Insanity: The Idea and Its Consequences

Rating:
Summary: Szasz' best book
Review: I strongly disagree with the Library Journal reviewer that this book is "not much of an addition to the author's previous work". Among his many works, this book is by far the clearest and best documented statement of his basic proposition that mental illness is a myth. Really, this is the book that his second and groundbreaking book "The Myth of Mental Illness" should have been.

I had the good fortune to meet Dr. Szasz in the mid-1990s, and I told him that I thought his best books were "The Manufacture of Madness" and "Insanity: The Idea and Its Consequences", in that order. He said that many people agree with me, but that he himself would reverse the order and put "Insanity" first. Who am I to argue?

For his brilliance, importance, and courage, Thomas Szasz is my greatest intellectual hero, followed by Karl Popper for similar reasons.

Rating:
Summary: Szasz' best book
Review: I strongly disagree with the Library Journal reviewer that this book is "not much of an addition to the author's previous work". Among his many works, this book is by far the clearest and best documented statement of his basic proposition that mental illness is a myth. Really, this is the book that his second and groundbreaking book "The Myth of Mental Illness" should have been.

I had the good fortune to meet Dr. Szasz in the mid-1990s, and I told him that I thought his best books were "The Manufacture of Madness" and "Insanity: The Idea and Its Consequences", in that order. He said that many people agree with me, but that he himself would reverse the order and put "Insanity" first. Who am I to argue?

For his brilliance, importance, and courage, Thomas Szasz is my greatest intellectual hero, followed by Karl Popper for similar reasons.

Rating:
Summary: Psychiatric Enslavement: Madmen or Mad Doctors?
Review: In _Ideology and Insanity_ Thomas Szasz, professor of psychiatry and libertarian activist, presents a view of the dark side of the psychiatric establishment. Szasz is known for being one of the originators of the anti-psychiatry point of view in the 1960s (along with such others as R. D. Laing) and is a noted libertarian in the school of such individuals as Karl Popper, Ludwig von Mises, and Friedrich Hayek. In this book, Szasz makes the rather odd, indeed astonishing claim, that mental illness is entirely a myth and rests on a misunderstanding of the nature of illness. Rather than viewing certain individuals as mentally ill and thus diagnosing them with particular mental disorders, Szasz argues that it is best instead to view these individuals as possessing problems in living. Szasz contends that the diagnostic labels used to categorize mental illness are in fact nothing more than stigmatizing slurs (despite the contention by psychiatrists to the contrary, or that "mental illness is an illness like any other"). Psychiatry has a long, bloody, and inglorious history, beginning perhaps with medieval manuals on witch-hunting (e.g. the notorious _Malleus Maleficarum_) often used to eliminate dissidents and heretics, and including Nazi experimentation, the authoritarian theories of Sigmund Freud, and communist totalitarian psychiatry. Indeed, Szasz tells the story of a certain poet who was found mentally imbalanced by a psychiatrist in the Soviet Union because "poetry did not constitute useful work" and thus held captive against his will in an asylum. Too often psychiatry has resorted to fascist brutality and cruelty, including coercion, outright fraud, lying, forced medication, forced incarceration in a mental hospital, forced electroshock and insulin treatments, forced confinement, and even dangerous psychosurgeries such as lobotomy. Szasz notes that much of the problem rests with the undefined role of the psychiatrist (or psychologist). Thus, the psychiatrist (or psychologist) is faced with a continual conflict of interests, is he primarily interested in the patient (as a doctor would be) or is he interested in protection of society from dissidence and persecution of deviancy. Too often the psychiatrist sees himself as an authoritarian figure, capable of bestowing a given label upon an individual for any reason at all (needing only to justify this with reference to the completely open ended categories of the _DSM_), and legally able to confine an individual against his will and recommend "treatments" which often amount to no more than tortures. Szasz examines the role of the psychiatrist in the government, in law, in the public schools, and at universities, and shows how each of these roles fundamentally rests on fraud and dishonesty. Psychiatrists (and psychologists) frequently violate so-called confidentiality in the best interests of an institution they serve (or an insurance company) for example so as to protect that institution from certain individuals declared insane. Szasz notes that much of what the psychiatrist does consists of an attempt to shift powers from the legal and judicial systems as well as societal and social responsiblities to a group of technocratic doctor/bureaucrats. It is this authoritarian/scientistic/collectivistic orientation of the psychiatrist that Szasz finds so alarming. While I believe Szasz would say that psychiatrists (and psychologists) can and do generally help people, he notes that their entire profession fundamentally rests upon an attribution error, fraud, and a conflict of interests. This is not to disparage the many good and caring individuals who enter these professions in an effort to help others. The arguments of Szasz are radical, in that even "illnesses" such as bipolar disorder and schizophrenia which are now almost entirely believed to be biologically based, are argued by him to be based on mere convention. Frequently, by assigning these labels to individuals they are conveniently scapegoated, their rights denied them, and then they are thrown to the dogs of society and left to fend for themselves. This is a true travesty of justice and a great shame to our society. Szasz proposes an entirely individualist ethic which orients the psychiatrist towards the patient and which views man as autonomous and endowed with free will. I disagree with certain points of this ethic, in that I do not believe in a right to abortion or suicide etc., however I do note that psychiatry is frequently used merely to categorize those who are not like us. Szasz's orientation is secular and humanistic as well as atheist; however, he oddly mentions God quite a few times within his book. Also, I note that he makes little distinction between outright behaviors (which a psychiatrist may deem deviant) and reports of inner states (thoughts, moods, and feelings) which seem to play little role in his book. Indeed, most individuals who consult psychiatrists consult them voluntarily to help deal with thoughts or feelings which pose troublesome for them. Even individuals which are labelled schizophrenic by the psychiatric establishment (usually who are entirely harmless) may be able to identify their troubling thoughts and feelings. Perhaps schizophrenia merely consists in an alternative mode of perceiving the world. It is the authoritarian psychiatrist who declares the schizophrenic to be guilty of a "thought crime" and argues that his perception of reality has no validity. Szasz does not deny the existence of delusions, hallucinations, or illusions, but he merely questions their usefulness as determiners of "mental illness". Thus, all three occur commonly in life, even in the lives of so-called "normal" people. While there is much in this book that is controversial, it is sure to provide a great deal of concern for the individual living in the modern world as it increasingly comes to resemble that of 1984.

