Thomas Szasz: Hello.
René Talbot: Hello Thomas, this is René.
Thank you very much for the time you want to spend for this interview.
T.S.: You are welcome.
R.T.: I have prepared some questions. The first question is: What is distinctive about your new book "Coercion as cure – A critical history of psychiatry", which came out this year?
T.S.: What is distinctive about it is that no one has ever written a history of psychiatry based on the premise that there is no mental illness. All histories of psychiatry rest on the unquestioned belief that mental illness exists the same way that bodily illness exists and that doctors are trying to diagnose and cure it. This is nonsense. We ought to ask: What does the history of psychiatry look like if there is no mental illness? This is like asking, What does the history of (a monotheistic) religion look like if there is no God?
The answer then is that there are people who worship or do not worship God, there are churches, there are priests, and there is of course religious belief and religious disbelief and religious persecution. The answer for psychiatry is similar. There is voluntary psychiatry for people who want to got to psychiatrists and “worship” mental illnesses and cures; and they can get drugs, or electroshock, or psychoanalysis, or whatever the “soul doctors” are permitted to give them; and then there are people who reject psychiatry and on whom so-called “services” are imposed by force.
Today, neither psychiatrists nor the media distinguish – are allowed to distinguish! -- these diametrically opposite phenomena. I maintain that until society – the legal system – makes this distinction, the psychiatric situation will remain unchanged. And once the distinction is made, coercive psychiatry will be, will have to be, abolished – just as coercive religion has been abolished.
R.T.: Yes, there is a history of atrocities and cruelties and torture.
T.S.: Of course. That goes for any system of ideology based on a fiction plus force. The point is, there is the fiction of mental illness and there are psychiatrists who are agents of the state – just as there was, and is, the fiction of god and there are priests who used to be agents of the state but no longer are!
R.T.: The history of psychiatry and it's interpretation is always also connected with evaluations, questions of good and bad.
R.T.: Thus it also directly concerns the interests in contemporary psychiatric practice. What reactions have you had to your book?
T.S.: There has been only one review, which is very hostile, in a conservative, right-wing magazine called The Weekly Standard, I can send you a copy.
R.T.: And what was your opinion on this reaction?
T.S.: I expected this or no reviews at all. What else can psychiatrists do with my book except dismiss it?
R.T.: A new question: In the preface to the German translation of "The Myth of Mental Illness" you write: "Of all academic disciplines and sciences is perhaps none deeper rooted in the German language and culture than psychiatry. Kahlbaum, Kraepelin and Bleuler, Freud, Adler and Jung and many other founders of modern psychiatry wrote in German. Even if German has been overtaken by English since the nineteen-thirties as an idiom of psychiatry: it nevertheless remains the native language of this profession." What specifically do you see in the history of German psychiatry?
T.S.: What I had in mind is an interesting difference between German and English. In English, we have the word “mind,” used both as noun and verb. We speak of “mental illness.” In German, there is no word congruent with “mind.” There is Geist = spirit, and Seele = soul. This, I think, is one of the reasons why German psychiatry has been closer to philosophy, to religion, to the spiritual aspects of man, than has Anglo-American psychiatry, which has aspired to be materialistic, scientific, medical in the technical sense.
R.T.: So from the language-difference developed a different kind of history of psychiatry in Germany, do you think?
T.S.: Ironically, not. It is not different at all. The history of psychiatry is the same all over the world.. Everywhere it rests, first, on the fiction of mental illness (undefined as a disease, in fact used as a euphemism of misbehavior, unwanted behavior, like homosexuality or drunkenness); and second, it rests on coercion, the power of the psychiatrist to lock up the patient. In medicine, patients are treated with their consent. In psychiatry, persons – who often do not want to be patients – are treated without their consent. These simple facts are constantly denied, obscured, evaded.
R.T.: They change the bottle but it is always the same wine.
T.S.: Absolutely! Correct! That is why I titled my book "Coercion as Cure": because the crucial issue and term is coercion, the use of force authorized by the state.
R.T.: That is the central issue.
T.S.: That is the central issue in my work and that's why it doesn't matter whether the state is a communist state, a Nazi state, an American state, a British state, all use psychiatry as an arm of the coercive apparatus of the state
R.T.: …that legitimates this coercion and violence.
T.S.: Right. It is always a state in the modern world. Again, note the analogy to religion: In the premodern world religion legitimated the use of force. In the modern world, the secular state does so.
R.T.: Two chapters of your book "Coercion as Cure" are dedicated to drugs, whose introduction and dominance in psychiatry occurred during your professional career. You distinguish between drugs individuals want and drugs individuals do not want, between drugs the state permits and drugs the state prohibits. Is there, in your opinion, besides the side effects, any effect at all of the psychotropic – so-called therapeutic – drugs?
T.S.: In this connection, we should not use the word "side-effect." Drugs have certain biological and behavioral effects. Some effects are desired by patients or doctors or politicians, and some effects are not desired. We have to be very clear about this. “Desirable” and “undesirable” are not medical terms. They are terms that refer to cultural, social, medical contexts, personal preferences, political considerations, and so forth. Is morphine a good drug or a bad drug? If a patient is dying of cancer and is in pain, then it’s a good drug. If he is an ambitious politician who wants a bigger job, then he fights the “war on drugs” and declares opium poppies to be “enemies” that must be destroyed. Meanwhile, he or some member of his family may be secretly “abusing” heroin.
R.T.: In other words, are there no side-effects only effects?
are simply unwanted effects. In war, the death
of enemy soldiers is an effect. The death of our soldiers is a side
One of points I make in “Coercion as Cure” is that, in the case of all mind-altering drugs we must distinguish between the drugs that some people want to take and that some people do not want to take. Also, we must keep mind that many of the drugs people want to take are all illegal and if you buy or sell them you go to prison.
R.T.: Not all, alcohol is not forbidden.
T.S.: Not alcohol now! But there was a time, not so long ago, when alcohol was prohibited in the United States. It is still prohibited in Islamic states. I was referring to opiates, the war against drugs, the war in Afghanistan – and contrasting it with the “war for psychiatric drugs,” the drugs many people don’t want to take and are forced to take!
R.T.: Can you tell us something about the next projects you are working on?
T.S.: Yes, I can tell you, but the issues I address are too complicated for an interview. The title of my next book sums up what I have tried to do for more than fifty years: "Psychiatry: The Science of Lies". "Die Wissenschaft der Lüge". Mental illness is deception, self-deception, a lie. Psychiatry as a medical specialty is a lie. Psychotherapy is a lie. Again, there is the analogy, for an atheist, with religion as fable or myth or repression, or lie.
R.T.: I hope very much that your book "Coercion as cure" will be translated.
T.S.: Thank you. I hope so too, but I don’t count on it. Our western culture has grown increasingly uncritical of psychiatry during the past fifty years. “The Myth of Mental Illness” was translated into German. “Insanity” was not. “Liberation by Oppression” was not. The advent of the use of drugs for supposedly treating so-called mental illnesses has made psychiatry look like medicine.
R.T.: Yes, because it is a typical method in medicine to use drugs to treat diseases.
T.S.: Right. If you go to a doctor, he gives you drugs. Now the same thing happens: you go to a doctor, you say you are nervous and he gives you a drug and then it's called psychiatric treatment. This didn't exist when I went to medical school.