Editing Thomas Szasz (section)

== Positions ==

===Mental illness is a myth===

In Szasz's view, people who are said to have a mental illness only have "problems in living". Diagnoses of "mental illness" or "mental disorder" are passed off as scientific but are judgments (of disdain) to support certain uses of power by authorities.{{r|benning}} In that line of thinking, schizophrenia becomes not the name of a disease entity but a judgment of extreme psychiatric and social disapprobation. Szasz called schizophrenia "the sacred symbol of psychiatry" because those so labeled have long provided and continue to provide justification for psychiatric theories, treatments, abuses, and reforms. 

He argued that psychiatry is a [[pseudoscience]] that parodies medicine by using medical-sounding words, and that supported by the state through various Mental Health Acts, it has become a modern secular [[state religion]]. As a vastly elaborate social control system which disguises itself under the claims of being rational, systematic and therefore scientific, it constitutes a fundamental threat to freedom and dignity.

In ''The Myth of Mental Illness'' he argued that people can only play "the mental illness game" if their partner and those around them play a complimentary role - a situation that would later be described as [[codependency]].

===Separate psychiatry and the state===

Szasz believed that if we accept that "mental illness" is a euphemism for behaviors that are disapproved of, then the state has no right to force psychiatric "treatment" on these individuals. Similarly, the state should not be able to interfere in mental health practices between consenting adults (for example, by legally controlling the supply of [[psychotropic drug]]s or psychiatric medication). The [[medicalization]] of government produces a "therapeutic state", designating someone as, for example, "insane" or as a "drug addict".

In ''Ceremonial Chemistry'' (1974), he argued that the same persecution that targeted [[witch-hunt|witches]], Jews, [[Romani people|gypsies]], and homosexuals now targets "drug addicts" and "insane" people. Szasz argued that all these categories of people were taken as scapegoats of the community in ritual ceremonies. To underscore this continuation of religion through medicine, he even takes as an example [[obesity]]: instead of concentrating on [[junk food]] (ill-nutrition), physicians denounced hypernutrition. According to Szasz, despite their scientific appearance, the diets imposed were a moral substitute to the former [[fasting|fasts]], and the social injunction ''not to be overweight'' is to be considered as a moral order, not as scientific advice as it claims to be. As with those thought bad (insane people), and those who took the wrong drugs (drug addicts), medicine created a category for those who had the wrong weight (obesity).

Szasz argued that psychiatrics were created in the 17th century to study and control those who erred from the medical norms of social behavior; a new specialization, "drogophobia", was created in the 20th century to study and control those who erred from the medical norms of drug consumption; and then, in the 1960s, another specialization, [[bariatrics]] (from the Greek βάρος ''baros,'' for "weight"), was created to deal with those who erred from the medical norms concerning the weight the body should have. Thus, he underscores that in 1970 the American Society of Bariatric Physicians had 30 members, and already 450 two years later.{{citation needed|date=March 2019}}

