A Lexicon of Lunacy: Metaphoric Malady, Moral Responsibility & Psychiatry

by Thomas Szasz

Thomas Szasz is renowned for his critical exploration of the literal language of psychiatry and his rejection of officially sanctioned definitions of mental illness. His work has initiated a continuing debate in the psychiatric community whose essence is often misunderstood. Szasz's critique of the established view of mental illness is rooted in an insistent distinction between disease and behavior. In his view, psychiatrists have misapplied the vocabulary of disease as metaphorical figures to denote a range of deviant behaviors from the merely eccentric to the criminal. In A Lexicon of Lunacy , Szasz extends his analysis of psychiatric language to show how its misuse has resulted in a medicalized view of life that denies the reality of free will and responsibility. Szasz documents the extraordinary extent to which modern diagnosis of mental illness is subject to shifting social attitudes and values. He shows how economic, personal, legal, and political factors have come to play an increasingly powerful role in the diagnostic process, with consequences of blurring the distinction between cultural and scientific standards. Broadened definitions of mental illness have had a corrosive effect on the criminal justice system in undercutting traditional conceptions of criminal behavior and have encouraged state-sanctioned coercive interventions that bestow special privileges (and impose special hardships) on persons diagnosed as mentally ill. Lucidly written and powerfully argued, and now available in paperback, this provocative and challenging volume will be of interest to psychologists, criminologists, and sociologists.

214 pages, cloth

First published January 1, 1993

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

[Steven H · Rating 1 out of 5]

SZASZ FOCUSES ON THE LANGUAGE WE USE TO DESCRIBE ‘MENTAL ILLNESS,’ ETC.

Thomas Stephen Szasz (1920-2012) was a Hungarian-born psychiatrist who was professor of psychiatry at the State University of New York Upstate Medical University.

He wrote in the Preface to this 1993 book, “Anyone with an ear for language recognizes that the line separating the seemingly serious vocabulary of psychiatric diagnosis from the ludicrous lexicon of psychobabble, and both from the jesting colloquialism of slang, is thin at best and nonexistent at worst…

“This book consists of two parts. Part 1 is a critical reflection on the extraordinary profusion of terms in American English for behaviors conventionally called ‘mental illnesses,’ together with as complete a listing of such terms as I have been able to assemble… Part II is a collection of previously published papers that illustrate our propensity to use the language of mental illness to influence social relationships---in particular, to reduce or annul personal responsibility by shifting it from self to others or to the fiction of mental illness.”

He explains in the Introduction, “I took up the profession of psychiatry in part to debunk the biological-reductionist impulse that has motivated its very origin and that continues to fuel its engines; in other words, to combat the contention that abnormal behaviors must be understood as the products of abnormal brains.” (Pg. 3)

He adds, “psychiatrists… realize that their entire enterprise hinges on society’s acceptance of the proposition that human beings diagnosed as mentally ill have a brain disease that deprives them of free will.” (Pg. 7)

He states, “A young woman delivers her first baby, a beautiful, healthy baby. The next morning she weeps, has no appetite, says she is unhappy, and displays a mood of dejection. What do we say about her?... Each of these terms and phrases identifies the same phenomenon; each word and phrase is at once a ‘name’ and an ‘explanation.’ …Which explanation is true?... Why do we have a vocabulary that identifies a woman who is happy with her newborn baby as ‘healthy,’ and one who is unhappy with it as ‘sick’?” (Pg. 31)

He states, “Of course, there is no blood or other biological test to ascertain the presence of absence of a mental illness, as there is for most bodily diseases. If such a test were developed (for what, theretofore, had been considered a psychiatric illness), then… the condition would cease to be a mental illness and would instead be classified, instead, as a symptom of a bodily disease.” (Pg. 33)

He asserts that “real doctors do not have to go looking for diseases. The diseases… find them soon enough. This is not true in psychiatry. Thus, before homosexuals were struck down by AIDS as a disease, they were struck down by homosexuality as a diagnosis.… Unlike regular physicians, who have no need to rename diabetes or hypertension, psychiatrists labor under the unremitting pressure of cultural forces to slap approving or disapproving labels on certain behaviors.” (Pg. 38)

He proclaims, “The ancient prophets concealed their megalomania by claiming that God spoke to them. The new prophets---Marx and Freud---conceal their megalomania by claiming that science speaks to them. But God and science are silent. However, conceited men love to speak in their names.” (Pg. 109)

He quotes Chris Heginbotham (director of the National Association of the World Federation for Mental Health, who supports ‘conventional psychiatric interventions’), then comments, “He … does not ask who considers deinstitutionalization to be a failure. The patients who prefer to be OUT of mental hospitals? The patients who prefer to be IN mental hospitals? The patients’ relatives? Obviously, the answers vary, if for no other reason than because these parties often have conflicting interests, which Heginbotham systematically fails to acknowledge.” (Pg.130)

He summarizes, “I should like to reiterate that the very idea of giving rights to the mental patient expresses, once again, society’s collective contempt of him; and that the mental patient’s failure to protest against this ritual reinforces society’s collective sense of being justified in patronizing him. After all, Catholics do not have a specially identified right to accept or reject Holy Communion… Patients with arthritis or diabetes do not have specially identified rights to accept or reject treatment for their diseases. Mental patients, however, are specifically granted a right to treatment and a right to reject treatment. But so long as they are denied the right to disclaim having a mental disease and reject the role of mental patient, their ‘psychiatric rights’ are not merely worthless but an insult to their intelligence and dignity.” (Pg. 141)

He concludes, “Then we depend on the Other, we use language mainly to flatter him, and to justify and validate his beliefs and behavior. When we dominate the Other, we use language mainly to flatter ourselves, and to justify and validate our own beliefs and behavior.” (Pg. 185)

Szasz covers no real ‘new ground’ in this book, but his supporters should enjoy it.

[Helen · Rating 5 out of 5]

Szasz has written another philosophical winner! He defends freedom for all by stating that putting people involuntarily into a mental hospital for doing a crime is no different from the Russians hospitalizing political prisoners. He wants us to stop using psychiatry as an excuse for taking away the rights of citizens. Excellent arguments made!