Why do people kill themselves? Because they are mentally ill, assert the mental health experts, a message the media blindly repeats. “Mental illness kills.” In this view suicide is the result of mental illness, just as death from cancer is the result of bodily illness. This is patent nonsense, mindless belief in a literalized metaphor endowed with the power of agency.

According to the National Institute of Mental Health the persons most likely to kill themselves are the young and the old. Its website adds: “A person who appears suicidal should not be left alone and needs immediate mental-health treatment.” This is anti-suicide propaganda, pure and simple.

The actions of the suicide speak louder than the words of persons who presume to speak for them, while trying as best they can to deprive them of dignity and liberty. The most plausible explanation-motive for suicide at any age is the desire to die. Although every person’s reason for killing himself is uniquely personal, as a broad generalization we might say that the young choose voluntary death to escape the pain and responsibility of having to make a life for themselves, the old to escape the consequences of loss of autonomy due to disease and disability.

The suicidal person wants to get away from his life, his social environment. His action is best viewed as a form of emigration or secession. Jean Améry, the Austrian Holocaust survivor and bitter opponent of coerced suicide prevention protested, “I don’t like the word Selbstmord [self-murder] . . . I prefer to speak of Freitod [voluntary death]. . . . [T]here is no carcinoma that devours me, no infarction that fells me, no uremic crisis that takes away my breath. I am that which lays hands upon me, who dies after taking barbiturates, ‘from hand to mouth.’”

Jefferson on Suicide

In 1779 the Virginia legislature was considering a bill to repeal the punishment for suicide. Jefferson supported it and offered the following statement on its behalf:

Suicide is by law punishable by forfeiture of chattels. This bill exempts it from forfeiture. The suicide injures the State less than he who leaves it with his effects. If the latter then not be punished, the former should not. As to the example, we need not fear its influence. Men are too much attached to life, to exhibit frequent instances of depriving themselves of it. At any rate, the quasi-punishment of confiscation will not prevent it. . . . That men in general, too, disapprove of this severity, is apparent from the constant practice of juries finding the suicide in a state of insanity; because they have no other way of saving the forfeiture. Let it then be done away.

Jefferson went further. He considered suicide a perfectly rational act, viewing it as a kind of emigration. In his correspondence with Dr. Samuel Brown, a professor of medicine at Transylvania University in Lexington, Kentucky, concerning the use of toxic plants for killing oneself he wrote:

The most elegant thing of that kind known is a preparation of the Jamestown weed, Datura-Stramonium, invented by the French in the time of Robespierre. Every man of firmness carried it constantly in his pocket to anticipate the guillotine. It brings on the deep sleep as quietly as fatigue does the ordinary sleep, without the least struggle. . . . It seems far preferable to the Venesection of the Romans, the Hemlock of the Greeks, and the Opium of the Turks. . . . There are ills in life as desperate and intolerable, to which it would be the rational relief.

The term “Stramonium” is originally from the Greek strychnos (nightshade) and manikos (mad). All parts of Datura plants contain significant quantities of the alkaloids atropine, hyoscyamine, and scopolamine, chemicals that may be fatal if ingested by humans or animals. In the United States the plant is called “Jamestown weed” after the city in Virginia where British soldiers were drugged with it while attempting to suppress Bacon’s Rebellion in 1676. Today a person who so casually informs another of the suicidal potential of a readily available substance runs the risk of being charged with the crime of “assisting suicide.”

The result of this cultural-legal atmosphere is the destruction of the public’s trust in members of the medical profession and other formerly respected authorities. While suicide prohibitions—usually called “suicide prevention measures”—have not succeeded in preventing suicides, they have succeeded in preventing people from having an honest, private conversation about life and death. Those who trust mental health professionals with their innermost thoughts are likely to find themselves punished with psychiatric incarceration and lifelong stigmatization. Suicidal persons and their would-be helpers alike are paralyzed by prohibitionist censorship, deception, and legislation requiring the betrayal of trust. The first and major victims of the war on suicide, as in all wars, are liberty and truth.

Psychiatrists are expected—legally, medically, and socially—to prevent individuals from killing themselves. As professionals they are also expected to lie and withhold information about the subject. The result is that people can no longer trust physicians, teachers, science writers, or journalists, virtually all of whom have been co-opted, suborned, seduced, or intimidated by the anti-suicide apparatus of the Mental Health System and the Therapeutic State.

Emigration is “leav[ing] one’s place of residence or country to live elsewhere” (Webster’s). Secession is the peaceful separation of political entities. Analogically, we may view divorce as marital secession, and suicide as personal secession. Both terms refer to and are in part synonymous with “separation.”

Viewed as emigrant, the suicide moves from the land of the living to the land of the dead. Regarded as a personal secessionist, he separates himself from his family and society. Diagnosed as incompetent to know his own best interest, the suicide is declared insane, becomes the property of the federal government, and is stamped with the title of ignobility.

In the traditional religious worldview the sole agent with legitimate power to decide who should die is God, the Creator. In the modern medical view the sole such agent is the Therapeutic State. Secession—defiance of control by church and State—is the ultimate escape from oppression, the ultimate declaration of freedom.

