Psychiatry: The Science of Lies

by Thomas Szasz

For more than half a century, Thomas Szasz has devoted much of his career to a radical critique of psychiatry. His latest work, The Science of Lies, is a culmination of his life’s to portray the integral role of deception in the history and practice of psychiatry. Szasz argues that the diagnosis and treatment of mental illness stands in the same relationship to the diagnosis and treatment of bodily illness that the forgery of a painting does to the original masterpiece. Art historians and the legal system seek to distinguish forgeries from originals. Those concerned with medicine, on the other hand—physicians, patients, politicians, health insurance providers, and legal professionals—take the opposite stance when faced with the challenge of distinguishing everyday problems in living from bodily diseases, systematically authenticating nondiseases as diseases. The boundary between disease and nondisease—genuine and imitation, truth and falsehood—thus becomes arbitrary and uncertain. There is neither glory nor profit in correctly demarcating what counts as medical illness and medical healing from what does not. Individuals and families wishing to protect themselves from medically and politically authenticated charlatanry are left to their own intellectual and moral resources to make critical decisions about human dilemmas miscategorized as “mental diseases” and about medicalized responses misidentified as “psychiatric treatments.” Delivering his sophisticated analysis in lucid prose and with a sharp wit, Szasz continues to engage and challenge readers of all backgrounds.

Genres: Psychology, Psychiatry, Nonfiction, Mental Health, Audiobook, Science, History

148 pages, Hardcover

First published September 1, 2008

About the author

Thomas Stephen Szasz (pronounced /sas/; born April 15, 1920 in Budapest, Hungary) was a psychiatrist and academic. He was Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He was a prominent figure in the antipsychiatry movement, a well-known social critic of the moral and scientific foundations of psychiatry, and of the social control aims of medicine in modern society, as well as of scientism. He is well known for his books, The Myth of Mental Illness (1960) and The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement which set out some of the arguments with which he is most associated.

Reviews

[Carolyn · Rating 1 out of 5]

The desperate ramblings of a pseudophilosopher trying to justify a career's-worth of theory which has, in all essence, been disproven with the dawn of biological psychiatry. He remains maniacally engrossed in his little sphere of mind-body dualism. Entertainingly, Szasz injects his book with several out-of-place references to various philosophical works. From a sociological perspective, many of antipsychiatry's arguments make sense. Dr. S's delineations, however, bathe in a sump of ableism, bull-headedness, and hypocrisy.

[Miguel Cisneros Saucedo · Rating 4 out of 5]

As the controversy surrounding the DSM-5 continues to grow, it is perhaps the right time to remind all psychologists and psychiatrists of this prolific critic of psychiatry, Thomas Szasz, who was probably best known for exposing the “myth of mental illness”.
In this book, Szasz exposes Freud as a charlatan who colluded with his patients to turn nondiseases into diseases of the unconscious.

I believe everyone with an interest in mental health must read Szasz's work. Why? First, medicine is real science that deals with biological phenomena, especially cellular pathology. At its core, the role of medicine is the treatment of cellular/physiological pathology. According to Szasz, this is what makes medicine a real science with social value.

Now take a look at the DSM and you will immediately note that the DSM is not based at all on cellular pathology nor science. Diagnostic categories are instead based on abnormal behaviors, reports of subjective experiences (storytelling), and cognitive deficiencies, often exaggerated and even invented on the spot.
There are no organic explanations in the Manual... Is all pure metaphor and lies.

[Bob · Rating 4 out of 5]

This is a review given by Charles Steiner, Mr. Steiner says it better than I can & I concur with every word. This book is A-1
In this short, lean and eloquent brief of a book rich in historical analysis and lucid in deductive reasoning, Thomas Szasz makes the case that the professionals in the mental health field are "au fond" experts in pretending to be experts. He writes, "Being an expert in mental illness is like being an expert about ghosts and unicorns."

Mr. Szasz proves how the concept of mental illness is void of content. (In biological illness, there is some damage or lesion to the cell. In "psychological illness," there is only a diagnosis, nothing else.)

Mr. Szasz shows how real science, physical science, methodically and clinically works to resolve illnesses and he shows, by contrast, how the so-called behavioral sciences "treat" a so-called "mentally ill" individual merely by giving the "patient" a diagnosis.

Mr. Szasz names names and reveals their charlatanry and theatrical hocus-pocus, from Charcot and Freud to so-called psychotherapists of the present.

This book allows the reader to look afresh at what constitutes personal responsibility and feel refreshed from the burdens of a state-supported circus.

[Shea Mastison · Rating 4 out of 5]

"[F]actual error validated as Doctrinal Truth is essential for the survival of organizations whose aim is to satisfy man's unquenchable thirst to be relieved of the burden of moral responsibility."

A fitting summation to Szasz criticism of psychiatry as a whole, in this book. Apparently, he built an entire career acting as a contrarian psychiatrist; who dabbled in political commentary, and a degree of historical research.

It's too bad that while he was alive, he was treated as a curious old man. Unfortunately, he discovered his niche with some less than savory academicians; whose research methods were surely less thorough than his own.

I think this is a great book. I would recommend it, if you're looking for an alternate view of mental illnesses (or perhaps, modern notions of sin).

[Bon Tom · Rating 1 out of 5]

This is terrible. I can't even believe it's published not so long ago. Hell, I can't believe it's published at all. It's so backwarded it sounds like it's written at the dawn of last century. I understand it can have appeal to those uninitiated to medicine, psychiatry and psychology, and those who don't really understand how the science works, due to superficial "originality" of stance, which doesn't make it correct. To the rest of us inside the science, this is complete self servient (for motifs unknown to me) rambling of pseudo know it all individual fueled by very obvious anger of origin that can only be guessed upon.

[VEL – The Contemporary Heretic · Rating 2 out of 5]

The idea that psychiatric conditions like schizophrenia, alcoholism, ADHD and depression are illnesses ‘just like any other disease’ is obvious nonsense.

