I'm reposting some comments I left in two different places:
You begin by saying "It's really hard for me to understand where my American Christian friends are coming from when they oppose any sort of greater restrictions on guns."
When, however, I respond to you on your own terms, suddenly you "don't have time."
To me, that's symptomatic of somebody who's not asking a serious question. To say you stopped reading is a way of saying you stopped listening.
Do you want to know the other side of the argument or not?
And, yes, I think Australia's gun ban/confiscation was a mistake. From an ethical standpoint, the right of self-defense is a fundamental human right. At best, the police are a supplement, no
Steve Hays To piggyback on one of Lydia's points, by definition, if you confiscate enough guns, you may have fewer shootings. But that’s a deceptive comparison. That doesn’t mean you less violent crime.
Gun bans and gun confiscation can lead to a spike in crime. There’s a loss of deterrence. In addition, citizens can no longer defend themselves or their property. That gives crooks a green light.
It’s not enough to compare a drop in gun violence with a drop in gun ownership. You need to compare that with overall crime stats .
Steve Hays "Steve, please provide for me the evidence that suggests that there will be more violent crimes. I'm not convinced that introducing more guns (in law-abiding hands) in Australia is going to help us reduce our rates of violent crimes."
Several issues:
i) In one of the links, C’zar Bernstein cites evidence regarding the deterrent effect of private gun ownership. But you couldn't be bothered to read the links.
ii) I don't accept you shifting the burden of proof as if the onus lies exclusively on me. You have your own burden of proof to discharge. It's not all on my shoulders.
iii) Likewise, although you are, of course, at liberty to frame the issue according to your own priorities, you can't impose that on me. In addition to stats, there are ethical issues:
iv) I believe in the right of self-defense. Therefore, even if (ex hypothesi) private gun ownership didn't reduce violent crime overall, there's more at issue than the sum total. There's the right of individuals to protect themselves and their dependents.
Other people may choose not to take advantage of that option. But that ought to be an option.
Take a woman who's endangered by the stalker ex-boyfriend. Or a woman who lives in a seedy part of town because that's all she can afford at the moment. It's a high crime area, so she carries a gun for self-protection.
Now, whether or not the availability of guns lowers violent crime generally is, I'd say, irrelevant to her right to protect herself. She's a person, not a statistic. The fact that it prevents some crimes which would otherwise occur is sufficient justification on moral grounds alone. Innocent people have a standing right to protect themselves. That's an individual right. It's not counterbalanced by the right not to be protected in some utilitarian calculus.
In addition, guns are always available to the criminal class. It's not as if disarming private, law-abiding citizens disarms robbers, muggers, rapists, house-burglars.
Anti-gun laws are irrelevant to the criminal class because they break the law, including laws against gun-ownership. Indeed, there's a lucrative black market in gun-running. That's an entrepreneurial opportunity for enterprising crooks. Disarming her doesn't make her safer from would-be assailants. Not to mention that it doesn't take a gun to assault a woman.
v) Likewise, there's the principle of limited gov't. Beyond a certain point–and we reach that point very fast–the more you empower gov't, the more you disempower the governed. As a rule, I think the least gov't is the best gov't. The power that can be used for good can be used for evil. A gov't that has a monopoly on violence is a gov't with a police state apparatus. That's a recipe for a totalitarian state.
BTW, this isn't hypothetical. The vice is tightening on Christians Down Under:
Psychiatric treatment is not a panacea. You can’t fix a broken mind the way you can fix a broken clock.
Certainly some people benefit from psychiatric treatment. In some cases, psychotropic drugs keep mentally ill/unstable people sane and functional.
However, psychotropic drugs can backfire. People can do crazy things on psychotropic drugs. Do it because of the meeds.
Moreover, the psychological/psychiatric community is full of secular quackery.
Furthermore, we don’t want to make it easy for the state to involuntarily commit someone. Not only is that, in itself, easily subject to abuse, but there’s the additional potential abuse that occurs given involuntary commitment.
At the risk of stating the obvious, the insanity plea is a classic way of shifting blame away from the perpetrator. So we need to take those claims with a grain of salt. For instance, it wouldn’t surprise me if Dylann Roof’s lawyer mounts an insanity defense, based on Roof’s use of psychotropic drugs. Point is, people needn’t be crazy to commit atrocities–they need only be evil.
Per Mr Roof, the problem with the insanity plea is that it assumes clinical psychiatry to be an exact science like physics or chemistry rather than the tommyrot it is, allowing mere speculation by a profession opposed to capital punishment to stay the hand of the civil magistrate. I someone is abled to plan and execute as Roof was, how mind-altering can such drugs be?
