Monthly Archives: September 2012

The Quotable Thomas Szasz (April 15, 1920 – September 8, 2012)

(If you want to skip my comments, the quotations are at the end of this post.)

I came across Thomas Szasz’s The Myth of Mental Illness many years ago, after I had spent several years with the New York State Narcotic Control Commission, which operated under the jurisdiction of the Department of Mental Health. His premise, as stated in the title of the book, was startling. But I had already developed my own attitudes toward psychiatry based on personal experiences–it seemed I could never talk to anyone at a party or even in a one-on-one conversation without the person, sometimes a total stranger, saying, “My therapist says…” or in some other way introducing their therapy into the conversation as if it were as relevant as the weather–as well as a result of my years with the NACC.

For one thing, the psychiatrist at the facility where I worked ranked above and could overrule the director, held a higher grade, in civil service terminology. As well, I sometimes sat in on case reviews at which the psychiatrist ruled with as iron a will as anything I had seen in my days as a Catholic school student. I recall asking about the reasoning for an interpretation of a particular addict’s drawing (drawings of houses were used as indicators of personality disorders). The psychiatrist’s response was hostile and dismissive, more or less telling me that as a layman I should keep quiet and defer to the judgment of professionals like himself. I wasn’t, of course, denying the validity of his interpretation, just asking for the reasoning behind it.

Also, the agency operated with a flagrant disregard for the Constitution and eventually was brought to court on that account, though not until many years of functioning outside its bounds. I kept, for instance, a stack of warrants in my desk drawer. If I wanted someone arrested and brought to our facility–usually for failure to keep his weekly or bi-weekly appointments with me or because he had given a “dirty” urine–I had only to pull one out and sign it. Legally, I was doing so under the authority of the facility director, but practically I was more or less on my own. And constitutionally, I was behaving like King George.

There were plenty of other problematic issues with the way the agency operated, but they became moot when the state legislature stopped funding it and it began farming out its patients to private drug programs.

Meanwhile, many if not most of the staff I worked with had therapists. It was, again, very reminiscent of the religious environment in which I had been raised and educated, though I didn’t make a lot of conscious connections at the time. It wasn’t until much later, especially after I became involved with someone who had two family members diagnosed as schizophrenic that my thoughts began to take a more conscious, coherent shape.

I discovered Szasz’s book after the great discharge of mental patients from institutions to aftercare in the late 1960s and early 1970s, but it was and still is a radical point of view. My more recent readings about the more recent psycho-pharmacological treatment of so-called mental patients has convinced me that nothing has changed except the means of confinement. For this you might want to look into Robert Whitaker’s Mad in America: Bad Medicine and the Enduring Mistreatment of the Mentally Ill. And, of course, Michel Foucault’s Madness and Civilization. Foucault, like Szasz, was a fierce opponent of social control masquerading as medicine.

For the full Szasz interview you can go to: http://www.psychotherapy.net/interview/thomas-szasz

The quotes:

My premise is that responsibility is, morally speaking, anterior to
liberty. So if a person wants to gain more freedom — in relation to his
fears, his wife, his work, etc. — he must first assume more responsibility
(than he has been) toward them; then he will gain more liberty in relation
to them....

The goal is to assume more responsibility and therefore gain more
liberty and more control over one's own life. The issues or questions
for the patient become to what extent is he willing to recognize his
evasions of responsibility, often expressed as "symptoms."...

It is the hallmark of totalitarianism that there can be no personal
secrets from the state. That's why I call our present political system a
"therapeutic state." Such a state is your friend, your benefactor, your
doctor. Why should you want to hide anything from it?...

Modern psychotherapy is based on psychoanalysis, and the psychoanalytic
relationship was based on the relationship between priest and penitent
in the confessional. The crux of the confessional is self-accusation on
the part of the penitent, and the secure promise, by the priest, that
the confession he hears will and can have no consequences for the
self-accuser in this world (but only in the next). A priest hearing
confession and working as a spy for the state would be a moral
obscenity. Not in the darkest days of totalitarianism did such a thing
occur....

The same thing is true for psychotherapy based on confidentiality and on
the premise that the patient "accuses" himself in the hope that, by so
doing and with the help of the therapist, he might be able to change
himself....

What is truly ugly about psychotherapy today is that many patients labor
under the false belief that what they say to the therapist is
confidential, and that therapists do not tell patients, up front, that
if they utter certain thought and words, the therapist will report them
to the appropriate authorities, they may be deprived of liberty, of
their job, of their good names, and so forth....

Of course it [hostility to his ideas] did [concern him], especially when people
actually wanted to injure me — personally, professionally, legally. No
need to get into that. I tried to protect myself and escaped, luckily
enough. I found boundless support in literature, in the great writers.
Ibsen said, among other things, that "the compact majority is always
wrong."...

