Thomas Szasz

The myth of mental illness

Well, how did this begin? It didn´t begin the way most psychiatric books have it. Now let me show you how it began. As you know, in ancient religious law, in jewish law and then Christianity copied this and then Mohammedinism copied this: one of the graviest sins and crimes is suicide because your life was given to you by God and taken by God. So this is a serious crime. Now, if something is a crime, if something is bad, it has to be punished. If it is not punished, then it´s just a piece of hypocrisy, then it´s just words. There is a wonderful english/american proverb which says: "Action speaks louder than words." Now that´s not accurate enough. Only action speaks! Words are, until proven otherwise, lies - in politics and in religion. They are justificatory lies. So only actions speak. So how was suicide - you might say: "How can you punish suicide? The person is already dead!" Well, in religion suicide was punished of course when people believed in religion, they thought that their soul will go to hell and they will roast forever and that´s a very serious punishment, if you believe it. But that wasn´t all! If you go to Israel and you go to an old cemetery, you will find that there are stones that are burial sites outside the city and both in Judaism an in Christianity, traditionally, the dead body was denied burial. In England, in the middle ages, not only was the body denied burial, but it had to be buried at the crossroads with a stake driven through the heart. Very much like witches - a kind of connection there. Now that was the situation until essentially the 13th century in England. As England became a more carefully, legally organized society, and I trace much of this history through England - because it is my model and then subsequently the U.S., but this all started in England - not only was suicide a serioius crime against the church, but it became also a serious crime against the sovereign, the king, because one of his subjects was destroyed. It was essentially a feudal concept. I hope you follow me. Now, again you might ask: "How can it be punished?" I don´t know if any of you are aware of this history. Suicide was punished in addition to the religious punishments which I described by the criminal law by confiscating the suicide´s property and giving it to the sovereign´s [armourner] This was the beginning of welfare. It is assumed that in the 14th to 15th century there was an Englishman who invested in the trade, had a ship, borrowed some money, the ship went down, he lost his money, he had a wife, 5 little children. All the property was taken away and the family was left to starve. His suicide was a serious crime. Let's go forward. This was 1300, 1400, 1500 and England gradually becomes the leading power. 1600: Shakespeare! This is still more or less the case. How did people know who committed suicide. Well nothing, so to speak, is obvious about illness or death - a body is found in a [..]. Well, maybe the person drowned himself, or maybe someone killed him and threw him in the water. A body is found hanging in a [bar]. Well, maybe he hanged himself but maybe someone killed him and hanged him to disguise the murder. So, and this remains to this day, I think also in Germany - if a body is found unattended by a physician's attendance - supervision - then that becomes a coroner's case. There's an autopsy and in England the procedure was - and in theory still is, in English-speaking countries, (this is the wonderful rule) - if there is a question of suicide, it became determined by what was called a „coroner's jury", which was usually composed of six citizens, to whom evidence was presented, whether or not, in this particular case, death was due to suicide, because if it was suicide, it was very much like murder. Then certain criminal punishments [...]. Exactly like in a murder case. If it was murder, (it was called by the way). Language is beautiful, you know, the word „suicide" doesn't exist in German - it´s called „selbstmord" - that is what it was called in English: „self-murder". „Freitod" is a unique word, that's an 18th or 19th century word - I looked all this up - again only in German! There is nothing like that - again, the word „suicide" did not exist before the 17th century in English. The only words - if you look in Shakespeare - "self-murder", "self-slaughter", "self-killing": all verbs, implying that someone is doing it - it's not an event, it's an act, like murder, slaughter. Allright, so a jury would determine this and the punishment would follow. Well, by the time - roughly Shakespeare´s time: 1600 - juries became more and more unhappy about this idea, [here] was this unhappy man, of calling this suicide and confiscating all the money and ruining the wife, and little children, innocent two-year old children, being punished in this way. And at this point the english legal profession reached for help - and this will be repeated later - this is the origin