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Some Additional Remarks

In 1973 The Age of Madness appeared. This book can be considered further defense and expansion of the positions taken in The Manufacture of Madness. The book consists of several publications of literary, journalistic, and scientific character, collected by Szasz and provided with introductions. The contributions span more than two centuries. These contributions criticize institutional psychiatry, and in particular, involuntary incarceration and treatment. The earliest contribution is from 1728 by Daniel Defoe. It condemns men who put their respectable and virtuous wives away in psychiatric institutions in order to be at liberty to lead a lewd and lascivious life. John Conally (1830) writes among other things about declaring men insane, “When men’s interests depend upon an opinion, it is too much to expect that opinion always to be cautiously formed, or even in all cases honestly given…” (p. 10) In addition there are contributions about abusive circumstances in psychiatric institutions, about unjust declarations of insanity, about strange views on mental illness such as that the democratic persuasion is a new form of mental illness, and about the use of deceit in treatment.

Ideology and Insanity that appeared in 1970 is a collection of essays with dehumanization by (institutional) psychiatry as the common theme. All of these essays had been published previously, some (“The Myth of Mental Illness” and “The Rhetoric of Rejection”) already before the publication of The Myth of Mental Illness, and others during 1961-70. Their themes are similar to those of The Myth of Mental Illness and The Manufacture of Madness, but certain aspects are examined more deeply. For example, the theme of representing two adversary parties at once is highlighted in the essay “Mental Health Services in the School.” Szasz quotes several authors on this subject. It is clear that pupils’ interests are different, and sometimes obviously opposed to the interests of the school. He demonstrates that psychiatrists – serving not their patients but the school – side with the school when pressured by the system. The last essay, “Whither Psychiatry,” will be discussed in 8. This collection of essays conveniently presents Szasz’s most important views.

The Theology of Medicine (1977) is a collection of essays similar to Ideology and Insanity that is subtitled: The Political-Philosophical Foundations of Medical Ethics. In the introduction Szasz attempts to clarify his political-philosophical premises from a different angle. He starts by positing that human life without suffering is unthinkable. People can only struggle to achieve things they want in life at the expense of other desired things. The things we as humans want exclude each other so we have to make choices. At the same time, different people often have very different desires. That means that people in similar situations suffer to different degrees, and that relief of suffering can have totally different meanings to different people.

When people aim to maximally relieve the suffering of humanity, conveniently assuming that all people suffer to the same degree and in the same circumstances, the result is more, not less, suffering. The greatest suffering was/is generated by political programs that claimed/claim to relieve suffering most radically – examples being Marxist communism and medical-scientific ideology.

Nowadays nobody would want to impose a religion on someone else, Szasz says. Why does such a thing happen to people who are labeled mentally ill? There are two reasons for succeeding. The first is that language has been deflected from reference to suffering and happiness to reference to illness and health. The second is the destruction of the ideals and institutions that are supposed to protect us against those who would help us.

Szasz uses the words theology and religion in an unconventional meaning. He means everything in which people believe and that provides sense and purpose to their lives. So religion encompasses both what is conveyed by the French word foi and the word croyance, and is about synonymous to what Stüttgen in 1972 calls ideology. In short, it encompasses everything in which a person believes. (Ceremonial Chemistry, 1974, p. 2) In my opinion the use of the word religion this way is confusing and strictly speaking incorrect. The same holds for the title of the book, The Theology of Medicine. Nowhere in the book is there any reference to theology. The title is, I believe, intended to suggest that health has become a (false) god, the physician a priest, and medicine a theology. So the title is to be understood as a metaphor. The contents of the essays in this collection have already been discussed above.
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