Thomas Szasz: Hello.
René Talbot: Hello Thomas, this is René.
Thank you very much for the time you
want to spend for this
interview.
T.S.: You
are welcome.
R.T.: I have prepared some questions. The first
question is: What
is distinctive about your new book "Coercion
as cure – A critical
history
of psychiatry", which came out this year?
T.S.: What
is distinctive about it is that no one has ever written
a history of psychiatry based on the premise that there is no mental
illness.
All histories of psychiatry rest on the unquestioned belief that mental
illness
exists the same way that bodily illness exists and that doctors are
trying to
diagnose and cure it. This is nonsense. We ought to ask: What does the
history
of psychiatry look like if there is no mental illness?
This is like asking, What does the history of
(a monotheistic) religion look like if there is no God?
The answer then is that there are people who
worship or do
not worship God, there are churches, there are priests, and there is of
course
religious belief and religious disbelief and religious persecution. The
answer
for psychiatry is similar. There is voluntary psychiatry for people who
want to
got to psychiatrists and “worship” mental illnesses and cures; and they
can get
drugs, or electroshock, or psychoanalysis, or whatever the “soul
doctors” are
permitted to give them; and then there are people who reject psychiatry
and on whom
so-called “services” are imposed by force.
Today, neither psychiatrists nor the media
distinguish – are
allowed to distinguish! -- these diametrically opposite phenomena. I
maintain
that until society – the legal system – makes this distinction, the
psychiatric
situation will remain unchanged. And once the distinction is made,
coercive
psychiatry will be, will have to be, abolished – just as coercive
religion has
been abolished.
R.T.: Yes, there is a history of atrocities and
cruelties and
torture.
T.S.: Of
course. That goes for any system of ideology based on a
fiction plus force. The point is, there is the fiction of mental
illness and
there are psychiatrists who are agents of the state – just as there
was, and
is, the fiction of god and there are priests who used to be agents of
the state
but no longer are!
R.T.: The history of psychiatry and it's
interpretation is always
also connected with evaluations, questions of good and bad.
T.S.: Absolutely!
R.T.: Thus it also directly concerns the
interests in contemporary
psychiatric practice. What reactions have you had to your book?
T.S.: There
has been only one review, which is very hostile, in a
conservative, right-wing magazine called The Weekly Standard, I can
send you a
copy.
R.T.: And what was your opinion on this reaction?
T.S.: I
expected this or no reviews at all. What else can
psychiatrists do with my book except dismiss it?
R.T.: A new question: In the preface to the
German translation of
"The Myth of Mental Illness" you write: "Of all academic
disciplines and
sciences is perhaps none deeper rooted in the German language and
culture than
psychiatry. Kahlbaum, Kraepelin and Bleuler, Freud, Adler and Jung and
many
other founders of modern psychiatry wrote in German. Even if German has
been
overtaken by English since the nineteen-thirties as an idiom of
psychiatry: it
nevertheless remains the native language of this profession." What
specifically do you see in the history of German psychiatry?
T.S.: What
I had in mind is an interesting difference between
German and English. In English, we have the word “mind,” used both as
noun and
verb. We speak of “mental illness.” In German, there is no word
congruent with
“mind.” There is Geist = spirit, and Seele = soul. This, I think, is
one of the
reasons why German psychiatry has been closer to philosophy, to
religion, to
the spiritual aspects of man, than has Anglo-American psychiatry, which
has
aspired to be materialistic, scientific, medical in the technical sense.
R.T.: So from the language-difference developed
a different kind
of history of psychiatry in Germany, do you think?
T.S.: Ironically,
not. It is not different at all. The history of
psychiatry is the same all over the world.. Everywhere it rests, first,
on the
fiction of mental illness (undefined as a disease, in fact used as a
euphemism
of misbehavior, unwanted behavior, like homosexuality or drunkenness);
and
second, it rests on coercion, the power of the psychiatrist to lock up
the
patient. In medicine, patients are treated with their consent. In
psychiatry,
persons – who often do not want to be patients
– are treated without their consent. These simple facts are
constantly
denied, obscured, evaded.