According to Article I, Section 9, Clause 8 of the U.S. Constitution, “No title of Nobility shall be granted by the United States,” forbidding the State from ennobling and favoring a class of Americans. The Constitution does not forbid the United States from degrading and disfavoring a class of Americans. Formerly, societies had “nobles”—dukes and princes and kings—persons people were expected to look up to and respect. Today, societies have ignobles—depressives and schizophrenics and suicidals—nonpersons people are expected to look down on and disrespect.

Before his shooting spree Loughner had produced a video he called “My Final Thoughts,” in which he said, “All humans are in need of sleep. Jared Loughner is a human. Hence, Jared Loughner is in need of sleep.” On the morning of his massacre he posted a message on his MySpace account acknowledging his sense that he was at the end of his rope and his decision to let go: “Goodbye. Dear friends . . . Please don’t be mad at me.”

“War is a continuation of politics by other means,” said Prussian general Carl von Clausewitz (1780–1831). I suggest that, similarly, mass murder in plain sight, such as Loughner committed, is a continuation of suicide by other means. Sometimes it is called “suicide by proxy” or “suicide by cop.”

Loughner, to use his metaphor, has gone to sleep. And so have we if we prefer to believe that his self-destructive and destructive act is the senseless product of his “mental illness” rather than the result of his planned, “sensible” decision. The latter view is unpopular and unacceptable because it acknowledges Loughner’s humanity and free will, precisely the qualities that psychiatrists—aided and abetted by the criminal justice system—are intent on removing from persons they label “mad.” This medicalized view of certain offenses—usually crimes that particularly upset people—has, for reasons I have presented elsewhere, become widely accepted in our society, embraced equally by the right and the left.

Normally, we infer the motive for an action from its consequences. For Loughner, one of the consequences of his action is that his life is over, if not biologically then socially. Loughner was well aware of his failure to transition from childhood to adulthood. After years of fruitless travail, he decided to bring his life to a dramatic end. He committed mass murder and let himself be destroyed by the society that, he felt, obstructed his efforts to succeed.

Loughner’s crime, like any act, was not senseless at all, provided we are willing to put ourselves in his shoes. Of course, it makes no sense if we are unwilling to do that, denying the personhood of the actor, dismissing a priori his possessing free will, attributing his action to mental disease instead of personal decision.

The only thing we know with certainty about the Loughner case is the identity of the shooter. We do not know why he committed this crime. Nevertheless, commentators ritually refer to Loughner as the “alleged” assailant and confidently assert that he is crazy, deranged, lunatic, mentally ill, and schizophrenic. Former Vice President Dick Cheney told NBC News, “We need to be a little careful about assuming that somehow the rest of society or the political class bears the responsibility for what happened here when it was the act of a deranged, crazed individual that committed a crime.”

E. Fuller Torrey, a recognized expert on schizophrenic murderers, agrees. He refers to Loughner as “the alleged shooter” and states that he “is reported to have had symptoms associated with schizophrenia . . . and almost certainly was seriously mentally ill and untreated. . . . These tragedies are the inevitable outcome of five decades of failed mental-health policies.”

Torrey’s remedy for the problem of people being at liberty to commit crimes and suffer the consequences is intensifying the traditional legal-psychiatric practice of incarcerating innocent individuals and calling it “hospitalization” and “treatment” and even “suicide and crime prevention”: “The solution to this situation is obvious—make sure individuals with serious mental illnesses are receiving treatment. The mistake was not in emptying the nation’s hospitals but rather in ignoring the treatment needs of the patients being released. . . . Others are unaware they are sick and should be required by law to receive assisted outpatient treatment, including medication and counseling. . . . If they do not comply with the court-ordered treatment plan, they can and should be involuntarily admitted to a hospital.”

In contrast, Ashley Figueroa, a former girlfriend of Loughner, told ABC News that she remembers him as “a drug user with a grudge against the government. . . . I think he’s faking everything. . . . I think that he has been planning this for some time.” A writer for Salon.com adds: “Figueroa is not a doctor, and these claims conflict with the opinion of top doctors in the field of psychiatry. (Dr. E. Fuller Torrey actually told Salon that Loughner looks like a ‘textbook’ case of paranoid schizophrenia.)”

True, Figueroa is not a “doctor.” Does having a medical degree qualify a person to diagnose someone he has never laid eyes on as a schizophrenic? Does the fact that Figueroa knew Loughner, that they had a real-life human relationship, count for nothing?

It did not take long for authorities, in Arizona as well as nationally, to heed Torrey’s advice to cure would-be “schizophrenic murderers” by constricting the liberties of all Americans. On January 15, exactly one week after Loughner’s rampage, one of his victims, J. Eric Fuller, 63, a military veteran, attended a televised forum on “helping the community to heal” and angrily confronted a fellow participant with the metaphor, “You’re dead.” Fuller’s words were interpreted as a “threat,” and he was involuntarily committed for a 72-hour mental-health evaluation. According to CBS News, “[Pima County sheriff’s spokesman Jason] Ogan said the hospital will determine when Fuller will be released.”

The war on words continued in Congress. Before Tucson, the Republicans opposed Obamacare, calling the bill “job killing.” Overnight, that term vanished from the political vocabulary, replaced by “job crushing” and other metaphors. Foolishly, Washington Post columnist Dana Milbank hailed this piece of semantic surgery: “[House Speaker John] Boehner, in a pair of statements on his Web page, dropped the ‘job-killing’ phrase in favor of ‘job-crushing’ and ‘job-destroying.’ House Majority Leader Eric Cantor . . . did not allow the k-word to escape his lips at Tuesday afternoon’s news conference. . . . [T]he new GOP majority generally showed a skill that had been lacking in the Republican caucus for the past two years: self-restraint.”

