Surname:

Szasz

First name:

Thomas Stephen

Place of birth:

Budapest

* 15.04.1920

† 08.09.2012

American psychiatrist, psychotherapist and critic of psychiatry.

Thomas Szasz (1920–2012) was born in April 1920 into a Jewish family in Budapest, Hungary. He was the second child of his parents, Lily Wellisch and Gyula Szász, and initially bore the Hungarian name Tamás István. Thanks to a privileged visa, he was able to emigrate to the US in 1938, before the beginning of WW II. As he later recalled in his Autobiographical Sketch (2004), it was already in Budapest in the 1930s that he had read Freud’s and Ferenczi’s writings on psychoanalysis and developed his ethical positions on the relationship between psychiatry and psychotherapy under the influence of Hungarian writer Frigyes Karinthy.

Szasz matriculated at the University of Cincinnati in February 1939 and obtained his B.S. (Hons) in physics in May 1941, with the prospect of joining medical school (Szasz 2004: 14). However, because of his Jewish background numerous applications were needed before he was finally accepted at the College of Medicine in August 1941. After receiving his M.D. from the University of Cincinnati in June 1944, he completed his residency at the Chicago General Hospital and then trained in psychiatry and psychoanalysis in Chicago (2004: 18). He opened his own practice as a psychoanalyst in 1948 and received a tenured position in psychiatry at the New York State University in Syracuse in 1956. He retired in 1990. Szasz was married to Rose Loshkajian, with whom he had two daughters. He died in 2012 in Manlius, NY. Having suffered a serious fall, he decided to take his own life instead of living on in chronic pain.

Schizophrenia as a myth

Szasz achieved international attention with his 1961 book The Myth of Mental Illness. He deemed the concept of mental illness a pseudo-scientific product of negotiation processes lacking factual substance. Instead, he argued, this concept of illness was there to rationalise and pathologise personal “problems in life” and “unwanted” thoughts, feelings and behaviours. Fifteen years later, Szasz picked up on the issue in his book Schizophrenia, explaining once again that “[t]he point I wish to emphasize here, right at the outset, is that the claim that some people have a disease called schizophrenia (and that some, presumably, do not) was based not on any medical discovery but only on medical authority; that it was, in other words, the result not of empirical or scientific work, but of ethical and political decision making” (Szasz 1976/1988: 3).

The opening statement of Szasz’s historical analysis The Manufacture of Madness reads, “The concept of mental illness is analogous to that of witchcraft” (1997/1970: 23). He argued that modern psychiatry resembled the Inquisition: “The end of one ideology is thus the beginning of another: where religious heresy ends, psychiatric heresy begins; where the persecution of the witch ends, the persecution of the madman begins” (1997/1970: 110).

Social history and history-of-science background

Szasz’s arguments met with fierce opposition from the outset (see, e.g., Shorter 2011; Clarke 2007; Schaler 2005) but also helped establish a fundamental criticism of psychiatry in a historical situation when institutional reforms of the care system seemed just as necessary as revisions of psychopathology and diagnostics. At about the same time, the British psychoanalyst Ronald D. Laing published his first critical analysis The Divided Self (1961), the French philosopher Michel Foucault his first major work Histoire de la Folie (1961) and the Canadian-American sociologist Erving Goffman his criticism of institutions in Asylums (1961). This was also the time when Franco Basaglia (1968) initiated the dismantling of asylums in Italy. The work of Szasz was well-perceived and received in these scholarly contexts. Although Szasz can be considered one of the most radical critics of psychiatry in the second half of the 20th century along with David Cooper (1967), he rejected the classification of his work as part of so-called “anti-psychiatry” just as much as much as he disapproved of the British strand around Laing and Cooper did (Szasz 2008a; 2008b).

