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Libertarian Principles and Psychiatric Practices: Are They Compatible?

Thursday, September 25, 2003
4:00 pm

Featuring distinguished lecturer, Thomas Szasz.

The Cato Institute
1000 Massachusetts Avenue, NW
Washington, DC 20001

Thomas Szasz is a pioneering critic of the psychiatric establishment and a leading libertarian thinker. His many books include The Myth of Mental Illness, Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers, and The Therapeutic State. In this lecture he will draw on his most recent book, Liberation by Oppression: A Comparative Study of Slavery and Psychiatry, and his work in progress, Faith in Freedom: Libertarian Principles and Psychiatric Practices, to argue that the greatest and most immediate domestic threat to individual liberty is psychiatry. He will show why this is the case, discuss how this situation came into being, and consider the diverse libertarian responses to it.

Link: http://www.cato.org/events/030925f.html

From the Thomas Szasz website: http://www.szasz.com

The purpose of this site is to advance the debate about Thomas S. Szasz's basic ideas and their practical implications. He suggests the following summary statement as a manifesto...

  • "Myth of mental illness." Mental illness is a metaphor (metaphorical disease). The word "disease" denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term "mental illness" refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. As the whale is not a fish, mental illness is not a disease. Individuals with brain diseases (bad brains) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad behaviors), like societies with economic diseases (bad fiscal policies), are metaphorically sick. The classification of (mis)behavior as illness provides an ideological justification for state-sponsored social control as medical treatment.

  • Separation of Psychiatry and the State. If we recognize that "mental illness" is a metaphor for disapproved thoughts, feelings, and behaviors, we are compelled to recognize as well that the primary function of Psychiatry is to control thought, mood, and behavior. Hence, like Church and State, Psychiatry and the State ought to be separated by a "wall." At the same time, the State ought not to interfere with mental health practices between consenting adults. The role of psychiatrists and mental health experts with regard to law, the school system, and other organizations ought to be similar to the role of clergymen in those situations.

  • Presumption of competence. Because being accused of mental illness is similar to being accused of crime, we ought to presume that psychiatric "defendants" are mentally competent, just as we presume that criminal defendants are legally innocent. Individuals charged with criminal, civil, or interpersonal offenses ought never to be treated as incompetent solely on the basis of the opinion of mental health experts. Incompetence ought to be a judicial determination and the "accused" ought to have access to legal representation and a right to trial by jury.

  • Abolition of involuntary mental hospitalization. Involuntary mental hospitalization is imprisonment under the guise of treatment; it is a covert form of social control that subverts the rule of law. No one ought to be deprived of liberty except for a criminal offense, after a trial by jury guided by legal rules of evidence. No one ought to be detained against his will in a building called "hospital," or in any other medical institution, or on the basis of expert opinion. Medicine ought to be clearly distinguished and separated from penology, treatment from punishment, the hospital from the prison. No person ought to be detained involuntarily for a purpose other than punishment or in an institution other than one formally defined as a part of the state's criminal justice system.

  • Abolition of the insanity defense. Insanity is a legal concept involving the courtroom determination that a person is not capable of forming conscious intent and, therefore, cannot be held responsible for an otherwise criminal act. The opinions of experts about the "mental state" of defendants ought to be inadmissible in court, exactly as the opinions of experts about the "religious state" of defendants are inadmissible. No one ought to be excused of lawbreaking or any other offense on the basis of so-called expert opinion rendered by psychiatric or mental health experts. Excusing a person of responsibility for an otherwise criminal act on the basis of inability to form conscious intent is an act of legal mercy masquerading as an act of medical science. Being merciful or merciless toward lawbreakers is a moral and legal matter, unrelated to the actual or alleged expertise of medical and mental health professionals.

  • In 1798, Americans were confronted with the task of abolishing slavery, peacefully and without violating the rights of others. They refused to face that daunting task and we are still paying the price of their refusal. In 1998, we Americans are faced with the task of abolishing psychiatric slavery, peacefully and without violating the rights of others. We accept that task and are committed to working for its successful resolution. As Americans before us have eventually replaced involuntary servitude (chattel slavery) with contractual relations between employers and employees, we seek to replace involuntary psychiatry (psychiatric slavery) with contractual relations between care givers and clients.


    ( 11 comments — Leave a comment )
    Dec. 17th, 2003 03:26 pm (UTC)
    OK. What does he propose doing with the criminally insane? Or does he think people have a right to commit crimes against others as a form of liberty?
    Dec. 17th, 2003 03:29 pm (UTC)
    I guess what I am asking is, does he not believe in insanity at all? If not, what does he propose is "wrong" with the sociopath in society? Society?

    This really sounds like a load of crap to me... or schizophrenic logic :-p
    Dec. 17th, 2003 04:27 pm (UTC)
    does he not believe in insanity at all?

    He beleives in brain diseases. The difference between a brain disease and a mental illness is that doctors reach a diagnosis of brain disease based on the results of physical tests of the brain. Psychiatrists reach a diagnosis of "mental illness" based only on the behavior of the subject.

    He thinks some people go crazy, but sanity and insanity are legal terms, not psychiatric terms. Psychiatrists do not describe people as being sane or insane. His primary position is that it is immoral to inprison people who have committed no crime under the guise of providing them with treatment for "mental illness." Crazy people who commit crimes should be punished. Crazy people who have committed no crimes should be left alone unless they ask for help.
    Dec. 17th, 2003 04:36 pm (UTC)
    Re: does he not believe in insanity at all?
    I see a lot of people in home health who are crazy enough to be a danger to themselves or others, if you want a loose definition... including people with disorders as 'minor' as OCD, who hoard newspapers up to the ceiling and then get drunk and smoke in their apartments.

