Kris Ulland’s recent post on Scientology involvement with Thomas Szasz’s Citizens Commission on Human Rights has been generating a lot of interest. I made a remark in one of my comments to her post that politics makes strange bedfellows. Organizations and politicians may disagree vehemently with another’s policy planks, but when their interests occasionally coincide they are more than happy to get into bed together to further a common goal.

Szasz’s reputation as an anti-psychiatrist is built on his disagreement with the idea that mental illness is a disease. I have come to the same conclusion myself, based on my observations of my son’s behavior. It walks like a duck, it quacks like a duck, but it is not a duck. It looks in many ways like a physical illness (slow and odd movements, incoherent speech, etc.) but it is not a physical illness. It didn’t really matter if Chris was on drugs or off drugs, the behavior was the same. I am glad to report that this is not the case now.

Wikipedia on Thomas Szasz:

While people behave and think in ways that are very disturbing, and that may resemble a disease process (pain, deterioration, response to various interventions), this does not mean they actually have a disease. To Szasz, disease can only mean something people “have,” while behavior is what people “do”. Diseases are “malfunctions of the human body, of the heart, the liver, the kidney, the brain” while “no behavior or misbehavior is a disease or can be a disease. That’s not what diseases are” Szasz cites drapetomania as an example behavior which many in society did not approve of, being labeled and widely cited as a ‘disease’ and likewise with women who did not bow to men’s will as having “hysteria”[9] Psychiatry actively obscures the difference between (mis)behavior and disease, in its quest to help or harm parties to conflicts. By calling certain people “diseased”, psychiatry attempts to deny them responsibility as moral agents, in order to better control them.

Szasz, in his later book, The Manufacture of Madness (1970) writes:

The best, indeed the only, hope for remedying the problem of “mental illness” lies in weakening – not in strengthening – the power of Institutional Psychiatry. Only when this peculiar institution is abolished will the moral powers of uncoerced psychotherapy be released. Only then will the potentialities of Contractual Psychiatry be able to unfold — as a creative human dialogue unfettered by institutional loyalties and social taboos, pledge to serving the individual in his perpetual struggle to rise, not only above the constraints of instinct, but also above those of truth.

I worked for many years in politics at both the national and state levels and directly for a couple of political parties. I have a certain sympathy for Scientology, not because I am a member, which I am not, but based on the experience of being the brunt of political correctness when the going gets down and dirty in politics. The party in perpetual power where I worked, would float all kinds of accusations against the party I worked for – racism, sexism and religious fundamentalism are the big three that generally make middle of the road people, tempted to shift allegiances, scurry right back to their comfortable center line. Do I want to be a Scientologist? No, but that doesn’t mean that I disagree with everything they have to say. Their stance on psychiatry (anti-drugging and anti-coercion) is one of the things they stand for that strikes me as appropriate.

Thomas Szasz suffers from the same political problem as any person or organization whose opinions are not held by the mainstream. He is politically incorrect by North American standards. I may be stepping on a lot of Hungarians’ toes here (hi, Tibor!), but Hungarian’s (like many of their European counterparts) are more often than not politically incorrect. Europeans have a long history of being at the mercy of the state and of those who enforce state control. Who are Szasz’s critics? Institutional Psychiatry, of course and those who are under its power.

I began to really appreciate Szasz when I was looking for something positive to believe in about my son’s prospects. Institutional Psychiatry was hinting that Chris was a lifer. It is odd that this psychiatrist, who mainstream psychiatry kept insisting was a heretic, was actually a psychiatrist who seemed to put the rights of the individual first. He seemed very much on the patient’s side. From my limited experience with institutional psychiatry at the time, I never got the feeling that it understood (had empathy for) the patient.

Szasz believes that the label of schizophrenia is like being persecuted for being a witch.

A direct line of progresion can be traced from the witch’s marks to the so-called stigmata of the hysteric, and, most recently, to the signs which schizophrenics are made to reveal through projective psychological testing. Each of these “diagnostic” findings is used to incriminate the subject — as witch, hysteric, or schizophrenic; each is then used to punish him — by means of theological, medical, or psychiatric sanctions.

He then goes on to say that “While some witches may have survived dunking, no “madman” survives psychological testing.” (Read Szasz for dark humor, too.)

The figure of the psychotic or schizophrenic person to psychiatric experts and authorities, according to Szasz, is analogous with the figure of the heretic or blasphemer to theological experts and authorities. According to Szasz, to understand the metaphorical nature of the term “disease” in psychiatry, one must first understand its literal meaning in the rest of medicine. To be a true disease, the entity must first, somehow be capable of being approached, measured, or tested in scientific fashion. Second, to be confirmed as a disease, a condition must demonstrate pathology at the cellular or molecular level.

A genuine disease must also be found on the autopsy table (not merely in the living person) and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association.

The above quotes are from taken from Wikipedia and directly from Szasz’s The Manufacture of Madness, Random House, 1970.

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Roughly speaking, institutional psychiatry is imposed on you, perhaps by force of law, while contractual psychiatry is when the individual seeks out a psychiatrist and retains complete control over his participation with the expert.