Remarks by Richard E. Vatz at the Szasz 80th Birthday Symposium: "Liberty and/or Psychiatry: 40 Years After The Myth of Mental Illness"

I am most honored to contribute to this special symposium in honor of Thomas S. Szasz's 80th birthday. The speakers here are charged with commenting on the impact of Tom Szasz's writings. Being in the field of rhetoric, I should like to comment on the rhetorical, or persuasive, impact that Tom has had on the field of psychiatry.

But first, if you will indulge me, I should like to reflect on the impact Tom has had on me.

One of the first pieces I ever wrote on Thomas Szasz, co-authored with my closest friend, Lee Weinberg -- who, parenthetically, does the best imitation of Thomas Szasz in America -- was "A Szaszian View of Death, or The Myth Of Death" in The Journal of Humanistic Psychology (1977) almost 25 years ago. The journal's editor, Thomas Greening, a fine and unthreatened fellow, suggested that we subtitle the piece, "With Apologies to Thomas Szasz," so as to cue readers that the piece was satirical. We refused, reasoning that if anyone need not be clued in as to the satirical nature of a satire it was Szasz and Szaszophiles. Since the piece has been reprinted, but never, to our knowledge, referenced, I thought it might bear repeating here. It goes like this (reprinted by permission of Sage Publications):

A Szaszian View of Death, or the Myth of Death
We have been impressed by the humanistic writings of Thomas Szasz about the myth of mental illness (Szasz: 1961). It occurs to us that Szasz provides a paradigm for understanding other behavioral phenomena. A particularly poignant example is the behavior called "death."
What is "death"? In fact there is no objective reality to what we call "death."
"Death" is simply the name we give to people whose behavior (typically lying down and doing nothing) we neither understand nor approve. By labeling it "death," we pretend that we understand it and enfranchise a panoply of actions to be taken ostensibly in the interest of the "dead" but, in fact, as we shall show, serving primarily to derogate and persecute those we call "dead." We give no sustained care to "dead" people. We take away their vote (except in Cook County, Illinois). We deprive them of food. "Death" therefore, is but a self-fulfilling prophecy.
The rhetoric of death serves to aggrandize and provide employment for those who "treat" the "dead." Surely, if there are "dead" people, we must train others to "take care of them." The harsh truth is that "alive" morticians need "dead" people more than "dead" people need morticians.
"Death" is a metaphor, despite the public's treatment of the term as reality. When we as a society see no purpose in behavior, we call the person or behavior "dead." The metaphor is now ubiquitous in lay usage. A party may be called "dead." We even have, as I. A. Richards (1936) explains in The Philosophy of Rhetoric, "dead metaphors." The metaphor of death is the prevailing ultimate term of derogation. In short, any phenomenon not conforming to our standards may risk being labeled "dead."
The behavior we call "death" cannot be considered apart from the context within which it occurs. It is no coincidence that elderly people, who are singularly ignored or patronized in our society, are the ones who most frequently demonstrate the behavior we call "death." This is perhaps the ugliest aspect of the taxonomy of "death." It is a scheme of categorization superimposed upon those who can least well defend themselves: the old, the injured, and the critically ill.
Let us examine, now, from a new perspective the behavior that we have traditionally labeled "death." Let us consider "death" not as nonexistence, whatever that means, but as an iconic body sign. It is an expression of nondiscursive symbolism whose meaning lies within the "dead" person. "Death" is communication. Let us ask ourselves, therefore, the following question: Since "death," as all behavior is learned, how does it function within its given psychosocial context?
A person who exhibits the behavior we call "death" has learned throughout his or her life that such behavior garners immediate attention and produces guilt and redemption-seeking from loved ones. "Death," therefore, as in the case of "mental illness," is a form of blackmail. The loved ones have virtually no choice but to attend to luxurious preparations for honoring the "dead" person. Once a person has been labeled "dead," he or she no longer can be held responsible for his or her actions. Furthermore, unlike prisoners or even the "mentally ill," this label is permanent.
In the preparation of the body and the burial itself, the"dead" person is never consulted. During the festivities of the funeral, the "dead" person is either covered up or set in a position from which he or she cannot even see what is happening, much less participate.
The rhetoric of burial, as in the rhetoric associated with justifying the involuntary incarceration in "mental institutions," is the language of doublethink. We imprison the dead in maximum security, no escape prisons which used to be called the "hole" in the old gangster movies, and we call it "burial." Relatives periodically come to the site of this "burial" and call it "visiting" or "paying respects." Visiting whom? They do not see their "dead" relative. They bring flowers and taunt the "dead," however innocently or naively, by putting their flowers outside of the smell of the one they are "visiting."
The rhetoric of "death," like that of "mental illness" is a rhetoric of mystification and disparagement, not of understanding. It is based upon the myth of the empirical reality of something called "death." In fact there is no such phenomenon. What we call "death" is simply symbolic behavior misunderstood and exploited by morticians, family, and society to benefit themselves while justifying their actions in the name of the interests of the "dead."