Rating:
Summary: Psychiatric Enslavement: Madmen or Mad Doctors?
Review: In _Ideology and Insanity_ Thomas Szasz, professor of psychiatry and libertarian activist, presents a view of the dark side of the psychiatric establishment. Szasz is known for being one of the originators of the anti-psychiatry point of view in the 1960s (along with such others as R. D. Laing) and is a noted libertarian in the school of such individuals as Karl Popper, Ludwig von Mises, and Friedrich Hayek. In this book, Szasz makes the rather odd, indeed astonishing claim, that mental illness is entirely a myth and rests on a misunderstanding of the nature of illness. Rather than viewing certain individuals as mentally ill and thus diagnosing them with particular mental disorders, Szasz argues that it is best instead to view these individuals as possessing problems in living. Szasz contends that the diagnostic labels used to categorize mental illness are in fact nothing more than stigmatizing slurs (despite the contention by psychiatrists to the contrary, or that "mental illness is an illness like any other"). Psychiatry has a long, bloody, and inglorious history, beginning perhaps with medieval manuals on witch-hunting (e.g. the notorious _Malleus Maleficarum_) often used to eliminate dissidents and heretics, and including Nazi experimentation, the authoritarian theories of Sigmund Freud, and communist totalitarian psychiatry. Indeed, Szasz tells the story of a certain poet who was found mentally imbalanced by a psychiatrist in the Soviet Union because "poetry did not constitute useful work" and thus held captive against his will in an asylum. Too often psychiatry has resorted to fascist brutality and cruelty, including coercion, outright fraud, lying, forced medication, forced incarceration in a mental hospital, forced electroshock and insulin treatments, forced confinement, and even dangerous psychosurgeries such as lobotomy. Szasz notes that much of the problem rests with the undefined role of the psychiatrist (or psychologist). Thus, the psychiatrist (or psychologist) is faced with a continual conflict of interests, is he primarily interested in the patient (as a doctor would be) or is he interested in protection of society from dissidence and persecution of deviancy. Too often the psychiatrist sees himself as an authoritarian figure, capable of bestowing a given label upon an individual for any reason at all (needing only to justify this with reference to the completely open ended categories of the _DSM_), and legally able to confine an individual against his will and recommend "treatments" which often amount to no more than tortures. Szasz examines the role of the psychiatrist in the government, in law, in the public schools, and at universities, and shows how each of these roles fundamentally rests on fraud and dishonesty. Psychiatrists (and psychologists) frequently violate so-called confidentiality in the best interests of an institution they serve (or an insurance company) for example so as to protect that institution from certain individuals declared insane. Szasz notes that much of what the psychiatrist does consists of an attempt to shift powers from the legal and judicial systems as well as societal and social responsiblities to a group of technocratic doctor/bureaucrats. It is this authoritarian/scientistic/collectivistic orientation of the psychiatrist that Szasz finds so alarming. While I believe Szasz would say that psychiatrists (and psychologists) can and do generally help people, he notes that their entire profession fundamentally rests upon an attribution error, fraud, and a conflict of interests. This is not to disparage the many good and caring individuals who enter these professions in an effort to help others. The arguments of Szasz are radical, in that even "illnesses" such as bipolar disorder and schizophrenia which are now almost entirely believed to be biologically based, are argued by him to be based on mere convention. Frequently, by assigning these labels to individuals they are conveniently scapegoated, their rights denied them, and then they are thrown to the dogs of society and left to fend for themselves. This is a true travesty of justice and a great shame to our society. Szasz proposes an entirely individualist ethic which orients the psychiatrist towards the patient and which views man as autonomous and endowed with free will. I disagree with certain points of this ethic, in that I do not believe in a right to abortion or suicide etc., however I do note that psychiatry is frequently used merely to categorize those who are not like us. Szasz's orientation is secular and humanistic as well as atheist; however, he oddly mentions God quite a few times within his book. Also, I note that he makes little distinction between outright behaviors (which a psychiatrist may deem deviant) and reports of inner states (thoughts, moods, and feelings) which seem to play little role in his book. Indeed, most individuals who consult psychiatrists consult them voluntarily to help deal with thoughts or feelings which pose troublesome for them. Even individuals which are labelled schizophrenic by the psychiatric establishment (usually who are entirely harmless) may be able to identify their troubling thoughts and feelings. Perhaps schizophrenia merely consists in an alternative mode of perceiving the world. It is the authoritarian psychiatrist who declares the schizophrenic to be guilty of a "thought crime" and argues that his perception of reality has no validity. Szasz does not deny the existence of delusions, hallucinations, or illusions, but he merely questions their usefulness as determiners of "mental illness". Thus, all three occur commonly in life, even in the lives of so-called "normal" people. While there is much in this book that is controversial, it is sure to provide a great deal of concern for the individual living in the modern world as it increasingly comes to resemble that of 1984.

