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SZASZ
Schizophrenia
I r^Tfrrs^KjTnTiTi'
of Psychiatry
Schizophrenia
AND PLEASURE
(ED.)
SIN
CEREMONIAL CHEMISTRY
HERESIES
Schizophrenia
THOMAS SZASZ
SilU
Copyright
1976, 1988 by
Thomas Szasz
The author
gratefully
acknowledges permission
to quote
Dementia Praecox or
copyright
How
to
Overcome
it,
1969 by
93 92 91
90 89
in this
minimum
requirements of American
Permanence of Paper
ANSI Z39.48-1984.'oor
Materials.
Schizophrenia
the sacred
symbol of psychiatry
Thomas
Szasz.
cm.
new
New York
pref.
Bibliography: p.
Includes index.
ISBN 0-8156-0224-3
1.
Schizophrenia.
2.
(alk. paper)
Psychiatry
Philosophy.
I.
Title.
RC514.S93 1988
616.8'982 dcl9
Manufactured
87-26748
CIP
in the
The
legitimate
But
does
it
me no
injury for
my
my
leg.
Constraint
neigh-
neither picks
It
.
my
may
fix
him
Thomas
Jefferson
(1781)
i\
Contents
ACKNOWLEDGMENTS
ix
PREFACE
xi
XV
Chapter
The Model
Psychiatry:
of the Syphilitic
Mind
Chapter 2
Anti-Psychiatry:
The Model
of the Plundered
Mind
45
Chapter 3
Schizophrenia: Psychiatric
Scientific
Syndrome
or
Scandal?
85
Chapter 4
Psychiatry
i^g
Chapter 5
Madness, Misbehavior, and Mental
Illness:
18$
Epilogue
Schizophrenia:
Appendix
The View
of
Mental
Illness as
199
Brain Disease:
A Chronology
20J
Appendix II
Psychiatry and Anti-Psychiatry: The Superior
Virtues of the Oppressor and the Oppressed
212
REFERENCES
INDEX
21^
231
Acknowledgments
THE FALL
IN
uled to be held in
Tokyo
in
May
"What
1975, was to be
Is
Schizophrenia?"
rethink
years, ^
my
and
Kyoto, gave
me
my
views on what
psychiatry which
there
than
it
to
Japanese
seemed no reason
circumstance.
I
Tadao Miyamoto,
my
hosts
President of the
and
Kyoto University; Dr. Kotaro Nakayama of Kyoto;
and Dr. Kenji Sakamoto of Osaka. I am grateful to them not only
Neurology
for inviting
at
me
making
my
visit
personally
Marie Szasz,
my
my
brother;
M argot Szasz
IX
Acknowledgments
DeVeaugh-Geiss,
Joseph
McNamara, my
friends
have
all
making
Jonathan
and
Ecker,
my
secretary.
this
book
Kathleen
possible.
their
my
They
help in
Preface
THE CLAIM
now
all
around
us.
typical
example appears
in a recent issue
is
of
Schizophrenia,"
it
is
in Florida in
past
three years," the reporter tells us, "have seen genuine progress in
excellent snapshot, as
it
One was
left
itself.
all
of
it
USA is set to become very big business in the near future. Several
lay pressure groups last year joined under the banner of NARSAD
(National Alliance for Research into Schizophrenia and Depres-
sion) and
was an
Ne\^^
issue
on the
at
once, schizophrenia
over 90
result
phrenia research next year. After-dinner speakers seriously predicted research funds being on par with cancer research within
five years.*
Indeed, every
medical, scientific
modem
now
S.
authority
exactly the
same sense
word
schizo-
that the
pp.
word
1216-
17.
XI
Preface
is
invariably dismissed as a
who
dissents
as denial
To
and anti-psychiatric
someone "denies"
say that
when
a psychiatrist
is,
in this
a proposi-
no proof. And
is
acknowledging
is
it;
the
judgment being
which
one today
calls
an existential philosopher or a
at
who
now
No
is
almost obsolete.
is
although
their
My point
is
from the
practical
communism
sally held to
is
meaning
not univer-
political creed or
system
is
is
Union; which
is
like
power of psychiatry,
it
political
worth noting
in this
in particular
was not
Xll
to
whose
to seize
aim
it.
Preface
albeit not
leaders
where would
diabetes,
problems
social
were proven
is)
to
Would
it
be a disease,
like
we view
symptoms of
as the
this
was recognized
were accordingly
dread disease?
in this connection.
as a disease spread
isolated.
With
Long ago,
by contagion. Lepers
identified.
However,
this dis-
covery did not change the social disposition of lepers: they were
still
was not
social policy
Instead,
it
was
the result of
any new
in
scientific discovery.
it
others.
would
if this
still
of
him against
"it."
Would
confining
him
Would
that
still
justify restrain-
his will?
Or suppose
that
in a
still
that
and
it
position of lepers
so, in
my
xin
Preface
control
it)
would
by themselves,
not,
of schizophrenics.
change
categorized as mentally
ill
in social policy
nature and degree of the danger which patients suffering from such
(alleged) diseases present, and a decision that
present
it
believe
our fellow
deserving
common-sense
punishment
if
This book,
interested in
he does not.
examining
and
are willing,
if
The more
an illness, because
illness,
because
mendation
to rethink,
inclined he
.
,"
,"
Its
appeal
about
is
is
likely
or "But,
we
should treat
we ought
to
do
or
it
my
as an
recom-
it is
but,
not do
it.
Syracuse,
New York
September 1987
XIV
are
necessary, to reject
agnosticism:
is
who
first
disposition to treat
Thomas Szasz
EVERY GROUP
or organization whose
and
rituals.
to-
distinguishing symbols
its
is
the cross
ritual is the
especially
things
tion
alike.
many
share, as their
They
ritual,
also share
and drugs.
symbols and
If these are
and
psychiatrists share,
them?
who do
is
their
patients.
When
thus
becomes the
Similarly,
when
carrier
of
it
the
water and
XV
is
awesome
In this
come
its
in its implications.
book
I shall try to
in the battle to
become
toward
mark
the mark
the
it
how
of psychiatric
reverence toward
of psychiatric heresy;
this "diagnosis" as
XVI
to a
has
by approaching
it
if
medical disease.
it
may be advanced
pointed to a religious
Schizophrenia
Chapter 1
Psychiatry:
The Model
Syphilitic
of the
Mind
WHAT
IS
SCHIZOPHRENIA? What
phrenia mean? In
schizophrenia
Eugen
is
its
word an
is
word an
idea and a
name an
vented
and a
idea
it.*
The
point
soft
I
is
in-
called
it
scientific
To
have to review,
especially as
it
and
his invention.
1900.
When
shall
Let us
we
typically,
something
like
SCHIZOPHRENIA
syphilis.
"Know
syphilis in all
its
will
today. Indeed,
how many
This
is
all
things clinical
cases of syphilis
do modern medical
is
re-
our
the
cian
may know
be
still
all
there
to
know about
clearly, a physi-
schizophrenia and
own
is
peril.
we forget
among modern
That lesson
is
the agreement
at
our
physi-
tween being a patient and having a disease; and their resolution to regard as diseases only those processes occurring in the
identify,
measure, and
syphilis
And
less
a third
was
organs and
tissues,
appropriately named,
the general
it
was common.
all
investigators
Thanks
to
the
phenomena
litigated
amazingly successful
"products."
in
ever,
been
Psychiatry:
sis
Syphilitic
all
Mind
different
What made
these
and epistemological
criteria
syphilis. In other
for judging
histological, biochemical,
it
was possible
this disease
it,
were
were
in fact syphi-
not.
These developments were of the most far-reaching importance for physicians, including psychiatrists, working at that
time.
medical
specialty.
politically,
Its
respectability,
both
scientifically
and
from
diseases.
The
psychiatric patients
difference,
in
this
view,
between non-
them
to
diseases
Meynert
do
in
mental
on a purely anatomical
basis."
Meynert sought to
re-
itself.
SCHIZOPHRENIA
The discovery
was a
brilliant
scientific
ment
of
"mental
diseases" that
is,
abnormal
of
treat-
biological
and
social
"symptoms"
model
came
fatefully tied to
and treatment.
this
It is
medicine and
necessary that
its
we understand
exactly
how
happened.
There are experiences that we may read about, and know about
intellectually,
who
but cannot,
appreciate in their
sonally,
full
human
Most people
impact.
desperately
ill;
those
who
are rich,
what
it
is
it
is
to be
to be desperately
poor.
lives.
become almost
Many
For medical
as legendary
erations ago.
It is
we must
re-
role of neurosyphilis
Psychiatry:
The Model
of the Syphilitic
Mind
from general
paresis.
had
paresis.
At
the
At
paretics.
to
the
in 1930,
And
so
it
30 percent
went through-
the
it
of psychiatry?
And
that psychiatry
To vary
the
in-
metaphor,
deed a
Now,
as
it is
series of
while
awake,
it
if
paresis
still
its
lips?
asleep,
psychiatry
if
still
dreams about
it;
while
hind every foolish face or troubled thought. Thus has the image
of the crooked spirochete
the
minds of many
psychiatrists,
in
Viewed
modern concepts
from that
The
in
officially
which
it is
to
me
of dementia praecox
usually presented.
is,
briefly, that in
began
acter
to
diseases,
and that
this led
some
identify
of these diseases.
many
to
how
to prevent
and
treat
some
and
of them.
SCHIZOPHRENIA
According
some
others in
particular,
Bleuler discovered
and
syphilis,
identified
schizophrenia.
As
I see
it,
this is
It is
all.
true that
last century,
diseases in
particular,
and
dementia praecox,
made no
trists
it
is
schizophrenia,
(or neuroses).
or
Psychia-
would have
qualified
at that
by
time as
having a disease.
It
this
and empirical; and that it beand theoretical again with the introduction of
came
abstract
psychopathological,
psychoanalytic,
psychosomatic,
and psy-
into nosology.
Before Virchow, the model of disease was "humoral pathology"; since him,
until
it
bile,
omist,
showed
humors but
fluid
humors
precisely,
of the
body that
is,
blood,
and black
that diseases
to
an imbalance of
to lesions in organs.
a French anatomist,
composed
More
some
and sug-
Psychiatry:
be affected.
It
The Model
of the Syphilitic
Mind
when Virchow
pathologie in ihrer Begrlindung auf physiologische und pathologische Gewerbelehre (Cellular Pathology
iological
and Pathological
Histology),
that
to this
of the
body may be
tion
effected
is:
model of disease
in
by curing the
scientific
What
^
cells.
The
real ques-
when
cells are
in scientific discourse
dis-
covered no histopathological lesions or pathophysiological processes in their patients. Instead, they acted as
if
diseases.
Bleuler did not discover the diseases for which they are famous;
they invented them.*
modern
psychiatry,
it
is
easy to
fall into
lem
in this field,
and
an important prob-
* It is
or privation of certain
toxic substances.
."
SCHIZOPHRENIA
Actually, the concept of dementia praecox, as
it,
we now know
new
disease or developed a
in
scientist, as
new
1898.
if
treatment; in fact,
achievement was
drome."
in
The
^^
He
he had
this:
is
very
"Kraepelin's in-
originally described
"hebephrenia," or
silly
by Ewald Hecker
want
to
emphasize here
is
that each of
these terms refers to behavior, not disease; to disapproved conduct, not histopathological change; hence, they
may
loosely be
conditions. If
them together
still
is
a disease, putting
who
whose histopathology,
etiology,
hoped that
had
up a gap
it
"I
filled
in
As these two sentences and, indeed, the whole of his work show,
Freud never ceased flirting with the aim of extending the paradigm of
paresis from "injuries
caused by infection or by gross anatomical
.
diseases.
10
In
Psychiatry:
Greek that
to
And
is,
Its
of the Syphilitic
is,
Mind
incidence that
its
The Model
schizophrenia.
to
its
Eugen
it
etc.
symptoms
enough; that
is,
^^
of syphilology
are unmistak-
able here:
is ill.
new
my
rests, in
it,
opinion, on having
new
justification for
latter as a
hospital.
Still,
most
this
Just
question at
psychiatrists, past
and present.
are
now
possession or exorcism.
We
beliefs
demonic
Wassermann, Noguchi,
11
SCHIZOPHRENIA
and Moore whose work demonstrated irrefutably
was due to, and was a manifestation of, syphiHs.
Similarly,
due
and
to,
that paresis
is
is
is
illustrative:
Bleuler believed that schizophrenia was the outcome of a pathological, anatomical, or chemical disturbance of the brain." ^^
in the
charist.
These
Eu-
no more consequence
do
of
ler's beliefs
Why,
penicillin.
and Bleu-
Why
do they
pathology of schizophre-
nia. Instead,
of disease,
from histopathology
structure
was unquestionably
psychopathology that
to
to
abnormal
personal
is,
be-
true that
havior. Since
it
how
It will
1911:
By
the term
12
is
at
times
The Model
Psychiatry:
marked by
chronic, at times
of the Syphilitic
Mind
and which
intermittent attacks,
at
from a
irrelevant
is
characterized by a
is
.^*
.
The
medi-
strictly
is
paretic's thinking.
it
seems
me,
to
in
is
sick: that
has already
whose power neither patient nor laymen can match, and which
no colleague dare challenge. The schizophrenic's thinking is
thus anatomized and pathologized in order to create a science
of psychopathology,
dynamics,
all
as a medical
(psychiatric)
patient,
madman
Throughout
his
the
that
schizo-
letters,
and other
He
is
is full
of illustrations of the
linguistic
offers
productions of so-
typical:
language
in
the language of
itself,
but rather in
its
lie
in
the
content. ^^
schizophrenic patient he
is
impression that
in
describing
whom
who
he.
13
SCHIZOPHRENIA
Bleuler, disagrees.
He
may show
of linguistic expression
to convince all of
my
is
every imaginable
We often
was unable
his
argument:
this line of
and
sick
is
The form
this is not
At
times,
audiences attending
clini-
phrenic
logic.^"^
Bleuler's premise
tended
to
phrenic
is
preclude questioning
"sick," that he
is
bona
fide "patient."
what way he
We
to question only in
illness
To
assent to this
beginning to play
is,
of course, to give
are al-
sickwhat sort of
lowed
is
away
the
exhibits.
game before
it.
is
"wrong" (as
that he speaks in
it
metaphors unac-
Some-
this.
For exam-
he writes that
is
To
and
in the
Here,
submit,
we have
14
in-
schizo-
so-called
the
that
is
all
(italics
added). ^^
quintessentially
word
forms of torment
human,
how
and,
at
lan-
the
Psychiatry:
same
time, to see
When
Mind
be used to deprive
persons imprisoned
in
in-
men-
liberty
of the Syphilitic
figures of
priate
The Model
"disease,"
the
"hospi-
and
are
psychiatrists
using
not
of
figures
The remarkable
thing about
much
of
of this
all
much
do many psy-
metaphor. Nevertheless, he
is
better than
is
the
felt justified,
this
fact
in
the literal
rather
When one
is
Switzerland, or
when
be quite incomprehensible
key
to the explanation
at first glance.
But we obtain
to
and think
in
symbols
is,
infinitely
"symptoms"
For
this
still
fur-
civil libertarian.
upon
"symptoms"
tions
and
creates
us:
is
If
that
what
makes
"schizophrenic"
utterances
still
If
why
confine those
i5
SCHIZOPHRENIA
who
them
utter
even
in
if
emperor was of
the legendary
Consider
in this
visible clothes.
connection the
am
Switzerland.' She
may
woman
and
in the
also say,
'I
am
makes
woman
this
says,
What
^^
Bleuler explains:
The
and
in the
it
is
line
scured.
phors
The
result
is
in a literal sense.^^
The source
of Bleuler's egocentric
Would
and ethnocentric
fallacy
is
symptom of
ness known
point of view,
the
literalized
these
psychiatric
conception
--
of
Mutatis mutandis,
mental
cardinal
Catholic
in
illness
my
is
if
hold
also
view, between
x6
mad-
lies
not in any
symbols but
in their so-
Psychiatry:
cial
The Model
of the Syphilitic
Mind
latter
being illegitimate.
to bring
ogy
psychopathology.
to
these three
men worked
World War
the outbreak of
were the
earliest
The
pathology.
was
entitled
It
I,
first
Jahrbuch
fiir
Psychoanalytische
{Yearbook
Psychopathologic Investigations).
Bleuler and
Bleuler
closely
Forschungen
thologische
is
for
publishers
Its
its
of
iind
Psychopa-
and
Psychoanalytic
editor
were Eugen
psychiatry,
and Jung
is,
life
work
popular
(1901). 2^ It
all
was
in this
the universal
belief in
events."
The
^^
Psychopathology
book
that
of
he most
Everyday
fully
Life
developed "his
application of determinism
to
mental
become,
in
all
are
"deter-
and idea of
fining
it;
illness,
their followers
it
is
Thus
and de-
histopathology by psychopathology.
SCHIZOPHRENIA
Although modern psychiatry began with the study of paresis
and the
efforts to cure
it,
it
efforts to control
it.
as mad-doctoring, psy-
chiatrists
Through
but deviants.
is,
pseudo-
this
scientific
psychiatry
"scientific"
ment.
known
And
became and
now everywhere
is
schizophrenia
its
is
all
society
or convinced by their
diagnose,
in
largest grab
own
now ready
are
zeal,
prognose,
schizophrenia
"medical" manage-
its
symbol the
sacred
bag of
the
accepted as the
psychiatry
is
illustrated
role
to
of
phrenia,
-'
Organization
(WHO).
The authors of
they call them
this
study
list
"inclusion
about, or attributed
to, a
when observed
criteria" which,
in-
The
and medical
pretensions
vanish like
-^
makes
list
Inclusion
inclusion, re-
scientific
its
frightened
the
child's
We know
what they
are:
Freud was
a scientist
and
is
believing that
is
now
and psychoanalysis
will
the son of
is
still
you are
God who
alive; or that
science of the
an ounce.
Inappropriate or unusual behavior. Well, we
i8
know
that, too,
Psychiatry: Tfie
when we
see
it:
Model
Mind
of the Syphilitic
No problem
off the
here,
fire,
either:
with deities or dead people (and being unsuccessful at claiming a "divine calling" or being a spiritualist); or seeing one's
them
to
someone who
speaker "actually"
sees them.
hits close to
home: the
eight-
porch
forcibly
sitting
retired
healthy but
still:
traveling
hope
will
be forgiven
my
levity.
am
who
using
it,
at this
which psychiatry
prefer to be policemen
Let us not forget that medicine had been pregnant with psychiatry for a long
founding of madhouses,
when
until the
it
years,
name was
christening.
The baby's
last
father.
Hence the
had
to
by
its
whom we owe
the
19
SCHIZOPHRENIA
phrenia." Their authoritative legitimization of
cally healthy
is
When
how
it
sorts of medi-
all
is,
modern
psychiatry. This,
happened.
all
psychiatrists,
already an
became
form of
established
What
his less
in
hospital, just as
meant
that he
had the
women often
and
legal, to
thousands of them
madness
still
were considered
to
be mentally
full
men was
therefore
in
Still,
ill
like
of people
patients.
and discover
men
all
scientific
social on
and
madman
is
as
fide
these
sick
sick!
scientifically
not a disease?
To
And
could they
Had
20
in fact,
it
was not
their first
The Model
PsycJiiotnj:
of the SypJiilitic
Mind
to
be suffering from an
ill-
do not be-
away with
The reason
it.
is
simple.
in their hospitals
to
conclude that
were not
sick; at least,
wrong with
even
this,
confinement,
patients'
if
no one was
which,
after
first
It
is,
in
fact,
could not,
psychiatrists.
at that time,
and survived
as "medically well"
Indeed, they
have declared
their "patients"
as professionals, as physicians
still
cannot do
and society
in
so.
The "pa-
general wanted to
In
in
place.*
chiatrists
and
knew
everyone
all and
psychiatric
his
"confessions,"
mad-
saying
'I
rate
much
find
nothing wrong,'
can't give
any
help,' or
'I
"Almost
as
number of doctors, is
when he makes an examination
the statement
of
the
'I
patient.
When
'slanted'
by other family
practice." 30
21
SCHIZOPHRENIA
houses. This was a
fait
accompli on
a massive scale, at
that
Had
many
of
sick,
The medical
and
They would have
gotten rid of such psychiatrists and replaced them with men who
did what was expected of them. And they would have richly rewarded those who so fulfilled society's needs for social control
profession, the psychiatric profession, the legal profession,
society as a whole
for
it.
Bleuler,
This,
Freud
in
their loyal
brief,
why
is
the conquistadors
wanted them
to
so;
it
and
wanted them
it
wanted them
to
behavior
in
madmen by
this.
In his
the
disease
As
century
alienists. 31
ours the age of "mental illness" as the inventors of the internal combustion engine stand to
andising geniuses
22
who made
Psychiatry:
The Model
of the Syphilitic
must be decided."
mean
that
it
is
^^
By whom?
to be decided
Mind
institu-
Clearly,
by the patient!
Hence, from the point of view of the "patient" who does not
want
to
be confined
ful act.
The
it
Much
in a
is
institution as such
may be
same
the
time,
may become
carries with
it
due
it
it
may
At
to psychic influences.
life,
and
also that
it
is
greatly
he has
institution, after
which he
is
grips of a
Like American
jurists
is
burden
was caught
in the
satisfactorily resolve.
