The Case of Thomas Szasz
‘[...] a poor model for those in training’
Anthony
Stadlen
Copyright © Anthony Stadlen 2003, 2020
[‘A poor model for those in training’: The case of Thomas Szasz
Existential Analysis 14.2 (July 2003): 213-244]
[…] Szasz may be a poor model for those in training.
Hugh Hetherington (2002: 228)
Hugh Hetherington (2002: 228)
I have never found that people go wrong from ignorance, but from want
of consciousness. Even the ignorant are ignorant because they wish to be—an
ignorant in bad faith.
Lord Acton (1988: 670)
Lord Acton (1988: 670)
Two papers in the July 2002 issue of this Journal
contain critical remarks on the work of Professor Thomas Szasz. The authors
also criticize those existential therapists and thinkers who have found value
in Szasz’s work. Thus, one of the authors, Darren Wolf, writes, of ‘us
existential therapists’, that (2002: 299)
We have taken on board far too readily, in my opinion, the assumptions
of Szasz and others around the whole area of mental illness…
The other author, Hugh Hetherington, noting (2002:
227) that Szasz is on the editorial board of Existential Analysis and that ‘some existential thinkers laud his
views’, warns (2002: 228):
If our aim, in life, as well as in therapy, is to: ‘attempt to remain
as open as possible to whatever presents itself to our relational experience…
to remain accessible’ (Spinelli, 1997: 8) then Szasz may be a poor model for
those in training.
This is an interesting
situation, which deserves some consideration. No other member of this Journal’s
editorial board has been criticized in this way in its pages.
Professor Szasz is a
long-standing member of the board. Even before being invited to join it, he had
played an important part in the activities of the Society for Existential
Analysis. He was one of the first people invited to address the Society after
it was founded in July 1988, and the first issue of this Journal printed an
article[1]
by Szasz (1990a) related to his seminar. The seminar itself, in February 1989,
was described in an article in the Society’s Newsletter for 1989, which was
reprinted in the Hermeneutic Circular
on the occasion of Szasz’s eightieth birthday (Ticktin 2000 [1989]). Szasz was
invited again in December 1991, this time to give the main lecture at the
Fourth Annual Conference of the Society, which was devoted to discussing his
views, as was the third issue of this Journal (July 1992), which carried the
cover title, ‘Thomas Szasz on the Therapeutic Dialogue’. He first appeared on
the editorial board of the Journal in the fifth issue (July 1994).[2]
The present paper will
examine what new insights are offered by Hetherington’s and Wolf’s discussion
of the work of Thomas Szasz and its relation to existential analysis.
Our approach will be more
phenomenological if we begin with a substantial quotation, as a precaution
against quoting isolated phrases or sentences out of context.
Hetherington (2002: 227–228)
writes about Szasz as follows:
While good doctors and therapists may aspire to be open, some are
surprisingly prone to adopt positions based on convictions and conclusions.
Let us take Thomas Szasz and Ernesto Spinelli as
examples. The former offers an example of ideological conviction that could get
in the way of good therapy or philosophising. The latter offers a paradigm of a
more apprehensive and less comprehensive approach. Of course, Szasz has never
professed to be an existentialist; but this did not deter him from assuming
that his views were ‘in harmony and sympathy’ with an existential audience in a
speech delivered to the 4th SEA conference in December 1991. Dr.
Szasz is also on the board of the Existential Analysis Journal and some
existential thinkers laud his views. Buffon’s saying ‘le style est l’homme même’ suggests that we can gauge a persona and world view from style as
well as content. Spinelli’s style in speech and writing tends to be careful,
tentative, gently probing, philosophical, open. Szasz’s style tends to be
closed and might be seen as slightly bombastic. Conclusions have already been
drawn – and here they are! Spinelli has a view, of course; but it emerges, lets
itself be known, disclosing itself, almost in the manner of Being in
Heideggerian thought. There is also a seemly sense of the provisional,
reminding us of temporality.
Here they are, each outlining his view of what constitutes therapy:
It always seemed obvious to
me that the so-called therapy of neurotics consisted of…
(Szasz, 1992: 95)
Right from the womb, Szasz has had a view! Even more
worryingly, he has nursed the same view, unexamined, to the present moment…
As I personally see it, then, therapy, at its most fundamental level,
involves…
(Spinelli, 1997: 1)
The repeated parentheses and commas in some of
Spinelli’s writing may irritate some, but they reflect care and philosophical
doubt rather than overblown conviction disguising anxious doubt; open concern
and anxiety rather than an attempt to exclude these reflectors of Being.
Szasz is working via comprehension and has (surprisingly early in life) formed
convictions. Spinelli is working, via apprehension, towards meaning. The latter approach resonates with the Heideggerian
notion that things matter to us, already have meaning for us; that true knowing
can be uncovered, got back to, as if for the first time, via un-knowing. Much
of T. S. Eliot’s poetry also touches on this. The recovery can never, of
course, be complete.
If our aim, in life, as well as in therapy, is to:
‘attempt to remain as open as possible to whatever presents itself to our
relational experience… to remain accessible’ (Spinelli, 1997: 8) then Szasz may
be a poor model for those in training.
Furthermore, he is unashamedly dualistic in his
thinking, proclaiming that illness ‘can affect only the body’ so that ‘there
can be no mental illness’ (Szasz 1972: 275). A consequent resistance to
‘treatment’ of ‘mentally’ ill people (for example, by medication) is a harsh
example of relinquishing our always
possible obligation to others. It also defies the logic of existential analysis
applied to clinical disturbances for, as Cohn points out, ‘one cannot rule out
the effectiveness of a physical remedy in the case of a psychological
disturbance’ (Cohn, 1997: 66). The reason is that we are in a total
situation in which body and mind are simultaneously implicated.
The above passage consists
of ten paragraphs.
In the first nine
paragraphs, we are not told what Szasz’s ‘positions’ or ‘conclusions’ are, or
what his ‘ideological conviction’ is, though we are told that he lacks one kind of ‘ideological
conviction’, namely, ‘Szasz has never professed to be an existentialist’.
We are given what we are
told is an example of ‘each outlining his view of what constitutes therapy’.
However, we do not learn what these views are. We are given the beginnings of
two sentences, represented as quotations from Szasz and Spinelli, to exemplify
their respectively ‘closed’ and ‘open’ styles. Each incomplete sentence
promises to say something about ‘therapy’, but is broken off, in this passage,
before it can keep its promise. We are urged to see, in each case, ‘le style’
as ‘l’homme même’.