ReplyDeleteKirk Skeptic
Delete"Per Mr Roof, the problem with the insanity plea is that it assumes clinical psychiatry to be an exact science like physics or chemistry rather than the tommyrot it is, allowing mere speculation by a profession opposed to capital punishment to stay the hand of the civil magistrate. I someone is abled to plan and execute as Roof was, how mind-altering can such drugs be?"
1. On the one hand, I don't excuse let alone defend Roof. Not at all.
2. On the other hand, not all psychiatry is necessarily "tommyrot."
a. I'm not sure psychiatry should be held to the same scientific standard as physics or chemistry. Broadly speaking, psychiatry deals with mental illness, and for starters the human mind isn't necessarily quantifiable in the same way physics is.
b. In fact, I'd say a lot of medicine isn't "an exact science like physics or chemistry." Yet is there a reasonable person who wouldn't think medicine is scientific to some significant degree?
c. There are indeed core aspects of psychiatry which have a strong scientific basis. For example, a psychiatrist may have to distinguish whether a person has delirium or dementia. A psychiatrist may begin by looking at a complete blood count, electrolytes, glucose, a renal panel, chest x-ray, oxygen saturation, etc. Sometimes they might even investigate further ordering or performing tests like arterial blood gases, EKGs, EEGs, CT and MRI scans of the head. The psychiatrist needs to be able to interpret these tests in a way relevant to their patient's treatment and management.
Another example is a psychiatrist can test for substance abuse (e.g. alcohol, illicit drugs). They can directly test using blood and urine screens, creatinine phosphokinase and aspartate aminotransferase elevations, etc. A psychiatrist may need to help manage alcohol and other drug withdrawals including signs and symptoms like seizures, spasms, perhaps even crashing patients (although for the latter they may need the assistance of other colleagues). Point being, the psychiatrist needs to have a strong knowledge of pharmacology and various pharmacotherapies, among other scientific and clinical disciplines, in order to do these well.
None of the above has anything to do with culpability of a person able to plan and commit enormity; indeed it has been documented that psychiatric testinmony in trials can be rather confused and confusing (see my blog series on Christian counseling). Again, the entire concept of "mental illness" has no scientific vasis, as Dr Szasz demonstrated that it is an oxymoron (ie, a mind can't be ill any more than an idea can be purple). A brain can be ill, as illness is physical, but mind is something altogether different. I think you will agree that psychiatry and clinical psychiatry are responsible fgor a lot of exculpatory kaka de toro, from Spock-coddling rotters to mollycoddling thugs...and yes, medicine is not without its share of guilt, so why add to it by countenancing psychiatric testimony?
DeleteBTW any physician can order the tests you mention, and many (including myself) have to distinguish between delirium and dementia, but neither has anything to do with evil - a category psychiatry and psychology are most uncomfortable dealing with because of that Romans 1 thing.
Kirk Skeptic
Delete"None of the above has anything to do with culpability of a person able to plan and commit enormity"
I explicitly stated I neither excuse nor defend Roof.
"indeed it has been documented that psychiatric testinmony in trials can be rather confused and confusing (see my blog series on Christian counseling)."
1. Yes, of course. I don't disagree.
2. However, you're conflating "psychiatric testinmony [sic] in trials" with "Christian counseling." The two aren't necessarily equivalent. For example, it's comparing apples to oranges to compare "trials" with counseling sessions (as I presume you would know if you're a physician). Also, not all "Christian counseling" involves psychiatrists.
3. This takes us far afield, but what you say isn't limited to psychiatric testimony. Many other types of testimonies can be "confused and confusing."
"Again, the entire concept of 'mental illness' has no scientific vasis, as Dr Szasz demonstrated that it is an oxymoron (ie, a mind can't be ill any more than an idea can be purple)."
1. I wasn't using "mental illness" in the way Szasz uses the term since I wasn't sparring with Szasz but rather your contention that "psychiatry" is not "an exact science like physics or chemistry" as well as your assertion that "psychiatry" is "tommyrot."
2. Besides, I do agree with a lot of what Szasz says.
"A brain can be ill, as illness is physical, but mind is something altogether different."
Why can't one be a substance dualist, but also an interactionist when it comes to mind?
"I think you will agree that psychiatry and clinical psychiatry are responsible fgor a lot of exculpatory kaka de toro, from Spock-coddling rotters to mollycoddling thugs..."
I don't have a problem saying this.