War who
disapproved
felt
and the
justice
dictates
and responsible
mized
it
and
legiti-
cerning the "disease" that transforms free citizens into psychiatric slaves (that
Bleuler
knew
is,
23
SCHIZOPHRENIA
schizophrenia functioned and was used as a justification for
as,
another
in
context,
it
the
justifi-
"should not"
it is
chiatric moderation.
legal option,
But insofar
For
if
commitment
for schizophrenia
or
knew
it.
Still
social institutions,
all
is
is
tives,
Bleuler
as the
is
is
own
none, and
criteria of
The
indication
is,
of course, given
when he
members
when
it is
no longer possible
to in-
which he
The unruly
which he
will
child
be released.
is
^"^
is
A graver
indictment
difficult to find,
or even
"bad,
castigates
overcrowded
institutions"
in
which schizo-
who
treat
persons."
them
as
if
24
they
^^
Psychiatry:
and most of
today
Mind
if
his
of the Syphilitic
namely: What,
The Model
still
anything, justifies
if
freedom and
is
why even men like Jefferson exand why even men like
practiced slavery,
my
Astonishingly,
is
two of
my
many
own words,
psychiatrist
is
last
is
paragraph of
this
this
his recognition of
that the
institutional
The most
serious of
am
drive. I
all
schizophrenic symptoms
even taking
this
is
the suicidal
become
unbearable for them for valid reasons; this alone is bad
enough. However, it is even worse, when life is made increasingly intolerable for these patients by using every means
to subject them to constant humiliating surveillance.^^
People are being forced to continue a
This
is
that has
on Bleuler's
tal patient,
part.
psychiatrist acts
trist-agent
life
me
its
psychia-
exceedingly similar to
25
SCHIZOPHRENIA
their victims; or that, in a totalitarian society, judges are ex-
trials in
all
that in each of
The
them
the victimizer
even a totalitarian
state,
to be brutal executioners,
tarily or willingly in
state,
services, the
Most
acknowledges
its
all this:
we were
if
more or
psychiatrists.
prestige
important to remember
it is
is,
would be unnecessary
all this
would,
at least, serve
it
is
this
in exceptional cases
suicide,
if
if
a few
patients
more
killed
themselves does
this
fact that
we
disease?
At
we
am
very surveillance
Only
drive.
commit
And
even
and aggravate
psychiatrists are
their
burdened
it is
its
attribute
all
else.
Swiss
26
He must
in
society is
a sincerity
whose
Switzerland is forced to
it is
But
sincerity.
madmen
an exceptionally
disingenuous.
The
civilized
result so
are treated
and decent
patently
self-
The Model
Psychiatry:
serving of
barbarities
trying to
Alas,
if it
explanation
to
blame
foregoing
Bleuler's
is
of the Syphilitic
psychiatric
The
true.
a period of the
and
social transformations.
unchanged
is
The only
still
still
if
This
lines.
was
virtually
in
especially
and he
in general,
On
for them.
for
Mind
Nor could
it
much
it
methods by which
is
as they
this is
were then.
not enough to
murmur
And
they
still
cannot do
necessary systematically to
condemn
it
is
and eschew
so. It
bad;
it.
it is
That
is
the simple, but inescapable, lesson which the history of institutional psychiatry teaches us.
Further confirmation of
my
foregoing thesis
may be found
in a
none
in the world,
attack
he wrote a
little
book
that
is,
in effect,
an
titled Autistic
27
SCHIZOPHRENIA
Undisciplined Thinking in Medicine and
is
very
little
known. ^^
cles.
In
preface
reasons, as
to
How
Overcome
to
It is
I shall
now
show.
try to
Thinking the
Autistic
It,
cir-
title
alluding,
of
symptoms
of
when
and
earthy,
biting,
criticism in this
book
is
[Nevertheless,]
at times peasant-like
his
words."
Most
^^
in
simple,
of Bleuler's
made no sharp
practice. It
book
this
in
distinction
is
plain "earthy
peasant-like" language.
this
Why
submit that
it
it
is
time to
let
is itself
and im-
unscientific
he
is ill
is
taking a "cure,"
do not
main
but
hope
The lady
told
me,
"My
daughter
Baden-Baden
to the
Then
on
to
"What
28
is
air
asked.
Psychiatry:
"Oh,
The Model
of the Syphilitic
Mind
"From what?"
asked again.
No
different
from
The whole
few
lines
down
the
what "schizophrenia"
illustrating clearly
young
somewhat
is
is
as a "mental disease"
it
girl,
offers a vignette
sanatorium],
is
delicate
meaning
to her
life.
What can
cay in idleness.
living with
dangerous.
one,
is
condemned
to
make her
Since
woman
It is still
whether
such advice as
relative ease,
this
is
extremely
women
really
to
is
it
is
used
in
at all:
consider
the
connections
and modern
between
legislation
matrimony
and
compels
psychiatry,
29
SCHIZOPHRENIA
us to
make
here and there. But definitions of this type are forensic and
not medical.'*^
agree,
and de-
entities!
Halfway
book we
into this
comparing doctors
find Bleuler
is
which there
is
We
administer
all
whose
of treatments
sorts
has
efficacy
which we are
therapy.
insufficiently informed,
.
There
"do something"
flection.
children,
to
We
among
is
combat an
illness,
in place of
savages,
among
doctors,
and
calm
re-
among
small
in tales
from
mythology; also to some extent in the discourse of philosophers; and in morbid form,
ular.
...
It
is
medical practice
As he warms
the
is
schizophrenics, in partic-
founded.^^
alternately,
encouragement he
if
tells
he wishes
him
is
or even in
and redeploys
modicum
to give himself a
condition
30
among
overwork;
his
this
same sentence,
When
upon
tells
is
it:
of
due to
him
The Model
Psychiatry:
tistic.
Careless thinking
is
autistic thinking is
Mind
of the Syphilitic
hallucination.'*^
cumbs here
Perhaps
it
still
(mis) behavior as
think of
disease,
self-
is
Is
simply stupid,
is
serving, exploitative,
"autistic."
to his habit,
gizing behavior.
suggest:
it
does
is
diagnosed as
is
Many
positive?
total
in
it
all
rights,
Clearly, this
chiatry;
Bleuler,
it
little
abandonment
book
is
all,
etc."*^
who through
on psychiatry, and
his textbook
institution, depriva-
of his profession,
is
after
Never
certainty.
the consequences:
all
a case of "latent"
his
his
own
sins.
For
it
was
book on schizophrenia,
own work as an asylum
scathingly criticizes.
is
that,
nothing of the
rhetorically,
resulting
illness is
in
sort.
society,
"But
is it
strain
some
critic,
he
really necessary,"
from
that
he asks
disease
for
much
real tasks of
life,
and
^*
3^
SCHIZOPHRENIA
But
made
is
it
Eugen Bleuler
and professor
same
he being
had
of
who
held, repu-
if
demned him
for
Reviewers
Many
con-
ethical stan-
last
and preserve
loyalty to his
his
own
technical
field.50
his father
wrote in
this little
book was
own
all
else,
of his "irresponsibility."
as a
in
all
^^
The
Bleuler of
official
1911the
The
Bleuler of
1919 the
tient"
and
institution.
ceremonies does
32
it
On what
rest? I
have
sacred
tried to
a powerful ide-
symbols and
ritual
my work
during
show
in
The Model
Psychiatry:
would happen
politicians,
Mind
and
of the Syphilitic
rests
it
to psychiatry
if
Roman
Catholicism as a religion.
To be
so-called schizophrenic
and of the
politics,
se-
mantics and sociology not jurisdictions for control by medicine and psychiatry. Similarly, there would remain, after the
demythologizing of the Eucharist, the moral problems of persons and the moral prescriptions of priests, but
would be problems
for control by
The
all
ethics
for
these, too,
jurisdictions
literalization of the
not accepted by
is
all
modern Catholic
to the
The
However,
is
is,
by
On
Roman
Catholics of the
September
literal
inter-
years
before the above was written, in his encyclical Mysterium Fidei, Pope
3,
1965,
only three
Paul VI "called for a retention of the full reality of the Catholic faith
about the Presence of Christ in the Eucharist, and specifically for a
retention of the dogma of transubstantiation, together with the received
terminology in which it has been expressed, particularly at the Council
of Trent." 53
In any case, I am offering this comparison between theological and
psychiatric metaphors to expose and criticize beliefs and practices based
on the literalization of the metaphor of mental illness, not to expose or
criticize beliefs
literalization of the
metaphor
S3
SCHIZOPHRENIA
It
is
substantiation
is
Catholics, recognize that wine and wafer are just that, and not
the
deity.
more
olics
thing symbolized.
The question
is:
Why
if
is
said to be a
behave. Cath-
all
do people
act this
way?
what establishes
their iden-
Non-Cath-
do mainly because
olics
it
is
is say,
in
church the
polite
thing to do.
Similarly,
is
it
mental
illness is
that cadavers
psychiatrists
Most nonpsy-
reasons.
syphilis,
just that,
they
as
all
if
the
thing symbolized;
that
is,
as
if
to
this? Psy-
their iden-
preserve.
Non-
because, as a rule,
society lest
one
of the Eucharist.
First
Amendment
it is
do
in
our
The
is
enshrined in the
Law and
Constitution.
34
The Model
Psychiatry:
The
gist
of
my
argument
is
that
men
Mind
of the Syphilitic
like
KraepeHn, Bleuler,
to
be namely,
political leaders
what were
and are
not,
Why
diseases
not,
we may
ask:
in
Why
the
Vir-
original,
suffering
in other
to their care
were sick
until
that they
were
sick,
and
it
was
would be demonstrated?
The answers
to these
and of schizophrenia
modern psychiatry
in particular.
in
Furthermore, in
me
to
in each,
which
much
of
modern
psychiatry:
(or,
the two
streams are
(body with behavior, objects with agents) and confusing patients with prisoners (cure with control,
moral and
would compare
it
to the
political,
like
and party
politicians in coun-
oil.
What
3S
SCHIZOPHRENIA
should they do? Take the
oil
Or should
they
and
free
no
less
Where,
it
may be
objected,
lemma
dilemma over
of
century?
is
political
What has
with conquest?
and the
di-
It has,
of course, everything to
"clinical
Bleuler,
institutional practice
tal patients,"
oil,
worked?
If
do with them.
material" the
and
as
oil,
their colleagues
it
in
be wrong as wrong as
if
he said that
a military attack
tually,
richly
revealing of the
martial
launched
States in 1974.
is
Acitself
modern medicine with which these psychiaworked was not patients but prisoners. Some were pris-
in the fabric of
trists
oners in the
literal
sentenced
to
imprisonment
for
any crime.
I
refer here to
some elementary
facts
and
their extremely
sequences.
The
the persons
are not so
much
much
that they
call
main, so-called
madmen
themselves suffer
it
is
not so
that they
suffer.
whom we now
Psychiatry:
The Model
of the Syphilitic
Mind
themselves as
ill
itiesdeclare
as
ill
"help" on them.
In this connection,
interesting to
is
it
madmen the
tional
system
Under
at
this
home.
ticed
in
was a sort of house arrest, such as is still pracsome countries when highly placed persons are
It
This
sort.
is,
brutalization of
they take
madmen
me
War
terms; that
to
ill.^*
for
it
in
hands of
their
own
rather unlikely.
am making
is
that in Japan,
under
is,
early
when
sort
in
In-
the
this
Europe,
their will. In
patients.
and such
37
SCHIZOPHRENIA
by showing up
similarly,
at the gate
is
to a
a criminal;
mental hos-
be a
legal,
such confinement.
emphasize
this to drive
home
were wardens.
The
which
have
to restate
and psychiatry
them from
somewhat
want
different angle.
new
afflicted
Minot discovered liver exand Fleming discovered penicillin. Because these sub-
pernicious anemia,
patients,
diseases,
erallyas treatments.
Psychiatric pioneers invent
new
new
theories of the etiology of these diseases to justify calling certain preexisting social interventions "treatments." Kraepelin in-
regarding
it
as a
calling
justify
conversation
them
to
as
dis-
yet unde-
to
3^
it,
too, as a
Psychiatry:
The Model
mentally
is
ill
of the Syphilitic
Mind
it
all
to
good
on
of life
^^
patients;
his
disturbances in
medicine
(psychiatry)
helps
fake
real
physicians
men-
tally sick).
was no
less significant:
"inaccessible"
to
psychoanalysis
or
and
fit
psychotherapy,
lacking
word
to the
problem posed by
right to freedom. ^^
Schreber,
his
imprisonment or
who was
his
"psychotic,"
to his
ques-
freedom. Freud,
who was
freedom of one of
Freud's
his
official silence
jects outside of
in
his
it.
The
professional
psychiatry
it
this matter.
is
After
in psychiatry,
fact that
writings,
to
him
me
decisive
completely ignored
how
evi-
he expressed him-
eloquent testimony to
all,
life
Freud,
involuntary
be locked
39
SCHIZOPHRENIA
up by
psychiatrists.*
chiatric
It
and
more
ambitious, and
It is
is
almost as
if
of
all
itself Freud
life
successful, than
deemed
fined, or
fit
no
whole world
everyone
whom
it
had
to
in
a patient
his consulting
room, and
Such
is
cast of characters
and
modern psychiatry
their deeds to
conform
to
contemporary
As may be
recalled,
the
middle of their
fell
victim to
How
The
He
to operate
told
him
that his
on the Cyclops'
calcitrant mental
patients
is
May
6,
word about
1908, to Jung.
It
this practice,
begins as follows:
"Dear friend, Enclosed the certificate for Otto Gross. Once you have
him, don't let him out before October, when I shall be able to take
charge of him." ^8 otto Gross, the "patient" referred to here, was a
physician who was then being "treated" by Jung at the Burgholzli
40
Psychiatry:
When
eye.
The Model
of the Syphilitic
is
Mind
fel-
his
The
credibility
their escape.
on several hidden
which
want
to call attention.
it
it
depends
on the precise semantic structure of the wounded giant's complaint; that is, on his saying "Nobody is Winding me," instead of,
for example,
And
third,
calls himself
Nobody
report.
Had
blinding me."
When
is
it
madhouses
the keepers of
call
"pa-
ments," they
By
attaching the
names
me"
blinding
some
and Freud
sort of deception
way
things in such a
others uttered
were led
laid the
assertions
and
is
that
that
who
people
depended on the
which
called attention a
them and
The
articulate
first
them
moment
in
Latin and Greek, and their bearers the names of patients, also
in these
sacred languages,
fulfilled this
requirement.
41
SCHIZOPHRENIA
The second requirement was
of lunatics in the
new
one.
The
met
this
But
requirement.
all this
met that
if
is,
willing
those
who
and eager
to
If the
third requirement
listened
these
to
form a judgment
nonpsychiatrists
like the
By
facts, I
mean
would have
seen that someone had blinded one of their fellows, and that
whoever did
it
Similarly, ordinary
imprisons them as
if
as
it
too well
all,
not a legend)
why
ordinary
the
naked
want
it,
is,
did not
no one
who does
Many
peo-
to see
now,
is,
the facts
rights.
was the
modern psychiatry:
This, then,
see,
and
Psychiatry:
which
The Model
way
of the Syphilitic
it
might seem
grew
chete.
in
is
Mind
wanted
not as surprising
into
to see
its
nostically.
munological
of the blood)
test
much
as
it
was probably
it
their faith in
model of
the
syphilis
The nature
no one
in so
will
young a science
produced by
assume
many
that
now
shall
obscured. But
is
logical to
Almost
"new
the
is
will
we
re-
at present
we have
.^2
sixty years
although
And
we may
new facts about neurochemistry and psychopharmacology, we have none about schizophrenia. We know neither
what it is nor what causes it. Still, we have made progress in
understanding its etiology: we no longer believe and claim
that schizophrenia is caused by masturbation. And we have
made progress in understanding what it is: the WHO Report,
have
to
lots of
which
43
SCHIZOPHRENIA
phrenia
more
is
a word.
may
It
of intensive psychiatric
discover that
it is
"Why," ask
to
only a word.
authors of this
the
schizophrenia necessary
tion as follows: "Firstly,
schizophrenia has
study,
come
into
concept of
"is
They answer
because we have the
at all?"
their
term.
is
it
order to keep
in
it
^^
sophical folly, and the moral monstrosity of this official psychiatric posture,
and
shall refrain
some "old
facts"
first,
will
Among
these
in the
would
way
single
curing
and
disease
controlling
and
deviance;
second,
the
human
rights that
is,
call these
"new
facts" generated
not so
much
in the direction of
it
this
problem may
may
still
and what
to them.
44
psychiatrists
if
some valuable
moral, and legal
yield
fail to
do,
Chapter 2
Anti-Psychiatry:
The Model of
Plundered
the
Mind
first
in syphilology, psy-
two decades of
among them:
paresis
it
this
were,
psychiatry,
as
into syphilolo-
making a
was, and
"differential
is
still,
diagnosis."
called
is still,
called
"specializing"
in
diagnosis
the
and
its
characteristic
the
supposedly
became
the
became
the
chemotherapy (and
artificial
fever)
and conversa-
choanalysis.
I
emphasize
these
historical
changes which
were
partly
47
SCHIZOPHRENIA
caused by certain fresh
erated
some
fresh
scientific discoveries
practices in
social
which
order
in turn gen-
identify
to
as
must see
War
end of World
we must
firepower at
however, done so
it.
As
now
shall
As
II.
it
a sharpshooter
and
try to
show, we have,
in
reasons.
its
movement,
it
is
publication of
in
like the
movement
seeks to supplant,
is
The
no small part
to
movement. This
also centered
common
enemies of
all
we
are
of psychiatry.
It is true,
face the
same enemy. So
did, in
enemy
"the
of
my enemy
my
is
the term
reject
misleading,
it
anti-psychiatry
because
*
It
themselves
The term
was used
anti-astrologers * If
is
imprecise,
do astronomers
anti-psychiatry
as early as
critical of psychiatry.2
48
it
Anti-Psychiatry:
The Model
of the
Plundered Mind
nosis
committed
to
one
diseases, then
"opposing" psychiatry
as
indeed,
is,
specialty not
a
I
of
must be
by the mythologizers
is
insisted that I
am
why
have always
am
not
consenting adults.
On
if
identify
and
articulate
numerous practices
to
I
do
in
this in several of
oppose, what
my
is
necessary
of
As
the
have tried
it
what
ently absurd. In
do which
is
pat-
state
whether they object only to involuntary psychiatric interventions, or also to those that are voluntary; to all involuntary psy-
adversaries.
by
their po-
they support real tolerance for contractual psychiatric interventions, or only "repressive tolerance" for
occur in
an
(against)
them
"exploitative-capitalist"
we
As
justify
their
aims and
rich
49
SCHIZOPHRENIA
by claiming
that the "insane" are authentic, while the "sane" are inauthentic.
anti-psychiatry
his
work with
so-called
the study of
book, published in
first
1960,
is
personality."
Four years
later,
with
it is
is,
no mention of what,
also
what,
them
if
if
in this
any of the
Nowhere
in depriving these
if
in-
any,
persons of
to regain
it.
is
some
method
to those offered
I
is
by other psychiatric
institutions or practitioners.
no
there
disease, there
is
no one
claim that
ally)
is
is,
to
is
nothing to
treat.
treat;
if
insist, that if
there
Insofar as others
that schizophrenia
it.
make
(and mental
However, inasmuch
as
is
the
illness
there
patient,
same
gener-
no "treatment"
SO
no
is
psychiatrists
if
"help"
is
The Model
Anti-Psychiatry:
of the
Plundered Mind
if
sup-
"treatment."
and
them
legitimizes
as
"commun-
who, because of
"sufferers"
in his
others.
There
premise which
ing so.
It is,
numbers
of
is
inexplicit but
say
it is
is
it
more about
more important
the
for be-
it is
is all
Laing
this
it
is
virtuous to "purchase"
it
for suffering.
should
suffice to
On
hardly unconventional.
the contrary,
communist and
capitalist
fully
countries,
situations," *
now
is
the fa-
to his abilities, to
each
citizen,
with
whom
those
I
who undertake
uation, unmolested
by
if
a person
his family
The exoression
is
madness.
is,
in his
current
sit-
now
to "journey" through
if
he
is
still
accepts
Kenneth Minogue's.s
51
SCHIZOPHRENIA
him
bona
am
and
from the
often suffer
I
am
slings
ally that
him
legitimizes
as
may
it
in
I
I
am
is
-never
their critics
is
make
made
trying to
know,
explicit either
tax-
in
the
no more of a
direct
vote on
the
for the
war
in
people mad,
his
pockets.
