Cruel Compassion: Psychiatric Control of Society’s Unwanted

Abstract

THOMAS SZASZ: Cruel Compassion: Psychiatric Control of Society's Unwanted. John Wiley and Sons, New York, 1994, 264 pp., $19.95. Thomas Szasz maintains in Cruel Compassion his antipsychiatric stance but has moved on to deal with an issue he calls adult dependency and the society's unwanted. In the first part of the book, he makes the case that modern psychiatric treatment is similar to segregating paupers in workhouses, incarcerating default debtors in prisons, and exiling epileptics to colonies. His argument is almost entirely based on analogy. In the past paupers, debtors, epileptics, et al. were coerced and controlled because they were unwanted by society. He asserts that the same thing is happening today with the so-called mental housed in mental hospitals. His argument lacks one thing: proof. Later in the book, he turns his attention to the de-institutionalized people on the street who he admits can be disruptive and dangerous. De-institutionalization seems o be what he has always advocated, i.e., a liquidation of psychiatric hospitals. However, now he blames psychiatry for homeless people. In this approach, his style is to attack psychiatry and disabled patients, and his technique is provocative. The primary target of his anger is the general psychiatrist, but he speaks ill of a wide range of people and organizations: the American psychiatric Association, the National Institute of Mental Health, parents of the mentally ill, the National Alliance of the Mentally Ill, Hobbes, John Stuart Mill, John F. Kennedy, the Joint Commission on Mental Illness and Health, Philippe Pinel, Eugene Bleuler, Henry Maudsley, Sigmund Freud, Anna Freud, Carl Menninger, Nathan Kline, E. Fuller Torrey, Paul Applebaum, Richard Lamb, Bruno Bettleheim, and Lewis Thomas among others. He does have heroes and quotes approvingly from Shakespeare, Adam Smith, and himself. One might think his attacks on psychiatry are some form of professional autogenocide, however this is not quite the case. He never speaks of himself as a member of the profession. He gives no personal case material to indicate how he would actually take care of patients. Nor can one really imagine Szasz conducting his own receptive, nondirective interview with patients. He is so certain he knows what is wrong, how could he possibly listen to ill patients describe bizarre delusions, auditory hallucinations, poor concentration, threatening thoughts, and marked ambivalence in speech and action. …