R.T.: They change the bottle but it is always
the same wine.
T.S.: Absolutely!
Correct! That is why I titled my book
"Coercion
as Cure": because the crucial issue and term is coercion,
the use of force authorized by the state.
R.T.: That is the central issue.
T.S.: That
is the central issue in my work and that's why it
doesn't matter whether the state is a communist state, a Nazi state, an
American state, a British state, all use psychiatry as an arm of the
coercive
apparatus of the state
R.T.: …that legitimates this coercion and
violence.
T.S.: Right.
It is always a state in the modern world. Again, note
the analogy to religion: In the premodern world religion legitimated
the use of
force. In the modern world, the secular state does so.
R.T.: Two chapters of your book "Coercion
as
Cure" are
dedicated to drugs, whose introduction and dominance in psychiatry
occurred
during your professional career. You distinguish between drugs
individuals want
and drugs individuals do not want, between drugs the state permits and
drugs
the state prohibits. Is there, in your opinion, besides the side
effects, any
effect at all of the psychotropic – so-called therapeutic – drugs?
T.S.: In
this connection, we should not use the word
"side-effect." Drugs have certain biological and behavioral effects.
Some effects are desired by patients or doctors or politicians, and
some
effects are not desired. We have to be
very clear about this. “Desirable” and “undesirable” are not medical
terms.
They are terms that refer to cultural, social, medical contexts,
personal
preferences, political considerations, and so forth. Is morphine a good
drug or
a bad drug? If a patient is dying of cancer and is in pain, then it’s a
good
drug. If he is an ambitious politician who wants a bigger job, then he
fights
the “war on drugs” and declares opium poppies to be “enemies” that must
be
destroyed. Meanwhile, he or some member of his family may be secretly
“abusing”
heroin.
R.T.: In other words, are there no side-effects
only effects?
T.S.: Side-effects
are simply unwanted effects. In war, the death
of enemy soldiers is an effect. The death of our soldiers is a side
effect.
One of points I make in “Coercion as Cure” is that, in the
case of all mind-altering drugs we must distinguish between the drugs
that
some people want to take and
that
some people do not want to
take. Also, we
must
keep mind that many of the drugs people want to take are all illegal
and if you
buy or sell them you go to prison.
R.T.: Not all, alcohol is not forbidden.
T.S.: Not
alcohol now! But there was a
time, not so long ago, when
alcohol was prohibited in the United States. It is still prohibited in
Islamic
states. I was referring to opiates, the war against drugs, the war in
Afghanistan – and contrasting it with the “war for psychiatric drugs,”
the
drugs many people don’t want to take and are forced to take!
R.T.: Can you tell us something about the next
projects you are
working on?
T.S.: Yes,
I can tell you, but the issues I address are too
complicated for an interview. The title of my next book sums up what I
have
tried to do for more than fifty years: "Psychiatry: The Science of
Lies". "Die Wissenschaft der
Lüge". Mental illness is deception,
self-deception, a lie. Psychiatry as a medical specialty is a lie.
Psychotherapy is a lie. Again, there is the analogy, for an atheist,
with
religion as fable or myth or repression, or lie.
R.T.: I hope very much that your book "Coercion
as cure"
will be translated.
T.S.: Thank
you. I hope so too, but I don’t count on it. Our
western culture has grown increasingly uncritical of psychiatry during
the past
fifty years. “The Myth of Mental Illness” was translated into German.
“Insanity” was not. “Liberation by Oppression” was not. The advent of
the use
of drugs for supposedly treating so-called mental illnesses has made
psychiatry
look like medicine.
R.T.: Yes, because it is a typical method in
medicine to use drugs
to treat diseases.
T.S.: Right.
If you go to a doctor, he gives you drugs. Now the
same thing happens: you go to a doctor, you say you are nervous and he
gives
you a drug and then it's called psychiatric treatment. This didn't
exist when I
went to medical school.