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Szasz as Author – Introductory Comments

Below I will describe Szasz’s thoughts, views, and theories as they are expressed in his publications. Mainly of concern will be his critical-psychiatric theories. Although Szasz is often considered an antipsychiatrist, he himself has always denied this and distanced himself from the term. Nonetheless, as he, like the antipsychiatrists, attacks the very foundation of psychiatry, he is included among them by others. He criticizes the very foundation of conventional psychiatric theory and practice, as well as the social role and significance of psychiatry as a science, an applied science, a profession, and an institution.

In addition to these critical reviews, Szasz has dedicated several publications to psychosomatic, psychoanalytic, and psychotherapeutic subjects. These will be discussed below only to the degree that they are necessary for understanding the complete oeuvre.

Szasz is a prolific author. Besides countless articles – until 1983 around 380 according to his own bibliography – he has written 18 books.* Some of them became bestsellers. Undeniably his work has attracted considerable attention both inside and outside his own profession. They appeal especially to people in the legal field and interested “laymen.” Many of his books appeared in pocket versions, and were translated to other languages. Not only did Szasz publish in psychiatric and psychoanalytic journals, but also in legal and philosophical journals, as well as in general newspapers and magazines. He has written and continues to regularly write letters to editors in which he presents his views on current affairs. He published two** anthologies of aphorisms, in which he expresses himself on all sorts of social issues, not at all limiting himself to psychiatry. This reflects a certain shift in his work. Initially he directed his writing mostly to colleague professionals via professional journals. In time he began directing his writings more towards the public at large, for whose benefit the entire field of psychiatry with all its institutions is constructed. This shift is also reflected in his use of professional jargon, which over time gives way to language that is comprehensible to the general public. Probably this shift is due, at least in part, to the hostile responses Szasz received inside of psychiatry. Among other ways, this is demonstrated by the refusal of professional journals to publish his submissions. He has enjoyed much more recognition and appreciation by non-psychiatrists. This is exemplified by the many awards he received, often from institutions concerned with civil rights, and the fact that he was chosen as “humanist of the year” in 1972. It is notable that he continues to consider himself a psychiatrist, and keeps returning – no matter how critically – to what he considers his own professional territory. From a scientific point of view that is the part of psychiatry that deals with psychological and sociological methods, and in which man is seen as a social being who imparts meaning to life. From a practical point of view it is a helping service that is summoned at the patient’s request.

Seen chronologically, in the beginning his publications were mainly about psychosomatic subjects, viewed from a psychoanalytic point of view. This seems to be linked to his training. His trainer, F. Alexander, was interested in psychosomatics from a psychoanalytical point of view. Szasz’s publications from this early period are discussed in the next section.

Preceded by several articles leading up to it, that are discussed in section 4.1, he published The Myth of Mental Illness in 1961. This book can be considered his basic thesis that he has defended ever since. Some aspects of this basic thesis are discussed more thoroughly in The Manufacture of Madness, published in 1970. Together these two books provide a good and fairly complete insight into his views. They are discussed in section 4.2.

In several of his books and publications Szasz elaborates on his basic tenets and applies them. Particularly important for general psychiatry are his books regarding addiction (1974), schizophrenia (1976), and sexology (1980), as well as several articles. These elaborations on his main thesis are discussed in section 5.

The problems of justice and law regarding psychiatry form an important preoccupation for Szasz. This interest is expressed in several books, such as Law, Liberty, and Psychiatry (1963), Psychiatric Justice (1965), and Psychiatric Slavery (1977), as well as numerous articles. Mainly he discusses the problems of involuntary incarceration of psychiatric patients, their rights, and lack of them. He also discusses how psychiatry is used by judges. These views are summarized in section 6.

Szasz has always remained generally dedicated to the convictions he launched in 1961. Contrarily, his approach towards psychoanalytic theory and therapy changed rather fundamentally. In 1965 he published The Ethics of Psychoanalysis, in which he presented a detailed framework for psychoanalytic psychotherapy. The year 1978 saw the appearance of The Myth of Psychotherapy. His book about Karl Kraus (1976) is particularly interesting because of the position that Szasz develops in it on the function of Freud’s psychoanalysis and other psychoanalysts in the first decades of the twentieth century. Section 7 elaborates on these aspects of Szasz’s work. Although Szasz is active primarily as a critic – often most polemically and acrimoniously – he has occasionally suggested new theories. He has also suggested concrete changes to the mental health system. These are discussed in section 8.

Except for views on the significance of psychoanalysis, Szasz’s work consists of elaboration on views of which the essential foundations were already committed to paper in 1961, rather than of the development of new ideas and theories. Therefore classifying his work chronologically is not particularly useful.
If we do so anyway, then we might do it as follows:
  • The first period, up to 1956, is a time when Szasz publishes works on psychosomatic phenomena and “orthodox” psychoanalysis, in which there is as yet no hint of the controversial path he will follow later.
  • The second period, from 1956 to 1961, is the period in which he is preparing The Myth of Mental Illness up to which he leads with a profuse amount of critical articles.
  • The third period, from 1961 to 1970, culminates with publication of The Manufacture of Madness. This period is characterized mainly by further elaboration on the theme of The Myth of Mental Illness.
  • The fourth period lasts from 1970 until today [1984]. Now Szasz can be described as a political philosopher. He seems to move away from psychiatry as a practical and applied science. Although he is still intensely dedicated to the subject of psychiatry, he increasingly views it from a political-philosophical point of view rather than from within. This period is also marked by a clear shift in the type of journal in which he publishes: less psychiatric and more general. Many of his letters to editors are published in this period. They are commentaries on all sorts of current events from a certain political-philosophical point of view. A symposium held in Albany, NY, in 1980, calls Szasz a “libertarian humanist” in its subtitle.

*as of 1984. See the appendix. – translator
**Now four. – translator

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