Wedded to the idea that we have two kinds of lawbreakers in America, sane and insane, we are unable to attend to the human problems we call “mental illnesses.” But not to worry: We can always operate on the vocabulary.

In contemporary English the meaning of the noun “coercion” is clear and uncontroversial. The Merriam-Webster online dictionary defines it as “the act, process, or power of coercing; . . . <a promise obtained by coercion is never binding> . . . synonyms: arm-twisting, force, compulsion, constraint, duress, pressure . . .; near antonyms: agreement, approval, consent, permission.” Coercion is emphatically not the private “subjective response” of the oppressed person; it is the objective, publicly observable action of the oppressor. According to the authoritative Black’s Law Dictionary (Fourth Revised Edition), the relationship between hospital psychiatrist and patient clearly constitutes coercion: “COERCION. Compulsion; constraint; compelling by force or arms.”

Contemporary practitioners of psychiatry, enlightened by neuroscience, brag about their love of the naked power they exercise over their captives.

In her book Weekends at Bellevue, Julie Holland explains:

So why am I so attracted to this patient population? I’ve always been enthralled by insanity. . . . [N]ow I am the doctor in charge of Bellevue’s psychiatric emergency room. . . . I run two fifteen-hour overnight shifts on Saturday and Sunday nights. They call me “the weekend attending.” It feels just like rock-and-roll psychiatry to me. This is my Saturday night gig. . . . [The police deliver a prisoner receiving methadone detoxification.] I go inside to talk to Nancy [the nurse]. “The cop wants dead weight, the prisoner wants methadone. Looks like we should probably just take advantage of the situation.” We agree to do something that everyone knows damn well is completely against the rules. I have never done it before or since: I tell the patient we are going to give him an injection of methadone, and we give him Thorazine. . . . [S]ometimes down here, the end justifies the means. This way, he calms down, the cop is happy, they both leave and we can go on with our night.

The State-sanctioned forcible control of one group of innocent persons by another group of persons authorized to control them is, of course, as old as civilization. We call its prototype “slavery.” Justified by religious and philosophical authorities, the supporters of such systems of institutionalized domination-submission always felt morally superior to those who rejected their reasoning and opposed their power. Today, the system based on the same age-old rationalizations is called “psychiatry.” I have renamed it “psychiatric slavery.”

“If slavery is not wrong,” declared Abraham Lincoln, “nothing is wrong. I cannot remember when I did not so think, and feel.” Slavery is wrong because it empowers one group of persons to deprive another group of liberty on the ground of who they are, not of what they do. I knew very little about Lincoln when I grew up in post-World War I Hungary. But I did recognize, as a gut feeling, that if the domination of the mental patient by the psychiatrist is not wrong, then nothing is wrong. I cannot remember when I did not so think and feel.

Wrong but Necessary

Many decades later I learned about Lincoln’s more complex, confused, and conflicted opinions about slavery, and also about the inconsistency of libertarians’ passionate commitment to the principle of self-ownership as a pillar of individual liberty and their penchant to turn their gaze away from psychiatric slavery as an integral part of the political-social fabric of modern Western societies.

In 1999 an editorial in the British Medical Journal warned, “The growing pressures on them [psychiatrists] to deliver public protection was perhaps inevitable, given the rise of biopsychomedical paradigms as explanations for the vicissitudes of life in modern Western society. Psychiatrists have played their part by assuming the authority to explain, categorize, manage, and prognose in situations where well defined disease (arguably their only clearcut remit) was not present.”

Such warnings have not deterred prominent psychiatrists from making brazen claims about the nature of psychiatry as a medical specialty. In an editorial in the September 2010 issue of Current Psychiatry, titled “Integrating Psychiatry with Other Medical Specialties,” psychiatrist Henry A. Nasrallah—professor of psychiatry at the University of Cincinnati College of Medicine (my alma mater)—writes, “As a specialty that deals with brain disorders, psychiatry is now much more integrated with other medical and surgical specialties than in the past. Psychiatry is no longer perceived as a ‘different’ discipline. . . .” Where is the outrage at this shameless mendacity? Nowhere.

Forgotten Human-Rights Violations

The human-rights violations of chattel slavery, colonialism, the Inquisition, national socialism, and communism have been well documented. Sporadic reports of the human-rights violations of psychiatry abound in our newspapers and magazines. They are quickly forgotten as exceptional “abuses.” More than 50 years ago I set myself the task of not letting the profession and the public forget that psychiatry—the oppression of the patient by the psychiatrist, today justified as the patient’s liberation from an illness that robs him of freedom and responsibility—belongs in the same pantheon of brutal oppressions as do chattel slavery, colonialism, the Inquisition, national socialism, international socialism (communism), and institutions dedicated to the coercive betterment of humanity not yet invented.

Sixty years ago, when I was young, the psychiatrist was embarrassed by his role as coercer. Now, when I am old, he is proud of it. That, in my opinion, is the sum total of the “progress” achieved by modern, “scientific psychiatry.” It is a fearful truism that we learn from history that we do not learn from history: “The time to guard against corruption and tyranny, is before they shall have gotten hold on us. It is better to keep the wolf out of the fold, than to trust to drawing his teeth and talons after he shall have entered.” (Thomas Jefferson, 1782)

But this wolf does not enter. He is inherent in human nature, and we must purge it from our own souls, one soul at a time.