At the same time there are many psychiatrists who practice psychiatry in medically informed and responsible ways (e.g. Christian psychiatrists).
"and yes, medicine is not without its share of guilt, so why add to it by countenancing psychiatric testimony?"
1. I haven't faulted medicine here. These are your words, not mine.
2. However, to answer your question, that's because you said "psychiatry" is not a "science," but modern psychiatry has a strong basis in medical science (for which I've given examples).
"BTW any physician can order the tests you mention, and many (including myself) have to distinguish between delirium and dementia"
Delete1. I didn't simply say a psychiatrist could "order the tests" and that's it. Rather, I said a psychiatrist would have the medical knowledge to do so, would know how to appropriately interpret the tests, would know how to medically treat and manage patients, etc.
2. What you say may in fact help prove my point. If psychiatrists can do all these things too, then either it doesn't take much medical education and training to do all these things, or psychiatrists should be considered physicians just like other physicians.
3. If you're a physician, then why do you denigrate the entire field of psychiatry by calling it "tommyrot"? Indeed, you have less excuse if you're a physician, because you ought to know better than the general public.
4. By the way, I'm not sure why you differentiate "psychiatry" from "clinical psychiatry." It's as if you're attempting to imply psychiatrists don't practice clinical medicine. Or perhaps you're working with a dated material.
"but neither has anything to do with evil - a category psychiatry and psychology are most uncomfortable dealing with because of that Romans 1 thing."
1. Once again, I have no issue with saying what Roof did was evil. Indeed, I explicitly stated I neither excuse nor defend Roof.
2. There are many otherwise faithful Bible-believing Christian psychiatrists who don't see a conflict or inconsistency between calling evil evil and practicing good psychiatry.
3. There may be aspects to modern psychiatry which a Christian psychiatrist would have no problem heartily disagreeing with. But this doesn't mean all psychiatry is "tommyrot."
In short, sure, there are many bad aspects to modern psychiatry, but this doesn't mean all psychiatry is "tommyrot" and isn't scientific. Don't throw out the baby with the bathwater.
DeleteThe basis of psychiatry is a secular understanding of both mind and man which is at odds with what God says about them. Even if psychiatry were divorced from the coercive power of the State - which will happen no time soon - the humanistic presuppositions would not be righted. The new DSM is nothing but a DNC playbook, replete with made-up "diseases" like gender dysphoria, and prescriptions for genital mutilation and hormonal "therapy" described as "medically necessary." You have an interesting view of science.
DeleteThe Christian practitioner faces the dilemma of any dichotomiSt, particularly when giving testimony - which is supposedly based on his expertise in a scientific field. Do you believe that there is any science here, when psychiatrists can differ so widely on the culpability of a defendant? Antibody testing, viral loads, genotypes, and APRI's give me an objective picture of a person with hepatitis c, and none of that information depends upon my views on capital punishment, queer theory, or whether the patient is a lesbian Eskimo albino. The testimony issue is important because it shows both a lack of science and ethics in psychiatry; ie the profession should eschew legal involvement and call it the quackery that it is, but hasn't done so for what I can reasonably suspect to be pecuniary intererest.
Anyway, show the baby
"The basis of psychiatry is a secular understanding of both mind and man which is at odds with what God says about them."
DeleteThis is an assertion without an argument.
"Even if psychiatry were divorced from the coercive power of the State - which will happen no time soon - the humanistic presuppositions would not be righted."
You're ranging far and wide. You keep going off on tangents.
I myself have said nothing about the state thus far in my interactions with you. Although I happen to think what Steve Hays said in his post about the state is entirely correct.
"The new DSM is nothing but a DNC playbook, replete with made-up 'diseases' like gender dysphoria, and prescriptions for genital mutilation and hormonal 'therapy' described as 'medically necessary.'"
No doubt. But as you ought to know if you're a physician, there's considerable disagreement and debate among psychiatrists over the DSM-5. One can be a psychiatrist without subscribing to the entire DSM-5.
"You have an interesting view of science."
I'm just responding to you on your own terms.
If you wish, you can go ahead and attempt to define "science."
"The Christian practitioner faces the dilemma of any dichotomiSt, particularly when giving testimony - which is supposedly based on his expertise in a scientific field."
Ok.
"Do you believe that there is any science here, when psychiatrists can differ so widely on the culpability of a defendant?"
You're generalizing. Psychiatry as a field isn't limited to courtroom testimonials. Many if not most psychiatrists don't even testify in court as part of their job.