Furthermore,
resemble
anti-psychiatrists
psychiatrists
and
psychoanalysts in their insistent inattention to whether the socalled mental patient assumes
signed to
it
anti-psychiatrists
teria
his
role
voluntarily or
is
as-
seemingly
different,
and
sometimes
even
Thus
a "victim."
all
of these
antagonistic,
ap-
this crucial
To
is
a victim
psychoanalyst he
is
a victim of a
a combination of both;
52
and
weak
to the anti-psychiatrist
he
is
a vic-
The Model
Anti-Psychiatry:
of the Plundered
Mind
person he really
freedom
is;
self-definition.
treatment of
the psychoanalyst
it;
and
analytic interpretation,
and the
and
for himself
try,
result
is
need for
to
resist
him "inaccessible"
to
The
his
right
and
illness
denies his
penchant for
his
moral
virtue.
sons.
to take care of
themselves are placed in the same class with those willing but
who
same
who
are innocent
but claim to be guilty; and persons charged with and convicted of lawbreaking are placed in the
who
same
may be
is,
on the one
vic-
all
psychoanalysis,
and anti-psychiatry
to
far
in
their
ap-
outweigh the
among them.
insofar as
me
among
it
moral treatment
is
a continuation of the
in psychiatry,
a political perspective
is
human
it
is
nothing new;
on society and a
relations,
it
is
set of
an inversion of
53
SCHIZOPHRENIA
and arrangements. Some of these points
of
critics
most
anti-psychiatry,
The
gist of
agreement,
that Laing
underbelly of the
New
is
a preacher of
By
Left.
"soft
am
in substantial
New
Leftism" Martin
bourgeois invention."
tin, "is
recurrent
Martin
"^
nature
the
"to
calls
of
gnomic,
is
it
attention to Laing's
society
capitalist
formed,"
and notes
because
is
it
contemporary
that this
completely
but because
capitalist societies
is
as
de-
is
false,
Martesta-
it
is
less
true of
we know
is
to avoid
and
and
tions
Here,
denials.^
might add,
lies
similarities
whom
is like
is
heart
psychotic's
own
54
mad the
is
is,
demeaned
by being
Anti-Psychiatry:
All of anti-psychiatry
larity to
what
it
is
who
tance."
^^
fond of tossing
still
the other
it is
remarks such
off
what
in
almost putting
is
That
Mind
in Laing's writing,"
gesting that
of the Plundered
The Model
word
own
sug-
inheri-
it
as:
single
his
is
is
temporary
"leftist"
is,
of course,
mentality in the
characteristic
still
of the
con-
"free" societies.
"We
are
all
Martin, Laing
..."
According to
^2
is
sence of religion
is
ecstasy.
tion to build
and
There
insists
is
sloganized
discussion.
in Laing's
whole
up a sequence of ordered
points,
supported
in respect to this
virulence,
which
destroys
the
possibility
of
^3
is
a base rhetorician.^*
Lionel Trilling has also noted that Laing's criticism of the existing social order
is
he proposes
55
SCHIZOPHRENIA
for
it
Although
creeds.
more
it is
most of
diagnose),
difficult to
Thus, Trilling
right
is
in
regard
and important.
reemphasizing indeed,
think
emphasis
of
the
is
inauthentic
human
in
^^
existence."
new
He
"human
being," that
man
should
know
the
is
moral ideal
is
not in
lies
follows,
no longer
as
that
For what
Oscar
cites
concealed in
we do
this prescription is
nothing
means.
it
less
than
life itself.
and
its
role
in
this
"disorder."
It
is
precisely
on
this
Laing's work:
an
external
circumstance,
an
it;
who
directly
calls
an "ontological insecurity," a
...
It is
the family
56
is
the consequence of
is
influence
is
which
the
"di-
categorical in saying
Anti-Psychiatry:
The Model
is
Plundered Mind
of the
to be understood as "a
hve an
demand
is
is
not.
We may
put
patient's
it
that
the
as
ticity.17
some ways,
As
stitutional psychiatry.
sacred symbol,
is
is
is
it
is
latter view,
people
is,
in-
"schizophrenia," so in anti-psychiatry
modern
"authenticity."
to
human problems
factors.
[But
to society,
it
was
inevitable, according to
was not
inevitable
human
existence which
authenticity."
This
is,
is
to be
esteemed for
in
social
its
is
a state of
commanding
^^
By making
it,
my
human decency
for
all
cant:
it
is
my
is
view,
insane
it
is
is
madman
is
57
SCHIZOPHRENIA
disagreement as disease which Trilling seems to think
But
scientific proposition.
Trilling
is
has discovered
tific"
To
many
emphasizing that
Many
a ''schizophrenic"
phenomenon
in the
way
The
erogatory.
propriate. This
name
position
mode
to
of cant.
modern vocabulary
course,
may be
be super-
think,
characterized as being in an
mode
the intellectual
is
The disappearance
argument would,
of analytical
intellectual
the
as has
this,
is
right in
The disappearance
that once
not ap-
is
went under
of the
worth remarking.^^
is
and
of this word,
intimately related to
also of rhetoric,
is,
of
the
have remarked
at length elsewhere.^*^
schizophrenia from
we
coercive policy
critical of the
toward
mean
balanced
to
the
cant of anti-
and for
to illustrate
fully
and Bleuler
Kraepelin
For a
cant.
fully
we must
schizophrenia,
we do
reject
the
the punish-
ments of psychiatry.
We
can
all
it
is
58
down
is
of psychiatry
the
same
thing,
Anti-Psychiatry:
of
it
The Model
of the
Plundered Mind
to Foucault's
Madness and
Civilization:
Madness ...
way
is
groundwork of the
reahzation of what
what madness
destroys
itself
we
are about.
what madness
is,
by
its
own
is
more
truth of
specific
madness
and
strategy.
Madness, for
is
is
instance,
is
The
am
Actually,
it is
from Cooper's
in
The Death
writings, as well as
Cooper declares
of the Family
Cooper
here confuses himself not only with Jesus Christ but also with
"The bourgeois
it is
The
human
diseases
conflicts.
state,"
Cooper
from
^3
equally illuminating:
fulfillment of liberation
ropolitical
mac-
effective
action.
in
power
structures
impotent by any
significantly
organized,
student-worker
their
rebel-
24
S9
SCHIZOPHRENIA
lumpen
The
The Death
the former
Cuba
refers to
as "already liberated,"
communist conquest
in
Vietnam
capitalist leaders
communist
of
is
to the
guerrillas,
impending
toward
and
^^
as unqualified as
is
his
endorsement
leaders:
man" images
regurgitated by
non-human,
in
men
etc.
The
like Fidel
Mao
Castro and
Tse-tung,
artificial,
institutional-
Kennedys,
both in
of the Family. In
is
Churchills,
embodied
who
lead by
.^^
Laing's political cant has the same ring: "we" are wicked,
this revealing
sixties,
Richard Evans
atrocities:
was far
on. Cambodia was being
let
at the
icans
British Air
they
seek,
For the
less
men- women
60
is
sophisticated
typical:
middle-class
and working-class
and
Anti-Psychiatry:
The Model
of the
Plundered Mind
finally
tally
This
is
guns
will
come
to
in,
strikes,
is
felt,
whom we
can
^^
their
ments: each
is
on those who
resist
him by whatever
calls
psychiatry;
it
force
Cooper conceals
in their wildest
of
it,
as the
follows:
We
might
Romanoff-Lenin
effect,
anti-psychiatrists.
He who
liberates
calls
it
anti-psy-
modern
bour-
Not
be neces-
chiatry.
may
which
would define
as
antagonist.
I
think
draw from
we owe
it
to
Cooper
him
to take
seriously,
and
to
faulted; he has
made them
explicit
enough:
All deaths in the
first
Revolution,
assume
all
I believe,
New Man
too.
gets very
61
SCHIZOPHRENIA
close to the extended sense of revolution that
who
New Man
power
structures of the
to
have pur-
is
dream
apocalyptic-millenarian
of
It is
the old
As
of the collectivist
all
is
"brotherhood"
all
is
it.
The sane
are
but
all
West
is
is
no schizophre-
madder than
the insane,
latter,
The
communist East,
the
off,
One
this
connection
1969. This
is
is
in
1965-
call
Let us see
how
the
62
asylums
it
no
staff.
and
Indeed, in-
Anti-Psychiatry:
dividualism,
ment,
is
The Model
self-identification
denounced
Plundered Mind
form of self-aggrandize-
as
of the
which reads
as follows:
who
people
of
many
name,
communal experience
To
all
is
is
"A
organization
exemption
itself
Revenue Code."
To
relieve
its
^^
The purposes
"from
of
the
of the Association
mental
illness
of
all
descriptions, in particular
schizophrenia.
To
illness,
the
means
of
its
its
treatment.
To
To
illness.
To promote and
illness.^^
by Ronald Laing.
It
sounds
like Laing's
attempt to set up
"residential
manufacturing
mental
patients
(called
"schizophrenics"
in
63
SCHIZOPHRENIA
both cases), and for training future factory workers and managers
The
first
into a "residential
which opened
no
is
staff,
doors
its
in
which
feasible there
is
in
intolerable in
There
make
their
are, at least
own
it,
emphasized,
is
is
that:
others,
and
rules.^^
upon
no obligations or
this report,
the "residents."
not mentioned.
it
Behaviour
pay for
according to
Hall,
told,
it
What
is
Above
all,
they
they have to
if
mentioned, indeed
when
from a
Menninger Clinic
much
the
same way
In each case,
first-class hotel.
other, regardless of
calls itself
or the other.
the
traditional
asylum
relationship on
madman,
treats his
64
The
"needy"
payment
for
Anti-Psychiatry:
his services
from
others.
The Model
of the
Phindered Mind
char-
and
dis-
Laing imposes no
on the "pa-
patient
may
have, or of
on
it
"need"
is
deserving of care?
and
By measuring
his willingness to
been held to
madmen
same contempt
displaying the
of
and
at the Burgholzli,
his
submit
ethics.
It
embrace, thus
always displayed.
then, that
It is clear,
so
much any
of
contract. In short,
price,
not
so
is
much
coercion as
as legally on
Sooner or
the two
that
is
is,
all
contracting parties.
later,
it
all
choose between
this choice,
commands and
in
in
support of
similarities
whom
The phrase
is
William F. May's.35
6s
SCHIZOPHRENIA
There are troubling inconsistencies not only between Laing's
assertion that schizophrenia
is
it,
no
(Clinic)."
ically
his
own
rhetorical
devices.
psychiatric
work
of
hand grenades;
made me conclude
that in the
the
trenches facing
each other, lobbing the same grenades back and forth, hoping
they will go o5 in their enemies* faces rather than in their own.
I
am opposed
to
this
medical vocabulary,
of
invert
tially, is to
the family
its
of
is,
My
ent
is
at least
a "victim,*' he
and points
actually do.
concerning
Briefly put,
is
times,
is
ipso
his victimizers.
to
different
quite
and
my
supposedly
My
at the things
secondary charge
what psychotics
differ-
conclusions.
at
suffer
their
from.
66
some
premises
claims
his disease.
is,
in fact, a
form of
Anti-PsychiatTy:
The Model
of the
phrenia"
and
immoral (and,
is
that the
in the
phenomenon
Flundered Mind
uncon-
States,
is
on
of hberty
loss
United
name
of
While there
no need
is
to
encumber
Mary
this'
presentation with a
tions of anti-psychiatry.
Mary Barnes
is
to
psychoanalysis: each
is
leader.
It
consists of two
is
to
case,
its
miraculous powers of
to the
Through Madness,^^
Barnes,
Wolfman
of a Journey
Mary
much
of
anti-psychiatr\\
The advertisement
plies another,
for the
both important.
It
are
certain
similarities
between
this
It
implies
account
and
The top
in
Publishers
glimpses into
Weekly, reads:
"One
of
innovative psychotherapy
most penetrating
techniques."
Then
SCHIZOPHRENIA
follows the publisher's
own
text,
Two
when they
lived
who helped
R. D. Laing's thera-
in
in this blurb
who work
1.
there are
Kingsley Hall:
at
is
no schizophrenia and
that
The communards
2.
are
no patients and
at
we
are told
The operators
3.
owned
of
this
enterprise;
here
yet
is
it
is
identified
explicitly
it
is
not
communal
"R.
as
D.
Laing's."
Laing and
4.
we
is
would be
difficult,
even
if
one
tried, to
Mary
in
would
account,
the
where Berke
beginning in
the
68
Acknowledgments,
writes:
like
to
acknowledge
my
indebtedness to Ronald
indicated at several
is
my
account.
refer,
most
discuss
and
illustrate
particularly,
to
the
Anti-Psychiatry:
by which the
nature,
may
that a person
same
the
The Model
may be
renews
self
of the
Plundered Mind
and
to the
awareness
time.*^
to
As
for
Mary
to
reveahng observation:
Unable
to
seemed
ple:
cope
ways
that
at sea.
at
angry.
Then
was seemed
interesting that
my own
other people
on
much more
make
^^
in
Just in going
at times to
with myself."
ways, being as
It is
in
at
is
Mary
Barnes' passion to
as plain as Laing's
and Berke's
to
hospital with
admission
is
its
controlling
word
word denotes
To me
Mary
Kingsley Hall
is
is
She has made them act out the roles she wished to impose on
them. Laing's theorizing
deny
is,
from
this perspective,
such as
an
effort to
Mary Barnes:
69
SCHIZOPHRENIA
on informed consent and economic
contract, but
me
Politics of
Experience
way that
The style is
in a
Few books
There
"reality."
^^
Does
is
Why
own books
He
more.
cut
also likes
down
and
social
For
it is
"feasible,"
and
trees
as
"forgivable"
and
bleed.
to
one edition of
this
book," he
at
truth
this arbitrary
regards his
of
conjunction
little
One
tells
*^
style is his
and
literary
serting anything. It
is
what
it is
as-
a particu-
lar
mind
with a
Of
is
somewhat
make some
original." ^^
assertions,
and many of
70
The
Anti-Psychiatry:
The Model
Mind
of the Plundered
complex
tific-industrial
is
hold
The
of.
was
largely
programmed,
vise
him on what
we now know
that
astrologically,
by
employed a
Hitler's astrologers
Perhaps because we
"know"
all
tell
free to
do anything
it
doing.**^
is
at
my mind
that
is
^^
his own
make and
However,
"facts."
no evidence of
and consummate
cares to do."
II
astro-
Hitler's
were
World War
reliability is
style.
This explains
why Laing
self-
systematically
and
vice versa.
"lets us
know"
that he
not satisfied
is
if
he had his
way, only he (and perhaps a few others) could put ink marks
that, in short,
would
let
you know."
if I
could
tell
if
you
^^
There
try
is thus a consistent symmetry between the old psychiaand the new anti-psychiatry. In psychiatry the dominant
it
man
him
to "find the
mind he
lost";
if
him meant,
he refused
it
meant
71
SCHIZOPHRENIA
him back
"driving"
imagery
into
In
it.
man
that of
is
it
up by following the
To be
self; if
he refuses to lose
if
it
were enough
name and
pay
to
it
sure, occasionally
is
or to
it
false
is
a metaphor.^^
lip
no such
But
say
thing, that
then, almost as
Here
people.
The
a typical passage:
is
men]
[future
what we
call
"schizophrenia"
in
this
idea.
We
must assume,
therefore,
that he
means
chiatry
course,
that
it,
it is
and a psychopathological
term as a
state defined
of
treats
much
literalized
what
less to define,
asserts that
be
But
that
he
refers to
break-through."
Bleuler.
it is
is
it
^^
all
That sounds
not a whit
more
breakdown.
nice.
Much
It
may
nicer
also
than
downs and why, which are breakthroughs and why, and how
we
distinguish
Laing continues
and Freud
short,
insofar
he has his own categories of approved and disapproved conducthe even calls them "sanity" and "madness"! but does
as
72
Anti-Psychiatry:
not
us, clearly
tell
ler's
of the
Plundered Mind
The Model
despite
"Wolfwoman" Mary
its
on schizophrenia
is
is
by Laing's
As Freud
As
man had
a "neurosis," which
analysis, so
the Wolf-
is
which
a "psychosis,"
anti-psychiatry.
is
And,
the sacred
as
finally,
Freud's famous patient and the legends about him and other
patients authenticated
rotics, so
Freud
as
The general
and
structural similarities
anti-psychiatry
are
equally
lunatic
The
arresting.
set of
their clients
was a
the
hospital,
who run
jailers,
on
their journey
and
is
The
patients.
is
much
the
same
in the lunatic
is
and
his keepers.
As
defini-
73
SCHIZOPHRENIA
main
differences between
them
is
submission,
imagery of
lost
Mary
meme
it
chose.*
on her
ability to
will-
these
self-esteem.
and
Schizophrenia
is
it
is
Of
course, schizophrenia
disease; but
is
it
also like
may be said
many other
to
and
ous, conceited,
The
point
is
selfish.
justifies its
metaphor of
management by means
of.
term
"schizophrenia"
"patient" has,
it
disordered that
designates
some
"problem"
that
is,
it
is,
an
ostensible
"patient's"
life
is
it
suffering,
74
The Model
Anti-Psychiatry:
of the Plundered
in her transformation
Mind
from ''paranoid
demotion diag-
the
She
writes, referring to
an
a "guide" in her
artist enlisted as
"
Sea.' "
This
is
it is
who
whom
flattery
It
by superior
rather,
is,
another
of
schizophrenia by making
And
Mary Barnes
as a "resurrected"
distinguished,
woman
left,
five
me
final
It
as a
As
"promotion ceremonies."
to
It
surely
Or
means of
impHes no en-
or her self-esteem by
knowledge and
skills,
as
Do
latter.
What
they symbolize
do commencement
is
important, in
7S
SCHIZOPHRENIA
ways we cannot consider
here, SufiBce
it
Mary Barnes
to
is
is
really learned to
legitimate reason
be a "gifted painter"
On
jacket
it is
Mary
book there
ing
on a
an
art critic.
slice of elm,
And
done
even
if
in the Spring of
I
is
were,
my
A finger paint-
1969."
^^ I
am
not
by others. But
art; it is "finger
painting" defined as
Let us view
Mary
is
not
art.
painting
her
sacrahzes
as
"gifted
painter"
or
priests
and profane
into
And Mary
St.
The
only the logic and the vocabulary, but even the trappings, of
psychiatry,
theoretical
principles
me
at least, only
all
as their
own
"original"
contempt and
^^
pity.
in
smearing of paint. Or, what comes to the same thing, the psychiatrists seek for the signs of
in the
76
Anti-Psychiatry:
The Model
of the Plundered
and
Mind
find them, in
the paintings of
sis,
and the
patient, especially
The
rates.
anti-psychiatrist
and the
genius,
recovers.
method?
painting
patient, especially
How many
calls
diagno-
discovering
it
he believes
if
five-year-old
and
blesses
it
duly deterio-
it,
it,
reverently
who
he believes
if
proto-Picasso
the
really
Mary Barnes
really the
this
Is every finger-
mother
his
Mary
Cassatt her
to be? Is every
just
One
their riches?
The
anti-psy-
of the
most
her "journey"
is
striking things
submit,
is
"no."
Mary
about
Barnes' account of
who
life
and
their "loved
War
supposed to
be.
These
parallels
is
of
between
it is
obvious that
many
it
of
from
madmen
free-
are important
adults lack
is
regimes
dom by masses
I.
al-
77
SCHIZOPHRENIA
thrown
who
it
act this
way may
chotic (especially
theless,
no room
these facts.
The
that
if
it is
is
in Laing's
is,
never-
schizophrenic, he claims,
is
always deprived of
society.
Implicitly,
bosom
in the
it
chiatry, society.
Psychiatrists
want freedom;
deny
that
and
like lock
fit
anti-psychiatrists
tourists
all
on
all
be rich
copper mines. In
if
human
through plunder.
intervention.
ashamed
The Chileans
who
would
see-
all
tourists
The
insist
self is
Cooper
is
"rich."
"sane."
The
their
flow from
Such intervensitting
on top of
articulates
this
naivete:
78
and
it
sells
them back,
in tins, to country
at
300
The Model
Anti-Psychiatry:
percent
This
profit.
is
known
and treatment.
close to help
as "aid,"
.
Plundered Mind
of the
.^^
If
one
itself,
same
human
pattern:
problem
this
way, namely
in
edgment of the
nothing of himself
for the other, then
is
left
to himself since
we must conclude
that,
so that finally
he
altogether
is
nothing
Here, at
last, is
it,
as he
at
least, real,
their possessions.
Who,
The question is, of course, rhetorical. In the imagery that Laing and Cooper are promoting, we
are both victims and victimizers. Who, which, and when is not
for us to ask. They will let us know when they are ready.
der,
which
is
It
should be clear by
of paresis
was not
now
paradigm
their
modern anti-psychiatric paradigm is not origiwith Laing and Cooper and their followers. The psychiatrists
followers, so the
nal
it,
79
SCHIZOPHRENIA
a
specialty based
state.
New
it,
him
is
insane
madman
merely an extension of
is
make
is
is
Both
theft."
stitution, private
other. In the
something as someone
property neces-
else's
This
it.
is
constitutive
property."