Almost 50 years ago Szasz published The Myth of Mental Illness. It changed the political framework in which mental illness was addressed by laying the foundation for a concept Szasz developed through a series of books, including The Manufacture of Madness (1970). That concept was “the Therapeutic State”—a collaboration between psychiatry and the State through which “undesirable” actions, thoughts, and behavior patterns were suppressed. Thus Szasz not only disputed the moral and scientific basis of psychiatry but also argued that modern medicine was an engine of social control, with pharmaceuticals as primary tools.

A new slate of drugs now addresses a wide range of so-called disorders, or dysfunctions, that former generations considered environmental problems or lifestyle choices: from obesity to attention deficit, from erectile dysfunction to social anxiety (shyness), from menopause to alcoholism. Indeed, laziness is now being discussed as “a neuro-developmental dysfunction” for which drugs are being developed. The current Therapeutic State may be best analyzed as a collaboration between modern medicine, the pharmaceutical industry, and the State.

The debate stirred by Szasz has muted. The medical establishment and mainstream media are now advocates of the Therapeutic State. Similar advocates dominate universities, studies, prestigious committees, FDA hearings, and governmental bodies. Since writing The Myth, Szasz himself has noted that “the formerly sharp distinctions between medical hospitals and mental hospitals, voluntary and involuntary mental patients, and private and public psychiatry have blurred into nonexistence. Virtually all medical and mental health care is now the responsibility of and is regulated by the federal government, and its cost paid, in full or in part, by the federal government.” Problems of everyday life have been medicalized, and people are viewed as having little or no ability to “cure” conditions such as alcoholism or drug abuse through willpower or change of habit. The focus Szasz tried to foster on the individual’s responsibility for his or her own dysfunctions has eroded.

Happily, a backlash against the medicalization of everyday life is occurring. Alas, it is being fought on the wrong ground.

In this regard, a fascinating book has just been published. Sex, Lies, and Pharmaceuticals: How Drug Companies Plan to Profit from Female Sexual Dysfunction by Ray Moynihan and Barbara Mintzes is a work of investigative journalism that explores the close financial relationship between the medical experts who define and develop the “science” behind new dysfunctions and the $500-plus billion pharmaceutical industry that profits from treating them. For example, Moynihan examines the makeup of experts on committees that define dysfunctions for the extremely influential Diagnostic and Statistical Manual of Mental Disorders (DSM); it is from the DSM that “social anxiety disorder” derives. (Revealingly, homosexuality was only delisted as a disorder in 1970.) Moynihan observes, “The DSM has been criticised for the closeness between the expert committees who write the definition of diseases and the pharmaceutical companies that sell the drugs prescribed to treat them. One study that looked closely at the affiliations of the men and women on those committees found that more than half of them had ties to drug companies. On the committees revising mood disorders, including depression, the figure was closer to 100 per cent.”

In short, he constructs a strong case for endemic bias within the medical establishment in favor of drug companies and the creation of disease.

Another sign of backlash is the emergence of grassroots rebellions against specific “diseases,” such as the currently emerging “female sexual dysfunction,” and against the use of drugs, such as Ritalin, to “cure” attention deficit disorder in children.

A reopening of debate on medicalizing everyday life is to be applauded. But, unlike Szasz, the new critics, such as Moynihan, do not take aim at the Therapeutic State; instead they focus on the therapeutic industry—that is, the flow of money between the medical establishment and the pharmaceutical companies. The culpability of the government in the creation of disease is either marginalized or denied.

Other pharmaceutical dissidents tend to view the State as the solution, not part of the problem. For example, feminist activist Leonore Tiefer works through the World Health Organization to impose new legislation that promotes such “rights” (or entitlements) as “the right to comprehensive sexuality education” and “the right to sexual health care, which should be available for prevention and treatment of all sexual concerns, problems, and disorders.”

It is possible that critics like Moynihan and Tiefer will accomplish some good. Perhaps they will be able to reduce the widespread prescription of the powerful Ritalin to grade-school children. But without understanding the essential role played by the State in the medicalization of everyday life, critics can never strike at the root of the problem. Indeed, they may well worsen matters by shifting blame and giving more authority to the very agency most responsible for the creation of disease.

The Need for a New Focus

The focus of the reemerging debate needs to shift onto Szaszian grounds, onto an analysis of the Therapeutic State, in at least four ways.

First, it must be clear that government defines the framework for all medical practices within North America. Second, the protection offered to pharmaceutical companies should be analyzed as legal privilege. Third, the relatively new and influential “private-public partnerships”—a marriage between the corporate sector and government institutions—should be examined and exposed. And, fourth, the role government plays in “marketing” drugs through institutions like the public school system and social services must be examined.

Government framework. There is no genuine competition allowed in the practice of medicine or the administration of drugs. Both of these vital functions of society are monopolies that the government assigns to those who meet State requirements and abide by State rules. Thus the American Medical Association (AMA) is able to exert monopoly control of medical care, such as hospitalization, and has a long history of persecuting competitors such as midwives.

