In lieu of an abstract, here is a brief excerpt of the content:

  • Psychiatry, Anti-Psychiatry, Critical Psychiatry: What Do These Terms Mean?
  • Thomas Szasz (bio)

Liberty, cooperation, coercion, authority, power

I thank Professor Fulford for giving me an opportunity to comment on Bracken and Thomas’s essay. Unfortunately, this requires accepting the authors’ focus on discourses rather than deeds, on what psychiatrists say and how they say it rather than on what psychiatrists do and how they justify it. This I cannot do in good conscience. Nevertheless, out of respect to Professor Fulford and the journal Philosophy, Psychiatry, & Psychology, as well as a sense of professional obligation, I offer herewith my brief comments.

Bracken and Thomas are not the first persons to compare my work with Foucault’s, nor the first to comment on my writing style. In 2001, a pseudonymous blogger posted this comment (still available):

Although the perceptions which motivate Thomas Szasz are similar to those which motivated Foucault to write his first book, Madness and Civilization, Szasz’s writing style relies on a number of forms Foucault was reluctant to use. Foucault preferred to show the story and let the consequences speak for themselves, thereby insinuating his position. . . . As a result, Foucault’s work is ambiguous and difficult to make heads or tails of. Szasz, however, makes clear his disdain for this social cowardice. . . . On this matter, Szasz is definitely the better scholar and the better writer. The flipside of this better writing style is that the “Establishment,” while content to let the baroque writings of Foucault slide under their radar, have a special place in Hell reserved for Szasz. In a footnote early in The Manufacture of Madness, Szasz quotes his colleague Frederick G. Glaser: “The question will inevitably be raised whether sanctions of some form ought to be taken against Dr. Szasz, not only because of the content of his views but because of the manner in which he presents them. He has not chosen to limit his discussion to professional circles, as his magazine article, not the first that he has written, testifies.” (“The dichotomy game: A further consideration of the writings of Dr. Thomas Szasz,” American Journal of Psychiatry, 121, May 1965.) The article to which Dr. Glaser refers was published in Harper’s. Glaser’s comments, which practically reek with Inquisitorial undertones of censorship and persecution, reflect the discomfort which Szasz inspires in psychiatrists whose job it is to find “sick” people and “help” them—whether the “patient” wants that help or not.

(available from:

Bracken & Thomas (B&T): “Because psychiatry deals specifically with ‘mental’ suffering, its efforts [End Page 229] are always centrally involved with the meaningful world of human reality” (2010, 219).

Thomas Szasz (TS): Let us begin at the beginning. We relate to others in two opposite ways: by cooperation and by coercion. Some psychiatric relations are consensual, some are coercive. Contractual psychiatry, based on cooperation, is like mutually desired love-making. Coercive psychiatry, based on force, is like rape (Szasz 1987/1997/2004).

B&T: “As such, it [psychiatry] sits at the interface of a number of discourses: genetics and neuroscience, psychology and sociology, anthropology, philosophy, and the humanities” (2010, 219).

TS: I am unable to recognize in this picture a portrait of contemporary psychiatry in the United Kingdom or the United States. The psychiatrist’s paradigmatic practices are involuntary mental hospitalization and the insanity defense. Without these interventions psychiatry, as we know it, would cease to exist. Yet Bracken and Thomas do not even acknowledge their existence (Szasz 1963/1989/1970/1997/1993).

B&T: “[Psychiatrists] are always centrally involved with the meaningful world of human reality. . . . Each of these [interfaces] provides frameworks, concepts and examples that seek to assist our attempts to understand mental distress and how it might be helped” (2010, 219).

TS: I do not believe that the attaching of stigmatizing psychiatric diagnoses to individuals whom psychiatrists (ostensibly) seek to help is “always centrally involved with the meaningful world of human reality.” I do not agree that such actions assist us in “our attempts to understand mental distress and how it might be helped” and deny that prescribing mind-altering drugs helps in this endeavor. I believe we can...


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pp. 229-232
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