The tenth paragraph begins:
‘Furthermore…’. This sounds as if it is going to continue the theme or themes
of the first nine paragraphs, in confirmation perhaps of what they have said or
shown about Szasz’s style, or way of relating to an audience. It does so, in
that it continues to characterise Szasz’s ‘thinking’ and his mode of speaking
or writing; but it also, for the first time, quotes two short, but complete, sentences
of Szasz’s. These sentences are introduced as follows:
Furthermore, he is unashamedly dualistic in his thinking, proclaiming
that illness ‘can affect only the body’ so that ‘there can be no mental
illness’.
The reader is told, in advance, that Szasz’s
‘thinking’ is ‘dualistic’, and that Szasz is not ‘ashamed’ of this, though by
implication he should be. The reader is told, not that Szasz states, argues, or
gives evidence for, his view on ‘mental illness’, but that he ‘proclaims’ it.
More subtly, the linking word ‘furthermore’ suggests that Szasz’s two short
sentences, together with their content,
are themselves merely further
manifestations of his ‘closed’, ‘slightly bombastic’ style.
In what follows it will be
important for us not to lose sight of the distinction between style and
content, in so far as they can be kept distinct.
Let us start with style.
What evidence does the
passage present for its assertions about Szasz’s style? It cites two examples,
one spoken and one written. In the first, Szasz speaks to his audience of
‘harmony and sympathy’; in the second, he writes, ‘It always seemed obvious to
me…’.
Let us examine them in turn.
First, what did Szasz say
about ‘harmony and sympathy’, and in what context?
On 14 December 1991, at the
Fourth Annual Conference of the Society for Existential Analysis, Thomas Szasz
gave a largely improvised lecture, ‘Taking dialogue as therapy seriously:
“Words are the essential tools of therapy”’ (Szasz 1991a,b; Jonathan 1992;
Stadlen 2000c).[3]
Szasz began his address with
a warm compliment to his audience, saying, as Hans Cohn reported, that it was
‘an unusual pleasure to speak to a group with which I can feel in harmony and
sympathy even before I start’ (Szasz 1991a,b; Cohn 1992: 24; Sabbadini 1992:
26).[4]
Cohn wrote (1992: 24) that it was ‘not surprising’ that Szasz felt this way,
…for he clearly shares many of the assumptions of an existentially
orientated psychotherapy. His insistence on the equality of therapist and
patient, his refusal of the power games which are so often the frame-work for
the therapeutic enterprise, his denial of the possibility of predetermining the
result of therapy – all this finds echoes in an existential conception. The aim
of therapy is defined as making ‘the patient more free to act in the world as
he wants to act’ – in other words, it is defined by the patient rather than the
therapist, and this again corresponds to an existential approach.
Existentialists would also fully agree with Szasz’s
rejection of the medical model, at least in the form in which it has
established itself at present.
Moreover, this was the
second time Emmy van Deurzen had invited Szasz to address the Society. She had
first met him at a conference in London
His first presentation to
the Society was on 11
February 1989 [6] (Szasz 1989, 1990a; Van Artsdalen and Zanger
1990a,b; Ticktin 2000 [1989]). It was a spontaneous seminar, lasting three
hours. A videotape (Szasz 1989) shows van Deurzen warmly introducing Szasz, who
gives a short, pensive and passionate, account of the heart of his practice,
and then invites questions, saying he prefers dialogue. At one point, Szasz
describes himself, in his practice of psychotherapy, as an ‘existential
behaviourist’, in that his primary concern is what people choose to do, not
what is in their ‘minds’.
On the evening of 13 December 1991 , again at
van Deurzen’s invitation, Szasz, in his fine academic robes, had given the
address at the Regent’s College School of Psychotherapy and Counselling
graduation ceremony. He had expressed his pleasure at the creative and original
titles of the dissertations on psychotherapy and counselling for the degrees he
was presenting. As he said, at 99% of university psychology departments such
titles would be unthinkable. At the reception afterwards, he had had friendly
conversations with a number of people. Ernesto Spinelli describes his
conversation with Szasz that evening in his book, Demystifying Therapy (Spinelli 1994: 62, n.; 2003). Spinelli had to
return to Canada
What happened next can be
seen and heard, in greater detail than in Cohn’s brief but accurate report, on
the videotape of Szasz’s speech (Szasz 1991b). Emmy van Deurzen introduces him:
‘I feel extremely proud and honoured to be able to introduce to you today
Professor Szasz…’. Szasz then says (my transcription):
Emmy, thank you again, thank you for your kind introduction, and for
inviting me to come to London Newcastle
This, then, was the social
context of Szasz’s remark about feeling in harmony and sympathy with his
audience.
The reader will, I hope,
forgive me for repeating how Hetherington describes the occasion (2002: 227):
Of course, Szasz has never professed to be an existentialist; but this
did not deter him from assuming that his views were ‘in harmony and sympathy’
with an existential audience...
This account, which gives no
source, distorts what Szasz said. It changes Szasz’s opening remark, that he felt ‘in harmony and sympathy’ with
his audience, into an ‘assum[ption]’ that ‘his views’ were ‘in harmony and
sympathy’ with it.
This curious
English[7] can only mean that Szasz
was claiming to know that the audience
was ‘in harmony and sympathy’ with Szasz’s views.[8]
Hetherington’s
single word ‘deter’ reinforces the transformation of Szasz’s courteous
introductory comment into a narcissistic presumption, and represents the
audience as ‘existential’ in name but unphenomenological, and indeed
prejudiced, in practice. For what truly ‘existential’ audience would be so
closed as to be swayed by the fact that the speaker did not ‘profess to be an
existentialist’?
As it happens, the
conference was open to the public. A large audience
heard Szasz. That it was an ‘existential audience’, whatever that would mean,
is itself an assumption.
It is clear,
however, that Szasz was justified in
feeling supported by leading members of the Society. This does not mean they
agreed with everything he said on all topics.
At the end of the conference
that evening, Szasz remarked (1991b, my transcription):
I really can’t recall any occasion when—in recent memory, or perhaps
altogether—in which so much thoughtful attention has been given by so many nice
people to really crucial issues, and I thank you all.
Hetherington had access to
the correct version of Szasz’s ‘harmony and sympathy’ remark, as he refers to
Cohn’s (1992) and Sabbadini’s (1992) articles where it is quoted.
As for Szasz’s remark, ‘It
always seemed obvious to me…’, as we saw, Hetherington introduces, quotes, and
comments on it, as follows (2002: 227–228):
Here they are, each outlining his view of what constitutes therapy:
It always seemed obvious to
me that the so-called therapy of neurotics consisted of…
(Szasz, 1995: 95)
Right from the womb, Szasz has had a view! Even more
worryingly, he has nursed the same view, unexamined, to the present moment…
Hetherington implies that,
if Szasz is telling the truth in saying that something ‘always seemed obvious
to him’, then ‘right from the womb, he has had a view’, and ‘has nursed the
same view, unexamined, to the present moment’. Hence, if Szasz is telling the
truth, he is infantile (‘womb’, ‘nursed’, ‘unexamined’). If, on the other hand,
Szasz is not telling the truth, then he is both infantile and a liar, because
he is making a false claim which, if true, would reveal him as infantile.
