Liberation By Oppression

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Originally called mad-doctoring, psychiatry began in the seventeenth century with the establishing of madhouses and the legal empowering of doctors to incarcerate persons denominated as insane. Until the end of the nineteenth century, every relationship between psychiatrist and patient was based on domination and coercion, as between master and slave. Psychiatry, its emblem the state mental hospital, was a part of the public sphere, the sphere of coercion.

The advent of private psychotherapy, at the end of the nineteenth century, split psychiatry in two: some patients continued to be the involuntary inmates of state hospitals; others became the voluntary patients of privately practicing psychotherapists. Psychotherapy was officially defined as a type of medical treatment, but actually was a secular-medical version of the cure of souls. Relationships between therapist and patient, Thomas Szasz argues, was based on cooperation and contract, as is relationships between employer and employee, or, between clergyman and parishioner. Psychotherapy, its emblem the therapist's office, was a part of the private sphere, the contract.

Through most of the twentieth century, psychiatry was a house divided-half-slave, and half-free. During the past few decades, psychiatry became united again: all relations between psychiatrists and patients, regardless of the nature of the interaction between them, are now based on actual or potential coercion. This situation is the result of two major "reforms" that deprive therapist and patient alike of the freedom to contract with one another: Therapists now have a double duty: they must protect all mental patients-involuntary and voluntary, hospitalized or outpatient, incompetent or competent-from themselves. They must also protect the public from all patients.

Persons designated as mental patients may be exempted from responsibility for the deleterious consequences of their own behavior if it is attributed to mental illness. The radical differences between the coercive character of mental hospital practices in the public sphere, and the consensual character of psychotherapeutic practices in the private sphere, are thus destroyed. At the same time, as the scope of psychiatric coercion expands from the mental hospital to the psychiatrist's office, its reach extends into every part of society, from early childhood to old age.

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Editorial Reviews

From the Publisher
"The book is readable and challenging; readers will never see psychiatry in the same way again." —Choice "Szasz now appears to have been transformed into an ally rather than an enemy of the National Health Service general adult psychiatrist. Szasz's project has always been to argue passionately for a boundry of demarcation around the responsibility and power of psychiatry....But what saves this book from being just another mugging of psychiatry is that Szasz does raise a fundamental question at the core of our discipline. If we restricted our attention only to those clients who wanted to see a psychiatrist, and disengaged from all those who really didn't, how different might our professional practice and experience be?" —The British Journal of Psychiatry “In Liberation by Oppression . . . his latest thrust at the therapeutic state and psychiatric mendacity, Szasz leaves no doubt as to the legitimacy and credibility of his arguments. Masquerading as therapy and working under the name of medicine, present-day psychiatry subjects its patients (victims) to the most heinous forms of mental and physical oppression. Comparing psychiatry to slavery may seem extreme at first glance, but as Szasz expands his argument, we find his reasoning profound and convincing. Because the state proclaims that psychiatry is a branch of medicine and that all mental diseases are brain diseases, psychiatry takes ever-greater control of people and their behaviors. With the power forcibly to drug, restrain, and imprison, it occupies the throne of the therapeutic state. Despite all of its self-proclaimed efforts to “free” persons from their “illnesses,” it actually oppresses and confines them. Therapeutic enslavement by psychiatry is worse than all the forms of political slavery the world has endured thus far. . . . Liberation by Oppression is a valiant and worthy effort by one of the great modern thinkers to keep the flame of liberty burning. It is a bold, powerful, and intellectually spirited debunking of the psychiatric pseudoscience that debases the human spirit and damages countless lives. Szasz’s message urgently needs to reach both those who value science and those who share the values of the Declaration of Independence. It is a masterful defense of both reason and individual rights.” —Robert A. Baker, Independent Review "Thomas Szasz has created an extraordinary body of work, that continues to raise consequential challenges to the the prevailing myths of the culture of psychology." Tobias Wolff, PEN/Faulkner Award-winner, Stanford University
From The Critics
Less a true comparative study than a passionate denunciation of coerciveness in the practice of psychiatry, this book does draw parallels between modern psychiatric justifications for coercive practices and rhetoric justifying the practices of American slavery. Szasz (emeritus, psychiatry, State U. of New York in Syracuse) suggests that, as slavery depended on denying the slave's humanity, the survival of psychiatry depends on denying the legitimacy of the psychiatric patient's unqualified right to personhood. Annotation c. Book News, Inc., Portland, OR
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Product Details

  • ISBN-13: 9780765805409
  • Publisher: Transaction Publishers
  • Publication date: 9/1/2003
  • Edition description: New Edition
  • Pages: 252
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.57 (d)

Meet the Author

Thomas Szasz (1920–2012) was professor of psychiatry emeritus at the State University of New York Upstate Medical University in Syracuse, New York and adjunct scholar at the Cato Institute, Washington, DC. He was a prominent figure in the anti-psychiatry movement and a critic of the moral and scientific foundation of psychiatry.

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Table of Contents

Introduction: Perilous Rescues 1
1 Psychiatric Slavery: Legal Fiction and the Rhetoric of Therapeutic Oppression 13
2 The Psychiatric Slave Status: From Dred Scott to Tarasoff 35
3 Psychiatric Slavery as Public Health: Infection and Insanity 55
4 Justifying Psychiatric Slavery: "Dangerousness" as Disease 75
5 Jim Crow Psychiatry I: The Psychiatric Will and Its Enemies 87
6 Jim Crow Psychiatry II: The Patient Self-Determination Act 105
7 Expanding Psychiatric Slavery: Outpatient Commitment 121
8 Glorifying Psychiatric Slavery: Therapeutic Jurisprudence 147
Epilogue: "Liberty is the Prevention of Control by Others" 165
App. I The Power of False Truths: The Maternity Hospital and the Mental Hospital 169
App. II Victims of Psychiatric Slavery: A Sampler 179
Notes 201
Selected Bibliography 221
Index 231
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