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    Anyone into Szasz? Psychiatry

    Happiness is an imaginary condition, formerly attributed by the living to the dead, now usually attributed by adults to children, and by children to adults.
    -Thomas Stephen Szasz
    http://en.wikipedia.org/wiki/Thomas_Szasz

    http://www.szasz.com/


    I was just introduced, but it seems like he has some pretty interesting things to say. Here a few excerpts from the wiki.

    His main arguments can be summarized as follows:

    The myth of mental illness: It is a medical metaphor to describe a behavioral disorder, such as schizophrenia, as an "illness" or "disease". Szasz wrote: "If you talk to God, you are praying; If God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; If you talk to the dead, you are a schizophrenic." While people behave and think in ways that are very disturbing, this does not mean they have a disease. To Szasz, people with mental illness have a "fake disease," and these "scientific categories" are in fact used for power controls. Schizophrenia is "the sacred symbol of psychiatry" and, according to Szasz, simply does not exist. To be a true disease, the entity must somehow be capable of being approached, measured, or tested in scientific fashion. According to Szasz, disease must be found on the autopsy table and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association. Mental illnesses are "like a" disease, argues Szasz, putting mental illness in a semantic metaphorical language arts category. Psychiatry is a pseudo-science that parodies medicine by using medical sounding words invented over the last 100 years. To be clear, heart break and heart attack belong to two completely different categories. Psychiatrists are but "soul doctors", the successors of priests, who deal with the spiritual "problems in living" that have troubled people forever. Psychiatry, through various Mental Health Acts has become the secular state religion according to Thomas Szasz. It is a social control system, which disguises itself under the claims of scientificity. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well, such as Michel Foucault in Madness and Civilization (1961).

    Separation of psychiatry and the state: State government, by enforcing the use of shock therapy, has abused Psychiatry with impunity. If we accept that "mental illness" is a euphemism for behaviors that are disapproved of, then the state has no right to force psychiatric "treatment" on these individuals. Similarly, the state should not be able to interfere in mental health practices between consenting adults (for example, by legally controlling the supply of psychotropic drugs or psychiatric medication). The medicalization of government produces a "therapeutic state," designating someone as "insane" or as a "drug addict". In Ceremonial Chemistry (1973), he argued that the same persecution which has targeted Witches, Jews, Gypsies or homosexuals now targets "drug addicts" and "insane" people. Szasz argued that all these categories of people were taken as scapegoats of the community in ritual ceremonies. To underscore this continuation of religion through medicine, he even takes as an example obesity: instead of concentrating on junk food (ill-nutrition), physicians denounced hypernutrition. According to Szasz, despite their scientific appearance, the diets imposed were a moral substitute to the former fasts, and the social injunction not to be overweight is to be considered as a moral order, not as a scientific advice as it claims to be. As with those thought bad (insane people), those who took the wrong drugs (drug-addicts), medicine created a category for those who had the wrong weight (obeses). Szasz argued that psychiatrics were created in the 17th century to study and control those who erred from the medical norms of social behavior; a new specialization, "drogophobia", was created in the 20th century to study and control those who erred from the medical norms of drug consumption; and then, in the 1960s, another specialization, "bariatrics", was created to deal with those who erred from the medical norms concerning the weight which the body should have. Thus, he underscores that in 1970, the American Society of Bariatic Physicians (from the Greek baros, weight) had 30 members, and already 450 two years later.

    Presumption of competence: Just as legal systems work on the presumption that a person is innocent until proven guilty, individuals accused of crimes should not be presumed incompetent simply because a doctor or psychiatrist labels them as such. Mental incompetence should be assessed like any other form of incompetence, i.e., by purely legal and judicial means with the right of representation and appeal by the accused.

    Death control: In an analogy to birth control, Szasz argues that individuals should be able to choose when to die without interference from medicine or the state, just as they are able to choose when to conceive without outside interference. He considers suicide to be among the most fundamental rights, but he opposes state-sanctioned euthanasia. In his 2006 book about Virginia Woolf he stated that she put an end to her life by a conscious and deliberate act, her suicide being an expression of her freedom of choice.

    Abolition of the insanity defense: Szasz believes that testimony about the mental competence of a defendant should not be admissible in trials. Psychiatrist testifying about the mental state of an accused person's mind have about as much business as a priest testifying about the religious state of a person's soul in our courts. Insanity was a legal tactic invented to circumvent the punishments of the Church, which, at the time included confiscation of the property of those who committed suicide, which often left widows and orphans destitute. Only an insane person would do such a thing to his widow and children, it was successfully argued. Legal mercy masquerading as medicine, said Szasz.