^^
of
rule
the
institution
of
private
comments:
If
one
sense.
tries to
It
was intended
as an external
it
makes no
its air
of
to the
on the
deck of some
rules
institutions
and
still
all
institutions
by)
we
One could
is
uncommunicative, law
sible institution. ^2
lie,
is
marriage
not
consider char-
But
institutions overboard.
overboard?
acteristically
to live
80
is infidelity,
tried
language
is
Anti-Psychiatry:
Interestingly, this
and why,
The Model
is
in part, they
Plundered Mind
of the
fected youth of our age who, having nothing to live for, are
envious of
that give
who
those
all
meaning
do,
means
individuals as insane as a
(which
the
is
psychiatry) as
do
as insane (which
my
to the lives of
meaning
of gaining
cannibalism
existential
to individuals
part,
demeaning other
I feel just as
lives
and want
for their
characteristic
demeaning groups or
of
societies
is
anti-psychiatry).^
This, in short,
why
is
still
intellectually because
it
it
wrong,
psychiatry
is
anomie
authenticity;
as
condemning
politicians,
it
justifies the
is
a wrong,
as
disease;
intellectually because
it
interprets
selectively
own
who would
of our society,
disagreement
make
own
personal or po-
reasons.
not only
as
opposites
usually
do,
This similarity
is
images invoked
this
in
but
and
its
also
in
their
management.
nant image
is
had
"lost"
is
that
the schizo-
81
SCHIZOPHRENIA
phrenic had a "sound mind," or could have had one, but was
deprived of
it
it.
How? By
his personality
is
it
in-
is
synonymous with
a nearly universal
human
of schizophrenia,
possession, and
which
achieved without
is
self,
which
sanity
is
and
results
from damage
it,
too,
is
is
synonymous with an
human
Rous-
possession or poten-
effort; insanity
brain/self
is
dropped back
as a
in
measure
is
hand. Syphiliza-
major contender
among
the anti-
in the lead.
measure of
truth;
how
is
an ardu-
"sanity" what
call
a great deal to
we
do with
82
conflict;
Anti-Psychiatry:
The Model
and
much
not so
of
some
cannot be
requires
It
an
mental health,
life
Mind
of the Plundered
altogether
model
different
perspective-
or
no statue hidden
in the stone. If a
no marble
ing
it
man
statue,
it is
because
it
it
the
is
wants
is
wrong
stolen
idol;
nor
because he
it
The
and the
failure to
meet
this
from infant
we
is
it
think
into child,
we ought
numerous
that very
"self"
finds
no place
whose self-making
and
chiatry. Psychiatrists
tic in their
this
anti-psychiatric
view,
make everyone
allowing incompetent,
self-destructive persons to
contempt of others
in the neat
is
wallow
in their
Alps of alienation,
village
and
live
and
self-contempt and
them
after
sane. In the
destructive,
safely through
which
all will
arrive
happily ever
after.
re-
8s
Chapter 3
Schizophrenia:
Psychiatric
Syndrome
or Scientific Scandal?
IF
SIXTY-FIVE YEARS
of "progress" in
it
modern
"scientific"
And what
is
syndrome? According
it,
to Webster,
as a
syndrome.
it is
"A group
it is
or pathophysiological abnormality
Schizophrenia
is
nevertheless a disease.
is
it
is
It
would therefore be
some
It
is
impossible to
as
it
would be
to
possible, however,
modern writings about schizophreways this term is used, and thus show
characteristic
it
it
None
of this
means
is
meaningless.
On
the con-
trary, its
meaning
crucified Christ
The
ward
is
is
entire literature
in
the
^7
SCHIZOPHRENIA
dreds of thousands of "learned" books and essays in
important languages-is,
my
in
"schizophrenia" as
when
disease,
if
it
fact
in
the
all
all
it
treat
the
is
it
when
in
fact
psychiatrists
it
do
legitimizing something
a justification
is
to them.
when
that
come
to
believe
refers
to
disease
that
is
is
is
simply not
complex
set of
so.
What such
moral and
ment of schizophrenia
support
legal
it
treat-
in
this interpretation.
is
of
it,
in his classic
before obvious
Noyes' Modern
typical:
symptoms
The
patient
only occa-
Following the
made
initial
as to whether
or admitted to a hospital.
prompt admission
to
If
threaten
is
social
acceptance,
indicated.^
The
that
it
88
account
is
how
him by force or
sion
fraud. Furthermore,
who
is
it
someone brings
Kolb says, a "deci-
usually
is:
as
if,
"treated,"
tives,
The answer
to
make
is
usually
By not
made by
it?
appear as
if
it
were
like
who has an
have redoubled
World Biennial
rights,
human
whenever
possible. Illustrative of
is
Volume
of
The
specifically
on
to ascertain, there
people
called
volume includes an
entire
chapter
up people,
obscenely
Yet,
"schizophrenic."
is
by A.
V.
especially
enough,
the
Snezhnevsky,
of the
numerous contributors
involuntary psychiatry.*
And
so
it
to this
volume,
totally ignore
goes.
psychiatrists
in insane asylums. In
SCHIZOPHRENIA
Germany, Franz Josef Kallmann the pioneer
mental
disorders offered
revealing
this
of
geneticist
about
opinion
the
It
generally
is
many
lies in
known
commitment of
The blame for the delay
some
officials
and physi-
still
The
which
Since "schizophrenia"
term since
my
it
is
it
what "his"
is
wrong with
psychiatrist does to
the alleged
him it
in
is,
if
is
is
legal,
a disease
scientific
is
its
is
now
is
a disease, but to
The discovery
of
not
lobotomy exemplifies
efthis
orientation.
In 1935 Egas
try,
and
for his
in
work
The
citation
90
it.
"^
Thus, explicidy,
as
it
rec-
ognized that "certain psychoses" for the most part what Ameri-
dis-
What
else
own
Here, in Moniz's
omy
words,
human
brain?
his explanation of
is
how
lobot-
Starting
from
chic
Normal psy-
me
to the following
it is
in their constant
It is interesting
and
Nobel
the
Prize,
is
which
is
transubstantiation.^
its literal
As
doubted or challenged
in the
be doubted or challenged
as priests,
his
of exactly the
validity of
by
Age
in the
Age
of Science. Furthermore,
so
lobotomy and
is,
so far
condemned by
banned
in the Soviet
Union.
9^
SCHIZOPHRENIA
More
revealingly
still,
Moniz acknowledges
human
aim
that his
much
in try-
to find a
is,
to establish a firm
On
the eve of
moment,
my
first
my
fears
all
attempt, in
favorable results.
If
we could
we would prove
ing groups,
tions
tion
were closely
as a
fundamental fact
an organic
basis.
related.
on
^^
I cite
to their elabora-
much
to
condemn
it
as to under-
from
traditional
studied
the
prove that
try to
body, calling
it
paretic's
shock after
was
it,
justified,
this
on the basis of
it is
How-
electro-
their use
are
now
the results
affect
many people
92
just
method of "research"
example,
quilizers
and
it
so-called
psychotic
behavior
in
ways
that
Thus, while the more romantic and radical therapies of schizophrenia come and go, the psychopharmacologists are
tling
down
work
in earnest to
for
all its
worth
now
set-
their particular
announcement
March 1975
in the
issue of the
magazine
new
old
for
"Carbazepine
new
of
drugs,"
seizures,"
for
sulfonylurea," and
drugs,
three
"Molindone HCl
an
"Glyburide,
investigational
in schizophrenia.
Molin-
of
dosage,
its
easily
adverse
"Evaluation: Molindone
and
is
offers
metabolism,
effects,
and,
as effective in schizophrenia
an alternative
in refractory
^^
come
stuff,
he might
a disease,
is
"like
is
he
is
treating for
it
it.
in
now
diagnose.
recent essay
support to
my
by a leading
it
constitutes the
is
ground on which
93
SCHIZOPHRENIA
successfully
unmasking
their
now regrouping
depredations, are
and moral
medical pretensions
for a
new defense
of their
strategic
that disagreement
Hq
psychiatry. ^^
of
retreat
is
candidly
acknowledges
The enemy,
in this
imagery,
my
is
which
is
of, so-called
mental
illnesses,
its
The
its
claims
of the occupied
all
and outlying
territories
It
is
all
unhappiness and
all
undesirable behav-
illness.^'*
is
powerful
dell's retreat to
thinks
let
is
94
order.
Ken-
all
means
we
first
is
an
illness
it
and that
than anyone
But
let
mankind."
same
for
and
guild
titled,
is
the woes of
all
^^
patriotic leaders
members
of their
of their fellow
make such
But the
claims.
issue
It is
whether schizophrenia
and whether
is
psychiatrists
a disease
should be
it.
scientific,
which the claims of modern psychiatrists concerning schizophrenia and their conduct toward schizophrenics
to say,
drome
called
"schizophrenia"
is
rest.
That
is
consistently
correlated
with
only of schizophrenics.
Or
(and
more dangerous
human
to themselves
On
justified.
this last
is
remains revealingly
silent.
arms:
it
is
command
to
on schizophrenia
is
95
SCHIZOPHRENIA
to insist that
do are investigations
institutional psychiatrists
and treatments of
and
shall
for
a disease
for
now
try to offer
evidence to support
this view.
bert
reviews
the implications
known
difficult
than
health
made
psychiatric
(LPS)
commit-
it
means an opponent
Los Angeles,
as the Lanterman-Petris-Short
at
new mental
of California's
this
act,
no
the author, by
is
this
.^"^
.
know and always have known that this is really the reason
why people get locked up in mental hospitals: because they are
it,
a nuisance.
But
this idea or
How,
the
dis-
then,
were these persons who, according to Urmer, were hospitalized only because
96
Since 25
now
residing
in
such
assume that
safely
hospitals
are
so
classified,^
we can
Urmer
refers to
I
they are
^o I shall
get called
how
add to
this diag-
want
Department of
many
my
conten-
and "treated" by
who
mental
institution.^^
authors of this study identify the two groups with the lowest
mortality rate as the "elite patients" and the "normal patients."
Greenblatt and Glazier who cite this study with unbounded approval,
sponsive, independent in
but manifesting
self-care,
relatively
large
and
re-
number
of
psychiatric
debili-
The
latter
group
is
actually "healthier"
is
97
SCHIZOPHRENIA
mission that
many
continues
unabated and
is
for
now
their
"mental
powerfully
rein-
forced not only by the claims of psychiatric inquisitors preaching a "right to treatment," but also by the contentions of civil
and "liberal"
rights lawyers
tution
jurists
"right
treat"
to
their
victims.2*
The proposition
is
wanted
to
demean and
If
this
"diag-
had only
atric diagnosis
or obsessionals or homosexuals.
to call
Why,
know what he
is
doing,
is
is
it
the
and continues
justified,
involuntary
psychiatric
to justify,
interventions
on
the
"patient"
so
diagnosed.
quire a book,
want
9*
re-
psychiatrist. Dr.
would
this term.
identifies
her-
I left
Union
Soviet
12 years.
last
I
for
my
in
one of the
patients
it
my work
that could
exist.2^
number
never "so-called" to Woikhanskaya. They are "real." She believes in schizophrenia as firmly as she believes in
"This problem
[i.e.,
"and
Marxism.
the
it
me
What "honest psychiatrists" actually do in the SoUnion we soon learn, all too clearly, from her answers to
greatly." ^7
viet
Question.
How
is
Woikhanskaya.
Soviet
send
Union and
mentally
it is
ill
this
that there
is
in the
any danger of
this
if
Question.
And
Woikhanskaya. Yes.^
if
be some
If
to
in Russia,
little
and
realize,
this "disease"
has
Brezhnev's Moscow:
official
come under
99
SCHIZOPHRENIA
and there must be
be admitted
to
criteria
in this
to
order
in
fit
way?
is
and consistent
of a boring
Syndrome
of
types.
They
They
are not
ill,
is
people.^^
ill
Here
it
is,
all
of
it,
pure culture:
in
"Seeking reform"
as
and
and
word means must
be inferred from the way it is used, then this is what schizophrenia means not just in Communist Russia but everywhere.
A brief case history of the "diagnosis" and "treatment" of a
"dissident" was published in a recent issue of the New Stateshis involuntary "treatment." If linguistic philosophers
man.^^
It
complements
and
Woikhanskaya's
amplifies
Dr.
Jew and a
Zionist,
account.
A
the
The
USSR
police ask:
between
Krilsky, a
arrested in
is
Israel
Who
would he
and Russia?
Israel,
event of war
he answers. Here
is
what
happened next:
His father, called by the
KGB,
Moscow] mental
ment
(Jan was
now
18.)
The
oil,
which sent
is
temperature
100
his
London
psychiatrist
Committee
Scientific
Moscow and
six
months
later re-
Foreign Minister
Gromyko about
KGB
for
Yakovenko
to the
[Later],
drafted
his desire to
letter
go to
to
Israel,
angrily. This
to another.^^
By now,
an
official
Israel.
committed Jan
court]
a mental
to
^-
may
seem, the
gangsters
However
who
ing them!
In his recent,
Diagnosis in Psychiatry, where he never mentions the psychiatric repression of deviants in Russia or elsewhere,
three
of
sub-types,
this
illness
periodic,
he
states:
[schizophrenia]
sluggish,
and
em-
shift-like
and
less
by
its
actual
symptomalOl
SCHIZOPHRENIA
European psychiatrists, a fact which has
some bearing on recent political controversies.^^
tology than other
The Russian
psychiatrists
same
of the
form the
"clinical" base
recommendations
now
Let us
for
consider
its
rest their
their
proper treatment.
how
this
mous contemporary
biologists, chemists,
In
and
fa-
geneticists.
winner
in
He
medicine.
$10 million
research.
for the
.
new
era in
coming
fiscal
he
listed diabetes
We may
102
it.
He
Among
those
assume
would
that he
on a reputable psychiatrist to
would thus base his genetic speculation on a pro-
make
part.
and schizophrenia.^^
some
rely
fessionally organized
work on
the
genetic literature on
most
biologists of
now
appears
trance.
We
a genetic morphism.
nia
Huxley has
in
." ^^
mind Jesus's?
it
involves
schizophre-
All these men, and of course countless others less well known,
trusts.
how much
is
diagnosed,
it is
remark-
is,
first,
its
it
chiatrist, asserted:
The
The importance
From
the
a whole,
known
it
population
is
be
afflicted
schizoid-schizophrenic
with
disease.^
This
is
all
it
guarantees
it
a se-
103
SCHIZOPHRENIA
In the same year Elaine
Gumming,
New York
State
a half of
platitudes
Above
all,
stigma
still
to
in psychiatry
we have
mind
illness
as schizo-
debilitating to
is
enquiry,
rate,
[of schizophrenia]
would be a double
from a
truly awful
illness.^^
This
who,
is
were an
atry.
suspect, really
illness, that
specialty.
if
knew
It
would
for psychi-
genetic defect.
It
would,
versa. It
shown
in
to
to
also please
be a "mental
be such a "mental
Jews
illness,"
Mohammedanism
if
it
is
the other
is
if
com-
and vice
could be
in a
illness,"
ir-
phrenia
is
all
How
else
"scientific"
a disease, preferably
circles,
genetic
104
it is
that schizo-
disease?
Why
is
a myth, a medical
mistake
The standard
indis-
is
New
we
are informed:
Schizophrenia
is
of the population
through the
hundred
many more
against a
in a
of
Some 60,000
one
lives
... All
this
occurs
scientific
it
It
is
menot
so
many
authorities
made
so
many
be objectively identified by means of histopathological or pathophysiological criteria and observations; where, in other words,
the very identity, not to mention the nature, of the disease
is
shrouded,
if
set
surely in controversy.
There
is
at present
a disease. Indeed,
if
first
is
not a
phrenia
is
disease;
it
is,
SCHIZOPHRENIA
everywhere, although, because of differences in national
life
styles,
somewhat
it
differently.
that
American
make
psychiatrists
the
Aro-Abeokuta,
cannot
it
ac-
on the
"Once a
cine, relates,
USSR,
that
as having schizophrenia, he
is
Union
is
diagnosed
^'^
She
remarks:
may
trist
his
cerned, paternal,
power
Lest
political change.
Patients have
treats them.
leave,
on
to
change the
patient's job
place
situation,
it
He
his
life.
has the
him on
.^^
.
loose, variable,
and morally
106
remembered,
is
is
must be
it
Among
he included a "subgroup"
we
[sic].
again interpreted
.
Our concept
cold-hearted,
indecisive
and
fanatic
by
regarded
types
headed
all
touch with
reality.
chopathic individuals
who showed
whom
re-
such symptoms
stition,
a striking and disproportionate degree, dominating the personality of the individuals in question.^^
Is this
a disease?
mense
Or
of the
is
an unquestion-
"symptoms" of such
If the
here.
hoax
it all
is?
is
needed
That schizophrenia
And
that,
is
to
to stop right
show what
a cruel
medieval
terrifying
as
such like
The examples
'^^
SCHIZOPHRENIA
just like
things.
that
First,
none of the
knows how
a disease which he
and
their accounts,
is
in psychiatry
to recognize
politics,
as political ac-
is
in the brains of
in
identify.
the brain
and
Treponema
pallida
hand, are supported not by evidence but by power: for example, the policy of forcibly confining certain people without
accusing them of crime or trying them for
and of forcibly
it,
is
in
particular
to act in these
such power
and confined
status
is
and segregate
is
when
persecution;
their fellow
is
when
is
psychiatry.'*''^
While some experts worry about the nature and cause of schizophrenia, others among them biologists and chemists as well
as psychiatrists are ready to treat
108
it.
Among
the nonpsychia-
it
is
no
less
As
coeditor of a
book
titled Orthomolecular Psychiatry, and modestly subtitled Treatment of Schizophrenia, Pauling claims that schizophrenia is
How
of schizophrenia
he knows that he
unclear.
is
nia
is
is
is,
treating a
bona
fide case
ill
call schizophre-
becomes a
scientist of his
stature.
of the brain
defined as a chronic
is
inducing chronic
article (J.
disordered
mental
insanity
is
ent day
...
it
At
the pres-
is
is
the
Pauling quotes
mind
it is
in a healthy brain.^*^
this passage,
articulating the
terestingly,
is
Pauling treats
as
if
it
were a
fact.
as-
In-
was, but
it
paradigm of the
tries to establish
rejecting, the
Moore proved
that paresis
is
"psycho-
genic":
By
log
SCHIZOPHRENIA
because of the development of psychoanalysis by Sigmund
Freud. The earlier definition of insanity was deleted, and
replaced by discussions from two points of view [one organic,
the other psychogenic].^
After
quoting
standard
the
psychoanalytic
of
definition
and psychiatry
now
is
rapidly
The
recognition
by changing
Pauling
is
and
its
can be no mental
is
illness,
brain disease,
if all
is
all
But
if
all
mental disease
is,
must
First,
Paul-
illness, that
there
definition, bodily.
is
"mental
diseases,
by
We
at once.
no mental
that illness
disease
molecular composition.^^
With
is
it
diseases:
it
one
would be necessary
at
all;
it
is
so proved
by appropriate and
110
and
third, that
fundamental
society
have
they
and treatment.
all
his
un-
mental patients
have brain diseases. Instead, Pauling draws three other inferences, all of which seem to me empty, false, or immoral.
Pauling asserts that psychoanalysis has failed as a ther-
First,
apy;
it
impossible
is
cure
to
("mental")
nonexisting
diseases.^^
Second, Pauling points to the use of modern psychopharmacologicals as evidence that mental diseases are brain diseases;
itself
deficiency.
And
human
needs to be treated";
livers,
race
Pauling
third,
this
is
owner
to
be the unlucky
its
cisively, that
it
their
customary
in pediatrics
and psy-
chiatry).
The upshot
is
somehow, no psychiatric
are
only
diseased
brains
needing
fixing
by orthomolecular
strongly supports
my
their
patients,
foregoing remark:
111
SCHIZOPHRENIA
The
who do
vitamins
of
by their patients
to
certain
arbitrary
levels,
psychotherapists,
Psychiatrists,
been accused of
all
and
sorts of mischief,
have
psychoanalysts
dare
is
new
word "de-
vitamin intake
tients'
psychiatrists
mins
is
least.
Actually, most
wonders what,
if
if
anything, he
know
vita-
one
this,
in
psychiatry.^2
I
detail, first,
in
some
its
chief
and
third,
there
in the
is
civil
libertarian,
any other
zation,
Long
civil rights
and treatment.
Abram
Hoffer and
phrenics
112
Anonymous
International.
Hoffer and
Osmond
set
on schizophrenia
pamphlet
in a
titled
a nonprofit corpora-
is
brochure we
to the
was prepared by
What
Amer-
a recovered schiz-
Abram
Hoffer, director of
in
to
Schizophrenia
not favor
not a
is
homosexuality or
in
the
of
not a crime.
life. It is
...
It
stress.
same way
How
the
is
same
body of
does
is
a physical
And
it
is
a disease
It
not caused by
Schizophrenia
that pellagra
which
is
devils or difficult
disease,
way
or intellectuals.
artists
scientific
them
so:
is
a victim of a
bance
ality,
in
and behavior. ^^
offers
much
interesting informa-
first
somnia.
4.
An
2.
Headaches.
3.
injunctions such as
"You must
." ^^ It
a darker hue.
also includes
on the judg-
113
SCHIZOPHRENIA
ment of your physician and follow
fully.'* ^^
There
is
instructions
his
faith-
effects
of
various brands of perfume on the offensive body odor of schizophrenics, nor of the social consequences of deodorizing
them
by commitment.
therapy on Schizophrenics
Any
individual
by a mental health
specialist
invited to attend.
is
Members
God and
a pledge of faith in
as a schizophrenic
medicine.^^
The
rules of Schizophrenics
Came
to believe that a
restore us to sanity.
of
lives
Sought through prayer and meditation to improve our conscious contact with
His
It
will for
God
would be hard
to top Hoffer
insist,
is
a physical dis-
ease just like pellagra and diabetes (the examples are theirs).
and
[their]
lives
phrenics International.
be
difficult to
amusing
114
aflBicted
know what
is.
with
it
"turn [their]
God" and
In this connection,
it
is
Schizoit
would
especially
Linus Paul-
the
atheistic
for
scientist,
form of state-supported
this
religion.
