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by Thomas Szasz

Originally called mad-doctoring, psychiatry began in the seventeenth century with the establishing of madhouses and the legal empowering of doctors to incarcerate persons denominated as insane. Until the end of the nineteenth century, every relationship between psychiatrist and patient was based on domination and coercion, as between master and slave. Psychiatry, its emblem the state mental hospital, was a part of the public sphere, the sphere of coercion.

The advent of private psychotherapy, at the end of the nineteenth century, split psychiatry in two: some patients continued to be the involuntary inmates of state hospitals; others became the voluntary patients of privately practicing psychotherapists. Psychotherapy was officially defined as a type of medical treatment, but actually was a secular-medical version of the cure of souls. Relationships between therapist and patient, Thomas Szasz argues, was based on cooperation and contract, as is relationships between employer and employee, or, between clergyman and parishioner. Psychotherapy, its emblem the therapist's office, was a part of the private sphere, the contract.

Through most of the twentieth century, psychiatry was a house divided-half-slave, and half-free. During the past few decades, psychiatry became united again: all relations between psychiatrists and patients, regardless of the nature of the interaction between them, are now based on actual or potential coercion. This situation is the result of two major "reforms" that deprive therapist and patient alike of the freedom to contract with one another: Therapists now have a double duty: they must protect all mental patients-involuntary and voluntary, hospitalized or outpatient, incompetent or competent-from themselves. They must also protect the public from all patients.

Persons designated as mental patients may be exempted from responsibility for the deleterious consequences of their own behavior if it is attributed to mental illness. The radical differences between the coercive character of mental hospital practices in the public sphere, and the consensual character of psychotherapeutic practices in the private sphere, are thus destroyed. At the same time, as the scope of psychiatric coercion expands from the mental hospital to the psychiatrist's office, its reach extends into every part of society, from early childhood to old age.

Download Liberation by Oppression: A Comparative Study of Slavery and Psychiatry epub
ISBN: 0765805405
ISBN13: 978-0765805409
Category: Other
Subcategory: Medicine & Health Sciences
Author: Thomas Szasz
Language: English
Publisher: Transaction Publishers; 1 edition (September 8, 2003)
Pages: 237 pages
ePUB size: 1266 kb
FB2 size: 1168 kb
Rating: 4.9
Votes: 774
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Reading Szasz is like reading Voltaire: it expands one's vision and opens one's mind allowing to clear oneself of some of the deadliest prejudices of our time. Liberation by oppression: A comparative study of slavery and psychiatry brings together two of the most pernicious institutions
and compares their effects on people's lives and on our culture. We have come to understand the
meaning of historic slavery, but we are unaware of the amounts of slaves of modern times and of their despair.
I think everybody should read Szasz's books and meditate on what is written in them. And if a reasonable amount of readers understood and started acting upon his ideas I think our world would be a lot better and each of us would sleep feeling safer.
The struggle for freedom is unending; tyranny constantly renews itself and dons new faces. With ease we can retrospectively see the brutality of monarchy, theocracy, communism, and chattel slavery, but each of those survived long enough to lead to widespread brutality and bloodshed. In its heyday, each was considered both practical and necessary by the elites and the hoi polloi.

As James Madison is associated with opposition of unchecked clerical power, and William Lloyd Garrison to black slavery, Thomas Szasz is the leading opponent of psychiatric coercion.

With psychiatry as the leading internal threat to personal liberty in Western countries, and Szasz as its most articulate critic, he is arguably the most important philosopher of our time. "Liberation by Oppression" only serves to solidify the view that Szasz follows in the footsteps of Mill, Jefferson, Mises and Martin Luther King as a champion of freedom. He deserves our rapt attention.

Like Jefferson, Szasz writes such elegant prose that he is able to intellectually satisfy while stimulating moral outrage at the injustices he describes. Like all of his works, this book is a pleasure to read, brimming with erudition and a captivating journey into ideas. But at core it's a plea for toleration and decency, a humanitarian manifesto.

The American obsession with freedom was defiled by the blight of slavery. Our Constitution, the magnificent instrument of liberty, was used to define enslaved black people as three-fifths human. Even then psychiatric diagnoses were applied in the service of social control. Slaves who yearned to escape were said to be suffering from a mental illness called "drapetomania." Slaves who exhibited early signs of this disease, such as sulking, were "cured" by being whipped.