    Abolition of involuntary hospitalization: No one should be deprived of liberty unless he is found guilty of a criminal offense. Depriving a person of liberty for what is said to be his own good is immoral. Just as a person suffering from terminal cancer may refuse treatment, so should a person be able to refuse psychiatric treatment.

    Our right to drugs: Drug addiction is not a "disease" to be cured through legal drugs (Methadone instead of heroin; which forgets that heroin was created in the first place to be a substitute to opium), but a social "habit". Szasz also argues in favor of a drugs free-market. He criticized the "war on drugs", arguing that using drugs was in fact a victimless crime. Prohibition itself constituted the crime. He shows how the "war on drugs" lead states to do things that would have never been considered half a century before, such as prohibiting a person from ingesting certain substances or interfering in other countries to impede the production of certain plants (e.g. coca eradication plans, or the campaigns against opium; both are traditional plants opposed by the Western world). Although Szasz is skeptical about the merits of psychotropic medications, he favors the repeal of drug prohibition. "Because we have a free market in food, we can buy all the bacon, eggs, and ice cream we want and can afford. If we had a free market in drugs, we could similarly buy all the barbiturates, chloral hydrate, and morphine we want and could afford." Szasz argued that the prohibition and other legal restrictions on drugs are enforced not because of their lethality, but in a ritualistic aim (he quotes Mary Douglas's studies of rituals). He also recalls that pharmakos, the Greek root of pharmacology, originally meant "scapegoat". Szasz dubbed pharmacology "pharmacomythology" because of its inclusion of social practices in its studies, in particular through the inclusion of the category of "addictiveness" in its programs. "Addictiveness" is a social category, argued Szasz, and the use of drugs should be apprehended as a social ritual rather than exclusively as the act of ingesting a chemical substance. There are many ways of ingesting a chemical substance, or "drug" (which comes from pharmakos), just as there are many different cultural ways of eating or drinking. Thus, some cultures prohibit certain types of substances, which they call "taboo", while they make use of others in various types of ceremonies.

    Szasz has been associated with the anti-psychiatry movement of the 1960s and 1970s, although he has resisted being identified as an anti-psychiatrist. He is not opposed to the practice of psychiatry if it is non-coercive. He maintains that psychiatry should be a contractual service between consenting adults with no state involvement. He favors the abolition of involuntary hospitalization for mental illness. In a 2006 documentary film called Psychiatry: An Industry of Death released on DVD Szasz stated that involuntary mental hospitalization is a crime against humanity. Szasz also believes that, if unopposed, involuntary hospitalization will expand into "pharmacratic" dictatorship.
    I thought it was an interesting read, and he certainly covers a lot of ground, so I thought I'd throw it out there for any bored lizards with a passing interest in psychiatry.
    Last edited by Jasonwclark; April 23rd, 2008 at 03:36 PM.


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    I get the point of the mental illness thing, and so far I agree. Probably because I am very peeved against hypocrites and this statement of his seem to go through my way of reasoning.

    I am liking his theories and statements so far, I might just go check him out the more.
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    The idea that mental illness is somehow a myth really breaks down when you've met someone actually severely mentally ill. Not depression (although this is certainly very real) or mild OCD, but something that causes someone to act entirely inhuman. Think those stereotypical 'crazy' people that draw all over a room with gibberish and nonsense symbols.

    Yeah. That actually happens, and in fact, I have a friend to which this happened. So shove that 'myth' bullshit.

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    What a load of balls, this is truly out of touch with the way modern psychology and psychiatry operates.

    For example schizophrenia has physical symptoms, their is a abnormality in the brain its not just psychiatrists labeling someone as in need of treatment.

    "If we accept that "mental illness" is a euphemism for behaviors that are disapproved of"

    Mental illness (or abnormality as i'll refer to it from now on) is classifed by things like, is the person a risk to themselves? a risk to others? can they function on their own? can they achieve what they want in life? (ok that ones very open ended) not just things that the government doesn't want happening

    Involuntary hospitalization is supposed to take place when someone is a danger to others or can't function on their own.

    All drugs should be freely available? because every heroin addict chooses to be a addict! ii mean i'm for the legalisation of marijuana if only to stop heroin addiction but all drugs?! what civilisation does this guy live in?, then theres people commiting murder through drugging their victims.


    I cant remember enough right now to go through everything he's written , nor do i have the time to go through my books, but its horrendously out of date, or so it seems to me.

    Again, everything to do with psychology and psychiatry, complete balls.
    and the rest feels like neccessary evil to me.
    Last edited by Nrx; April 23rd, 2008 at 02:24 PM.