If these conditions are diseases, which depends how we define ‘disease’, they are clearly diseases very unlike the infections of pathogens with which we usually associate the word.

In ‘Psychiatry: The Science of Lies’, Szasz marshals powerful arguments against the ‘disease model’ of mental health.

Unfortunately, however, the paradigm with which he proposes to replace this model, namely a moral one based on notions of malingering and free will, is even more problematic than the disease model he proposes to do away with.

Physiological Basis?
For Szasz, mental illness is a metaphor that has been taken all too literally:

“Mental illness is a metaphorical disease; that, in other words, bodily illness stands in the same relation to mental illness as a defective television stands to an objectionable television programme. To be sure, the word ‘sick’ is often used metaphorically… but only when we call minds ‘sick’ do we systematically mistake metaphor for fact; and send a doctor to ‘cure’ the ‘illness’. It’s as if a television viewer were to send for a TV repairman because he disapproves of the programme he is watching” (The Myth of Mental Illness: p11).

But what is disease?

The paradigmatic disease is an infection. Thus, modern medicine began with the germ theory of disease, which assumes that disease is caused by pathogens (i.e. microscopic parasites such as bacteria and viruses) which infect hosts.

Yet developmental disorders and inherited conditions are also sometimes called diseases, but are caused by genes, not germs. Likewise, cancer is often called a disease.

How then, for Szasz, do mental illnesses differ from physiological ailments?

For Szasz, the key distinguishing factor is an identified physiological cause for the symptoms observed:

“The traditional medical criterion for distinguishing the genuine from the facsimile – that is, real illness from malingering – was the presence of demonstrable change in bodily structure as revealed by means of clinical examination of the patient, laboratory tests on bodily fluids, or post-mortem study of the cadaver” (The Myth of Mental Illness: p27).

Thus, in all cases of physical disease, a physiological correlate has been discovered, whether a microbe, a gene or cancerous growth.

In contrast, mental illnesses are defined purely by symptomology.

Of course, most diseases are, in practice, diagnosed by their symptoms. A GP will diagnose the flu virus without actually observing the virus itself inside the patient under a microscope.

Yet the existence of the virus, and its causal role in producing the symptoms observed, has been demonstrated in other subjects.

This is not true for mental illness. The latter were named, identified and diagnosed long before we had any understanding of their physiological basis.

Rather than diseases, we might better call them syndromes, deriving from the Greek for ‘concurrence’, which is usually employed in medicine to refer to a cluster of signs and symptoms that seem to correlate together, for which the underlying cause may or may not be understood.

Causes or Correlates?
Yet psychiatry, and psychology, have come a long way since Szasz wrote ‘The Myth of Mental illness’ in the early 60s.

Then, American psychiatry was dominated by Freudian psychanalysis, of which Szasz is rightly dismissive. But today few psychiatrists follow Freud.

Yet, reading ‘Psychiatry: The Science of Lies’, published in 2008, it seems Szasz’s own position has advanced but little.

Indeed, Szasz reveals in ‘The Science of Lies’ that he arrived at this conclusion even earlier, having decided to study psychiatry in order to attack the field from within (p87-8).

Szasz claims that, once an underlying neurological basis for a mental illness is identified, it ceases to be called ‘mental illness’, and is instead classed as a neurological disorder (e.g. Alzheimer’s).

Yet, today, studies are published in journals every month reporting physiological correlates (neurological, genetic and hormonal) for mental disorders.

In contrast, Szasz seems to subscribe to a Cartesian dualism, whereby human feelings and behavior are, in principle, irreducible to physiological processes.

However, there remain two differences between the correlates of psychiatric illnesses and the causes of physical illness.

First, for mental illness, the correlates remain just that—mere correlates.

Thus, few correlates are present in every single person diagnosed with the condition in question and those patients who present the symptoms without the physiological correlate are not henceforth identified as not truly suffering from the illness in question.

Thus, mental illnesses remain, in the last instance, defined by the symptoms they produce. Any physical correlates are ultimately incidental.

Second, the identified correlates are, as a rule, multiple and cumulative in their effect. Thus, there is not one single physiological correlate for a mental illness, but multiple correlates.

Indeed, recent research on the genetic correlates of mental illnesses, as summarized by Robert Plomin in Blueprint: How DNA makes us who we are, finds that the same genetic variants that cause psychiatric disorders also cause normal, non-pathological, non-clinical variation in personality and behavior.

This suggests that what we call mental illness is, at the genetic level (and thus presumably at the phenotypic level too), just an extreme presentation of normal variation in personality and behaviour – i.e. the tail-end of a normal distribution.

This is most obvious for ‘personality disorders’. Thus, a person low in empathy, or agreeableness, might be diagnosed with anti-social personality disorder.

Yet it also applies to other disorders. Thus, ADHD seems to be mere medical jargon for someone who is very impulsive, has a short attention span, and lacks self-control (i.e. low in conscientiousness).

Clinical depression, unlike personality, is a temporary condition from which people recover. However, it is so strongly predicted by the factor of personality known as neuroticism that Daniel Nettle writes:

“Neuroticism is not just a risk factor for depression. It is so closely associated with it that it is hard to see them as completely distinct” (Personality: What Makes You the Way You Are: p114).

Calling someone ‘ill’ because they are at the extreme of a dimension of personality is like calling a basketballer ‘ill’ because he is exceptionally tall or Einstein ‘ill’ because he was exceptionally intelligent.

Medicine or Malingering?
While Szasz identifies problems with the disease model of mental health, the model he proposes in its place is even more problematic.

Thus, he gives central place to the notion of malingering, i.e. the faking of symptoms by the patient.

This analysis may be a useful way to understand the nineteenth-century outbreak of hysteria, to which Szasz devotes considerable attention.

It may also be a useful way to understand shell shock (today, PTSD) among soldiers during World War One, another example he discusses (p24; p70).

It may also be a useful way to understand Munchausen syndrome, or perhaps chronic fatigue syndrome.