====The therapeutic state====

The "therapeutic state" is a phrase coined by Szasz in 1963.<ref name=Baker>{{cite journal|last=Baker|first=Robert|author-link=Robert A. Baker|title=Psychiatry's Gentleman Abolitionist|journal=The Independent Review|date=Winter 2003|volume=VII|issue=3|pages=455–460|url=http://www.independent.org/pdf/tir/tir_07_3_baker.pdf|access-date=February 12, 2012|issn=1086-1653|archive-url=https://web.archive.org/web/20190410081714/http://www.independent.org/pdf/tir/tir_07_3_baker.pdf|archive-date=April 10, 2019|url-status=live}}</ref> The collaboration between psychiatry and government leads to what Szasz calls the ''therapeutic state'', a system in which disapproved actions, thoughts, and emotions are repressed ("cured") through pseudomedical interventions.<ref>{{cite journal |url=http://reason.com/archives/2000/07/01/curing-the-therapeutic-state-t |journal=Reason Magazine |title=Curing the Therapeutic State: Thomas Szasz interviewed by Jacob Sullum |author=Jacob Sullum |date=July 2000 |pages=28 ''et seq.'' |access-date=2015-07-15 |archive-url=https://web.archive.org/web/20140114112507/http://reason.com/archives/2000/07/01/curing-the-therapeutic-state-t |archive-date=2014-01-14 |url-status=live }}</ref><ref name=Costigan>{{cite book|last=Costigan|first=Lucy|title=Social Awareness in Counseling|year=2004|publisher=iUniverse|isbn=978-0-595-75523-3|page=17|url=https://books.google.com/books?id=wfCesrlvK-gC&pg=PA17|access-date=2015-06-20|archive-url=https://web.archive.org/web/20140101161637/http://books.google.com/books?id=wfCesrlvK-gC&pg=PA17|archive-date=2014-01-01|url-status=live}}</ref>{{rp|17}} Thus suicide, unconventional religious beliefs, racial bigotry, unhappiness, anxiety, shyness, sexual promiscuity, shoplifting, gambling, overeating, smoking, and illegal drug use are all considered symptoms or illnesses that need to be cured.<ref name=Costigan/>{{rp|17}} When faced with demands for measures to curtail smoking in public, binge-drinking, gambling or obesity, ministers say that "we must guard against charges of nanny statism."<ref name="Fitzpatrick">{{cite journal|last=Fitzpatrick|first=Mike|title=From 'nanny state' to 'therapeutic state'|journal=[[The British Journal of General Practice]]|date=August 2004|volume=1|issue=54(505)|page=645|pmc=1324868|pmid=15517694}}</ref> The "[[nanny state]]" has turned into the "therapeutic state" where nanny has given way to counselor.<ref name=Fitzpatrick/> Nanny just told people what to do; counselors also tell them what to think and what to feel.<ref name=Fitzpatrick/> The "nanny state" was punitive, austere, and authoritarian, the therapeutic state is touchy-feely, supportive – and even more authoritarian.<ref name=Fitzpatrick/>

According to Szasz, "the therapeutic state swallows up everything human on the seemingly rational ground that nothing falls outside the province of health and medicine, just as the theological state had swallowed up everything human on the perfectly rational ground that nothing falls outside the province of God and religion."<ref name="Szasz, 2001">{{cite journal|last=Szasz|first=Thomas|title=The Therapeutic State: The Tyranny of Pharmacracy|journal=[[The Independent Review]]|date=Spring 2001|volume=V|issue=4|pages=485–521|url=http://www.independent.org/pdf/tir/tir_05_4_szasz.pdf|access-date=January 20, 2012|issn=1086-1653|archive-url=https://web.archive.org/web/20120214211148/http://www.independent.org/pdf/tir/tir_05_4_szasz.pdf|archive-date=February 14, 2012|url-status=live}}</ref>{{rp|515}} Faced with the problem of "madness", Western individualism proved to be ill-prepared to defend the rights of the individual: modern man has no more right to be a madman than medieval man had a right to be a heretic because if once people agree that they have identified the one true God, or Good, it brings about that they have to guard members and nonmembers of the group from the temptation to worship false gods or goods.<ref name="Szasz, 2001"/>{{rp|496}} A secularization of God and the medicalization of good resulted in the post-[[Age of Enlightenment|Enlightenment]] version of this view: once people agree that they have identified the one true reason, it brings about that they have to guard against the temptation to worship unreason – that is, madness.<ref name="Szasz, 2001"/>{{rp|496}}

[[Civil libertarians]] warn that the marriage of the state with psychiatry could have catastrophic consequences for civilization.<ref>{{Cite web|url=http://www.fff.org/freedom/fd0411b.asp|archiveurl=https://web.archive.org/web/20060115054600/http://www.fff.org/freedom/fd0411b.asp|url-status=dead |title=Bush's Brave New World |first=Sheldon |last=Richman |date=March 4, 2005 |archivedate=January 15, 2006}}</ref> In the same vein as the [[separation of church and state]], Szasz believes that a solid wall must exist between psychiatry and the state.<ref name="Szasz, 2001"/>

