RIP Thomas Szasz

[DynamicDidactic]

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Did not see this posted, thought some might find it interesting.
http://mindhacks.com/2012/09/11/thomas-szasz-has-left-the-building/

 

[toothless rufus]

Soooo, did this guy ever see and treat patients? Did he prescribe drugs? How did he manage to support himself as a psychiatrist if he was antipsychiatry?! Why didn't he just do an IM/FM residency after psych if he disliked his specialty so much?

 

[BS81]

Scientology money

 

[toothless rufus]

Scientology money

Really. Wow. That's actually pretty lame. And he thought psychiatry was based on BS?!

 

[splik]

yes he did see patients for 'autonomous psychotherapy' for 'problems in living' and he charged a huge amount of money for the privilege. He was a member of the APA throughout his life and continued his affiliation as professor emeritus at SUNY Upstate where he had mentored a certain Peter Breggin when he was a psych resident.

Although Thomas Szasz was labelled as an antipsychiatrist, it was a label he himself rejected (indeed it was coined by the south African Marxist psychiatrist David Cooper). He was very critical of diagnostic psychiatry and psychoanalytic psychiatry (which had been the prevailing model of the day). Although I am about as far from a libertarian as you can get, he does nicely sum up the libertarian perspective in psychiatry, and I do recommend reading Law, Liberty and Psychiatry. Issues of coercion in psychiatry are still relevant to this day.

Szasz was notably sued for not prescribing lithium to a manic-depressive physician who then hanged himself.

Let us not forget that those psychiatrists who criticize psychiatry benefit personally both in terms of notoriety and pecuniary gain, and in that respect have more in common with those drug company ****** than they would like to think...

 

[billypilgrim37]

Szasz was notably sued for not prescribing lithium to a manic-depressive physician who then hanged himself.

One of my past attendings was a resident at Upstate when this happened, had some rather incredible stories about this particular situation.

 

[pre med 2014]

When I saw the words RIP next to the name Thomas Szasz a little part of me died inside. I'm a big fan of Szasz.

 

[toothless rufus]

When I saw the words RIP next to the name Thomas Szasz a little part of me died inside. I'm a big fan of Szasz.

How many parts does that leave then? Check the obituaries. Maybe there are a few others whose passing will have a cumulative effect on you.

 

[OldPsychDoc]

How many parts does that leave then? Check the obituaries. Maybe there are a few others whose passing will have a cumulative effect on you.

I think premed2014 may be one of L Ron Hubbard's horcruxes.

 

[toothless rufus]

I think premed2014 may be one of L Ron Hubbard's horcruxes.

Haha!!

 

[Iwillheal]

Though can't say I'm shocked, I am dismayed at the lack of respect shown towards the Szasz by most people in this thread. There will be time for quips and jokes and mockery, but for now I know that, love him or hate him, an influential psychiatrist passed away, and that in history of ideas in psychiatry, he will always have a firm position.

 

[billypilgrim37]

Though can't say I'm shocked, I am dismayed at the lack of respect shown towards the Szasz by most people in this thread. There will be time for quips and jokes and mockery, but for now I know that, love him or hate him, an influential psychiatrist passed away, and that in history of ideas in psychiatry, he will always have a firm position.

He disparaged the specialty in a way that increases stigma, prevents people from accessing care, and hurts them. People died directly because of his dereliction of duty, and probably indirectly because of the sort of attitudes that he reinforced. I don't know how much respect he is owed by us.

 

[notdeadyet]

Agreed. You can't see someone knock a people repeatedly for years then be shocked when that community doesn't mourn for him.

I don't see anyone celebrating his death.

 

[vistaril]

He disparaged the specialty in a way that increases stigma, prevents people from accessing care, and hurts them. People died directly because of his dereliction of duty, and probably indirectly because of the sort of attitudes that he reinforced. I don't know how much respect he is owed by us.

People who are skeptical of the medical model of psychiatry pushed by bigpharma(but that may slow over time as fewer new drugs are in the pipeline) would say that he served as a useful counterpoint to the blindless(some would say) polypharm that created some of the stigma to begin with.....

I'm not a Szasz 'believer', but the idea that he is mostly wrong and that Stephen Stahl is mostly right seems pretty far fetched as well.....

 

[vistaril]

Agreed. You can't see someone knock a people repeatedly for years then be shocked when that community doesn't mourn for him.

I don't see anyone celebrating his death.

I think some of the psychodynamic community did mourn for him....we get a lot of forwarded emails from a few psychiologists and dynamic oriented psychs mentioning his passing and how he influenced the field(some good, some bad perhaps)

 

[notdeadyet]

I'm not a Szasz 'believer', but the idea that he is mostly wrong and that Stephen Stahl is mostly right seems pretty far fetched as well.....

