CHANCE TO COMMENT TO _BRITISH JOURNAL
OF PSYCHIATRY_ ABOUT FORCED "TREATMENT"
FOLLOWING THEIR ODD REVIEW OF TOM SZASZ BOOK
JOURNAL PROMISES TO PUT ALL COMMENTS WITHIN
GUIDELINES ONTO THEIR WEB SITE
The below review in the _British Journal
of Psychiatry_ of a Thomas Szasz book takes some
bizarre turns, and predictably misses the point.
Ths provides an opportunity to respond using
this influential journal's web site. They say they
intend to publish *all* letters they receive on
their web site that follow their extensive
guidelines... and select some for publication
in their print journal.
The book is _Liberation by Oppression: A
Comparative Study of Slavery and Psychiatry_ and
of course it's available in the MAD MARKET. To get
a copy just enter the MAD MARKET here and use
the search box:
http://www.mindfreedom.org/madmarket/
The URL for submitting letters on the review to
the _British Journal of Psychiatry_, including
that long list of rules for letters, is BELOW the
review here. At the BOTTOM is a sample letter,
and also how you can copy your own letter to
Tom Szasz!
~~~~~
REVIEW IN _BRITISH JOURNAL OF PSYCHIATRY_
Raj Persaud, "Review of 'Liberation by
Oppression: A Comparative Study of Slavery and
Psychiatry,'" British Journal of Psychiatry, 182:
173 (March), 2003.
Liberation by Oppression: A Comparative Study of
Slavery and Psychiatry By Thomas Szasz. New
Brunswick, NJ: Transaction Publishers, 2002. 237
pp. Lb 33.50 (hb). ISBN 0 7658 01450
Thomas Szasz became famous for being at the
vanguard of the anti-psychiatry movement, and his
latest book begins ominously enough with the
subtitle A Comparative Study of Slavery and
Psychiatry. The cover illustration is of a
psychotherapist's couch with a ball and chain
attached. However, something remarkable has
happened in the decades since The Myth of Mental
Illness Illness, one of his first polemical
attacks on psychiatry, was published (Szasz,
1962).
Szasz now appears to have been transformed into
an ally rather than an enemy of the National
Health Service general adult psychiatrist.
Szasz's project has always been to argue
passionately for a boundary of demarcation around
the responsibility and power of psychiatry. For
the clinician (generalist) who daily has to cope
with an increasing number of referrals for which
it seems to have become impossible clearly to
indicate what a psychiatrist cannot do or be held
responsible for, Szasz is like a lifebelt thrown
to a drowning man. After all, he gets to his
points quickly and via some catchy slogans:
'dangerousness is not a disease', he points out,
and this is certainly worth remembering by a
society that is increasingly abandoning
'dangerousness' at the door of psychiatry. One of
the topical arguments in the book centres on
Szasz's favourite preoccupation, coercive
psychiatry - topical because of the current
controversy over possible new mental health
legislation in the UK. Szasz makes the telling
point that most often we detain and commit
patients not so much because of what they have
done in the past, but more because of what they
might do in the future - be it to themselves or
to others. But the future, philosophy reminds us,
is a theoretical construct, and we probably
consistently overestimate how much of the future
we can reliably determine.
However, if we only ever committed patients after
a dangerous event, then psychiatry would be seen
to be failing in its science: it is an expertise
based on knowledge of human behaviour but how can
you claim to know anything if you can predict
nothing? Is this not the same charge we level
against astrology, which explains everything but
predicts nothing? The law operates in precisely
the opposite way - you are tried after you have
done something reprehensible, not before. It is
therefore not surprising that in Szasz's eyes
(and in the eyes of many users of mental health
services) the whole sectioning process resembles
something out of Kafka's The Trial. As ever,
Szasz blames psychiatry for forms of thinking
that the rest of society is equally guilty of.
All of us - psychiatrists or not - probably could
not conduct daily affairs without an overly
optimistic sense of a fairly predictable future.
Also, Szasz is guilty of some surprisingly weak
arguments - one that he marshals in favour of his
thesis that psychiatrists cannot predict
dangerousness is that if they could, they would
not so frequently be the victims of assaults by
their own patients.
