Coercion as Cure: A Critical History of Psychiatry
Understanding the history of psychiatry requires an accurate view of its function and purpose. In this provocative new study, Szasz challenges conventional beliefs about psychiatry. He asserts that, in fact, psychiatrists are not concerned with the diagnosis and treatment of bona fide illnesses. Psychiatric tradition, social expectation, and the law make it clear that coercion is the profession's determining characteristic. Psychiatrists may "diagnose" or "treat" people without their consent or even against their clearly expressed wishes, and these involuntary psychiatric interventions are as different as are sexual relations between consenting adults and the sexual violence we call "rape." But the point is not merely the difference between coerced and consensual psychiatry, but to contrast them. The term "psychiatry" ought to be applied to one or the other, but not both. As long as psychiatrists and society refuse to recognize this, there can be no real psychiatric historiography. The coercive character of psychiatry was more apparent in the past than it is now. Then, insanity was synonymous with unfitness for liberty. Toward the end of the nineteenth century, a new type of psychiatric relationship developed, when people experiencing so-called "nervous symptoms," sought help. This led to a distinction between two kinds of mental diseases: neuroses and psychoses. Persons who complained about their own behavior were classified as neurotic, whereas persons about whose behavior others complained were classified as psychotic. The legal, medical, psychiatric, and social denial of this simple distinction and its far-reaching implications undergirds the house of cards that is modern psychiatry. Coercion as Cure is the most important book by Szasz since his landmark The Myth of Mental Illness.
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American Psychiatric anosognosia asylum behavior beneﬁt brain disease called Cameron century chemical chlorpromazine clinical coerced coercive commitment conﬁned conﬁnement convulsions cure David Healy declared deﬁned deﬁnition deinstitutionalization depression diagnoses disorders doctors effective emphasis added epilepsy epileptic Ethics experience ﬁeld ﬁlm ﬁnd ﬁrst Freeman history of psychiatry human Ibid imprisonment incarcerated inﬂuence inmates insane institutions insulin involuntary Journal justiﬁed Kennedy leukotomy liberty lobotomy Macalpine mad-doctoring madhouse madness medicine mental diseases mental health mental hospitals mental illness mental patients modern Moniz moral treatment neuroleptic Nietzsche Nobel ofﬁcial outpatient commitment persons physicians Pinel political practice prison problem psychia psychiatric coercion psychiatric drugs psychiatric historians psychiatric treatment Psychology psychopharmacology psychosurgery psychotic psychotropic drugs punishment Quoted Rosemary Rosemary Kennedy schizophrenia scientiﬁc shock sleep therapy social society suicide Syracuse University Syracuse University Press Szasz term therapeutic Thomas Szasz tion Titicut Follies Today treat Treatment Advocacy Center York
Page 25 - Canst thou not minister to a mind diseased, Pluck from the memory a rooted sorrow, Raze out the written troubles of the brain, And with some sweet oblivious antidote Cleanse the stuff d bosom of that perilous stuff Which weighs upon the heart ? Doct.
Page 2 - Adam's children, being not presently as soon as born under this law of reason, were not presently free; for law, in its true notion, is not so much the limitation as the direction of a free and intelligent agent to his proper interest, and prescribes no farther than is for the general good of those under that law.
Page 2 - Children, I confess, are not born in this full state of equality, though they are born to it. Their parents have a sort of rule and jurisdiction over them when they come into the world, and for some time after, but 'tis but a temporary one.
Page 5 - The entire history of social improvement has been a series of transitions, by which one custom or institution after another, from being a supposed primary necessity of social existence, has passed into the rank of an universally stigmatized injustice and tyranny.
Page 3 - And so lunatics and idiots are never set free from the government of their parents ; " children who are not as yet come unto those years whereat they may have; and innocents which are excluded by a natural defect from ever having; thirdly, madmen, which for the present cannot possibly have the use of right reason to guide themselves, have for their guide the reason that guideth other men which are tutors over them, to seek and procure their good for them.