"Antibody testing, viral loads, genotypes, and APRI's give me an objective picture of a person with hepatitis c, and none of that information depends upon my views on capital punishment, queer theory, or whether the patient is a lesbian Eskimo albino. The testimony issue is important because it shows both a lack of science and ethics in psychiatry; ie the profession should eschew legal involvement and call it the quackery that it is, but hasn't done so for what I can reasonably suspect to be pecuniary intererest."
I'm by no means defending all psychiatrists, just as I wouldn't defend all physicians and surgeons. But you're just demonizing psychiatrists here. Ironic, considering you're a physician. What makes you think the day to day work of a typical psychiatrist involves regularly expressing their views on "capital punishment, queer theory, or whether the patient is a lesbian Eskimo albino"?
"Anyway, show the baby"
Sorry, that's not up to me, but rather up to you. I'm not the one who is contending psychiatry as a field is "tommyrot" and then doubling-down by calling psychiatry "quackery," by demonizing psychiatrists, by inferring greed in why they are giving testimonies as if this applied to all psychiatrists who give testimonies in court, etc.
Once again it is you who dodges the issue: if a person is "criminally insane" it should be objectively demonstrated and irrespective of personal bias - that is, if it were a matter of science. I - as has Szasz and other psychiatrists - claim that it is not science at all. If it is not science, what is it: art? personal opinion? Where is the science here? C'mon, out with it.
DeleteAs for humanistic presuppositions, are you suggesting that the lack of understanding of total depravity, imago Dei, the Law of God written on the heart of man, etc, in psychiatry has no ramifications vis-a-vis diagnosis and therapeutics - let alone, legal testimony? Dichotomists have yet to hermetically seal their compartments.
Whether or not you (assuming you are a clinician) recognize DSM-5 or not, the profession per se does, and its governing bodies have the say-so. Shouldn't such "scientific" poobahs and nabobs be able to see through the smoke-blowing? Again, lack of objectivity vis-a-vis what is and ain't science buttresses my claim - as does the DSM's burgeoning doagnoses making almost everyone a psych patient (what would they have said about Christ?).
Let's look at the pseudoscientific jargonese spewed forth as if from Sinai: what really is an Axis Ii diagnosis but a clinical way of calling a patient an anatomic pejorative? What does "medically necessary" mean, and how does that jibe with the "scientific diagnosis" of gender dysphoria? Why do the poobahs and nabobs deem mutilation and hormones for someone who thinks God made a mistake, and call it "medically necessary?" If it's so scientific and medically necessary, why did JHU ditich its genital mutilation department? Why can't you just look at the claims and evidence and see that there's a very minute baby in a tsunami of bathwater?
Why can't you also admit that lay counselors have performed as eelll as paid professionals, and that the therapeutica alliance between a troubled person and an empathetic decent human being is a beautiful relationship which need not be transmogrified by dressing it in a lab coat?
Furthermore, why can't you look at diminishing income over time and burgeoning psych diagnoses over time(DSM-1 through DSM-5) and not at least propose the logical connection? Why won't you admit that your credibility is sullied by bogus testimony where no true expertise exists, bogus diagmoses liek gender dysphoria, bogus pronouncements on childrearing, etc, ad nauseam? It is yiu who assert that psychiatry is science, and it is high time you back your assertion.
"Once again it is you who dodges the issue: if a person is 'criminally insane' it should be objectively demonstrated and irrespective of personal bias - that is, if it were a matter of science. I - as has Szasz and other psychiatrists - claim that it is not science at all."
DeleteYou're attacking a strawman. I never took issue with psychiatry's idea of the criminally insane. (And you're illicitly assuming there's psychiatric consensus on the topic.) Rather, I took issue with your assumptions about psychiatry.
"If it is not science, what is it: art? personal opinion? Where is the science here? C'mon, out with it."
For starters, you'd have to tell me what you mean by science.
"As for humanistic presuppositions, are you suggesting that the lack of understanding of total depravity, imago Dei, the Law of God written on the heart of man, etc, in psychiatry has no ramifications vis-a-vis diagnosis and therapeutics - let alone, legal testimony?"
Nope, that's not what I'm suggesting.
"Dichotomists have yet to hermetically seal their compartments."
A naked assertion.
"Whether or not you (assuming you are a clinician) recognize DSM-5 or not, the profession per se does, and its governing bodies have the say-so. Shouldn't such 'scientific' poobahs and nabobs be able to see through the smoke-blowing? Again, lack of objectivity vis-a-vis what is and ain't science buttresses my claim - as does the DSM's burgeoning doagnoses making almost everyone a psych patient (what would they have said about Christ?)."
