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A Word about this English Translation

Preface

My Experiences in Psychiatry
1. The First Experience
2. The Second Experience
3. The Third Experience
4. The Fourth Experience
5. The Fifth Experience
Two Quandaries
Thomas Szasz as a Source of Inspiration

Introduction

Part I Thomas S. Szasz’s Critical Psychiatry

Chapter I Szasz – the Man and his Work

1. Some Biographical Notes
2. Szasz as Author – Introductory Comments
3. Szasz and Psychosomatics (1947 – 1956)
4. Szasz as a Critical Psychiatrist
4.1 Leading up to The Myth of Mental Illness (1957 – 1961)
4.2 The Fundamental Hypotheses of Szasz’s Theory
4.2.1 The Myth of Mental Illness (1961)
4.2.2 The Manufacture of Madness (1970)
4.2.3 Some Additional Remarks
4.2.4 Psychiatry as a Social Institution
5. Views on Certain Types of Mental Illness
5.1 Ceremonial Chemistry (1974)
5.2 Schizophrenia (1976)
5.3 Sex by Prescription (1980)
6. Psychiatry, Justice, and Law
6.1 Law, Liberty, and Psychiatry (1963)
6.2 Psychiatric Justice (1965)
6.3 Psychiatric Slavery (1977)
7. Freud, Psychoanalysis, and Psychotherapy
7.1 Introduction
7.2 Szasz on Freud
7.3 Psychoanalysis
7.4 The Myth of Psychotherapy (1978)
8. Which Changes does Szasz Advocate?

Chapter II The Historical Context of Szasz’s Theories
1. Introduction
2. The Conceptualization of Problem Behavior as Mental Illness during the Course of History
3. Some Comments About the Development of Psychiatry in the Twentieth Century, in Particular in the United States
3.1 Developments in Ideas about Psychiatric Disorders
3.2 The History of the Institutions for Intramural Psychiatric Involvement and Treatment
3.3 The History of the Mental Health Movement
3.4 The History of the Psychoanalytic Movement
3.5 The Turning Point: 1961

Chapter III The Ideological Context of Szasz’s Theories
1. Introduction
2. Some of Szasz’s Personal Philosophies
2.1 Szasz as a Humanist
2.2 Freedom and Autonomy
2.3 Individualism and Collectivism
2.4 Szasz’s Political Views
2.5 Some Comments
3. Szasz and Dualism
3.1 Philosophy of Science, Physical Science and the Humanities
3.2 The Relationship Between Body and Mind
4. Szasz in Short
4.1 Szasz as a Heretic
4.2 Szasz as Theoretician

Chapter IV Szasz’s Argumentation and Rhetoric
1. Introduction
2. The Use of Language
3. The Argumentation
3.1 Presentation and Thought Processes
3.2 The Building Blocks of Argumentation
4. The Structure of Argumentation as revealed by Text Analysis
4.1. Introductory Comments
4.2 Following the Thought Process in Detail
4.3 Postscript to Section 4
5. Comparisons Between Different Presentations of Argumentation
6. Conclusions to Chapter IV

Part II The Myth and the Power: a commentary

Chapter V Is Mental Illness a Myth?

1. Introduction
2. The Problem of Conceptualization
2.1 “Being ill”
2.2 The “Disease” Concept
2.3 Disease and Organic Aberration
2.4 The Concept of “Mental Illness”
2.5 Psychiatric disorders and organic aberration
2.6 Summary and Conclusion on Conceptualization
3. Biomedical or Biopsychosocial? Implications of Conceptualization
3.1 The Biomedical Disease Concept and the Dualistic Concept of Man
3.2 The Unfalsifiable Thesis of Organogenesis
3.3 The Problem of Validation
3.3.1 Validation in Somatic Medicine
3.3.2 Validation in Psychiatry
3.3.3. A Comparison of Validation in Somatic Medicine and in Psychiatry
3.4 The Meaning of Psychiatric Disorders
3.4.1 The Connection Between Problems in Living and Psychiatric Disorders
3.4.2 Causality and Responsibility Regarding Physical Illness
3.4.3 Causality and Responsibility Regarding Psychiatric Disorders
3.5 Closing Remarks and Conclusions on Biomedical or Biopsychosocial?

Chapter VI Physicians, Patients, and Disease: The Consequences of Conceptualization
1. Introduction
2. The Biomedical Disease Concept as a Territorial Concept
3. Physicians and the Biomedical Disease Concept
3.1. Physicians as Professionals
3.2. The Psychiatrist as Helping Professional
3.3. Psychiatrists as Social Arbitrators
4. Psychiatric Patients and the Biomedical Disease Concept
5. The Psychiatrist-Patient Relationship
6. Closing Remarks on the Consequences of Conceptualization

Chapter VII Psychiatry and Coercion

1. Introduction
2. Some General Premises
2.1 Law and the Concept of Psychiatric Disorder
2.2. Law, Psychiatric Disorders, and Free Will
3. Involuntary Commitment to a Psychiatric Hospital
3.1. Justification of Involuntary Psychiatric Commitment
3.2. Predicting Danger
3.2.1 Predicting Danger to Others
3.2.2 Predicting Danger to Themselves
3.3 Involuntary Commitment as an Intervention
3.4 Abolition of Involuntary Commitment?
3.5 A Design for an Interim Provision to Bridge the Actual Situation and Future Abolition of Involuntary Commitment
4. Summary and Conclusions of Chapter VII

Epilogue: Recent developments

Introduction to Epilogue
The Concept of Illness in Psychiatry
The DSM system
The Neopositivistic Turn in Medicine and Psychiatry
Rationality and Relation
Professional Ethics
State Intervention
Coercion in Psychiatry
The Law in the Netherlands and Other Countries
Coercion and Science
Incompetence and Disease Insight as Basic Elements
Alternatives

References

Books by Thomas Szasz

About the Author

Title Page