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Freedom and Autonomy

Individual freedom, understood as self-determination, is both the most important point of departure of Szasz’s thinking about man, as well as his most important life value for himself.

In The Ethics of Psychoanalysis he asserts that the modern concept of freedom is complex and actually rather confusing, because it has two diametrically opposed meanings. In the Enlightenment a concept of freedom originated that has an individual and positive structure: freedom is the possibility for the individual to attain his own goals. The purpose of freedom is to become an “individuated person, an autonomous, authentic, self-responsible man.” (p. 18) This is “freedom to.” The second concept of freedom, originating in the eighteenth century, and carried out in the nineteenth century by “political revolutionists” such as Marx and Lincoln, is collectivist. It has a negative structure. It is formulated as freedom from something, such as: freedom from oppression, freedom from slavery, or freedom from abuse. In short, according to Szasz, this freedom is the freedom of a group to have the same privileges as all other groups. Szasz identifies “freedom from” with collective freedom. The individual has “freedom to.” The group has “freedom from.” In my opinion this could be confusing because both concepts of freedom are actually closely related as becomes apparent from the statement about privileges. Having privileges implies both “freedom from” and “freedom to.”

Although Szasz considers both forms of freedom desirable and necessary, collective freedom is to him meaningful only as a condition for individual freedom. He opposes the view that individualism and autonomy are but excuses to take advantage of the weak. In western nations where dictatorship, oppression, and tyranny have disappeared, the basic conditions for collective freedom have been satisfied. A well-functioning democracy provides the cultural conditions that enables citizens to shape their own individual freedom to personal autonomy. That is why Szasz considers democracy the most desirable form of government. (Psychiatric Justice, p. 12) Moreover, he states that never before in history have so many people had the opportunity to develop themselves as in our time. So for Szasz, the concept of freedom has first and foremost a political-philosophical meaning. This also applies to the concept of autonomy. Autonomy is a very central concept in Szasz’s thinking. He defines it as follows: “Autonomy is a positive concept. It is freedom to develop one’s self – to increase one’s knowledge, improve one’s skills, and achieve responsibility for one’s conduct. And it is freedom to lead one’s own life, to choose among alternative courses of action so long as no injury to others results.” (The Ethics of Psychoanalysis, p. 22)

Autonomy is not something that is given to a person. It can be attained only through effort. This is accomplished by developing oneself, by learning, but also by taking responsibility for what one does or causes. According to Szasz a person’s biggest and most central duty is to become an autonomous person. Szasz uses this term as synonymous to “Moral Man.” He postulates that in our world incredibly much improvement would be achieved if everybody would take responsibility for that for which he is indeed responsible.

Subsequently Szasz reasons that as it is essential to have the freedom to develop oneself, actually utilizing that freedom is virtuous. When one person achieves more than another it is justifiable to esteem the achiever more highly. Szasz not only regards the freedom to choose as important, but also the nature of the choices made. Achieving is to him more worthwhile than not aspiring to achieve. There is a paradox in this. A person is free to the extent that he can realize his own choices regardless of the nature of the choices he makes.

The boundary of individual freedom coincides with the boundary of the other’s personal freedom, namely where the freedom of one person restricts or violates the freedom of the other. Here a principle of reciprocity applies. It is not completely clear to me where exactly this boundary is in Szasz’s opinion. However, he does state that the boundary is violated when a person compels another to do things he does not want, and when he causes the other direct harm. In his political views, which amount to maximization of individual freedom and minimization of state power (see 2.4) there are indications of this boundary. Furthermore it is clear that free competition with others is within the “territory of freedom.” Obviously those who, for whatever reason, cannot keep up, will suffer in a society of free competition, unless this society instates measures to protect the weak. However there is little to be gained by punishing the good players for their success at the game. It is more useful to reward the bad players for their efforts at trying to play better.

Freedom is a core value in Szasz’s work. Only in freedom does man become man. Other life values, such as happiness and health, are secondary in relation to freedom. This applies not only to one’s own freedom but also to that of others. Freedom is so elementary that, even when there is only a little bit left, it is exactly that little bit of freedom that turns man into man, and therefore is more important than all other factors combined. “Following in the tradition of individualism and rationalism, I hold that a human being is a person to the extent that he makes free, uncoerced choices. Anything that increases his freedom, increases his manhood; anything that decreases his freedom, decreases his manhood. Progressive freedom, independence, and responsibility lead to being a man; progressive enslavement, dependence and irresponsibility, to being a thing. (Ideology and Insanity, p. 47) So it becomes an ethical premise that treating people as people means first and foremost: respecting their freedom.