Do you automatically genuflect to anything and everything your "profession" and "its governing bodies" lay down?
"Let's look at the pseudoscientific jargonese spewed forth as if from Sinai: what really is an Axis Ii diagnosis but a clinical way of calling a patient an anatomic pejorative? What does 'medically necessary' mean, and how does that jibe with the 'scientific diagnosis' of gender dysphoria? Why do the poobahs and nabobs deem mutilation and hormones for someone who thinks God made a mistake, and call it medically necessary?' If it's so scientific and' medically necessary, why did JHU ditich its genital mutilation department? Why can't you just look at the claims and evidence and see that there's a very minute baby in a tsunami of bathwater?"
None of this conflicts with anything I've said. Sorry to say you're wasting your breath here.
"Why can't you also admit that lay counselors have performed as eelll as paid professionals, and that the therapeutica alliance between a troubled person and an empathetic decent human being is a beautiful relationship which need not be transmogrified by dressing it in a lab coat?"
Wow, once you start going, you don't stop, do you? You're again tilting at windmills, for I have no quarrel with any of this.
By the way, you're equivocating when it comes to "lay counselors" and "psychiatrists."
"Furthermore, why can't you look at diminishing income over time and burgeoning psych diagnoses over time(DSM-1 through DSM-5) and not at least propose the logical connection?"
Delete1. You're acting as if you gave this argument in your previous reply. But all you previously said was "the profession should eschew legal involvement and call it the quackery that it is, but hasn't done so for what I can reasonably suspect to be pecuniary intererest."
In other words, your original contention was just calling psychiatrists who testify in court greedy but without supporting evidence or argument.
Now that you provide a supporting argument, you act as if I'm the one who missed it. If you're intentionally doing this, then that's not arguing in good faith. And to do so is unbecoming of a professing Christian.
2. Anyway, you don't provide evidence for this supporting argument. Not even a citation. Yet you should know better if you're a physician.
3. Also, even if this is true, you'd have to show more than mere correlation here. But "a logical connection" is not identical to a logical causation.
4. Plus, if (as you allege) psychiatry incomes have fallen over time while "psych diagnoses" are "burgeoning," then where's the financial benefit for psychiatrists? It seems like you're shooting yourself in the foot here.
5. Finally, as I've already pointed out, there are many psychiatrists who strongly disagree with the recent DSM.
"Why won't you admit that your credibility is sullied by bogus testimony where no true expertise exists, bogus diagmoses liek gender dysphoria, bogus pronouncements on childrearing, etc, ad nauseam?"
Not sure why you're attacking me personally. Why do you think my credibility is sullied? I'm not involved in any of this. I don't do any of this.
But nice jumping to conclusions about me, and attacking me. Your behavior towards me here is more telling of you than me.
"It is yiu who assert that psychiatry is science, and it is high time you back your assertion."
1. No, I never asserted "psychiatry is science" simpliciter. Rather, I said there are core aspects of psychiatry which have a strong scientific basis, and indeed I gave examples relevant to psychiatrists which, insofar as I can tell, you haven't overturned. Anyone can read what I've said above and see this.
2. Let's get this straight. You're the one claiming psychiatry is "tommyrot" and there's evidence of "both a lack of science and ethics in psychiatry."
But now the onus is on me (alone?) to prove psychiatry is a science while you can sit back? Sorry, that's not how it works. You have your own burden of proof to bear as well.
3. In any case, I don't have to prove psychiatry is a science to disprove or otherwise undermine your contentions. I just need to undermine your contentions.
You just asserted that psychiatry has a strong scientific core - now that's an assertion sans proof (ie whatyou accuse me of - rather telling of you, no?).
DeleteAs for kowtowing to poobahs and nabobs, I don't; then again, I don't believe my discipline to be a science, for science per se isn't done by guess and opinion but by fact. That doesn't deligitimize everything we do, but does note limits. When FP's and pediatricians waffle on about how corporal discipline is wrong, I ignore them; when, as the head of the AAFP spoke out against religious exemptions from immunizations, I called him out (as did many other docs). Medicine remains an art with some scince thrown ino the mix, Lewis Thomas notwithstanding; when its representatives play scientistic poobah and prods the coercive arm of the State, then it loses credibility - just like psychiatry.
