[xenophanes]

So your credentials consist of personal anecdotes? Maybe it's time to start taking the issue more seriously. I think it's a serious issue deserving a more serious approach.

For example, you might try reading literature with multiple different perspectives on the issue. Then try to figure out which ideas are right and why. (If you've already done this, forgive me, and please please inform me why Szasz is mistaken, I would love to learn something.)

[saalweachter]

I don't give two shits what Thomas Szasz thought about mental illness, because he wasn't a scientist or even a doctor, he was a goddamn libertarian philosopher. He found mental illness philosophically inconvenient because he couldn't see a way around the State being morally justified in providing coercive treatment to the mentally ill, so he just decided they didn't exist.

He was an asshole who spent sixty years shitting over real science to promote his politics, and you're an asshole for trying to promote his politics at a digital wake.

[einhverfr]

At the same time, I think it is inescapable, when studying how different cultures look at mental health and mental illness to see this as something which culturally constructed. Personality disorders for example, or ODD, or the like can only be thought of as disorders of inconvenient personality traits and therefore the way mental illness has always been used, and in the historical context, there is a very dark side to coerced therapy (which btw is no less dark when we convince parents to give their kids antipsychotic drugs because their kids are defiant).

my problem with Szasz though is different. He seems to accept the basic assumptions of mental illness that our society does, and therefore never frees himself from the problems of those assumptions. There is no scientific basis for these assumptions, as they form, effectively, the threshold questions under which one can try to make neurochemical inquiry into mental health. These assumptions are:

1. Mental illness, to the extent it exists, is objective and quantifiable.

2. Social context is irrelevant to mental health.

3. Therefore mental health is an individual issue.

Of course a libertarian will accept these assumptions because they are based on the assumptions of personhood behind that movement. But what if both of the first two are wrong? What if mental health is very much subjective and what if social context is an important factor in mental health? If so, then, not only is the science based on bad assumptions but so is Szasz's rebuttal to it, and mental health becomes more an art than a science.

None of this reaches the question of coercive therapy. The fundamental questions are who, when, and how (both regarding the coercion and the therapy). Obviously there are times when this is needed. But we should not ignore the dark side this has had throughout history.

[xenophanes]

> 1. Mental illness, to the extent it exists, is objective and quantifiable.

> 2. Social context is irrelevant to mental health.

> 3. Therefore mental health is an individual issue.

None of those are positions Szasz holds. The first two are just kind or ridiculous – he said contrary things, a lot. They are pretty opposite to his actual positions. For the third, he is pro-individualist but the "therefore" is wrong, and also the topic "mental health" includes things like the insanity defense which aren't just an individual issue.

Your supposed anti-libertarian insights are basically correct – but Szasz already knew them and wrote about them.

Of course what is labelled "mentally ill" depends on the social context, rather than being objective. That was a major point Szasz made. Have you read his books?

> Obviously there are times when this is needed.

Here, where you advocate coercion, you have an actual disagreement with me and Szasz. This, not your points 1-3, is your basic disagreement with Szasz. It's the standard disagreement most people have: they favor coercion, he and I do not.

[JustinCEO]

http://en.wikipedia.org/wiki/Thomas_Szasz

> In 1938, Szasz moved to the United States, where he attended the University of Cincinnati for his Bachelor of Science in medicine, and received his M.D. from the same university in 1944.[7]

[saalweachter]

Fine, he was a morally bankrupt doctor. I agree I should not have claimed otherwise in my initial invective and apologize for my error, but let me reiterate: his stance on mental illness did not originate from his medical or scientific observations, but from his philosophy. And despite living through fifty years of startling advances in medicine, where huge swaths of mental illness were found to have biological origins in the brain, he never recanted. So fuck him, he was an asshole.

[doktrin]

> And despite living through fifty years of startling advances in medicine, where huge swaths of mental illness were found to have biological origins in the brain

Pretty much this. Having just heard about him today, it's clear his [Szasz] statements reflect technological limitations of yesteryear combined with intense personal bias.

Why anyone would still espouse the concepts this guy put forward is beyond me.

[prestadige]

If science had found biological origins or symptoms for mental illness in the brain, don't you think these would be used for diagnostic purposes?

Szasz was indeed a deeply unpopular man, but progress often depends upon such people.

For instance, did you know that he was the first psychiatrist to claim publicly that homosexuality is not a disease? (In 'Sexual Inversion: The Multiple Roots of Homosexuality', ed. by Judd Marmor, Basic Books, 1965)

[vonmoltke]

> If science had found biological origins or symptoms for mental illness in the brain, don't you think these would be used for diagnostic purposes?

Science has found biological symptoms for Alzheimer's and rabies. Unfortunately, these can only be firmly identified post-mortem and are thus not useful for diagnostic purposes. Just two examples if diseases with biological markers that are not useful.