When Szasz speaks about freedom, he usually means individual freedom. By describing it as “the ability to make uncoerced choices” (Ideology and Insanity, p. 1) he underscores that freedom is a value, but also a skill that can be developed or neglected. The measure of an individual’s freedom is linked to and restricted by internal and external conditions. “His internal conditions, that is, his character, personality or ‘mind’ – comprising his aspirations and desires as well as his aversions and self-discipline – propel him towards, and restrain him from various actions. His external conditions, that is, his biological make-up and his physical and social environment – comprising the capabilities of his body, and the climate, culture, laws and technology of his society – stimulate him to act in some ways and inhibit him from acting in others.” (Ideology and Insanity, p. 1)

The individual is challenged to attain freedom and autonomy through effort. To do so, he must first learn to control his desires and aspirations. Secondly, he must learn to control his tendency to exercise power over others. And thirdly, he must learn to liberate himself from all sorts of external influences that interfere with his freedom and thwart him in developing his creativity. In so doing, the freedom of the individual is realized by striking a balance between defending one’s interests and self-control; expanding oneself and restraining oneself; taking space and allowing others space; developing the self and controlling the self. Actually, where to draw the line between a person’s autonomy and that of others is an ethical-moral problem. The moral character of this syllogism is exemplified in questions as, “Can man be held responsible for his conduct?” and “Where are the lines between his responsibility and the responsibility of others, and, as man is a social being, the responsibility of society?” Inasmuch as certain values shape the way people treat each other, the moral problem takes on the features of a political position.

Autonomous development is difficult and can be painful. It can be threatened, stagnate, and miscarry, in all sorts of ways, from within as well as from without.

A person’s autonomy can be threatened from within because he succumbs to the temptation to exert pressure on another person without respect for the other’s autonomy, or to exercise power at the expense of the other. His autonomy can also be threatened because he attempts to escape from a heavy responsibility, sometimes experienced as unbearable, by declaring himself dependent on the other, “handing over” his responsibility, or presenting himself as not responsible. Szasz’s thoughts on this issue are related to those of Sartre and Camus, whom he quotes repeatedly with assent (for instance, in The Manufacture of Madness and Psychiatric Justice).

The most important threat to a person’s autonomy from without is the power that others attempt to exercise over him. This power can present itself in all sorts of ways: the power of dictatorship, the power of tyranny, the power of authority, the power of the professional, the power of the state, the power of the church, and so forth.

So freedom and autonomy are values that are threatened from two sides. The person who wishes to dispose of his responsibility and the other person who agrees to accept it in exchange for an increase in his power, match each other in a complementary relationship. This construct reminds me strongly of the story of The Grand Inquisitor from Dostojewski’s The Brothers Karamazow. In this story, the Church offers a translation and disguise for the problem of human responsibility in religious terms, and offers the escape route of religion in exchange for the autonomy of the faithful. That is exactly what Szasz means, and he refers repeatedly to this construct as the characteristic heteronomy of the time when religion controlled life, the “Age of Faith.” But when Szasz describes this situation, he does so to provide an analogy with our time, characterized by him as the “Age of Science” or rather the “Age of Madness.” “In short, whereas in the Age of Faith the ideology was Christian, the technology clerical, and the expert priestly, in the Age of Madness the ideology is medical, the technology clinical, and the expert psychiatric.” (Ideology and Insanity, p. 5) He is suggesting that in modern times the healing arts, and psychiatry in particular, have replaced religion in this respect.

This threat to freedom from both sides has in our time led to the following construct among others:
  1. One of the ways by which man tries to escape his moral responsibility is by mystifying and technicalizing problems as symptoms of illness. This is precisely what happens nowadays when someone displays certain phenomena that are labeled as mental illness. The person identified as mentally ill is no longer held responsible for his conduct. Illness provides him with an excuse.
  2. Directly corresponding to this, psychiatrists and behavioral scientists have devised a system that Szasz calls “behavioral technology.” It is a system of psychiatric illnesses and disorders that provides those who want it a legal and socially accepted opportunity to escape the unbearable burden of their responsibility by becoming ill. In other words, psychiatry has transformed the dilemma of accepting or fleeing responsibility to the dilemma of health and illness. At the same time, the fundamental moral and political character of this choice between autonomy or heteronomy is veiled by the images and the jargon of medicine, illness, and health.
“The lesson is,” thus Szasz closes his arguments about the inquisition in The Manufacture of Madness, “that man must forever choose between liberty and such competing values as health, security, or welfare. And if he chooses liberty, he must be prepared to pay its price – not only in eternal vigilance against malevolent tyrants, bent on enslaving their subjects; in eternal skepticism of benevolent priests and psychiatrists, bent on curing souls and minds; but also in eternal opposition to enlightened majorities, bent on reforming misguided minorities.” (p. 134)
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