My book, The Myth of Mental Illness, was published in 1961. Its message is stated unambiguously in the title: mental illness is a fiction, a metaphor, a myth -- on a par with fictions such as witch, unicorn, mermaid, sphinx, ghost, or, horribile dictu, god. Translated into some twenty languages, the book is still in print in English, in a mass paperback edition. The Italian edition will be reissued in the spring and a new Hungarian translation will be published in March.

In "A Memo for the Volker Fund," dated May 25, 1962, Murray Rothbard reviewed The Myth of Mental Illness. On January 17, 2002, the review, titled "Rothbard on Szasz," suddenly re-appeared on the Llewellyn Rockwell web site. Two days later, the Rockwell web site featured Rothbard's keynote address, "Psychoanalysis as a weapon," delivered in 1980 at a symposium celebrating my 60th birthday. (http://www.lewrockwell)

Regardless of the reasons for the reprinting of these pieces at this time, I believe it is fair to say that psychiatry sits uneasily in the belly of libertarianism. Until recently, public mental health facilities were called "state hospitals." This alone ought to be a warning that libertarians cannot avoid reckoning with the force represented by the alliance of psychiatry and the state. Is psychiatry a friend or a foe of libertarianism?

The reprinting of the Rothbard pieces on an influential libertarian web site presents an appropriate occasion to engage this question head-on.

Rothbard on Szasz: Part 1

Rothbard's 1962 review was partly laudatory. He praised the book as "a highly original and unique work ... scattered throughout are intriguing libertarian points, ... attacks on governmental responsibility for inflation, on progressive income tax, on exploitation of one group by another, on totalitarianism, and on infringement of civil liberties, particularly in the practice of compulsory commitment of the (non-criminal) 'mentally ill.'" Approvingly, Rothbard acknowledged: "There is also certainly much value in criticizing the prevalent use of the cliche of 'mental illness' and the consequent linkage with somatic medicine. There are precious-few books on psychiatry, furthermore, which refer to Hayek's Constitution of Liberty or to Popper's Poverty of Historicism."

"Yet, despite these merits," Rothbard continued, "the book must be set down as an overall failure, for the bulk of the book consists in the setting forth of Szasz' own positive theories, which must be considered totally erroneous. ... Szasz tosses out the crucial concepts of 'consciousness' and the 'unconscious.' ... There are many weird results of this: one is that the crucial philosophic-psychologic concepts of individual will, responsibility, the line between the willed and the unwilled, etc. are tossed away..."

Faulting me for being an atheist, Rothbard added: "Furthermore, in a fashion rather reminiscent of Ayn Rand, Dr. Szasz is almost fanatically anti-religion, and especially anti-Christian. Religion, and especially Christianity, are held to be responsible for a large part of the world's neuroses, for fostering 'childish dependency,' as well as for encouraging behavior not proper to man's life: e.g., humility, meekness, naiveté, etc., all of which add up, in Szasz' view to 'incompetence.' Ministers and priests parasitically exploit their supporters, keeping them in this dependence, etc."

The Myth of Mental Illness, Rothbard concluded, "eliminates the whole problem of moral responsibility for actions because it eliminates the whole problem of whether an act is consciously willed or decided upon, or not. ... Szasz' fundamental philosophic error, perhaps, is his deliberate overthrowing of thinking in terms of 'entities' and 'substances,' i.e. 18th-century, natural-law, Aristotelian thinking."

Rothbard's criticism -- epitomized by the charge that my argument "eliminates the whole problem of moral responsibility for actions" -- was not merely erroneous, it stood the thesis of the book on its head. Rothbard blamed me for a feature intrinsic to the idea of mental illness and the psychiatric coercions and excuses it justifies -- precisely the errors and evils I attacked in The Myth of Mental Illness. My aim in writing The Myth of Mental Illness was to demonstrate the error in the belief that "mental illness" is a medical disease, and to deligitimize its use as a weapon in the unholy alliance of the war of psychiatry and state against the individual -- epitomized in the incarceration of innocent persons justified with the mendacious euphemisms of "hospitalization" and "treatment." Rothbard duly acknowledged this contribution.

Rothbard on Szasz: Part 2

In his later writings, Rothbard expressed unqualified agreement with my critique of the therapeutic state and the pivotal role of psychiatry in it. In his book, For a New Liberty (1978), he included a three-page section titled "Compulsory Commitment," devoted almost entirely to my efforts: "In the last decade, the libertarian psychiatrist and psychoanalyst Dr. Thomas S. Szasz has carried on a one-man crusade, at first seemingly hopeless but now increasingly influential, in the psychiatric field against compulsory commitment. ...(pp. 90-92). And again: "The libertarian Dr. Thomas Szasz has almost single-handedly managed to free many citizens from involuntary commitment ..." (p. 318).