But licensing is only the most obvious way in which the State and AMA define medical care. There are many other labyrinthine ways in which the medical establishment partners with authority. In reporting on the AMA’s support of Obamacare, for example, the Wall Street Journal explained last year, “The organization wants to protect a monopoly that the federal government has created for it—a medical coding system administered by the AMA that every health-care professional and hospital must use if they wish to get paid for the services they provide. This monopoly generates income of $70 million to $100 million annually for the AMA. That makes the AMA less an association looking out for doctors and more a special-interest group beholden to Congress and the White House.”

FDA Approved

Legal privilege. All prescription drugs must be approved by the FDA; but, again, the monopoly privilege of being the sole legal drug dealers in society is only the most obvious one granted the pharmaceutical industry and hardly captures the extent of partnership. Moynihan chronicles a less obvious privilege in writing about “one of the biggest healthcare frauds in U.S. history. Pfizer was accused of illegally promoting an anti-arthritis drug for unapproved uses and, so, creating a health risk to users. Pfizer admitted to limited guilt and paid a criminal fine of $1.2 Billion and civil penalties of $1B.” Despite the hefty financial hit, not one executive was held personally responsible; no retribution was sought. The sentencing judge, federal District Court Judge Douglas Woodlock (Massachusetts) commented in his concluding remarks, “This is a case in which no human being, apparently, is going to be held responsible for substantial criminal activity by a corporation.” He notes that Pfizer absorbed the financial hit as a “cost of doing business” and still returned record profits.

Private-public partnerships (PPP). A PPP is a collaboration between government and the private sector in which a venture is funded (in part or in full) by tax dollars and operated through the private sector, or else the private sector raises capital under contract with the government to provide services. Although PPPs are most often associated with infrastructure projects, such as the repair of roads or building of bridges, this sort of ersatz capitalism is rampant within medical research and drug promotion. According to a 2001 study, “hundreds of millions of dollars” have been invested in the United States to promote partnerships around health issues, creating “thousands of alliances, coalitions, consortia and other health partnerships.” That trend has only increased in the ensuing years. Tax-funded research is commonly funneled through nominally private organizations or researchers. Conferences, studies, reports, and such are conducted at taxpayer expense. Arguably, such funding constitutes the greatest barrier to alternative, independent research.

Uncle Sam the Pusherman

Government peddling of pharmaceuticals. It is not merely that private for-profit organizations have used tax dollars to climb aboard the public health bandwagon. The government uses its agencies to create a market base. Just one example is the role of the public schools as a “pusher” of Ritalin—a form of speed more potent than cocaine—to millions of school-age children. Overwhelmingly, it is prescribed to boys who are “unruly” in class. A 2001 report stated, “If Huckleberry Finn and Tom Sawyer were in a school in Massachusetts today, they’d be drugged with Ritalin, according to many psychiatrists and other experts.” As a recent September Huffington Post headline asked, “Do 2.5 Million Children Really Need Ritalin?” Dr. Sanford Newmark continued, “What is going on here? Have millions of our children become so hyperactive and unable to focus that they are incapable of succeeding at school or dealing with the demands of normal life? Or are we creating an illness where there is none, calling normal variations in temperament and personality a ‘disease’ that requires the intervention of long term, and extremely profitable, pharmaceutical medication?”

Monopoly, legal privileges, the rise of PPPs, the use of tax dollars to create disease and eliminate competition, the peddling of pharmaceuticals through government agencies—these issues must be prominent in any productive discussion of the medicalization of everyday life. If the discussion focuses on corporate greed, then the Therapeutic State will have merely entered a new phase.

This is not news. More than 200 hundred years ago Johann Wolfgang von Goethe (1749–1832) warned: “I believe that in the end humanitarianism will triumph, but I fear that, at the same time, the world will become a big hospital, each person acting as the other’s humane nurse.”

Moreover, Goethe foresaw the moral hollowness of the “humanitarian science” on which such therapeutic tyranny would rest: “I could never have known so well how paltry men are, and how little they care for really high aims, if I had not tested them by my scientific researches. Thus I saw that most men only care for science so far as they get a living by it, and that they worship even error when it affords them a subsistence.”

The depths to which such men would happily sink when worshiping error brings them fame and fortune became obvious only in the twentieth century.

Joaquim Maria Machado de Assis (1839–1908), the great Brazilian novelist and playwright, advanced the prescient literary satirization of the dark art of psychiatric diagnosis and the engine that drives it: the phony expert’s insatiable vanity and thirst for controlling his fellow man. His short story “O alienista” (1882, “The psychiatrist”) is a fable of a celebrated doctor retiring to a small town to pursue his scientific investigation of the human mind, gradually finding more and more of the townsfolk insane and needing to be incarcerated in his private asylum. Eventually he alone is left at liberty. As soon as modern psychiatry became a legitimate branch of medicine, Machado de Assis recognized and exposed its quintessentially unscientific-sadistic character.

It remained for the French playwright Jules Romains (1885–1972) to call public attention to the corruption of modern medicine by political power. “It’s a matter of principle with me,” declares his protagonist, “Dr. Knock” (1923), “to regard the entire population as our patients. . . . ‘Health’ is a word we could just as well erase from our vocabularies. . . . If you think it over, you’ll be struck by its relation to the admirable concept of the nation in arms, a concept from which our modern states derive their strength.”