    Is society then supposed to leave these people to their own devices until something happens, on the principle that they are within their rights to cause potential harm to themselves or others?

    The problem with this theory is that all mental disorders have a way of being diagnosed that is physical, ie, there is obvious brain or chemical dysfunction that can be discerned by currently available tests. That isn't true. It may be true in a decade or two, but even now, many disorders are diagnosed by symptomology, even by ruling out physical ailments.

    Frankly, I don't trust a judge to decide whether someone is competent or not. That isn't their job, and they are not trained for it in law school.
    Dec. 17th, 2003 04:54 pm (UTC)
    Re: does he not believe in insanity at all?
    Is society then supposed to leave these people to their own devices until something happens, on the principle that they are within their rights to cause potential harm to themselves or others?

    He gives a very specific answer to that question at the end of the Cato Institute talk. I rather suspect his answer will suprise you.


    The problem with this theory is...

    Given the questions you're asking, I don't think you've assimilated enough of Dr. Szasz's position to reach a conclusion that begins with those words.
    Dec. 17th, 2003 04:01 pm (UTC)
    What does he propose doing with the criminally insane?
    He talks about that at length in the Cato Institute address, but the short answer to that question is that he advocates punishing people who commit criminal acts by putting them in prison.
    Dec. 17th, 2003 04:20 pm (UTC)
    Re: What does he propose doing with the criminally insane?
    Ya know, I can't help but think that's kind of unfair to people who really *are* crazy, as opposed to simply criminal. They generally don't do well in a prison environment, particularly those who don't have a good grasp of 'reality'.

    I have more compassion towards them than that, I suppose. Yes, there is a difference between insanity and incompetence, but I don't think the judgement of that should be whether a person felt something they did was right or wrong.

    A. Some people do not understand the concepts of 'right' or 'wrong'
    B. The concepts vary from culture to culture
    C. Some mental illnesses, particularly compulsive disorders, may drive a person to commit an act they 'know' is wrong, but that does not mean they are truly in control of their faculties/behavior.

    I think these people should be incarcerated... but not in prison.
    There are certainly flaws in the mental health system... but there are flaws in just about any system. To come close to a relevant case for this, I don't think we should throw the baby out with the bath water.

    Why is it 'better' to be evil than crazy? Or maybe not better, but preferable to judge other people as such? That seems like a cop out to me... that some crimes (such as drug trafficking) should be decriminalized (though it might result in death), while murder, even under duress or mental weakness, is punishable by incarceration.

    Dec. 17th, 2003 04:52 pm (UTC)
    LOL... bear in mind, I'm not debating you, per se, just this guy's theories. I have some personality quirks that might be classified as pathological, including my shamanic journeying and other 'mystical' beliefs and behaviors.

    I would hope, though, that if I were to become 'dangerous' that someone would perform an intervention and have me evaluated, at least. The catch-22 about liberty and insanity is that the people who really need treatment don't think they do... that is one of the main differences between being neurotic and psychotic ;-)

    Besides, there are an awful lot of homeless people who have mental disorders, which is a social problem, not simply a personal choice. We all know how homelessness is a vicious cycle, and people suspicious of the system simply disenfranchise themselves further from possible assistance.
    Dec. 17th, 2003 09:02 pm (UTC)
    I believe in insanity, for I am seeing it right here.
    The most greatest DOMESTIC threat to personal liberty is Psychiatry?

    He ever try waving a protest sign outside a "Free Speech" zone? I'd link to the article Prester Scott pointed out but it seems to have disappeared.

    Beyond that, there are tons of TOTALLY INSANE people who have no fear of being 'confined in a nuthouse'. These range from the Street Preecher to people on their 'own trip' (Allegedly Raelians and other UFO cultists) right down to the homeless people who will wince AWAY when offered money. This is not counting the number of insane in prison without any treatment who probably NEED confining. Anyone who just wants to be 'weird' but knows what they are doing has a ton of options ranging from disguising it as religion (possibly earning money) to attracting free legal help should any authority try to 'get' them. (Mr. Mobster, if I can keep THAT NUT out of the wacky house, look what I can do for you...)

    I really hope no one takes this person seriously. Otherwise, we'll be "Liberating" ourselves to a society that makes the one in Dicken's Novels seem warm and compassionate.
    Dec. 17th, 2003 10:04 pm (UTC)
    Re: I believe in insanity, for I am seeing it right here.
    I really hope no one takes this person seriously.

    I do and have for years. I think Dr. Szasz's book Our Right to Drugs: The Case for a Free Market is the most devestatingly insightful and incisive critical analysis of the prohibitionist mentality I've ever encountered.

    Check out this collection of quotes from Szasz:


    I'm guessing you didn't watch/listen to the Cato Institute speech. It's worth the time and effort to focus enough concentration on it to get thru his thick accent and follow the content of the talk thru to the end of the Q&A. There's some really good stuff there.

    Dec. 23rd, 2003 02:36 pm (UTC)
    I haven't been able to listen to the speech yet, but I'm happy to see stuff like this out there.

    I have a BA in Psychology and I got really frustrated with it when I was in school. The way I thought about it at the time (which still fits) was that psychology is structured on the belief that there are certain norms and whatever is not within the norms is not healthy. I didn't see anything that stopped to question whether the norms are healthy to begin with.

    In your first point, the whole question of biology is really interesting. There doesn't seem to be much debate in the psych community that some forms of depression and such are biological. It's generally known that people can change their biology in all sorts of ways, but I rarely see anything investing research in how to change biology without drugs.

    Ditto on all your points. I think that a lot of "mental illness" is actually spiritual in nature, which makes a stronger case for the State staying out of it.
    ( 11 comments — Leave a comment )

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