The bare facts of the story, as reported in the press, are as follows. For nine months the trio hid in plain sight, made frequent trips to the city, was seen at a grocery store and a restaurant, and for about a week lived one block from the Salt Lake City police headquarters. A freelance photographer has a picture of the trio dressed in white robes.

In March 2003, when the police found her, Elizabeth was wearing a gray wig and dark glasses, and her head and face were covered. Approached by officers, Elizabeth identified herself as Augustine, claiming to be Mitchell’s daughter. “We took her aside,” one of the officers related. “She kind of just blurted out, I know who you think I am. You guys think I’m that Elizabeth Smart girl who ran away [sic].” When the officers insisted that she was Elizabeth Smart, she replied, “Thou sayest” and “showed concern only for their [Mitchell’s and Barzee’s] welfare, not her own.”

Mitchell, a devout Mormon, was no stranger to the Smarts. In 2001 Elizabeth’s father, Edward Smart, employed him as a handyman. “He was astonished,” the press reported, “at Mr. Mitchell’s mastery of deception. ‘When I was up there on the roof with him, I never could have guessed. He was so soft-spoken; he was so quiet. I never would have guessed that such an animal would have existed behind such a person.’’’

All that was more than six years ago. Mitchell and Barzee have still not been tried, and we still have no idea about what actually happened to Elizabeth Smart. While mental health professionals prevented the defendants from defending themselves in court, the Smarts convicted Mitchell and Barzee in the media as “sexual predators.”

Defenseless Defendants

Actually, there was no hard evidence that Elizabeth had been kidnapped, much less raped. Eccentric and poor, the defendants inspired no one to protect their constitutional right to trial. That would have required Elizabeth to be cross-examined and testify under oath about why she made no attempt to escape her alleged captors and why she lied to the police about who she was and referred to herself as “the girl who ran away”—not “was kidnapped.”

Elizabeth’s parents, Edward and Lois Smart, rushed into print with a book, titled “Bringing Elizabeth Home: A Journey of Faith and Hope,” a boring protestation of their Mormon faith and belief in “miracles.” “If you want just the straight story, as I did,” comments a reader on Amazon.com, “you’ve come to the wrong place. . . . The excruciating details of the family’s faith were belabored and preached and whined about until I wanted to scream and I couldn’t finish the book.” The Smarts’ book was used as the basis of the television movie The Elizabeth Smart Story, aired on CBS on November 9, 2003.

On March 9, 2006, Elizabeth Smart went to Congress to support sexual predator legislation. In 2008 she contributed to a pamphlet sponsored by the U.S. Department of Justice, titled “You’re Not Alone: The Journey from Abduction to Empowerment”: “Like you, I am also a survivor. . . . Do not feel obligated to tell people your experience. . . . [J]ust because they ask, or do something nice for you, does not give them the right to know what you went through. What happened is your story, which you can choose to share or to keep private.” Should a person allegedly kidnapped and raped be able to choose to keep silent while her silence is used to indefinitely incarcerate the persons accused of the crime?

Early in 2004 Mitchell was declared competent to stand trial and answered “not guilty” to six different charges related to the kidnapping of Elizabeth Smart. After he began singing the Christmas hymn “Oh come, oh come, Emmanuel” at the hearing, he was ordered to submit to a new competency evaluation. (Emmanuel is the name Mitchell used as a street preacher.)

In January 2005 attorneys for Mitchell requested Elizabeth’s school and medical records. Attorneys for the Smart family refused on the ground that “efforts to obtain the records are merely a ploy to get the family to agree to a lenient plea agreement.” Edward Smart declared that he would rather see prosecutors make a plea bargain with Mitchell “than having his family go through the trauma of a trial.”

In July 2006, TV pundit and victims’ rights advocate Nancy Grace interviewed Elizabeth Smart and repeatedly asked her for information about her experience. Elizabeth asked Grace to stop and stated, “I really am here to support the bill and not to go into what—you know, what happened to me.” Grace persisted, asking Elizabeth what it was like to see out of the burqa she was wearing. Elizabeth replied, “I’m really not going to talk about this at this time.”

Mitchell continued to play the part of a Mormon prophet, interrupting one of his 2005 competency hearings “by singing religious songs, the third time he has done so.” A defense expert testified that Mitchell is incompetent to stand trial “because he is consumed by ‘messianic delusions’ and wants to be crucified.”

The psychiatrists “treating” Mitchell, confined in a Utah state mental hospital, sought to drug him to restore his competence. He refused and the courts were unwilling to authorize forced drugging. This prompted U.S. Attorney Brett Tolman, in October 2008, to announce his intention to prosecute Mitchell in federal court. A competency hearing for Mitchell was scheduled to begin in November. As a prelude to it, Elizabeth Smart testified in court for the first time—in a hearing ostensibly about Mitchell’s mental competence to stand trial—about being raped by Mitchell “three or four times a day.” According to the press, “Smart testified early because she is going on a religious mission for the Mormon church in Paris.” She was not cross-examined and Mitchell—whose physical appearance belies the sexual prowess attributed to him by Smart—was excluded from the proceedings.

My brief remarks in this column are intended to call attention to still another case of the psychiatric denial of the right to trial of socially embarrassing defendants. Despite their publicity, such stories make no dent in dispelling the widely held belief that no American accused of a crime is deprived of liberty indefinitely without trial. The canard that psychiatry is a “helping profession” is even more impregnable.

Related posts:

1. The Shame of Medicine: The Depravity of Psychiatry
2. The Shame of Medicine: The Case of General Edwin Walker
3. The Shame of Medicine: The Case of Alan Turing

On September 29, 1962, Walker issued a public statement: “This is Edwin A. Walker. I am in Mississippi beside Governor Ross Barnett. I call for a national protest against the conspiracy from within. Rally to the cause of freedom in righteous indignation, violent vocal protest, and bitter silence under the flag of Mississippi at the use of Federal troops. . . .”

The campus demonstration led to a riot in which two people were killed and six federal marshals were injured. Importantly, according to a United Press report, “During a lull in the rioting, General Walker mounted a Confederate statue on the campus and begged the students to cease their violence. . . . His plea was greeted with one massive jeer.”

Unnoticed at the time and forgotten today is the fact that while the federal government used the military to guarantee Meredith’s constitutional right to equal protection of the laws, it used psychiatry to deprive Walker of his constitutional right to trial. This was another example of my long-held view that we are replacing social controls justified by race with social controls justified by psychiatric diagnosis.

Guilt by Diagnosis

Arrested on four federal charges, including “inciting, assisting, and engaging in an insurrection against the authority of the United States,” Walker was taken before a U.S. commissioner and held pending the posting of $100,000 bond. While he was making arrangements to post bail, Attorney General Robert Kennedy ordered Walker flown, on a government aircraft, to Springfield, Missouri, to be incarcerated in the U.S. Medical Center for Prisoners for “psychiatric observation” on suspicion that he was mentally unfit to stand trial.

Walker’s entry in Wikipedia mentions neither this nor the ensuing confrontation between Walker’s legal team and the government’s psychiatric team. The reader is told only that Walker “posted bond and returned home to Dallas, where he was greeted by a crowd of 200 supporters. After a federal grand jury adjourned in January 1963 without indicting him, the charges were dropped.”

How could this happen? Was it legal? It was legal, and in Psychiatric Justice (1965) I presented a detailed, documented account of how it happened. Here I wish to add a few personal details not previously reported.

