By Thomas
Szasz
Life is an
unending series of choices and, therefore, “problems inThe Therapeutic State living.” Ordinary
choices—what to have for breakfast—we ignore as trivial. Extraordinary
choices—whether to kill ourselves (or worse)—we dismiss as the symptoms of
mental illness. The profession of psychiatry rests on, and caters to, the
ubiquitous human desire to avoid, evade, and deny the very possibility of
morally “unthinkable” choices. We use the rhetoric of psychiatry to transform
such choices into medical-technical problems and “solve” them by appropriate
“medical treatments.” This is why deception and prevarication are intrinsic to
the principles of psychiatry, and fraud and force are intrinsic to its
practices.
We humans are
choice-making animals. The freedom to make choices is both a blessing and a
curse. Depending on age, temperament, information, and alternatives, some
people experience the opportunity for choice as exhilarating, others as
tormenting. Traditionally, it was one of the functions of religion to relieve
people of choices. Today, psychiatry and the therapeutic state perform the same
job.
Karl Jaspers
(1883–1969)—the great twentieth-century German
psychiatrist-turned-philosopher—understood this. But he identified only one
part of this drama, the patient’s: “Generally formulated, we may say that these
people [“neurotics”] are determined that events for which they are accountable
and in which they are understandably concerned shall be taken as mere
happenings, for which they are entirely irresponsible.” Psychiatrists were, and
are, happy to play the other part, authenticating the person’s false
self-definition as mental patient—medical object, not moral actor.
Lord Acton
There is
important religious precedent for the authoritative declaration of falsehood as
truth. In 1870, under the leadership of the legendary Pope Pius IX—Pio Nono,
the longest-reigning and one of the most colorful popes in history—the Vatican
declared the dogma of papal infallibility. This was anathema to Lord Acton
(1834–1902), the most respected Catholic layman in Europe in his time.
Alienated from the Church, Acton did not leave it; and, probably because he had
not been ordained, he was not excommunicated. It was in the context of this
moral conflict that, in 1887, in a letter to Bishop Mandell Creighton, Acton
made his famous pronouncement:
“I cannot
accept your canon that we are to judge Pope and King unlike other men, with a
favorable presumption that they did no wrong. If there is any presumption it is
the other way against the holders of power, increasing as the power increases.
Historic responsibility has to make up for want of legal responsibility. Power
tends to corrupt and absolute power corrupts absolutely.”
Most people
who quote Lord Acton’s famous dictum today are unaware it refers to papal power
and was made by a devout Catholic. In 1882 Acton, now alienated from his great
teacher and lifelong friend, Father Johann Ignaz von Döllinger, who was
excommunicated for opposing the infallibility doctrine, writes him:
“I came, very
slowly and reluctantly indeed to the conclusion that they [the great Catholic
notabilities] were dishonest. And I found out a special reason for their
dishonesty in the desire to keep up the credit of authority in the Church. . .
. When I got to understand history from the sources, especially from
unpublished sources, the reason of all this became obvious. There was a
conspiracy to deceive. . . . That men might believe the Pope it was resolved to
make them believe that vice is virtue and falsehood truth.”
Acton regarded
the claim of papal infallibility as evidence of intolerable religious arrogance
and power. I regard psychiatric infallibility—the unfalsifiability and
irrefutability of psychiatric diagnoses backed by mental-health laws—as
evidence of intolerable psychiatric arrogance and power.
Acton thought
“he witnessed the triumph of error in history.” Indeed, he had. Today, we
witness a similar—but more ominous—triumph of error in medicine-psychiatry. In
addition to persuading the public and the government that human problems are
medical diseases, psychiatrists have succeeded in abolishing the concepts of
responsibility, guilt, and innocence, and in replacing punishment with the
irrefutable and ineradicable stigmata of psychiatric “diagnoses” and
“treatments.” “Modern psychiatry,” I wrote in 1970, “dehumanize[s] man by
denying . . . the existence, or even the possibility, of personal
responsibility, central to the concept of man as moral agent.” It accomplishes
that evil by treating responsibility, following Ambrose Bierce, as “a
detachable burden easily shifted to the shoulders of God, Fate, Fortune, Luck
or one’s neighbor.” In our day, it is not merely customary but, in matters that
really count, mandatory to unload responsibility on Mental Illness (“he
snapped,” “had a breakdown,” “battled his demons,” “was on drugs,” “went off
prescribed medication,” and so forth).
In Acton’s day
the separation of church and state was an established political practice in
many countries. Hence, the Church’s moral failures and self-arrogated powers
affected only persons who chose to be its adherents. Our predicament is more
serious. We live at a time when the alliance of medicine-psychiatry and the
state is taken for granted—viewed as an unalterable social fact and undoubted
moral and social good. Everyone, regardless of personal choice, is affected,
directly or indirectly, by the powers of the therapeutic state.
Psychiatry and the State
Given its
limited legal-political powers, the Vatican could not have tried to purge the
world of its critics, much less intimidate them into becoming its
crypto-supporters. In contrast, in our day the alliance of psychiatry and the
state has enabled pharmacracy to do just that. Its so-called critics—who call
themselves “antipsychiatrists,” “critical psychiatrists,” “ethical
psychiatrists,” and so on—oppose one or another psychiatric “diagnosis” or
“treatment,” rarely even psychiatric coercion. But they all support the view
that the misbehavior of individuals afflicted with/suffering from so-called
mental illnesses ought not be regulated by the same rules as are the
misbehaviors of individuals not so denominated: They recoil from defending an
ethic based on personal responsibility for public actions (as distinct from
private actions, called “thoughts”) and of every individual’s inalienable right
to his or her life and death, lest they appear uncompassionate and, perish the
thought, unscientific and illiberal (in the modern, statist sense of
“liberal”). Thus they endorse—explicitly or by the assent of silence—psychiatry’s
war on responsibility, epitomized by the wars on drugs, mental illness, and
suicide and by the insanity defense.
“Truth,” said
Thomas Jefferson, “will do well enough if left to shift for herself. She seldom
has received much aid from the power of great men to whom she is rarely known
and seldom welcome. She has no need of force to procure entrance into the minds
of men. . . . It is error alone which needs the support of government.”
Jefferson was right in applying this principle to religion: modern states
should not (and for the most part do not) lend their coercive powers to the
support of the clerical lies of priests. Nor should they lend their coercive
powers to the support of the clinical lies of psychiatrists. As long as they
do, serious persons ought not to take psychiatry seriously—except as a threat
to reason, responsibility, and liberty.
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