Thomas S. Szasz, M.D. (1920 - 2012) The Manufacture Of Madness 1970
A Comparative Study of the Inquisition and the Mental Health Movement
Part II The manufacture of madness
11. The New Product-Masturbatory Insanity
...I hold that in each of the foregoing persecutory situations we are confronted with a relationship between oppressor and oppressed; the oppressor invariably resorts to both force and fraud in subduing and exploiting his antagonist; frequently he develops a therapeutic rhetoric, justifying his domination by claims of selflessness and a desire to help the victim; criticism of the oppressive practice is rendered impossible by persecution of the critic as a traitor to the existing social order; finally, the ideology of helpful coercion is institutionalized, stabilizing and perpetuating the persecutory practices over long periods of time.
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As heresy is an offense against the authority of God "and priest, so madness is an offense against that of Nature and physician. With the displacement, in our day, of the authority of both God and Nature, priest and physician, by that of popular opinion and mass man, the quintessence of evil becomes personal autonomy, that is, conduct in defiance of the wills and ways of the "enlightened majority"; and the symbol of evil becomes the nonconformist rejecting accepted belief or custom.
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In order to conquer an area of human life for medical expertise and intervention, it is necessary first to define its norma1 functioning as the manifestation of disease. Once this is accomplished, the next step may be taken: this consists in defining destructive interventions by doctors as medical treatments. The third and final step, typical of psychiatry, is the imposition of the destructive intervention on the patient against his will. The triumph of medical imperialism is complete when the laity regards normal bodily and mental functions as diseases, and harmful interventions-even against the patient's will-as treatments.
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12. The Manufacture Of Medical Stigma
PARPALAID: You may think me too much of a stickler for ethical standards, but doesn't your method subordinate the interest of the patient just a bit to that of the doctor?
KNOCK: Dr. Parpalaid, you're forgetting that there is an interest which is greater than either.
PARPALAID: What?
KNOCK: The interest of medicine. I serve that interest and that alone . . . You've given me a township inhabited by several thousand neutral individuals, individuals without direction. My function is to direct them, to lead them into a life of medicine. I put them to bed and see what can be made of them: tuberculosis, neurasthenia, arteriosclerosis, whatever you like, but something, for God's sake. Nothing gets on my nerves like that indeterminate nonentity called a healthy man.
-Jules Romains
...More than a hundred years ago, Kierkegaard anticipated and saw clearly what was wrong with arguments justifying the "democratic" suppression of conduct not directly injurious to majorities but offensive to them, as exemplified by our mental hygiene laws. Observing that for centuries men have fought against the tyranny of popes and kings, thus associating oppression with them, Kierkegaard warned that "It does not occur to people that historical categories change, that now the masses are the only tyrant and at the bottom of all corruption. . . . Nowadays, when a man is censured for some trifling wrong but, be it noted, by the King, by someone in authority, he has the sympathy of everyone, he is a martyr. But when a man is, intellectually speaking, persecuted, ill-treated, insulted day in and day out by the stupidity, inquisitiveness, and impertinence of the plebs, then it is nothing at all and everything is as it should be."*
*Alexander Dru (Ed.), The Journals of Kierkegaard (1835-1854), pp. 123-124.
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"We do not argue that a more or less adequate statement of our financial affairs should not be made available at regular intervals to the inspector of taxes," continues Gould. "Why then," he asks, "should we jibe at the idea that a full, accurate, and regular account of our physical (and, indeed, mental) state should be rendered to some central authority? . . . Ideally, our medical record cards should be sent to the Ministry of Health, say once a year, and all the information on them should be fed into a computer. Moreover, these cards . . . should list our jobs, past and present, our travels, our relatives, whether and what we smoke and drink, what we eat and do not eat, how much we earn, what sort of exercise we take, how much we weigh, how tall we are, even, perhaps, the results of regular psychological tests, and a host of other intimate details."
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