Book Review: General Psychiatry: Szasz under Fire: The Psychiatric Abolitionist Faces His Critics

Abstract

General Psychiatry Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics Jeffrey A Schaler, editor. Chicago (Ill): Open Court La Salle; 2004. 450 p. US $36.95. Reviewer rating: Good This book is edited by Jeffrey Schaler, a psychologist and associate professor of justice, law, and society at American University. The format is as follows: a states his or her position vis a vis Szasz and then he replies. Few authors of 12 chapters are psychiatrists or psychotherapistspsychoanalysts, with exception of RE Kendell and Ronald Pies. Most contributors have doctorates in philosophy or law, which colours content and sets tone. Several contributors seem to subscribe partly to some of Szasz' views, although they are less extreme in their propositions. The first chapter is an autobiographical sketch by Thomas Szasz, and herein we find crux: illness is a myth, and therefore it is foolish to look for causes or cures of imaginary ailments we call 'mental diseases.' Kendell builds on this, summarizing Szasz' claims that a condition is a disease only if a morphological abnormality is demonstrated (following Virchow criteria). It follows, then, that there is no medical, moral, or legal justification for involuntary psychiatric hospitalization or treatment. Szasz restates his belief that psychiatry and coercion are like conjoined twins and cannot be separated. KWM Fulford, a professor of philosophy and mental health, believes Szasz is skeptical rather than antipsychiatry, and by explaining what he calls value-based medicine, he hopes to show that Szasz does not lead to demise of psychiatry but, rather, to its strengthening. Szasz disagrees with much of Fulford's paper, and he states that value-based medicine and its twin, evidence-based medicine, are merely obfuscatory, self-approbating slogans. This pattern runs through practically every chapter. One critic at times agrees with part of Szasz' beliefs or thesis and yet, in a devastating counterattack, is severely criticized for his misinterpretations. Another author, Scott Percival, thinks Szasz is unnecessarily open to criticism because he lacks a strong epistemology and proposes that his perspective could be found in work of Karl Popper. Interestingly, Szasz, by way of answer, invites us to read his exchange of letters with Popper. Szasz also defends his position on suicide, clearly stating that he is opposed to suicide prevention because it refers to the practice of using coercive apparatus of state to deprive people of their liberty. …