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Summary Article: Szasz, Thomas from Cultural Sociology of Mental Illness: An A-to-Z Guide

Thomas Szasz was born on April 15, 1920, in Budapest, Hungary. He moved to the United States with his family in 1938, where he studied at the University of Cincinnati, and subsequently graduated as valedictorian with a medical degree in 1944. He spent his career as a psychiatrist, writer, and academic. Szasz authored 35 books that have been translated into many languages, as well as hundreds of journal articles.

Szasz worked briefly at Cincinnati General Hospital before moving to the Chicago Institute for Psychoanalysis, where he gained his diploma and then worked for the next five years. During this time, Szasz also spent two years in military service with the U.S. Navy. He joined the State University of New York (SUNY) faculty, where he gained tenure in 1962, and remained there until his retirement in 1990. Szasz continued to publish prolifically after retirement, until his death on September 8, 2012, aged 92.

Szasz has frequently been associated with the antipsychiatry movement; however, he did not accept this and was negative toward both the label and those most closely associated with it, for example, R. D. Laing. Szasz believed in the validity of noncoercive psychiatric practice, but he opposed involuntary psychiatric interventions. In addition, he argued against the categories that psychiatrists had developed with regard to mental illness. Instead, Szasz contended that these were meaningless and without scientific validity. Szasz believed strongly that mental illness does not exist in the way that it has been defined by the psychiatric profession. He further argued that treating this behavior medically therefore represents both coercive practice and the exercise of control by the psychiatric community.

Szasz described mental illness as a myth, and at best merely a metaphor. He saw the context of behavior as crucial in defining mental illness, stating that “If you talk to God, you are praying; if God talks to you, you have schizophrenia.” He outlined his theories in 1961, with the publication of The Myth of Mental Illness. This book was published during a time of some crisis for psychiatry generally, with the emergence of the antipsychiatry movement. Szasz argued that mental illness was a pseudoscientific term. He contended that illness or disease must be related to the body, not the mind, and that mental illness can therefore only exist as a metaphor.

He argued that the popular approach to mental illness as disease, while understandable given some of the similarities, is flawed. Given that the term mental illness generally refers to undesirable thoughts, feelings, and behaviors, he contended that mental illnesses are problems with living, as opposed to the result of any observable pathology. Szasz attacked psychiatry for categorizing such behaviors and suggested that this process of categorization and the labeling of patients as diseased was an attempt to exert control. He thus saw the medicalization of behavior as an exhibition of power that removed free will and responsibility from people. Szasz further argued that the true nature of disease is manifested in pathology at the cellular or molecular level. His position was that if one cannot measure or test something in a scientific way, as he contended was the case with mental illness, then it should not be labeled as disease. Szasz advocated a libertarian view of freedom and suggested that human freedom should only be restricted by a criminal act. He saw human beings as free agents and, as such, fully responsible for their actions.

Szasz felt that individual competence should be a matter for the legal system to decide. He argued against the assumption that medical professionals, and mental health workers more generally, possess the ability to determine the correct course of action for someone exhibiting behaviors seen as undesirable. He therefore suggested that in legal settings, expert witnesses should not be allowed to testify regarding the mental state of an accused individual, for example, in support of an insanity defense.

Szasz's views were criticized by many of his peers. It was suggested that his theories could do damage to people who were suffering. Critics suggested that people are not always in a position to take responsibility for their actions because of what they are experiencing. However, at the core of Szasz's arguments was a genuine concern for those who were suffering. His pro-psychiatry stance can be overlooked, with his theories misrepresented as anti-intervention, rather than anticoercion over antimedicalization. Szasz's critics further suggest that mental illnesses can and are now approached and measured in a scientific way, thereby rejecting Szasz's main argument that mental illness is a myth and cannot be considered as disease. These critics include the American Medical Association (AMA) and the American Psychiatric Association (APA).

Szasz is recognized as one of the foremost critics of psychiatry, coercion, and medical treatments for behavior. His criticisms of psychiatry focused on practices that restricted freedoms, questioning the legitimacy of such approaches. This concern and his unwavering defense of personal freedom and responsibility led the American Humanist Association to honor him as Humanist of the Year in 1973. His championing of individual rights against the power of medical authority has influenced some current psychiatric practice, such as user-led approaches.

See Also: American Psychiatric Association Antipsychiatry Biological Psychiatry Medicalization, History of Medicalization, Sociology of

Further Readings
  • Szasz, Thomas.Debunking Antipsychiatry: Laing, Law, and Largactil.” Existential Analysis, v. 19 (2008).
  • Szasz, Thomas. The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. Paul B. Hoeber New York, 1961.
  • Szasz. Thomas. The Second Sin. Doubleday Garden City NY, 1973.
  • James Edward Houston
    Nottingham Trent University
    © 2014 SAGE Publications, Inc

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