Hetherington’s words suggest
that, whatever Szasz is, truthfully or untruthfully, saying ‘seemed obvious’ to
him, by that token cannot be true. Hetherington does not tell the reader what Szasz says ‘always seemed obvious’
to him.
Nowhere does Hetherington
allow for the possibility that, when Szasz says something ‘always seemed
obvious’ to him, this might be both true and reasonable.
In ordinary English, ‘It
always seemed obvious to me…’ does not mean that the speaker is claiming that
‘right from the womb’ he ‘has had a view’. It means that, as far as he can
remember, from the time when he first began to consider the matter, something
seemed plain to see, though not necessarily as plain as it seems now.
What Szasz actually wrote
was the following sentence (1992: 2):
It always seemed obvious to me that the so-called hospital treatment of
psychotics rested on the psychiatrist’s power to imprison his patient; that the
so-called psychotherapy of neurotics consisted of talking, listening, and
observing certain rules about the interaction between therapist and patient;
and that neither of these interventions is, strictly speaking, medical in
character.
What Hetherington represents
as a quotation from Szasz is, therefore, not a quotation at all. Hetherington
leaves out a sequence of seventeen-and-a-half words, but does not indicate to
the reader, with ellipses or an author’s note, that he has done so. This
neglects elementary rules of scholarship. It again distorts what Szasz is
saying. How could such a distortion illustrate Szasz’s style?
Szasz provides some of the
evidence for what he is saying in his most recent book, Liberation by Oppression: A Comparative Study of Slavery and Psychiatry
(2002a), published when he was eighty-two. In it, he describes (2002a: 13–14)
how, as a child and adolescent in Budapest
One of my most vivid childhood memories is being forced, when I was
six, to go to school. I wanted to stay home. Why did I have to go to school?
Because, I was told, all children my age went to school, and because it was
good for me. It didn’t feel that way.
This was the beginning of a
lifetime’s questioning. In due course, he learned that
…people who did bad things were locked up in bad places; that there
were two kinds of bad people—criminals and crazies; and two kinds of places
where they were locked up—prisons and mental hospitals.
Continuing his investigations, he reflected:
Adults who are labeled ‘mentally ill’ are not children. Most of them
have not been convicted of a crime. Mental illnesses, whatever they are, are
not contagious. Why, then, are persons with psychiatric diagnoses deprived of
liberty? According to the authorities, mental patients are ill and dangerous;
they need to be institutionalized for their own welfare and for the protection
of society. This explanation never made sense to me.
And so:
By the time I was an adolescent, I concluded that people declared to be
crazy are incarcerated because they embarrass their family; that removing them
to insane asylums serves the interests of their relatives and other members of
society; and, most importantly, that inquiring into the justification for
locking up mad people is taboo. Crazy people belong in madhouses. Only a crazy
person would ask, why?
Szasz has told me (2002b)
how deep an impression Mark Twain’s Huckleberry
Finn (n.d. [1885]) made upon him when, as a boy, he read it in Hungarian,
and, as a man, in English. Szasz was moved that Tom Sawyer, ‘an ignorant
child’, could recognise the ‘evil of slavery’, although the adults could not.
Szasz later drew detailed, telling comparisons between slavery and involuntary
psychiatry, in ‘The sane slave’ (1971b), Psychiatric
Slavery (1977b), and Liberation by
Oppression (2002a) itself.
His childhood and adolescent
observations were confirmed when he became a physician and psychiatrist in the United States
…the involuntary legal status of the mental hospital patient became,
for me, the defining characteristic of psychiatry as a
medical discipline…
We can
now see what Hetherington has done in offering a purported example of Szasz’s
style. By omitting the crucial first clause, about the involuntary ‘treatment’
of ‘psychotics’ as imprisonment, he has destroyed the subtly articulated
complexity of Szasz’s sentence. This is unphenomenological, to say the least.
Hetherington
has cut the moral heart out of the sentence, without telling the reader.
It is important to note that
Hetherington does not indicate whether Szasz’s ‘view’ on ‘therapy’ is an
empirical one, which could be true or false, or an ethical one, or both.
Szasz’s writings provide
ample testimony that, far from ‘nurs[ing]’ his views ‘unexamined’, he deeply examines and questions even what seems
obvious to him. He has devoted his life to testing what seems ‘obvious’
or ‘self-evident’, whether to himself or to others, by taking it as an
hypothesis and exposing it to the possibility of contradiction in the light of
argument and evidence.
The
official records of the court stenographer in the case of ‘Mr Louis Perroni’
heard on 12 April 1962 in the Onondaga County Court, in Szasz’s book Psychiatric Justice, report that Thomas
S. Szasz was ‘called and duly sworn’ (Szasz 1965a: 123). He testified (1965a:
128) that, in his view, ‘Mr Perroni’ was competent to stand trial. He was
asked, by ‘Jerome Gross, Esq.’, acting for the defendant, ‘Is there the
slightest doubt in your mind, Doctor, about your conclusion?’ Szasz replied:
‘No more doubt than about anything else I have in my mind. I always have doubt.’
At the same time, on moral
questions, there is an urgency in Szasz’s writing, a passionate commitment, a
responsibility to his fellow human beings, which is absolute. This writing,
whatever Szasz has or has not ‘professed to be’, is in the authentic existential
tradition, from the Bible through Kierkegaard to Levinas and beyond.
Hetherington (2002: 227)
cites Szasz as an example of ‘ideological conviction that could get in the way
of good therapy or philosophising’. It is not clear whether, in Hetherington’s
view, having ‘convictions’ differs from having principles. Hetherington invokes
Kierkegaard to support his case against ‘convictions’ (Hetherington 2002: 229),
but appears unaware that Kierkegaard (1978: 340) wrote in his diary that he had
‘had a polemic view of all existence since childhood’.
One of Szasz’s favourite
authors, Lord Acton, wrote (1988: 652): ‘A convinced man differs from a
prejudiced man as an honest man from a liar.’ And (1988: 655): ‘Prejudice to
conviction as pride to dignity.’