(Note that I am not saying that it is a useful way to understand these conditions, only that it might conceivably be.)

However, it is much less readily applicable to, say, schizophrenia.

Here, patients may vehemently insist that they are not ill. However, their delusions are often such that they are undoubtedly, in the colloquial if not the medical sense, completely bonkers.

Medicine or Morality?
The fundamental fallacy at the heart of psychiatry is, according to Szasz, the mistaking of moral problems for medical ones. Thus, he opines:

“Psychiatrists cannot expect to solve moral problems by medical methods” (The Myth of Mental Illness: p24).

Szasz has a point. Whether a cluster of associated behaviors represents merely a cluster of associated behaviors or a mental illness is determined partly on moral grounds.

Popular cliché has it that mental illnesses are caused by a ‘chemical imbalance’ in the brain. Certainly, it is the chemical composition of the brain that causes behaviour, pathological or otherwise. But on what criteria are we to say that a certain chemical composition of the brain is an ‘imbalance’ and another ‘healthy’?

Mental illnesses are defined as such because they cause suffering or distress either to the person suffering from the illness, or those around them. This is a moral, not a scientific, criterium.

It is also a politicized question, as first, homosexuality, and now gender dysphoria are reclassified as non-pathological at the behest of activists.

Yet homosexuality is obviously, from a Darwinian perspective, biologically maladaptive.

In contrast, psychopathy is likely biologically adaptive at least under some conditions.

Yet strangely no one proposes treating psychopathy as normal or natural variation in personality, even though it is likely just that.

Free Will
The encroachment of medicine upon morality continues apace, as part of what Szasz calls the medicalization of everyday life. Thus, there is seemingly no moral failing or character defect that is not capable of being redefined as a mental disorder.

Selfish people are now psychopaths, people lacking in willpower and with short attention spans now have ADHD.

But if these are simply variations of personality, does it make much sense to call them diseases?

Yet the distinction between ‘mad’ and ‘bad’ also has practical application in the operation of the criminal justice system.

The assumption is that mentally ill offenders should not be punished for their wrongdoing, but rather treated for their illness, because they are not responsible for their actions.

But, if we accept a materialist conception of mind, then all behavior must have a basis in the brain. On what basis, then, do we determine that one person is mentally ill while another is in control of his faculties?

As Robert Wright observes:

“[Since] in both British and American courts, women have used premenstrual syndrome to partly insulate themselves from criminal responsibility… can a ‘high-testosterone’ defense of male murderers be far behind?… If defense lawyers get their way and we persist in removing biochemically mediated actions from the realm of free will, then within decades [as science progresses] the realm will be infinitesimal” (The Moral Animal: p352-3).

Szasz wants to resurrect the concept of free will and hold everyone, even those with mental illnesses, responsible for their actions.

My view is the opposite: No one has free will. All behaviour, normal or pathological, is determined by the physical composition of the brain.

Indeed, determinism is not so much a finding of science as its basic underlying assumption – i.e. that all events have causes and that, by understanding the causes, we can predict behavior.

The whole notion of free will is, then, unscientific, and criminal penalties must be justified by utilitarian considerations such as deterrence and incapacitation rather than the moralistic notion of just deserts.

A Moral Component to All Medicine?
Szasz claims that psychiatrists make the mistake of attempting to “solve moral problems by medical methods” (The Myth of Mental Illness: p24).

Yet there is a moral element to the identification and diagnosis of physical illnesses too.

Thus, physical illnesses, like psychiatric illnesses, are called illnesses in part because they cause pain, suffering and impairment in normal functioning to the person diagnosed as suffering from the illness.

If an infection did not produce any unpleasant symptoms, then the patient would never bother to seek medical treatment and thus the infection would never come to the attention of the medical profession in the first place.

What if the infection in question, not only caused no negative symptoms, but actually had positive effects on the person infected? What if it caused people to be fitter, smarter, happier and more generous and hard-working?

Actually, this hypothetical thought experiment may not be entirely hypothetical.

There are indeed surely many microorganisms that infect humans which have few or negligible effects and with which neither patients nor doctors are especially concerned, while some infections may be beneficial to their hosts.

Take, for example, gastrointestinal microbiota, marketed as ‘good bacteria’ in the advertising campaigns for yoghurt-like drinks. These are microorganisms that inhabit our digestive tracts and are thought to have a positive beneficial effect on the health and functioning of the host organism, and are classed as probiotics.

Another example is mitochondrial DNA. This began as the DNA of a separate organism, a bacterium, that infected host organisms, but ultimately formed a symbiotic relationship with us, and now plays a key role in the functioning of the organisms whose ancestors they first ‘infected’.

In short, all medicine, as an applied science rather than a pure science, has a moral dimension. We treat diseases to minimize human suffering, and the minimization of human suffering is ultimately a moral, rather than a purely scientific, endeavour.

In this respect, psychiatry is no different to any other branch of medicine.

Full (i.e. vastly overlong) review here.

[Tadas Talaikis · Rating 4 out of 5]

Reality check along the reading:

1. Although we have the new religion called "the chemical imbalance", there is no evidence for that. "Evidence against the hypothesis comes from the efficacy of a newly developed antidepressant, Stablon (Tianeptine), which decreases levels of serotonin at synapses." source

2. Depression is mostly cultural imperialism arising from pharmacy corporate self-interests. Disconnection between adverts and scientific literature
What I think myself, etc.

I think similarly, there are only one type of real disease - physical, everything else is invented fiction. Due to brain plasticity, people, with "normal" brain structures, most probably, experience depression due to orderings of such condition. Consequently, such conditions, as any of behavioral or cognitive biases, cannot be assumed as real diseases.

Going further, self-help is another similar religion that trains pseudo-patients to behave and believe in someone'es programs, has no evidence for its idiotic claims. Everything is just about a business, not reality.