Beyond psychoanalysis, the theoretical foundations for Szasz’s work were provided by interactionist sociology as developded by the second Chicago School, namely Herbert Blumer’s and Erwin Lemert’s theory of social deviance, which Thomas Scheff (1966) specified with regard to psychiatric theories of disorder and stigma (cf. Szasz 2000). Heiner Keupp welcomed the results of these new approaches in his 1972 book on the myth of illness in psychopathology and hoped that a social-science model of mental disorders would offer a theoretical backing for the incipient reform of German psychiatry. Karl-Peter Kisker (1978: 816, 820) wrote that Szasz still presented “the most well-founded arguments for detaching psychiatry from the medical frame of reference” but, at the same time, was ignorant towards the “brutal daily experiences” inside and outside of psychiatric institutions, especially since Szasz treated his own patients in Syracuse in “absolutely conventional” ways (all quotes translated from German). Szasz also published numerous texts on the issue of psychotherapeutic practice (e.g., 1976a; 1957; cf. Plessis 2001). More recent commentaries emphasise the historical function but also the anachronicity of the main arguments in Szasz’s criticism of psychiatry to which he adhered until the end (e.g., Shorter 2011). This makes Thomas Szasz one of the most prominent but also controversial representatives of his discipline in the second half of the 20th century.

Radically liberal and ultra-conservative agenda

His 1994 book Cruel Compassion, which addressed the issue of involuntary psychiatric treatment, deepened his radical liberal views. Basically, Szasz saw people as merely individual economic subjects; their possible dependence on state support would make them "predators" of social goods: "In sum, there are three ways a person can obtain the necessities of life: (1) As a dependent, receiving food and shelter from donors (parents, family, church, state); (2) as a producer, providing for his own needs; or (3) as a predator, using force or the threat of force to rob others of the goods and services he needs and wants. An individual who does not want to be, or cannot be, a producer, must become a dependent or a predator or perish." (Szasz 1994, p. 143).

Involuntary psychiatric hospitalization prevents the people from learning anything by suffering the consequences of their selfish or unwise actions. Szasz called for a strict separation between psychiatry and state, described compulsory treatment as an “abuse” of state power and argued that everyone had the right to free self-medication. He described psychiatric patients as “socially unwanted” victims of the state’s exercise of power, just like the poor and homeless, but remained vague about how they should be treated instead and what their social position should be. Altogether, his point was that dealing with deviance should be a matter of law enforcement, not psychiatry. Szasz’s entire concept was distinctively individualistic, ultra-conservative and right-libertarian, while the ideas of welfare-state compensation or of socio-structural reforms apparently did not occur to him.

Involvement with the Church of Scientology

In 1969, Szasz and the Church of Scientology co-founded the Citizens Commission on Human Rights International to oppose involuntary psychiatric treatment. According to Westbrook (2017), he worked as a psychiatric expert for the Church of Scientology in a lawsuit against a member of the organization. According to Lehmann (2013: 24), connections between Szasz and Scientology could still be proven for the year 1978. Moreover, Szasz received an award from the Citizens Commission, co-founded by him, still in 1994 and took part in a Russell Tribunal in Berlin in 2001, during which psychiatry was accused of human rights violations.

Awards

2001: Honorary doctorate awarded by the Upstate Medical University (Syracuse, NY).

Literature

Basaglia, F. (1968): Instituzione negata. Turin: Einaudi. 

Breeding, J. (2011): Thomas Szasz: Philosopher of Liberty. In: Journal of Humanistic Psychology 51 (1), pp. 112–128.

Clarke, L. (2007): Sacred Radical of Psychiatry. In: Journal of Psychiatric and Mental Health Nursing 14 (5), pp. 446–453.

Cooper, D. (1967): Psychiatry and Anti-Psychiatry. London: Tavistock, Paladin.

Foucault, M. (1961): Histoire de la folie à l’âge classique: Folie et déraison. Paris: Plon.

Goffman, E. (1961): Asylums. Essays on the Social Situation of Mental Patients and Other Inmates. New York: Doubleday & Company.

Keupp, H. (1972): Der Krankheitsmythos in der Psychopathologie. Munich: Urban & Schwarzenberg.

Kisker, K. P. (1978): Antipsychiatrie. In: K. P. Kisker, J. E. Meyer, C. Müller, E. Strömgren (Eds.): Psychiatrie der Gegenwart. Vol. I,1. Berlin, Heidelberg: Springer, pp. 811–826.

Laing, R. D. (1960): The Divided Self. An Existential Study on Sanity and Madness. London: Tavistock.

Lehmann, P. (2013): Me & Thomas Szasz. Contrary Approaches to Anti-Psychiatry. In: Asylum. The Magazine for Democratic Psychiatry 20 (1), pp. 24–25.