===Abolish involuntary commitment===

Szasz made efforts to abolish [[Involuntary commitment|involuntary psychiatric hospitalization]] for over two decades, and in 1970 took a part in founding the [[American Association for the Abolition of Involuntary Mental Hospitalization]] (AAAIMH).<ref>{{cite book |last=Torrey |first=Edwin Fuller |author-link=Edwin Fuller Torrey|title=Surviving Schizophrenia: A family manual |year=1988|publisher=Perennial Library|isbn=978-0-06-055119-3|page=315|url=https://books.google.com/books?id=uYJHAAAAMAAJ|access-date=2015-06-20|archive-url=https://web.archive.org/web/20160804101738/https://books.google.com/books?id=uYJHAAAAMAAJ|archive-date=2016-08-04|url-status=live}}</ref> Its founding was announced by Szasz in 1971 in the ''[[American Journal of Psychiatry]]''<ref>{{cite journal|last=Szasz|first=Thomas|title=American Association for the Abolition of Involuntary Mental Hospitalization|journal=[[American Journal of Psychiatry]]|date=June 1, 1971|volume=127|issue=12|page=1698|url=http://ajp.psychiatryonline.org/article.aspx?articleid=152361|pmid=5565860|doi=10.1176/ajp.127.12.1698|access-date=June 1, 2014|archive-url=https://web.archive.org/web/20140203022238/http://ajp.psychiatryonline.org/article.aspx?articleid=152361|archive-date=February 3, 2014|url-status=live}}</ref> and ''[[American Journal of Public Health]]''.<ref>{{cite journal|last=Szasz|first=Thomas|title=To the editor|journal=[[American Journal of Public Health]]|year=1971|volume=61|page=1076|url=https://books.google.com/books?id=jVUqAQAAMAAJ|doi=10.2105/AJPH.61.6.1076-a|pmid=18008426|pmc=1529883|issue=6|access-date=2015-06-20|archive-url=https://web.archive.org/web/20150318141938/http://books.google.com/books?id=jVUqAQAAMAAJ|archive-date=2015-03-18|url-status=live}}</ref> Until it was dissolved in 1980, the association provided legal help to psychiatric patients and published a journal, ''The Abolitionist''.<ref name=Schaler>{{cite book |title=Szasz Under Fire: A Psychiatric Abolitionist Faces His Critics |year=2004 |publisher=Open Court Publishing |isbn=978-0-8126-9568-7 |ol=17135675M |page=xiv |editor=Schaler, Jeffrey}}</ref>

According to Williams and Caplan, "Szasz's philosophical activism was not intended to improve the treatment of people affected by mental illness as much as to block involuntary treatment." Citing Szasz's writings, legal reforms were enacted, and all 50 US states narrowed their criteria for involuntary commitment from the prior standard of "need for treatment"—causing the number of patients in public psychiatric hospitals to plummet, and the [[Homelessness in the United States|homeless population]] to balloon. It also exponentially increased the prison population with an estimate of 40%–80% inmates with mental illness by 2006.{{r|williams and caplan}}

Three legal decisions were key:
* ''Lessard v. Schmidt'' (1972) required states to narrow their vague commitment statutes, 
* ''[[O'Connor v. Donaldson]]'' (1975) limited commitment to imminently dangerous mentally ill persons, and 
* ''[[Rennie v. Klein]]'' (1978) established the right of patients to refuse mental treatment.{{r|williams and caplan}}

===Abolish insanity defense===

Szasz advocated for the removal of the [[insanity defense]]. Just as legal systems work on the presumption that a person is innocent until proven guilty, individuals accused of crimes should not be presumed incompetent simply because a doctor or psychiatrist labels them as such. Mental incompetence should be assessed like any other form of incompetence, i.e., by purely legal and judicial means with the right of representation and appeal by the accused.