Many
certain
in
this
no way shakes
their
faith
pocrisythat
is,
con-
its
What
is
heated,
or
if
is
The ways
in
is
remarkable.
nonspecific
(i.e.,
tician's theoretical
background and
to
be affected by such
most
difficult
And
problem of all it
a diagnosis of schizophrenia.
is
conducted
There
(e.g.
is
the
no
test
is,
in fact,
schizophrenic.^^
What
vali-
is
a medical diagnosis.
It
is
utterly
115
SCHIZOPHRENIA
misleading to
"problems"
to
call the
problem"
difficult
at
concerning
all,
schizophrenia:
they
are
not
not now,
is
will
be a bona
this
medical diagnostic
fide
term.
However, none of
ical disease.
of
it
in principle,
This
no
different
from
to help
Why
if
diabetes.^^
The
not surprising.
is
mega-
should
we
expect
made
it
want
between
add here a
to
scientific
brief
observation on the
relations
its
of medicine, the
disease, the
Today
there
phrenia
is,
or
who
really
is
or
is
is
phenomenology of schizophrenia
dows,
its
And
if
the
None
of this
it.
fasting, appropriately
an
its
dangers,
An Old Cure
we
learn that:
116
for Fat,
from hallucinations
apathy
to
more
paranoia afflicts
to
than two million Americans and costs the country more than
$14
billion a year.^^
Having so
the
"identified"
presumably put
in the
alleged
the
disease,
reader
is
men
who
white coats
in
"more than two million Amerimention the $14 biUion. The author of this
cans," not to
article,
we have
Now all we need
disease. After
treating
it.
afl,
is
another one:
is
in the battle
No
phenothiazines in 1951.
win prove
to
be a comparable breakthrough.
limited
num-
Were
the
human
merchants not so
the scene
now
unfolding before us
don't
know how
to diagnose
know what
it.
At
schizophrenia
same
the
would be
time,
is,
and
one group
by feeding the
it
ommends
withholding
all
it is
It is
hard to see
how
how
both
easy to see
false.
Among
those
surprisingly,
not
Russian psychiatrists,
now
widely recognized as
total
food
at the prestigious
abstinence
[sic]
have
Psychiatric Institute
in
117
SCHIZOPHRENIA
Moscow. There, Professor Uri Nikolayev was
the
among
7000
to try
first
... He
his
has
more than
patients.^*
abstinence";
we had
Undeterred by
marvelous
the
all
who
schizophrenia, those
we weep.
"medical"
treatments
is
for
a "psy-
treatments for
it.
lists
the contribu-
tions of eleven
schizophrenia.
He
own "technique"
as
aiming
at
reestablishing the
patient,
niques,
bond
of
attacking psychotic
human
relatedness with
symptoms with
specific
ally in the
the
tech-
especi-
expands
many
in
interpretative.
directions. It
.
Although
is
just as
nourishing as
decency of
this
its
passage
author,
it
faithfully
reflects
patient.^-'^
fundamental
do
to
of
it.
118
the
it
is
assumes a
Although
it
not
whose pioneering
work
patients
we
learn
some
of his schizophrenic
late
a malpractice suit
of a
is
it
The
As we
shall
see,
and
"treatment."
patient, Alice
Hammer, was an
The following
trial
court
Ham-
mer's parents:
It
was brought
the defendant
ment
made
of schizophrenic patients.
Nurse
After com-
the testimony of
that
after
treatments
she
Mrs.
to conversations
Hammer
in
Hammer
1^9
SCHIZOPHRENIA
that the treatment
by reason of the
if
freely consented
mother
to
testified that
treatment. ^^
The appeals
tients
been limited
tion having
to
doing
in
it
mental hospital.
We
analysis. It has
been replaced by other revolutionary treatments for schizophrenia, such as the following, recently announced in the pages
of the Schizophrenia Bulletin,
Institute of
and beatings,
phrenia
The
at
it
shows us as
is
is
of the
Lounge
relatively unthreatening
to provide
is
way
got under
an environment
at
October
in
Maimonides Com1971.
Patients
that the
if
renewed.
It
was
setting
also
were told
Lounge can be
arts
and
mentioned
staff.
Lounge
crafts,
Hall,
music, and
This
ward. ...
It
in schizophrenia.^^
120
and
scientific journals,
promoting
this
im-
literalized
ment"
for "schizophrenia."
^^
a disease.
is
Paresis
is
is
now convinced
disease for
that schizophre-
because the paretic patient suffers from a demonstrable abnormality of his brain. Schizophrenia
is
a disease for
because he
is
last
istically
is
rea-
is
on the verge
suffer;
psychiatric treatment;
This
many
sons:
and because
his
disease
is
expensive.
criteria of
schizophrenia-
The
phrenia
typical
is
form of
this
method
make any
obviously an illness as to
is
it
so
question seem imbecilic is to document the carefully calculated cost of the "disease"
is
and
its
is,
appropriately,
at the
the
chief
of
and
the
National Institute of
Mental Health. As a modern "dynamic" psychiatrist and a devotee of Laing, Mosher is clearly unfamiliar with medicine. But
as
a federal
bureaucrat, he
is
familiar
V21
SCHIZOPHRENIA
The
one-fifth
to
treatment costs.
siderably higher
if
due
this cost is
to lack of productivity
The
better figures
This
ity"
is
pure rhetoric.
By
as
if
it
seem
comparable circumstances, or
exerted
themselves more,
or
less
as
if
schizophre-
many people
less
are "un-
than others
because
they
lazy
are
if
they
or
are
and
health.
them,
do
however,
all
manage
to
compose an
about the
writing
psychiatrists
In
way
this
cost
of
of
psychia-
To none
"unproductive."
rhetorical
effect
The following
and,
ex-
presumably, a
all
mental
illness
was placed
productivity.
...
the
It
seems safe
community account
for
50 percent of the
loss of pro-
not get jobs, and others because they are afflicted with the
called
disease
schizophrenia
scrutiny.
is
are
this
distinction
assumption that
thus rendering
unavailable for
a disease,
75 percent of
"the
it
unemployed contribute
ber of unemployed."
3 to
schizophrenics
all
4 million
to the total
num-
'^
Ironically,
though
it,
"Taking a prevalence
who
By implying
"schizophrenia."
that
al-
might have been the neuropathology laboratory and the chemotherapy research
institute,
now
is
it
this
the
point though
boss,
Bertram
S.
it
cite,
is
not the
with un-
Brown, the
di-
in the area of
is
so,
why
^^
If
this
Freud
instead of
We
need
one than
to demonstrate that
it
treatment makes
it
we
to treat
some-
If
more not
costs
it
will
be
saved.'^^
collectivistic-positivistic
defective objects.
The
traditional reasons
first,
and
justifications for
and consents
to treatment for
it;
12S
SCHIZOPHRENIA
and
for treatment
to
this
list one,
among
justification
ists:
a fourth justification
interests of society. It
is
in the best
economic
is
even prohibited,
The
society.
if
it
is
patients'
desire
course,
health
all
principle enunciated by
surprising.
The
the
is
who
are
the
is
hardly
they,
mental
so-called
in
field,
represent,
After
recipients
all,
that
it
is
funds
of the
here debated.
Some
twist has
been added
to
it
in
modern
new
collectivistic-coercive
got
is
that
patients
But
traditionally,
psychiatry.
the patients
In the
true
new arrangement
not want, and the state pays the psychiatrists for coercing,
confining,
its
recalcitrant
citizens.
others,
and
its
was superimposed on
124
to
con-
it.
it
and
Although
most of what
and
the
societies
mental patient
it
now
in
such
In
to Soviet psychiatry,
is
relationship
between
psychiatrist
and
consider
In the Soviet
more
for medical
are
Union
patients,
more
services.
services,
The
result
are
like prisoners
is
psychiatrists,
that personal
and
social
problems of
all
the
US
or the
more
readily in the
USSR
than in
UK.
The
different
many
Soviet psychiatrists
is
is
large
component
responsibility,"
of the difference
is
but another
political
rather than
medical.'^^
No
political
infarction
differently
in
capitalist
diagnosing
continue to
insist that
schizophrenia
is,
nevertheless, a disease,
125
SCHIZOPHRENIA
pneumonia and myocardial
some Russian
chiatric
diseases,
infarction.
names
when
Because
of certain psy-
way
name
is
used
seems not to
this
bona
of a
no
"cor-
names. Wing
it
is
fide
in
affect
medical
disease:
As we have
ticularly schizophrenia,
than in the
UK.
personality disorder.
I
is
None
of the people
the USSR]
we would call
[in
whose case
histories
in the
same
of people
[sic]
to
mental hospitals
would
call
(though
prising people
social theories
rently
orthodox Marxism.
as alternatives to cur-
Most
British
psychiatrists
a diagnosis of schizophrenia
illness) in
(or
such cases."
is
none
is,
or feels, free
to
all.
126
in practice:
human
is
rights in psychiatry,
a difference
demonstrable
or paroled prison-
it
is
between comdifference
not
very
difficult
my
for
it
is
seemed
it
happening.'^^
it
It
seem
and
recall
it
city to
to
And
them
it
geneticists
who
to try
does not
chemists,
more
to
by accepting physicians
who
Communist
society;
if
they
collectivistic
essential
colleagues.
for their
This process,
is
it
for
that
reversed,
in
of
can
lead only to the gradual erosion and ultimate disappearance of the values
and
identities of the
amateur sportsman
in
athletics
127
SCHIZOPHRENIA
than with health and disease, more with semiology than with
biology, more, in short, with politics than with genetics.
To
my
place
perspective,
it is
and
basic ethical
briefly
now
political
first,
modern
in
it,
to raise
questions;
methods
I
necessary,
and second,
to
review
illness,
psychiatry.
to the
decencies
observe.
The questions
are
these:
if
the right to
do so
if
diagnosed?
I
The whole
have the
living or dead,
premise
our
own
all
the
right to "diagnose"
whether he or she
likes
it
anyone, anywhere,
or not.
consider this
as radically as
I believe we must
we can as much for
at
repudiate
in
it
and
repellent.
human
beings.
I
128
if
who
has ever
In
societies free
all
in short, of everyone.
That matter
is
is
sphere of in-
as socks
and
inti-
sort
as
he
wishes. But there are other things, less tangible but no less
real,
now
gen-
ma-
possessions as
terial
have mentioned.
It is
is
a remarkable para-
go uninvited into a man's home and rename his dog, but he can
go into his home uninvited and rename him. This
ways
We
is
one of the
is
in
more precious
What
What
and deserves, greater protection from authorities (regardless of who they are or what their
or to our parents?
motives
may
be)
is
requires,
Our
right to
it is
lie
home or to the
name our-
or to
this curtain
which con-
There
is,
and
moreover,
premise that psychiatrists out to have a right to "diagnose" people without their consent or even against their will,
and the
premise that psychiatrists ought to have a right to "treat" people without their consent
wish
to,
their will.
neither
have advanced
129
SCHIZOPHRENIA
against this latter practice. ^^ Let
me
it
becomes
Since this
absurd,
is
put
to
psychiatrists
mildly,
and
societies
it
seems
the deviant
acts
of course differ
totalitarian
in
to consider
ture to culture
far as
it
now, worldwide,
to
me
which
from
cul-
Furthermore, inso-
all
physicians are granted the privilege indeed, have the duty im-
and
is
which
alters significantly
We
are
now
ready to turn
to
the
remaining unarticulated
what constitutes
tifying
methods
illness
the expansion
it;
modern
in
and our traditional methods for idenand transformation of these ideas and
something an
illness,
or
someone
tally sick),
sick
now
call
mean anything
like
what the
or claim
Toward
was defined
saw, disease
ISO
we
The accepted
scientific
method
for
first,
of identifying their
preferably on
ani-
not at
However, since
this
now,
least, until
it
has not.
of
criteria
new
several
criteria of disease,
demonstrating
touched on
all
of them,
and
it
presence,
its
it.
been
will suffice
generated.
now
summarize
to
for
have
this
The
to
classic
include
This
was
first
expanded
by
accomplished
arose
there
the
practice
inferring
of
disease
If
heels,
its
role.
And
if
the person
was confined
to the presence of a
in a
mental hospital,
former inference
treating "patients"
justified
The
without demon-
came acceptable
to
antibiotics or
disease
infer
response to treatment.
criterion
hormones, and
institutional
from the
patient's
it
be-
alleged
cially
methods
effective therapeutic
they
made him
was regarded
as an illness. This
psychiatry,
authenticating
such
interven-
SCHIZOPHRENIA
tions as insulin shock, electroshock, lobotomy,
and psychophar-
its
By
medical care.
for
this criterion
of
in the nation,
and indeed
in the
world.
than
want
which
have heretofore,
to articulate,
more
justifications
of
might be able
by reference
to
do
this best,
to a recent psychiatric
statement on the
many
of the epis-
understanding of causes
sup-
An
explicitly
treatment
We
is
edge as to
justified
is
that
it
produces improvement.^^
This statement which condenses an incredible amount of stupidity, immorality,
and
just plain
wrongheadedness
into a
mere
and
universal,
132
at
least
prevalent.
Its
on therapy
author
that
belittles
is,
the
if
not
impor-
Whether a persons'
erroneous.
is
simply
by
caused
is
syphilitic optic
is
vision
failing
for him.
This author also asserts that he can treat "the acute symp-
toms of schizophrenia" by medical means, meaning drugs, without knowing the cause of schizophrenia. However, he has not
established either that schizophrenia
is
That
this
easily
is
a disease.
is
false
is
is
a drug, normality
is
a treatment.
This
is
is
that
it
particular value
("improvement")
it
justification
produces improvement."
is
an assertion about a
may be used
is
mastectomy
is
what
justifies
mastectomy,
that
it
is
Second
what
is
justifies
legitimizes therapy
What
in fact,
is
missing?
from
politically
most relevant
^33
SCHIZOPHRENIA
sideration: namely, consent. In this-ethical, legal,
cal-view, what
justifies
mastectomy
is
ing to perform
The
it.
and
politi-
is
will-
so overarching in importance
is
that
impossible to exaggerate
is
it
Although
it is
it
is
illness:
(To be
this is a linguistic
ther
comment
here.)
employed methods
Similarly, physicians
in the past,
and continue
to
employ methods
harmful.
Was
shock (mindletting)
pared
to rewrite
a therapy? Clearly,
unless
or even
Is electro-
we
is
are
pre-
worthless
exception
and
is
psychiatric therapy.
political
dimension of
illness
have emphasized
this ethical
it
provides,
we glimpse
new
metaphorical microscope,
diseases
is,
we can
anatomical or histological)
(and
^34
legal, political,
criteria,
and so on)
By
distinguish
among
various
to morphological (that
criteria.
We may
never treat
We may
We may
atitisin
which
still
illness,
may
physicians in
we may
by the alleged
reality of this
cial
patient. It
sort of "treatment,"
is
it,
that, as I
word
for
it)
ticularly schizophrenia.^ j^
said to
be
that disease
which
tj^jg
justifies
atric
to
it
harms him.*
Madness,
as
is,
it
helps or
in a sense,
manu-
who do
is
them as ipso facto harmful or noxious; whereas psyand other socially authenticated authorities responsible for
imposing such interventions on unwilling "patients" are likely to regard
them as helpful or therapeutic if they make the "patients" more docile,
socially conforming, and receptive to further "treatment."
likely to regard
chiatrists
135
SCHIZOPHRENIA
schizophrenia, or,
phrenics.
It is
more
important that
we be
schizo-
they do so, and what the practical implications of this view are
for our attitude toward the so-called
The
sense in which
phrenia
mean
slavery, there
problem of schizophrenia.
readily illustrated
is
psychiatry
tional
can be no
institu-
there
If
no
is
slavery
if
mean
is
who might
like
who
to be
But
if
there
Similarly,
if
is
no
there
slavery,
slave.
is
Hence,
psychiatry.
(institutional)
if
psychiatry
who might
who might
like to
suredly
remain
sorbed, or
who
mean
is
abolished,
persons
who
are
incompetent,
if
there
is
who
or
self-ab-
offend others in
be schizophrenic.
To be
does not
make him
educated,
self-sufficient,
it
attractive,
em-
him
It
free
from
It
self-sufficient,
would only
set
his psychiatrist.
the slave within the slave system, and in particular from his
136
master.
It
is
from
his psychiatrist.
phrenics
pursued
sued at
is
The "improvement"
of slaves
and schizo-
intelligently
and properly,
it
if it is
not
all.
^37
Chapter 4
Psychiatry and
Matrimony:
Arrangements
for Living
why
historically well
tion of the
mized
in
modern mental
in the
persistent:
hospital;
it
language of psychiatry;
is
it
psychologically
is
it
legiti-
moral,
political,
methods
is
and func-
it
life
provides
in
untried
it.^
of-
lies
of disease
offer a
and
precisely in
and the
its
futile, as
Thus, an
institution of medicine.
would be the
is
effort to
about as feasible,
model
me
way
to
is
by completely
on them and
by viewing them instead as arising not simply out of the socalled patient's
rich
141
SCHIZOPHRENIA
network of relations
in
The
is
in the brain
wrong
thing going
tient; that
still
it is,
in the
not just
it
more
plainly
and
an
interpersonal,
precisely, that
prob-
not only
it is
work
and society
as a
psychosocial
per-
whole this
spective
on schizophrenia
phrenia as
it
actually
is
has,
much
has given
rise to
religion,
these
is
it
new
I think,
because
model
classical disease
Treponema pallidum
of
new
It
problem of schizo-
the
crazy,"
clarify
resting
still
as
and
dramaturgic,
existential,
psychiatric
and anti-psychiatric
is
theories,
now,
in
"driving
out of focus;
it
it
seeks to displace,
is
still
completely
intellectually
and morally
life
satisfying
we
If
on so-called schizophrenia
need
is
seriously,
it
what we need
drama
a part,
We
that
142
we
and
in
do not have
is
a model of
which "schizophrenia"
somehow
generated.
marriageespecially of the
traditional,
arranged
show
sort-
scheme we
psychiatrist
the husband,
as
schizophrenia
the
as
and/or
diagnosis/child
the
as
the psychotic
shall
view the
wife,
and
schizophrenic-
commitment/wedding or
psychiatrist/husband after
all,
it
is
it;
we
shall
keep
receives
in
mind
from the
that,
above
status
of each
partner as
matrimony
be
will
in its traditional
model
our
for
-institution of
clarifying
arranged
or
institutional
psychiatry.
Marriage
a universal
is
social
As an
time.
and
institution,
social functions,
from the
marriage
three
relationship,
distinct
phases:
the
like
the
will suffice to
psychiatric
initiation
of
the
relationship,
relationship;
has
the
This
is
initiation
and termina-
relationship insofar as
it
is
"arranged"
for,
rather than
by,
a transaction not so
much between
the
two (ostensible)
Moreover,
143
SCHIZOPHRENIA
was
initiation,
"As
arbitrarily
of
pri-
ments
it
was quickly
At
of Europe.
It
was thus
secularized.
to
be indissoluble
after the
French Revo-
is
Jews only),
com-
pulsory.^
Although
among
the
better-educated
classes
Europe,
of
model
now
pre-
The
go-
who may
or
may
who may
or
may
first
inquiries of the
go-between to
forefront."
are
in
the
it
was
institutionalized,
its
characteristic
acquisition,
economic pat-
distribution,
and
inheri-
tance of goods and services. Hence, where the support for these
arrangements
144
is
in indus-
West and
societies in the
in
Communist
societies in the
"Communism,"
writes
and matchmaking;
communism
Where
marry
the choice to
is
behind.
matrimony
tions of
in the physical
spaces
is
known
space
known
here.
of the
in the
that
idea
symbolic
and so on.
It
matrimony
is,
in part at least, a
matter of hous-
The
main func-
to locate persons,
home, and
as the
The view
is
in this space-
ing,
One
as a social institution
is
fully
explicit
"When
man
no favor
some uncleanness in
divorcement, and give
to
it
then
in her
let
comes
it
him
write
her a
bill
of
house."
it
her;
in his eyes,
reform
it.
Divorce, he asserts,
fornication. Actually,
is
what he has
mind
is
still
a masculine
Who-
SCHIZOPHRENIA
soever shall put away his wife,
divorcement: But
away
commit adultery." ^
The Biblical English phrase
to "put
on
this presently.
The change
ment
in divorce
New
Testa-
clearer articula-
tion, of
over one's
own
new
or,
more
specifically,
over one's
clearly
is
articulated,
for example,
is
good
for a
in
man
let
every man have his own wife, and let every woman have her
own husband." ^ Why is it, as He later puts it, better to
"marry than
to
burn"?
^^
Because
in
wife."
own
"The wife
his
own
12
all
as
is
I.
But
if
myself.
It is
...
to burn."
would
if
they abide
them marry:
for
it
is
^^
146
let
marry than
is
its
their
thus sacrament.
is
"And
let
not the
^*
his wife."