Szasz has written in his
book, Karl Kraus and the Soul-Doctors
(1977a [1976b]; 1990b [1976b]), about character assassination, and about
rhetoric, noble and base. He has argued, in The
Myth of Psychotherapy (1979b [1978b]: 208) and in this Journal (1992: 7–8),
that ‘psychotherapy’ itself should be iatrologic,
‘a branch of rhetoric and logic’. He has criticized the base rhetoric of
writing on psychiatry and psychotherapy that purports to be ‘value-free’.
Szasz’s own first paper was
published fifty-six years ago (Szasz and Elgart 1947). In 1975, he wrote a new
preface (1975a) for the second edition of his first book, Pain and Pleasure (1975c [1957]). In it, he explained (1975a:
viii):
I was then not only trying to understand this subject but was also
trying to establish my professional identity. As a result, and perhaps because
this was the only way I was then comfortable writing, I wrote largely in what I
now regard as the professional jargon of psychiatry and psychoanalysis…
…I have added, preceding the complete reprinting of
the original edition, a new chapter which expresses my present views, in my
present style, on the subject.
The new chapter (Szasz 1975b) makes a striking
contrast with the rest of the book. Since then, a further twenty-eight years
have passed. Szasz’s style has continued to evolve. How could one do justice to
it with part of one sentence, and not a real one at that?
It has been necessary to
discuss the above two examples in rather lengthy detail. It is easy to smear,
but less easy to reveal the smearing.
Hetherington’s discussion of
Szasz’s style is inextricably tangled with his insinuations about content, even
when he fails to tell the reader what the content is. But he and Wolf do make
some direct criticisms of what Szasz says. What are they?
Hetherington alleges (2002:
228) that Szasz is ‘unashamedly dualistic in his thinking, proclaiming that
“illness can affect only the body” so that “there can be no mental illness”’.
Wolf quotes Szasz (2002: 299): ‘Strictly speaking, disease or illness can affect
only the body; hence, there can be no mental illness.’ And: ‘Mental illness is
a metaphor.’ The quotations are from a Summary that Szasz added to the second,
revised edition of The Myth of Mental
Illness (1974a [1961]: 267–268).
Let us first clarify what
Szasz means by ‘affect’. Students sometimes argue that he is saying bodily
illness cannot affect mind or mood, which would of course be absurd. Nobody who
had read the book, rather than just the Summary, could think he means that. The
context makes his meaning clear. I recently asked him, however, if he could
substitute another word for ‘affect’, to preclude such misunderstanding. He responded
immediately (Szasz 2002b): ‘Disease can predicate
only the body (not mind).’
Hetherington (2002: 222,
228) implies that Szasz’s ‘thinking’ is self-evidently ‘dualistic’, since
‘existential thinking posits a connectedness which transcends’ such notions as
‘mind/body’ and ‘subject/object’. However, Hetherington, while warning against
‘conclusions’, seems himself to be falling yet again into what Flaubert, quoted
by Binswanger in his 1945 lecture, ‘On the daseinsanalytic research direction
in psychiatry’ (1947 [1946]: 192; 1958a [1946]: 192; my translation of title),
called ‘la rage de vouloir conclure’.
On the next page, Binswanger
called the ‘subject-object-split’ the ‘cancerous evil of all psychology’ (see
Stadlen 2003b, in this issue of this Journal). But, in ‘Madness as
life-historical phenomenon and as mental illness: The case of Ilse’, also
published in 1945, Binswanger (1957a [1945]: 54;
1958b [1945]: 235–236;
my translation of title and text) wrote how close to him was the
thinking of his friend, the philosopher Paul Häberlin,
who
…by strictly
logico-ontological deduction shows that ‘the psyche’ can
never be ill, that no man can be ill ‘in his psyche’.
Häberlin had indeed written
(1941: 94; my translation and brackets):
Illness is thus in the end
always unruliness [Unbotmäßigtkeit] of the body. The psyche [Seele] itself is never ill. … No man is ill in
his psyche.
‘Seele’ can, of course, be translated as ‘psyche’, ‘soul’, or
‘mind’.
Is Binswanger, then, a ‘dualist’? Heidegger (1994 [1987]: 286; 2001 [1994]: 227; Stadlen 2003b) criticized Binswanger’s proposals for
overcoming the ‘subject-object-split’ as based on a misunderstanding of
Heidegger, but did not criticize Binswanger’s disbelief in ‘mental illness’.
Indeed, Eckart Wiesenhütter wrote (1979:
158, my translation) about Heidegger:
Once he said frankly that he
was not convinced of the correctness of the exclusively medical interpretation
of schizophrenia as illness. Could it not even simply be a question of an ‘other’
kind of thinking?
(See
Stadlen 2003a: 173–175; Stadlen and Stadlen 2004.)
Moreover, Sartre wrote, in his Foreword (1964 [1963]) to Laing and
Cooper’s Reason and Violence: A Decade of
Sartre’s Philosophy (1964: 7):
…je tiens—comme vous, je
crois—la maladie mentale comme l’issue que le libre organisme, dans son unité
totale, invente pour pouvoir vivre une situation invivable.
In
my translation:
…I—like you, I think—regard mental illness as the way
out that the free organism, in its total unity, contrives in order to be able
to live an unliveable situation.
Binswanger, Häberlin, Heidegger, and Sartre are thus all
saying something rather close to what Szasz is saying. This does not prove that
any of them is right. It does, however, suggest that what Szasz says cannot be
simply disposed of by a vague invoking of ‘existential thinking’.
Just what Hetherington means by ‘existential thinking’ is left
undefined, and appears somewhat eclectic and ill-thought-out. For example, he
remarks (2002: 222):
Existential thinking
proposes that we are ‘thrown’ into a
world-with-others. Intersubjectivity is a given, ab
initio. There is always therefore a
social dimension to existence.
The
first sentence is consistent with Heidegger’s position, but the second two are
not. Heidegger writes of ‘being-with’ and ‘thou-thou relationships’ (1994 [1987]:
145, 263; 2001 [1994]: 111, 210). He does not write of
‘intersubjectivity’, which presupposes a relationship between ‘subjects’. As Heidegger
says (1986 [1927]: 118; 1962 [1927]: 155; 1996
[1927]: 112; my translation and brackets): ‘The world of Da-sein is with-world [Mitwelt]’. Being in the world with others is not one ‘dimension’ of
being human. It is what being human is.
The
amateurishness of Hetherington’s ideas on ‘existential thinking’ is further
shown by his remark (2002: 222) that ‘the “body” was constantly pushed into the
background in philosophical discourse until Merleau-Ponty decisively reinstated
it’. So much for Bergson, Marcel, Sartre.[9]
The accusation of ‘dualism’ is particularly inept, since Szasz has specifically addressed the
so-called ‘mind-body’ problem, and so-called ‘Cartesian
dualism’, in several books, from his first, Pain
and Pleasure (1975c [1957]), through The
Myth of Mental Illness (1962 [1961]; 1974a [1961]), to his recent The Meaning of Mind (1996).
