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For the Record

"The enemy of my enemy is my friend."

"The modern [psychiatry] resident simply views Szasz's ideas as irrelevant. ... organized psychiatry has shabbily treated Szasz. Few psychiatrists even tried to deal with the serious issues he raised by responding with calm and reflective dialogue. Rather, he was attacked in the worst kind of ad hominem ways and subjected to scorn and ridicule. I have always felt that if organized psychiatry had responded to his first critical book, The Myth of Mental Illness, with a truly intellectual dialogue, that perhaps Szasz would have been more temperate in his later writings. ... I hope that some day the APA will find a way of honoring Dr. Szasz as a scholar who, whether right or wrong, has made significant contributions to the intellectual dialogue dealing with our understanding of mental illness. A man who has written 22 books on psychiatry and who is widely read throughout the world should not go unnoticed by our professional organizations. Perhaps, if our leaders formally acknowledged his intellectual relevance, we might find that out students would be more open to thinking about a broader variety of ways to view their patients." -- Seymour L. Halleck, M.D., review of A Lexicon of Lunacy: Metaphoric Malady, Moral Responsibility, and Psychiatry, New Brunswick, NJ: Transaction Publishers, 1993. Academic Psychiatry,, 17: 165-167, 1993.


Cf. Obituary, Judd Marmor, Psychiatrist who changed the view of homosexuality as a mental disorder, BMJ 2004;328:466 (21 February), doi:10.1136/bmj.328.7437.466
and
"Treating homosexuality as a sickness: Summary of responses. BMJ 2004;328:956 (17 April), doi:10.1136/bmj.328.7445.956-a

Giving Marmor Credit for the Idea that Homosexuality is Not an Illness is Undeserved 21 February 2004

Jeffrey A. Schaler, Ph.D.,
Assistant Professor, Department of Justice, Law and Society, School of Public Affairs
American University, 4400 Massachusetts Avenue, N.W., Washington, D.C. 20016-8043 U.S.A.
Email Jeffrey A. Schaler, Ph.D.


Sir:

Re: Obituary. Judd Marmor: Psychiatrist who changed the view of homosexuality as a mental disorder. BMJ 2004;328:466 (21 February).

Although the Latin proverb, "De mortuis nil nisi bonum," enjoins us that "Of the dead, we should speak kindly or not at all," giving Marmor credit for the idea that homosexuality is not an illness is undeserved. In fact, he deserves blame for knowingly borrowing this idea from Thomas Szasz, and claiming it as his own.

In the first edition of the book on homosexuality that he edited, Sexual Inversion: The Multiple Roots of Homosexuality, (New York: Basic Books, 1965), Marmor included a chapter by Szasz. In that chapter, published 5 years after his paper titled "The myth of mental illness" (later the title of his book), Szasz set forth his case against viewing homosexuality as a mental illness. Revealingly, Marmor, in his Introduction to the volume, wrote: "Is homosexuality an ’illness,’ or is it merely a different ‘way of life'? Most of the psychoanalysts in this volume (except Szasz) are of the opinion that homosexuality is definitely an illness to be treated and corrected" (p. 15).

Marmor's parenthetical phrase, "except Szasz," clearly indicates that Marmor, also a psychoanalyst, did not then share this view. (He never ceased his bitter opposition to Szasz's views.) In that book, Marmor never asserted that homosexuals are not mentally ill and regularly referred to them as "patients."

Ronald Bayer, in his definitive Homosexuality and American Psychiatry: The Politics of Diagnosis (New York: Basic Books, 1981), wrote: "It was Thomas Szasz who attempted to shift the terms of discussion to a conceptual level, focusing his attack on both the underlying ideological assumptions of psychiatry and the power of the profession in contemporary society. ... For Szasz the fundamental self-serving error of psychiatry was its effort to claim that deviations from behavioral norms were illnesses..." (Pp. 54-55).

Moreover, Szasz did not simply assert that homosexuality is not an illness, he asserted, and showed why, none of the (mis)behaviors psychiatrists classify as mental illnesses are illnesses. This, as Bayer recognized, was too much for psychiatry to stomach: Szasz's "far-reaching critique could not serve as the basis for the transformation of psychiatric thinking on homosexuality. To follow Szasz would have required a radical rupture with the deepest commitments of contemporary psychiatry" (p. 60).

Bayer noted that Marmor's 1965 views on homosexuality were "seen by contemporary homosexual critics as supportive of the dominant pathological view [of mental illness]" (p. 61). Unlike Szasz, Marmor was a loyal psychiatrist, always ready to defend the profession from its critics.

In short, Marmor rescued psychiatry from its commitment to labeling and persecuting homosexuals as sick, while at the same time he carefully preserved the profession's privilege to label and persecute as mentally ill other deviants, such as drug abusers and transsexuals. For this, organized psychiatry was duly grateful to him.


References

Szasz, T. The myth of mental illness. American Psychologist 1960 Feb; 15: 113-118

Szasz, T. The myth of mental illness: foundations of a theory of personal conduct. New York: Paul B. Hoeber, 1961.

