Thomas Szasz: The Rebel Who Changed Psychiatry

Dr. Thomas Szasz wasn’t a popular figure in his chosen specialty of psychiatry, in part because he denounced his colleagues as little more than quacks and questioned whether the disorders they were diagnosing even existed. Indeed, Szasz’s controversial 1961 book, The Myth of Mental Illness, contained the mental health equivalent of the 95 Theses that Martin Luther nailed to a church door in Wittenberg.

Szasz, who died on Sept. 8 at age 92 at his home near Syracuse, N.Y.,  charged that there was little or no scientific evidence to back up many of his profession’s then-prevailing principles, such as the Freudian notion that adult mental disorders were often caused by unresolved childhood sexual traumas. Moreover, he argued that there might not even be a thing such as a disease that existed only in the mind, and that what patients and their doctors actually were struggling to deal with were “personal, social and ethical problems in living.”

Szasz also questioned the confinement of patients in mental hospitals and the value of psychiatric drugs. As he explained in a 1978 article in Rolling Stone:

You have not demonstrated that this woman you have described is anything but a troublesome human being. In what way is she ill? The fact the chemicals change her doesn’t prove anything. Martinis change you, too. It doesn’t mean that before the martini you were ill. But this is the logic of modern psychiatry. You take somebody; you give them a drug; they act differently; therefore they were sick.

Szasz’s own career had some tumultuous moments.  After he joined forces for a time with the Church of Scientology’s controversial campaign to discredit psychiatry, New York state officials barred him from working at a teaching hospital there. In his 70s, he was sued by the widow of a patient who committed suicide after Szasz urged him to stop taking medication, and he paid a settlement to end the case in 1994. His obituary in the Los Angeles Times concluded that he went too far with his complete dismissal of psychiatry and mental illness, saying that “Szasz, in effect, threw the baby out with the bathwater.”

Nevertheless, even critics now concede that Szasz’s crusade against psychiatric dogma helped improve mental health treatments. Psychiatrist and bioethicist Robert Daly, who studied under Szasz, told the Syracuse Post-Standard that Szasz’s attack on forced confinement in mental hospitals led to better legal and ethical protections for patients. And Szasz’s influence may be seen in the increasing shift of mental health practitioners toward cognitive behavioral therapy, in which patients work to develop better strategies for responding to life’s challenges.

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