News of Walker’s psychiatric incarceration had barely hit the newspapers when I received a telephone call from Robert Morris, then president of the University of Dallas, formerly chief counsel to the Senate Judiciary Subcommittee on Internal Security. He identified himself as one of Walker’s attorneys, explained he had been given my name by William F. Buckley, Jr., and asked me to help his team to free Walker from psychiatric imprisonment.

I flew to Dallas and spent a long afternoon and evening with Morris and his team of lawyers. They believed it was obvious that Walker was sane. They wanted me to examine him and say so in court. It was not easy to disabuse them of their conventional beliefs about mental illness as a medical disease and psychiatry as a medical specialty. I summarized the evidence for my view that psychiatry is a threat to civil liberties, especially to the liberties of individuals stigmatized as “right-wingers,” illustrated by the famous case of Ezra Pound, who was locked up for 13 years while the government ostensibly waited for his “doctors” to restore his competence to stand trial. Now the Kennedys and their psychiatrists were in the process of doing the same thing to Walker.

I reminded the attorneys that a courtroom confrontation concerning his “sanity” would not be a search for truth or justice (which they well understood), and noted that they were on the losing side of the civil rights battle (which they well knew). I urged them to avoid unnecessary dramatics and focus on freeing Walker from psychiatric detention as their sole goal. Finally, I persuaded them that in a Mississippi courtroom, I–with a foreign name and a foreign accent–would not be the best possible expert for Walker and talked them out of their plan to have me examine him and engage in a contest of “expert opinions” about the predictably dire diagnoses of the government’s psychiatric experts. Instead, I proposed that they “nominate” a prominent Dallas university psychiatrist as their defense expert–that is, a local, publicly employed physician who could ill afford to declare Walker insane on the basis of his “racist” views. (Before the Civil War, proslavery physicians in the South diagnosed black slaves who tried to escape to the North as mentally ill, “suffering from drapetomania.” In the Walker case, pro-integration psychiatrists in the North diagnosed white segregationists as mentally ill, “suffering from racism.”) Next morning I flew back to Syracuse.

For Whose Own Good?

A competency hearing was scheduled. Dr. Robert L. Stubblefield, chief psychiatrist at the Southwest Medical Center in Dallas, was to examine Walker and testify in his defense. The prosecution’s expert was Dr. Manfred Guttmacher, long-time chief medical officer at Baltimore City’s Supreme Court. Walker’s attorneys had no trouble exposing Guttmacher for the evil quack he was. Guttmacher kept referring to Walker as if Walker were his patient and supported the prosecution’s request that Walker be incarcerated (“hospitalized”) for up to three months, testifying under oath that doing so would be “for Mr. Walker’s own good from a medical point of view.”

In the end, the government’s psychiatric plot failed. Walker was declared mentally fit to stand trial, a federal grand jury refused to indict him, and the charges against him were dropped.

Less than two years later, my view that organized American psychiatry was becoming overtly political, seeking the existential invalidation and psychiatric destruction of individuals who do not share the psychiatric establishment’s left-liberal “progressive” views, received further dramatic support. In 1964, when Senator Barry Goldwater was the Republican candidate for president, 1,189 psychiatrists publicly declared–without benefit of examination–that Goldwater was “psychologically unfit to be President of the United States.” Many offered a diagnosis of “paranoid schizophrenia” as the basis for their judgment.

Psychiatry is despotism in the service of the Therapeutic State, rationalized as “progressive” science and “compassionate” medical care. In the past, racial stigmatization and segregation were indispensable for the political class and the State. Today, psychiatric stigmatization and segregation are indispensable for the political class and the State. This is why no exposure of brutal psychiatric injustices makes a dent in the mental health system’s lofty social status as a benevolent, ethical, scientific medical discipline.

Related posts:

1. The Shame of Medicine: The Case of Alan Turing
2. The Shame of Medicine: The Depravity of Psychiatry
3. The Shame of Medicine: Conviction by Psychiatry

people have apologized for the past crimes of the groups with which they identify: the U.S. for Japanese internment, the Church for Galileo, Swiss bankers for Nazi money laundering, even the Japanese (kind of) for their war crimes. I’d like to see psychiatrists do the same—to admit that unusual preferences are not ‘disease,’ affirm that it is wrong to treat people against their will, and turn their backs on the ‘greats’ of their profession who believed in and practiced coercive therapy.”

I am grateful to Caplan for calling attention to a problem most people prefer to ignore. His expectation will, however, not be fulfilled, and it is important to understand why. Claiming competence in astronomy and incarcerating heretics are not integral to the identity of the Catholic Church. In contrast, claiming competence in predicting “dangerousness” and incarcerating persons alleged to be so because of “mental illness” are integral to the psychiatric enterprise. Wikipedia defines civil commitment as “the practice of using legal means or forms as part of a mental health law to commit a person to a mental hospital, insane asylum or psychiatric ward against their will and/or over their protests. . . . A common reason given for involuntary commitment is to prevent danger to the individual or society.”

Psychiatrists alternately deny and delight in possessing special professional skill at detecting future “dangerousness” that entitles them to the special power to incarcerate individuals they so stigmatize in prisons that masquerade as hospitals. The American legal system makes heavy use of psychiatric determinations of dangerousness, as a result of which vast numbers of Americans are deprived of liberty and, at the same time, of opportunity to demonstrate the injustice of their detention. Examples abound.

Kafka in Court

In March 2004 Susan Lindauer was arrested in Maryland and charged with “acting as an unregistered agent of a foreign government.” She faced up to 25 years in prison. Instead of trying Lindauer, government psychiatrists declared her mentally incompetent to stand trial and incarcerated her at the Carswell Federal Medical Center in Texas, a facility described as providing “medical and mental health services to female offenders.” But Lindauer was not an offender. She was an innocent American.

After “hospitalizing” Lindauer for 18 months, her “medical” torturers concluded that, although she was still mentally ill and incompetent to stand trial, she no longer needed psychiatric “care.” Released from detention, she returned to Maryland where federal court services referred her to a private agency for counseling. According to a motion filed by her attorney, her counselor, Dr. Bruke Tadessah, said, “That evaluation showed a diagnosis of post traumatic stress disorder due to her experiences at Carswell.” Last January the federal government dropped its case against Lindauer as ”no longer in the interest of justice,” implying that her psychiatric persecution had been in the interest of justice. 

Consider the contrast. Inmates of American mental-health facilities are stigmatized as “mental patients”; their torture is called “treatment”; and they are regarded as the beneficiaries of a caring government’s therapeutic services. The inmates at the Abu Ghraib prison in Iraq were not stigmatized as “mental patients”; their torture was not called “treatment”; and they were regarded as the victims of government-sponsored “detainee abuse.”

Indefinite Incarceration

When Donald Schmidt was 16, he molested and drowned a 3-year-old girl. Under California law juvenile offenders who commit serious crimes can be kept in the system only until they are 25. But Schmidt’s detention has been extended under the state code that allows “continued detention if a jury finds the inmate has a mental disorder, defect or abnormality that causes the person to have serious difficulty controlling his or her dangerous behavior.”

What is Schmidt expected to do to get a divorce from his “doctors” and regain his liberty? Every two years he can petition for release and hope that a judge will order a “trial,” letting jurors decide whether he remains a “danger to society.” Anticipating another such contingency, a Santa Cruz County district attorney Bob Lee declared, “We believe he’s a psychopath.” Richard A. Starrett, a clinical psychologist, agreed that Schmidt was still a danger, though “not a psychopath.” Barry Krisberg, president of the National Council on Crime and Delinquency in Oakland, California, called Schmidt’s situation “one in a million.”

