Thomas Szasz and Myth of Mental Illness

Post Reply New Topic

Yes, I know it’s a really long radio interview. You can skip to around 1 hour in to hear him answer a direct question from the dad of three kids, one of which is autistic.

I’ve been really into this guy lately. He basically said, for like 50-60 years, that any mental health cannot be assessed and therefore mental illness cannot be determined. I’m going to try to explain it further below for those who don’t want to read or listen to stuff for an hour. I am curious what people think about this.

Brain health can be determined. We can see the brain with our naked eyes and by using instruments. It is an objective, concrete structure that can be said to have a state of normalcy. Therefore, we can say that it is diseased or malformed if something is different. If there are enough people with the difference and it does not cause injury or death that is outside of regular human functioning, the difference is then included under the umbrella of what is normal for humans. This happened when the male majority realized that women were also fully human, it happened again when the white majority realized that other races were human, and it happened most recently when the heterosexual majority realized that homosexuality was also human. Femaleness, some races, and being gay all used to be scientifically classified as mental diseases.

Are we on the same page so far? Because as we go on it starts getting weird.

A mind is not a concrete object. We can only reference mental states through describing thoughts, feelings, opinions, etc. We can also talk about behaviors of the person in question. Thoughts, feelings, behaviors, etc are all influenced by things that happen and by real, concrete structures. That’s the first thing to understand.

Then, he says it’s important to realize that medication for a behavior or feeling does not cure or treat the problem. People historically have used household herbs for minor problems, such as headaches and cuts, and these are considered normal. Examples might be tea to get to sleep, cacao to pep up, witch hazel to disinfect a wound. (Cacao is the plant that both cocaine and chocolate are made from).

He says that for hundreds of years, people would also use drugs such as nicotine, alcohol, and opium, which were more expensive, and they would buy freely. They might come from a doctor, or they might not. More serious ailments, such as a broken leg, would be given care depending on how much the patient could afford. This is why people died in childbirth or went lame. Something epic, like the plague, was considered otherworldly. The priests came in at that point. Doctors could see what it was, so they didn’t bother trying. People prayed and they’d get better or die.

I’m sorry for the length. It’s just complicated.

So he says that people today who are using antidepressants, sleeping pills, viagra, stimulants for attention, etc-anything that is not directly treating a disease from which you will recover-those people are no different than a person smoking a cigarette or taking a bump of cocaine. We are all using a drug to make ourselves feel better.

Here’s the last point: He’s says that giving children, the elderly in care situations, or any adult in a care situation a drug, is unethical, because they cannot choose. He thinks if teenagers and adults choose to take medication or drugs that’s their own decision. But anything done to a person against their will or during a time of life when they do not consent, is abuse.

I’m fascinated with this viewpoint. As the child of a mentally ill and dangerous person, it’s hard to say that she has the right to be a miserable human being. I also hate illegal drugs. But I can’t find any fault with his arguments.

Thoughts?

One autism doctor gave a paper list of autistic symptoms and corresponding drug treatments.

The list showed individual treatment successes including age, gender and autism diagnosis.

So, drugs seem to have some success.

Or it could be wishful thinking? Or self promotion of his services?

“...does not cure or treat the problem...”

The above quote would seem to include the Dr’s disapproval of managing the symptoms of chronic disorders.

Does the Dr. feel the same way about managing symptoms of chronic physical disorders? Chronic pain? Etc?

Or does the Dr reserve disapproval for the management of mental diagnosis only?

Anxiety has been shown to be interpreted by the brain in the same way as physical pain. Does this earn people suffering from anxiety a “pass”? Can they manage the symptoms of their incurable chronic mental condition given that the brain interprets the symptoms the same as those of a physical condition?

Interesting topic.

Just a tiny correction. Cocaine comes from the coca plant (Erythroxylum spp.) Chocolate comes from cacao plant (Theobroma spp.) the latter are legal. The former is not. In the USA.

I think the argument might be turned upside down: if a medication, tea, coffee, alcohol etc. improves your quality of life, why shouldn't any consenting adult be able to use them?

As to giving medication to infants, babies, children and people in care (we would say incapacitated, I would be totally opposed to that. I can't imagine not providing anyone with medication to relieve pain and suffering. Children have parents to make those decisions. Incapacitated persons have guardians to make those decisions. There should be safeguards in place, and there are in the USA.

I had a profound experience with this in my childhood. Technically I'd say it's a bit like ages 11 to 19 got stolen from me by pharmaceutical side effects. My parents were almost like hypochondriacs on my behalf, seemed to almost look at doctors like a priestly class when we all know they're just people with degrees, and I ended up on haldol with at least one or two other SSRI's for several years followed by the rest of that time on Risperidal instead of the Haldol.

