Category: Arts & Culture

Thomas Szasz’s The Manufacture of Madness –  A Comparative Study of the Inquisition and the Mental Health Movement was published in 1970. The gist of the book is that the Inquisition that persecuted witches, heretics, Jews and homosexuals and a variety of “others” is similar to modern psychiatry and the Mental Health Movement that diagnoses people for their insanity and locks them up, against their will in institutions for safekeeping and treatments.

That was 1970. I am sure there is still the practice of putting people with schizophrenia and other diagnoses against their will into institutions and it may be good to remember that The Manufacture of Madness was written in the time of One Flew Over the Cuckoo’s Nest. Additionally it was a time when homosexuality and masturbation were often considered diseases that needed to be cured. I will refrain from the gory details of the treatments.

Of course, comparing the Mental Health Movement to the Inquisition made Dr. Szasz a very controversial academic and he surely had many enemies.  In effect he was declaring that mental illness is a myth and the profession of psychiatry a hoax and the people who practice it immoral and dense – not a good way to make friends. Szasz’s thesis surely has merit and it is odd that people then and today dismiss his theories simply because it makes them uncomfortable and they do not like them. In every era we think we become more noble and advanced but time and time again it turns out that more often than not the same dynamics are in play; it is only the words, players and titles that change.

What one thinks of Rush’s tactics depends, of course , on what one thinks of the ideology of psychiatric imperialism and its attendant quasi-medical sanctions.

The chapter The New Manufacturers – Benjamin Rush, The Father of American Psychiatry is an eye-opening account of how Benjamin Rush thought that criminals had mental diseases that needed to be “cured” and that Black people suffered a “disease” from the color of their skin

More surprising than Rush’s self-proclaimed love for the Negro is his theory of Negritude. Rush does not believe that God created the Negro black; nor that a Negro is black in nature…  About 1792, white spots began to appear on the body of a Negro slave named Henry Moss. In three years he was almost entirely white. Moss had the symptoms of an hereditary disease we now know as vitiligo. The condition, characterized by loss of skin pigmentation, occurs in both white and colored people… The gist of Rush’s theory was that the Negro suffered from congenital leprosy which “… appeared so mild a form that excess pigmentation was its only symptom.”

By inventing his theory of Negritude, Rush solved the issue of racial  segregation. Whites and Blacks could not have sexual contact and God-forbid marry as it would propagate this dreaded disease of being Black.  By conflating race with a disease, he was promoting a concept that humans could be cured of their race – or in more modern terms, they would then be cured by becoming  transracial. Race (as gender is today) was considered a preexisting medical condition. In the 18th and 19ths centuries, it is clear that unless you were a white male, you had some sort of disease that needed a medical remedy.  Women suffered from hysteria and pregnancy was a disease. Black people had the disease of Negritude. It is a sobering fact that this is the basis of psychiatry in America  as conjured up by Benjamin Rush, the preeminent doctor and a man who signed the Declaration of Independence.

All students of psychology and psychiatry would do well to read the work of Thomas Szasz as he was a very influential person, intelligently questioning the status quo and his work goes deep into the history of psychiatry. That he is fading into the background of history is predictable. People in the field of medicine that question the profit sector of the industry will always get pushed aside. That the last forty years has seen huge profits in the mental health pharmaceutical industry speaks to this conundrum.

What is interesting is how much has changed in the Mental Health Movement in the last fifty years. Homosexuality and masturbation are no longer considered diseases. Since President Ronald Reagan helped to defund mental health services in the 1980s we see plenty of people that are mentally imbalanced on the streets. If mental illness is a myth, tell that to the homeless person screaming at the moon at 3 AM in the middle of the night.  Their condition may go beyond just the cardboard box they sleep in. Indeed. they may have a “problem with living” and a warm, clean safe bed, a toilet and shower is surely part of the remedy, but years of abuse, living on the edge and poverty has its toll. People are complicated. Simple solutions are often overly simplistic.

But then again, as Szasz pointed out, the Mental Health Movement is always manufacturing new diseases. Here are just some of the the latest disorders that people are diagnosed with.

The DSM-5 (2013)
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals around the world. The manual is the guide by which mental health professionals base their diagnosis. Below is a list in alphabetical order of the 15 new disorders added to the DSM-5.

1. Binge Eating Disorder
2. Caffeine Withdrawal
3. Cannabis Withdrawal
4. Central Sleep Apnoea
5. Disinhibited Social Engagement Disorder
6. Disruptive Mood Dysregulation Disorder- DMDD
7. Excoriation (Skin-picking) Disorder
8. Hoarding Disorder
9. Hypersexual Disorder
10. Premenstrual Dysphoric Disorder – PMDD
11. Rapid Eye Movement Sleep Behaviour Disorder
12. Restless Legs Syndrome
13. Sleep-related Hypoventilation
14. Social (Pragmatic) Communication Withdrawal

From https://www.aifc.com.au/14-new-disorders-in-the-dsm-5/

The list above is just the tip of the iceberg. Dr. Thomas Szasz was definitely on to something no one wants discuss. I highly doubt he is required reading in university programs. Need I say more?

You can hear an amazing Studs Terkel sixty minute interview of Dr. Szasz from 1970.

The Manufacture of Madness
by Thomas S Szasz
ASIN ‏ : ‎ B000GJVK5E
Publisher ‏ : ‎ Paladin; 1st Edition, 5th Printing (January 1, 1970)
Paperback ‏ : ‎ 383 pages