Book wouldn't be popular as many others that sell the truth, due to the fact that people want to buy fantasies. They need to be told that the cause of their problems is something or someone outside themselves. And if that's some invented concept, even better - you can create your own world of fantasy where every fantastic thing fits its place.

[Steele Dimmock · Rating 1 out of 5]

I didn't finish this book. The author has points in that mental health is a hard thing to substantiate, but that doesn't invalidate it. You could say that mental health is a lie, but how do you explain people that have gotten better. The author assumes that everyone has a sound Theory of Mind, which is not always the case.
Ultimately, I feel like the author's writing is just wasted time, arguing with shadows.

[Can Küçükyılmaz · Rating 5 out of 5]

Ortaçağda kiliseyi eleştirmek nasıl karşılanıyorsa günümüzde eğitim, psikiyatri gibi modern kurumları da eleştirmek öyle karşılanıyor. Bu kurumları eleştirmek için ya akılsız olmalısınız ya da bilgisiz. Kiliseyi geri plana öteleyen modernite kendi putlarını mı yerine koyuyor yoksa? Ya da gerçekten söyledikleri gibi psikiyatri ve psikoloji bilimsel şeyler mi yoksa bir aldatmaca mı? Yazar çok güzel bir şekilde irdelemiş bu konuyu.

[Valdimar · Rating 1 out of 5]

Szasz loves to accuse others of quackery all the while ignoring major developments in biomedical sciences, with himself becoming the ultimate quack, shouting his out-dated "mental diseases aren't real" schtick. Psychiatry deserves a lot of critique, but you're better off reading Foucault or Deleuze for that instead of this Libertarian idiot.

[Jon]

After decades of debunking the excesses of psychiatry, does Thomas Szasz have anything new to say? Unlike with Alice Miller or Albert Ellis, both of whom tended to keep writing the same book again and again, the answer is yes: this book is a worthy addition to his oeuvre (which includes such must-read items as CEREMONIAL CHEMISTRY and THE MANUFACTURE OF MADNESS). I was especially intrigued by his critique of Lauren Slater's INSIDE SKINNER'S BOX, a book which I enjoyed reading, but whose flaws Szasz convincingly enumerates. Recommended to anyone interested in this topic, whether or not one has read Szasz before.

[Erin · Rating 2 out of 5]

Not one of his better works. Whilst his perspectives on antipsychiatry are valid, this can become a very controversial topic as the experience of mental illness has become much more prevalent.

I am a fan of Szasz and have used his work often to support theories within my own writings, however, this is not very good. I found myself wondering what relevance some of his points had to what he was attempting to articulate to the reader & in parts it was difficult to follow.

If you haven't read any of his works before, I recommend bypassing this one altogether & recommend looking at 'The Manufacture of Madness' or 'The Myth of Mental Illness' instead.

[Linda Vituma · Rating 4 out of 5]

Ir patiesi interesanti atklāt, cik daudz savā dzīvē esmu lasījusi grāmatas, kuru autori izrādās ir... psihiatri. Sākot ar vienu no nozīmīgākajām grāmatām manā dzīvē Stāsts par Sanmikelu, kuras autors ir ārsts - psihiatrs Axel Munthe un tagad - kā apsēsta "ēdu" grāmatu pēc grāmatas, kuru autors ir Thomas Szasz.

Psihes "kaites" kā metafora.
Psihes "kaites" kā atbildības neuzņemšanas.
Psihes "kaites" kā dzīvošanas un kopdzīvošanas veids.
Un tam visam pāri - kāds lērums apzinātu un neapzinātu melu.

Meli - tēma, kas tieši šobrīd man pašai dzīvē ir ļoti aktuāla.
Pēc grāmtas izlasīšanas jūtos, kā nedaudz pirkstos turējusi diegus, no kuriem ir austs melu audekls.

Ne katrs Thomas Szasz sniegtais paveidiens būs izturīgs (izturēs laika kritiku), ne katrs atbildīs tieši mana melu audekla iepazīšanā, bet noteikti ir ierosme un iedvesma lūkoties savas psihes pasaulē un mēģināt saprast: "Kas notiek?", "Kā tieši tas viss te darbojas?"

[Mark · Rating 2 out of 5]

In high school they strongly encouraged us to take dual-credit online college classes through the local community college. I remember seeing all my friends signing up for Psychology, but I opted instead for Western Civ, a history class. Fast forward to my undergraduate where I took my first communications class. I remembered its more sociological moments feeling very arbitrary and squishy. They had us memorize arbitrary clusters of terms with their arbitrary definitions, and the whole thing left a bad taste in my mouth. It felt like sociology was attempting to shove the infinite complexity of human relations into nice neat labels and boxes which just didn't fit. Later in undergrad, I remember writing down my dreams for the first time, and then after graduating I attempted to read Freud's Interpretation of Dreams, but was badly disappointed. It was around this time I saw several different therapists but none of them worked that well for me. When I got to grad school, I had to interact with other thinkers influenced by Freud, especially Lacan and Zizek. Through all of this, I became deeply suspicious of psychiatry.

I found a surprising ally in Derrida, who complained that people most often use psychoanalysis to find psychoanalysis. By this he meant that it is often a self-fulfilling prophecy, one where the psychoanalyst pastes their own ideas over something, destroying the original thing in the process. Instead of using psychoanalysis to better understand something, psychoanalysis obliterates the original object and shoves the remaining pieces into a psychoanalysis-shaped box. These are the main thrusts of my complaints about psychiatry: the religious subservience of everything to its goals, its squishy, ill-defined and constantly shifting definitions, and its often lackluster results.