If you are at all familiar witht he presupositions of psychiatry and psycholigy, you would note the lack of concept of sin; sorry, but that's humanistic. How familiar are you with the literature of those disciplines? Having rotated on pspychiatric services and tended such patients I, while no expert, am no novice. That there are honest and decent psychiatrists does not change the facts of the underpinnings of the profession. Legal testimony, and DSM-5 illustrate this rather graphically; read Szasz on "sluggish schizophrenia" and then tell me where you stand. BTW per your point 4' with deceasing reimbursements the pressure to branch out into other arenas to bring in income is what I was referrring to; expert testimony isn't given gratis. This is not unique to psychiatry, as too many docs ar wiling to serve as what we call"disability whores" in getting able-bodied patients on the dole, and the ubiquitous Dr Feelgood types who are but licensed pushers. The difference is that the latter two examples abuse their training, while the former is recognized by the profession as being in good standing. It is sad that the decent Christian psychiatrist must buck his own profession's doctrine and standards, but that he must in order to be decent and Christian; he must engage in cherry-picking and answering boards according to what they want to hear. This is not how science is done.
Undermining examples suggests counterexamples, of which you supply none. Without such, your arguemnt reduces to a Pythonesque "no it isn't." Since you claimto be all about good behavior towards an opponent, kindly practice what you preach.
So if your quarrel with me is that I overgeneralize, show me where; ie provide some specifics.
To continue: merely ordering blood tests, EEG's, etc, is not psychiatry, as none of these tets mind per se: physical tests test physical entities, like a brain. Do you assert that mind and brain are the same? The fact is that there is no objective measurement of mind; dementia is a brain disease, where psychiatric diagnoses are bereft of physical lesions - this is what is demanded of a physical diagnosis. My example of diagnosing and following hepatitis c shows objective and irreffutable evidence of a lesion. The psychiatrist who diagnoses the "diseases" of alcoholism and gender dysphoria has no such advantage. Besides, to which discipline does the psyche belong: medicine or divinity? Does psychiatry show greater efficacy than what was once called "cure of souls?" If so, how and wher? How is a mind cured, and how do you know? I can measure transaminases and viral loads for a patient with hepatitis c, but what of a patient with bipolar disorder II?
ReplyDeleteI think this comment would be a good place for any interested readers to start if they haven't followed the back-and-forth so far, because it attempts to get to the real meat of the debate.
ReplyDeleteKirk Skeptic
1. There's a lot of emoting, huffing and puffing, and other similar theatrics on display in your recent comments. But I think I'll take a pass on all this, thanks.
2. Since you're a Thomas Szasz devotee, it'd be best to go straight to the source and comment on Szasz.
Before I do, though, I'll just reiterate I agree with a lot of what Szasz has said. He did some helpful work. But he's far from perfect.
3. For starters, I think some of Szasz's criticisms are grounded in a dated knowledge about medical science. He's predominantly sparring with psychiatry in the mid-20th century or so. He lived until 2012, but at least as far as I can tell most of his best work was done in the 20th century.
4. A lot has changed since Szasz first came on the scene in the mid-20th century. In fact, Szasz has inspired many young psychiatrists (among other health professionals) to change the field of psychiatry. In this respect, a lot of Szasz's criticisms of psychiatry and psychology are no longer relevant today because his disciples reshaped much of psychiatry according to Szasz's mold.
5. However, as the British psychiatrist Theodore Dalrymple aka Anthony Daniels has noted, Szasz was quite "dogmatic" over "mental illness" not being real:
"Thomas Szasz, a brilliant but dogmatic polemicist (as well as a professor of psychiatry), overcame this problem by denying that psychiatric disorder existed. According to Szasz, bizarre, distressing, or harmful behavior was either the result of an objectively observable pathology - hypothyroidism, say, or hypoglycemia, Cushing’s syndrome, or a brain tumor - or the patient was wholly responsible for it and suffered from nothing but a moral defect."
Yet that appears to be a false dichotomy. For example, take depression. Is depression merely neurotransmitter dysfunction and naught else, as Szasz might say? If we fix the neurotransmitter dysfunction, then we've cured depression? But what about the psychosocial components?
6. I suspect Szasz's libertarianism drove a lot of his psychiatry. For instance, he couldn't countenance instances in which it may have been reasonable to restrain a psych patient (e.g. to keep them from harming themselves, to keep them from harming others). I suspect that's due at least due in part to his libertarianism since he wouldn't have wanted to see any persons ever restrained against their will.
7. Some people who suffer from mental illness experience symptom relief with medication. Whatever the ultimate source of their mental illness, psychotropic drugs make their condition manageable. Restore sanity. Enable them to function. So there can be a physical component (the brain, pharmaceuticals) to treatment, where nothing else works, regardless of whether that goes to the root cause. Maybe it just suppresses the underlying problem. But it's enough to make the difference: a huge difference.