The claim that Schmidt’s indefinite psychiatric sentence is unusual is typical of the deceit and depravity intrinsic to forensic psychiatry. John Hinckley, Jr., never convicted of a crime, is serving his 28th year of psychiatric imprisonment. Evidently the government’s greatest psychiatrists need more time to cure him of dangerousness.

Psychiatry is the political legitimation of the incarceration of innocent individuals under psychiatric auspices, a practice that appears to enjoy near-universal approval by people in modern societies. Recognition of the fact that noncoercive psychiatry is an oxymoron is obscured by the concurrent practice of seemingly consensual “therapy.” I say “seemingly” because the mental-health professional retains the privilege and obligation to deprive his patient of liberty if he “poses a danger to himself or others.” As a result, psychiatrists and the press regularly tout psychiatric “reforms,” while the “doctors” engage in ever-increasingly refined forms of psychiatric depravity, supported by the unquestioned and unquestionable premise that “dangerousness” justifies imprisonment called “hospitalization.”

In the published report of a 1981 workshop titled Behavioral Science and the Secret Service, sponsored by the prestigious Institute of Medicine, Robert Michels, University Professor of Medicine and of Psychiatry at Weill Cornell Medical College in New York, asserted that “most mental health professionals believe that there is no major ethical dilemma if it is in the patient’s interest to violate his confidentiality, and that it is generally in the patient’s (as well as society’s) interest to prevent a major violence.” The assertion that “most mental health professionals believe” that violating a defendant’s Sixth Amendment right to trial serves his interest is evidence of psychiatric depravity, not morality.

To make matters worse, a few pages later the workshop reporter informs us that “Some conferees, including psychiatrists Robert Michels and Loren Roth [a prominent forensic psychiatrist and professor at the University of Pittsburgh], questioned the utility of making dangerousness determinations at all, because such decisions at any one time are likely to be highly unreliable and invalid. . . . Mental health professionals in general have not been shown to be better than anyone else in making predictions about behavior which might occur in the distant future under changing conditions.”

None of this evidence impairs the professional standing of psychiatry as an ethical and scientific medical discipline. The psychiatric enterprise is so deeply rooted in social control and so strongly supported by pseudoscientific magic and prejudice that psychiatrists must either cling to and justify the coercive services they render or repudiate and abolish their profession as they and we know it.

Related posts:

1. The Shame of Medicine: Conviction by Psychiatry
2. The Shame of Medicine: The Case of General Edwin Walker
3. The Shame of Medicine: The Case of Alan Turing

Turing was a mathematician, cryptographer, and pioneering computer scientist. He was good-looking, athletic, eccentric, and openly homosexual. In 1935, backed by John Maynard Keynes, Turing was elected a Fellow of King’s College, a remarkable achievement for so young a man. In 1936 he published a paper that immediately became a classic in mathematics and earned him an an invitation from John von Neumann to continue his studies at Princeton University. In 1938, having been awarded a Ph.D. in mathematics, Turing returned to Cambridge and was soon working at Bletchley Park, the famous British code-breaking “factory.” When the war ended, Turing moved to Manchester where the university created a special readership in the theory of computing for him.

In 1951 Turing began a homosexual relationship with a working-class youth. Returning home one evening, he found that his house had been burglarized. He reported the crime to the police and communicated his suspicion that the culprit was an associate of his gay friend. He confessed to his homosexual affair and was charged with “gross indecency,” a crime then punishable by a maximum of two years’ imprisonment. The judge, taking into account Turing’s intellectual distinction and social position, sentenced him to probation, “on the condition that he submit for treatment by a duly qualified medical practitioner.” In April 1952 he wrote to a friend, “I am both bound over for a year and obliged to take this organo-therapy for the same period. It is supposed to reduce sexual urge whilst it goes on, but one is supposed to return to normal when it is over. I hope they’re right.” Turing was never the same again. His body became feminized. He grew breasts.

Fatal Treatment for a Fictitious Disease

On June 8, 1954, Turing was found dead by his housekeeper, a partly eaten apple laced with cyanide next to his bed. At the inquest, the coroner ruled his death a suicide. Neither his homosexuality nor his psychiatric treatment was mentioned. The coroner said, “I am forced to the conclusion that this was a deliberate act. In a man of this type, one never knows what his mental processes are going to do next.” The verdict was “suicide while the balance of his mind was disturbed.” Even in death, psychiatry and the state stigmatized Turing as mad. The posthumous diagnosis of suicide as mental illness is the ritual degradation ceremony of our therapeutic age, much as the posthumous burning of the heretic’s corpse was the ritual degradation ceremony of an earlier theological age.

No one in Turing’s circle, himself included, was able or willing to transcend the psychiatric zeitgeist: Homoerotic behavior and self-determined death are self-evident symptoms of mental illness, it argues, requiring and justifying coercive medical-psychiatric treatment. Turing’s psychiatrist, Dr. Frank M. Greenbaum, vehemently rejected the coroner’s diagnosis, though not by contesting the claims that engaging in homosexual conduct and self-killing are evidence of diseases curable by doctors. “There is not the slightest doubt to me that Alan died by an accident,” declared Greenbaum.

In 1967 the UK decriminalized homosexuality. Overnight it ceased to be a disease in England but not the United States, where for six more years it remained both a crime and a “treatable disease.”

Turing’s biographer, Andrew Hodges, notes that Turing did not consider his homosexuality a disease, a crime, or a shameful condition. He suggests that Turing opted for medical treatment rather than a brief period of imprisonment because he feared that a criminal conviction would be fatal for his career. Countless of Turing’s gay contemporaries at Cambridge and in London—Wittgenstein, Keynes, Lytton Strachey, many of the Apostles and Bloomsburys—sensibly stayed away from psychiatrists. Many famous people—Gandhi, Russell, and Nehru—spent time in prison, though, and went on to do memorable work. This is not true for people imprisoned in mental hospitals. After the psychiatric degraders finish their job, the “patient” is dead—if not biologically then socially.

Psychiatric destruction often begins with psychiatric self-destruction, the denominated patient believing the psychiatrist’s self-deceptions about nonexisting diseases and their damaging treatments. “The worst enemy of truth and freedom in our society,” declared Henrik Ibsen (1828–1906), “is the compact majority. Yes, the damned, compact, liberal majority.” Let us not forget that the power of science is limited to informing and misinforming. It does not have the power to coerce. In contrast, power to coerce is the very essence of psychiatric pseudoscience allied with the state. Psychiatrists regularly characterize their power to coerce as “suicide prevention.” The opposite is often the case.

The original function of psychiatry—which is approximately 300 years old—was penological: The psychiatrist stigmatized persons as “mad,” deprived them of liberty, and assaulted them with chemical and physical interventions. A little more than 100 years ago individuals began to seek psychiatric help for their own problems. As a result, many people who entrusted themselves to the care of psychiatrists became entrapped in the machinery of punitive mad-doctoring, dramatically portrayed in Ken Kesey’s best-selling novel, One Flew Over the Cuckoo’s Nest, and the film based on it. The recent film Changeling presents a real-life example.

So does Alan Turing’s psychiatric undoing.