of the insanity defence. English criminal law now reached back to roman law and resurrected the concept - this was all in Latin - of "non compos mentis" and the jury was given the option of finding the dead corpse - of course, they didn't know, it may have been in the [...] for two months - of finding that at the time of suicide - the suicide was "non compos mentis", in which case it was not suicide, but an innocent act. The person killed himself while "non compos mentis". This goes back to roughly 1550, 1600. Now, by the end of the 17th century virtually 100% of the cases of suicide were where juries had decided that this was due to insanity. Now since the end of the 19th century - best as I have been able to determine, this is rather interesting - no Jewish or Christian church anywhere in the western world has denied religious burial to a suicide. If you look at catholic, papal, Vatican writings, they all say that suicide is due to temporary insanity and therefore the person is innocent and does not burn in hell. So, all of the churches have completely bought into the psychiatric ideology. Now this is very important to keep in mind, because this is really the model on which the insanity defense was built. Now we come to the real applications of how psychiatry begins. Before there is psychiatry, before there is mental illness, there is a kind of family problem that's described in Hamlet, in Macbeth, in King Lear, where there are these family problems of incompetence, senility, a dangerous young man, who realizes that his mother is a killer - you realize that Freud and many other people have analyzed Hamlet as being schizophrenic - because he can't decide. Well, how are you supposed to feel, if you think your mother killed your father and with the collaboration of your uncle, what kind of mental state are you supposed to be in? Are you supposed to be very tranquil and happy? So naturally he was upset. Now, to take care of this problem, arose the creation of private mental hospitals - this is described, lots of books on this [...] in lunacy. This was a good business. The trade in lunacy - business. This is the term that was used: "the trade in lunacy". You see, supposing you were a rich Englishman in 1700, 45 years old, you've been married for 20 years to this woman that you hate by now, who has had 10 children and doesn't look very good and you want to get rid of her and you want to marry a nice young woman or have sex with a nice young woman but you can't get rid of your wife, because there's no divorce and murder is illegal. So you have her locked up! Now keep in mind that before the French Revolution the same problem could be solved by having your wife or your daughter locked up in a nunnery. The priest would play the same roll "lettre de caché". Your daughter wanted to marry somebody you didn't like and you were a rich man, you had her locked up! Nunneries were prisons for young women! This is what psychiatry took over. But mind you, the first private mental hospitals were not related to medicine. They were run by clergymen, who were called "mad doctors". Now, by the end of the 1700´s, by the end of the 18th century, keep in mind that King George III was treated by "mad doctors". This was during the American Revolution. So by this time, "mad doctoring" is becoming accepted as a form of medicine. What is it? "Mad doctoring" is depriving someone of his competence and doing something to him to normalize him. Now it begins, psychiatry consists operationally of two things - I translate this accurately, I will repeat it and repeat it, when I say this in America, my psychiatric colleagues go crazy: Psychiatry consists of two things, if you look at it from my libertarian, liberal point of view: It consists of depriving innocent people of liberty, called "involuntary mental hospitalization" and (of) course excusing people of the worst crimes of being criminals, like John Hinkley, [MacNaughten]. People who deliberately shoot other people and [... want to kill him]. Now, how did that arise? Virtually every crime during the 18th century up until the 19th century, virtually every crime from pick-pocketing to murder in England had only one punishment. Foucault was not quite right about all these things - there were not all these jails - there was only one punishment: hanging! Now, again, put yourself in the frame of mind of Englishmen in the 18th, 19th century - they were becoming very civilized, you know, like we are. This idea of hanging people - as I understand, in Germany there not even the death penalty anymore, is that correct? Because you see, the death penalty is something so awful! Well, is it any more awful than locking up someone for life? You realize that if you lock up someone for life in America, billions are spent in making sure that he doesn't commit suicide. Now why shouldn't he commit suicide in jail? Socrates was allowed to commit suicide. [... go in exile]. There are worse things than death, especially if you