8. I wonder how Szasz would have classified the psychological impact of demonic possession.
9. This article might be worth reading for some: "The Myth of Thomas Szasz" by Jeffrey Oliver.
10. Steve Hays has a fine blog post on nouthetic counseling, which involves Jay Adams, one of Szasz's most well-known disciples, and relevant to the Reformed community.
11. Dr. David Martyn Lloyd-Jones has been a critic of Thomas Szasz in his lecture "Body, Mind, and Spirit":
DeleteThe third category to which your patient, or enquirer, may belong is the psychological. I use that general term, but if you prefer it, it could be "mental illness." This is at the present time an important consideration because we are now in the midst of one of the latest crazes, or fashions, in the Christian, and even evangelical, world. The concept of "mental illness" has come under attack at the present time, mainly as the result of the writings of Thomas Szasz. He has written a number of books such as The Myth of Mental Illness, The Manufacture of Madness, Ideology and Insanity.
What is Szasz's thesis? He contends that this regarding of people as mentally ill, and treating them accordingly, is but the latest manifestation of something which has taken place for centuries. In the Middle Ages, he claims, it was the punishment of heterodoxy by the church. A heretic was ostracized and punished in various ways by the Inquisition. This gradually passed out of fashion and was replaced by witch hunting, and this latter lasted until the end of the seventeenth century in this country and in America. What do they do now? Szasz's reply is, "they diagnose people as being mentally ill and put them in various institutions." The argument is that this is precisely what is happening and that it is something we have to resist.
This man Szasz and his writings are not only interesting, but entertaining. He is a brilliant writer and an able man. If you want some enjoyable reading you should sample some of his books, which are available, for example, in the library of the Royal Society of Medicine and may have been imported, or printed, in Britain by now. There is a good deal of truth in what he says. He is an anti-Freudian and he is attacking what has become a cult - "Send him to a psychologist." Everyone is labelled and everything is covered by the psychological. Szasz discusses the financial aspects of this - and it needs to be dealt with. But what concerns him still more is the element of moral judgement that is involved. Sometimes a man becomes labelled in a moral sense by his wife, family and the doctor. He may be completely helpless and he is simply handed over to treatment in some form. He is assessed, judgements are passed on him and if this process continues and becomes more prevalent there will be an acute danger to individual liberty.
The press, from time to time, gives glimpses of what - in an extreme form - is happening in Russia. But there is no doubt at all that in America some of the same sort of thing in a polite form has entered a lot into industry. Men fail to get a post, or are sacked, on such psychologists' categorisations. People who are in any way different may find themselves labelled, a judgement will be passed and they will be manipulated in spite of their wishes. Szasz is concerned to point out how these psychologists (or sometimes even psychiatrists) take it upon themselves to pass sweeping opinions. Everyone can be explained - Hamlet, for example, or Darwin, as indicated above. But this trend is not simply confined to a few postmortem diagnoses. The writer quotes a case of a man setting up to run for election as President of the U.S.A. who was assessed in this way. The report was published in the newspapers, and there were people ready to believe it and to regard these psychologists as having a complete understanding of human nature and the characteristics and foibles of any given individual.
DeleteSo Szasz emphasises the tremendous danger. What he is out to prove is that you read what they did with people considered "mad" in the past, and you are horrified; but, he urges, they are doing exactly the same now in a more polite way. In his book The Manufacture of Madness he point out,
"As recently as 1860 it was not necessary to be mentally ill to be incarcerated in a maniacal mental institution. It was enough to be a married woman! When the celebrated Mrs. Packard was hospitalized in Jacksonville State Insane Asylum for disagreeing with her minister husband, the commitment laws of the State of Illinois were such that married women could be entered or detained in the hospital at the request of her husband or guardian, without the usual evidence of insanity required in other cases!"
This woman was thrown into an asylum for venturing to disagree with her "minister husband"!
What is your reaction to such a statement? I am sure that most of you would bemoan the fact that human beings could ever have been guilty of such conduct. (Though one or two present may be muttering to themselves, "Those were the days!") However, I am convinced that Szasz completely overstates his case. While there is a considerable element of truth in much that he says, he goes too far in saying that there is no such thing as mental illness. Unfortunately, too, he now has a number of followers who are writing up his views in popular books. One of the best know is Jay Adams with his widely selling Competent to Counsel. But he is just a popularizer of Thomas Szasz and he is simply affirming, with Szasz, that there is no such entity as mental illness, that the patients are really suffering from sin and need to be dealt with purely in a scriptural manner. These writers reprimand those sufferers and counsel them with great severity.