Szasz is remarkable in his ability to shed new light on well-examined historical events. He notes, for instance, that in the reprehensible Dred Scott decision, Chief Justice Taney states that at the time of the Declaration of Independence and the framing of the Constitution, "the negro might justy and lawfully be reduced to slavery FOR HIS BENEFIT." (emphasis added.) In the same way, Szasz observes, psychiatric patients, the so-called mentally ill, have long been subject to imprisonment and the most cruel "treatments" for their "own benefit." Since so many "mentally ill" people do not consider themselves to be ill, and since there are no medical tests that establish that they are ill, it has been essential for psychiatry to justify its coercive treatments by claiming that they are in the best interest of the unwilling patients. Paternalism was an indispensable rationale for chattel slavery, as it is for psychiatric slavery.

Psychiatry recognizes no aspect of life as beyond its authority. The right to self-medicate was once taken for granted by Americans, until they were stripped of it in the early 1900s. Americans from every walk of life, including Washington and Jefferson, self-administered opium for various discomforts. Since the burgeoning of the "therapeutic state," a term Szasz coined, such behavior is not just criminal but proof of uncontrollable addiction. Now, the prominent psychiatrist Sally Satel declares that "force is the best medicine" for addicts, and virtually everyone arrested for possession is assumed to be an addict who obliged to submit to 'therapy" and "education." Force was also the "best medicine" for non-compliant black slaves with drapetomania. Force, shows Szasz, is what psychiatry is about.

Szasz describes a frightening society that is virtually a cradle-to-grave psychiatric clinic. Preschoolers are given drugs for "attention deficit hyperactive disorder." Parents are now required to allow their children to be given drugs like Ritalin; if they resist they risk having the children taken by the state. Rescue workers at the site of the World Trade Center have "grief therapy" forced upon them. People who act strangely but not criminally are imprisoned, restrained, and drugged. People thought to be suicidal are taken into custody "for their own protection.

Psychiatry has thoroughly debased the justice system. As Szasz puts it: "Criminal law, based on a recognition of the intrinsically adversarial nature of the relationship between accused and accuser, separates the roles of prosecuting attorney and defense attorney. In contrast, mental health law, based on a denial of the intrinsically adversarial nature of the relationship between the person accused of mental illness and his accuser, combines and confuses the roles of prosecuting psychiatrist and defense psychiatrist: even when the psychiatrist imposes his intervention against his will, mental health law defines the psychiatrist's role as serving the best interests of the patient."

In this masterful work, Thomas Szasz describes the thorough undoing of legal and social protections in the name of psychiatry and "mental health." Despite the cliché that "mental illness is just like any other illness," anyone diagnosed with a "mental illness" is subject to coerced treatments, physical and chemical restraint, imprisonment, and the loss of freedom, without ever having to do harm or commit a crime. With remarkable breadth of scholarship, Szasz ties together his thesis that much of what justified chattel slavery now justifies psychiatric slavery.

Many who read this book will be shocked. As an abolitionist, Szasz challenges widely held beliefs, just as Madison and Garrison did. The ideas in this book will be new and challenging to most readers. But, unlike many scholars, Szasz writes prose that is crystal clear and sparkling. He does not hide behind a wall of jargon and pretentious nonsense, he writes to be understood.

Anyone who is interested in "mental health," criminal justice, American history, and social philosophy should consider "Liberation by Oppression" a "must read." It also fits nicely in the libraries of those who simply read to broaden their knowledge. Agree or disagree with him, Thomas Szasz has set forth a moral case that must be considered in light of the profound transformations wrought by the therapeutic nature of the modern state. And he has done it with great polish. To paraphrase Mencken, Szasz is one of the few scholars who can really write.
Friday, July 03, 2009 15:52 EDT

The subtitle of this book is "A comparative study of slavery and psychiatry." On page 5 of the introduction, Szasz reintroduces the expression "psychiatric slavery," which he defines as "the social sanctioning of involuntary psychiatric 'diagnosis' and 'treatment' imposed on one person or group by another person or group" (page 16).

This expression is also the title of his 1977 book, whose last chapter was Chattel Slavery and Psychiatric Slavery. Liberation By Oppression is an expansion of that chapter.

Szasz's strategy is to compare "chattel" slavery (which we now believe to be cruel, inhuman and immoral) with psychiatry (which we still believe to be compassionate, humane and "scientific"), locate and scrutinize the fundamental similarities between these two institutions, and then offer a challenge to our beliefs about the morality of psychiatry as currently and historically practiced and justified. (This is a strategy Szasz also employed in The Manufacture Of Madness: A comparative study of the Inquisition and the Mental Health Movement.)