Szasz, T. Legal and moral aspects of homosexuality. In, Judd Marmor, ed., Sexual inversion: the multiple roots of homosexuality. New York: Basic Books, pp. 124-139, 1965.

Bayer R. Homosexuality and American psychiatry: the politics of diagnosis. New York: Basic Books, Inc., 1981.

Competing interests: None declared

Lock up those who need psychiatric care by Mona Charen, Jewish World Review, July 29, 1998

"Diseases are something we have, behavior is something we do." On this premise, Torrey develops his theory that the vast majority of people whom we call "mentally ill" have problems of living rather than physical disabilities. They are not ‘sick' and therefore must not be ‘warehoused' and ‘treated' on the basis of a medical model.

E. Fuller Torrey, The Death of Psychiatry (Radnor, PA: Chilton Book Company, 1974), dust jacket.

INSIDE FRONT COVER OF DUST JACKET
. . .

At this point, disciples of the medical model may answer: "What we really mean, of course, by mental 'disease' is brain disease." ... Indeed, there are many known diseases of the brain ... But these diseases are considered to be in the province of neurology rather than of psychiatry. ... None of the conditions that we now call mental "diseases" have any known structural or functional changes in the brain ... This is true not only for conditions with labels like "explosive personality" and "paranoid personality," but also for the behavior we categorize as "schizophrenia."
Ibid., pp. 38-39.
. . .

We abide by the tenet that it is not justified to lock up people for something they might do, for this is an infringement on our freedom. But not so with mental "patients." They are kept for indeterminate, and often interminable, periods for what they might do... As Szasz points out, a drunken driver is infinitely more dangerous to others than is a "paranoid schizophrenic," yet we allow most of the former to remain free while we incarcerate most of the latter."
Ibid., pp. 76, 89.
. . .

Another element which further muddles the scene is the way in which the term "schizophrenia" has come to be used, especially in the United States and the Soviet Union. ... As such the term has become meaningless and its demise, along with that of psychiatry itself, will be a welcome addition to clarity of thought. ... The term "schizophrenic" will wither away to the shelves of museums, looked back upon as an historical curiosity along with the crank telephone.... until we have more precise indicators, it is best that we err on the side of labeling too few, rather than too many, as brain diseased. In other words, a person should be presumed not to have a brain disease until proven otherwise on the basis of probability. This is exactly the opposite of what we do now as we blithely label everyone who behaves a little oddly "schizophrenic." Human dignity rather demands that people be assumed to be in control of their behavior and not brain diseased unless there is strong evidence to the contrary.
Ibid., pp. 160, 161.
. . .

When the concept of nonresponsibility is rejected outright, then people who [sic] we have called mentally "ill" are given back some of their dignity. ... there would be no such thing as depriving a person of his right to stand trial. Everyone would retain this civil liberty as guaranteed by the Constitution and it could not be usurped by a psychiatrist or a judge. ... It should not be possible to confine people against their will in mental "hospitals."
Ibid., pp. 179, 180.
--E. Fuller Torrey, M.D., The Death of Psychiatry (Radnor, PA: Chilton Book Company, 1974)


"Once a patient realizes that he has no disease, and so can never be cured, he might as well terminate his treatment. He may have been put in touch with good things in himself, and may even still be benefitting from the relationship with the therapist, but once he realizes that he can continue as a disciple in psychotherapy forever, only then can he see the absurdity of remaining a patient, only then does he feel free to leave."
--Sheldon B. Kopp, If You Meet the Buddha on the Road, Kill Him!, page 188.

Click here to view a scanned copy of the letter from Dr. Ellis

ALBERT ELLIS INSTITUTE
45 East 65th Street * New York, N.Y. 10021-6593
Phone: (212) 535-0822 * Fax: (212) 249-3582 * E-mail: info@rebt.org

March 27, 2002

C. Rodney Yoder
Chester MHC
1315 Lehman Dr.
Chester, IL 62233

Dear Mr. Yoder,

Thank you for your letter of March 19th and for all the material you sent me. You certainly are putting up a great fight and perhaps it will be successful.

I quite disagree with Dr. Thomas Szasz. I have debated with him in public and tried to show that he is almost completely mistaken in his view of mental illness. I have been in practice for almost 60 years and I have found many people who are severely mentally ill. They are often not treated very well and we have a stigma against them in our society but none-the-less they suffer from a severe biological and social disturbance and many of them, of course, resist treatment.

It may well be that you have been over-hospitalized and not treated very well and therefore you may be justified in fighting this kind of treatment. But I want to have nothing to do with any cause that promotes the idea that mental illness is a myth. Unfortunately, it is not.

