Thomas Szasz , the psychiatrist who himself was one of psychiatry’s most strident critic, died on Saturday September 8 at the age of 92. I’ve read several obits, some praising and some ridiculing the man, but none that capture his real importance. The writers are taking the arguments of Szasz’ seminal book, “The Myth of Mental Illness,” way too literally. Szasz called mental illness ‘problems in living’ and scoffed at the idea they were literally rooted in brain malfunction. On this one, he was partly to largely wrong.
But his larger points had nothing to do with this. Szazs’ saw psychiatry as a companion to and replacement for religion in the modern world, and he saw both institutions equally committed to preserving the status quo by policing behavior of the average citizen. Those who transgress social rules and social mores are either ‘bad’ or ‘mad.’ The former are condemned to Hell and/or imprisoned, the latter locked away in madhouses.
Szasz was the first to expose psychiatry as a tool of political oppression. Today we know that the history of psychiatry is fraught with shameful collusion with the holders of social power. In the 1800’s, ‘drapetomania’ was a mental disease that supposedly caused slaves to want to run away. In the twentieth century suffragists were thought to suffer from androgyomania – wanting to be male. Later in the 20th century,people who loved others of the same sex were stricken with the disease of homosexuality. Even now, in the 21st, people who fail to conform to gender norms are diagnosed with Gender Identity Disorder. Those labeled ‘mentally ill’ are stigmatized, punished, and until the movement Szasz helped found changed the laws – put away in psychiatric hospitals against their will. It was not until after the middle of the twentieth century, for example, that a husband lost the right to have his wife committed, or parents could not automatically hospitalize an unruly child.
But Szasz was the first to expose this, the first to question the ethics of psychiatry. And he sparked a movement – a movement that reformed Draconian civil commitment laws, humanized mental hospitals and gave patients rights., a cause that put in place laws to protect people from being locked away simply for engaging in behavior that society deems ‘deviant’, even if it harms no one. Szasz put the politics in psychiatry, and he sparked the community mental health movement – the idea that mental health practicioners should devote themselves to helping those most in need due to poverty or oppression based on race, sexual identity, or gender. His work laid the ground work for the concept of ‘minority stress’ – the idea that living in a society that stigmatizes you can make you crazy. And he encouraged the now enormous ‘self-help’ movement.
I went to graduate school in clinical psychology with a copy of “The Myth of Mental Illness” in one hand and Phylis Chesler’s “Women and Madness” under the other. Szasz’s ideas, which Chesler brilliantly applies to the treatment of women, have shaped my entire view of my career – and my mission in life.
Because of Szasz I am suspicious of the power of psychiatry. Because of Szasz I see the political ramifications of all kinds of mental health issues. Because of Szasz I started a counseling agency to work battered women, and later founded others to help oppressed sexual minorities and work with people with AIDS. My worldview, my life work, the essence of who I am has been shaped by his ideas.
R.I.P., Thomas. You were one of the great ones. I’ll always be in your debt.