ask the subject, who commit serious crimes often say: "I want to be put to death". How do you deal with that? That's another issue. The point is that psychiatry came in to being to fulfill these two functions: 1) get rid of family embarrassments and 2) excuse people from being hanged. Instead of being hanged, let them be locked up, in forensic institutions. I hope you know the history of the MacNaughten case, the first hospital for the criminally insane, "Broadmoore Hospital", in England was built to accommodate this gentleman, who then spent the rest of his life - 21 years - in this hospital where he died. So, in effect, this kind of hospitalization was a life sentence, in lieu of a criminal sentence. Now, everybody knows this! One of my questions is: "Is it a job for physicians to lock up people and deprive them of liberty?" This is job for communists, for nazis, this is not a job for a civilized society! All right, now we come to many other inter-relations that then crept into the law. Being competent to make a last will. Again, let's be very practical about this - these are all practical issues. Let's assume that you have $100 million. A lot of people have $ 100 million in America, or $ 50 million, and you are an old lady, your husband made all this money. All your relatives have died, your children have died - by now you are 90 years old but you are in good shape and your house is full of cats. (I'm making this up but it's kind of a real story.) You have some distant relative in Australia or in Berlin, God knows where and you have these $ 50 million and you make a last will and you leave all your money to the "Society for taking care of cats". OK? Now comes your cousin or 2nd cousin or your cousin's daughter from Berlin and says: "But she was crazy - she really loved me" and gets a lawyer and the lawyer goes to court and he says: "She was crazy - obviously she's crazy to leave all this money to cats!" and she immediately gets $ 5 million just to go away. It's called a settlement. You see how useful this concept is! Every time, I don't know, I assume some of you have made last wills - I don't know how it is in Germany, but in every last will it says: (and usually this is a lawyer and the lawyers secretary signs this) "I appear here as Thomas Szasz in my right mind, I am competent and so..." and then the lawyer signs it. It doesn't mean a thing! If someone wants to attack it after you are dead, it can be attacked and then you can get some money. Because again common sense comes into play, potentially this becomes a jury trial. In America its in the constitution that any civil claim for more than $20 can become a jury trial. But the lawyers´ fees become so expensive that when someone sues an estate, they usually get some money just to get away. So, the last will! Then suppose you want to adopt a child? You are examined by psychiatrists, by social workers: are you competent to adopt a child? If you simply want to have a child by having intercourse, that you can do! But if you want to adopt a child, then you have to be competent! [...] this is a recent development in America: (and actually, I wrote something about this 40 years ago - actually, this made a concrete change - people want to talk about alternatives, well you can make some alternatives! I don't know if you have this in Germany too?) Let's assume - this was an actual case that I'm going to cite now (which is in my book: "Psychiatric [...]", which I don't think has been translated because it's a purely legal analysis of these kind of cases) and in which I testified for the person and was of some use. A very interesting story!) - let's assume that you are a 35 year old gas station attendant. This man was a polish-american. Born in America, of polish descent, very close family, 4 or 5 brothers - all very close, lower or lower-middle class, was a lonely man, didn't get married, a loner, ran a gas station in a suburb and there came a real estate development and wanted to build a mall in this area and they wanted to get this gas station and they were going to buy the property and this guy was uninterested in the money! "I'm not selling, I'm not selling!" - you know: "leave me alone!" So naturally the real estate people, there are legal methods. They went to court and said: "You know, we are offering 2 - 3 times the value of this land and this interferes with this approved project to make the city better" - they will take the land from him in this legal manner. So, they went to court, the real estate people prevailed and they notified him that they are going to take his property. Then came some people from the real estate agency to put a sign there: "Sold! - a mall is coming up here!", at which point he went into his gas station, took out his rifle and fired a shot in the air. Now, it should be added that this man was a sharp-shooter in the war, and had a chest full of medals. He didn't try to shoot them, he shot in the air. The police came and he was arrested. He is