The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement, by Thomas S. Szasz, is a brilliant book published in 1970. His perspective is the closest I have found to my own. I recommend reading this book, along with any other books by him, many of which are available as free PDFs.
Below is the original Preface of the book and, in my opinion, provides the most compelling portrayal of the energy that fuels the so-called War on drugs and has lead to the emotional, physical and spiritual harm of millions.
If you are able to read with an open mind, it it sure to change or enhance your perspective.
I separated one of my favorite sections and placed in italicized bold. This part represents my personal driving passion behind my lawsuit.
The Manufacture of Madness: Preface
It is widely believed today that just as some people suffer from diseases of the liver or kidney, others suffer from diseases of the mind or personality; that persons afflicted with such "mental ill nesses" are psychologically and socially inferior to those not so afflicted; and that "mental patients," because of their supposed incapacity to "know what is in their own best interests," must be cared for by their families or the state, even if that care requires interventions imposed on them against their will or incarceration in a mental hospital.
I consider this entire system of interlocking concepts, beliefs, and practices false and immoral. In an earlier work, The Myth of Mental Illness, I tried to show how and why the concept of mental illness is erroneous and misleading. In the present work, I shall try to show how and why the ethical convictions and social arrangements based on this concept constitute an immoral ideology of intolerance. In particular, I shall compare the belief in witchcraft and the persecution of witches with the belief in mental illness and the persecution of mental patients.
The ideology of mental health and illness serves an obvious and pressing moral need. Since the physician's classic mandate is to treat suffering patients with their consent and for their own benefit, it is necessary to explain and justify situations where individuals are "treated" without their consent and to their detriment. The concept of insanity or mental illness supplies this need. It enables the "sane" members of society to deal as they see fit with those of their fellows whom they can categorize as "insane." But having divested the madman of his right to judge what is in his own best interests, the people – and especially psychiatrists and judges, their medical and legal experts on madness – have divested themselves of the corrective restraints of dialogue. In vain does the alleged madman insist that he is not sick; his inability to "recognize" that he is, is regarded as a hallmark of his illness. In vain does he reject treatment and hospitalization as forms of torture and imprisonment; his refusal to submit to psychiatric authority is regarded as a further sign of his illness. In this medical rejection of the Other as a madman, we recognize, in up-to-date semantic and technical garb, but underneath it remarkably unchanged, his former religious rejection as a heretic.
Well-entrenched ideologies – such as messianic Christianity had been, and messianic Psychiatry now is – are, of course, not easily refuted. Once the basic premises of an ideology are accepted, new observations are perceived in its imagery and articulated in its vocabulary. The result is that while no fresh observation can undermine the belief system, new "facts" generated by the ideology constantly lend further support to it. This was true in the past for the belief in witchcraft and the corresponding prevalence of witches, and it is true today for the belief in mental disease and the corresponding prevalence of mental patients.
Unfortunately, it is easier to perceive the errors of our forebears than those of our contemporaries. We all know that there are no witches; however, only a few hundred years ago, the greatest and noblest minds were deeply convinced that there were. Is it possible, then, that our belief in mental illness is similarly ill conceived? And that our practices based on this concept are similarly destructive of personal dignity and political liberty?
These are not idle or unimportant questions. On our answers to them depends not only the fate of millions of Americans labeled mentally ill, but, indirectly, the fate of all of us.
For, as we have been warned time and again, an injustice done to one – especially in a society that aspires to be free – is an injustice done to all. In my opinion, the "mental health" – in the sense of spiritual wellbeing – of Americans cannot be improved by slogans, drugs, community mental health centers, or even with billions of dollars expended on a "war on mental illness." The principal problem in psychiatry has always been, and still is, violence: the threatened and feared violence of the "madman," and the actual counter violence of society and the psychiatrist against him. The result is the dehumanization, oppression, and persecution of the citizen branded "mentally ill."
If this is so, we had better heed John Stuart Mill's warning that “. . . it is contrary to reason and experience to suppose that there can be any real check to brutality, consistent with leaving the victim still in the power of the executioner." The best, indeed the only, hope for remedying the problem of "mental illness" lies in weakening – not in strengthening – the power of Institutional Psychiatry. Only when this peculiar institution is abolished will the moral powers of uncoerced psychotherapy be released. Only then will the potentialities of Contractual Psychiatry be able to unfold – as a creative human dialogue unfettered by institutional loyalties and social taboos, pledged to serving the individual in his perpetual struggle to rise, not only above the constraints of instinct, but also above those of myth.
In sum, this is a book on the history of Institutional Psychiatry – from its theoretical origins in Christian theology to its current practices couched in medical rhetoric and enforced by police power. The importance for man of understanding his history has perhaps never been greater than today. This is because history, as Collingwood reminds us, "is 'for' human self-knowledge. Knowing yourself means knowing what you can do; and since nobody knows what he can do until he tries, the only clue to what man can do is what man has done. The value of history, then, is that it teaches us what man has done and thus what man is." By showing what man has done, and continues to do, to his fellow man in the name of help, I hope to add to our understanding of what man is, where coercion, however well-justified by self-flattering rhetoric, leads him, and what might yet become of him were he to replace control of the Other with self-control.
This book presupposes no special competence or training in the reader – only open-mindedness. But it requires of him one more thing – that he seriously consider, with Samuel Johnson, that "hell is paved with good intentions," and that he conscientiously apply this caveat to the ideology, rhetoric, and rituals of the political organization characteristic of our age – the Therapeutic State.
Syracuse, New York December 1969
Thomas S. Szasz
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