Happily, there is a whole lot of middle ground between Szasz and Stahl. Considering one the alternative to the other is the equivalent of the hard core right considering anything less to be communist.

The world's a much more intellectually stimulating place when we give less intellectual bandwidth to the loud fringe communities and start paying attention to the nuances of what's in between.

 

[Iwillheal]

I sort of disagree. For a number of reasons, I think there is value in listening and having debates with people on the fringe. And some of them are loud simply because they're not being heard. But the argument advanced earlier, about people having little sympathy for someone who derided their profession, does make sense to me.

 

[notdeadyet]

For a number of reasons, I think there is value in listening and having debates with people on the fringe. And some of them are loud simply because they're not being heard.

Most of them are loud because you get the most airplay by being loud and are heard way out of proportion to the value of your ideas. Stephen Pinker and Noam Chomsky were pretty cutting edge in their day and weren't nearly so shrill as what makes up most of the fringe. Pandering overproportional attention to the fringe gets in the way of actually doing valuable work. Look at the output of our current congress. But to each their own.

 

[vistaril]

Happily, there is a whole lot of middle ground between Szasz and Stahl. .

yeah, I agree with that. But psychiatrists all over the country have stahl's books on their desk and cite his stuff as if it is meaningful.....

 

[Ibid]

He wrote the myth of mental illness in the early seventies and whatever one thinks of that he was the first psychiatrist to speak out about the classification of homosexuality as an illness. He put that in writing in 1965, an idea that was on the fringe at the time if there ever was one. Whatever else he deserves some credit for that.

No?

 

[OldPsychDoc]

yeah, I agree with that. But psychiatrists all over the country have stahl's books on their desk and cite his stuff as if it is meaningful.....

Are you saying that my patients' brain cells don't have colorful little polygons on their surfaces? 😱

 

[notdeadyet]

He wrote the myth of mental illness in the early seventies and whatever one thinks of that he was the first psychiatrist to speak out about the classification of homosexuality as an illness.

Meh, I don't give him as much credit. His Myth of Mental Illness in '61 basically said that mental illness as a whole is just code for what society deems as socially unacceptable. This argument was adopted by sociologists and the gay community who furthered it before Szasz came back to the theme specifically in regards to homosexuality. He paid it more attention as the gay rights movement grew. He thought all mental illness should be tossed out as a label; homosexuality's removal from the DSM was happy collateral damage.

I'm not anti-Szasz, I just think he's a bit lionized by some. He brought out a lot of discourse, but the actual work was done by other better minds.

 

[Ibid]

Meh, I don't give him as much credit. His Myth of Mental Illness in '61 basically said that mental illness as a whole is just code for what society deems as socially unacceptable. This argument was adopted by sociologists and the gay community who furthered it before Szasz came back to the theme specifically in regards to homosexuality. He paid it more attention as the gay rights movement grew. He thought all mental illness should be tossed out as a label; homosexuality's removal from the DSM was happy collateral damage.

I'm not anti-Szasz, I just think he's a bit lionized by some. He brought out a lot of discourse, but the actual work was done by other better minds.

Thanks. It's a narrow point, I did just wonder what your take on it would be.

What doesn't appeal to me is the underlying cruelty of his message. Setting aside criminality, it is the inescapabillity for the mad of not being able to fully take responsibility for thoughts, words and deeds at times of greatest distress in a fundamental everyday sense rather than a narrow legal one that he misses out. I don't think I have ever met anyone who has experienced madness who has wanted to use it as an excuse, quite the contrary.

His failure to take the complexity of the position/situation mad people find themselves in is argueably just as inhuman as the inhumanity he posits by the imposition of a mad label.

Ironically, in my experience, it is the not mad and never mad who are much more likely to excuse some personal human failing with a recourse to "being ill".

 

[Iwillheal]

Stephen Pinker and Noam Chomsky were pretty cutting edge in their day and weren't nearly so shrill as what makes up most of the fringe...

I'm not anti-Szasz, I just think he's a bit lionized by some. He brought out a lot of discourse, but the actual work was done by other better minds.

good points

 

[vistaril]

He wrote the myth of mental illness in the early seventies and whatever one thinks of that he was the first psychiatrist to speak out about the classification of homosexuality as an illness. He put that in writing in 1965, an idea that was on the fringe at the time if there ever was one. Whatever else he deserves some credit for that.

No?

most of us don't like Szasz because he threatens what most of us do- to bring people into our offices, tell them that we're going to increase their effexor from 225 to 300mg because that will give them more energy and motivation because of the increased NE/Ser reputake ratio at this dose, and then bill their insurance to support our comfy salaries and go about our day as if the mechanism of Effexor(or the dose of effexor in general) has a darn thing to do with how the pt is truly functioning.....

he was the one more than anyone who called BS on that, and of course that's why he is disliked.