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    I think he receives a lot of criticism for seeming to endorse a Cartesian style mind/body separation (generally rejected by most scholars/physicians), but philosophical underpinnings aside he still levels some pretty interesting criticisms. I'm not a devotee by any means, I was just introduced, but I thought it was compelling enough to bare with him for a bit.

    What sparked my interest initially, was that Frank Herbert sited Szasz as one his most important influences while he was writing the first four Dune novels. The material is dated its true (dude was born in 1920), but I think its less dated than it appears at first. I just posted some of the more controversial arguments I could find to see if I could spark any interest/discussion. The information I actually found most intriguing though was in these two articles:

    Defining Psychiatry and The Medicalization of Everyday Life



    Edit:
    Here is an index of some other articles for anyone who's into it. I thought this article was interesting too
    Mental Illness as Brain Disease: A brief history lesson

    Also, I guess I should mention that one of my closest friends is schizophrenic (diagnosed with the 'split brain' 5 years ago.) I've also known a number of manic/depressives and alcoholics, two people with bipolar disorder, and had to deal with the fallout of a pretty ugly suicide in my circle a few years back. I definitely wouldn't want to downplay the fact that these conditions can be very disruptive and difficult deal with, or that people don't need help, but I'm not so sure that's what Szazs is suggesting either. His point about mental "illness" being a myth, seems more to do with the origins of Psychiatry and its foundational assumptions and analogies; how we define pathologies and the like.
    Last edited by Jasonwclark; April 25th, 2008 at 05:43 PM.

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    Personally I don't agree with much of anything in the "myth" part. I agree with Nrx. I have a friend with schizophrenia and it's no picnic.....

    Also, I persoanlly don't trust much of anything on wikipedia because anyone can go on there and change anything they like....

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    Hmm... interesting thoughts.

    Certainly his ideas are no longer in vogue, as you said Jason he seems to believe in a strict separation of mind and body which hardly any credentialed physician believes in any more.

    However if one can put that aside he does bring up some very interesting questions as regards judgement in the realm of psychiatry.

    What is normal? Why is not being "normal" bad? Why are these value judgements being decided by psychiatrists? On what basis does a psychiatrist deem whether or not a certain mental condition is bad and thus a mental illness? To what degree are the above driven by social mores?

    Furthermore, what about beyond the group of psychiatrists? After all, most of us have the internet and can read up on the disorders ourselves. How often do non-psychiatrists categorize others into certain mental disorders? How does this pigeon-holing effect a person's social standing and credibility?

    Though I find there to be value in the field of psychiatry, it is a field that is less than exact and includes many value judgements both by psychiatrists themselves and by those outside the field. Those I think are plenty of reasons to view psychiatry with a critical eye.

    This is all just going off of the quoted section in the original post though. Maybe later I'll sit down and give the guy's site a read.
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    Quote Originally Posted by Anid Maro View Post
    Hmm... interesting thoughts.

    Certainly his ideas are no longer in vogue, as you said Jason he seems to believe in a strict separation of mind and body which hardly any credentialed physician believes in any more.

    However if one can put that aside he does bring up some very interesting questions as regards judgement in the realm of psychiatry.

    What is normal? Why is not being "normal" bad? Why are these value judgements being decided by psychiatrists? On what basis does a psychiatrist deem whether or not a certain mental condition is bad and thus a mental illness? To what degree are the above driven by social mores?

    Furthermore, what about beyond the group of psychiatrists? After all, most of us have the internet and can read up on the disorders ourselves. How often do non-psychiatrists categorize others into certain mental disorders? How does this pigeon-holing effect a person's social standing and credibility?

    Though I find there to be value in the field of psychiatry, it is a field that is less than exact and includes many value judgements both by psychiatrists themselves and by those outside the field. Those I think are plenty of reasons to view psychiatry with a critical eye.

    This is all just going off of the quoted section in the original post though. Maybe later I'll sit down and give the guy's site a read.
    This is all taken into account in modern psychology, there are heavy ethical guidelines that help to protect people from being unfairly judged by the public, and that stop psychologists and psychiatrists interfering with people who are not in need of care.

    If these measures wern't taken psychology would become the spanish inquisition of modern day, but this was realised and now ethics plays a massive role in everything psychological. (in fact many would argue that ethics are holding back the development of our understanding on a large scale)

    and yes, everything should be seen with a critical eye, especially actions by those who we deem to be a trustworthy authority.

