Thursday, January 13, 2011

Szasz in One Lesson

(First posted in 2006, and now amended. The relevance to the Tucson massacre is self-explanatory.)

This is something I came up with some time ago to summarize a good deal of what Thomas Szasz, a great libertarian and hero of mine, has been saying for half a century.

If neuroscientists discovered that mass murderers and people who claim to be Jesus had different brain chemistries from other people, most everyone would accept this as evidence that they suffered from a mental illness/brain disorder (MI/BD) and that this disorder caused their behavior.

If neuroscientists discovered that homosexuals had different brain chemistries from heterosexuals, far fewer people would accept this as evidence that they suffered from a MI/BD and that this disorder caused their behavior.

If neuroscientists discovered that nuns had different brain chemistries from everyone else, very few people would accept this as evidence that they suffered from a MI/BD and that this disorder caused their behavior.

If neuroscientists discovered that married men had different brain chemistries from bachelors, no one would accept this as evidence that they suffered from a MI/BD and that this disorder caused their behavior.

Clearly, a difference in brain chemistry per se is not enough to make people believe that someone has a MI/BD. It takes more. Why, then, would a difference in one case be taken as evidence of MI/BD, while a difference in another case would not be? The obvious answer is that people, including psychiatrists, are willing to attribute behavior to mental illness/brain disorder to the extent that they disapprove of that behavior, and are unwilling to do so to the extent they approve of, or at least are willing to tolerate, that behavior. (Psychiatry once held that homosexuality was a mental illness. That position was changed, but not on the basis of scientific findings. Science had nothing to do with the initial position either.)

In other words, the psychiatric worldview rests, not on science or medicine, as its practitioners would have us believe, but on ethics, politics, and religion. That would be objectionable only intellectually if that were as far as it went. Unfortunately, it goes further, since the practitioners and the legal system they helped shape are empowered:

First, to involuntarily “hospitalize” and drug people “diagnosed” as mentally ill and thought possibly to be dangerous to themselves or others, and

Second, to excuse certain people of responsibility for their actions (for example, via the insanity defense).

Postscript: I'm often asked which one of Thomas Szasz's two dozen books I'd recommend to someone unfamiliar with his work. I suggest Insanity: The Idea and Its Consequences. This highly readable book covers most of his views on psychiatry, mental illness, and the Therapeutic State, with responses to his critics along the way. Of course, after that, you'll want to read the rest.

11 comments:

Jim Bovard said...

Bravo!

Anthony Stadlen said...

Quaduple (and more) bravos!

Anthony Stadlen

Sheldon Richman said...

You fine gentlemen are too kind!

tobarstep said...

I don't know if the link to the book is from the original article, but it leads to nullspace for me.

Terry Hulsey said...

Ditto Bovard, whence I got this link. -- To be recommended to my daughters.

Tom said...

Sheldon,

I knew you would post something Szasz in light of recent events. I agree about Insanity. I might lean toward Manufacturing Madness or Ceremonial Chemistry for the second choice. But you really can't go wrong picking up any of his books. I was going to post a link to a talk he gave at Cato in 2003 (I think Bovard was there) but the link is broken.

MarkZ said...

Nice job, Sheldon. I'm a neuroscientist (actually affiliated with the same hospital as Szasz, though I've never met him in person). My take is that most people (including the vast majority of politicians) are so unfamiliar with the brain that they're incapable of making judgments about these sorts of issues. I guess you could say that's true about virtually everything the legislature has to make decisions about. After all, they're professional politicians, not professional neuroscientists, petroleum engineers, or even economists.

[Even if we dismiss the obvious cronyism component of the BP disaster, for example, politicians were NEVER equipped to make judgments about what constitutes "safe" and "reasonable" drilling procedures, no matter how many experts they consulted.]

Anyway, I'm reminded of an old All in the Family episode where Archie Bunker explained that the heart is where your emotions are stored. This drew laughs, but I think it actually summarizes quite well the view that most people hold. I always find it amusing that people are shocked when scientists discover differences in the brain (whatever they may be) that underlie different behavioral or cognitive tendencies. Where else did they expect these differences to reside? In the liver?

Nicolas Martin said...

Judges and prosecutors, lawyers and psychiatrists, all protest their passionate desire to know why a person accused of a crime did what he did. But their actions completely belie their words: their efforts are now directed toward letting everyone speak in court but the defendant himself -- especially if he is accused of a political or psychiatric crime. -- Thomas Szasz, The Second Sin, p. 40. (Anchor, 1973)

Sheldon Richman said...

Sorry about the outdated link. Google the book title and you'll find it.

Nathan said...

Brilliantly put. Psychiatry inherently involves normative judgment, as opposed to medicine. Or as I like to say, if you live in North Korea, you're insane if you're too religious, if you live in Iran, you're insane if you're not.

I find particularly hilarious the lawmaker who's proposing a bill to allow involuntary commitment of those who have lost contact with reality, even without evincing signs of posing a danger to self or others. Around half of Americans believe the earth to be 6,000 years old. We're going to need a lot more cages...

ToryII said...

Just don't forget, he shot, at close range, a beautiful adult female (in the freaking head), and another beautiful nine year old (in her tiny little chest).

I'm not accusing anyone here of being insensitive. The topic is about sanity or insanity.