Tom didn't know Lee or me, but coincidentally, within weeks of the publication of our satire, I met up with Tom at a psychiatric convention where he was speaking at Western Psychiatric Institute and Clinic (WPIC) in Pittsburgh. A little nervous, I approached Tom, who upon hearing my name broke out into a big grin, a hearty handshake and said: "Richard Vatz? Yes...The Myth of Death!

I have had many person interactions with Tom since that meeting in the 1970s. In fact in 1999 Tom was the Commencement Honoree at Towson University. He was greeted heartily and the speech was brilliant and went perfectly. I heard from so many faculty and students who loved Tom's address.

This brings me to my second major point, which is that I disagree with the pessimistic assessment of some the impact of Tom Szasz's work over the years is substantially limited.

For better or for worse, one of the realities that I have witnessed repeatedly is the stealing of Tom Szasz's ideas. It has become so frequent that I for one have chosen to write criticisms of the only the most flagrant borrowings by important sources.

Charles Caleb Colton, an English writer coined the phrase "Imitation is the sincerest form of flattery" in the early 19th century, but the proliferation of this theft is by those who, with some exceptions, only begrudgingly grant Tom the validity of his arguments. Some recent examples:

In the Wall Street Journal of April 23, 1998 (Dalrymple:1998) was an article titled "Ill Deeds Aren't a Sign of Ill Health," decrying the labelling of criminals and other miscreants as mentally ill in order to exculpate them.

In "The Doubting Disease" by Jerome Groopman in The New Yorker (April 10, 2000) the author questions the neurological specificity of obsessive?compulsive disorder, the epistemological status of mental diseases in general and the psychiatric model promoting the idea that problems are "a chemical disease of the brain."

He further cites quotes warning of the dangers of long?term effects of psychotropic drugs on children and the possible economic motive behind "excessive pathologizing of people's problems."

Nowhere is Tom Szasz mentioned in the piece.

Now, how in the world does an author of a major piece in a major periodical justify ignoring over 40 years of work including scores of books and hundreds of articles by psychiatrist Thomas Szasz as well as countless writings of others.

I eagerly await Mr. Groopman's next ground?breaking piece in psychiatry: "Bumps in the Night: Puncturing Phrenological Research."

But the chutzpa award for expropriation goes to an eminent psychiatrist at Johns Hopkins whose recent article in Commentary ("How Psychiatry Lost Its Way," December 1999) is right on the mark in so many areas, but who makes almost no acknowledgment of intellectual debt to Tom. Listen to the points he makes with no reference, points which have all been made -- some repeatedly -- by Thomas Szasz:

1. We are witnessing a proliferation of new, nonorganic, bogus psychiatric disorders;

2. Psychiatry utilizes reliability of psychiatric disorders (testing to see if diagnosticians agree on what psychiatric disease patients suffer from) in the place of a search for validity (ascertaining whether psychiatric diagnosis measures what it claims to measure);

3. In psychiatry, as opposed to somatic medicine, the symptom is the disease, rather than a sign for the disease;

4. There is collusion between some pharmaceutical companies and some psychiatric diagnosticians;

5. The problematic DSM approach of "using experts and descriptive criteria in identifying psychiatric diseases has encouraged a productive industry";