Christian marriage
lels,
husbands disposing of
is justified,
and participates
in,
"paral-
it
ness and love exchanged between Christ and his bride, the
Church."
15
der" what
This
God
is
why,
has united
is
a mortal sin,
away,"
is
more
When
a Christian hus-
he or she
such a person
is
Divorce,
if it is
acceptable option,
If
it
is
is
it,
of dissolving
it,
or at least allay-
the
to this problem.
murder
this
by excusing the
act as
especially appealing
when
the passion
is
that of a
man
defend-
ing his honor defiled by an unfaithful wife.* Mental hospitalization has the advantage of accomplishing the
same
result as
mur-
is
free,
when they have had enough of each other, to leave their partners rather
than commit violence against each other, the psychiatrist by incarcerating
the patient,
psychiatrist.
M7
SCHIZOPHRENIA
der, but without leaving a corpse; the
handhng
by
justified
appeals
to
is
namely,
property,
characteristic
its
of the product
moreover readily
madness.
women
Until recently,
cannot do so except
culturally
women had
make
to,
their
others, mainly
homes under
developed both
and
have
still
men.
In the past, a
woman had
living with her father (or his surrogate, such as uncle, brother,
In each of these
and subordination
to
man
old maid,
The
wife,
creation of
arrangement
to them.
new
be chosen
for,
madwoman. This
also a
option
a career of religiosity.
modern
psychiatric
sophisticated"
religiosity
Hence
thought
and
in
modern
"intellectually
and
madness madness
supposedly
often
being
Moreover, although a
lish
148
home
man
a father,
wife,
or
Church, he, too, was under immense social pressure to opt for
And
to,
of
the
home-
available
to the
also could,
advantage
take
added
opportunities
it
offered.
so for
make members
to time)
of
to place
need of the
Once we
chronic,
see
women,
women
its
becomes
apparent.
(patriarchal)
all
societies
women who
wife,
until
rejected matrimony, or
become? Before
who
to be a
becom-
recent timesfailed to
marry
main
had
for
and becoming a
could
In
especially
woman
En-
home."
Ham-
If
I'll
be thou as chaste as
ice,
women
to the
madhouse.
modem
He
Go
farewell. ^^
social
life,
Kallmann
^49
SCHIZOPHRENIA
carceration as a systematic social policy on so-called eugenic
"On
grounds.
low cultural
level,"
obviously
inmates."
But
life,
tends
barely
are
able
obtain
to
the
reduce
to
conditions
the
inimical
to
the
^"^
The
not enough.
this is
Kallmann,
In effect, he
to prevent
is
recommends mental
hospitalization as a substitute
for marriage:
On
patient.
if
must exer-
Of
and
is
extended
all
heredi-
still
It
is
first
stages of schizophrenia
are not
(diagnosed
warned against
early
breakdown."
The
of
practice
the
principle
own
his
time is
illustrated
by the following
story, reported in a
daily newspaper:
^50
unknown reasons
in
1875
to a state
at the
mental hospital
Psychiatry
Ohio Department of Mental Health and Mental Retardation. She was 103 years old.
State officials said they were
to the
still
To
ask
seventy
is
not sure
on
why
confined
until she
all
her
life.
She
this
woman was
an answer:
namely, that the hospital was her home. Of course, that answer
is
ideologically insufficient. If
in the
Middle
have no
other
live in
place
to
but
because
they
are
schizophrenic.
at the be-
madhouse
is
psychiatry.^^
more
Even
it
amply confirms,
and
its
Two hundred
novelist Daniel
This leads
much
in
justification
fifty
years
in
in
the past or
Defoe denounced
me
to
careful study of
came
home
history of institutional
vogue among
now
so
SCHIZOPHRENIA
the worst sort in fact, namely, the sending their
Mad-Houses
at
every
Whim
This
is
the
it is
nay worse. ^^
One
to
may be more
Wives
all
Milton, had addressed himself at about the same time that the
building of insane asylums got under
way in
following
the
remarkable words:
When,
and
religious, domestic,
concerning the
first,
...
my
atten-
explained
my
... for he
in the
in vain
if
circumstances rendered
makes
an inferior
at
home.
On
when
the
man
servitude to
vilest
necessary;
it
published
home,
camp
of the
My
point
is
Illinois
statute
specified that
Psychiatry
married
women
same
without evi-
in other cases." ^^
principle
when
Edward VII (popularly known as
for Living
the Prince of
1869,
in
"Bertie") was
monarch:
There was one more attempt
loyal Sir
Thomas
scandal by the
to divert the
had
his
who somewhat
itself
The
judiciary
most
unfortunate predicament.^^
and
is
considered to be sacred
compulsory treatment
We
are ready
now
will
be considered to be
matrimonial model in
phenomena
that
Kraepelin
called
"dementia
is
its
scientific.
in
which the
praecox"
and
The context is
The "affected"
whose develop-
SCHIZOPHRENIA
ment
(I will
woman
often a
seems
proceed
to
way
such a
in
is
more
as to give
He may
and dependent on
from them
in a defiant
show
much
man
tientis
now
beyond
it.
less as the
The subject or
increasingly doubtful.
^^
detached
dent adult,
be excessively
that
is,
"prepatient,"
as
Goff-
just
Still,
is
is,
which
in
it is first
"identified"
and possibly
"difficult"
and
What
when
the parents
This
is
the
become
feeble
At
will
and die?
happen
How
situation
in
to this "child"
will
he live?
Who
statu
nascendi
(in
its
directorship,
Bleuler's
women
in-
him?
praecox or schizophrenia
in the
men and 79
^^
nascent
"Schizo-
per cent of
and
its
patients.
."
implications of saying
^54
it.
Psychiatry
state). It is a situation,
the circumstances in
tials
As
"prewife"
life
mean
when she
the
role, so
young woman
and sometimes
and
still is,
at the
role.
By
passes, imperceptibly,
in all essen-
called "marriageable."
What
as
did people
ought
to give her
away
to
in marriage.
The
were expected
to
be unemployable
home. They
in
ex-
homemakers.
justification for
Having arrived
prewives, young
sion:
women
usually
made
change
in their status
by
having become
effecting this
my
their families,
by
in
their
is
why
the
institution
of
matrimony
Formerly,
it
their families,
their families.
Now
dividuals,
and
this
it
fails to
in-
do.
SCHIZOPHRENIA
ranged psychiatry.
certification
It
is
important
in
this
ding ceremony,
is
"commitment" a term
called
is
similarities to the
the patient
committed
wed-
that betrays
to the hospital,
but that patient and psychiatrist, like wife and husband, are
also
"committed"
The
to
each other.
structural similarities
own and
describe
more
fully.
More
enters volun-
bond which
shall
falls
worker,
Having found a
"mental
health
professionals."
and physi-
cian are readied for the certification ceremony: one of the participants
other
is
is
more
tightly
in
than
the
other,
is
formally
accredited
as
"hospital."
name and
name her husband gives her, so in psychiatric matrimony the patient loses his name and takes the name his psyIn short, as in holy matrimony the wife loses her
takes the
chiatrist gives
transform
identifying
him henceforth
schizophrenic,
Doe."
is
common human
participants in this
also
its
drama spared
the need of
newly creating
toward resolving
exert,
all
needs
their particular
way. Par-
in this
who
ents
to be self-caring.
Such persons
are,
and coercion
authoritative pressure
to
do
so, certain
and famihes
people and
as their sup-
As
in the
may be no
courtship at
tient
hand.
As
the
all:
time pa-
first
in the
is
latter.
former
Committed by
matrimonial model,
obvi-
it is
is,
it,
both to
initiate
care and
union that
to terminate such a
is,
such a union
and under
to discharge, as
in
this
connection
is
his
What
is
is
ostensibly
political
characteristic
by the
of
patient,
medicine namely,
and vice versa. In
the
short,
model of
the romantic marriage or love-match, freely entered into by two
consenting parties choosing one another, the modern psychiatwhile the
modern medical
the
model of
mony
are
now
SCHIZOPHRENIA
every society everyone has his or her "proper place" and
more or
less rigidly,
kept in
it.
Although
is
it
this is
for
more
is,
true for
modern, seemingly
is
a characteristic of
all
societies.
German
phrase,
Kirche,
kitchen).
As women and
Kinder,
became seemingly
the mentally
children,
others.
ill
the classic
in
(children,
church,
Kiiche
classless,
class,
Now
and be kept
it is
the
in, their
members
must know,
mary symptoms
literative
"three
the
"primary
classic
symptoms
of
femininity."
The
outcome of schizophrenia
may
of dementia praecox
women
which young
married.
The
is,
as
we have
seen, the
characteristic
still
are,
same
as that at
expected to get
medical and psychiatric of Victorian prewives and Bleulerian preschizophrenics are also the same: incompetence outside
of the
ability in the
market place.
the
patients
(wives)
are
ex-
them from
parts
their
death
till
is
husband
gets a di-
From
and misleading
rehospitalized
is
this perspective,
is
it
would be as
a chronic con-
it
and
institutional
long time
if
divorce
social sanctions.
covery from
it is
Of
is
Of
arrangements than
if
re-
was
until recently
vice versa,
and
psychiatrists
had a
live as
him
is
offers a certain
way
try.
is,
is
life";
it is
as
it
the
is
"schizophrenic"
schizophrenia a "way of
arrangement and
and
and a
to live as a patient
live;
to
is
the
^59
SCHIZOPHRENIA
husband
more
are
"doctor"
other
the
children
whom
for
"schizophrenic
mother
and
institutional
father the
recovery" and
of the work,
all
The
and the
reaping
latter
all
it.
matrimony
same
And
"psychotic"
rhetoric
on the one
may be dangerous
to himself or others
and hence
fit
ment.
On
trists,
fairly
and
injuries for
why,
tric
own
can always
their
values and sympathies, so in litigations between psychiapartners a judge or jury can always find fault with one
is,
why
skill
drama,
human,
to see
how
it
From
Solomon
it is
abused, and
it
will
always require a
this perspective
it
is
why one
of the
160
whom
symptoms
the characteristic
is
why one
of
contemporary schizophrenic
is,
he
is
therapeutically unre-
whom
he
refuses to submit.
In
many
hospital psychiatry as
it
we now know
replica of the
it
psychiatric. It
is
It is
peaceful power
is
distributed
and secured
in
is
matrimony
commitment
produces nothing
if
not marital
produces nothing
if
We
must keep
in
bliss,
so psychiatric
now
am
quite seri-
make
its
members happy or
healthy.
their
own way
Each
who want
to
to attain their
it.
Chekhov
to Pinter
prescribed
few citations
much
my
of
argument.
whose
and creative
161
SCHIZOPHRENIA
was
human
submission in
not only as
method of mystifying
from The Kreutzer Sonata.
his
it.
just released
anonymous
interlocutor:
from
is
of domination-
it
problem
medicine
affects
a fragment of a dialogue
and
domination of
"The
Here
It is
man
asked.
demons
it
as a
between a
saw
affairs,^^
this."
"What domination
of
the world
women?"
on the man's
want to say. It explains the extraordinary phenomenon that on the one hand woman is reduced to the
just
what
Woman's
that she
man's equal
use a
to
man
choose a
man
As
it is
man
has
him. ...
while a
in sexual intercourse
or abstain from
we substitute
woman, the fit is
If
at
him
woman
is
^o
psychiatrist for
still
right to
at present, a
it."
perfect:
man and
schizophrenic for
"diag-
as
women"
as
condemned
He
spiritual
development."
^^
162
dilemma of mankind:
Psychiatry
you don't
"I see
malevolent tone
like doctors,"
whenever he alluded
in his voice
as they
life
to them.
lives of
thousands
no longer
say:
life, it is
caused by
So you must go
nerves.
cannot
One
a bad
the
anyone
you
else. If
live
to them,
and they
You
get
again.
An
worse:
still
excellent trick!"
This, surely,
is
^^
a prescient perspective
It
extended
is
in
human
which
in
disease,
and repulsive
one. Charcot
and that
hysterical,
have
we
my
tried to cure
We
were
like
to cure.
it.
married people
that
it
Thus
we were
wife was
in.
and
know
lives
one
was
in
and
cannot be otherwise.^^
is,
in
i6s
SCHIZOPHRENIA
fact,
now
is
than
in Tolstoy's day.
bonds of
an aside similar
The
is
More-
on those struggling
influence
was
it
to Tolstoy's
in
are.
being right but only in protecting the knowledge they feel com-
fortable
Horwitz's protagonist
is
told by a
in prison, Horwitz's
wife, children,
is
told
As
by a man who
is
magazines
Miriam saw me
as a
man who
was
anyone else."
Miriam "goes mad,"
herself or
America
in
lives in the
planning to
is
it
kill his
important
is
realize
Tolstoy's story
and served
who
a successful editor
don't
still
utterly
according
Newsweek,
to
^^
tries suicide,
becomes a mental
hospital
Husband and
selves, in a
This, then,
is
it," 2^
who
examine,
treat
much
Miriam
less dissolve,
distract
them
dissolving.
show
will not
psychiatrists
from examining or
only too
marriage they
it
am mad,
Psychiatry
diagnosis, Miriam's
American
nears
its
madness
resentment.
It
is
clearly
is
would
psychiatrist
climax,
call
As
schizophrenia.
the story
believe I
ill.^^
He
is right.
always knew
it.
But
they both went along, she playing the role of suffering patient,
The
psychiatrist
who
comments on
final
telling:
his
fell
across
number
of deaths
by
suicide.^^
He
trists
If
and
train.
Kesey
know something
fidelity
the
modern "dynamic"
Modern
ally alienated
suffer
anomic.
i65
SCHIZOPHRENIA
should have dragged Miriam away from the Seventy-fourth
Street psychiatrist.
out verbs.
He
left
madmen
who
before him
life.
believed they
It
may seem
like a long
contemporary America
to
way from
Japan
after
World War
Tolstoy's,
Horwitz's,
where
II,
Yet,
(Kinjiki).
similar,
form
vis-a-vis
first,
to con-
When
a girl appears
to [says
Shunsuke
her, since
who
loves
you
to Yuichi],
you have
to get
it
as
much
that's
why
they call
it
woman
in
to
marry
sacred.*^
Yasuko seems
as
the necessity to
the implication
the
in the social
on the pressure
clear, she
is
and overwhelms
man:
[Yuichi]: "But
get married
he doesn't
if
want to?"
[Shunsuke]: "I'm not joking.
marry
ice
boxes. Marriage
Men marry
is
logs; they
man's own
necessary.
can even
invention.
It
is
The only
isn't
is
166
^^
Even
Psychiatry
we may
Here, again,
woman by
and
perfect.
What
man by
replace
fit
remains
from
hospital psychiatrist,
psychiatry forbids
conduct
for Living
prescribes,
is
set forth
this principle,
movingly by Chekhov
The
and the
in
Ward
No.
6.^3
but
home
in
him
else
had awak-
we stopped
time that
shake.
If
marriage
is
held captive by
And
if
pily for
trists
it,
psychiatric
commitment
is
this.
same
First,
so often remarry?
why do
patients
sort of situation?
and psychia-
on people generally,
wives, psychiatrists
identities
of husbands
and
matrimony
167
SCHIZOPHRENIA
means
offers a
man-woman
of controlling the
relationship that
women,
ease,
psychiatrists
and often do
and
patients, can
so.
of
whole gamut
explicitly
or
tacitly
liberated
sex partner to
Muriel
is
is
stultifying,
ment of The
Home
it.
institu-
to be married to
brilliantly,
on the develop-
into a
an obsolete
much wants
Having uttered
enticingly racy
ried),
it
it
till
is
five (after
to stay
home.
It is
a paradox
The
point, of course,
is
that
That
168
is,
is,
as attempts sequentially to
In
article,
Westoff reports
mainly
on
second
marriages,
Leslie
that, in the
in divorce
internally contradictory
social practices.
first
latter.'*^
mental
hospital,
in
rates.
by current trends
and readmission
necessitated
by
supposedly
schizophrenic
many
psy-
mit that
stage of the
this
"illness"
an
is
increasing.
At
the
same
rates,
Uke
first
created by
artifact
first
admis-
marriages, continue
end
in discharge, just as
for
remarks Westoff
by
relationships, unfettered
the desire
is
compulsion? What
ment? What,
is
to vary the
marital
difficulties
more
is
at
with mar-
realistic
and equal
our
all
in a phrase that
trite,
both
for
all.
is,
in
For what
is
marriage without
metaphor,
is
sides?
It
me that just as a
man and woman negates
seems to
between
169
SCHIZOPHRENIA
tient negates the
this
it
differently, I
^^
as marriage
is
to
an
is
would suggest
that invol-
to voluntary or contractual
afifair.
The former
locks the
them together
convenience. This
marry women
their
why
is
as
in a loose
virtuous because
they
willingly
men who
shoulder
why
puritanical
psychiatrists
regard physicians
their
this is
who commit
as
responsibility"
toward
"desperately
to
ill
mental patients."
is
sonally,
in
both holy
worth noting
in this
Homely language thus reflects more honestly than does technical language the frequently exploitative nature of the sexual, and marital,
relationship. These terms are now also commonly applied to the psychiatric relationship by those who disapprove of the psychiatrist's uncontrolled power over his patient.
170
guilt,
and exploitation
for,
Instead
of mutual need, each feels and talks about help one wanting
to receive
each
it,
feels
and
it.
fied
chiatrist
and
psychiatrist,
the psy-
psychiatrist's,
the tip of
"bad marriage" of
each partner
is
bitterly
dissatisfied
On
the
so-called
map which
for the
special clarity,
well as in
the
many
United States as
is,
patient; nor could a psychiatrist admit such a person as a patient, that is,
gained through court action only. Being a mental hospital pathen meant being committed to the hospital; being a doctor
tient
to
him by
a judge
Obviously,
this
It
at all in the
"shotgun wedding."
husband which,
woman's
father
In
such
in
American
wedding,
slang,
is
man and
typically
by
his
daughter
is
to him.
Civil
commitment
is
also a "shotgun
lyi
SCHIZOPHRENIA
wedding":
order of a judge
the
who, under the guise of protecting the public safety and the
patient's mental health, actually wants to get rid of the burden
which the
It is
madman
to him.
is
relationship between
him and
them assigned
created or
literally,
is
to both. This
manufactured:
commit-
civil
all
and medicine,
major
the
religion
and
tion"
roles
prestige.
when
arose had
first
it
made
it
chotic and psychiatrist did not choose each other. Like wife
and husband
in arranged marriages,
they
knew
be
left in
own
role
had
to
Each could
large,
the
stability
1J2
they
This
ac-
relation-
at
being
psychotic;
the
by
"developed"
psychiatrist
becoming
The
arrangement was
was supposed
to give,
momentum
with
was
rape that is, the "therapeutic attacks" of the psyon the psychotic, through metrazol, insulin, electricity,
Then,
in
just as the
the twentieth
century,
so
was
that the
this
new
"permissiveness"
choose and reject each other; another was that after being
united in matrimony, they could,
if
velopments
it
became
in
it.
in
Marriage
principle,
then
in
relatively
it
possible for
practice to choose to
made
this, in turn,
de-
him first
new
became,
style:
easy,
in other
leave
words,
and
so,
often,
did dis-
V3
SCHIZOPHRENIA
However,
ways strengthened
some
it,
it.
and
distinct concepts
remained
mar-
it,
and
val-
legally protected
socially esteemed.
insane or without
personal
it,
conversation
have remained
distinct
and
concepts
values; the institution of psychiatry has remained legally protected and socially esteemed.
The
result
is
who
fre-
new bonds
of
trists
typical
prepatients
make them
well (happy),
and psychiatrists
whom
who
will
in equally desper-
(being unmarried).
Only
sometimes
is
is,
and so
or recently divorced
vice
which
phenomenon,
woman
(and
in
among
name
is
of an ambitious and
V4
the
quick succession, of
these
men-
new
other
methods promise
psychiatric
fell
cure
to
the
(and everyone
schizo-
his
mental
faith in psychiatric
else's)
among
to effect cures
man who
woman
promises a
unhappily married
new mar-
although
may be more
to
just
is
some
others, I
want
by
their
own
roles as "therapists"
To
put
it
and the
roles
as they
have
chiatry-is
This,
think,
history,
is
and
patients.
Women's
liberationists
women by men,
courage to go beyond
to
it,
acknowledge that
come
their subjection
is
have reemphasized
and
women have
way
ex-
to over-
men
women
should not be
as wives, but
must support
liberationists
175
SCHIZOPHRENIA
pression
of
it,
mental
institutionalized
patients
by
institutional
go beyond
to
to
way
subjection
from
is
to
their
overcome
their
psychiatrists.
as patients,
To
women and
"psychotics" cannot, or do
who
The appositeness
of medicine,
cally
remain enslaved
who
to
men
"treat" them.
is
revealed dramati-
medical relationship: during the past century, arranged marriages have been
partners,
classes,
its
of medicine
by the physician (except under certain special emergency conditions), was too obvious to be articulated. At the same time
classes,
it
was an
and husband;
it
would
iy6
In
particular,
marriage
Psychiatry
who provided
it
she,
not reasonable to
or at least have
be
let
say
whom
marry?
to
she,
acceptable?
are
the
be
left to
We now
support of arranged
in
moral
in
partners.