Sigmund Freud (1856–1939), too, has played an important part in persuading people that health is an abnormal state. This old joke is illustrative: “If the patient is early for his appointment, he is anxious; if he is on time, he is obsessive-compulsive; if he is late, he is hostile.”

Particular psychiatric diagnoses have not escaped professional criticism. Wishing to make a name for themselves as psychiatrists, “critics” object to one or another diagnosis (homosexuality)—or to “overdiagnosis” (ADHD)—but continue to respect the American Psychiatric Association (APA) as a scientific organization and regard the various incarnations of the DSM as respectable legitimating documents. This is dishonest. Confronted with the DSM, the challenge we face is to delegitimize the authenticators, the APA and DSM, not distract attention from their fundamental phoniness by ridiculing one or another “diagnosis” and trying to remove it from the magical list.

I have consistently rejected this piecemeal approach. In my essay “The Myth of Mental Illness,” published in 1960, and in my book with the same title that appeared a year later, I stated my view forthrightly. I proposed that we view the phenomena conventionally called “mental diseases” as behaviors that disturb others (or sometimes the self), reject the image of “mental patients” as helpless victims of patho-biological events outside their control, and refuse to participate in coercive psychiatric practices as incompatible with the foundational moral ideals of free societies. In short, I rejected the authority of the APA as a legitimating organization and of the DSM as a legitimating document. I believe nothing less can undo the mischief wrought by the successive editions of the “psychiatric bible.”

Settled by Political Power

But times have changed. Fifty years ago it made sense to assert that mental illnesses are not diseases. It makes no sense to do so today. Professional debate about what counts as mental illness has been replaced by political-judicial decree. The controversy about the nature of so-called mental diseases/disorders has been settled by the holders of political power: They have decreed that “mental illness is a disease like any other.” Political power and professional self-interest have united in turning false beliefs into lying facts: “Mental illness can be accurately diagnosed, successfully treated, just as physical illness” (President William Clinton, 1999). “Just as things go wrong with the heart and kidneys and liver, so things go wrong with the brain” (Surgeon General David Satcher, 1999).

The claim that “mental illnesses are diagnosable disorders of the brain” is not based on scientific research; it is a deception and perhaps self-deception. My claim that mental illnesses are fictitious illnesses is also not based on scientific research; it rests on the pathologist’s materialist-scientific definition of illness as the structural or functional alteration of cells, tissues, and organs. If we accept this definition of disease, then it follows that mental illness is a metaphor, and asserting that view is stating an analytic truth not subject to empirical falsification.

For centuries the theocratic State exercised authority and used force in the name of God. The Founders sought to protect the American people from the religious tyranny of the State. They did not anticipate, and could not have anticipated, that one day medicine would become a religion and that the alliance between medicine and the State would then threaten personal liberty and responsibility exactly as they had been threatened by the alliance between church and State.

The Founders faced the challenge of separating the cure of souls by priests from the control of people by politicians. Today the therapeutic State exercises authority and uses force in the name of health. We face the challenge of separating the consensual treatment of patients by medical doctors from the coercive control of persons by agents of the State pretending to be healers.

When psychiatry was in its infancy the belief that all human “dysfunctions” are manifestations of brain diseases was a naive error. In its maturity the mistake was treated as a valid scientific theory and the justification for a powerful ideology and the powerful institutions based on it. Today, in its senescence, psychiatry is deceit and self-deceit—coercion concealed as objective science (“medical diagnosis”) and benevolent help (“medical treatment”). As a result, paraphrasing Orwell, telling the truth becomes “a revolutionary act.”

As is customary with Szasz’s work, there is painstaking historical analysis, beginning with the term “anti-psychiatry movement.” That term originated not, as might be thought, in the 1960s, when it became synonymous with the work of Scottish psychiatrist R. D. Laing and his colleague David Cooper, but in late nineteenth-century Germany. Then as now the term was employed, Szasz writes, to “divert people’s attention from the core moral-political problems of psychiatry, coercion and excuse making.” In short, it was a dismissive label to prevent serious criticism of psychiatry.

The “antipsychiatry movement” was largely ignored until the late 1960s when Laing and his allies sought to draw attention to themselves by appropriating the label for their critique of conventional psychiatry. Szasz argues that despite some differences between mainline psychiatry and Laing and his followers, their actions were in fact fully in accord with psychiatry’s central precepts. Laing and his allies held a core belief in the existence of mental illness as a medical entity—to be treated with drugs if necessary—and a belief in their own power to cure people of purported mental illness, with the use of force if required. As such, rather than challenging, as is usually thought, psychiatry’s customary mores, Laing and his associates are described as practicing an alternative form of it and thereby reinforcing the myth of mental illness that Szasz has correctly challenged for almost 50 years now.

Readers coming to the book with some knowledge of Laing’s work will be disappointed and somewhat shocked to see his inconsistencies exposed. His employment of forced “treatment” at Kingsley Hall (the anti-psychiatric “residence” in the East End of London ) is dissected in detail. Disconcerting though it may be, we are better and wiser for this knowledge. As is well known, Laing’s behavior, often fueled by alcohol, could be particularly unpleasant. Szasz highlights his inconsistencies: While he made lucid attacks on the barbaric nature of psychiatric treatment, he was ultimately incapable of rejecting the movement that gives rise to them. Laing compromised and sacrificed the potential strength of his arguments in pursuit of establishment recognition and fame.