> For instance, did you know that he was the first psychiatrist to claim publicly that homosexuality is not a disease? (In 'Sexual Inversion: The Multiple Roots of Homosexuality', ed. by Judd Marmor, Basic Books, 1965)

A broken clock is right twice a day. When you claim mental illness doesn't exist in toto, then of course you will be "right" about bullshit mental illnesses like homosexuality.

[gruseom]

I like Szasz too, as well as his hippie counterpart R.D. Laing (whom you might check out if you're interested), but please, don't play intellectual hardball in this thread. The OP just lost his brother.

[mynameishere]

How is he playing hardball? He's being dickish crank. BTW, dickish crank, your hour-old xenophanes2 account seems to have already been hell-banned.

[xenophanes]

People are spreading very bad, destructive ideas that will result in more dead brothers. I think that's more important than being "nice".

Also, Szasz and Laing are closer to opposites than counterparts. See for example:

http://www.amazon.com/Antipsychiatry-Quackery-Squared-Thomas...

Quote from the book, by Szasz:

> In the late 1960s, a group of psychiatrists, led by David Cooper (1931-86) and Ronald D. Laing (1927-89), 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.

> For more than a half century, I have consistently asserted two simple but fundamental propositions: mental illnesses do not exist, and coercions justified by them are wrong. Anyone who seeks to help others must eschew the use of force. Not a single antipsychiatrist has ever agreed with these principles or abided by these practices. Subsuming my work under the rubric of antipsychiatry betrays and negates it just as effectively and surely as subsuming it under the rubric of psychiatry. My writings form no part of either psychiatry or antipsychiatry and belong to neither. They belong to conceptual analysis, social-political criticism, and common sense. This is why I rejected, and continue to reject, psychiatry and antipsychiatry with equal vigor.

[ChrisClark]

So, what you are saying is that if I notice that a friend of mine is suicidal, I should not try to spend time with him in person?

Am I still allowed to talk to him on the phone? Email? Can I be within a kilometer of his house? Is it like a restraining order?

All the comment you replied to is saying is that if you notice a friend in trouble, spend time with him. You seriously think that is an awful thing?

[scott_s]

What did Mz say that you are objecting to? Everything she said aligns with what I have read and heard about suicide.

[doktrin]

If I understand the parent correctly, he agrees with a certain Thomas Szasz' [1] opinions on psychiatry. Central among his opinions is the assertion that mental illness is a "myth" due to the lack of observable changes at the cellular level (or at autopsy), and that mental illness patients are "malingerers".

My opinion : the dude sounds like an ass and his opinions are eye-rolling.

[1] http://en.wikipedia.org/wiki/Thomas_Szasz

[einhverfr]

Mental illness is a really tough thing to discuss in an objective way. See the debates about the DSM-5. I personally think mental health and mental illness are socially constructed.

This being said, the experiences relating to mental illness are very real. The larger question is how we make sense of them as a society. For something like depression how much of the illness is cognitive? How much is biological? How much is social? Somehow that last question never gets asked.

[doktrin]

> I personally think mental health and mental illness are socially constructed.

> This being said, the experiences relating to mental illness are very real.

What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

[einhverfr]

> What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

What is the difference in value between a $5 bill and a $20 bill? Is this difference not both real and socially constructed?

I.e. why do you assume that what is socially constructed can't be real?

The question is, really, what goes into the experience and what are the limits to the current science. If it is socially constructed, the science is limited to the current cultural context.

[doktrin]

> I.e. why do you assume that what is socially constructed can't be real?

I'm assuming you wouldn't say "pneumonia is socially constructed". If you did, I would read that as "pneumonia isn't real".

> The question is, really, what goes into the experience and what are the limits to the current science. If it is socially constructed, the science is limited to the current cultural context.

I honestly don't know what you're trying to say.

[Mz]

That last is very hard to ask because the vast majority of people are raised with either a guilt or shame model, thus asking it comes across as finger pointing.

Anyway, I need to go so cannot elaborate.

[einhverfr]

It's not a question of finger pointing so much as asking what social structures we have that make this harder.

You mentioned your kids live with you. How hard would it be if they didn't? Does the fact that we stigmatize adults living with their parents and make mental illness into an individual problem contribute to it?

[Mz]

People who are raised with a shame or guilt model will read fingerpointing into what you say whether it is there or not.

Given the problems I have, if they did not live with me, I likely would have died already.

[Mz]

FYI: I have done lots of reading. I spent time in therapy. Etc. And, for a time, I essentially had an unpaid "consultancy" where parents who had super difficult kids who had been failed by all the experts would get given my email address and talk with me a bit and a year or so later I would hear back that their "impossible" kid was getting their act together. So I strongly suspect that I know what I am talking about, better than most so-called experts.