We
partners,
we no
and
to accept the
chiatrythat
in free
totalitarian societies,
the
tion
themselves.
exactly the
thus
come
participants
and
we have
of
choice of marriage
same
arranged medicine
as the explanation
and
is,
moreover,
justification
for
ar-
this
"explanation" runs,
is
an institution that
affects countless
would be wrong
be freely
who
it
and the
re-
state,
The
is
patient
too
is
difficult a
task to be
left to
the partners
177
SCHIZOPHRENIA
the former
by, patient
The
ters.
is
and groom
It is best,
courts,
abortion
a state-prohibited crime
is
shaped by
deemed
safe,
heroin
The
legislatures,
examples abound:
Illustrative
is
days gone
in
to
pills
and
cigarettes are
result
of
methadone
momentous
these
a treatment. ^^
is
and
cultural
economic
one
to
both
of
the
from arranged to
shifting
of matrimonial
marital
Japan.
in post- World
War
to amplify
conformed
rope,
communism
in
developed
strict
in feudal
Eu-
At
the
same
service dispensed
those
who
it
was
available,
was a
who
made
The
free,
state,
from grounds
beyond the
178
and
freely terminated
by
free market,
rallied
and the
riage
civil
capitalist
mode
The marriage
authority.
The
pattern
clerical
relatives to self-selection
now
by
rulers.
much
became
physician
state,
as
much
as
marriage
by patient and
of an absurdity under
communism
is
initiated or terminated,
if
it
is
them
their
own
desire to
do
or
if
so.
World War
Then they
both changed dramatically. According to Landis, among all of
the countries in the modern world, "The greatest shift from
arranged marriages to some other type came about after World
remained relatively stable
War
II in
ranged."
^2
until after
all
II.
massive and rapid spread in that country during the same time
of the principles
and practices of
institutional psychiatry.
179
SCHIZOPHRENIA
Traditionally, the care of so-called mental patients in
was, as
mentioned
The
ter.^3
so-called
earlier,
members
their
looked
and servants.
in "cells" in their
after, well
some
of
they were
was, in
It
Japan
effect,
War
II that
it
was not
it
As Masaki Kato
World
their families
and
society,
and ur-
industrialization
chiatric
after
explains:
until
became excluded
i.e.,
more than
of
It is
chiatric beds
when
the
tremendous increase
number
is
some
in psy-
states
decreased precipi-
by 50 percent or more.
is
which
in the
due
these drugs have also been widely used in Japan, this claim
least.
It
and
i8o
it
matri-
so
pro-
legal,
and
are
as
just
social contexts in
is
would be as
foolish
Thorazine as
to
would be
it
to
attribute
divorce to Valium.
me
to
of the
am
now
is
matrimony, so we
is
matrimony.
ric
and
is
called, for
societies
is
called, for
is
prohibited
example, "dangerousness to
and "dangerousness
to self
self
is,
prohibited and
is
both "fornication"
flourish out-
and
not be a marriage at
all,
so madness without a
madhouse provicissitudes
of
certificate
would
madness
certifi-
all.
protector-persecutor
into
them
"psychiatric
physician,"
and
is
why
them
to their partners,
tied
181
SCHIZOPHRENIA
tection of mental patients against institutional psychiatrists
(and
them
to their partners.
Moreover, as we
tions
and
roles of
we should
now
in
is
and
intolerant,
and the
counter-
latter
marital pattern
characteristic
cieties.
Arranged medicine,
first
of
patriarchal
feudal,
developed
so-
in psychiatry, is the
modern, (nominally)
egali-
is
and
regulated medical
psychiatric
patterns
state-
prescribed
of
pairings.
was
arranged marriage
it
of the relationship,
became submissive or
ended up
"mental
illness,'*
it
tutional psychiatry,
of the relationship,
182
control
and often
domination by
tor-
or suicidal aggression.
Similarly, in the
ended up
lost
rebellious,
who
insti-
it
domination by
Psychiatry
tormenting him with his incurability. Occasionally the psychiacontrol to the patient or his family, and
trist lost
was then
it
illness,"
or suicidal
aggression.
it,
more than
measure of control
over
it;
is
by
their
in the past
whoever
institution of marriage,
today patients are controlled by their physicians, and physicians by the institution of medicine.
It
all
of these
changes and
phoses of modern
especially
arranged medicine
societies.
The
new form:
medicine, tra-
and
the
slaves, or
same
same
in
pairings
Regardless
sort of justificatory
human
of
masters
183
SCHIZOPHRENIA
In short, although schizophrenia
schizophrenia
marriage,
it
from time
acts
is
not necessarily
is
meaningless:
like
the
term
and culture
to culture set of
We
can,
if
we
we deem
the
But we cannot do
As husbands and wives
this so
desirable.
psychiatrists.
existential
long as
lies
184
we remain
Chapter 5
Madness, Misbehavior,
and Mental
Illness:
Review and
a Restatement
IN
modern
of
and nature
of
schizophrenia; and
recommended
matrimony
chapter
consider
want
and psychotic
its
paradigm
in psychiatry. In
my
thesis in
The
first
populations:
ers
step,
and
their
own
dangerous and
fictions
of the
madhouse-
The
third
step ushering
in
the
era
of
so-called
"moral
first
1&7
SCHIZOPHRENIA
explicit recognition,
mad
gorized as
ill;
cate-
were expected
to teach
madmen
to
behave prop-
How-
disease.^
ever, this
that,
and
deprived of
to the next
The
that
development
in psychiatry.
is,
of insane
thai
psychotherapizing of
is,
the
behavior
of
the
persons
many
and outside of asylums (for example, the "neuroses" and "perversions"), and to the psychotherapizing of
many
kinds of be-
soil
vesting.
harpsy-
names
with the
tation as
it
of Kraepelin
new
names
The
War
188
I,
next,
or
fifth
step,
in ro-
species of psychothera-
of Janet, Freud,
and
insulin
and
Sakel.'*
Illness
and
their
because
justified
lesions, or
what
is
on seeing what
psychiatrists
it
War I
is
The conceptuaHzation
of
symbol of
psychiatry.
as lawyers
and
institutional psychiatry,
psychiatric institutions
became
fix their
their eyes
schizophrenics
trists,
and
more
difficult
others,
would pay
to their
it
attention
less
well
as
was
that
psychia-
World War
II,
all
mental diseases.
still
not
much
less
the
it
is
a disease
now
set
out to "prove"
The development
of
With the
sole
exception
of
the
modem
segregation
of
dif-
medilepers
189
SCHIZOPHRENIA
(which occurred long before the birth of modern medicine),
of
nor has
names created
cal,
until
relatively
after discoveries in
for
it.
identification
and
macroscopic
pathological
changes
apparent in the
is
changes
in
observed
first;
naming
the precise
of diseases
that
is,
microscopic
organs,
comes
next. This
in
naming
of
psychiatry:
alleged
the
diseases
precise,
came
or rather pseudoprecise,
first;
existence
the
morphological
of
Hence
names
any of them
from agoraphobia
to
on the model
scientific
in psy-
of paresis.^ It
is
the greatest
* This scandal has grown to such vast proportions that it now invades
almost every nook and cranny of our daily lives. As I was writing, and
then revising, this book, the American Orthopsychiatric and Psychiatric
Associations furnished, through their ceaseless meddUng in everybody
else's business, the
At
following example of
the Fifty-second
Association,
held
in
it.
Annual Meeting of
March
1975,
the
mental disease."
The American
American Orthopsychiatric
Committee on
"Racism is the number one
the
association's
is
igo
it
boomerang and
There
no such thing
in short,
is,
phrenia
is
disease.
Although there
(though by no means
and speak
in
ways
who
all)
that differ
name
of
an alleged
no schizophrenia, there
Many
as schizophrenia. Schizo-
Illness
are,
of
behave
all)
What has
around him, or to
all this to
all
that
is
The
conflicts
and
politics, rhetoric
concerned.
The answer
is:
nothing.
domains of
ethics
is
American psychiatrists, especially the Jews among them, right between the eyes. In the fall of 1975 the United Nations passed a resolution declaring that Zionism is a form of racism. This made Zionism
according to the United Nations, whose activities have until this time
enjoyed the unqualified support of the American Psychiatric Associationa "contagious mental illness"! In December 1975 the Board of
Trustees of the American Psychiatric Association duly adopted another
hit
term "racism," like that of "mental illness," depends on who has the
power to fill that semantic bag with rhetorical hot air, the board instead
denounced anti-Semitism. The irony of these developments is heightened
by the fact that on February 19, 1974, the board had unanimously
supported the United Nations in its "Decade of Action to Combat Racism
and Racial Discrimination." However, the board's vote on the United
Nations' resolution on Zionism was not unanimous: three members
voted against it. Does this mean that the Board of Trustees of the
American Psychiatric Association has three members who actually
believe that
illness"?
Or
that
it
is
191
SCHIZOPHRENIA
all
it is
a mistake to con-
a mistake
is
it
Because schizophrenia
is
is
and
its
diagnosis
unless, that
is,
was
the challenger
It
is
Modern
society
who might be
inclined to
assume a
and
accred-
its
toward
psychiatry.
There
is
who has
and,
he soon
left
Karl Jaspers
1946offered
we
In physical illness
latter
in a seventh edition in
comments:
the incompleteness
freedom and
and vulnerability
1^2
human
new dimension. Here
of human beings and
life
of course, to
their
refer,
General Psychopathology
and reissued
ments on the
may be
in his
as he goes along.
He
themselves a cause
man
lacks an inborn,
Although
classic in
his
in
Germany, Jaspers
chopathologist,"
break through
others within
its
about
reservations
his
in
Illness
what
secular fashion
in
faith."
if
earlier
was per-
much
deserves to have as
priests.
of psychiatric practice as he
it
Rational treatment
saw
it
and
then,
reality
anyone who
as
now:
is
the
in
sense.
strict
Admission
to hospital often
takes place against the will of the patient and therefore the
psychiatrist finds himself in a different relation to his patient
approach
He
tries to
make
by deliberately emphasizing
to the patient,
is
his purely
and
resists
many
med-
cases
is
these medical
efforts. 10
this
scandal, that
truth;
and
is,
so integral
was
in
^93
SCHIZOPHRENIA
or perhaps for
he was
all
when
in his thirties. ^^
human
way, the
ditional
try,
flicting interests,
it
is
necessary
now
to
list,
in
a systematic
ethical, legal, and political premises that underlie traEuropean psychiatry, American institutional psychia-
and psychiatry
in general as
it
is
now
practiced through-
may be based on
patient. It may be
symptoms" of the
alleged
postmortem examination despite the absence of demonstrable histopathology or pathophysiology. In other words, the fact
that there
is
of which
diagnosed as schizophrenic
is
not schizophrenic in no
way im-
(psychiatric) diagnosis.
The very
idea,
in
patient's "rights"
is
this
psychiatric
scheme of
Third,
the
schizophrenic patient
is
usually
in
considered
to
is,
schizophrenic
^94
"dangerousness" psychiatrically
his involuntary
and
require,
confinement in a mental
modern
try as well as of
is,
justify,
institution.
legally
Illness
and
legal,
political
institutional psychiatry.
To
appreciate
pertinent premises of
modern
hospital medi-
and involved
parties interested
in
it:
all
of the
and so on.
may
own
suf-
must
may
only
when
claim
his
is
it
narrowly,
treatment and
its
its
consequences are
facts,
and so are
to
is
viewed as a pro-
upon another,
cine
may be
therapeutics
it
is
political act.
is
^9S
SCHIZOPHRENIA
but they cannot be made
ble as the
to disappear.
They are
as inexora-
life
itself,
of
Strictly
tations
their treatments.
It
cannot be, and must not be, concerned with the behavioral
and
linguistic
manifestations
differences.^*
It is
position
ticulated
or expert
on so-called psychiatric problems may now be arand viewed. I maintain that the professional person
is,
above
all else,
an agent. Our
and duty
he
especially important
is.
my own
This
is
almost always
is
in
is
to ascertain
first
and
when
assert
is,
whose agent
the expert is as he
psychiatry a party to a
duty in formu-
typically
conflict.
In tra-
is,
These
shape
facts
typically
many
and
First, in
political
society.
My own
relevant ethi-
premises are:
clients
to be sharply distinguished
own
benefit
ought
to accept or reject.
196
Illness
would be allowed
parties concerned
want
practices
to fall into
to place them,
would thus be
like
which
homewhereas
example
may
or
not consider to be a
like
crimesfor
or
battery,
assault,
may
would be
so
literal,
sometimes
metaphoric.
is,
we must both
phors. However,
we can do
this
by taking ourselves
iously,
trists
less seriously
by and
ser-
are, of course,
large,
In short,
trist,
madman and
it
is
life:
meta-
selves,
as
a facet of a
is
of the varieties of
social
it,
regulation.
human
There
no problem of schizophrenia
for
is
and
as
moral agents
conscience.
^97
Epilogue
Schizophrenia:
ACCORDING TO
its
even
real
and teaching of
What
but
This
tivity;
and
But anyone
truths.
is
surprising, to
an institution
slightly familiar
is
how
is
closely
its
it
me
Nor
at least,
has approximated
human
religious;
not
how
far science
because
is
is
it-
is,
it.
after
all,
human
and because, as a
ac-
gregarious
it.
it
humanize
less scientific.
it
in
subtle
Indeed, they
make
As
a result, the
in part, as
who
The
fate of
digm of vapors
infectious
in
agents,
may
be recalled
in
this
it
with that of
connection.
The
201
SCHIZOPHRENIA
him and
his ideas
this instance
is,
of
is
human endeavor
be, to
some
me
modern
and inasmuch
as
so-called
will, it is
by persons
carried out
ideology.
science,
seems to
and values. In
social institutions
its
it
come under
of
bound
nation-state
state
natural
is
to
and
wants to use
laws
are
inde-
indeed
it
who might
help
it,
if
ai>d
so
on and
descriptions, of
how
such
human
it
is
often disguised as
relations
very
much
ence. In the social sciences the state can use false or fake
science and
make
it,
in the
202
West
communist
is
in
whose
"valid-
Schizophrenia:
ity"
is
no way impaired by
in
its
Moreover, even
a paradigm
is
"Once
it
if
an alternate candidate
The
is
facts
is
inconsistent
is
declared invalid
available to take
These
it
noted,
only
Kuhn has
is
its
place.
always simultane-
quite
untenable
is
would
And
its
place.
Kuhn
transfer of allegiance
from paradigm
paradigm
and chemistry,
they can
if
ligious" character, as
in physics
are
scientists,
it is
much more
is
"The
a conver-
If all this is
so
so in psychology and
pseudoreligions. This
is
The
paresis
is
digm
will
be replaced by another,
it
would conclude,
first,
no such
is
much
203
SCHIZOPHRENIA
will
phrenic;
its
it
it
now
defined as ther-
will cease to
as schizo-
204
profit
from them.
Appendices
References
Index
Appendix
c.
1650-1750
Madhouses
are established,
throughout the
c.
1750-1850
The
1841
The
first
world.
its
is
founded.
It
Asylum Journal,
in 1853.3
1844
Institutions
resolution
is:
the
Insane
founded.
is
"Resolved, that
it
is
the
all
means of personal
restraint
c.
1800-1900
Its
of
American
first
official
unanimous sense
abandon entirely
is
not sanctioned
professionals,
caused by masturbation.
1838
new law on
drafts a
2oy
Appendix
Esquirol.
illness." ^
Wilhelm Griesinger (1817-1868) publishes his epochmaking Pathologie und Therapie der psychischen Krankheiten {Pathology and Therapy of Mental Diseases), staking out psychiatry as a medical specialty. According to
He made
of psychiatry."
1869
As
[that]:
'Mental
a result of Gries-
it
to excessive masturbation.
1880
way
mate medical
diseases,
legiti-
1884
20S
Appendix
It
and
intellectual classes.
life,
all
Many
kinds of headache
to the
brain
external
manifestations
of
the
effects
upon the
brain-
aberrations
c.
1890-1910
of madness.
1893-1895
Joseph Breuer (1842-1925) and Sigmund Freud (18561939) rehabilitate hysteria as a "phychoneurosis," by
defining imitating illness as itself an illness. ^^
1898
1900
Freud publishes The Interpretation of Dreams, transforming dreams, the traditional province of the poets,
into medical problems.
He
succeeds
in
securing medical
209
Appendix
1904
account
first
1904
ance of paresis."
1905
Fritz
(1871-1906)
demonstrates
pallida)
lesions of syphilis
ganism of
(Spirochaeta
Schaudinn
nema pallidum
is
i^
and
identifies
it
in
the
the
Trepoprimary
syphilis.
1906
1909
first
1910
1911
1913
"de-
ic
1917
Julius
paretics
von
disease;
1917
tabes.
Wagner-Jauregg
with
therapeutic
and
malaria
tertian
value
of
fever
inoculates
(1857-1940)
and demonstrates the
for
the
Emil Kraepelin
treatment
it
of
this
in 1927.
rearticulates the
for progress
in
psychiatry:
young a science as ours; in this respect the diseases produced by syphilis are an object lesson. It is logical to
210
Appendix
assume that we
many
shall succeed in
1919
Elmer
at
present
we have not
the
." i^
E. Southard
(1876-1920) proclaims the evangeliand missionary calling of the psychiatric crusaders: "May we not rejoice that we [psychiatrists] ... are
to be equipped by training and experience better, perhaps,
than any other men to see through the apparent terrors
cal faith
of anarchism, of violence,
of destructiveness,
of para-
in capitalists
This
call
for world
is,
of every
human
activity has
since
been
reechoed
by
211
Appendix
II
My suggestion that we regard the sane and the insane on the one hand,
and psychiatrists and anti-psychiatrists on the other, as adversaries, each
claiming superiority for himself and inferiority for his opponent, invites
putting these images in the broader perspective of other superior-inferior
relationships and their characteristic mythologies. I have remarked on
this theme elsewhere, in connection with my analysis of the relationship
between institutional psychiatrist and institutionalized mental patient and
its similarities with the relationship between inquisitor and heretic. ^ Here
I want to extend this sort of analysis to the relationship between psychiatrist and anti-psychiatrist, with particular emphasis on the moral character of their respective claims.
framework
which this controversy fits perfectly. "One of the permankind," Russell suggests, "is that some sections of
the human race are morally better or worse than others. This belief has
many different forms, none of which has any rational basis." 2 After remarking on how this human predilection finds its most obvious outlets in
the chauvinisms of sex, nationality, and class, Russell notes that some
people prefer to admire and aggrandize groups to which they do not
belong from which, indeed, they are excluded:
into
sistent delusions of
is
212
Liberals
Appendix
II
is something in the nature of the power rebetween those who dominate and those who are dominated, and
human
nature of
One
compen-
seem
sane which
to
me
is
to begin
merely substitute for the "superior virtue" of oppressed women the "superior sanity" of oppressed schizophrenics. This particular game of the
anti-psychiatrists seems to me to be both crude and contemptible, for
the result of the idealization of the "authenticity" of insanity,
of the
two
things, both of
On
which
oppose.
lost tourist.
and
Or
it
may
the
when
oppressor
man
as a
to play a
as wife or psychotic.
On
the
other hand, people will believe in the superiority of the oppressed for
example, women and psychotics mainly when they feel guilty toward
them. Support for the countermythology is thus much less secure than
for the mythology; this difference accounts for the much greater stability
of the former as compared to the latter. Russell's remarks in this connection are perhaps
more
politics of the
human tragicomedy:
As
it
the stage in
transient
and unstable.
It
is
begins only
we have
considered,
when
the oppressors
come
is
to
213
Appendix
have
11
The
longer secure
virtue
ous.
is
is
It
women
and
It
of the
was a
dirt>'
work of
politics.
its
th^ir
power
is
sobfectioo
if
fine self-sacrifice
when
...
virtue.
only happens
this
it
no
if
superior virtue
is
a reason in favor
having power, and the oppressors will find their own weapons
turned against them. When at last power has been equalized, it becomes apparent to evcrvbody that all the talk about superior virtue
was nonsense, and that it was quite unnecessary as a basis for the
claim to equaJity.s
of
its
which
madman
and mythcriogizing
the
virtues, or powers.
In sum.
it
seems to
we now know
it,
me
that
if
s^
Some
each according to
its
for
214
ethics.
References
Acknowledgments
1.
See T.
S.
Szasz,
"Some Obsenations on
the Relationship
Between
nation?"
chives of Psychiatry and Neurology 77 (1957): 86-92; idem. "Commitment of the Mentally 111: Treatment or Social Restraint?" Journal of
Nervous and Mental Diseases 125 (1957): 293-307; idem, "Psychiatry,
Ethics, and the Criminal Law," Columbia Law Revie^^' 58 (1958): 183198; idem, "The Myth of Mental Illness," American Psychologist 15
(March
Chapter
1.
A. B. Barach,
D.C.:
of a Theory of Personal
1941),
5.
p. 44.
"An
in
Sig-
also
215
References
American Handbook of
1003-1020 (New York: Basic Books,
Psychiatry, ed.
1959);
7.
1005.
p.
Ibid.
11.
S. Arieti,
1-74;
p. 25.
"Schizophrenia:
1,
12. Ibid.
I.