Thomas Szasz's book, with a title such as this one, signals that he's either a kook, a boomer, or both. Mostly he's the latter, but he has his fair share of kooky moments and issues with too-informal of a tone. Interestingly, he starts in a place very similar to those French philosophers and writers who are infamous for relying heavily on psychoanalysis: all of them are very suspicious. None of them take for granted that anyone may be telling the truth, least of all religious texts. What they do with this suspicion is where they're set apart: Szasz is a hard-line materialistic, scientific atheist who doesn't trust anything that can't be measured objectively. The French thinkers I mentioned are much more interested in creating new, subversive stories to explain away the old stories and thus put themselves and their own interests in power. Szasz seems like a very boring person, as he doesn't see any value at all in psychotherapy's storytelling tendencies. He deeply fears ever needing to trust anyone, so to him psychiatry's reliance on self-reporting and rapport-building are horrifying. To him, any science built on human interaction must be fallacious.

Thus, his central complaint is built off of that distrust, which finds its roots in what used to be called "malingering," or faking illnesses for gain. Knowing that it's possible to simply make things up, he then becomes suspicious and doesn't trust anything any supposed patient says unless it can be objectively verified. This seems odd as he relies very heavily on subjectivity insofar as he is a strict adherent of personal responsibility. The unspoken claim he makes throughout the book is that mental illness doesn't exist, and therefore personal responsibility must exist. He prefers the legal system and its black and white pronouncements of innocence and guilt, as opposed to the psychiatric system which he sees as undermining the justice system more broadly and personal responsibility more specifically. I find all of this very surprising given that he's a materialistic atheist, and they're among the most virulent determinists I've ever run across, usually opposing any meaningful sort of agency. He never resolves this central contradiction in this short book.

If Malingering is one leg of Szasz's edifice, the other leg is his claim that psychiatry is built on a fallacy that mental illness is an illness like any other illness; however, because it doesn't have the same somatic, empirical (i.e. objective, not subjective) qualifications, thus it can't be trusted. This argument is only partially true. Yes, there is a scandalous amount of shuffling going on with every new edition of the DSM, in part or in whole due to its overt politicization and big-pharma-indebtedness. The three examples he points out are the removal of "Hysteria" (which used to be the most common diagnosis that early psychiatry gave out), as well as the falling out of fashion of including homosexuality or transgenderism in the DSM. What he misses is that all sciences are politicized to some degree. It's impossible to have a pure science because the application of science is always already fraught with politics. Oppenheimer is an obvious example. Additionally, I find it telling that Szasz is wholly ignorant of trauma studies, as the one time he talks about PTSD he explains it all away as mere malingering for the sake of continued health insurance (which is exceptionally offensive and ignorant). He also completely misses the central metaphor of trauma, which is the "wound;" even if Szasz were totally ignorant of trauma studies (which he was), if he were literate in etymology he would know that "trauma" is Greek for "wound." Trauma in fact may be the best example of where the somatic and the psychic touch: it's a contact point between the story-telling mind and the sense-perceiving body. In trauma, something incomprehensible happens which drives a wedge between these two: the stories we tell no longer do justice to our experience.

The ironic thing is that Szasz tells his own subjective stories, and he simply prefers them over the subjective stories of psychologists. I'm not a relativist who says that these are two stories with equal worth, but it is telling when a person gets tunnel vision and fails to see their own worldview's shortcomings. I say this with some frustration, because Szasz sometimes makes quite important connections, such as medicalization as an aspect of secularization, replacing the theological state with a medico-juridical state where sins are redefined as sicknesses, requiring treatment. But the thing is that Foucault beat him to the punch and is a much smarter man than Szasz.

I think that Szasz's issue is that, despite this being one of his last in a long line of books making the same argument, he doesn't think things through. Sure, we use psychiatric labels to excuse people from crimes nowadays, but he doesn't interrogate why that is, as Foucault does in his works which explore the complex intersection between the justice system, the healthcare system, and psychiatry. Another example is that it's possible that mental diseases are a sort of god of the gaps for doctors, but it's also possible that there's things we can't quantify, at least not in the way that current science does.

Szasz is at his worst when spending an absurd amount of time character-assassinating Freud and Jean-Martin Charcot; for a guy who only cares about logos, who gives a crap if either of these guys were bad people? Ethos and pathos shouldn't matter, only the logos! Szasz is at his best when sticking to the issue at hand, which he frequently strays from. Concerning the questionable nature of the DSM, I think he's on to something when he argues that psychiatry is concerned with diagnoses because for it, diagnoses ARE diseases. But I also understand why psychiatry does this: the stories we tell ourselves, despite possibly being "fictions," do really have somatic results. Suicide is an obvious example. Less dramatic examples abound as well. Szasz also raises an important issue when bringing up how easy it is to fake your way into psychiatric facilities, but how impossible it is to escape, even if you are really healthy. I remember first running across that argument as a kid and finding it convincing, but as an adult I don't find it so. The reason why is that they let you in because you were lying; you broke the contract from the word 'go.' They're assuming the best of you, and you're assuming the worst. It's a clash of two different worldviews. In fact, the sort of person who fakes their way into a mental institution does have something wrong with them, that they in their cynicism want to disprove trust, love, and everything good between people.

I agree with Szasz that forced mental institutionalization is a scary thing, and it really is imprisonment, no matter what we call it; but he doesn't give any sort of alternative. At no point in this entire book (or his entire oeuvre, as far as I can tell) does he give any alternatives to the psychotherapeutic model. He complains and then crosses his arms, which is exceptionally unhelpful. Yes, we should be wary of medicalizing things which aren't objectively medical (for example, religion and the travesty of gay conversion camps); but this doesn't mean that we have no tools with which to work through these things. I think that perhaps the central lesson that psychiatry has taught us is a return to the storytelling part of ourselves. That's what most "mental illnesses" boil down to: telling ourselves stories which don't match up with reality. As opposed to what Szasz would like, I think that the humanities are precisely where psychiatry should focus if it is to slowly de-medicalize itself. In order to do that, however, it would need to get free of the pharmaceutical industry, which it doesn't look like will happen anytime soon. Trying to simply undermine the present state of affairs in a conspiratorial/Sokal Affair tone of voice is not helpful. Providing legitimate alternatives is, which I've done more of in this short review than he did in this entire book, supposedly a summary of all he'd written up to this point. What a loser. It's a dark kind of fun when you read someone you're more intelligent than despite them being twice your age.