Szasz argues in The Meaning of Mind that the word ‘mind’
was originally a verb and only became reified as a noun in the sixteenth
century. He argues that there is no such thing
as the ‘mind’. In this, he is in accord with Heidegger’s Being and Time (1962 [1927]; 1986 [1927]; 1996 [1927]) and Zollikon Seminars (1994 [1987]; 2001
[1994]), and with Sartre’s The
Transcendence of the Ego (1957 [1936–1937]), Being and Nothingness (1966 [1943]), and Critique of Dialectical Reason (1976 [1960b]). Szasz suggests in The
Meaning of Mind (1996: ix) that ‘the mind’ is a ‘potentially infinite
variety of self-conversations’. Here he is again in tune with Heidegger, who,
in his 1936 essay, ‘Hölderlin and the
essence of poetry’ (2000a [1936]: 56), finds essential meaning in Hölderlin’s line, ‘Since we have been a conversation’, from a draft
to his unfinished poem, ‘Versöhnender, der du
nimmer geglaubt…’.[10]
What evidence does Hetherington adduce that Szasz is wrong to say ‘there can be no
mental illness’?
He argues (2002: 228) from what he alleges is a consequence of Szasz’s
argument, namely, ‘a consequent resistance to “treatment” of “mentally” ill people
(for example by medication)’. Hetherington calls this ‘a harsh example of
relinquishing our always possible
obligation to others’.
But who is
‘resist[ing]’ whose ‘treatment’ of whom? Szasz has repeatedly stated that he has
no objection to the ‘treatment’ of adults, whether or not they regard
themselves, or somebody else regards them, as ‘mentally ill’, by medication or
by any other means, if they have given their informed consent. He objects only
to force and fraud.
Hetherington is,
therefore, logically and empirically mistaken in asserting that a ‘resistance’
to such ‘treatment’ is a ‘consequence’ of a disbelief in ‘mental illness’.
Hetherington goes on:
It also defies the logic of
existential analysis applied to clinical disturbance for, as Cohn points out, ‘one cannot rule out the effectiveness of a physical remedy
in the case of a psychological disturbance’.
Cohn says this in his book, Existential
Thought and Therapeutic Practice (1997: 66). Hetherington writes as if Cohn
is saying this in criticism of Szasz, but Cohn nowhere mentions Szasz in this
book.[11] Hetherington is arguing, however, that what Cohn says here proves that
Szasz is illogical.
But does Hetherington imagine Szasz does
‘rule
out the effectiveness of a physical remedy in the case of a psychological
disturbance’? This would be absurd. Many physical ‘remedies’, for example, a
glass of water or whisky, herbal teas, Prozac, heroin, Tai Chi, osteopathy,
football, dancing, making love or war, may make a person, who feels or is felt
by others to be ‘disturbed’, feel or be felt by others to be less ‘disturbed’.
But how does this prove that the person was ‘mentally ill’?
Hetherington’s
‘logic’ involves petitio principii.
It starts from what should be his conclusion. It assumes what has to be proved,
namely, that a ‘psychological disturbance’ is a ‘clinical disturbance’, a
‘mental illness’.
Hetherington
states (2002: 231):
‘Psychotically’ disturbed human beings have become
ill – ill in their way of being…
Again, this is a mere assertion. The
‘“psychotically” disturbed human beings’, whoever they are, and whatever this
means, do not become ‘ill’ merely because Hetherington pronounces them so.
Here is another sample of
Hetherington’s writing vaguely directed against Szasz (2002: 231):
Those who follow too simplistically the notion that
pathology is a misnomer (the ‘we are all pathological really’ line) are
choosing to ignore the existential possibility that attunement may be healthy or pathological referred to
by Boss (1979: 50). The question of intervention
or non-intervention and what constitutes ‘voluntary’ or ‘involuntary’ is too
broad to be discussed here; but it is clear that intervention may be equally
justified for pathology not manifested purely somatically. Someone whose sight
has become impaired early in life and who has a chance of a sight-enhancing
intervention, whether conceived as ‘physical’ or ‘psychological’ should have
that treatment available. Any debate thereafter may involve ethics and
temporality; the paradox of resistance and desire; the nuances of persuasion
and coercion.
But who says
‘pathology is a misnomer’? It is an indispensable concept in scientific
medicine. And, if anyone were to say
it is a ‘misnomer’, how could they simultaneously take the ‘line’ that ‘we are
all pathological really’? Szasz thinks it a misnomer when used of the ‘psyche’.
It is certain people who believe it is not
a misnomer when used of the psyche, such as Freud in The Psychopathology of Everyday Life (1960 [1901]), who could be
said to be saying ‘we are all [psycho]pathological really’.
Hetherington
refers to an alleged allusion by Boss in Existential
Foundations of Medicine and Psychology (1979 [1975]: 50) to ‘the
existential possibility that attunement may be healthy or pathological’. In
fact, although the English text does mention ‘pathological attunement’ at this
point, this is a mistranslation from Boss’s Grundriss
der Medizin und Psychologie (1975 [1971]: 173), which attributes ‘Verstimmung’ to his patient, Regula Zürcher. ‘Verstimmung’ is
an everyday word, meaning here ‘out-of-tune-ness’ or ‘mistunement’ (as of a
piano); it can also mean ‘disgruntlement’, ‘ill-feeling’, or ‘ill-will’. Boss
does not here say that this ‘mistunement’ is ‘pathological’, though he does elsewhere
in the book (1975 [1971]: 406; 1979 [1975]: 175). But his concept of
phenomenological or daseinsanalytic ‘pathology’ begs all the questions raised
by Szasz.
Why is ‘the question of intervention
or non-intervention and what constitutes “voluntary” or “involuntary”…too broad
to be discussed here’? Does Hetherington suppose
there is some mystery about ‘what constitutes “voluntary” or
“involuntary”’?
It is not ‘clear that intervention may be equally justified for pathology
not manifested purely somatically’, if that intervention is involuntary. If
pathology is ‘manifested purely somatically’, the patient has the legal right
to refuse treatment. Szasz argues that the same principle should apply if what
is claimed to be ‘pathology’ is not
‘manifested purely somatically’. Hetherington ignores Szasz’s argument, and
simply asserts the opposite.
It is unclear what
Hetherington is talking about in his curious sentence: ‘Someone whose sight has
become impaired early in life and who has a chance of a sight-enhancing
intervention, whether conceived as ‘physical’ or ‘psychological’ should have
that treatment available [sic].’ What
is a ‘psychological’ ‘sight-enhancing intervention’? Whatever it is, he implies
someone is opposed to it. But why should anyone oppose it, provided it is
voluntary?