R. C. Batchelor, Henderson
1950),
p. 9.
147-160.
Ibid., p. 148.
18.
Ibid., p. 151.
207.
25.
J.
Strachey, introduction,
ibid.,
in
pp. xiii-xiv.
of Schizophrenia, Vol.
I:
to
113-114.
30. Ibid., p. 182.
2l6
References
31. In this connection see, generally, F. A. Hayek, The CounterRevolution of Science: Studies on the Abuse of Reason (1955) (New
York: Free Press, 1964); and, specifically, T. S. Szasz, The Manufacture
of Madness:
Health
A Comparative
32. Bleuler,
33.
Ibid., pp.
p.
1970).
474.
474-475.
35. See T.
atric
Szasz,
S.
Against Humanity"
Man (Garden
Dehumanization of
City, N.Y.:
Crime
Dementia Praecox,
p.
Doubleday-Anchor,
(New York: Free
475.
37. Ibid.
38. Ibid.
39. Ibid., p. 488.
40. Ibid., pp.
488-489.
M.
51. Ibid.
52. See "Eucharist" in
ology
53. 'Transubstantiation,"
1968), vol.
2, p.
257.
vol. 22, p.
175.
Watanabe, "The Past, Present, and Future of Mental HosJapan," Journal of the National Association of Private Psychiatric Hospitals 5 ( 1973 )
6-8.
54. See E.
pitals in
55.
For example,
see
I.
'The Far East: Reflections on the PsyWorld History of Psychiatry, ed. J. Howells,
Veith,
chological Foundations," in
56. K.
2iy
References
Freud
58.
May
to Jung,
6,
p. 147.
60.
vol. 2, pp.
62. E.
Penguin,
1955),
354-356.
Baskin
63.
World
Kraepelin,
Wade
(New York:
Chapter 2
1.
T. S. Szasz, The
of Personal Conduct
York: Harper
& Row,
B. Beyer,
Ibid., p. 68.
8.
Ibid., p. 75.
9.
Ibid., p. 83.
12.
13.
Ibid., p. 90.
Man and
His Ideas
(New
p. 89.
Ibid., p. 160.
18.
Ibid., p. 168.
2l8
p. 124.
References
19. Ibid., p. 169.
Quoted
22. D.
1970),
in Trilling, Sincerity
and Authenticity,
p. 170.
(New York:
Pantheon,
p. 103.
The
10.
1965-
31. Ibid., p. 2.
32. Ibid., p. 3.
33. Ibid., p. 7.
34. Ibid., p. 11.
35. See
W.
F.
p.
31.
von Mises,
Human
Action:
40. Ibid.
41. Barnes
p. 6.
54. Barnes
p. 160.
2ig
References
55. Martin, Tracts Against the Times, p. 83.
(London
56. Ibid,,
for example,
57. See,
C.
Fenichel,
Neurosis
58. E.
Rinehart, 1941).
1967),
61.
p. 45.
J.
R. Searle,
Question:
losophy, ed.
"How
to Derive 'Ought'
from
'Is,'" in
The Is-Ought
Moral Phi-
W. D. Hudson,
pp.
p. 132.
62. Ibid.
Chapter 3
1.
L. C. Kolb, Noyes'
Modern
Vol.
S. Arieti, ed.,
I,
ity
City, N.Y.:
9.
Doubleday-Anchor, 1973),
p. 158.
220
p. 159.
References
11.
12.
Its
p. 9.
Implications for
13.
in the
See R.
APA
15. Ibid.
Psychiatric Association,
sociation, 1968).
19. See Kolb, Noyes' Modern Clinical Psychiatry, 8th ed., p. 312; and
"Schizophrenia and Alcoholism Head Listing of Inpatient Ills," Roche
Report: Frontiers of Psychiatry 5 (April 1, 1975): 2.
Press, 1977).
25.
Autumn
26. Ibid, p. 9.
221
References
27.
Ibid.
New
Statesman
(London),
31. Ibid.
32. Ibid.
ease," Science 167 (January 16, 1970): 249-256; pp. 249, 255.
37. E.
"Two Minds on
New
Schizophrenia,"
p.
122.
Scientist,
December
10,
1970, p. 424.
39. See
"Schizophrenia:
MDs Make
News
chiatry
(November
1974):
1;
see
also
Kendell,
Role
of
Diagnosis.
40.
Quoted
chiatry
41.
News
in
to
a Schizophrenic in the
43.
Justice
1965).
46. D.
L.
Pauling,
48. Ibid.
49. Ibid., pp. v-vi.
50. See T, S. Szasz,
Method
of
Autonomous Psychotherapy,
Factors
222
References
Schizophrenia (Ann Arbor, Mich.: American Schizophrenia Foundation,
1965), facing p.
54. Ibid., p.
1.
1.
55. Ibid., p. 2.
56. Ibid., p. 12.
57. Ibid.
G. Gerlach,
58.
to
let
A New
61.
An
Disease,"
November
Berman, "Fasting:
62. S.
see
11,
3,
A New
Treatment
"An Overview
65. S. Arieti,
Hammer
66. See
Ct.,
McNally,
v.
J.,
68.
Hammer
v.
Schizophrenia Bulletin, no. 10, Fall 1974, pp. 93-96; pp. 93, 96.
70. See T. S. Szasz, "Medical Metaphorology," American Psychologist
30 (1975): 859-861.
71. J. G. Gunderson and L. R. Mosher, 'The Cost of Schizophrenia,"
American Journal of Psychiatry 132 (1975) 901-906; p. 901.
:
76. J. K.
Journal
(March
1964).
223
References
The Myth of Mental Illness: FoundaTheory of Personal Conduct (New York: Hoeber-Harper,
1961); rev. ed. (New York: Harper & Row, 1974); and idem, Ideology
and Insanity: Essays on the Psychiatric Dehumanization of Man (Garden
City, N.Y.: Doubleday-Anchor, 1970).
81. H. R. Huessy, "Some Historical Antecedents of Current American
Mental Health Practices," Psychiatric Annals 4 (1974): 31-39; p. 38.
82. See T. S. Szasz, "Reflections on Medical Ethics," in T. S. Szasz,
The Theology of Medicine (New York: Harper & Row, in preparation).
83. See Chapter 1.
84. Szasz, Manufacture of Madness.
80. See especially T. S. Szasz,
tions of a
Chapter 4
1.
See T.
S.
Scientific
Revolutions (Chicago:
ed.
(New York:
3.
generally,
See,
rev.
"Marriage,"
Sills,
International Encyclopedia
in
vol.
10,
pp.
1-23
of
the
p.
ed., s.v.
M.
Rheinstein, "Marriage,"
927.
5.
Ibid., p. 928.
6.
Ibid.,
s.v.
J.
D. Landis, "Marriage
iand
Family Organization,"
p.
928.
7.
Ibid.
8.
Deut. 24:1.
9.
St.
Matthew 5:31-32.
10.
Corinthians 7:1-2.
11.
Ibid., 7:9.
12.
Ibid.,
New
Corinthians 7:6-9.
13.
14.
Matthew
15. J.
7:11.
p. 155.
16.
3, sc. 1.
F.
18.
Ibid.
J.
224
New York
References
tary Mental Hospitalization Presented in Selected Texts (Garden City,
N.Y.: Doubleday- Anchor, 1973).
21. D. Defoe, "Demand for Public Control of Madhouses" (1728), in
ibid., pp.
7-8.
in
J.
(Northbrook, 111.:
23. See W. LI.
Private
AHM
Parry-Jones,
Madhouses
in
England
The Trade
in
in
the Eighteenth
p. 104.
Lunacy: A Study of
and Nineteenth Cen-
24.
Columbia University
J.
Edward
Pearson,
Edward
VH (New
27. Ibid.
1961).
29. See H. Troyat, Tolstoy (1965), trans. Nancy Amphoux (New
York: Dell, 1969).
30. L. Tolstoy, The Kreutzer Sonata (1889), trans. Ayler Maude, in
L. Tolstoy, The Death of Ivan Ilych and Other Stories, pp. 157-239
(New York: Signet, 1960), p. 178.
31. Ibid., p. 192.
32. Ibid., p. 194.
33. Ibid., pp.
34.
J.
200-201.
Winston, 1975),
(New York:
Holt,
Rinehart and
p. 2.
(New York:
Berkley, 1974),
p. 29.
Guemey, in
(New York:
225
References
Mishima, Forbidden Colors,
44.
p.
126.
August
p.
Sew York
November
Times Magazine,
13.
M. Freedman
et
al.,
Modern Synopsis
of
p.
240.
48. Westoff,
"Two-time Winners,"
p.
15.
53.
Seep. 37.
54.
See
I.
Foundations,"
703
Veith,
in
55.
in
(1973):
5.
Chapter 5
Hunter and I. Mac Alpine, Three Hundred Years
1535-1860 (London: Oxford University Press, 1963);
G. Rosen, Madness in Society: Chapters in the Historical Sociology of
Mental Illness (Chicago: University of Chicago Press, 1968); and M.
Foucault, Madness and Civilization: A History of Insanity in the Age
of Reason, trans. Richard Howard (New York: Pantheon, 1965).
2. See, generally, T. S. Szasz, Ideology and Insanity: Essays on the
Psychiatric Dehumanization of Man (Garden City, N.Y.: DoubledayAnchor, 1970), and idem, The Age of Madness: A History of Involuntary Mental Hospitalization Presented in Selected Texts (Garden City,
N.Y.: Doubleday-Anchor, 1973).
3. See, generally, A. Deutsch, The Mentally III in America; A History
of Their Care and Treatment from Colonial Times, 2nd ed. (New York:
Columbia University Press, 1949), esp. pp. 88-113, and S. J. Bockoven.
Moral Treatment in American Psychiatry (New York: Springer, 1963).
4. See,
generally, G. Zilboorg, A History of Medical Psychology
1.
See, generally, R.
of Psychiatry,
226
References
(New York: Norton, 1941), esp. chaps. 9 and 10, and H. F. Ellenberger,
The Discovery of the Unconscious: The History and Evolution of
Dynamic Psychiatry (New York: Basic Books, 1970).
5. See, generally, T. S. Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (New York: Hoeber-Harper,
1961); rev. ed. (New York: Harper & Row, 1974); and idem, The
Manufacture of Madness: A Comparative Study of the Inquisition and
the Mental Health Movement (New York: Harper & Row, 1970).
6. A. Herndon, "Racism Said to Be America's Chief Mental Health
Problem," Psychiatric News, April 16, 1975, p. 25.
7. "Trustees Protest UN Zionism Resolution, Withdraw Support,"
Psychiatric News, January 21, 1976, pp. 1, 30.
8.
J.
ed., trans.
1963),
9.
Press,
p. 8.
Ibid., p. 807.
11.
13. Ibid.
14.
Myth
See Szasz,
15. In this
of Mental Illness.
S. Szasz, The Second Sin (Garden City,
and idem, Heresies (Garden City, N.Y.:
connection see T.
N.Y.:
Doubleday, 1973),
Doubleday- Anchor, 1976).
Epilogue
1.
See, generally, T. S.
Scientific
Revolutions
Ibid., p. 77.
3.
Ibid., p. 150.
4.
See T.
S. Szasz,
Psychiatric Slavery
Press, 1977).
Appendix I
M. Foucault, Madness and Civilization: A HisAge of Reason (1961), trans. Richard Howard
(New York: Pantheon, 1965), and T. S. Szasz, ed.. The Age of
1.
Madness:
22y
References
2. See, for example, W. LI. Parry-Jones, The Trade in Lunacy: A
Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge & Kegan Paul, 1973).
Ibid., p. 89.
3.
W. Thudicum, A
Treatise on the
(New York:
Chemical Constitution of
the
(1884),
with
L.
in
12.
in
Press, 1950).
17.
Wade
E. Kraepelin,
Baskin
Appendix
1.
T. S. Szasz,
of the Inquisition
per
& Row,
228
Hope,"
II
References
2. B. Russell, "The Superior Virtue of the Oppressed," in B. Russell,
Unpopular Essays, pp. 58-64 (New York: Simon and Schuster, 1950),
p. 58.
58-59.
3.
Ibid., pp.
4.
Ibid., p. 61.
5.
Ibid., p. 63.
22g
Index
Alienists,
22m
to
Overcome
I90n
191/1,207
190A1,
American
Founda-
Schizophrenia
tion, 113
psychiatry
212-214;
73-74;
and,
literal-
metaphor of schizophrenia
in, 74/i; Martin's criitcism of, 5455; Marxism and, 51, 56; paradigm of, 79-80; plundered-mind
image in, 79-83; "promotion ceremonies" in, 75-76; psychiatry and
ized
psychoanalysis as similar
55,
I.
R.
C,
12
48-83,
Anti-psychiatry,
asylum
78;
sanity
in
view
to,
52-
of,
82;
Cooper,
Ronald D.
David;
also
See
Laing,
Association
118-119
Medical
Superin-
Undisciplined Thinking
in
Med-
icine
on pressures to diagnose as
21m; on suicidal drive of
schizophrenics, 25, 26; on thinksick,
ing disorders, 13
Hospitals, 207
of
15;
Asylums and
207
Manfred, 28, 32
Brown, Bertram S., 123
Bleuler,
Asylums: Laingian, 62, 64, 65, 7374; See also Lunatic asylums
Authenticity,
57.82
anti-psychiatry
and,
California,
LPS Act
in,
96-97
231
Index
Capitalist
society,
anti-psychiatry
pathology,
model,
8,
as
disease
Cruelty in treatment of
madmen,
25-27
Cuba, Cooper on, 60-62
Cumming, Elaine, 104
Cures of schizophrenia, see Therapy
Current Prescribing (magazine), 93
Cyclops, legend of the, 40-42
Coercion, psychiatric:
Delusions, 18
marriage
Christianity,
and,
144,
146-147
ignored by
Com-
mitment; Confinement
LPS Act
on, 39-40;
in California
ment
55-56, 78, 124, 179,
pulsory
hospitalization),
47;
on question
of,
Commitment
Consent
of,
to therapy,
7,
8,
Schizophrenia
13
Diagnosis of schizophrenia:
hospitalization
com-
justified
also
cept
pulsory
Communism,
jSoviet
100-102, 125-126
Diagnostic and Statistical
Manual
of
Liberation,
The
(Cooper), 60
134-137
169-173
Contractual
relationships,
Laing
and Cooper as opposed to, 65, 71
Control over one's body, 146
Cooper, David, 50, 57-62, 65, 76,
78-79
Cost of schizophrenia, 121-123, 132
Contractual
atry,
2^2
or voluntary
Divorce,
145-147,
152,
159,
160,
169, 174
Index
Economic
cost
of
schizophrenia,
122-124, 132
Ehrlich, Paul, 210
Hammer,
Alice, 119
Healthy
persons,
see
Medically
healthy persons
207-208
Esterson, Aaron, 50
Evans, Richard, 60
155
Fasting,
as
treatment
for
schizo-
Hospitalization,
involuntary,
see
Commitment; Confinement;
phrenia, 116-118
Federn, Paul, 69
Forbidden Colors (Mishima), 166,
167
Freedom, anti-psychiatry and, 7778
103,203
Hoffer,Abram, 112-114
Holland, Jimmie, 106
Horwitz, Julius, 163-166
on neuroses,
vol-
Humoral pathology,
as
model of
disease, 8
9az-10a2,38
Fromm,
Erich, 77
Fromm-Reichmann,
Frieda, 175
18-19
factors
and idea
of,
72
schizophrenia,
Glazier, E., 97
Groddeck, Georg, 59
Gross, Otto, 40n
Hamlet, 149
56, 57,
102-103
Hallucinations, 19
Inauthenticity, Laing
Institutionalization,
see
Confine-
phrenia
{^HO)
Interpretation
18,43-44
Dreams,
The
hospitalization,
see
of
(Freud), 209
Involuntary
Commitment; Confinement
233
Index
Jahrbuch fiir (continued)
(Yearbook for Psychoanalytic and
Psychopathologic Investigations),
Mary
Experience,
17
prisonment"
Jaspers, Karl,
144,
103,
55-59
146,
179
Lanterman-Petris-Short (LPS) Act,
148
Jewish law, marriage and divorce
under, 144-146
96
Lederberg, Joshua, 102-103
Liberation, Cooper's views on, 59-
61
Lincoln,
Abraham, 103
Linguistic
behavior,
13-17,
191;
Bleuleron, 13-15
208
Kallmann, Josef, 90, 107, 149-150
Kato, Masaki, 180
Kendell, R. E., 94, 101-102
Kesey, Ken, 165
Kiev, Ari, 89
Kingsley Hall, 50, 64-69; economic
relationships
Barnes
at,
10,
64-65;
at,
Mary
67-69, 74-76
Mao
38,41,61,209,210
similarities
158;
attractions
Kreutzer Sonata,
162-163
The
73-
74
(Tolstoy),
between,
of,
struc-
155-
167-169;
for psychiatrist-patient
relation-
Laing,
160,
on
women's
inauthenticity,
56,
57,
72;
234
Index
Martin, David, 54-55, 62, 75
Marxism (Marxists),
124,
Mary
51,
55,
78,
202
Barnes:
Two Accounts
Through
(Bames and Berke), 67
Journey
of a
Madness
6,
7,
Paresis
105
Masturbation, 11
(Kolb), 88
Medicine, premises
of,
nology of view
eralization of
of,
209-211;
metaphor
of,
lit-
33,
34
Merskey, Harold, 100-101
Metaphors, 14-17; literahzed, 33/z34/1, 74n, 197
Meynert, Theodor, 5-6
Milton, John, 152
Ophelia, 149
Orthomolecular psychiatry,
109,
111-112
Orthomolecular Psychiatry (Hawkins and Pauling, eds.), 109, 112
Osier, Sir William, 4
Osmond, Humphry, 112-114
O'Sullivan, Sonya, 168
Over-activity, 19
Minogue, Kenneth, 5 In
Mises,
Paradigm
or
model
of
disease:
6,7,9/1-10/1,43, 190,209-211
Parras, Antonio, 120
33/1
115,120,121
Phenothiazines, 180-181
^35
Index
Philadelphia
Report,
Association
1965-1969,62-63
Plundered mind, as image
psychiatry, 79-83
Politics of Experience,
in anti-
The (Laing),
91
70,71
Prefrontal lobotomy, 90-92
Prison,
and mental
Privacy, right
212-214
Russell, Bertrand,
37-38
hospital,
Union
129
to,
Private property, 80
"Promotion ceremonies," in
psychiatry, 75-76
Proudhon, Pierre Joseph, 80
Psychiatrists: cruelty
society
of,
anti-
of,
atric
to
and psychi82
Sanity, Madness, and the Family
(Laing and Esterson), 50
Schaudinn, Fritz, 210
Sanity, anti-psychiatric
demanded by
25-26; right
views
of,
Schizophrenia:
25
characteristics
of,
ilar to,
ends as replayed by, 40-42; matrimonial model of, 142-143, 156161; "moral treatment" in, 187188;
premises
of,
compared
to
194-197;
schizophrenia as created by, 135136; stages in history of, 187-189
those
of
medicine,
52-53; Paul-
specific
topics
Schizophrenia Bulletin,
115,
of
behavior,
Schizophrenics
tional,
Anonymous
Interna-
112-114
Science, 201-203
188
model
of,
Searle, J. R., 80
Self-esteem, 74, 75
Snezhnevsky, A. V., 89
Social sciences, 202-203
Racism, 19 In
236
116,
120
Psychopathologizing
8; as
Index
Union, 98-102,
Soviet
117-
106,
untary confinement
127; marriage
in,
98,
126-
and medicine
in,
Under-activity, 19
Unemployed
122-
schizophrenics,
123, 132
126-127
Vasomotor therapy, 5
Vesania typica, 10
Victim, patient
76
Stalin, Joseph, 48,
103,203
as, 52-53
Virchow, Rudolph, 8
109, 112-113
Sullivan,
87, 95
Voluntary or contractual
atry, 169-173
psychi-
174-175; consent
disease inferred
to,
134-137;
from response
131-132; justifications
of,
to,
132-
11,
210
mond), 113
Wilde, Oscar, 56
Wing, LK., 125-127
Woikhanskaya, Marina, 98-100
Thorazine, 181
Wolfman
case (Freud), 73
Women:
out,
Ludwig
Thudicum, Johann
helm, 208-209
Wil-
for,
Catholic
doc-
on Laing and
89
of
34,91
Trilling, Lionel,
confinement
riage
Transubstantiation,
148-150;
anti-
^37
Schizophrenia
"Szasz argues that the word schizophrenia does not stand for
disease, that ps\chiatr\
genuine
s\
mhol
to
them with
ventions.
loves the clever analogy, the well-turned phrase, the dramatic surprise."'
George W. Albee,
"Szasz
is
Contemporaf-y Psychology
a valuable critic
Szasz has
much
to
Spectator
Weekly
Also available by the sawe author
The Theology
The Myth
of Medicine
The Political-Philosophical
of Psychotherapy
Rhetoric,
and Repression
Paper 0225-1/SZTMP
He
is
both a practic-
professor of
and
Its Consequences.
State Universitv of
Syracuse,
New
New
York,
in
York 13244-5160
ISBN 0-8156-0224-3/SZSSP