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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. |
> 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.