Professor Thomas Szasz, Emeritus Professor of Psychiatry, State University of New York Health Centre, Syracuse , New York

Thomas Szasz, A.B., M.D., D.Sc. (Hon.), L.H.D. (Hon.), is Professor of Psychiatry Emeritus at the State University of New York Upstate Medical University, in Syracuse , New York. He is the author of 33 books, among them the classic, The Myth of Mental Illness (1961) and, more recently, Faith in Freedom: Libertarian Principles and Psychiatric Practices (2004),  "My Madness Saved Me": The Madness and Marriage of Virginia Woolf (2006), Coercion as Cure: A Critical History of Psychiatry (2007) and The Medicalization of Everyday Life: Selected Essays (scheduled for publication in the fall of 2007). Dr. Szasz is also the author of many essays, book chapters, book reviews, and miscellaneous pieces in both professional and popular publications and the contributor of a bimonthly column to the magazine The Freeman.

Dr. Szasz is widely recognized as the world's foremost critic of psychiatric coercions and excuses. He maintains that  just as we reject using theological claims about people's religious states (heresy) as justification for according them special legal treatment, we ought to reject using psychiatric claims about people's mental states (mental illness) as justification for according them special legal treatment.

Dr. Szasz has received many awards for his defence of individual liberty and responsibility threatened by the Therapeutic State, a modern form of totalitarianism masquerading as medicine. A frequent and popular lecturer, he has addressed professional and lay groups, and has appeared on radio and television, in North, Central, and South America as well as in Australia , Europe, Japan , and South Africa . His books have been translated into every major and many less than major languages.   

Keynote Presentation: Psychopathology: Mendacity and Metaphor 

Although we tend to view illness as a disvalue, there are many circumstances in which it is useful to be ill or be so regarded by others, that is, to malinger or imitate being ill.

Imitation and incentives for it are ubiquitous, reflected in the many words we have for various aspects of the act, such as: camouflage, chicanery, deception, disguise, dishonesty, distortion, duplication, duplicity, copy, counterfeit, fabrication, fakery, falsification, forgery, fraud, identity theft, impersonation, invention, lie, malingering, mendacity, misrepresentation, perjury, pretense, prevarication, simulation. The imitation of illness is memorably portrayed by Molière (1622-1673) in his famous comedy, "The Imaginary Invalid" (Le malade imaginaire). Molière wrote this play shortly before his death and died while performing it, of hemorrhage from pulmonary tuberculosis.

Now, I wish to call your attention to a very important cultural-conceptual change since Molière's times. Today, the medical profession – in alliance with the state – defines imaginary illnesses as real illnesses, in effect abolishing the notion of pretended illness. Malingering has become a disease "just as real" as melanoma.

The result is an astonishing social phenomenon: we recognize every imitation of an "original" as a "copy" -- but one. Counterfeit art is "forgery." Counterfeit testimony is "perjury." But counterfeit illness is "mental illness," "a disease like any other."

How did this mass belief / delusion based on pharmacratic faith come about? Suffice it here to say that it came about because medicine, allied with the state – much as formerly church and state had been allied – decided to politicize, and in effect abolish, the objectively identifiable boundaries between unwanted diseases of the body and unwanted behaviors of individuals. In medicine, and only in medicine, do authorities with the power to distinguish originals from forgeries authenticate counterfeit illness as real illness.
The consequences of this policy – economic, legal, medical, moral, philosophical, political, and social – are momentous: counterfeit disability, counterfeit disease, counterfeit doctoring, and the bureaucracies administering and adjudicating these matters make up a substantial part of the national economies of modern western societies.

Let us remember that, according to classic, pathological-scientific criteria, disease is a product manufactured by the body, in the same sense that urine is a product manufactured by the body; whereas diagnosis is a product manufactured by persons, in the same sense that a work of art is manufactured by a person. In 1952, when the American Psychiatric Association (APA) published the first edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), it did not include hysteria in its roster of mental diseases. The term's historical and semantic allusions to women and uteruses was too embarrassing. However, the APA did not declare hysteria to be a nondisease; instead, it renamed it "conversion reaction" and "somatization disorder."

If we dispense with the somatic pathological criterion of disease, we destroy the rational basis for distinguishing real, medical diseases of the body from fake, psychiatric diseases of the "mind" (and other nondiseases). This is what Charcot and Freud did and what modern psychiatry and medicine do: there are no necropsy findings verifying DSM diagnoses. Since there is no objective method for detecting the presence of mental illness, there is also no objective method for establishing its absence. The claim that a mental illness is a brain disease is profoundly self-contradictory: a disease of the brain is a brain disease, not a mental disease.

Addiction is one of modern psychiatry's paradigmatic mental diseases, routinely "treated" with imprisonment by judges and coercion by psychiatrists. Nevertheless, in the August 15, 2007 issue of the prestigious Journal of the American Medical Association, we read: "... decades of comprehensive genetic and neurobiological research have provided indisputable evidence that addiction is brain disease resulting from mesolimbic brain dysregulation that, if diagnosed in a timely fashion, can be properly treated. Addiction meets all characteristics of the disease concept, i.e., (1) a clear biological basis; (2) unique, identifiable signs and symptoms; (3) a predictable course and outcome; and (4) the inability to control the cause of the disease."
Q.E.D.

Streaming video (windows media format) of presentation

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