then taken to psychiatrists to be examined to determined whether he is mentally fit to be tried. In America it's in the constitution that if you are arrested for a crime, you have a right to be tried. If you are tried you can be acquitted by the jury! This is a true story! If this man had been tried, he would have been acquitted. What was the crime? Maybe he would have been sentenced to a $20 fine. Instead, he was put in a mental hospital. When I found him, he had already been in a mental hospital for 15 years! Now as I said, I wrote a whole book about this - George Alexander, as I mentioned, was a lawyer [friend], who was then dean of the law school and several people in the law profession got involved in this because this was quite a common process in America. Lawyers took this up and one of these cases came before the U.S. Supreme Court and the Supreme Court then held a very interesting thing, namely, that no-one can be held in a mental hospital under these circumstances for a period longer than he would have been held in prison, had he been convicted. Which is not perfect either, because obviously he would have been acquitted, but you see its much better, because you see, it meant you could only hold him for 4 weeks or whatever, 6 months - you couldn't hold him for years! There was another case where actually a young man - 19 or 20 years old - stole a bar of chocolate and he also was in hospital by this day for 10 or 15 years. Now you remember, hundreds of thousands of people in America were in mental hospitals! Who were all these people? Well, these kind of people! Now this you can't do anymore but you can still lock up people as unfit to be tried, for a shorter period of time. Let me make a couple of more points and then finish. These are the main points which I will be happy to discuss: Parenthood, Standing trial, Insanity defense and civil commitment. I was reminded of something: apropos the discussion about homosexuality and the history of psychiatry, for which the psychiatrists never apologized. I have described this also in one of my earlier books. It might interest you to know, that long before there was the World Health Organization and DMS3 and DMS1, there was such a thing as slavery in America and as you know, during slavery not the whole country had slavery, only the southern states, OK? Massachusetts had no slavery, New York State had no slavery, in fact there was a so-called "underground railroad", a very interesting history of smuggling slaves to New York, mostly to New York through the area where I happen to live, because I only about an hour from Canada by car. Of course in Canada, slavery was abolished by the British Empire in the 1820´s. So, during slavery naturally - if you have read "Uncle Tom´s cabin" and some of this anti-slavery literature - it was not uncommon for slaves to try to escape. In other words, to start walking north. Now around 1835 there appeared a series of articles in medical journals describing the disease ["disasthisea etheopis"] and the other one was called [....some latin name] describing the disease of negro slaves who run away. The run-away slave as mental patient! I'm not making this up! I´d be glad to send you the documentation - this is fully documented - this is before the civil war: 1830 - 1840. This is part of american medical history. So you see, there is nothing new under the sun. When people tried to escape from Russia, what did the russian psychiatrists say? "This is a perfect country! The whole society is for the people! Everything belongs to you! The subway belongs to you, everything! This is a perfect democracy! If you want to run away from here, you must be crazy!" Now this is exactly what american psychiatry is now saying. "Keep smiling - you have the most perfect country here! If you want to run away and kill yourself, you must be crazy and we will treat you for it and we will give you a lobotomy, if necessary, to prevent you from this terrible disease called "depression"." Of course, if you want to commit suicide, you have this disease "depression"! How do you know that you have depression? Because you want to commit suicide! And of course then you call it a biological disease and you give drugs for it and then you prove that this is a disease. Now, let me end on this note and how far we have come around. What is the mother of Jesus Christ called in Latin? ["Martha de la Rosa"!] You were supposed to be depressed up until mother nature. Solemnity was the only proper attitude. It was only [Rablé] who reinvented humor. Between the advent of Christianity and the 13th century, you were not supposed to be happy! Depression was the normal state of mind. This war on depression is a part of the new religion of "if you are mentally healthy, everything is wonderful and you can't possibly be depressed, you can't have any conflicts and so on. If you can't study in school, you take [....], if don't get along with your wife, get psycho-therapy and so on."

Well, that's it.