Updated: Aug 18, 2022
Thomas Szasz, The Meaning of Mind: Language, Morality, and Neuroscience, 1996, Praeger Publishers
Thomas Szasz didn't believe that the mind exists. He also didn't believe that the brain is the seat of personhood. I share these views about mind and brain, which is why I read this one book of his. I believe that a human being is an indivisible being, conscious and bodily, but in so sense a soul/mind/brain + a body. It turns out that beyond those basic premises, Szasz and I have little in common. He believed that "mind" is a verb and that consciousness essentially means "minding," which is basically talking to or with yourself. He believed that "mind" and brain-as-seat-of-personhood are modern notions used to justify control of certain kinds of deviant people. Such people are said to be "mentally ill," but since there's no mind, there's no "mental." As for the brain, Szasz allowed that it can be affected by "lesions," but these can only be identified in a post-mortem examination and rarely are seen in "mentally ill" people who are, he claims, physically indistinguishable from "normal" people. (I don't know whether the diagnostic imaging of today would bear him out; the book is a quarter-century old.) In any case, he didn't attribute any of the typical "mental illnesses" to lesions, nor to faulty genes or neurotransmitters, nor to abuse, nor to trauma of any kind (p.37). If you do not have a lesion, then your chosen way of minding that is to blame.
For Szasz "mental illness" was a social construct. He only uses that term on the very last footnote of the book, when he describes the seemingly mysterious but socially constructed connection between genius and madness, but I think it is fair to apply it to his ideas in general. Be that as it may, the social construction of mental illness cuts both ways: taking the concept at face value "justifies" the psychiatric establishment's control of the "mentally ill," but it also "exonerates" the "mentally ill" from responsibility for their actions. Since Szasz was libertarian par excellence, he believed that the individual's responsibility for his deeds should not be abrogated, and he completely rejected involuntary treatment and institutionalization. These views are what he is famous for, but in this book at least, he gets down to more fundamental positions.,
For Szasz, the most fundamental right that the psychiatric state is trying to deny is the right to kill oneself. The right to suicide has a complicated history, as Szasz told it. When people committed suicide before the eighteenth or nineteenth century, they were not allowed burial in hallowed ground and their worldly goods went, not to their heirs, but to the king. According to Szasz the invention of mental illness was part of an effort to save would-be or successful suicides from criminalization. "They're not responsible—don't punish them—they're mentally ill!" Of course, once doctors "diagnosed" you as mentally ill, the law gave them the authority to lock you up with other "crazy" people.
This almost makes the therapeutic state look kind—it's trying to rescue people from Church and Crown. But evidently power corrupts, because we ended up with a massive controlling establishment. As you might expect, the social construct of mental illness has a payoff for the psychiatrists who impose it on people. Szasz opined that it is probably financial and existential self-interest (p. 138)
Why the fixation on suicide? I think I can connect the dots here. Szasz discussed Sartre's notion of freedom and coercion (pp. 141 - 2), according to which you always have a choice because if you don't want to do what someone else is trying to make you do, you could always commit suicide. Denying someone the ability to commit suicide, which the psychiatric establishment frequently does, is perhaps the most fundamental means of depriving them of the ability to choose, which for Szasz is dehumanizing to the extreme. (Notice, by the way, how this emphasis on choosing to die is antipodal to the choice to live, which is the spark to Ayn Rand's ethical engine.)
Thus far I would almost sympathize with Szasz. Clearly, people have been institutionalized for being dissidents, "wayward girls," eccentrics, and so forth. I suspect the concept of mental illness has been misconceptualized, and I would say that people with mental illness (however we're going to think of it) have frequently been manhandled and denied a role in their treatment. But I believe there is a core group of people that must be restrained because they are fundamentally non-rational. Szasz would call me an oppressor for that opinion.
However, where Szasz completely loses me is in his view of what people with "mental illness" actually are, if you strip away the social construction. Focusing on people with schizophrenia, Szasz claimed that they are not hearing voices. Based on the absolute sketchiest of reasoning, he asserted that they are just talking to themselves and not taking responsibility for it. He was very clear on that subject. "[T]he schizophrenic patient who 'hallucinates' or has 'delusions' is profoundly dishonest with himself." (p. 129 - 30) In other words people who claim to have schizophrenia are liars.
Thus, the good doctor would gaslight people with mental illness (vulnerable people at that) by saying that they are wrong about their own experiences. They choose to do the things they are doing even if they feel they are not. Do you hear voices? Stop talking that way. You say you have OCD and that you have intrusive thoughts? Stop thinking that way. It's all you're own fault and you're immoral if you deny it.
Talk about blaming the victim!
Szasz was an influential theorist in his day who was so much in the grip of his own theory that he could not see plain reality. And he made such awful arguments! One example: You say that people with schizophrenia have disjointed speech and thus a brain disease? Well, Picasso and Pollock painted disjointed paintings. Are you going to say that they have a brain disease? If they're not diseased, then neither are people with schizophrenia, because they are doing essentially the same thing as the artists are (p. 123). The baldness of this fallacious reasoning is breathtaking.
That's the superficial level. At first, I took Szasz to be just another rationalist, as some libertarians are. But there is much more going on here.
The first inkling I got was in how Szasz spoke of "minding" as seemingly the primary, almost the only, mental function, and minding consists almost exclusively of speaking and listening What's up with that? I thought. As I view it, the bedrock mental function is perception. Perception is how we know anything of reality: everything true is built on it. Szasz almost sounds like he believes that words are virtually self-sufficient level of cognition. But without perception, words can only refer to other words. It's starting to feel very French in here, at least if my at-a-distance view of thinkers like Derrida is correct.
At the end of the book (pp 142 - 3) Szasz finally showed his hand: According to Szasz, "Truth" means one of two things: 1. That which works. 2. That which is conventionally believed to be the case. My jaw dropped when I read this But he didn't (from his point of view) leave things looking so bad. There is something that is better than truth, namely, "understanding." And understanding is "dialectic" and is concerned with "outlooks" and "personal insights," that are as unique to the individual as are his fingerprints. In other words, life through the activity of "minding," is an endless conversation with oneself (and perhaps with others). We never arrive at truths and should not try or say that others should try: the minding journey is the destination. Although I disagree with his view of knowledge at a fundamental level, Szasz's rendering of it strikes me as a sensitive description of subjectivism.
I think we can now see why Szasz leaves perception out of his account of mental life. If we have real contact with the world, a contact that all human beings share, then there is a truth beyond the practical and the social, and not all "insights" and "outlooks" are created equal. I think Szasz would adamantly oppose these claims. I think that for Szasz, "Truth" is tyranny.
It's funny how much Szasz sounds like a postmodernist in this book. I don't think he's usually labelled that way; the emphasis is usually on his libertarianism. It's been a long time since I've read Richard Rorty, but to me that's who he resembles—in his antifoundationalism, his relativism, and his view that a healthy culture about conversation, rather than settled principles. Perhaps they share a pragmatist lineage, given that Rorty styles himself as a pragmatist, but big-name pragmatists such James and Dewey are not in the bibliography. (Neither is Derrida.) Rorty is in the bibliography, but not the index or notes. Szasz was very well read, so perhaps the most recent common ancestor is farther back in time.
Rorty tried to base his politics on compassion. You could say that he failed, but he tried. Szasz, on the other hand, would ultimately gaslight his patients, call them liars, and blame them for their suffering. Such actions are, needless to say, not compassionate. Oh well, at least people with problems could always commit suicide—if the state would just leave them alone. Given that "mental treatments" have no real existence (p. 138), that might be, in Szasz's warped universe, a good idea.