Szasz meticulously documents Laing’s desire to work both within and outside the established system at the same time and depicts him as a “trickster”—willfully exposing psychiatric brutality at the start of his career, but subsequently endorsing the “standard of care” of modern biological psychiatry as his swan song. Laing and Cooper emerge as sad and rather disturbing people, notwithstanding the effect they had on others.

To describe Laing as a “bad person,” as Szasz does, seems somewhat harsh, but that probably reflects Szasz’s disappointment in him. Laing had the potential to contribute greatly by exposing the medical myth-making at the dark heart of psychiatry, but threw it away amidst a trinity of drink, abuse, and desire for celebrity.

In sum, Szasz makes a strong argument that the “antipsychiatrists” have presented only a very limited vision of liberation for the psychiatric service user. The changes that are required in society to restore freedom and dignity to those said to be “mentally ill” need a greater vision than theirs.

This is an important book, and it deserves to be read closely alongside Szasz’s other works. For those with an earnest desire to support human freedom, it provides more food for thought about the damage wrought, under the guise of benevolence, by the relentless psychiatric machine.

He explores that question, and offers many stinging rebukes, in his latest book, Faith in Freedom: Libertarian Principles and Psychiatric Practices. Its focus makes this very much an “inside baseball” book for those interested in libertarianism’s philosophical and intellectual history. It’s not a good place to begin dipping into the intellectual richness of Szasz’s huge oeuvre. Often he seems to assume a ready familiarity with his own heterodox thinking about the real nature of mental illness and how contemporary psychiatry deals with it. Szasz condemns as a pernicious myth the popular notion that the behaviors for which people are labeled “mentally ill” are caused by organic brain diseases that segregate those thus labeled from the liberal world of freedom and responsibility. Psychiatry, Szasz asserts, has built a citadel of coercion around that myth, one whose dual purposes are to incarcerate the innocent, through involuntary hospitalization, and exonerate the guilty, through the insanity defense.

Szasz presents his case for these ideas at length elsewhere—most vividly and convincingly, to this reader’s judgment, in his 1987 work Insanity: The Idea and Its Consequences. But here he uses his ideas about mental illness mostly as a set point from which to condemn other liberal and libertarian thinkers for abandoning their frequent bravery and good sense when it comes to psychiatry. Chapters are devoted to how libertarian or liberal thinkers and institutions, including John Stuart Mill, the American Civil Liberties Union, Ayn Rand, Nathaniel Branden, Ludwig von Mises, F. A. Hayek, Murray Rothbard, and Robert Nozick, have dealt with—or not dealt with—these issues to which Szasz has dedicated his career. He finds them all wanting, either through failures of omission or commission.

“I believe that all Americans—especially libertarians—have a moral and intellectual duty to confront the conflict between liberty and psychiatry and articulate their position regarding the idea of mental illness and the psychiatric coercions and excuses it justifies,” Szasz insists. Only the Libertarian Party among contemporary libertarian institutions, he says, fully applies libertarian ideas of self-ownership and the rule of law to the world of psychiatry.

I think Szasz is being somewhat unfair through much of this book. He doesn’t pay proper heed to the economic principles of comparative advantage and opportunity cost. It ought not necessarily be the task of every advocate of libertarianism to man the barricades on every specific application of libertarian ideas to the real world, despite Szasz’s lament that “many libertarians . . . dwell on the importance of free markets, except in psychiatry, and tirelessly recite the mantra that ‘people should be free to do whatever they want in life as long as their conduct is peaceful,’ but do not mention mental health laws, much less advocate their repeal.”

Given the idea, going back within the libertarian tradition at least to Mill, that liberty applies fully only to adults competent to handle their own affairs responsibly, it takes a particularly fierce independence of mind, combined with careful study of his work, to endorse Szasz’s application of classical-liberal principles to the so-called insane. To someone who has aimed his intellectual efforts in other directions—who has not, as Szasz has, studied the world of psychiatry extensively and from the inside—it is a perfectly excusable error for an “educated layman” libertarian to presume, as all the experts insist, that the so-called insane are not, any more than children or Alzheimer’s victims would be, competent individuals deserving all the rights and privileges of such, but are in fact people who require paternalistic care. (Szasz himself has criticized Rand for not recognizing the existence of innocent dependency in the human world, as witness her lack of children or the extremely aged in her work.)

When his complaint is that the writers in question don’t mention the psychiatric-control issues that Szasz has built his career on, not that they have openly advocated the incarceration of the “mentally ill,” his barbs seem especially ill-aimed.

Szasz is a brilliant and brave thinker, and I can understand his frustration that he has slashed and walked paths that few have been prepared to join him on. In this case, that frustration has led to a book not quite up to his highest standards in all its parts, although it still contains valuable chunks of his brilliant and passionate defenses of liberty and responsibility.

“Nature,” observed Thomas Carlyle (1795-1881), “admits no lie.” While nature neither lies nor tells the truth, persons habitually do both. As the famous French mathematician and philosopher Antoine Augustin Cournot (1801-1877) observed, “It is inconceivable that [in the science of politics] telling the truth can ever become more profitable than telling lies.” Indeed, deception and prevarication are indispensable tools for the politician and the psychiatrist—experts expected to explain, predict, and prevent unwanted human behaviors.

