Thomas Szasz (1920 – 2012) Life, Liberty and Politics… Dr Thomas Szasz’s life-long defence of basic human freedoms came to an end on September 8th. Although sidelined for years by mainstream toxic psychiatry, Szasz’s work remains far from irrelevant. On both sides of the Atlantic, the government of the people by corporate and business representatives against the people appears committed to eroding or abolishing those liberties that have been won through determination and hard-fought struggle.
It was always clear where Szasz stood in this contest. I believe Szasz’s work is much misunderstood – and not just by the unimaginative, slavish adherents to the totems of biological psychiatry. Considered a fascist in some quarters and radically liberal in others, this apparent conundrum is resolved if we understand that Szasz was distrustful of all forms of organised power, from the state downwards.
Remember that he grew up in Hungary, a country occupied first by the Nazis and then by the Moscow Communists, those twin totalitarian monsters of the 20th century. However, Szasz should not be seen as simply reacting emotionally to the horrors of mass political crimes. His views were always reasoned and eloquently expressed, although perhaps sometimes difficult to digest emotionally. He supported the advanced psychiatric directive, the idea of people should be able to use the drugs of their choice, and that people have the right to commit suicide.
He also argued that forms of sex therapy are essentially state-supported prostitution. All this amounted to the consistent expression that people own their own bodies and should be the final arbiters of what they do with them. In the course of his career his voice was a beacon for the rights of mental health patients, of women, ethnic minorities and gay people. For example, it was Szasz who documented the shocking use of psychiatry against runaway slaves in the 19th century, and who ridiculed the idea that homosexuality was a disease.
However, Szasz’s disdain for state healthcare systems (public health) has not enamoured him to many on the political left, where opinion still clings to a basic trust that the operations of the state can be harnessed for the good. The unfortunate truth is that they seldom are. The much lauded British National Health Service is a case in point: its current auctioning-off in bits and pieces to the highest bidders serves to demonstrate, if nothing else, that it was never in the people’s hands to begin with.
Szasz’s criticisms ought to direct those on the left towards rethinking how the ‘management’ of their own healthcare might be re-appropriated by the people – collectively and individually – so that everyone, including the most vulnerable, is truly valued and cared for. These are problems ultimately connected to how we relate to our fellow human travelers on the planet. Szasz’s argument about the threat posed by what he identified as ‘The Therapeutic State’ is of a different order.
With the medicalisation of practically every aspect of day-to-day living, we have become de facto prisoners in a totalitarian medical nightmare – transformed from citizens into patients, our rights at the mercy of doctors who perform an increasingly political function. Szasz saw the doctors as a neoliberal management elite acting at the behest of an intrusive state; the state apparatus has evolved perennially to monitor and patrol proscribed deviations from the behavioural, psychological and political status quo.
At a moment’s notice, individual liberty may be curtailed with forceful interventions so as to mould the individual into a person who is compliant with institutional mores. In this respect, Szasz’s fears seem better founded with each passing year. A key under-explored theme arising from his work is how the liberty of the individual can be preserved whilst simultaneously preserving the social values and freedoms from group exploitation and oppression.
In The Ethics of Psychoanalysis, Szasz expressively supports both the logic and the rights of people to organise and protect these social freedoms. He correctly recognised that too often restrictions on individual freedoms have resulted from perhaps well-meaning collective action. In which case, the challenge for libertarians and others on the left is to recognise that this is an unresolved problem worthy of serious attention. I am sure some readers might want to disagree, but Szasz’s views do have much in common with those on the libertarian left of an anarchist bent – Chomsky for example – who are similarly distrustful of state power, and do not at all believe in a necessary trade-off between individual and collective freedom.
Like Sartre, Szasz twinned freedom with responsibility. He believed that human beings must always be considered as autonomous, responsible agents. This was not intended as a declaration of some objective scientifc truth but as a basic moral position about the nature and dignity of human subjectivity. His criticisms of the pseudo-scientifc ideology at the core of reductionist biological psychiatry were principally concerned with the elimination of notions of agency and selfhood by the psychiatric juggernaut, and the moral, psychological, social, legal and political trouble that this spells.
It is this fundamentally moral position that lay behind Szasz’s most famous assertion – that mental illness is a myth. Szasz’s concern with the implications of scientifc theory and practice for our view of ourselves overlaps with Laing’s existentialist musings, although Szasz’s work explores more the legal, moral and social implications of the road we’re on. While Szasz acknowledged a worthy contribution by RD Laing (in a footnote in The Manufacture of Madness), his more usual literary relationship to Laing was one of antipathy. He charged Laing with practising a mirror-image to mainstream psychiatry, and one which, like the mainstream, did not preclude either the deprivation of liberty or the resort to coercive ‘treatment’.
In that respect, Szasz’s opposition to psychiatry was far more consistent than Laing’s. However, neither Laing’s inconsistency nor his personal failings can undermine the brilliance and insight contained in such books as The Divided Self or Sanity, Madness and the Family, and it is hard not to imagine that Szasz’s disregard for Laing had some basis in an acute sense of disappointment with what his Scottish counterpart might have achieved. I think it is a mistake to identify these two as very similar practitioners of ‘anti-psychiatry’.
Yet I believe an accommodation between the best of Laing and the best of Szasz is still possible, although future work will be required to set the boundaries on the scale of such an accommodation. What is clear, though, is that Szasz never committed anybody to a mental institution. He never gave anybody electric shock ‘treatment’. And he never administered drugs, against their will, to anybody in psychological diffculty.
He once told a newspaper: “I am probably the only psychiatrist in the world whose hands are clean.” Nothing human was alien to Thomas Szasz. His profound respect and tolerance for all forms of human diversity, his belief that people should enjoy the right to pop their heads in the clouds and think what they want, free from state-sanctioned psychiatric interference, is something worth remembering.
Ron Roberts, Kingston University September 2012
- Thomas Szasz (1920-2012): Life, liberty and politics by Ron Roberts, p.3-4.
- Child abuse and adult mental health: (p.4 -7: Chris Holley 1958-2011 (p.4 – 5);
- Safety model for adult survivors (p.5-6); Emerge: Sexual Abuse: Victim to Survivor (p.6 -7).
- What to do if you are sectioned: Six ideas from a survivor by Jeremy Spandler p.8.
- Work capability assessment: Squeezing the vulnerable (p.9 – 11) A service user
- comments, (p.11 -12)
- Challenging the benefits regime by Phil Hutchinson (p.12–13 +22).
- Beyond Recovery by Jeremy Gluck, p.14
- Hearing voices (p.15–19) Hearing Voices is Normal by Dr John Rowan (p.15 -16);
- Listening to the inner voice: Consciousness and mental distress by John Myhill, p.16 – 18);
- What does hearing voices have to do with me?: Connecting professional and private selves by Caroline von Taysen, p.18 – 19.
- News and findings, pp 19-22
- Creative writing pp 23-25 (Interview with Peter Campbell – Poems by Peter Campbell and Don Weitz and Jenny Johnson).
- How well do anti-capitalist campaigners respond to mental deviance? by Ronny Worsey
- Book reviews (pp 27-28)
- Mindful Occupation: Rising Up Without Burning Out. Reviewed by Tamasin Knight.
- Narrative Psychiatry: How stories can shape clinical practice by Bradley Lewis. Agnes’s Jacket: A Psychologist’s Search for the Meaning of Madness) by Gail Hornstein. Reviewed by Jasna Russo.
- Alternative sources of support