It is necessary for us to work with those in this field who have to establish the reality of mental illness, otherwise we are going to be guilty of great cruelty to some of those who come to consult us. Why would I affirm the reality of such illness? I suggest that the familiar (hereditary) element in the case histories alone is sufficient to establish it. Another factor is the periodicity so characteristic of many cases - clear, lucid intervals, and then a recurrence. Not only that, but there are many cases of mental illness which do not respond at all to spiritual, scriptural treatment and, indeed, are even made worse by this.
DeleteI would argue along the following lines. There are various psychological types. Some persons are placid, some are mercurial and others are temperamentally different. In mental illness these variations are carried further as disease entities. It is, at least, becoming more popular today to take the view that mental illness results from defects in the chemistry of the brain, just as diabetes results from derangement of the chemistry of the pancreas. Difficult as it may be to classify them, there are obviously some clear clinical entities in mental medicine.
In history there have been cases which clearly establish the fact of mental illness. One that is outstanding is William Cowper the poet. He was a dedicated Christian man, who knew evangelical doctrine and delighted in it. But he had periodic attacks of his mental condition. His friends reasoned with him, and did all that we are often told we should do to help our cases, but without result. It rather made him worse and added to his distress.
A Puritan writer of three hundred years ago - Richard Baxter - in a most remarkable manner reveals great insight at this point. Baxter, better than anyone I have ever read on this subject, provides us with the differential diagnosis between a spiritual and a mental case. He says,
Delete"I do not call those melancholy who are rationally sorrowful for sin, and sensible of this misery, and solicitous about their recovery and salvation, though it be with as great seriousness as the faculties can bear. As long as they have sound reason, and the imagination, fantasy or thinking faculty is not crazed or diseased. But by melancholy [i.e. mental illness] I mean this diseased craziness, hurt or error of the imagination, and consequently of the understanding, which is known by these signs."
He then gives thirty-five points in the differential diagnosis between what may be called "mentally ill" cases as distinct from those who are in "spiritual" distress...
And on he goes with his list of thirty-five points. But he ends in the following way:
"Point 35. Yet in all this distemper, few of them will believe that they are melancholy [melancholic, or mentally disturbed], but abhor to hear men tell them so, and say it is but the rational sense of their unhappiness, and for the forsakings and heavy wrath of God. And therefore they are hardly persuaded to take any physic or use any means for the cure of their bodies, saying they are well, and being confident that it is only their souls that are distressed. This is the miserable case of these poor people greatly to be pitied, and not to be despised by any. I have spoken nothing but what I have often seen and known, and let none despise such, for men of all sorts do fall into this misery, learned and unlearned, high and low, good and bad; yea some that have lived in greatest jollity and sensuality when God hath made them feel their folly
I cannot add to that. I do hope that people who tend to follow Thomas Szasz and his popularizer Jay Adams will take all that to heart.
As far as my own experience would go, I would summarize Baxter's thirty-five points in the following way: I think that you will find almost invariably that those who are mentally ill do not really listen to you. You quote Scripture, they do not listen. They keep repeating the same statements and give the impression that they are waiting for you to finish so that they can say their piece over again. This is almost invariable. You notice the difference as compared with those in spiritual trouble. The latter are anxious to have help. The others are not. I always feel with them that I am a kind of tangent to a circle. One never penetrates, they are almost impatient and go on repeating the same thing.
12. According to the IEP:
DeleteSzasz’s critics have responded along several lines.
[a] Some do not take issue with his underlying understanding of the illness concept but disagree with his claim that it is not applicable to mental phenomena. Mental illnesses, according to these critics, have been (or will soon be) reducible to neurological or neurochemical dysfunction. They argue that advances in neuroscience give us reason for thinking that the prospect for finding the neurological or neurochemical correlates for at least some of our mental illnesses categories is high (Bentall 2004, 307).
[b] Other critics have argued instead in the other direction and attacked Szasz’s construal of physical illness. Szasz’s arguments have been taken, by some, to imply that physical illness itself is a deeply evaluated category reflective of value-judgments in much the same way mental illness is meant to on Szasz’s account (Fulford 2004; Kendell 2004).
[c] Still others have aimed to preserve Szasz’s primary claim that the overarching category of ‘mental illness’ will prove to be a non-natural interactive-kind, reflective of our values and practices, while simultaneously maintaining that “particular kinds of mental illnesses may yet constitute valid scientific kinds” (Pickard 2009, 88).