His final sentence is
sinister in its smooth equivocation: ‘Any debate thereafter may involve ethics
and temporality; the paradox of resistance and desire; the nuances of
persuasion and coercion.’ Why should there be any question of ‘coercion’ if
someone has a chance of a ‘sight-enhancing intervention’, whether this be
ophthalmological, for a sight defect, or ‘psychological’ or daseinsanalytic,
for a difficulty in phenomenological ‘seeing’? What happens if the person does
not want the intervention? And what does ‘thereafter’ mean? After the
‘intervention’ has already happened?
Hetherington writes (2002:
232):
The shock or fall into ill-being is not metaphorical
as argued by Szasz … but real …
But the opposite of ‘metaphorical’ is ‘literal’, not
‘real’. Szasz says that the phenomena described, as he argues, metaphorically as ‘mental illnesses’,
are not literally illnesses. He does
not say that they are not real.
Szasz has explained this so
many times in the last half century that there is a wealth of quotations to
illustrate it. It is puzzling that Hetherington does not take account of this.
Does he not believe Szasz means what he says? Hetherington (2002: 228) says
that ‘Andrea Sabbadini [1992: 28] may be getting to the heart of it in
suspecting that Szasz possibly does not believe half of what he is saying’.
Perhaps, to have a greater
chance of convincing Hetherington and Sabbadini that he believes what he is
saying, Szasz should speak under oath? The case of ‘Louis Perroni’, mentioned
above, provides just such an occasion. On 12 April 1962 , Szasz was cross-examined by
‘Robert Jordan, Esq.’, Assistant District Attorney, acting for the people, as
follows (Szasz 1965a: 129–130):
Q.
Now, Doctor, you call it The Myth of Mental Illness. In my layman’s terms would that mean that
mental illness doesn’t exist?
A.
You could put it that way.
Q.
So you are of the belief, Doctor, that there
is no such thing as mental illness, is that correct?
A.
That is fairly correct. Only
fairly.
Q.
Only fairly? Well, Doctor, I
want to be fair. You tell me what it is.
A. I will be glad to. It means that the phenomena—the human
behaviors which some people call mental illnesses—do indeed exist. But I think
that calling them mental illnesses is about as accurate as to call them
witchcraft, which they used to be called.
Almost everything
Hetherington writes about what he supposes Szasz to be saying is as confused as
the above examples. There is not space to document it all here, but if the
reader can find anything Hetherington says about Szasz that makes sense, I
should be grateful if he or she would let me know.
Perhaps Wolf’s arguments are
more substantial? He writes (2002: 299):
We have taken on board far too readily, in my opinion, the assumptions
of Szasz and others around the whole area of mental illness, and in doing so we
have been careless in overlooking the far more philosophically rigorous, and
indeed more phenomenologically informed, approach to pathology and health which
Nietzsche has to offer.
…as philosophical therapists, we have a much larger
concept of the human body than Szasz allows for. The human body includes all of
the organs which constitute it, including mind and soul. Phenomenologically
speaking, the mind is as much a part of what constitutes my embodied existence
in the world as is my leg, my heart or my liver. When Nietzsche talks about
health in the context of philosophy he is not using a mere metaphor.
But Szasz already ‘allow[ed]
for’, and criticized, Wolf’s ‘much larger concept of the human body’ more than
forty years ago. In The Myth of Mental
Illness, Szasz wrote (1962 [1961]: 218; 1974a [1961]: 195) of the then
fashionable ‘scientism’:
Finally, having a healthy ‘mind’ has been added to this value-scheme by
regarding the ‘mind’ as though it were simply another part of the human
organism. According to this view, the human being is endowed with a skeletal
system, digestive system, circulatory system, nervous system, etc.—and a ‘mind’.
Wolf says he is speaking
‘phenomenologically’. If he says that he experiences his ‘mind’ and ‘soul’ as
‘organs’ of his ‘body’, then we must, of course, accept this. But is it
phenomenological of him to attribute his own experience to the rest of us?
Is it not Wolf and
Hetherington, rather than Szasz, who are ‘dualists’, in the sense that they try
to treat the ‘mind’ as a kind of ‘double’ of the body? It seems implicit in
their thinking that if anything can be said of the body it must be possible to
say it of the ‘mind’ as well.
The logic of this position
is that, if each member of a football team has a red shirt, then the team
spirit should have a red shirt too.
Wolf’s assertion that
‘[w]hen Nietzsche talks about health in the context of philosophy he is not
using a mere metaphor’ (my emphasis)
suggests that he, like Hetherington, takes the opposite of ‘metaphorical’ to be
‘real’, rather than ‘literal’.
In Human, All Too Human, Nietzsche refers to the following as
‘diseases’: the ‘will to free will’
(1994 [1878]: 6–7); the ‘kind of pity’ which results from ‘compassion and
concern for another’ (48); the ‘male’s…self-contempt’ (196); ‘annoyance’ (237).
In The Gay Science, Nietzsche calls ‘severe suspicion’ an ‘illness’
(2001 [1887]: 7). He also writes (177):
I have named my pain and call it ‘dog’ – it’s just as faithful, just as
obtrusive and shameless, just as entertaining, just as clever as every other
dog – and I can scold it and take my bad moods out on it the way others do with
their dogs, servants, and wives.
If these allusions are not
metaphors, what are they? Does Wolf believe that this ‘dog’ is actually a dog?
Nietzsche uses the metaphor
of ‘sickness’ to characterise his initial
(and, so to speak, initiatory) experience of the ‘death of God’.[12]
The ‘convalescence’ leads to the ‘great
health’ of the ‘free spirit’ (1994 [1878]: 7–8), a ‘health’ without God.
But Nietzsche’s is only one
among many such existential explorations. Jean Paul, Kierkegaard, and T. S.
Eliot, for example, have used the metaphor of ‘illness’ and ‘health’ in ways
that radically contradict Nietzsche’s, in that they move from the experience of
the ‘death’ or ‘absence’ of God to the reaffirmation of God.[13]
These explorations of human
existence in terms of conflicting metaphors of ‘health’ and ‘sickness’ are
indeed an important field of study for existential psychotherapists. Szasz,
similarly, uses the metaphoric language of the ‘cure of souls’ and ‘healing
words’ to describe ‘psychotherapy’.
But is it not a logical non sequitur for Wolf to try to make
such metaphoric language the basis of a literal
‘pathology’ of psychotherapy clients?