[Sandy Batesel]

WARNING ~ If you think you may be suffering from a mental illness and grab this book to read thinking you may find help ... DON'T! It seems the author doesn't really believe in mental illness or so one would think after reading his book. No, you're really not depressed you're just malingering or basically ... lazy.

To be fair, I could be mistaken in my review so far as I'm just a lay person and not a linguist as Mr. Szasz ... or does he just keep a thesaurus handy while he's writing?

As awful as this book (I've NEVER siad that in any of my reviews before and I have reviewed over a hundred books) I thought I'd wade through it in hopes of maybe getting some great information on psychologist greats. WRONG! Mr. Szasz is not a fan of Freud, or Skinner, or Jung, or ... anyone but himself it seems!

I realize this review is a bit harsh and full of unnecessary punctuation marks but I'm trying to convey to those who grab this as, maybe, a self-help book. It is NOT! I think the book should come with that warning but since it doesn't here's mine ... WARNING ~ THIS BOOK IS NOT FOR SOMEONE WHO THINKS THEY MAY BE SUFFERING FROM A MENTAL ILLNESS or, even, for a person just looking for insight to psychology greats!

[John Hancock · Rating 5 out of 5]

This is one of the best books written about the deceptive, coercive nature of psychiatry. I can't recommend this book more highly. Please read it as soon as possible, especially if you or someone you love is presently in the grips of psychiatry or taking any sort of psychotropic drugs ("antidepressants" and so forth):

https://psychiatricsurvivors.wordpres...

[Ned · Rating 5 out of 5]

Profound

This is one of the most enlightening, profound, and important books I have ever read. Pithy and devoid of fluff, Dr. Szasz' words resonate with the undeniable ring of truth. If my electronic highlighter could be worn out, it would have met its doom with these pages. The emperor stands naked indeed.

[Nicolas S Martin · Rating 5 out of 5]

Szasz was the brightest mind of his generation, and never failed to point out when the psychiatric emperor was naked. It still remains true that psychiatry employs coercion and that behaviors are not diseases. But homosexuals, anorgasmic women, and epileptics are no longer mentally ill, while school boys and unhappy people now are. The bills are paid by expanding the DSM.

[Lukasz · Rating 5 out of 5]

Thomas Szasz urodził się na Węgrzech. W 1938 zdąrzył jeszcze wyemigrować do USA przed holocaustem. Przeczuwał że sytuacja w Europie nie zmierza w dobrym kierunku. Fakt ze Szasz był pochodzenia żydowskiego i uciekał przed holocaustem miał mocny wpływ na całe jego życie zawodowe.
Szasz uzyskał wykształcenie z dziedziny psychologii, psychiatrii i psychoanalizy. Zasłynął już na początku lat 60tych kiedy opublikował pierwsza książkę w której mocno kwestionował główny nurt który panował wtedy w psychiatrii. Książka "Psychiatry" została przez Szasza napisana pod koniec jego życia i podsumowuje jego całą karierę życiową. Co ciekawe sam Szasz odwołuje się do aktualnych wydarzeń oraz badań której miały miejsce zaledwie kilka czy kilkanaście lat temu już po roku 2000.
Szasz często jest źle odbierany. Często uważa się że jest tzw. "antypaychiatrą" czyli całkowicie odrzuca leczenie psychiatryczne. To błędna interpretacja jego podejścia. Mianowicie, Szasz uważa że większość diagnoz psychiatrycznych, sama DSM która używana jest w celach diagnostycznych przez psychiatrów była kilkukrotnie zmieniana i fakt i�� homoseksualizm był uważany za chorobę psychiczną a dziś przecież można w niektórych państwach legalizować związki homoseksualne świadczy o tym jak psychiatrzy tworzą na własne potrzeby "mity" w postaci kryteriów diagnostycznych. Szasz uważa iż nie ma do końca czegoś takiego jak choroba psychiczna. Całkowicie nie zgadza się z wykorzystywaniem kryteriów diagnostycznych typu DSM do definiowania chorób psychicznych i stygmatyzowania przez to ludzi. Ale co ciekawe, jeśli pacjent sam tego chce i sam oczekuje pomocy lekarza i terapeuty wtedy jak najbardziej Szasz uważa iż takiemu pacjentowi powinno się pomóc. Chociaż podkreśla że pacjent musi chcieć sam sobie dać pomóc i to tylko dobra wola pacjenta może przyczynić się do polepszenia zdrowia pacjenta.
Szasz jest wielkim przeciwnikiem wykorzystywania kryteriów diagnostycznych w ramach systemu ubezpieczeń, tym bardziej jest przeciwnikiem wykorzystywania psychiatrii w systemie karnym i w sądownictwie.
Wielkim highlithem książki było opisanie przez Szasza eksperymentu Rosenhana. Ten eksperyment odbył się w latach 70tych i całkowicie podważył fundamenty współczesnej psychiatrii. Ów eksperyment polegał na tym iż całkowicie zdrowe osoby zgłaszały się do szpitali psychiatrycznych twierdząc ze słyszą głosy a w zasadzie kilka pojedynczych słów. Każdy z uczestników eksperymentu Rosenhana został wpisany do szpitala. Każdego zdiagnozowano, głównie na schizofrenie u każdy spędził kilkanaście bądź kilkadziesiąt dni w szpitali mimo iż zachowywał się całkiem normalnie. Eksperyment miał miejsce w USA. Nawet najbardziej nowoczesne i renomowane szpitale psychiatryczne wypadły dość kiepsko w tym eksperymencie.

