIA So. St. Augustine, FL 32084 904-461-6899 |
|
Robert W. Daly, MD Department of Psychiatry SUNY Health Science Ctr. 750 E. Adams Street Syracuse, New York 13210 315.464.3104 315.464.3163 fax |
John M. Friedberg, MD 3000 Colby Street Suite 305 Berkeley, CA 94705 510.644.2282 |
Abraham L. Halpern, MD 720 The Parkway Mamaroneck, NY 10543-4299 914-698-2136 |
|
Keith Hoeller, PhD 4739 University Way NE / #1238 Seattle, WA 98105 206.367.5764 206.365.3036 fax |
Ron Leifer, MD #115 215 North Cayuga St. Ithaca, New York 14850 607.272.7334 |
Zvi Lothane, MD 1435 Lexington Avenue New York, NY 10128 212-534-5555 |
|
James C. Mancuso, PhD Department of Psychology Univ. at Albany SUNY Albany, NY 12222 518.439.4416 |
Andrea Millen Rich 73 Spring Street, Suite 507 New York, NY 10012 212-925-8992 |
Irwin Savodnik, MD, PhD 7009 Calle Del Pajarito Rancho Palos Verdes, CA 90275 310.377.3652 |
|
Jeffrey A. Schaler, PhD 1001 Spring Street, Suite 104 Silver Spring, MD 20910 USA 301.585.5664 |
Anthony Stadlen, MLCP, BCP Reg, UKCP Reg 64 Dartmouth Park Road GB - London NW5 1SN England Tel: +44 (0) 20 7485 3896 |
Peter J. Swales 285 Mott Street #14B New York, N.Y. 10012 212.966.4754 (also fax) |
|
Rene Talbot Vorbergstrasse 9A 10823 Berlin, Germany 011-49-30-7874334 Berlin, Germany |
Richard E. Vatz, PhD Department
of Communication Studies and Mass Communication Van Bokkelen Hall Towson University Towson, MD
21252 |
The Thomas S. Szasz Cybercenter for Liberty
and Responsibility |
Mental
illness is a myth whose function is to disguise and thus render more palatable
the bitter pill of moral conflicts in human relations. In asserting that there is no such thing as
mental illness I do not deny that people have problems coping with life and
each other.
—
What
people nowadays call mental illness, especially in a legal context, is not a
fact,
but
a strategy; not a condition, but a policy; in short it is not a disease that
the alleged patient has, but a decision
which those who call him mentally ill make about how to act toward him,
whether he likes it or not.
—
Bodily
illness is to mental illness as literal meaning is to metaphorical meaning.
Bodily
illness is something the patient has, mental illness is something he does.
—
Formerly,
quacks had fake cures for real diseases;
now, they claim to have real cures for fake
diseases.
—
When
culturally undeveloped, men treat objects as agents; when culturally developed,
they treat agents as objects. The primitive explains nature in terms of human
nature, the psychiatrist explains human nature in terms of nature. The modern
scientist has refuted the savage's mistake, but has ratified the
psychiatrist's.
Who,
then, will correct the psychiatrist's mistake?
—
If
you don't value your family, you will not have a family that values you. If you don't value money or health or
liberty, you will have no money or health or liberty.
If
you don't value knowledge and competence and self-reliance, no one, including
yourself, will value you‑and no amount of psychiatric treatment will
remedy your failure to value what is worthy.
—Thomas
S. Szasz, MD