Wolf’s discussion of
‘pathology’ culminates in the following passage (2002: 303):
Szasz denounces psychotherapy and psychiatry because these professions
pathologise particular ways of being or behaving. In other words, he designates
the use of the terms psychopathology and mental illness as pathological, as wrong, as empty of all positive values
and associated with all negative values instead. At the very point where
pathology is termed pathological, it is clear that Szasz’s liberal-humanism
simply seeks to replace one set of criteria for another in defining what
constitutes pathology. Essentially he is arguing that he, and not therapists or
doctors, should have the power to decide what will be designated as wrong, sick,
pathological. The debate around psychopathology in therapy is revealed as a
battle to assert which value system will prevail in policing what is acceptable
in therapeutic and philosophical discourse and what is not.
This whole passage is so
absurd that it is embarrassing to have to spell out what is wrong with it.
Szasz argues that the ‘myth
of mental illness’ is wrong. He does not say it is ‘pathological’.
The very heart of what Szasz
is saying is that it is wrong to use the word ‘pathological’ to mean ‘wrong’.
Wolf is alleging, without
evidence, that Szasz is doing just this. If Wolf were right, then Szasz would
be a hypocrite.
But can Wolf cite one place
in Szasz’s more than seven hundred publications over the last fifty-six years
where ‘he designates the use of the terms psychopathology and mental illness as
pathological’?
In fact, it is Wolf who is replacing Szasz’s argument
that these terms are wrong with the
idea, attributed by Wolf to Szasz, that they are pathological.
Szasz does not ‘seek to replace
one set of criteria for another in defining what constitutes pathology’. On the
contrary, he argues for retaining the existing scientific medical criteria, as
established by Virchow in the nineteenth century, for pathology (see, for
example, Szasz 2001: 12–17). He criticizes psychiatrists and psychotherapists
for ‘seek[ing] to replace’ these criteria.
Wolf confuses medicine with
morals, and attributes his own confusion to Szasz.
Wolf’s attempt to apply the
words ‘power’ and ‘policing’ to Szasz is, to say the least, misplaced. Szasz is
criticizing the actual power of psychiatrists, backed by the actual power of
the actual police, to imprison their so-called ‘patients’ on behalf of the
state, and to ‘treat’ them forcibly, under the pretext that they have ‘an
illness like any other’. If, of course, the patients did have ‘any other’
illness, they would have the right to refuse treatment.
This Journal has shown, by
publishing Hetherington’s and Wolf’s papers, that it is willing to publish
criticism of Szasz’s work. This is to be welcomed, as serious criticism, based
on serious study of Szasz’s writings over fifty-six years, could sharpen
discussion of his ideas.[14]
I hope I have demonstrated
that Hetherington’s and Wolf’s ‘criticisms’ are not serious. They are ill-read,
ill-informed, and illogical. They repeat ‘arguments’ that have been brought
against Szasz repeatedly for nearly half a century. When Szasz patiently
explains the fallacies in these ‘arguments’, he is accused of repeating
himself.
Very few of the
contributors to this Journal who have mentioned Szasz (see note 2 below) give
any sign of recognising the profundity, the originality, or the historical
importance of his work, or how privileged the Society and the Journal are that
he should support their activities.
Is the Society for
Existential Analysis really not able to produce anything about Szasz better than this?
Anthony
Stadlen has
practised since 1970 as an existential-phenomenological psychotherapist with
individuals, couples and families. He teaches and supervises at several London Freud
Museum , London
[1] The Editors’ Note says that the published
essay is an ‘extract from the preface to his book The Ethics of Psychoanalysis’. It is, in fact, the whole new
preface (1988 [1965b]: ix–xiii) to the then just published Syracuse
[2] The reader may find the following list of
references to Szasz in this Journal useful.
1. Van Artsdalen and Zanger
1990a.
2.
Van Artsdalen and Zanger 1990b.
3. Szasz 1990a.
4. Lemma and Spinelli 1992.
5. Szasz 1992.
6. Jonathan 1992.
7. van Deurzen-Smith 1992.
8. Cohn 1992.
9. Sabbadini 1992.
10. Lemma 1992: 136.
11. Du Plock 1993: 91, 107.
12. Burston 1993: 136.
13. Spinelli 1993: 154.
14. Young 1995: 97.
15. Moja-Strasser 1995: 106–107.
16. Du Plock 1995: 116.
17. Hoeller 1996: 55.
18. Davis
19. Cohn 1997: 186.
20. Cohn 1998: 135.
21. Milton
22. Stadlen A. 2000a: 67.
23 Stadlen A. 2000b: 157, 159.
24. Hetherington 2001: 151.
25. Madison 2002: 10–11, 14–17,
21, 24, 27–28, 30.
26. Groth 2002: 158.
27. Hetherington 2002: 227–228,
236.
28. Wolf 2002: 299, 303,
307–308.
29. Stadlen N. 2002: 335–336.
30. Stadlen A. 2003a: 170–171.
[3] The editors, Alessandra Lemma and Ernesto
Spinelli, wrote in this Journal (Lemma and Spinelli 1992: 1):
…the editors are pleased to be able to provide the Journal readership
with the written version of Thomas Szasz’s provocative paper on therapeutic
dialogue delivered at the Fourth Annual Conference of the Society for
Existential Analysis. The editors are not only greatly indebted to Thomas Szasz
for his willingness to have the paper published by us, but also for the
additional time and effort he took to revise his paper for a written text,
rather than for oral presentation. That he was able to achieve this task in
time for this issue’s publication says a great deal, we believe, for his keen
interest in and continuing support for the Society.
The
final section of Szasz’s paper (1992: 7–8) develops the final section of his
book, The Myth of Psychotherapy
(1979b [1978b]: 208).
[4] This compliment does not appear either in
Szasz’s (1992) written paper or in Jonathan’s (1992) detailed account of
Szasz’s talk. It is found in a transcript (Szasz 1991a) from an audiotape, and
in a videotape (Szasz 1991b). The transcript was available for other speakers
at the conference, who were invited to respond in this Journal. Van Deurzen,
Cohn and Sabbadini responded; Esterson and I did not.
[5] The other speakers at the conference were
Hans Keller and Anthony Clare. Emmy van Deurzen and I discovered, on comparing
notes recently, that we were both in the audience that day (van Deurzen 2003).
It was the first time either of us had seen Szasz in person. I can understand
why van Deurzen was so impressed.
[6] The Editorial by Carole Van Artsdalen and
Elena Lea Zanger (1990a: 1) gives the date of Szasz’s presentation as ‘February
1989’, but their Editors’ Note (1990b: 63) says it was ‘in autumn 1988’.
Ticktin’s report (2000 [1989]: 14) and the videotape (Szasz 1989) both give the
date as 11 February 1989 .