Psychiatry: Trap, Not Treatment

The identification of psychiatry with medical healing and humane helpfulness is factually false and morally deceptive, concealing an existential trap with untold-of potentialities for injury and death for the entrapped. More successfully than ever, the modern “biological” psychiatrist misrepresents his profession as based on biological science and medical discovery, while more than ever it is based on pseudoscience and therapeutic deception.

The persecution of homosexuals is paradigmatic of the history of psychiatry’s monumental blunders and brutalities and of its policy of never acknowledging nor apologizing for them. Instead, organized psychiatry intensifies the celebration of its founding quack, Benjamin Rush (1746–1813). Declared Rush, “I have selected those two symptoms [murder and theft] of this disease [crime] (for they are not vices) from its other morbid effects, in order to rescue persons affected with them from the arm of the law, and render them the subjects of the kind and lenient hand of medicine.” What did Rush mean when he spoke of medical kindness and lenience? Lamenting the “excess of the passion for liberty inflamed by the successful issue of the [Revolutionary] war,” he explained, “Were we to live our lives over again and engage in the same benevolent enterprise, our means should not be reasoning but bleeding, purging, low diet, and the tranquilizing chair.” Psychiatry—glorifying the use of coercion as cure—is the shame of  medicine.

Related posts:

1. The Shame of Medicine: The Case of General Edwin Walker
2. The Shame of Medicine: The Depravity of Psychiatry
3. The Shame of Medicine: Conviction by Psychiatry

We humans are choice-making animals. The freedom to make choices is both a blessing and a curse. Depending on age, temperament, information, and alternatives, some people experience the opportunity for choice as exhilarating, others as tormenting. Traditionally, it was one of the functions of religion to relieve people of choices. Today, psychiatry and the therapeutic state perform the same job.

Karl Jaspers (1883–1969)—the great twentieth-century German psychiatrist-turned-philosopher—understood this. But he identified only one part of this drama, the patient’s: “Generally formulated, we may say that these people [“neurotics”] are determined that events for which they are accountable and in which they are understandably concerned shall be taken as mere happenings, for which they are entirely irresponsible.” Psychiatrists were, and are, happy to play the other part, authenticating the person’s false self-definition as mental patient—medical object, not moral actor.

Lord Acton

There is important religious precedent for the authoritative declaration of falsehood as truth. In 1870, under the leadership of the legendary Pope Pius IX—Pio Nono, the longest-reigning and one of the most colorful popes in history—the Vatican declared the dogma of papal infallibility. This was anathema to Lord Acton (1834–1902), the most respected Catholic layman in Europe in his time. Alienated from the Church, Acton did not leave it; and, probably because he had not been ordained, he was not excommunicated. It was in the context of this moral conflict that, in 1887, in a letter to Bishop Mandell Creighton, Acton made his famous pronouncement:

Most people who quote Lord Acton’s famous dictum today are unaware it refers to papal power and was made by a devout Catholic. In 1882 Acton, now alienated from his great teacher and lifelong friend, Father Johann Ignaz von Döllinger, who was excommunicated for opposing the infallibility doctrine, writes him:

Acton regarded the claim of papal infallibility as evidence of intolerable religious arrogance and power. I regard psychiatric infallibility—the unfalsifiability and irrefutability of psychiatric diagnoses backed by mental-health laws—as evidence of intolerable psychiatric arrogance and power.

Acton thought “he witnessed the triumph of error in history.” Indeed, he had. Today, we witness a similar—but more ominous—triumph of error in medicine-psychiatry. In addition to persuading the public and the government that human problems are medical diseases, psychiatrists have succeeded in abolishing the concepts of responsibility, guilt, and innocence, and in replacing punishment with the irrefutable and ineradicable stigmata of psychiatric “diagnoses” and “treatments.” “Modern psychiatry,” I wrote in 1970, “dehumanize[s] man by denying . . . the existence, or even the possibility, of personal responsibility, central to the concept of man as moral agent.” It accomplishes that evil by treating responsibility, following Ambrose Bierce, as “a detachable burden easily shifted to the shoulders of God, Fate, Fortune, Luck or one’s neighbor.” In our day, it is not merely customary but, in matters that really count, mandatory to unload responsibility on Mental Illness (“he snapped,” “had a breakdown,” “battled his demons,” “was on drugs,” “went off prescribed medication,” and so forth).

In Acton’s day the separation of church and state was an established political practice in many countries. Hence, the Church’s moral failures and self-arrogated powers affected only persons who chose to be its adherents. Our predicament is more serious. We live at a time when the alliance of medicine-psychiatry and the state is taken for granted—viewed as an unalterable social fact and undoubted moral and social good. Everyone, regardless of personal choice, is affected, directly or indirectly, by the powers of the therapeutic state.

Psychiatry and the State

Given its limited legal-political powers, the Vatican could not have tried to purge the world of its critics, much less intimidate them into becoming its crypto-supporters. In contrast, in our day the alliance of psychiatry and the state has enabled pharmacracy to do just that. Its so-called critics—who call themselves “antipsychiatrists,” “critical psychiatrists,” “ethical psychiatrists,” and so on—oppose one or another psychiatric “diagnosis” or “treatment,” rarely even psychiatric coercion. But they all support the view that the misbehavior of individuals afflicted with/suffering from so-called mental illnesses ought not be regulated by the same rules as are the misbehaviors of individuals not so denominated: They recoil from defending an ethic based on personal responsibility for public actions (as distinct from private actions, called “thoughts”) and of every individual’s inalienable right to his or her life and death, lest they appear uncompassionate and, perish the thought, unscientific and illiberal (in the modern, statist sense of “liberal”). Thus they endorse—explicitly or by the assent of silence—psychiatry’s war on responsibility, epitomized by the wars on drugs, mental illness, and suicide and by the insanity defense.

“Truth,” said Thomas Jefferson, “will do well enough if left to shift for herself. She seldom has received much aid from the power of great men to whom she is rarely known and seldom welcome. She has no need of force to procure entrance into the minds of men. . . . It is error alone which needs the support of government.” Jefferson was right in applying this principle to religion: modern states should not (and for the most part do not) lend their coercive powers to the support of the clerical lies of priests. Nor should they lend their coercive powers to the support of the clinical lies of psychiatrists. As long as they do, serious persons ought not to take psychiatry seriously—except as a threat to reason, responsibility, and liberty.

Related posts:

1. House of Aces
2. Treatments Without Diseases
3. Psychiatry Versus Liberty

In February 2008 David Tarloff—a career “schizophrenic”—is released from a type of prison we call “hospital.” Ten days later he kills a psychologist who shares offices with a psychiatrist whom Tarloff holds responsible for depriving him of liberty. In June the New York Times reports: “A lawyer for a schizophrenic man accused of killing an Upper East Side psychotherapist tried three times on Tuesday morning to persuade his client to leave his holding cell for a hearing.” The lawyer was unsuccessful. Tarloff was not interested in being cooperative. He was interested in his life situation as he saw (constructed) it. Of course there is nothing new about defendants—especially defendants charged with a capital crime—not cooperating with the judicial system. What is new about it is the way the medical-judicial system now deals with such a person. According to the Times,

The hearing, held in a small courtroom at Bellevue, was held to decide whether doctors could force Mr. Tarloff to take his medication. . . . Justice John E. H. Stackhouse of State Supreme Court in Manhattan granted the hospital’s request. . . . Ronald L. Kuby, a defense lawyer, said medication was too often used to create a false sense of sanity. “When the jury sees your client sitting there calmly, peacefully, sort of blankly staring, that person then looks sane,” Mr. Kuby said. “But that’s a chemically induced stability designed to make the judicial railroad function.” . . . “When somebody is in need of medication,” Mr. Konoski [Tarloff's principal attorney] said, “forcing them not to have it, forcing them to deal with their demons instead of being able to suppress them through the medication, that’s almost like torture.” [Emphasis added.]