But what saves this book from being just another
mugging of psychiatry is that Szasz does raise a
fundamental question at the core of our
discipline. If we restricted our attention only
to those clients who wanted to see a
psychiatrist, and disengaged from all those who
really didn't, how different might our
professional practice and experience be? Is it
not possible that it could be a lot more positive
for both clinician and patient? What is useful
about this approach is that it would force the
rest of society to acknowledge that it is they
who desperately want psychiatrists to assist in
the management of those who appear unpredictable,
suffering and insightless.This is the key point at
which Szasz is found wanting. If psychiatry were
less eager to take over too many of other
people's problems, it might find that it was
wooed more. Ironically, then, the great
antipsychiatrist could end up saving the
psychiatrist profession after all.
Szasz, T. (1962) The Myth of Mental Illness.
Foundations of a Theory of Personal Conduct
Conduct. London: Secker & Warburg.
Raj Persaud Consultant Psychiatrist, Maudsley
Hospital, Denmark Hill, London SE5 8AF, UK
- [end of review] -
===============
HOW TO SUBMIT YOUR LETTER VIA
THE _BRITISH JOURNAL OF PSYCHIATRY_
WEB SITE:
http://bjp.rcpsych.org/cgi/eletter-submit/182/3/273
They promise to put all letters on their
web site that follow guidelines within seven days.
~~~~~~~~~~~~~~
BELOW is a sample letter that I've submitted.
PLEASE USE YOUR OWN LANGUAGE. Please note that
you need to include a disclaimer that you don't
have a financial, etc. interest in publishing of
the letter.
NOTE: If you'd like, you can e-mail a copy of your
letter to Dr. Szasz at: <[EMAIL PROTECTED]>.
~~~~~~~~
LETTER TO EDITOR:
Where are voices of psychiatrists who supposedly
oppose coercion in the mental health field?
I spotted a glimmer of hope when Raj Persaud
asked, in his review of "Liberation by
Oppression: A Comparative Study of Slavery and
Psychiatry" by Thomas Szsaz [(March), 2003], "Is
it not possible that [a fully voluntary mental
health system] could be a lot more positive for
both clinician and patient?"
Unfortunately, rather than simply answering his
own question in the affirmative as I had hoped he
would, the reviewer rapidly appeared to offer the
psychiatric profession a kind of insanity defense
for its historic complicity with forced
psychiatry. Dr. Persaud appears to claim that a
significant number of psychiatrists are
personally reluctant to engage in forced
procedures. He seemed to excuse the psychiatric
profession by pointing out that it is society
that "desperately wants" involuntary procedures
to manage troublesome citizens.
While many individual psychiatrists may look at
forced procedures with distaste, the fact remains
that with few exceptions psychiatrists and their
organizations have been far too silent about
opposing forced psychiatry, and they have often
endorsed and actively campaigned for laws
allowing more forced procedures. For example,
involuntary psychiatric drugging is a fact of
life internationally, and the practice is now
spreading in some countries to an outpatient
basis using court orders. Also, electroshock
(also known as electroconvulsive therapy) against
the expressed wishes of the subject continues to
this day, and our office has heard several
anecdotal reports that this especially horrifying
and intrusive practice is increasing in developing
nations.
Both forced drugging and forced electroshock are
endorsed by many organizations of psychiatric
professionals, except for a few courageous
exceptions such as the International Center for
the Study of Psychiatry and Psychology [1].
I feel privileged to direct a Non Governmental
Organization -- Support Coalition International
-- that frequently works with some of the few
psychiatrists who speak out against involuntary
human rights violations in the mental health
system [2].
Rather than giving society the lion's share of
the blame for the continuation and spread of
forced treatment, psychiatrists and their
organizations need to take responsibility for
their own role, and end these severe human rights
abuses now.
Sincerely,
David Oaks, Director Support Coalition
International
[1]
http://www.ICSPP.org
[2] http://www.MindFreedom.org
As requested by your guidelines, this is a
declaration that I have no self interest or
conflict of interest in the publication of this
letter, including no fees and grants from,
employment by, consultancy for, shared ownership
in, or any close relationship with, and
organisation whose interests, financial or
otherwise, may be affected by publication of the
letter.
- end -
PLEASE FORWARD TO ALL APPROPRIATE PLACES
ON AND OFF INTERNET. THANKS.