Ksiazka może nie była aż tak łatwa w odbiorze. Trudno mi powiedzieć do kogo jest skierowana. Może ktoś kto siedzi fachowo w tym temacie lepiej odbierze całość. Mimo wszystko uważam tą książkę za bardzo ważną.
Szasz niewątpliwie wniósł wiele do nowoczesnej psychiatrii. System jednak reformuje się wolniej niż tego sytuacja wymaga. Za bardzo ważne uważam podsumowanie książki które sprowadza się do trzech rzeczy:
- Rozum
- Odpowiedzialność za własny los
- Wolność

[Zdenek Sykora · Rating 3 out of 5]

"Psychiatry: The Science of Lies" by Thomas Szasz is a provocative and controversial book that challenges the conventional understanding of psychiatry and its practices. Szasz, a renowned critic of psychiatry and a psychiatrist himself, presents a scathing critique of the field, arguing that it is based on false premises and perpetuates deception.

The book is written in a scholarly and scholarly manner, backed by extensive research and historical analysis. Szasz argues that psychiatry, as a medical specialty, lacks scientific rigor and relies heavily on subjective assessments and social norms to define mental illnesses. He posits that psychiatrists often pathologize normal human behavior and label it as mental illness, thereby engaging in what he refers to as "the science of lies."

Szasz challenges the concept of mental illness itself, arguing that it is a metaphorical construct rather than a medical condition with objective markers. He questions the legitimacy of psychiatric diagnoses and treatments, including the use of psychiatric medications, electroconvulsive therapy (ECT), and involuntary commitment, asserting that these practices violate individual autonomy and are often used to control and suppress dissenting voices.

Moreover, Szasz delves into the historical and social aspects of psychiatry, examining its roots in social control and the ways in which it has been used as a tool of oppression and coercion. He presents arguments against the use of psychiatry as a means of social control and calls for a reevaluation of its practices and ethics.

While "Psychiatry: The Science of Lies" presents a compelling critique of psychiatry, it is important to note that Szasz's views are controversial and not universally accepted. Many psychiatrists and mental health professionals may disagree with his arguments and view psychiatry as a valid and necessary field of medicine that helps individuals with mental health challenges. However, the book provides a thought-provoking perspective on the complexities and controversies surrounding psychiatry and its practices, challenging readers to critically evaluate the assumptions and practices of the field.

In conclusion, "Psychiatry: The Science of Lies" is a bold and thought-provoking book that challenges conventional notions of psychiatry and its practices. Szasz's arguments are presented in a scholarly manner, backed by research and historical analysis, and provide a dissenting voice in the ongoing debate on the nature and role of psychiatry in modern society. Whether readers agree or disagree with Szasz's views, the book serves as a thought-provoking and important contribution to the discourse on mental health and psychiatry.

[Melinda Polet · Rating 5 out of 5]

Thomas Szasz, a Hero of truth

I’ve gone down a lot of rabbit holes since finding myself an unwitting psychiatric survivor, and I don’t use that term lightly. Having never bought into the idea that mental disorders are chemically based (without diving in prior to my unfortunate experience, I suppose I got lucky and always just assumed that mental illness was usually attributed to the highly creative and unruly) Thomas doesn’t rally to defend those that become victims in the psychiatric system, he goes much further. He demands utmost responsibility.
Malingering and hysteria are the topic of the first half of the book, explaining the once adhered to diagnosis of those that are now labeled mentally Ill. Throughout the book, he weaves in equal measure, the doings (or undoings) of Freud and his grand role in tipping psychiatry over the edge to where it is today: a behemoth of power, coercive control, and of course, lies.
Szasz didn’t leave many stones unturned, his connecting the dots of other psychiatrists, researchers, neurobiologists and doctors also weave in and out fluently, culminating in a very clear picture of where we are today: caught in a web of lies, myth, and much manipulation.
Yes, it confirmed my bias that the disease of mental illness doesn’t exist, but, he is so firm, lucid, and coming from such a place of integrity, that anyone, even those convinced of the lie, cannot go away thinking the same.
Please read this book, if you have any doubts about psychiatry’s validity in this matter and give it to those who have fallen prey to its talons, though, they may not want to read it. They would have to take responsibility for the role they played in the lie and few can admit such error,
Thomas Szasz remains, one of the iconoclasts of the 20th century. Although he doesn’t reiterate it in this book, he is true to the physicians vow, “Do no harm” a vow that has been all but buried in modern psychiatry, sadly.

[Budge Burgess · Rating 4 out of 5]

Relatively short book - 117 pages - soundly argued and with some humour.
Szasz has long emphasised the difference between the natural sciences (physics, chemistry, etc.) which rely on physical evidence and the elaboration of clear (falsifiable) laws, and the social sciences, like psychology, which claim a different level of verification and validity.
Szasz, of course, is a passionate critic of psychiatry and its claims to be treating mental illnesses or diseases of the mind. Diseases, he will point out, are identified because of their physical evidence - just as a broken bone will show on an X-ray, illnesses can be identified by examining the evidence of the body - damage to organs, chemical changes, etc., etc.
So-called mental illnesses do not produce physical evidence - they're left to psychiatrists to invent names for them (he reminds us that 'hysteria' became the scourge of the 19th century, while homosexuality was regarded as an illness until the 1970s).
Szasz is particularly scathing on Freud and psychoanalysis. Freud was a fraud who invented a so-called science which has set back our understanding of the human mind by a century and more. His claims to have found ego, id and superego are vapid. Freud invented an industry, a highly profitable one: it has hijacked our ability to relate to and understand people, and trapped many into believing the delusions of the therapist.
Psychiatry, meanwhile, has leapt into bed with Big Pharma and created a huge market for drug treatments of 'diseases' and 'conditions' for which there is no physical evidence.
Entertaining and informative read - if you have any concerns about the role of psychiatry or psychoanalysis, you could do worse than start reading here.