Voilà: The defendant who refuses to ingest a chemical straitjacket has a medical need for the drug. Acceding to the defendant’s wish to not be chemically restrained is torturing him. Only in the age of psychiatry could people believe such brazen lies.

I was a trained physician and psychoanalyst before the advent of the class of chemicals we call “psychiatric drugs.” I well remember watching—1954 or 1955, when I was serving my required military tour of duty at the National Naval Medical Center in Bethesda, Maryland—what must have been one of the first films promoting chlorpromazine, patented in the United States as Thorazine. The film showed monkeys, rendered irritable and aggressive by starvation and crowding, being injected with the drug and becoming “tranquilized.” The term was new then. This, we were told, was the new cure for schizophrenia. I did not like what I saw and immediately wrote the following: “The widespread acceptance and use of the so-called tranquilizing drugs constitutes one of the most noteworthy events in the recent history of psychiatry. . . . These drugs, in essence, function as chemical straitjackets. . . . When patients had to be restrained by the use of force—for example, by a straitjacket—it was difficult for those in charge of their care to convince themselves that they were acting altogether on behalf of the patient. . . . Restraint by chemical means does not make [the psychiatrist] feel guilty; herein lies the danger to the patient.”

This, then, was the glorious—but unacknowledged and unacknowledgeable—psychopharmacological breakthrough: Restraint could be put in the patient instead of on him and be defined as “drug treatment” (of and for the patient). It was obvious from the start that neuroleptic drugs benefit psychiatrists, not patients. Psychiatrists deal with this predictable result by attributing it to a newly invented mental¬-brain disease they call “anosognosia.”

In 1931 Robert Frost (1874–1963) delivered a lecture at Amherst College with the unexciting title “Education by Poetry.” It is a profound meditation on, and warning about, uses and abuses of metaphor. Long before I “discovered” the vast errors hidden from us by the metaphor of mental illness, Frost wrote:

Health is another good word. And that is the metaphor Freudianism trades on, mental health. And the first thing we know, it has us all in up to the top knot. . . . What I am pointing out is that unless you are at home in the metaphor, unless you have had your proper poetical education in the metaphor, you are not safe anywhere. Because you are not at ease with figurative values: you don’t know the metaphor in its strength and its weakness. You don’t know how far you may expect to ride it and when it may break down with you. You are not safe with science; you are not safe in history. . . . They don’t know what they may safely like in the libraries and galleries. They don’t know how to judge an editorial when they see one. They don’t know how to judge a political campaign. They don’t know when they are being fooled by a metaphor, an analogy, a parable. And metaphor is, of course, what we are talking about. Education by poetry is education by metaphor.

Paraphrasing that phrase, I suggest that education by psychiatry is education by and with mendacity, a thesis I have maintained for more than half a century.

Recent reports in the press exposed Dr. Joseph Biederman, professor of psychiatry at Harvard Medical School, and his collaborators of failing to report “at least $3.2 million dollars they had received from drug companies between 2000 and 2007,” violating federal and university research rules designed to police potential conflicts of interest.

Biederman is said to be “one of the most influential researchers in child psychiatry, whose work has helped to fuel a controversial 40-fold increase from 1994 to 2003 in the diagnosis of pediatric bipolar disorder, characterized by severe mood swings, and a rapid rise in the use of antipsychotic medicines in children.”

He is confident that the children whose behavior displeases their mothers suffer from a brain disease that requires pharmacological treatment. But is drugging children allegedly suffering from “pediatric bipolar disease” analogous to vaccinating them against smallpox, as Biederman suggests? Never mind that antipsychotic drugs are promoted as therapeutic agents, not as prophylactics. Never mind that press reports routinely refer to antipsychotic drugs as subduing involuntary subjects. And never mind that the modern psychiatrists’ favorite “patients” are persons who are powerless to resist being cast in that role: children, prisoners, and old people in nursing homes.

If you are ignorant of metaphor, warned Frost, “You are not safe with science; you are not safe in history . . . in the libraries and galleries.” You are certainly not safe if you believe that psychiatrists care for and cure sick people, when in fact they coerce and control persons helpless to resist their violence.

Related posts:

1. Treatments Without Diseases
2. House of Aces
3. Civil Liberties and Civil Commitment

The libertarian philosophy of freedom is based on the premise that self-ownership is a basic right and that initiating violence against others is a fundamental wrong. What is self-ownership if not the right to choose what, or how much of it, to ingest? What is initiating violence against another if not forcibly incarcerating him for ingesting too much or too little of a particular substance?

Consider, in this connection, a recent article in the prestigious British Journal of Medical Ethics, titled “Should We Force the Obese to Diet?” Extending the logic of perverted psychiatric “ethics” from anorexia nervosa to morbid obesity, the author concludes: “A person with anorexia can be detained under the Mental Health Act 1983 and forcibly fed. The obese cannot, so far, be forced to diet. The justification for this differential and possibly irrational distinction is unclear. . . . If the latter is competent, why should we assume the former is not? If it is right to force-feed an anorexic, why shouldn’t it be right to force-diet the obese?”

From Status to Contract

Famed English jurist Sir Henry Sumner Maine (1822–1888) aptly observed: “The movement of the progressive societies has hitherto been a movement from Status to Contract.” In other words, in liberal (free) societies the law treats persons as contracting individuals, not as members of status groups. Modern psychiatry has declared war on this principle. Marcia Goin, M.D., a former president of the American Psychiatric Association, declares: “We can make contracts with builders, insurers, and car dealers, but not with patients.” Builders, insurers, and car dealers make contracts with persons whom psychiatrists call “patients.” Why can’t psychiatrists make contracts with them? Because contracting implies two (or more) legally equal parties, each putting his cards on the table. It implies mutual obligations, each party having legal power to compel his partner to fulfill the contract or compensate him for failure to do so.

Such mutuality is contrary to psychiatric ethics. Psychiatrists reject the “base” ethics of commerce in favor of the “loftier” ethics of care. The seller of plumbing services is obligated to deliver only that which his customer has requested and he has agreed to provide. The seller of psychiatric services is obligated to deliver much more: he must protect the customer from himself, even at the cost of depriving him of liberty.

Civilized morality and the free market presuppose a commitment to valuing cooperation and contract more highly than coercion and control. Official psychiatry declares that ethically and legally proper practice requires the rejection of free contract in favor of “therapeutic” coercion. Daniel Luchins, M.D., a professor of psychiatry at the University of Chicago, states: “[E]mphasis on protecting negative liberties may be appropriate for a society of 18th-century country squires, but not for the seriously mentally ill in the United States.” In other words, the psychiatrist who contracts with his patient—and fails to protect him, say, from eating too little (anorexia nervosa) or suicide (clinical depression)—deviates from the “standard of psychiatric care” (is derelict in his “duty to protect” and denies the patient his “right to treatment”) and is presumed guilty of medical malpractice. This compels all psychiatrists to function as (potentially) coercive psychiatrists and makes noncoercive psychiatry an oxymoron.