[7] The odd phrasing alone would suggest, even if
we did not have the accurate account of Szasz’s words, that this is a
distortion. His sensitive mastery of the English language (of which he knew not
one word until he was an adult) is such that he would be unlikely to use such
phrasing.
[8] Sabbadini (1992: 26), in his response to
Szasz, reports Szasz’s statement about feeling in harmony and sympathy, but
calls it a ‘wishful assumption’. He writes: ‘…I hoped I could have belonged to
such a harmonious and sympathetic audience’. Thus he prepares the ground for
Hetherington’s distortion. Sabbadini also writes (1992: 28): ‘Things about the
human enterprise, Szasz shamelessly states, can be “true or false”, “right or
wrong”, “good or bad”.’ This sentence appears to be self-contradictory, for why
should Szasz feel ashamed if there is no ‘right or wrong’?
[9] For the relevant works and passages of
Bergson, Marcel, Sartre see Zaner 1964.
[10] Szasz refers explicitly to existential
writings in many of his books. In the first (but not the revised) edition of The Myth of Mental Illness (1962 [1961]:
95–96), he discusses critically Binswanger’s existential analysis as a school of European
[11] Hetherington (2002: 228)
writes that Cohn ‘accurately pinpointed inconsistencies in Szasz’s
thinking…just after Szasz’s address to the SEA’. What are these
‘inconsistencies’?
One alleged ‘inconsistency’ was
based on a trivial misunderstanding about the use of the couch in
psychoanalysis. Cohn (1992: 25) mistakenly thought that, when Szasz quoted the
words, ‘I hold to the plan of getting the patient to lie on the sofa while I
sit behind him out of sight’, he was reporting his own practice. But this is a
recognisable quotation (with one word, ‘his’, before ‘sight’, missing) from
Strachey’s Standard Edition translation of Freud’s paper, ‘On beginning the
treatment’ (Freud 1958 [1913]: 133). Szasz went on to argue that
psychoanalysts, by insisting on the
use of the couch, foster their patients’ dependency. Cohn mistakenly thought
Szasz was arguing that any use of the
couch did so. It therefore seemed contradictory to Cohn that Szasz had written,
in The Ethics of Psychoanalysis (1988
[1965b]: 170),
I invite the patient to assume whichever position he
prefers. If the patient asks me which
position I prefer, I tell him that it makes little difference to me but that if
it does not matter to him I prefer his lying down.
There is, of course, no
contradiction.
Cohn also
(1992: 25) ‘found [his] initial consent shaken’ because Szasz said that, on
occasion, he would become ‘extremely moralistic’. But Szasz was simply stating
that he would say, if necessary, that he was not prepared to work with a client
whose central project seemed, to Szasz, immoral.
In addition,
Cohn (1992: 24) expressed ‘unease about what strikes me as a tendency towards a
kind of dualism in Szasz’s thinking’. He concluded (1992: 25):
…in order to assess his work, we need to remember that he has chosen to
remain within the orbit of a Cartesian universe, with its split between subject
and world, where the therapeutic interaction is defined as a ‘contract’ rather
than the specific modification of the intersubjective field in which we all
find ourselves from the very beginning.
I have dealt with Szasz’s
alleged ‘dualism’ and ‘Cartesian[ism]’ above. I recently asked Hans Cohn what
he meant by the rest of this passage. He said (Cohn 2003) that he had written
this whole piece hastily; that he no longer uses the term ‘intersubjective’
(for reasons similar to those I stated above in connection with Hetherington’s
use of the term); and that he himself makes contracts with clients and has no
criticism of Szasz for doing so.
[12] Nietzsche also
characterises Christianity itself as a ‘debilitating malady’ (Hayman 1995
[1980]: 356).
[13] Bearn Bearn
to that excess of vivid healing, reproducing, reviving powers, the very
sign of great health, an excess that gives the free
spirit the dangerous privilege of being permitted to live experimentally and to
offer himself to adventure: the privilege of the master free spirit!
It means coming to terms
with the ‘death of God’ (1994 [1878]: 8):
The free spirit again approaches life… It grows warmer around him
again… He almost feels as if his eyes were only now open to what is near.
As Bearn
Other writers
have found ways of ‘healing’ the experience of the ‘death of God’ that
radically contradict Nietzsche’s. For example, at the heart of Jean Paul
Richter’s 1796 novel, Flower, Fruit and
Thorn Pieces: Or the Married Life, Death, and Wedding of the Advocate of the
Poor, Firmian Stanislaus Siebenkäs, is the ‘speech of Christ,
after death, from the universe, that there is no God’ (Richter 1845 [1796],
First Series: 332–340). This ‘dream’ of Jean Paul’s set the tone for the
nineteenth century. In a footnote, he writes (332, n.):
If ever my heart were so unhappy and withered, that all the feelings
which assert the existence of God should be destroyed, I would terrify myself
by this my essay, and it would heal me, and give me my feelings back again.
Thus, his vision of the
‘death of God’ would ‘heal’ him because, in contrast to Nietzsche’s later
vision, it would renew Jean Paul’s experience of God’s existence.
In
Kierkegaard’s The Sickness unto Death
(1980 [1849]), despair is called ‘the sickness unto death’. But, as
‘Anti-Climacus’, Kierkegaard’s pseudonymous ‘author’, writes (1980 [1849]:
24–25):
The common view also overlooks that despair is dialectically different
from what is usually termed a sickness, because it is a sickness of the spirit…
Not being in despair is not similar to not being sick, for not being sick
cannot be the same as being sick, whereas not being in despair can be the very
same as being in despair. It is not with despair as with a sickness, where
feeling indisposed is the sickness. By no means. Here again the indisposition
is dialectical. Never to have sensed this indisposition is precisely to be in
despair.
And (1980 [1849]: 14):
The formula that describes the state of the self when despair is
completely rooted out is this: in relating itself to itself and in willing to
be itself, the self rests transparently in the power that established it.
The overcoming of the
‘sickness’ is again quite different from Nietzsche’s. The ‘power that
established it’ is, of course, God.
Again, T. S.
Eliot, in East Coker, writes (1959
[1943]: 29):
Our only health is the disease
If we obey the dying nurse
Whose constant care is not to please
But to remind of our, and Adam’s curse,
And that, to be restored, our sickness must grow worse.
All these
existential explorations of the metaphor of ‘health’ and ‘sickness’, some of
them mutually conflicting, are important for existential psychotherapists. But
they can in no way legitimate Wolf’s claim to find literal ‘pathology’ in his
clients.
[14] Madison Madison take into account Szasz’s recent book, Pharmacracy (2001), which answers many
of the specific arguments Madison Madison
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