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Szasz argues that the diagnosis and treatment of mental illness stands in the same relationship to the diagnosis and treatment of bodily illness that the forgery of a painting does to the original masterpiece. Art historians and the legal system seek to distinguish forgeries from originals. Those concerned with medicine, on the other hand - physicians, patients, politicians, health-insurance providers, and legal professionals - take the opposite stance when faced with the challenge of distinguishing everyday problems in living from bodily diseases, systematically authenticating non-diseases as diseases. The boundary between disease and non-disease - genuine and imitation, truth and falsehood - thus becomes arbitrary and uncertain.
There is neither glory nor profit in correctly demarcating what counts as medical illness and medical healing from what does not. Individuals and families wishing to protect themselves from medically and politically authenticated charlatanry are left to their own intellectual and moral resources to make critical decisions about human dilemmas miscategorized as “mental diseases” and about medicalized responses misidentified as “psychiatric treatments.”
Delivering his sophisticated analysis in lucid prose and with a sharp wit, Szasz continues to engage and challenge readers of all backgrounds.
Thomas Szasz is professor emeritus of psychiatry at the State University of New York’s Upstate Medical University in Syracuse, New York.
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By Michael on 04-11-12
Over four hours of rant, with lack of rationale
This audiobook caught my attention since I thought it might provide insights into problems with modern psychiatry. In fact, the narration was pretty good, giving it a serious and somewhat determined read.
Unfortunately, I expected too much. The first three or so hours were mostly spent ranting about Sigmund Freud and select other figures from around Freud’s time, where most of the attack was on the character of the people rather than the actual psychological paradigms they devised. No doubt, certain old psychological philosophies were fraught with questionable explanations and diagnostic procedures, but few modern psychologists rely on such tactics today. Basing its primary arguments against such paradigms as Psychoanalysis and such persons as Franz Mesmer, the mesmeriser, this book is clearly attacking some of the weakest, most outdated beliefs in the entire field.
The author’s most repeated argument, or statement, is that “there is no such thing as mental illness”. He basically dismisses psychology and psychiatry as falsehoods that study a “mind” that “does not exist”. His arguments against the existence of mental disorders are weaker than even the most speculative psychoanalytic theories, making him quite a hypocrite. His primary premise is effectively “If there is no apparent lesion or other abnormality visible in the brain under a microscope, then no illness is present”. His reasoning here is like saying “the pages of words in book x look very much like the pages of words in book y, and since book x has no logical fallacies, book y must also be free from any such problems”. Being that his original thesis and books were written in the 50s and 60s, I guess it is no surprise that he is ignorant about many of the functional abnormalities of the brain that are now easier to recognise using fMRI and newer techniques, and about the enlarged cerebral ventricles of persons with advanced schizophrenia. Psychology and cognitive neuroscience are continually advancing, but the author seems to be stuck in the easier-to-refute past and fixated on characters rather than concepts.
The next biggest argument of his can be summed-up as follows: “Since people are capable of imitation and since a number of practitioners have witnessed patients lying about having mental illness, all claims of mental illness, whether from patient or from practitioner, are completely fabricated”. Moreover, no grounds are provided to support this inductive assertion.
I should let you know, I do believe that a fair share of psychiatrists are illegitimate practitioners who make hasty, shadily-supported diagnoses with catch-all labels, and I do believe that psych-drugs are often prescribed or pushed when other options are more appropriate; but the author’s extreme position that mental disorders do not exist, and that anyone claiming they do is a liar, is exceedingly callous. Feel free to buy this audiobook if you want an outdated rant, entrenched with shallow, poorly-supported arguments.
14 of 17 people found this review helpful
By Carlos Mario Cortés H. on 05-09-17
La tesis de este libro es fascinante así como su afirmación final. Sin embargo, la argumentación deja un sinsabor. Me queda faltando un comentario sobre los casos de pacientes mentales realmente incapacitados.
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By Alan Michael Forrester on 04-12-13
A good summary of Szasz's criticism of psychiatry
In "Psychiatry: The Science of Lies", Thomas Szasz argues that psychiatry is not about mental illness: it is about lies. Mental illnesses are in general not specified in terms of structural or chemical changes in the human body. Rather they are specified in terms of behaviour. So there are no objective tests for mental illness before or after a person dies. They are literally just labels for behaviour that people dislike. The point of such a label is to deny the moral agency of the person diagnosed with that label. Sometimes a mental patient seeks out this status to get drugs they want or to avoid prison after committing a crime. Sometimes somebody else seeks to impose the label on the mental patient because the mental patient's behaviour is deemed inconvenient. So psychiatry is about people lying to one another, and to themselves. The book is well written and is narrated well by Tom Weiner.
1 of 4 people found this review helpful
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By Amazon Customer on 08-28-16
Great book and well worth the read
Szasz's view is an interesting and well thought through combination of Libertarian and anti-psychiatric thinking. Most writers who question psychiatry do so from a liberal/progressive perspective. Szasz's Libertarianism brings him to some logical and consistent views that more liberal writers are silent on - particularly in regards to psychiatry's role in maintaining the social taboo on suicide via coercive psychiatric interventions.
1 of 2 people found this review helpful