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Monday, April 15, 2024

Thomas Szasz: Champion of Freedom

Today is the 104th anniversary of the birth of Thomas Szasz (1920-2012), the great if unappreciated libertarian and defender of individual autonomy and dignity. A psychiatrist by profession, for over 50 years, Szasz was the foremost critic of the social-control system we call institutional psychiatry, or what we could call the government-medical complex. He called it the Therapeutic State. He opposed involuntary mental hospitalization, forced medication, the insanity defense, prescription laws, drug prohibition, laws against suicide, and the psychiatric position (until the 1970s) that homosexuality was a mental illness requiring forced intervention. I am proud to have had him as a friend and also a columnist when I edited The Freeman. He was a delightful man. His books include The Myth of Mental Illness, Insanity: The Idea and Its Consequences, Our Right to Drugs, The Manufacture of Madness, and Faith in Freedom. He also published several collections of wonderful aphorisms.

I wrote the following about 20 years ago to summarize a good deal of what Thomas Szasz said in his dozens of books and hundreds of articles. I call it "Szasz in One Lesson":

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).

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.

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.

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.

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.

Post postscript: More on Thomas Szasz to come. Meanwhile, see my 2005 interview with Szasz.

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