Micha,

Two things.

1. You write: “If people who suffer from mental illnesses believe (or are convinced by believing friends and family) that mental illness is a myth, they may not get the help they need, and suffer greatly as a result.”

But Szasz’s views, if implemented, would not deprive the people currently labeled “schizophrenic,” “bipolar,” “depressed,” etc. from “getting help” for their problems. The notion that it would is based on a common but extremely careless misreading of Szasz’s argument. Szasz is quite explicit that the symptoms on which a diagnosis of these pseudo-“diseases” are based are quite real, and pose real problems for people’s lives. What he objects to is the philosophical and political leap of organizing the understanding and “treatment” of those symptoms under pseudomedical terms like “schizophrenia,” “bipolar disorder,” “depression,” etc., which ultimately have a lot more to do with the legal requirement that someone have a diagnosed “disease” in order to get most drugs, than they do with any real scientific basis for the claim that all these symptoms trace to a single, identifiable disease.

In Szasz’s ideal society, people who are suffering from what is now mistakenly called “mental illness” would in fact have far more access to help than they have now, since the abolition of pharmaceutical laws and government licensure laws would remove a couple of the major barriers to entry and price floors on psychiatric “help.”

Szasz also believes that psychiatrists should not have the power to force “help” onto their “patients” against those patients’ wills. But the power to force “help” on unwilling “beneficiaries” is quite a different issue from the ability to “get help” when one needs it.

1. You write: “But shouldn’t one of our goals be truth?”

Sure. But summary dismissal of an argument based on an unsubstantiated assertion that it is “backwards, anti-science, and ignorant” is not, as I see it, a reliable method of getting to the truth. Especially not when there are specific historical reasons to be cautious of “consensus” in the field in question, and when the person whose arguments are being thus dismissed without discussion is in fact a dissenter within the same community of experts whose authority is supposedly being referred to. (In this respect, Szasz’s position, as a professionally trained medical psychiatrist, is quite different from that of creationists who have no training in paleontology and evolutionary biology, or Holocaust deniers who have no training in history. That makes an appeal to authority, rather than an critical engagement with Szasz’s specific arguments, rickety in the extreme.)

Well, hell, if someone in a white lab coat says it, it must be true.

Certainly there is no reason to be cautious of appeals to scientific consensus in this field. There are certainly no prominent examples of appeals to scientific authority, or to psychiatry in particular, that had little to do with science and lots to do with providing cover for coercive normalization, inhuman “treatment” of so-called “patients,” or torture and brain damage posing as “cures.” No need to think for yourself, citizens; the experts have already done it for you.

Meanwhile, we can just safely ignore Szasz’s actual arguments, ignore the extent to which common criticism and “embarassment” over Szasz is based on easily refuted strawmen (such as the claim that he believes that hallucinations are “made up”), and substitute an appeal to authority and an ad hominem (abusive form).

The wikipedia entry on Szasz clearly states he believes schizophrenia is a “fake disease.”

Yes, he does, as do I. But you seem to have grossly misunderstood what that means.

Szasz does not deny that there are people who really have hallucinations. As a practicing psychiatrist he has often treated people who had persistent hallucinations. What he denies is the popular pseudomedical theory that mainstream psychiatrists use to explain those experiences–the theory that they are “symptoms” of a single, identifiable disease, called “schizophrenia.”

Back in the 19th century, psychiatrists believed that there was a mental illness called “hysteria,” which they used to explain all kinds of experiences that many women of a certain class reported having — emotional fragility, psychosomatic reactions, inability to enjoy sex, etc. Nowadays most psychiatrists regard “hysteria” as a bogus diagnosis. That doesn’t mean that they deny that many woman experienced certain kinds of emotional fragility, or psychosomatic reactions, or were unable to enjoy sex. Rather, they now realize that there were various explanations for these experiences, some personal, some medical, and some cultural, and that these experiences were not best understood as common symptoms of some single, identifiable disease. Szasz believes the same thing about “schizophrenia,” and in fact about the category of “mental illness” broadly.

I don’t want to be rude, but Szasz has spent a great deal of time making this point carefully in his writing, both in articles and in book-length treatments of the topic. Maybe you would be better off engaging with what he says there, rather than trying to puzzle out his views from the brief descriptions in a WikiPedia article?

or, he believes seeing spiders that aren’t there isn’t a disease (or symptomatic of a disease).

The claim that hallucinations aren’t necessarily symptoms of an underlying disease is certainly not ridiculous; in fact it’s true, and easily demonstrated. For example, you can get hallucinations right now, without having anything that could be identified as a “disease.” For example, by depriving yourself of sleep for a long period of time, or by consuming a lot of liquor.

Now, for all I know, and for all that Szasz says, it may well be that there is some neural disease that explains Tiffany Sitton’s hallucinations. But if so, then it’s incumbent on those who propose that explanation to give a description of the disease, its etiology, and its causes, and to give some evidence that Tiffany Sitton has it. For the reasons I explained, just saying “schizophrenia” doesn’t count as such giving such a description. “Schizophrenia” is defined in such a way that that does no more explanatory work than if you had said, “Tiffany Sitton has hallucinations because she has the hallucination-causing disease.”