Cordial regards,

(signed)

Albert Ellis, Ph.D.
President

AE/pw

A not-for-profit corporation charted by the Regents of the University of the State of New York
Formerly the Institute for Rational-Emotive Therapy

Click here to read a letter from Sir Isaiah Berlin to David Herman, dated June 14, 1988, an excerpt of notes by Berlin that appeared in the October 18, 2001 issue of New York Review of Books, and material by Szasz on Berlin.

"When I lived in the South, in the early 1960s, and worked in the civil rights movement, I saw psychiatric labels used all the time to denigrate SNCC workers. A few years ago, as a member of the Committee for Public Justice, I visited Soledad and Vaccaiville in California, where, unquestionably, vocal opponents of this society, especially those who belong to minority groups, have to contend, daily, with psychiatric coercion: tranquilizers used by jailers to bring silence, and various "conditioning techniques" similarly employed: isolation, food deprivation, especially burdensome work. I hate to nit-pick. I think Tom Szasz richly deserves the repeated commendations he has received from the ACLU; he's given American psychiatry the hard look it deserves."--Robert Coles, [PSYCHIATRY AND POLITICS, By Peter B. Reddaway, Sidney Bloch, Reply by Robert Coles, The New York Review of Books, March 9, 1978]

"My belief is that today, in 1998, you [the physician] should be put in jail if you refuse to prescribe S.S.R.I.s for depression. I also believe that five years from now you should be put in jail if you don't give crack addicts the medication we're working on now."
--Alan I. Leshner, Director, National Institute of Drug Abuse, quoted in Samuels, D. 1998. Saying Yes to Drugs. New Yorker, March 23, 48-49.

"There is only one true philosophical problem, and that is suicide" -- Albert Camus.

"Suicide is a fundamental human right. This does not mean that it is morally desirable. It only means that society does not have the moral right to interfere" -- Thomas Szasz, professor of psychiatry.

"Suicide is not a 'right' any more than is the right to belch" -- Edwin Shneidman, professor of psychiatry.
[October 13, 1993. Value-Free examination of the long goodbye, by Michael T. Kaufman. The New York Times, Section B, p. 3.]

"These stories cover a wide range of horrors. There is abuse by alcoholism counselors-many mentally ill themselves. . . . There are others who are driven to suicide by the cruel treatment they received in 12 step groups. . . .Those who contributed the stories here are strong and competent enough to perceive that what happened to them and around them in 12-step bedlam was wrong and harmful, and they had the courage to blow the whistle on it. This is an extremely healthy reaction that should be encouraged by those interested in mental health. . . . Thus in these stories we see people put up with incredible affronts to their dignity and their mental health." -- Stanton Peele, Ph.D., JD, Foreword to Twelve-Step Horror Stories. True Tales of Misery, Betrayal, and Abuse in AA, NA, and 12-Step Treatment, Compiled by Rebecca Fransway, Tucson, Arizona: See Sharp Press, 2000.

The Times (London)
Wednesday February 14 2001
Insanity defence set to be scrapped

By Frances Gibb, Legal Editor
"THE defence of insanity under English law, used for more than 150 years, is expected to be scrapped after a judge ruled that it breaches the Human Rights Act. A judge in Jersey said that the so-called McNaghten rules — which courts use to decide if offenders are insane — breach article five of the Act which guarantees the right to liberty. It is believed that a similar challenge would succeed in England and Wales and lawyers predict that ministers are likely to review the law. The ruling was made in a case at the Royal Court of Jersey by Sir Philip Bailhache, the Bailiff. He recommends a test which draws on medical evidence on the defendant’s state of mind yet retains a causal link between the offence and the mental disorder. Conor Gearty, a human rights specialist, and Professor of Law at King’s College London, welcomed the ruling. He said: “Hopefully officials will take this ruling as a stimulus to review the law.” He said the rules had been applied in an arbitrary way and had been criticised for decades."

"This book . . . demonstrates profound ignorance of earlier landmark works by writers--Charles Sykes and Paul Fussell, among others--whose critiques targeted some of the same issues raised by Elder: campus speech codes, American victimology, educational programs emphasizing self-esteem over academic achievement, etc. And yet Elder believes that his commentaries are "cutting-edge." The same goes for his proposal to legalize narcotics. In 1992, Thomas Szasz's provocative libertarian classic, "Our Right to Drugs," famously made the same proposal to an American audience--yet Elder never mentions Szasz."-- Mark Zimmerman Special to The Daily Yomiuri (Tokyo), January 28, 2001, page 15, reviewing Ten Things You Can't Say in America by Larry Elder.


"The book covers what we know about the biology of suicide and its treatment and prevention. The epidemiology, genetics, and methods of suicide as well as its relationship with psychiatric illness are all well described, as is the connection between the hopelessness and pessimism of depression and suicide."--Robert M. A. Hirschfeld, M.D., Titus H. Harris distinguished professor and chair of the department of psychiatry and behavioral sciences of the University of Texas Medical Branch at Galveston, reviewing Night Falls Fast: Understanding Suicide, by Kay Redfield Jamison, in Psychiatric Services, Volume 52, No. 1, p. 114, January 2001.

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