 

[notdeadyet]

most of us don't like Szasz because he threatens what most of us do- to bring people into our offices, tell them that we're going to increase their effexor from 225 to 300mg because that will give them more energy and motivation because of the increased NE/Ser reputake ratio at this dose, and then bill their insurance to support our comfy salaries and go about our day as if the mechanism of Effexor(or the dose of effexor in general) has a darn thing to do with how the pt is truly functioning.....

If that's your takeaway of Szasz, you should probably re-read him as you missed his message.

His dispute wasn't with psychiatry being ruled by psychopharmacology, his dispute was with the idea of mental illness. He wasn't primarily one of these "the meds don't work" guys like you're implying. He was a "mental illness is a myth" guy. One of the originals.

 

[F0nzie]

I think everything is a myth. My delicious chilli verde yesterday was out of this world but then it made me really sick. Why is that?

 

[Ibid]

Poignant: Szasz on the "Myth of Death"

[FONT=Arial, Helvetica, sans-serif]What is "death"? In fact there is no objective reality to what we call "death." .

[FONT=Arial, Helvetica, sans-serif][FONT=Arial, Helvetica, sans-serif]"Death" is simply the name we give to people whose behavior (typically lying down and doing nothing) we neither understand nor approve. By labeling it "death," we pretend that we understand it and enfranchise a panoply of actions to be taken ostensibly in the interest of the "dead" but, in fact, as we shall show, serving primarily to derogate and persecute those we call "dead." We give no sustained care to "dead" people. We take away their vote (except in Cook County, Illinois). We deprive them of food. "Death" therefore, is but a self-fulfilling prophecy. .

[FONT=Arial, Helvetica, sans-serif][FONT=Arial, Helvetica, sans-serif]The rhetoric of death serves to aggrandize and provide employment for those who "treat" the "dead." Surely, if there are "dead" people, we must train others to "take care of them." The harsh truth is that "alive" morticians need "dead" people more than "dead" people need morticians. .
[FONT=Arial, Helvetica, sans-serif][FONT=Arial, Helvetica, sans-serif]"Death" is a metaphor, despite the public's treatment of the term as reality. When we as a society see no purpose in behavior, we call the person or behavior "dead." The metaphor is now ubiquitous in lay usage. A party may be called "dead." We even have, as I. A. Richards (1936) explains in The Philosophy of Rhetoric, "dead metaphors." The metaphor of death is the prevailing ultimate term of derogation. In short, any phenomenon not conforming to our standards may risk being labeled "dead." .

[FONT=Arial, Helvetica, sans-serif][FONT=Arial, Helvetica, sans-serif]The behavior we call "death" cannot be considered apart from the context within which it occurs. It is no coincidence that elderly people, who are singularly ignored or patronized in our society, are the ones who most frequently demonstrate the behavior we call "death." This is perhaps the ugliest aspect of the taxonomy of "death." It is a scheme of categorization superimposed upon those who can least well defend themselves: the old, the injured, and the critically ill. .
[FONT=Arial, Helvetica, sans-serif][FONT=Arial, Helvetica, sans-serif]Let us examine, now, from a new perspective the behavior that we have traditionally labeled "death." Let us consider "death" not as nonexistence, whatever that means, but as an iconic body sign. It is an expression of nondiscursive symbolism whose meaning lies within the "dead" person. "Death" is communication. Let us ask ourselves, therefore, the following question: Since "death," as all behavior is learned, how does it function within its given psychosocial context? .

[FONT=Arial, Helvetica, sans-serif](more here).
[FONT=Arial, Helvetica, sans-serif]http://www.szasz.com/vatzremarks.html.


.....

 

[Iwillheal]

I think everything is a myth. My delicious chilli verde yesterday was out of this world but then it made me really sick. Why is that?

Szasz is sort of like an old guy in a hospital cafeteria who suddenly starts yelling, You call this piece of crap "food"? I suppose lots of people thought the food was not that good but nobody wanted to get up and make a big fuss about it. I mean life is full of things like that, and why make a big deal about this as oppose to something else? *takes a deep breath* But he did, and the cooks hated him for making them out to be some kind of uncaring evil people and some people wished he'd just shut up and sit down, and in fact even when the food got better partly because of his incessant complaints he'd still not shut up, and some said he is just a paranoid old man whose paranoia du jour is the cooking in hospital cafeteria and that he is being real stupid by trying to even stop some people from eating but dammit I admire him for whatever part he played in getting the debate started and being a force for change by challenging the most basic assumptions of what...food...really is, even if I did not like how he went about it or how he made some personal attacks

*takes a deep breath*