Psychology 309a
Doug Davis
notes on Thomas Szasz
We're reading two chapters of Thomas Szasz's The Myth of Mental Illness, and the themes sounded there seem a good basis both to discuss Bateson's "double bind" theory and to situate Showalter's Hystories.
"Szasz reminds us again of the absurdity, and the dangers, of using literal medicine to treat metaphorical diseases. He argues that to call something mental illness and equate it with physical illness gives too much power to mental health professionals and to the governments they serve and strips people of their responsibility for their own behavior."
—Mitchell Handelsman, in Contemporary Psychology
Consider some of Szasz's claims:
"'Mental illness' is a metaphor, and a bad one; we all have problems in living, and some of us may even—traumatically!—have brain diseases. But problems are not the same as diseases, nor are they necessarily the result of them."
"'Insanity' is a legal concept, not a medical one; it has its basis in ideology, not medicine."
"Modern psychiatry has is often not a means of helping people deal with problems, but a means of restricting their liberty, and is thus in league with the state."
"Psychiatry uses its false ideological claims to undermine morality and moral responsibility. It gets innocent people committed to institutions and guilty ones 'off'—'by reason of insanity'."
"Involuntary mental hospitalization of someone who has committed no crime, or harmed no one, is itself a crime against humanity."
Szasz is featured on the libertarion Laissez Faire Books Webpage, and his criticism of US drug policies is widely cited.
The Myth of Mental Illness
Chapter 7: Language and Protolanguage
Szasz borrows terminology from a variety of philosophers of science, logicians, and linguists, including the distinctions between "object" and "metalanguage" (cf. Bateson). Let's think if examples of each use of language. "Protolanguage" is Szasz's term for primitive, childish uses of language-like sounds and behaviors in the ways psychodynamic clinicians have called "hysterical" of "schizophrenic." The "pragmatics of protolanguage" (p. 115) refers to the use of such behaviors to convey a hidden meaning, e.g. "I am sick." Szasz cites Freud's patient "Cäcilie M."'s facial neuralgia (a "slap in the face") as an example.
Chapter 8: Hysteria as Communication
Szasz's main point is that "hysteria" can be seen as a "non-discursive language" -- i.e., a means of communicating that does not follow conventional, shared, explicit rules of conversation. The chart on pp. 136-137 illustrates the development of skill at using proto-language and language to get one's needs met from infancy to adulthood.
Chapter 13: Hysteria As A Game
Szasz has a section on "Lying: A specific strategy in hysteria":
It is unfashionable nowadays for psychiatrists speak of lying. Once a person is called a "patient," psychiatrists ceased to consider the possibility that he might be deceptive or mendacious; if in fact he is, they regard the lies as symptoms of a mental illness which they call hysteria, hypochondriasis, schizophrenia, or some other "psychopathology." As a result, anyone who continues to speak of lies and deceptions in connection with psychiatric problems is immediately regarded as "anti-psychiatric" and "anti-humanitarian"; in other words, he is dispensed as both mistaken and malevolent.
I have long considered lying as one of the most important phenomena in psychiatry, a view I have formed partly by taking some of Freud's earliest observations seriously. Let us recall here how and emphatically he Freud condemned certain social and medical hypocrisies, which are, after all, simply lies of the certain kind. Freud was especially critical of the deceitful habits of both physicians and patients with respect to sex and money. This is the gist of Freud's recollection of his encounter, early in his medical career, with the Viennese obstetrician-gynecologist Chrobak. Chrobak had referred a patient to Freud, a woman who, because her husband was impotent, was still a virgin after 18 years of marriage. The physician's moral obligation in such cases, so Chrobak told Freud, was to shield the husband's reputation by lying about the patient's condition. I mention this case only to show that lying -- on the parts of both patients and physicians -- was an important issue in psychoanalysis from its very inception. Indeed, I believe that certain psychoanalytic concepts came into being in order to deal with the idea of lies, for example, the unconscious and hysterical conversion; and that certain psychoanalytic arrangements came into being in order to deal with the management of lies, for example, free association and the psychoanalytic contract. (Szasz, 1974, pp. 222-223)