Let us not forget that there is no objective test for mental illness, much less a test to measure the severity of this alleged illness. How, then, do psychiatrists know that a mental illness is “serious” enough to justify coercive detention and “treatment”? They know it ex post facto: if the patient injures or kills himself, then he is said to have had a “serious mental illness.” The American Constitution prohibits ex post facto laws. The American Psychiatric Association and American mental-health laws espouse and rely on ex post facto determinations.

Does deprivation of liberty under psychiatric auspices constitute odious preventive detention or is it therapeutically justified hospitalization? Should forced psychiatric drugging be interpreted as assault and battery or medical treatment? Part of the answer to these troubling questions lies in clarifying the differences between the literal and the metaphorical meanings of the word “liberty.”

The Meanings of “Liberty”

The literal meaning of liberty is dyadic: freedom from external coercion. In this sense, liberty is an interpersonal concept entailing two or more persons. It is freedom from control by parent, policeman, or psychiatrist.

The metaphorical meaning of liberty is internal or monadic: freedom from “control” by our own passions. In this sense, liberty is an intrapersonal concept entailing only one person. It is freedom from our own unwanted impulses—freedom from lust, covetousness, envy, rage, hopelessness, “mental illness.” It is, in short, freedom from “self-enslavement,” liberty as self-control.

Philosophers and theologians have long distinguished between outer and inner freedom. Psychiatrists have appropriated this spiritual concept of freedom and founded a pseudomedical, “therapeutic” empire on it. The idea of insanity or mental illness entails the concept of unfreedom: the madman is “possessed” by “irresistible impulses” (formerly the devil, now a brain disease), is a “victim” of “mental illness,” has lost his “criminal responsibility.” Hence, he is properly a ward of the psychiatrist as agent of the state.

In everyday language we conflate and confuse these two radically different meanings of liberty, for example, when we say that for the adolescent, liberty is freedom from parents and teachers; for the prisoner, freedom from confinement; for the unhappy husband or wife, freedom from marriage; for the overburdened mother, freedom from children; for the sick person, freedom from illness; for the old person, freedom from having to live.

Libertarians discuss ad nauseam freedom from economic controls because they see themselves as among the controlled, and ignore the need for freedom from psychiatric controls because they do not see themselves as among the controlled. If they did, they would see psychiatry as Anton Chekhov (“Ward No. 6”) saw it, through the eyes of the psychiatrist who realizes the enormity of what he has done to his “patients” only after he is himself locked up with them:

[S]uddenly amid the chaos, the terrible, unendurable thought flashed clearly to his mind that these people who now looked like black shadows in the moonlight must have experienced the same pains for over twenty years, day after day. How could it happen that throughout over twenty years he had not known and had not wanted to know that? He had not known, he had no understanding of pain, meaning he was not guilty, yet his conscience, as intractable and hard as Nikita [the brutal attendant], made him grow cold from the top of his head to his heels. He jumped up, wanted to cry out with all his strength and run as fast as possible to kill Nikita, then Khobortov, the superintendent, and the orderly, and then himself, but not a sound came out of his chest.

Related posts:

1. Psychiatry: A Branch of the Law
2. Defining Psychiatry
3. House of Aces

The term “anti-psychiatry” was created in 1967 by the South African psychiatrist David Cooper (1931–1986) and the Scottish psychiatrist Ronald David Laing (1927–1989). Instead of defining the term, they identified it as follows: “We have had many pipe-dreams about the ideal psychiatric, or rather anti-psychiatric, community.” The “we” were Cooper, Laing, Joseph Berke, and Leon Redler, the latter two American psychiatrists and pupils of Laing.

“A key understanding of ‘anti-psychiatry,’ ” explains British existential therapist Digby Tantam, “is that mental illness is a myth (Szasz 1972).” Alas, this is not true. While many anti-psychiatrists pay lip service to rejecting the “medical model” of psychiatry, they continue to conceptualize certain human problems and efforts to resolve them in medical terms and, even more importantly, do not categorically reject “therapeutic” coercion and excuse-making. Psychiatrists engage in many phony practices but none phonier than the insanity defense. The anti-psychiatrists have not addressed this subject in their writings, but Laing gave “expert psychiatric testimony” in the famous case of John Thomson Stonehouse (1925–1988). Stonehouse, a British politician and Labour minister, went into business, lost money, and tried to bail himself out by engaging in fraud. When the authorities were about to arrest him, he staged his own suicide. On November 20, 1974, Stonehouse left a pile of clothes on a Miami beach and disappeared. Presumed dead, he was en route to Australia, hoping to set up a new life with his mistress. Discovered by chance in Melbourne, he was deported to the United Kingdom and charged with 21 counts of fraud, theft, forgery, conspiracy to defraud, and causing a false police investigation.

Stonehouse pleaded not guilty by reason of insanity; he was convicted and sentenced to seven years in prison. To support his insanity defense, he secured the services of five psychiatrists, R. D. Laing among them, to testify in court under oath that he was insane when he committed his criminal acts. In his book, My Trial, Stonehouse writes: “Dr. Ronald Laing . . . gave evidence on my mental condition. He confirmed . . . that in his report he had called it psychotic and the splitting of the personality into multiple pieces. He went on: ‘The conflict is dealt with by this splitting instead of dealing with it openly. . . . It was partial reactive psychosis.’”

Laing did not know Stonehouse prior to his trial, hence could have had no knowledge of his “mental condition” during the commission of his crimes. Laing’s “diagnosis” was classic psychiatric gobbledygook, precisely the kind of charlatanry he pretended to oppose. Laing and Stonehouse were both liars, plain and simple.

Laing’s fame was closely connected with his role as Emperor of Kingsley Hall, a “household” founded by him and by a group of his acolytes. It was promoted as a place to which a person—whom psychiatrists would diagnose as schizophrenic—could retreat, secure in the knowledge that he would be neither coerced nor drugged. Day-to-day life in Kingsley Hall was based on the fiction that all the “residents” are equal, no one is a patient and no one is staff. The American psychiatrist Morton Schatzman, who had chosen to live there for a year, emphasized that “No one who lives at Kingsley Hall sees those who perform work upon the external material world as ‘staff,’ and those who do not as ‘patients.’ ” This claim—that psychiatrists and residents share power equally—is the paradigmatic lie of the anti-psychiatrists. It is a revised version of the paradigmatic lie of the psychiatrists—the claim that depriving patients of liberty is care, not coercion.

The American writer Clancy Sigal (born 1926) went to London to be Laing’s patient. Soon the “therapy” ended and they became friends and LSD-using buddies. Sigal, one of the co-founders of Kingsley Hall, eventually became disenchanted with the Laingian commune, especially after he discovered that Laing and his cohorts preached nonviolence but practiced violence.

After returning to the United States, Sigal wrote a devastating exposé of Laing and his cult. Zone of the Interior, a roman à clef, was published in the United States in 1976. Using the threat of British libel laws, Laing prevented its publication in the United Kingdom. Only in 2005 did Zone of the Interior appear in a British edition. Sigal writes: “In September 1965, during the Jewish High Holidays, I had a ‘schizophrenic breakdown’ . . . or transformative moment of rebirth. It’s all in your point of view. My ‘breakdown’ did not happen privately but acted out in front of twenty or thirty people on a Friday shabbat night at Kingsley Hall. . . . The notion behind Kingsley Hall was that psychosis is not an illness but a state of trance to be valued as a healing agent.”

