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In 1961 a young psychiatrist by the name of Thomas Szasz published a book called The Myth of Mental Illness in which he argued that “psychiatry, unlike medicine, could demonstrate no physical basis for the ‘diseases’ it identified and ‘treated’”.

In a fascinating profile for Aeon, Holly Case writes that Szasz’s book was a big hit with the counter-culture of 1960s America, whose anti-establishment rebels delighted in what they saw as a repudiation of society’s suffocating norms.

And yet, Szasz was no leftwinger. In fact, he was a staunch Republican, who feared that, in the hands of the left, psychiatry would become a tool of political oppression:

  • “In the run-up to the 1964 presidential elections, Fact magazine published ‘The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater’, which contained the results of an informal survey of psychiatrists on the mental competence of the Republican candidate. More than 1,000 respondents declared him ‘psychologically unfit to be president of the United States’, and several offered a diagnosis of paranoid schizophrenia.”

The Goldwater campaign slogan “in your heart you know he’s right” was famously parodied by his opponents as “in your guts you know he’s nuts”:

  • “In the psychological marginalisation of… Goldwater, [Szasz] saw a trend towards the pathologisation of the right in general. The following year he declared that ‘psychiatry is a threat to civil liberties, especially to the liberties of individuals stigmatised as “right-wingers”.’ If those on the left focused on how the diagnosis of insanity was being used to marginalise unpopular voices, Szasz insisted the most unpopular voices were to be found, not in the slums or the colonies, but among US conservatives.”

There is a long history of psychiatric concepts being used to suppress inconvenient political opinions. For instance, before the American civil war slaves who tried to escape to the North were diagnosed as mentally ill. In the Soviet Union, psychiatry was an integral part of the apparatus of state terror. Even in our own time and place, outspoken purveyors of unfashionable points of view are routinely and not altogether un-jokingly dismissed as being ‘mad’ – as people like Peter Hitchens and Nadine Dorries know to their cost. 

But what about genuinely objectionable opinions like racism or religious fanaticism? Can it really be wrong to call those mad – especially when they motivate violent actions?

Szasz argued that it is – and went so far as to oppose the insanity defence in criminal trials:

  • “In line with his distinctively conservative perspective, he… feared that it removed responsibility from criminal acts. Unpopular politics should literally have their day in court, and this meant talking about a defendant’s motives (political or otherwise), as well as punishing them for crimes they had committed. This was not a matter of science, but of morality.”

In other words, we should oppose such points of view on the grounds that they are factually and/or ethically wrong, not as the symptoms of a supposed medical condition.

Even at its worst, political correctness (whether practised on the left or the right) has not ‘gone mad’, rather it uses concepts of madness to define opposing viewpoints. This, potentially, is what makes it so dangerous. Instead of debating the rights and wrongs of an issue, one can simply pathologise a minority opinion by noting its deviation from the norm – and thus defined, its repression can be re-defined as ‘treatment’. 

As Thomas Szasz once said, “it can be dangerous to be wrong, but, to be right, when society regards the majority’s falsehood as truth, could be fatal.”

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