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    (sorry about the essay length post, its just a topic I find interesting)

    Interesting read. I'm gonna have to echo everyone else's rejection of the "myth" of mental illness. We clearly understand nowadays that the brain and its chemicals are an organ that can develop pathologies just as the heart, liver and lungs can. I do think the question of the veracity of mental illness still exists because we still really don't understand how our conciousness and mental states are produceded by all the exchanges and signals of our brain, just that it is. However the idea that all differences in mental function are neccessarily bad I don't believe is true. Seriously schizophrenic people typically have hallucinations, and delusions of a terrifying and threatening quality, or are simply so confused by the changing reality infront of them that they can't cope. Obviously thats not good. However Synesthesisa, the condition where stimulus from one sense provokes a response in another, such as tasting color, and seeing sound, is relativly harmless, can actually provide benefits in terms of learning. Infact most people who have it claim to enjoy the addition of extra sensations. Clearly these people don't need to be expunged for their slight and perhaps even beneficial mental abberation. The world of conciousness is a wild and woolly one and I think it will continue to perplex scientists for a long time to come.

    I do have to say I mostly agree with his observations concerning the "drug war" and the criminalization of their use and possession. It does nothing but create crime where there was none. He also hints at some ideas that I've been thinking about lately concerning hallucinogens, and our society's reaction to them. In cultures where their use is sanctioned, ritualized, and guided, there are no psychedelic burn outs...No aged hippies that take too long to respond to your questions...no one "peels themselves because they thought they were a banana" A study was done of the people in the UDV, a christian Brazilian church that has adopted the drinking of the traditional psychedelic brew, Ayahuasca. The study actually showed an increase in clarity, reaction times, overall mental health and well being and a higher IQ score on average, by a couple of points, than the non Ayahuasca taking public, and members of the UDV drink it every two weeks! If you were to tell someone here in the US that you ate psilopsybin mushrooms every two weeks they would probably be like "OMG YOU'RE FRYING YOUR BRAIN" I think that because there is supervision, a ritualized setting, guides to help you through the rough spots, and a general positive expectation about the effect of the brew they are able to benefit from the insight that such experiences can provide.

    Here in the United States, most kids know more false information about drugs, ESPECIALLY hallucinogens, than true. There is also no cultural context within which those drugs are being taken, which leads to the freak outs, the terrifying confusion, and the belief that taking these drugs makes you insane, and can permenantly disable you mentally. Theres a lack of respect for the effects, with people taking it and going to some frat party, and socially theres a lack of respect for the state the person is in...people thinking its funny to terrorize or otherwise fuck with the tripping person. This is what leads to the general idea that these things are bad, the people who do them are bad, deviant, and mentally damaged. The fact that these drugs are at the top of the list, interms of legal severity, and are outrageously difficult for even medical professionals interested in research to get ahold of does nothing but make the situation worse.
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    Yeah synesthesia is wild, its interesting you bring that up.

    I remember hearing a lecture about it a few years back by this neurology expert at UCSD. At the time they were conducting experiments to determine whether varying degrees of Synesthesia were also present in the normal student population. I can't remember the numbers, but it turned out to be much more common than they expected at first - especially this thing with colored words and colored letters, where certain people would consistently see the same color for the same word/letter (red for A, or Air, or Airplane... something like that.) There was supposed to be a program about it on the Discovery Channel, or maybe National Geographic, but I'm not sure if anything came of that. I remember he was talking about a case where this guy would hear certain words and remember the tastes of specific foods from his childhood. And another about a blind man who was able to perceive certain colors when he heard specific words or sounds. For the longest time physicians just assumed they were lying, or under the influence of psychotropic drugs, but apparently they can confirm it now with MRIs and such.

    Edit:
    Youtube is pretty glorious, here's a video with the guy! Ramachandran
    I'm asssuming from the bitten RZA beats and all the overproduction that it actually did make it on TV.
    The last video is the best though



    Last edited by Jasonwclark; April 25th, 2008 at 07:00 PM.

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    a lot of people are saying "myth-shmyth, my friend was crazy and that was no picnic"

    i think whats being missed here is that current psychiatric standards dictate to us that mental illnesses are diseases, and are treated as such. as the original post pointed out, if it cant be found on the autopsy table, then it shouldnt be classed as a disease for the true sense of the word. as such its kind of a moot point to bombard it with drugs to treat it as you would cancer or some other disease.

    nobody is denying the existance of mental illness - i myself have seen friends literally snap and become complete other people right before my eyes, as if a psycho-switch was flicked on in their heads. they became hospitalised and doped to the eyeballs, but it didnt fix them. nobody is saying that it is a pleasant thing to have happen, because that would be like saying "i saw a puppy get killed and it didnt phase me, in fact i liked it" - its sadistic. all that is being suggested here is that medical science doesnt always have it right, particularly when it comes to distinguishing, dealing with, and treating mental illnesses.

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