In an interview after the publication of Zone of the Interior in Britain, Sigal described his folie à deux with Laing:

“We began exchanging roles, he the patient and I the therapist, and took LSD together. . . . Laing and I had sealed a devil’s bargain. Although we set out to ‘cure’ schizophrenia, we became schizophrenic in our attitudes to ourselves and to the outside world. . . . [One] night, after I left Kingsley Hall, several of the doctors, who persuaded themselves that I was suicidal, piled into two cars, sped to my apartment, broke in, and jammed me with needles full of Largactil [Thorazine], a fast-acting sedative used by conventional doctors in mental wards. Led by Laing, they dragged me back to Kingsley Hall.”

The Sigal saga ought to be the last nail in the coffin of the legend of Laing as a psychiatrist opposed to the practice of psychiatric coercion. Had Sigal’s book been published in Britain in 1976, Laing would have been exposed and perhaps punished as a criminal (for assault and battery), Kingsley Hall might have been shut down (as an unlicensed mental hospital), and the legend of Laing the “savior of the schizophrenic” would have been cut short. Shakespeare was right: “The evil that men do lives after them.”

As a result of the anti-psychiatrists’ self-seeking sloganeering, psychiatrists can now do what no other members of a medical specialty can do: they can dismiss critics of any aspect of accepted psychiatric practice by labeling them “anti-psychiatrists.” The obstetrician who eschews abortion on demand is not stigmatized as an “anti-obstetrician.” The surgeon who eschews transsexual operations is not dismissed as an “anti-surgeon.”

But the psychiatrist who eschews coercion and excuse-making is called an “anti-psychiatrist.” The upshot is that every physician—except the psychiatrist—is free to elect not to perform particular procedures that offend his moral principles or procedures he simply prefers not to perform.

Why is the psychiatrist de facto deprived of this freedom? Because in psychiatry the paradigmatic practice—coercing patients deemed to be dangerous to themselves or others, called “civil commitment”—is the medico-legal “standard of care,” deviation from which invites malpractice litigation and exposes the “deviant” psychiatrist to forfeiture of his medical license.

Related posts:

1. The Therapeutic State ~ Parity for Mental Illness, Disparity for Mental Patients
2. The Therapeutic State ~ Insanity and Intolerance
3. Psychiatry Versus Liberty

There are objective criteria to determine whether a person has or does not have, say, a case of acute gonorrhea. This makes it reasonable to ask whether an antibiotic drug, say penicillin, is effective against gonorrhea. However, it is not reasonable to ask whether an anti-psychotic drug, say Zyprexa, is effective against schizophrenia, because there are no objective criteria to determine whether a person has or does not have this alleged disorder. This is why it is futile to debate whether one or another psychotropic drug “works.” All we can know is whether a particular mental patient likes or does not like to take a particular psychotropic drug; whether a particular family member likes or does not like his “loved one” to receive a particular psychotropic drug; and so forth.

With respect to so-called mind-altering drugs, whether heroin or Haldol, introducing the coercive powers of the state into the controversy about the therapeutic effectiveness of one or another such drug further complicates the situation. We regard clerical-religious coercion as evil independently of its alleged theological benefits. This was not always the case and is not the case now in other parts of the world. Similarly, we have a choice between regarding clinical-psychiatric coercion as good because it is “therapeutic” or evil regardless of its alleged therapeutic benefits.

In my view, the ultimate arbiter of whether a psychiatric drug helps or harms a patient is the patient himself. And the best way to determine whether a person truly believes that a psychiatric drug helps or harms him is by attending to his behavior, not his words, much less the words of psychiatrists and pharmaceutical companies.

If a “mental patient” seeks a drug and pays for it, then it helps him; if he avoids the drug and is unwilling to pay for it, then it harms him. It is foolish to call entire classes of drugs “therapeutic” or “toxic,” good or bad, safe or dangerous, because the effect of a drug depends very heavily on the dose—as well as on the user and the social context.

From an economic-political point of view, drugs—especially psychiatric drugs—may be divided into two groups: 1) substances that people want to take and are willing to pay for, such as sleeping pills, and 2) substances that people do not want to take and are not willing to pay for, such as antipsychotic drugs. Not coincidentally, the substances people reject are the drugs typically administered to them against their will.

Drug Bonanza

Because many drugs affect the brain and the brain affects our behavior, the use of neuroleptic and other psychiatric drugs has proved to be a bonanza not only for pharmaceutical companies, psychopharmacologists, and personal-injury lawyers, but also for psychiatrists eager to testify in tort litigation about mental illness, drug treatment, and their supposedly scientific insight into people’s “dangerousness to self and others” (self-mutilation, suicide, assault, and murder). These fake experts also fall into two groups that we may call “pro-” and “anti-drug” psychiatrists.

The pro-drug psychiatrists claim that psychotropic drugs treat mental diseases, often manifested by suicide and homicide. When a patient does not take his “prescribed medication” and then kills himself or others, these experts blame the patient’s behavior on “untreated mental illness.” The pro-drug psychiatrist attributes agency to mental illness and non-agency to the person he calls “mental patient”—and testifies in court that the patient was not legally responsible for his lawless acts.

The anti-drug psychiatrists claim that psychotropic drugs cause or predispose to suicide and murder. When a patient takes his “prescribed psychiatric” medication and kills himself or others, the anti-drug psychiatrists blame the patient’s behavior on the psychotropic drug. They attribute agency to certain psychotropic drugs (but not to others, such as alcohol and nicotine) and non-agency to a patient whom he regards as a victim of psychiatric malpractice—and testifies in court that the drug company that manufactures the drug (stigmatized as “Big Pharma”) is guilty of negligent homicide.

Members of the two groups resemble one another in a crucial way: neither treats the patient-subject as a responsible moral agent. I maintain that neither mental illness nor psychiatric drugs cause suicide or murder. Killing—oneself or others—is a voluntary act for which the actor is responsible.

Pro- and anti-drug psychiatrists also resemble one another in their misuse of the concept of causation. There is an important difference between the way a drug such as Seconal (a barbiturate) causes sleep and the way a drug such Zyprexa (an antipsychotic) “causes” suicide. Sleep is a biological condition. Suicide is an action. To be sure, an antipsychotic drug may cause tormenting inner tensions that may “drive” a person to kill himself. But many of life’s vicissitudes—divorce, disabling illness, death of a loved one—may do the same. Coerced drugging is a moral and political evil, even if it has no biologically harmful effects. If it does, the evil is compounded.

“If you miss the first buttonhole,” remarked Goethe, “you will not succeed in buttoning up your coat.” There are times, however, when missing the first buttonhole is the politically and socially correct thing to do. I believe we live in such a time.

The modern psychopharmacologist is like the man who inserts the first button into the second buttonhole and then tries to make the garment fit. What is the first buttonhole? The nature of the problem for which people take, or are forced to take, psychotropic drugs. What is the second buttonhole? The sacred symbol called “mental illness.” Today, the person who makes a profession out of fastening the garment “scientifically” (but incorrectly) is richly rewarded, while the person who insists on fastening it correctly (but “unscientifically”) is dismissed as an uncompassionate charlatan.