The integrity of the natural scientific enterprise depends on truth-seeking and truth-speaking by individuals engaged in activities we call “scientific,” and on the scientific community’s commitment to expose and reject erroneous explanations and false “facts.” In contrast, the stability of political organizations and of the ersatz religions we call “behavioral sciences” depends on the loyalty of its practitioners to established doctrines and institutions and the rejection of truth-telling as injurious to the welfare of the group that rests on its commitment to fundamental falsehoods. Not by accident, we call revelations of the “secrets” of nature “discoveries,” and revelations of the secrets of powerful individuals and institutions “exposés.”

Because nature is not an agent, many of its workings can be understood by observation, reasoning, experiment, measurement, and calculation. Deception and divination are powerless to advance our understanding of how the world works; indeed, they preempt, prevent, and substitute for such understanding.

Psychiatry is one of the most important institutions of modern American society. Understanding modern psychiatry—the historical forces and the complex economic, legal, political, and social principles and practices that support it—requires understanding the epistemology of imitation and the sociology of distinguishing “originals” from “counterfeits.” With respect to disease, the process consists of two parts: One part is separating persons who suffer from demonstrable bodily diseases from those who do not, but pretend or claim to; another part is separating physicians who believe it is desirable to distinguish between illness and health, sick persons and healthy, from physicians who reject this desideratum and insist that everyone who acts or claims to be sick has an illness and deserves to be treated. In an effort to clarify the difference between medicine and psychiatry—between real medicine and fake medicine—I proposed a satirical definition of psychiatry, slightly revised as follows:

The subject matter of psychiatry is neither minds nor mental diseases, but lies, beginning with the names of the participants in the transaction—the designation of one party as “patient,” even though he is not ill, and the other party as “therapist” even though he is not treating any illness. The lies continue with the deceptions that comprise the subject matter proper of the discipline—the psychiatric “diagnoses,” “prognoses,” and “treatments”—and end with the lies that, like shadows, follow ex-mental patients through the rest of their lives—the records of denigrations called “depression,” “schizophrenia,” or whatnot, and of imprisonments called “hospitalization.” If we wished to give psychiatry an honest name, we ought to call it “pseudology,” or the art and science of lies and lying.

The imitation of illness is memorably portrayed by Molière (1622–1673) in his famous comedy, The Imaginary Invalid (Le malade imaginaire). The main character is a healthy individual who wants to be treated as if he were sick by others, especially doctors. Since those days, we in the West have undergone an astonishing cultural-perceptual transformation of which we seem largely, perhaps wholly, unaware. Today medical healing is regarded as a form of applied science. At the same time, the medical profession defines imaginary illnesses as real illnesses, in effect abolishing the notion of pretended illness: Officially, malingering is now a disease “just as real” as melanoma.

The view that pretending to be mentally ill is itself a form of mental illness became psychiatric dogma during World War II. Kurt R. Eissler (1908-1999), then the quasi-official pope of the Freudian faith in America, declared: “It can be rightly claimed that malingering is always the sign of a disease often more severe than a neurotic disorder. . . . The diagnosis should never be made but by the psychiatrist.” Now, more than 50 years later, this medicalized concept of malingering is an integral part of the mindset of every well-trained, right-thinking Western psychiatrist. For example, Phillip J. Resnick, a leading American forensic psychiatrist, declares: “Detecting malingered mental illness is considered an advanced psychiatric skill, partly because you must understand thoroughly how genuine psychotic symptoms manifest.”

In World War I soldiers afraid of being killed in battle malingered; psychiatrists who wanted to protect them from being returned to the trenches diagnosed them as having a mental illness, then called “hysteria.” Today, almost a hundred years later, soldiers returning home and afraid of being without “health care coverage” diagnose themselves as having a mental illness, called “post-traumatic stress disorder (PTSD)”: Almost 50 percent of the troops returning from Iraq suffer from post-traumatic stress disorder (PTSD) and depression “because they want to make sure that they continue to get health care coverage once their deployments have ended.” (Syracuse Post-Standard, Nov. 25, 2007, E1).

Psychiatrists and the science writers they deceive—and who eagerly deceive themselves—love to dwell on how far psychiatrists have “progressed” from their past practices. They have indeed, if we consider creating ever more mental illnesses/psychiatric diagnoses “progress.” Today psychiatrists assert that the person who regards himself as a mental patient suffers from a bona fide illness and laud him for his insight into his “having a disease” and “need for treatment.”At the same time, they lament the person who “denies” his mental illness, his “lack of insight” into being ill, and his “negative attitudes toward treatment seeking.” For example, from the International Journal of Eating Disorders we learn: “Considering that males have negative attitudes toward treatment-seeking and are less likely than females to seek treatment, efforts should be made to increase awareness of eating disorder symptomatology in male adolescents.”

Counterfeit art is forgery. Counterfeit testimony is perjury. But counterfeit illness is still illness—mental illness, officially decreed “an illness like any other.” The consequences of this policy—economic, legal, medical, moral, personal, philosophical, political, and social—are momentous: counterfeit disability, counterfeit disease, counterfeit doctoring, counterfeit rehabilitation, and the bureaucracies, courts, industries, and professions studying, teaching, practicing, administering, adjudicating, and managing them make up a substantial part of the national economies of modern Western societies and of the professional lives of the individuals in them.

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.

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.