[Designated Hysteric · Rating 1 out of 5]

What is truly disappointing about this book is that there are legitimate questions surrounding the utility of labeling certain behaviors as illnesses, the models we use to understand human consciousness, and the elitism of psychiatric establishment, but Szasz is way more interested in dishing out the blame, the perceived injustice done onto society by these, so he calls them, "the malingerers" and their enablers who profit from the malingering, and lack of punishment - as if punishment ever improved the function of society. It would seem to me that Szasz knew how to ask questions, but for all the wrong reasons, furthermore, bearing in mind alternatives less than desirable.
Szasz also completely misunderstands what science is. No, it is not the process by which we “discover the truth”, it is the process we use to develop models of understanding which we can then use to do things in a more efficient manner, therefore, whether mental illness “exists'' or whether it is a “disease” is wholly unimportant as far as truth is concerned. Whether those are the best classification for understanding people’s experience is a whole another conversation and that conversation has to come from the desire to improve the functionality of the field and people’s lives rather than a moral crusade with an intention to blame and ultimately punish.
The whole book is built on rather poor argumentation and anecdotes from history, and they mostly serve to create an undesirable picture of historical figures which Szasz blames for contributing to the institution of psychiatry. I truly have nothing good to say about this book and would recommend reading anything but this.

[Katarina Janoskova · Rating 1 out of 5]

I’m holding the dubious honour of declaring this ‘book’ the biggest pile of shit I ever read.

I wish I could give it zero stars. But that’s not possible.

What is wrong with this guy? Is he perhaps sorry he couldn’t make it doing research and something useful so he decided to cast himself as the world’s saviour from Freud? I bet he believes he would have done so should he have lived concurrently.

I honestly don’t know tho. And nobody thinks Freud was right in almost anything anymore. But he did one good thing - made space for us to not just declare someone insane and shut them somewhere, but try to help them.

To say that all mental illness is faking is frankly insulting to hopefully everyone.

And sure psychology and psychiatry are both still very young and we know far less than we don’t know, but that doesn’t mean we shouldn’t be trying to help people who are ill.

Did doctors (and probably still do) make grievous mistakes when treating patients? Yes. But this doesn’t happen only in psychiatry. And it is something we all should be striving to make better.

[Mathias · Rating 3 out of 5]

The problem of hysteria is also the crux of the gospel , the enigma of humanity , the answer to which is already contained within the new testament

Non-epileptic-seizure-disorder is the malingering , body language , of the plagued mind of the person ostracized and 'judged' by society. This is why Smerdyakov in 'The brothers Karamazov' has this disorder as an alibi for murder , A prophetic intuition by Dostoyevsky , in post-modern christian society

This enigma is answered by the gospels , Jesus is meeting people with the phenotype of NESD , and casts out the 'evil spirit' which is its cause , and transfers it to the swine herd. This indicates the psychosocial significance of the bible stories. Its main importance is psychiatrical , while its self-proclaimed proponents of today give it a mythological meaning, serving to preserve the dynamics that is the very cause of 'mental illness' , i.e. the spirit of evil , the unanimity of the crowd , which the romantic revival tradition confuses with the spirit of god

[?0?0?0 · Rating 3 out of 5]

There's no arguing that Thomas Szasz is incorrect in asserting that psychiatry is a sham run by actors skilled at lying about their supposed science which is as scientific as astrology only the harm, serious and lethal, caused by these not-so cute actors and their profession is far from the pitfalls of astrology. However, Szasz seems to think that not believing in free will is somehow a strike against psychiatry. I would ask of Szasz, were he still with us, what evidence he has for free will existing? For if he's asking psychiatry to provide extraordinary evidence for their nonsense, he should do the same for his stance on free will.
Regardless, this is a decent, easy read that is not demanding intellectually that could sway some people. However, better books have been written debunking psychiatry.

[Mary · Rating 1 out of 5]

I need to start by saying that I was very open to this book: I think it is vital to be able to critique psychiatry because like any other field, it is not perfect. This book, however, it is not a critique. It is a self-indulgent and petulant. Though Szasz makes some good points, his overall tone is so condescending that it undercuts his thesis. He fails to make any clear definitions, making his philosophizing meandering. It came across at several points as a hate letter against Freud and though I agree that Freud had some strange ideas, the vitriol with which Szasz denounces Freud speaks to someone who has a personal vendetta rather than an objective academic inquiry. I do not think this has aged well, either. Considering all of the research today, Szasz's views do not translate well into a modern times. Overall, this is not one worth anyone's time.

[. · Rating 5 out of 5]

Много много добра книга. Доста баяст, но просто аеторът (психиатър) си изказва мнението, подкрепено с много пеимери, че психиатрията е псевдо наука. Чсе лекарите психиатри не могат да различат луд от човек който се прави на луд. Че лудите наистина имат проблем, но той е свързан с това, че лъжат себе си и другите за реалността, а не я приемат. Човек обяви ли се за луд от психиатър, влезне ли в лудница вече няма начин да убедиш лекарите че не си луд. Ти си виновен до доказване на противното. Една репортерка, разказва авторът е направила това и колкото повече е обяснявала на лекарите че не е луда и че само се прави, толкова те са се убеждавали в обратното.
Човек има невероятни способности да се самозаблуждава

[Angie Dong · Rating 5 out of 5]

I devoured this book after being mistreated by psychiatric services for having an unusual pain disorder.

The book was absolutely enlightening. It explains the origins of psychiatry as only a psychiatrist and intellectual can. It provides extraordinary insights into the *social role* of psychiatry within human society and exposes the extent to which psychiatry deviates from objective scientific inquiry.

Thomas Szasz is a radical who believes that psychiatry should be abolished. Even if you are not a radical, you should read this as an invaluable perspective on the most controversial medical field.

[Emily Rosenberg · Rating 1 out of 5]

After finishing this book I changed its place on my bookshelf from non-fiction to fiction. Because it's fiction, right?
It's just an irrational rambling about something the author themselves have made up. It says in the beginning it's a criticism about all the so called mental health professions, which he calls lies but in the end there are only weird stories about psychoanalysis and the history of psychiatry. There are so many problems about psychiatry and other mental health fields but none of them were actually addressed. Just some tales about people who were not mentally ill and went to see a psychiatrist and how they ended up in a hospital or with a prescription.