Where should I start, there are many? Shakespeare, Goethe, Adam Smith,
Jefferson, Madison, John Stuart Mill, Mark Twain, Mencken. Tolstoy,
Dostoyevski, Chekhov. Orwell, C.S. Lewis. Ludwig von Mises, F.A. Hayek.
Camus and Sartre, though personally and politically, he is rather
despicable. He was a Communist sympathizer. He was willing to overlook the
Gulag. But he was very insightful into the human condition. His
autobiography is superb. His book on anti-Semitism is important.... Yes,
Camus broke with him, mainly about politics. Camus was a much better
person, a much more admirable human being. He was also a terrific
writer.
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9/11 2012

Another anniversary. Not decimal like last year’s and therefore not as important. But to be observed nonetheless.

There’s a new tower where the Twin Towers used to stand. I could see it if I wished from the rooftoop of my building. But I haven’t done so yet, maybe for the same reason I didn’t go up there to watch the original buildings burn and fall. I was too far away to have seen people flying out of windows above where the planes struck, but I was on the phone with someone who was a good deal closer and was watching from her own rooftop. Quite a different matter from observing via television–one channel was still managing to broadcast, all the others having had their antennas on the roof of WT2. Television made it seem less real, like the person a friend at Ground Zero saw emerging from a nearby subway exit who looked up and said,”‘Oh, they must be making a movie.”

There’s a memorial at the base of that new tower. The governor and the city’s mayor are wrangling about who pays for what, so the planned museum is on hold. Once it got under way, the new tower, Freedom Tower, went up quickly, or at least that was how it seemed to me. I find the name embarrassing, reminiscent of George Bush’s insistence that “they hate us for our freedoms.” His, though, was the only explanation I heard anyone of national prominence try to make for why those nineteen, mostly university-educated, hijackers did what they did. At least, his was the only reason I can recall being put forward by anyone who had the nation’s attention. Of course, it wasn’t so much an explanation as an assertion, self-explanatory, axiomatic.

One of my own first and most lasting thoughts about what happened that day is, what a luxury to be able to memorialize, at one’s leisure, as it were, a horrendous event like 9/11. Other people in other places where terrible things happen don’t have the time to memorialize, their attention already taken up by the next horrible thing that’s taking place, and then the next. But our own national tragedies are discrete, one-offs, separated by such long gaps of time that we can afford to wrangle about who pays for what and who is an appropriate speaker and who is not (no politicians this year, I understand). The violent events that took place on our soil stand out in our historical memory, begging for books to be written and documentaries to be made.

Pearl Harbor. The Shirtwaist Fire. The sinking of the Maine. The Alamo. The burning of the White House. Oklahoma City. Even the Civil War. And now, 9/11. They are singular and fixed in time, ripe for mythologizing and memorializing. We may worry and take care that nothing of the kind reoccurs. And nothing has in fact happened since September, 2001, unless you count what took place in New Orleans in 2005, an atrocity we seem to have cooperatively agreed we will not think about because it was our own fault and therefore who else can we blame.

Elsewhere, it’s another matter. If you happened to be living in a place that is experiencing war firsthand, you don’t have the luxury of forever memorializing. Who in the Congo can be thinking of memorializing the 6 million dead there since the start of that war several years ago? Less recently, who in Vietnam could start worrying about who would pay for which memorial while the bombs were still falling? And before that, who worried about memorials for those incinerated by incendiary bombs dropped on apartment houses and houses made of paper and tinder? Did anyone find the time to care how many and what kind of memorials would be erected to the victims of the Nazi concentration camps when a war still had to be fought and won? Has anyone put up a memorial in Baghdad to the 500,000 children who died as a result of the economic sanctions of the 1990s? That figure was not only not denied by our government, it was pronounced “worth it” by our secretary of state. You can see her do so on YouTube.

But no bombs have fallen on us, unless you count those passenger planes as such.  In any case, 9/11 took place in one day and ever since we have had the time to think about it and fight about who pays for the health care of workers made sick by the debris and whether the state or the city should foot the bill for a museum. Life has been normal since then, at least on the surface, though legions of police and other government agents are at work day and night ferreting out new plots, and laws that used to be considered unthinkable in a democracy like ours are accepted without much objection.

Today, like September 11, 2001, is bright and blue and breezy and a Tuesday. A couple hours after the planes hit, the plume of smoke, blown by a northerly wind, deposited ash and debris on the trees and parked cars outside my windows. It looked like a snowfall on a  planet devoid of water. Later, in the afternoon, I was sitting in Prospect Park when a fresh wave of foul-smelling air descended, and paper–memos? computer printouts? files?–floated down, singed but otherwise intact. Souvenirs, I thought. Memorials.