The term “mental illness” implies that persons with such illnesses are more likely to be dangerous to themselves and/or others than are persons without such illnesses. This is the source of the psychiatrist’s traditional social obligation to control “harm to self and/or others,” that is, suicide and crime. The ethical dilemmas of psychiatry cannot be resolved as long as the contradictory functions of healing persons and protecting society are united in a single discipline.Life is full of dangers. Our highly developed (...) consciousness makes us, of all living forms in the universe, the most keenly aware of, and the most adept at protecting ourselves from, dangers. Magic and religion are mankind’s earliest warning systems. Science arrived on the scene only about 400 years ago, and scientific medicine only 200 years ago. Some time ago I suggested that “formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic”.1We flatter and deceive ourselves if we believe that we have outgrown the apotropaic use of language .Many people derive comfort from magical objects , and virtually everyone finds reassurance in magical words . The classic example of an apotropaic is the word “abracadabra,” which The American Heritage Dictionary of the English Language defines as “a magical charm or incantation having the power to ward off disease or disaster”. In the ancient world, abracadabra was a magic word, the letters of which were arranged in an inverted pyramid and worn as an amulet around the neck to protect the wearer against disease or trouble. One fewer letter appeared in each line of the pyramid, until only the letter “a” remained to form the vertex of the triangle. As …. (shrink)

Now available in a Harper Colophon edition, this classic book has revolutionized thinking throughout the Western world about the nature of the psychiatric profession and the moral implications of its practices. Book jacket.

I thank Brassington for his reply, especially for stating “that there is rather a lot going for Szasz's argument, and I agree broadly with the conclusion”. In further support of my thesis regarding the fictitious nature of mental illness as a disease similar to diseases of bodily organs, I add the reminder that, prior to the sixteenth century, the word “mind” meant only minding. The birth of the concept of mind as an entity and of the term “mind” as a (...) noun is the symptom of the metamorphosis of the mediaeval, religious view of the world into the modern, scientific view of it. (shrink)

Prior to the second world war, most persons confined in insane asylums were regarded as legally incompetent and had guardians appointed for them. Today, most persons confined in mental hospitals are, in law, competent; nevertheless, in fact, they are treated as if they were incompetent. Should the goal of mental health policy be providing better psychiatric services to more and more people, or the reduction and ultimate elimination of the number of persons in the population treated as mentally ill?

I appreciate Professor Boyd’s offer to respond to the respondents of my essay, as it gives me an opportunity to thank them for their carefully considered comments.1–3In The Subjection of Women, John Stuart Mill sought to clarify the traditional subjection of women to men by comparing the institution of marriage with the ….

Neurofeedback is a complex learning scenario, as the task consists of trying out mental strategies while processing a feedback signal that signifies activation in the brain area to be self-regulated and acts as a potential reward signal. In an attempt to dissect these subcomponents, we obtained whole-brain networks associated with efficient self-regulation in two paradigms: parallel, where the task was performed concurrently, combining feedback with strategy execution; and serial, where the task was performed consecutively, separating feedback processing from strategy execution. (...) Twenty participants attempted to control their anterior midcingulate cortex using functional magnetic resonance imaging NF in 18 sessions over 2 weeks, using cognitive and emotional mental strategies. We analyzed whole-brain fMRI activations in the NF training runs with the largest aMCC activation for the serial and parallel paradigms. The equal length of the strategy execution and the feedback processing periods in the serial paradigm allows a description of the two task subcomponents with equal power. The resulting activation maps were spatially correlated with functionally annotated intrinsic connectivity brain maps. Brain activation in the parallel condition correlates with the basal ganglia network, the cingulo-opercular network, and the frontoparietal control network ; brain activation in the serial strategy execution condition with the default mode network, the FPCN, and the visual processing network; while brain activation in the serial feedback processing condition predominantly with the CON, the DMN, and the FPCN. Additional comparisons indicate that BG activation is characteristic to the parallel paradigm, while supramarginal gyrus and superior temporal gyrus activations are characteristic to the serial paradigm. The multifaceted view of the subcomponents allows describing the cognitive processes associated with strategy execution and feedback processing independently in the serial feedback task and as combined processes in the multitasking scenario of the conventional parallel feedback task. (shrink)

Is insanity a myth? Does it exist merely to keep psychiatrists in business? In Insanity: The Idea and Its Consequences, Dr. Szasz challenges the way both science and society define insanity; in the process, he helps us better understand this often misunderstood condition. Dr. Szasz presents a carefully crafted account of the insanity concept and shows how it relates to and differs from three closely allied ideas—bodily illness, social deviance, and the sick role.