Rating:
Summary: Correct, but not true
Review: My title refers to Heidegger's characterization of many received views--typically, they are OK in a restricted context, but miss the boat in a broader sense. I like Szasz (even have had my own work compared favorably to his once--in a letter to Editor, Am J. of Psychotherapy, in response to a paper of mine on the false memory syndrome), but, like others have in the past, see him as going overboard in some ways. Just because the notion of mental illness is so flawed and indefensible, as are the various neurobiological explanations and interventions, that doesn't have to mean that, say, "schizophrenia", or criminal behavior, are just actions of bad faith, maliciousness, evil, etc. One does not have to see these "entities" either as "mental illnesses" or offer some simple, commonsense, nonclinical alternative. There is such a thing as early human development (including foetal development), and if a person's evolution is deeply flawed (as is so frequently the case in our society) then the inner and outer behaviors will be pathological as well.(The nature/nurture dichotomy is inane, not viable--the two factors are inextricably intertwined from the start in utero.) That is one of the seminal contributions of Freud, buttressed by 100 years of world-wide clinical exploration and experience. To understand "psychopathology" adequately, one needs to look into the problems more deeply than Szasz manages to do; notions re psychopathology and psychotherapy involve basic notions such as the nature of self, mind, thought, intent, perception, language, inner/outer boundaries, etc. These paradoxial and elusive notions can't be simplistically explained or dismissed. I've tried to address these matters over decades in numerous publications.

Rating:
Summary: Truth by iconoclasm, by fermed
Review: Thomas Szasz's writing career has been founded on reaching for the truth by smashing the false linguistic and conceptual idols of psychiatry. His "Myth of Mental Illness," published in 1961, still stands as one of the most clear and devastating indictments of modern psychiatry: a system it describes as being rife with hypocrisy and mendacity. There is no such "disease" as mental illness, or schizophrenia, or insanity, he argues (brilliantly).

In this book Szasz brings together and summarizes the logical and conceptual underpinnings of his arguments. It is a tour de force. His language is simple, direct, unequivocal. The influence of Karl Kraus (about whom has written a book) on the purity of his language usage is patent in his prose and thus the reader is never left in doubt about what Szasz means.

Szasz recognizes the difficulty of abandoning any broad and pervasive set of concepts with which we have been raised, regardless of how wrong or absurd the concepts may be. Those who toil in the field of mental health may reject all (or most) of his arguments on the basis of their daily contact with the mentally ill: to be shown that there is no such thing as "mental illness" is bound to cause a jolt to their tranquility. Yet it should be the goal of society to seek a universe in which the behavior of people is not mislabeled and where truth in language reigns. Szasz points us in the right direction. An excellent bibliography, references, and name and subject indices are part of the book.