The best way i can explain it - I had akasthesia, so for anyone whose ever had restless legs syndrome when they try to go to sleep at night, think of having full restless body syndrome all day long to go with that. I also sweated profusely as a side effect, had a lisp accrue which even further tipped off all the 'cool kids' to the idea that I was gay (even if I had been it would have been none of their business but - this was the 90's), and by the end of high school I really thought I was going to be in an assisted living home for the rest of my life because it seemed like my brain was mash (SSRI's). I also noticed that SSRI's caused personality loss and that effect was something I noticed immediately when during a short stretch of time in my mid 20's I revisited some of this. That I ever made it to college, let alone graduated highest honors, ended up producing a bunch of music or getting a black belt in any martial art, is a miracle in and of itself and a new path for my life opened up around 1999 when a friend took me to Indiana for a 3-day rave and one of his friends who was studying neurology told me to read some articles about the medications I was on, ie. that it sounded like most of the problems I was having were side-effects of the medications.

Needless to say I took six weeks to pull myself off the meds, much against my parent's recommendation, and at first I really thought that even the ASD might have been a hoax for wringing money out of me and my parents until I realized that no - even though I made sense and was much healthier than before I still just didn't fit in.


Even with that survival horror experience with antipsychotics and SSRI's I still would say for anyone that if you find yourself constantly depressed, it has nothing to do with life circumstances and events, and you find an SSRI actually does the trick - great, take it, but people who are in that exact spot are easily in a single-digit minority. Truth be told it seems like the pile-up of side effects specifically happens for people who shouldn't be on a medication, like for me getting akasthesia from antipsychotics or blunting of memory from SSRI's. I mean if you're constantly seeing and hearing things that aren't there and are having trouble holding reality together (in my case it was perceived 'tourettes' - AFAIK they have better treatments now than blunt antipsychotics), and Haldol and Risperidal help, by all means - go for it. It's always a cost-benefit analysis that needs to be weighed by the person taking it though, and I would agree with some of the sentiments experessed by the OP that when a child is given these medications their grasp on the situation ends up getting ceded to the authority of an adult professional which TBH - especially in the 90's - was a bit of a propaganda tool because they barely understood how these medications worked yet, just that they did and that they were to be administered widely because it made the companies who patented them a lot of money.


Handling neurodivergence, hormonal divergence, etc. seems like it's something societies have generally been bad at, some rather remarkable exceptions for intersex in various cultures, and if I've noticed anything - the more shaky a society gets the more absolute and procrustian the demands for total social conformity tend to become. I'd agree that throwing the DSM at someone who is inconvenient to deal with for one reason or another is very expedient and a lot of people did just that. Then again the old joke was often that if you lived in Cuba or the USSR you'd need to add 'political dissident' or 'sluggish schizophrenia' to your local version of the DSM.

For what I've learned through the course of my life - society functions much better when the individual people in it are. The most important thing doctors can do when giving a childhood diagnosis is refrain from dishing out hopelessness, and rather sadly I had doctors literally tell me this during my 1991 dx - that I'd never be able to figure out how the world actually worked and that I'd never be able to trust my own intuitions and would have to always take other people's word for things. Can you imagine what patterns of predation that sets up for a person who actually takes such 'priestly class' advice seriously as a child? This is where we do damage to our culture, make more activists and zealots (I was half in that bag myself as a kid for a lot of reasons), and it would be avoidable if the people we counted on to be adults actually were that - and if we had a properly cynical accounting of them as simple apes trying to pay bills we'd be far less likely to take a child in for a diagnosis unless it was a truly crippling issue.

Other than that - if you have been damaged by things people have done to you, or even still are doing to you, there's a lot that you can do to heal from that trauma - everything from eating right, excercising, meditating, reading philosophy (I went as far as getting into western mystery traditions like Hermeticism and Rosicrucian philosophy to find a lot of my tools).

As for how people treat each other - the bright side of Darwinian evolution and natural selection is that there's guaranteed diversity whether we want it or not. The downside - nature seems to have equal contempt for what it creates and deep down people seem to have an instinct to play destructive zero-sum games for wealth, prestige, mates, etc. so there's a very winner-take-all kill-all-others mentality that tries to surface with every generation and especially if things are looking bad economically or socially the temptation to destroy anything that doesn't fit a narrow ideal amplifies by quite natural processes that are redundant in most of us.

In answer to OP "Thoughts?"

In some ways I can not disagree with Thomas Szasz M.D., but the quackish coefficient is also very high. Please allow me to explain.

The good doctor's critiques of scientism and the drug industry have legitimacy. MD's want to cut, drug and label, even if it does not help, or even cause harm. There is more than sufficient evidence to back up such a claim.

The problem is that his conception of modern psychiatry is deficient. Check out the wikipedia page on Szasz if you want the litany of criticisms of the doctor's style of practice. Reading those pages does not give one a good feeling about the dead doctors ideas.

It seems if you are a fan of the libertarian doctor, it is incumbant upon you to at least check to see if his main critiques are full of it, or not. Full disclosure, I am not a fan of Libertarian philosophies either, sorry.

Those are my thoughts.