I found the strategy effective, the arguments convincing, and the conclusion (abolition of psychiatric slavery) inescapable. Others may not, as Szasz acknowledges on page 119: " idea whose time has NOT come is easily dismissed. Abolishing psychiatric slavery is such an idea." The experience of reading this book, then, may be a close approximation to having read an American abolitionist tract well before the idea became widely accepted: to be at once personally exhilarated but also publicly dismissed, possibly even vilified. It can also feel like arriving at the party about 100 years too early.

What I liked about this book: It got me thinking.

It got me thinking about the institution of psychiatry in a totally different way than I have been accustomed to; thinking about the way we use language to glamorize what are, in fact, ugly acts; thinking about how different those acts can look in hindsight from how they are perceived while we are allowing them to be committed.

What else I liked about this book: The way Szasz weaves in obscure tidbits from history, culture, politics, philosophy, law, religion, current events, and also memorable quotes from great thinkers and classic literature. The word "erudite" comes to mind. Very clear, precise, easily understood, and above all, skillful writing. A pleasure to just read. To that list, I should also add "passionate." Szasz seems like a guy who really cares about truth, justice, freedom and human dignity, as (I hope) the following examples might show:

from Jim Crow Psychiatry I, page 89:
"At the 1980 annual meeting of the American Academy of Psychiatry and Law, two psychiatrists from Washington, D.C.'s Saint Elizabeth Hospital declared their 'commitment to freedom': 'We would submit that commitment can be justified on the grounds of enhancing the individual's future freedom.'" Comments Szasz: "These psychiatrists...are unconcerned about the contradiction inherent in depriving a person of liberty in order to liberate him."

from Jim Crow Psychiatry II, pp 119-120:
"The hands of the psychiatrist, unlike the hands of the regular physician, are soaked in the blood of coercion. Hence, he cannot acknowledge that his doctrines and doings are insults to his victims, who experience the very existence of their oppressors as an act of delegitimization and existential violence against them. If the psychiatrist would acknowledge this, he could no longer sleep soundly at night."

"The psychiatrist's hypocrisy, like the hypocrisy of the slave owner before him, is plain to all who use their eyes for seeing and their minds for thinking."

"I hold psychiatrists responsible for their crimes against humanity, their willful ignorance fueled by their bad faith."

The euphemisms of the psychiatric slaveholders make ignoring their crimes easier. Szasz makes it impossible...from page 157:

"In short, therapeutic jurisprudence is the name of a system of legal apologetics for justifying psychiatric slavery in particular, and the therapeutic state in general."

Readers looking for more specific accusations won't be disappointed. Szasz names the current advocates of psychiatric slavery and quotes them directly. For example, from the chapter entitled Glorifying Psychiatric Slavery: Therapeutic Jurisprudence, page 159,

"The glorification of chattel slavery on the eve of the civil war was no doubt useful for blinding the slaveholders to the brutalities of slavery. But it inflamed the abolitionists. The glorification of psychiatric slavery today has had a similar effect on me. I end this chapter with a brief review of the theory and practice of psychiatric brutalities, as described by their proud practitioners."

from the Epilogue:

"The longer I live, the more deeply impressed I am by the repetitive character of certain patterns of behavior, both individual and collective. Perhaps nowhere is this more apparent than in the forcible subjection of man by man in the name of benevolence and liberation, in short, coercive paternalism. Masters, aristocrats, priests, politicians, physicians at the top; slaves, serfs, women, sick persons, mental patients at the bottom."

In addition to mini-biographies of three famous "mental patients" (Vincent van Gogh, Dr. William Chester Minor, and Robert Walser), I found the book's two appendices, entitled, respectively, The Power of False Truths: The Maternity Hospital and the Mental Hospital, and Victims of Psychiatric Slavery: A Sampler, at once fascinating and disturbing. The Selected Bibliography at the end of the book is nine pages long and a fascinating read all by itself.

I was going to title this review "Unconventional Wisdom." Performing a search of that expression led me to this quote by Albert Einstein:

"Any intelligent fool can make things bigger and more complex... It takes a touch of genius - and a lot of courage to move in the opposite direction."

...which aptly describes, I think, both the author and what he has accomplished in Liberation By Oppression.