Legal-Social Context

Modern psychopharmacological treatment must be situated in its proper legal-social context. What is that context? It is a society in which the moral legitimacy of psychiatric coercions and statist drug regulations—exemplified by drug prohibition, prescription laws, and the criminalization of self-medication—are taken for granted. The parameters they set must not and cannot be questioned. The “scientific” psychopharmacologist—supported by the government (National Institutes of Mental Health) and the pharmaceutical companies—accepts the conceptual premises and coercive practices of psychiatry: mental illness is a medical illness like any other; the imprisonment of the mental patient is a medical treatment like any other. He validates psychiatry as a medical specialty and psychiatric drug treatment as a type of medical chemotherapy.

The result is the socially accepted pretense that the relationship between a patient with a mental illness and an antipsychotic drug is “just like” the relationship between a patient with an infectious disease and an antibiotic drug. This is a lie. Instead, the relationship between a forcibly “medicated” mental patient and the psychotropic drug resembles the relationship between a woman forcibly subjected to coitus and the aggressor’s sexual fluids. Coerced drugging is a form of “therapeutic” rape.

Related posts:

1. On Autogenic Diseases
2. House of Aces
3. Psychiatry Versus Liberty

Medical classification—the linguistic-conceptual ordering of phenomena we call “diseases” and of the interventions we call “treatments”—is a human activity, governed by human interests. In the United States today, the forces of medicalization rule virtually unopposed, indeed unrecognized for the economic, moral, and political interests they represent. Our drug policies are illustrative. For millennia, the regulation of drug use was a matter of self-control, custom, religion, and law. In part, this is still the case. More importantly, however, drug use is regulated by laws and ostensibly scientific “facts,” exemplified by a broadly based drug prohibition consisting of prescription laws and criminalization of the trade in many drugs, such as opiates, cocaine, and marijuana. This is drug medicalization from above. Drug medicalization from below is pursued no less zealously by individuals who, while ostensibly opposed to our drug laws, promote so-called medical-marijuana initiatives, physician-assisted suicide, and similar schemes. The result is loss of self-ownership and the right to self-medication—the classical liberal/libertarian perspective on drug use.

Diseased Mind?

Because the mind is not an object like the body, it is a mistake to apply the predicate disease to it. Hence, as I asserted half a century ago, the “diseased mind” is a metaphor, a mistake, a myth.

Actually, this idea is not as novel as it might seem. Emil Kraepelin (1856–1926), the creator of the first modern psychiatric nosology, acknowledged the fundamental analytic truth that there are no mental illnesses. In his classic, Lectures on Clinical Psychiatry (1901), he stated: “The subject of the following course of lectures will be the Science of Psychiatry, which, as its name [Seelenheilkunde] implies, is that of the treatment of mental disease. It is true that, in the strictest terms, we cannot speak of the mind as becoming diseased.” Half a century earlier, the Viennese psychiatrist Ernst von Feuchters-leben (1806–1849) explicitly emphasized the analogical-metaphorical character of mental illnesses: “The maladies of the spirit alone, in abstracto, that is, error and sin, can be called diseases of the mind only per analogiam. They come not within the jurisdiction of the physician, but that of the teacher or clergyman, who again are called physicians of the mind/soul only per analogiam.”

The transformation of religious explanations and controls of behavior into medical explanations and controls of behavior is one of the momentous consequences of the Enlightenment. The waning power of religion and the Church and the waxing power of science and the State are manifested, among other things, by the political control of medical practice and the drug laws that deny access to the layperson to drugs (except those classified as over-the-counter). To legally obtain or possess a “prescription drug,” the layperson must establish a professional relationship with a licensed physician and receive a diagnosis for an illness; that is, he must be a patient who suffers from a proven or putative illness. For example, to receive a sleeping pill, the person must “suffer from insomnia.” This charade contributes mightily to the medicalization rampant in our society. In turn, medicalization is mindlessly equated, especially by the cognoscenti, with scientific, moral, and social progress, and contributes further to its popularity.

Although medicalization encompasses more than psychiatry, we must be clear about one thing: Psychiatry is medicalization through and through. Whatever aspect of psychiatry psychiatrists claim is not medicalization, is not medicalization only if it deals with proven disease, in which case it belongs to neurology, neuroanatomy, neurophysiology, neurochemistry, neuropharmacology, or neurosurgery, not psychiatry.

Psychoanalysis is medicalization squared. It is important, in this connection, not to be fooled by lay analysis, clinical psychology, or social work. These and other nonmedical mental-health and counseling “professions” are medicalization cubed: as if to compensate for their lack of medical knowledge and qualifications, nonmedical mental-health “professionals” are even more deeply committed than psychiatrists to their claim of special expertise in the diagnosis and treatment of mental illnesses.

Freud’s Contribution

By the time Sigmund Freud (1856–1939) appeared on the historical stage, medicalization was in full swing. The birth of psychoanalysis is, in fact, a manifestation of the increasing popularity of this trend at the end of the nineteenth century as well as a cause of its explosive growth during the twentieth century. The gist of Freud’s thesis was that the symptoms of mental illnesses are the “products” of the same “mental processes” that are responsible for the thoughts and actions of normal persons. In other words, Freud rediscovered that “there is method in madness,” or as he preferred to put it, that sane and insane behaviors are subject to the same “psychological laws.” To create his special brand of pseudoscience, he titled his book The Psychopathology of Everyday Life. He could just as well have titled it The Everyday Normality of Psychopathological Life. There would, of course, have been neither fame nor fortune in that. Instead, he fanned the flames of medicalization and transformed a smoldering fire into an all-consuming conflagration. At the same time, because he knew better, Freud’s attitude toward medicalization was ambivalent and opportunistic.

People do not have to be told that malaria and melanoma are diseases. They know they are. But people have to be told, and are told over and over again, that alcoholism and depression are diseases. Why? Because people know that they are not diseases, that mental illnesses are not “like other illnesses,” that mental hospitals are not like other hospitals, that the business of psychiatry is control and coercion, not care or cure. Accordingly, medicalizers engage in a never-ending task of “educating” people that nondiseases are diseases.

Formerly, people felt depressed or were depressed. Now they have depression. Formerly, some depressed persons killed themselves, but most did not. Now people do not kill themselves, depression kills them, and (virtually) everyone who kills himself is said to have been depressed. And just as people can have cancer and not know it, so they may have depression and not know it, and hence need to be tested for it, lest “it” kill them. On its website, the Depression Is Real Coalition emphasizes: “Indisputable scientific evidence shows depression to be a biologically-based disease that destroys the connections between brain cells.”

Cui bono? The peddlers of psychiatric snake oil who are unfailingly silent about two important risks inherent in every professional contact between an individual and a psychiatrist, namely, stigmatization by psychiatric diagnosis and loss of liberty by psychiatric incarceration. Why do the promoters of psychiatric slavery regularly fail to mention the potential downside of “mental health services”? Because they self-servingly define psychiatric oppression of the patient as beneficial for him, much as the promoters of chattel slavery regarded oppression of the slave as beneficial for him. Lincoln’s answer to this outrage remains relevant: “But, slavery is good for some people! As a good thing, slavery is strikingly peculiar, in this, that it is the only good thing which no man ever seeks the good of, for himself.”

In short, medicalization is neither medicine nor science; it is a semantic-social strategy that benefits some persons and harms others.

“[T]he medical treatment of [mental] patients began with the infringement of their personal freedom,” warned Karl Wernicke (1848–1905), the pioneer German neuropathologist. It still begins with the infringement of their personal freedom.

Related posts:

1. Medicalizing Quackery
2. The Therapeutic State ~ Parity for Mental Illness, Disparity for Mental Patients
3. Mental Illness as Brain Disease: A Brief History Lesson