Pies, R. (1979): On Myths and Countermyths. More on Szaszian Fallacies. In: Archive of General Psychiatry 36 (2), pp. 139–144.

Plessis, R. d. (2011): Social Class and Psychotherapy. A Critical Reading of Thomas Szasz’s The Ethics of Psychoanalysis. In: Psychology in Society 42, pp. 21–34.

Schaler, J. A. (2004, Ed.): Szasz under Fire. The Psychiatric Abolitionist Faces His Critics. Chicago: Open Court.

Scheff, T. (1966): Being Mentally Ill. A Sociological Theory. Chicago: Aldine.

Sedgwick, P. (1982): Psycho Politics. London: Pluto.

Sedgwick, P. (1982): Psycho Politics. Laing, Foucault, Goffman, Szasz and the Future of Mass Psychiatry. New York: Harper & Row.

Shorter, E. (2011): Still Tilting at Windmills: Commentary on ‘The Myth of Mental Illness’. In: The Psychiatrist 35 (5), pp. 183–184.

Szasz, T. S. (2011): The Myth of Mental Illness: 50 Years Later. In: The Psychiatrist 35 (5), pp. 179–182.

Szasz, T. S. (2008): Psychiatry. The Science of Lies. Syracuse: Syracuse University Press.

Szasz, T. S. (2008a): Antipsychiatry: Quackery Squared. Syracuse: Syracuse University Press.

Szasz, T. S. (2008b): Debunking Antipsychiatry: Laing, Law, and Largactil. In: Current Psychology 27 (2), pp. 79–101.

Szasz, T. S. (2006): Secular Humanism and ‘Scientific Psychiatry’. In: Philosophy, Ethics and Humanities in Medicine 1 (5), pp. 1–5.

Szasz, T. S. (2004): An Autobiographical Sketch. In: J. A. Schaler: Szasz under Fire. The Psychiatric Abolitionist Faces His Critics. Chicago: Open Court, pp. 1–28.

Szasz, T. S. (2000): Second Commentary on ‘Aristotle's Function Argument’. In: Philosophy, Psychiatry & Psychology 7 (1), pp. 3–16

Szasz, T. (1997/1970). The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement. New York: Syracuse University Press.

Szasz, T. S. (1996): Our Right to Drugs. The Case of Free Market. Syracuse: Syracuse University Press.

Szasz, T. S. (1994): Cruel Compassion: Psychiatric Control of Society’s Unwanted. New York: Syracuse University Press.

Szasz, T. S. (1988): A Social History of Madness. Stories of the Insane. In: Medical History 32 (4), pp. 472–473.

Szasz, T. S. (1985): Ceremonial Chemistry. The Ritual Persecution of Drugs, Addicts and Pushers. Holmes Beach: Learning Publications.

Szasz, T. (1976/1988): Schizophrenia. The Sacred Symbol of Psychiatry. New York: Syracuse University Press.

Szasz, T. S. (1976a): Anti-Freud. Karl Kraus’s Criticism of Psychoanalysis and Psychiatry. Syracuse: Syracuse University Press.

Szasz, T. S. (1963): Law, Liberty and Psychiatry: An Inquiry into the Social Uses of Mental Health Practices. New York: Macmillan.

Szasz, T. S. (1961): The Myth of Mental Illness. Foundations of a Theory of Personal Conduct. New York: Harper & Row.

Szasz, T. S., W. F. Knoff, M. H. Hollender (1958): The Doctor-Patient Relationship and Its Historical Context. American Journal of Psychiatry 115 (6), pp. 522–528.

Szasz, T. S. (1957): A Contribution to the Psychology of Schizophrenia. In: Archives of Neurology and Psychiatry 77 (4), pp. 420–436.

Vatz, R. E. (1983): Thomas Szasz. Primary Values and Major Contentions. Buffalo: Prometheus Books.

Westbrook, D. A. (2017): “The Enemy of My Enemy Is My Friend”. Thomas Szasz, the Citizens Commission on Human Rights, and Scientology’s Anti-Psychiatric Theology. In: Nova Religio: The Journal of Alternative and Emergent Religions 20 (4), pp. 37-61.

Burkhart Brückner, Robin Pape

Photograph: Jennyphotos / Source: Wikimedia / License: CC BY-SA 3.0 or GDFL