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Szasz, T.S. (2002). The psychiatrist as accomplice. The Washington Times, April 28, Page B03, Section: Commentary.
Reprinted at the Szasz site by permission of The Washington Times



Thomas S. Szasz, M.D.

In the long history of priests sexually abusing children, perpetrators and victims play the principal parts. However, there are two other important players in this drama, only one of which - the priests' superiors, who ignored and indeed facilitated the crimes of their subordinates - have received attention.

But the identity, the very existence, of the other accomplices - the psychiatrists and psychiatric institutions that "diagnose" and "treat" priests who, in fact, are criminals - has been overlooked. Why? Because they are an integral part of our love affair with medicalizing life and replacing responsibility with "therapy."

The tragedy of pedophilia begins, as do many modern tragedies, by people stupefying themselves by confusing their own tongue, re-enacting God's punishment of mankind at Babel. An adult who uses a child for his sexual gratification is a kind of rapist: He is guilty of the crime of assault. Such a person is a criminal, not a patient.

How does medicine - talking about diseases and treatments - enter into this affair? The same way it enters into our belief that other (mis)behaviors are diseases, amenable to treatment - through psychiatry. It's a long story that can be condensed into a few sentences. For millennia, masturbation, homosexuality, and the many other non-heterosexual, non-procreative uses of the genital organs were considered to be grievous sins and were prevented and punished accordingly.

Toward the end of the 19th century, they started becoming "mental" diseases. This process played an important part in the transformation of mad-doctoring as quackery into modern psychiatry as a bona fide branch of medicine.

Creating diseases by coining disease-sounding terms was raised to the level of a psychiatric art form by Baron Richard von Krafft-Ebing (1840-1902), a German-born psychiatrist who was professor of psychiatry at the Universities of Strasbourg, Graz and Vienna. The work that made Krafft-Ebing world famous is "Psychopathia Sexualis,"the first edition of which appeared in 1886. Sexology became an integral part of medicine - and the new science of psychiatry - by physicians authoritatively renaming sexual sins "sexual perversions" and declaring them to be "cerebral neuroses" (Krafft-Ebing).

Lawyers, politicians and the public embraced this transformation as the progress of science, rather than dismissing it as medical megalomania based on nothing more than the manipulation of language.

Yet, Krafft-Ebing himself acknowledged that what he was doing had nothing to do with science. It had to with "compassion." He wrote: "The physician finds, perhaps, a solace in the fact that he may at times refer those manifestations which offend against our ethical and aesthetical principles to a diseased condition of the mind or the body. ... He can save the honor of humanity in the forum of morality, and the honor of the individual before the judge and his fellow-men."

Sigmund Freud extended Krafft-Ebing's psychopathologizing from sexual behavior to everyday behavior. In "The Psychopathology of Everyday Life" (1901), he inverted William Shakespeare's humanistic interpretation of conflict as an integral part of life into a dehumanized interpretation of tragedy as a manifestation of psychopathology.

At the root of the confusion about pedophilia lies the term "sex crime." Exemplified by rape, so-called sex crimes are particularly heinous types of assault. But assaults that result in blinding the victim or rendering him paraplegic are also heinous, but we do not, on that account, call them "eye crimes" or "neurological crimes." The belief that sex crimes are "special" paves the way for the delusion that they are diseases, a false belief psychiatrists turn into "reality" by naming what were formerly perversions "paraphilias" (homophilia, necrophilia, pedophilia, zoophilia).

This is factually erroneous and morally wicked, because sexually assaulting a child is not a disease (just as homosexuality was never a disease), and because viewing "pedophilia" as an illness, like pneumonia, implies that the subject is not responsible for it and it is treatable. In turn, these beliefs lead to excusing the behavior and engaging in a pseudomedical charade of treating it. The result is that psychiatrists and psychiatric institutions become accomplices to pedophilia, especially by priests.

According to press reports, "centers used by the Catholic Church today include the Johns Hopkins clinic, the Institute of Living and the Menninger Foundation in Topeka, Kans., according to those who treat pedophilic priests. For the most part, the regimen for treating pedophilia involves individual and group therapy to break down denial and a 12-step program, similar to the Alcoholics Anonymous model, to help control sexual addictions.

That is the psychiatrists' version of such programs. The clergy's version, judging by their actions, is that such programs provide safe houses for sexually misbehaving priests, where they can be hidden until they are quietly reassigned to ply their trade elsewhere.

Fred Berlin, the founder of the Johns Hopkins Sexual Disorders Clinic, is quoted as saying that pedophilic patients are closely monitored after being discharged from a program. However, pedophilic priests are criminals who should be imprisoned, not monitored by psychiatrists paid off for their collusion by the Catholic Church.

I contend that psychiatrists - especially the authors of the influential "Diagnostic and Statistical Manual of Mental Disorder," published in periodically revised editions by the American Psychiatric Association - are, like the pedophile priests' superiors, accomplices to their crimes. Their offense is classifying and treating pedophilia as a disease. In the absence of that deception, tragedies such as the Catholic Church and the victims now face could not come into being.

A Boston news Web site reported: "A.W. Richard Sipe, a psychotherapist and former monk who counseled sexually disordered priests in the 1970s and 1980s at the Seton Psychiatric Institute and the Johns Hopkins University Sexual Disorders Clinic, recalls: 'Oh, Father [John] Geoghan. He is well known in the circles of those who treat priest pedophiles. He is notorious because he has been treated by so many people, at nearly every psychiatric hospital in the country'" (http://www.bostonphoenix.com/ boston/news_features/top/features/documents/00882888.html).

Credo quia absurdum est.

Thomas Szasz is professor of psychiatry emeritus at the State University of New York, Upstate Medical University, in Syracuse.

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