Szasz believed that testimony about the mental competence of a defendant should not be admissible in trials. Psychiatrists testifying about the mental state of an accused person's mind have about as much business as a priest testifying about the religious state of a person's soul in our courts. Szasz argued that the insanity defense was a legal tactic invented to circumvent the punishments of the church, which at the time included confiscation of the property of those who committed suicide, often leaving widows and orphans destitute. Only an insane person would do such a thing to his widow and children, it was successfully argued. This is legal mercy masquerading as medicine, according to Szasz.<ref>{{cite web | url=https://www.irrenoffensive.de/szaszsymposium/myth.htm | title=Thomas Szasz - the myth of mental illness |website=irrenoffensive.de}}</ref>{{Better source needed|date=September 2024|reason=Self-published website; looks like a copy of a Szasz work}}

===Right to drugs===

According to Szasz, [[drug addiction]] is not a "disease" to be cured through legal drugs but a social habit. Szasz also argued in favor of a free market for drugs. He criticized the [[war on drugs]], arguing that using drugs is in fact a [[victimless crime]]. Prohibition itself constituted the crime. He argued that the war on drugs leads states to do things that would have never been considered half a century before, such as prohibiting a person from ingesting certain substances or interfering in other countries to impede the production of certain plants, e.g. [[coca eradication]] plans, or the campaigns against [[opium]]; both are traditional plants opposed by the Western world. Although Szasz was skeptical about the merits of psychotropic medications, he favored the repeal of [[drug prohibition]].<ref>{{Cite journal|last=Klein|first=Daniel B.|date=1993|title=[Book Review] Our Right to Drugs: A Case for a Free Market|url=http://econfaculty.gmu.edu/klein/PdfPapers/bookreviewofSzasz.pdf|journal=Southern Economic Journal|volume=59|issue=3|pages=552–553|archive-url=https://web.archive.org/web/20161225040053/http://econfaculty.gmu.edu/klein/PdfPapers/bookreviewofSzasz.pdf|archive-date=December 25, 2016|doi=10.2307/1060304|jstor=1060304}}</ref>

Szasz also drew analogies between the persecution of the drug-using minority and the persecution of Jewish and homosexual minorities.

{{Blockquote |text=The Nazis spoke of having a "Jewish problem". We now speak of having a drug-abuse problem. Actually, "Jewish problem" was the name the Germans gave to their persecution of the Jews; "drug-abuse problem" is the name we give to the persecution of people who use certain drugs. |author=Szasz in ''The Second Sin'' (1973)<ref name="Szasz1973">{{cite book |last=Szasz |first=Thomas Stephen |title=The Second Sin |year=1973 |ol=24219110M |publisher=Routledge & Kegan Paul |isbn=0710077572}}</ref>{{rp|64}} }}

Szasz cites former U.S. Representative [[James M. Hanley]]'s reference to drug users as "vermin", using "the same metaphor for condemning persons who use or sell illegal drugs that the Nazis used to justify murdering Jews by poisoned gas—namely, that the persecuted persons are not human beings, but "vermin."{{Sfn|Ceremonial Chemistry (2003)|p=15}}

===Right to die===

In an analogy to [[birth control]], Szasz argued that individuals should be able to choose when to die without interference from medicine or the state, just as they are able to choose when to conceive without outside interference. He considered [[suicide]] and the [[right to die]] to be among the most fundamental rights, but he opposed state-sanctioned [[euthanasia]]. In his 2006 book about [[Virginia Woolf]], Szasz stated that Woolf put an end to her life by a conscious and deliberate act, her suicide being an expression of her [[freedom of choice]].<ref>{{cite book |first=Thomas |last=Szasz |title=My Madness Saved Me: The Madness and Marriage of Virginia Woolf |url=https://books.google.com/books?id=w5JeUnEE94MC |location=New Brunswick, New Jersey |publisher=Transaction Publishers |year=2006 |isbn=978-0-7658-0321-4}}</ref>{{Page needed|date=September 2024}}<ref>{{Cite book |quote=The Nazis sought to prevent Jewish suicides. Wherever Jews tried to kill themselves – in their homes, in hospitals, on the deportation trains, in the concentration camps – the Nazi authorities would invariably intervene in order to save the Jews' lives, wait for them to recover, and then send them to their prescribed deaths. |last=Kwiet |first=Konrad |author-link=Konrad Kwiet |chapter=The Ultimate Refuge: Suicide in the Jewish Community under the Nazis |title=Part 2 The Origins of the Holocaust |pages=658–690 |doi=10.1515/9783110970494.658 |publisher=K. G. Saur |year=1989 |isbn=978-3-598-21552-0 |ol=2193372M}}</ref>{{Rp|661}}