Szasz argues that the word schizophrenia does not stand for a genuine disease, that psychiatry has invented the concept as a sacred symbol to justify the practice of locking up people against their will and treating them with a variety of unwanted, unsolicited, and damaging interventions.

"The complete list of the works of Thomas S. Szasz": pages 237-253.

This intriguing book undercuts everything you thought you knew about psychotherapy.

The essays assembled in this volume reflect my long-standing interest in moral philosophy and my conviction that the idea of a medical ethics as something ...

Obsessed with the twin beliefs that misbehavior is a medical disorder and that the duty of the state is to protect adults from themselves, we have replaced criminal-punitive sentences with civil-therapeutic 'programs.' The result is the relentless loss of individual liberty, erosion of personal responsibility, and destruction of the security of persons and property - symptoms of the transformation of a Constitutional Republic into a Therapeutic State, unconstrained by the rule of law.

The invention of psychopathology -- Malingering -- Doctoring -- Inculpating -- Sheltering -- Cheating -- Lying -- The burden of responsibility.

Classically controversial Szasz here challenges "modern" science's attempts to define the human mind as merely a collection of brain functions.

The religious justification for male circumcision proffered by Jewish and Islamic parents is frequently overlooked in current secular (medical/hygienic) discussions that (1) challenge the moral justification of this ancient practice, and (2) question the decisions of today's parents who are committed, on the basis of their religious beliefs, to continue this practice. This paper reviews critically these conflicting values and arguments and calls for compromise in the face of potential state intervention to coerce parents to abandon this practice. Keywords: disease (...) prevention, medicalization, mutilation, religious values, routine neonatal circumcision, therapeutic state CiteULike Connotea Del.icio.us What's this? (shrink)

In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris (...) to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. (shrink)

Psychiatric abuse, such as we usually associate with practices in the former Soviet Union, is related not to the misuse of psychiatric diagnoses, but to the political power intrinsic to the social role of the psychiatrist in totalitarian and democratic societies alike. Some reflections are offered on the modern, therapeutic state's proclivity to treat adults as patients rather than citizens, disjoin rights from responsibilities, and thus corrupt the language of political-philosophical discourse.

Antipsychiatry : alternative psychiatry -- The doctor of irresponsibility -- The trickster and the tricked -- Antipsychiatry and anti-art -- Antipsychiatry abroad.

This is a brief comment on Christopher Megone's essay appearing in this issue. Cells, tissues, organs, and human beings qua biological organisms have natural functions, but human beings qua agents do not. Persons-in-society, unlike organs-in-bodies, are the products of culture, not simply of nature. Bodily disease is defined as a deviation from an objectively identifiable biological norm. The natural function of the kidney is to secrete urine; uremia is a literal disease. The social function of adults in American society includes (...) mingling with others in places away from home; "agoraphobia" may thus be called a metaphorical disease. In short, typhoid fever is a literal illness or disease; spring fever is a metaphorical illness or nondisease. Megone, however, rejects the claim that literal diseases "are physical disorders." Would he regard spring fever as a "real disease"? If not, why not? (shrink)

The practice of psychiatry rests on two pillars: mental illness and involuntary mental hospitalization. Each of these elements justifies and reinforces the other. Traditionally, psychiatric coercion was unidirectional, consisting of the forcible incarceration of the individual in an insane asylum. Today, it is bidirectional, the forcible eviction of the individual from the mental hospital supplementing his or her prior forcible incarceration in it. So intimate are the connections between psychiatry and coercion that noncoercive psychiatry, like noncoercive slavery, is an oxymoron.

The author examines the existential, historical, and political roots of psychiatric power, locating them, respectively, in the universality of guilt feelings and the desire to escape them, in psychiatry (replacing religion) as an institution offering surcease from such (and similar disturbing) feelings, and in the alliance, in modern societies, between psychiatry and the state. Clinical psychiatry and psychoanalysis, each in its own distinctive way, have served to legitimize the uses of psychiatric power. Liberty from coercive psychiatry requires destroying the legitimacy, (...) and hence power, of coercive psychiatric principles and practices. (shrink)

I thank Professor Fulford for giving me an opportunity to comment on Bracken and Thomas’s essay. Unfortunately, this requires accepting the authors’ focus on discourses rather than deeds, on what psychiatrists say and how they say it rather than on what psychiatrists do and how they justify it. This I cannot do in good conscience. Nevertheless, out of respect to Professor Fulford and the journal Philosophy, Psychiatry, & Psychology, as well as a sense of professional obligation, I offer herewith my (...) brief comments. Bracken and Thomas are not the first persons to compare my work with Foucault’s, nor the first to comment on my writing style. In 2001, a pseudonymous blogger posted this comment (still .. (shrink)

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an (...) 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (shrink)