My point remains that seeing spiders that aren’t there is not, as Caplan claims, merely “bad behavior.” Do you, or Szasz, disagree?

This is a crude strawman. Caplan doesn’t claim that having hallucinations is “bad behavior.” If you think that he has, you have misread him very badly. What he suggested is that “schizophrenia is a linguistic excuse for bad behavior.” Again, the issue here is the use of the category “schizophrenia,” not the specific experiences that she reports having. What he’s challenging is the use of a psychiatric diagnosis to excuse specific behaviors (e.g. drug abuse and inflicting emotional suffering on her mother). Not the claim that she really does have hallucinations about spiders.

Scheule: Even if one girl lies about hearing demons, it’s nonsense to believe this explains the entirety of diagnosed schizophrenics.

I can’t vouch for Caplan’s views, but certainly Thomas Szasz has never claimed anything of the sort.

Scheule: Alternatively, Caplan thinks the girl is telling the truth but doesn’t want to call it a disease–but c’mon, she feels non-existent spiders itching around subdermally. If that’s not an illness, please, what is?

Smallpox is a disease. Feeling non-existent spiders itching around under your skin is a hallucination, not a disease.

Depending on the breaks, the hallucination may be a symptom of some identifiable neural disease. Or it may not be. Lots of well-defined neuropathologies can result in hallucinations, such as Parkinson’s disease, or brain tumors, or for that matter the syndromes that result from certain kinds of drug abuse. But lots of unpleasant things can also happen to your body without being to anything that you could call a “disease.” If you intend to bring in the medical model, it’s up to you to explain what the disease actually is and produce some evidence that it’s present in this case.

You might say, “Oh, well, the disease here is schizphrenia.” But just referring back to a term explicitly defined through a grab-bag of loosely-related symptoms, rather than in terms of etiology, doesn’t cut much ice. Since schizophrenia is defined in terms of things like the experience of hallucinations, citing it as the explanation for hallucinations is either tightly circular, or at best an unbacked promissory note for a physiological explanation, rather than the explanation itself. It’s hard for me to see what function, if any, pseudomedical terms like “schizophrenia” serve in helping us to understand what’s going on with someone like Tiffany Sitton.

Constant: I have never said, “if you want to know what a libertarian is, look at Ron Paul”. Do people do that? I guess if people do that, then that’s probably a mistake if they don’t agree with his whole platform. But do people really do that?

I don’t know whether anyone’s done that, but a lot of people have given money to the campaign, or put up signs and banners (“Ron Paul 2008,” “Ron Paul Revolution,” “Google Ron Paul,” etc.), or made personal endorsements of Ron Paul’s campaign, all of which they’ve justified on the grounds that Ron Paul’s campaign literature, debate answers, etc. promote libertarian ideals, and so getting more attention for his campaign will, in turn, educate more people about libertarianism and perhaps persuade more people to embrace it.

Presumably that’s only a good argument to the extent that Paul’s campaign actually is promoting libertarian ideals. If the money, for example, goes to produce nasty nativist-statist propaganda rather than propaganda that actually promotes libertarianism, then the money may be going towards promoting Ron Paul, but it’s not going towards promoting, or educating people about, libertarianism.

Arthur,

Again, I’m not denying that parents have a legitimate right to reclaim the money that is stolen from them in taxes, whether through education vouchers or through other means.

What I am saying is that voucher systems constitute a government subsidy to private schools, in virtue of forcing the parents to spend that reclaimed money within a cartel of government-approved private schools. There is nothing wrong with parents reclaiming stolen money through the voucher system, but the cartelized schools that financially benefit from federal patronage are still subject to the usual libertarian analysis and criticism offered against government subsidies.

There is no benefit that you could possibly get from a government voucher scheme that you could not get just as easily from a no-strings-attached tax break, and some specific evils that vouchers but not tax breaks would produce. So the question is, given the choice, why advocate the cockamamie transitional government scheme, rather than just advocating the simple libertarian measure?

No, “returning tax-payers’ money” is not a subsidy. But forcing the recipients to give the “returned” money to one of a select cartel of government-approved “private” schools is a government subsidy to those schools.

If you want to return tax-payers’ money, why not just advocate tax cuts?

Jonathan,

Everyone knows that the only true libertarians are those who support creating new transnational government trade bureaucracies and federal government subsidies for “private” schools. Didn’t you get the latest memo from HQ?

Fair enough, but then why describe the observation as “Stealth Marxism”? It’s not a distinctively Marxist claim; it’s an observation that anyone watching the show could have come up with, given a passing familiarity with recent American history.

At worst it seems like an example of “stealth banality,” or, perhaps just “observations on topics outside my interests.”

Though the crew, with black Uhura and the Asian Mr. Sulu, seemed to reflect newly enlightened attitudes, the program, like its 1930 relatives, was dominated by brave white males.

Isn’t this an accurate description of Star Trek?