In 1980, Rothbard was invited to present a keynote address at a three-day symposium given in honor of my 60th birthday, hosted by the State University of New York in Albany. In his address, Rothbard praised my efforts to defend individual liberty and personal responsibility against the threat posed to these values by psychiatry. "Thomas Szasz," he wrote, "is justly honored for his gallant and courageous battle against the compulsory commitment of the innocent in the name of 'therapy' and humanitarianism. But I would like to focus tonight on a lesser-known though corollary struggle of Szasz: against the use of psychoanalysis as a weapon to dismiss and dehumanize people, ideas, and groups that the analyst doesn't happen to like. Rather than criticize or grapple with the ideas or actions of people on their own terms, as correct or incorrect, right or wrong, good or bad, they are explained away by the analyst as caused by some form of neurosis. They are the ideas or actions of neurotic, or 'sick,' people." (See, http://www.szasz.com/rothbard.html.)

Which brings us finally to the issue of religion. In the West, we no longer live in theocratic states. We live, as I have argued for 40 years, in therapeutic states. We give medical, not religious, explanations for human behaviors (if we deem them bad, but not if we deem them good); and we justify the routine psychiatric imprisonment of innocent persons on medical, not religious, grounds. If those explanations and justifications are erroneous and invalid, as I maintain, they are erroneous and invalid regardless of a person's religious belief or unbelief.

Do Libertarians Oppose or Support Civil Commitment?

One of the besetting sins of psychiatry and psychoanalysis and all so-called mental health professions is that, as Rothbard himself observed, instead of criticizing and grappling "with the ideas or actions of people on their own terms, as correct or incorrect, right or wrong, good or bad, they are explained away by the analyst." Sadly, this sin is not limited to psychoanalysts. All human beings are susceptible to it, libertarians included. Attributing embarrassing ideas and practices to mental illness is not the only way to avoid dealing with them. Ignoring them and refusing to take a stand about them is just as effective.

The Myth of Mental Illness was intended to be more than just an academic exercise in semantics. It was also intended to be a denunciation of the moral legitimacy of the most violent method that the modern state possesses and wields in its perpetual effort to domesticate and control people, namely, depriving innocent individuals -- with the full support of physicians and lawyers -- not only of liberty but virtually of all of their constitutional rights, in the name of helping them.

Most libertarians are interested mainly in economic policies and philosophical issues, such as monetary policy, taxation, deregulation, foreign aid, welfare, the rule of law, justice, rights, and responsibilities. I am also interested in these policies and issues. However, the impact, on the everyday lives of ordinary people, of such social policies and scholarly debates is, for the most part, remote and indirect. Hence, I have been even more interested in certain social practices whose impact on the daily lives of people is immediate and direct, such as crime control, the regulation of drug use, and psychiatric coercions and excuses.

In the United States alone, there are approximately one million civil commitments per year, that is, more than 2,500 per day. (The practice is common in all advanced societies.) This figure does not include the countless times minors are assaulted with unwanted psychiatric interventions. Depriving defendants of their right to trial by declaring them mentally unfit and depriving them of finite prison sentences by declaring them not guilty by reason of insanity are two other obvious and important instances in a long list of psychiatric violations of human rights.

The reactions of psychiatrists and other mental health professionals to my likening involuntary psychiatry to involuntary servitude and organized psychiatry ("psychiatric slavery") to chattel slavery is not my concern here. Instead, my concern is to suggest -- more pointedly than I have done in the past -- that libertarians, as self-defined guardians of individual liberty and responsibility, have a duty to confront and articulate their position on psychiatric coercions and excuses, all of which rest on the concept of mental illness as squarely as the beliefs and practices of theistic religions rest on the concept of god.

The issue before us is whether psychiatric coercions and excuses are -- by the light of what we know today -- virtuous or wicked, praiseworthy or blameworthy, social practices. Where do libertarians stand on the practice of depriving innocent people of liberty in the name of "mental illness"? I believe it behooves libertarians to candidly acknowledge whether they support or oppose statist-psychiatric interventions and articulate the reasons for their position.

Psychiatric slavery -- like chattel slavery -- is an either / or issue. A person either supports it or opposes it. Tertium non datur.

Copyright, 2002, Liberty Magazine.
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