defines psychiatry as "a branch of medicine that deals with
mental, emotional, or behavioral disorders"; Wikipedia, as
"a medical specialty which exists to study, prevent, and
treat mental disorders in humans." These descriptions do
not tell us what the psychiatrist does and is expected, legally
and professionally, to do. That non-disclosure disguises the ugly
truth: psychiatry is coercion masquerading as care. It is testimony
to the effectiveness of that feeble disguise – and of our aversion
to recognizing embarrassing truths about ourselves and our honored
institutions – that most libertarian writers have given, and continue
to give, psychiatry a free ride.
are distinguished by the diagnostic and therapeutic methods that
characterize their work: the pathologist examines cells, tissues,
and body fluids; the surgeon cuts into the living body, removes
diseased tissues, and repairs malfunctioning body parts; the anesthesiologist
renders the patient unconscious and insensitive to pain; and the
psychiatrist coerces and excuses: he identifies innocent persons
as "mentally ill and dangerous to themselves and others"
and deprives them of liberty, and he excuses people of their responsibilities
for their actions and obligations by testifying in court under
oath that persons guilty of lawbreaking are not responsible for
their criminal acts. The former practice is called "civil
commitment," the latter, "the insanity defense."
These legal-psychiatric interventions constitute the pillars upon
which the edifice called "psychiatry" rests.
To be sure,
psychiatrists also listen and talk to persons who seek their help.
However, this does not distinguish them from others; nearly everyone
does that. The difficulty peculiar to psychiatry – obvious yet
often overlooked – is that the term refers to two radically different
kinds of practices: curing-healing "souls" by conversation, and
coercing-controlling persons by force, authorized and mandated
by the state. Critics of psychiatry, journalists, and the public
alike regularly fail to distinguish between the linguistic practice
of counseling voluntary clients and the forensic practice of coercing-and-excusing
captives of the psychiatric system.
and butter of the modern psychiatrist is: 1) writing prescriptions
for psychoactive drugs and pretending that they are therapeutically
effective against mental illnesses; 2) prescribing these drugs
to persons willing to take them and forcibly compelling persons
deemed "seriously mentally ill" to take them against
their will; and 3) converting voluntary mental patients who appear
to be "dangerous to themselves or others" to involuntary
mental patients. Indeed, the modern psychiatrist no longer has
the option to reject the use of force vis-à-vis patients:
such conduct is considered dereliction of professional responsibility.
my efforts to undermine the moral legitimacy of the alliance of
psychiatry and the state suffered a serious blow: the creation
of the antipsychiatry movement. Voltaire’s famous aphorism, "God
protect me from my friends, I’ll take care of my enemies,"
proved to apply perfectly to what happened next: although my critique
of the alliance of psychiatry and the state antedates by two decades
the reinvention and popularization of the term "antipsychiatry,"
I was smeared as an antipsychiatrist and my critics wasted no
time identifying and dismissing me as a "leading antipsychiatrist."
establishment’s rejection of my critique of the concept of mental
illness and its defense of coercion as cure and of excuse-making
as humanism posed no danger to my work. On the contrary. Contemporary
"biological" psychiatrists tacitly recognized that mental
illnesses are not, and cannot be, brain diseases: once a putative
disease becomes a proven disease it ceases to be classified as
a mental disorder and is reclassified as a bodily disease; or,
in the persistent absence of such evidence, a mental disorder
becomes a nondisease. That is how one type of madness, neurosyphilis,
became a brain disease, while another type, masturbatory insanity,
became reclassified as a nondisease.
the more aggressively I reminded psychiatrists that individuals
incarcerated in mental hospitals are deprived of liberty, the
more zealously psychiatrists insisted that "mental illnesses
are like other illnesses" and that psychiatric institutions
are bona fide medical hospitals. The psychiatric establishment’s
defense of coercions and excuses thus reinforced my argument about
the metaphorical nature of mental illness and importance of the
distinction between coerced and consensual psychiatry.
I have long
maintained that mental illnesses are counterfeit diseases (nondiseases),
that coerced psychiatric relations are like coerced labor relations
(slavery), and spent the better part of my professional life criticizing
the concept of mental illness, objecting to the practices of involuntary-institutional
psychiatry, and advocating the abolition of psychiatric slavery.
In the late
1960s, a group of psychiatrists, led by David Cooper (1931–1986)
and Ronald D. Laing (1927–1989), began to criticize conventional
psychiatry, especially so-called somatic treatments. But instead
of advocating the abolition of Institutional Psychiatry, they
sought to replace it with their own brand, which they called "Anti-Psychiatry."
By means of this dramatic misnomer, they attracted attention to
themselves and deflected attention from what they did, which continued
to include coercions and excuses based on psychiatric authority
and power. Thus, antipsychiatry is a type of psychiatry. The psychiatrist
qua health-care professional is a fraud, and so too is the antipsychiatrist.
In Psychiatry: The Science of Lies, I showed that psychiatry –
an imitation of medicine – is a form of quackery. In this volume,
I show that antipsychiatry – a form of alternative psychiatry
– is quackery squared.
form no part of either psychiatry or antipsychiatry and belong
to neither. They belong to conceptual analysis, social-political
criticism, the defense of liberty, and common sense. This is why
I rejected, and continue to reject, psychiatry and antipsychiatry
with equal vigor.
is an edited extract from Antipsychiatry:
Quackery Squared, by Thomas Szasz, to be published by Syracuse
University Press, September 2009.