6. There is a profound consequence of self?fulfilling prophesy in the public positing of new psychiatric disorders;

7. The findings of "biological markers" for psychiatric disorders are unreliable;

8. The changing of behaviors by psychotropic drugs ("Everyone is more attentive when on Ritalin...") affects anyone who takes them and cannot be validly used as indicative of psychiatric disorders;

9. And finally, the one point for which the author gives Szasz credit: "exercises in mental cosmetics should be offensive to anyone who values the richness of human psychological diversity."

I know from personal discussion with the author the personal distaste he has for Tom, but this should not prevent him from citing the lineage of these important and compelling points.

I should like to conclude by citing some comments I wrote for Tom at the Commencement at which he spoke for Towson University, comments which reflect what he has meant to the field of Rhetoric and Communication:

Tom, you have served a long and distinguished career as a Professor of Psychiatry at the SUNY health Science Center in Syracuse, N.Y. In you lengthy career you have pointed out -- and led to the correction of -- abuses of psychiatric practices, corrections that Dr. Tom Detre, the head of Western Psychiatric Hospital in Pittsburgh, Pa., has called "critical to the ethical functioning of our profession." You are a major figure in American and international debates on freedom, cited by friends and foes alike. Your intrepid support of the values of human autonomy and authenticity, coupled with the emphasis on individual responsibility have made you a symbol of free expression in the United States.

Your seemingly inexhaustible list of honors have well reflected your talents as well as the values you have supported in your 26 books and over 700 articles and reviews. These awards have included, but are not limited to: the Stella Feiss Hofheimmer Award for ranking first in the entire medical curriculum at the College of Medicine at the University of Cincinnati, the Meyer Memorial Lecturer from the University of Queensland Medical School in Brisbane, Queensland, the Mencken Award from the Free Press Association, the Alfred R Lindesmith Award for Achievement in the Field of Scholarship and Writing from the Drug Policy Foundation, the Lifetime Achievement Award from the American Institute for Public Service, and the Rollo May Award from the American Psychological Association. The establishment of the award named after you, The Thomas Szasz Award for Outstanding Contributions to the Cause of Civil Liberties, also speaks eloquently to your values.

Your focus on the persuasive uses of language distinguishes your writing and lectures. Your focus on the importance of what philosopher and rhetorician Richard Weaver called the "true," as opposed to the "base," rhetorician. Base rhetoric ends with exploitation. Weaver defined rhetoric at its truest that which "seeks to perfect men [and women] by showing them better versions of themselves," and your works point out that rhetoric at its finest leaves it to people to reach that pinnacle on their own through individual effort.

You have argued that because some conventional notions of "mental illness combine a mistaken conceptualization of non?disease as disease with an immoral justification of coercion as cure, its effect is two?pronged: it corrupts language and curtails freedom and responsibility."

Tom, as you accomplish the completion of your eighth decade of life, a life representative of the values of hard work, dedication to freedom and responsibility, and exemplifying decency and courage in facing those who disagree with you, I just want to say what an honor it is to be your friend.

Bibliography

Dalrymple, Theodore. "Ill deeds are not a sign of ill health." The Wall Street Journal. (April 23, 1998) A18.

Groopman, Jerome. "The doubting disease." New Yorker. (April 10, 2000). 52-57.

McHugh, Paul. "How psychiatry lost its way." Commentary. (December: 1999). 32-38.

Richards, I.A. The Philosophy of Rhetoric. New York: Oxford University Press. (1936).

Szasz, Thomas Stephen. The Myth of Mental Illness; Foundations of a Theory of Personal Conduct. New York: Hoeber?Harper (1961).

Vatz, Richard E. And Weinberg, Lee S. "A Szaszian View of Death." Journal of Humanistic Psychology. (Spring, 1977) 17. 71-73.

*Richard E. Vatz is professor of Communication at Towson University and the winner of the 1994 Thomas Szasz Award.