Keith Hoeller's letter in JAMA reply to Henderson's review of Szasz Under Fire

Letters to the Editor
Journal of the American Medical Association
JAMA. 2005;293:1978.

Szasz Under Fire

To the Editor: In reading Dr Henderson’s review of the book Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics,1 it was difficult to determine why Henderson seems surprised that Dr Szasz and his critics continue to disagree. In Thomas Kuhn’s terms,2 Szasz and psychiatrists have incommensurate paradigms. The essays in this book were well-chosen and illuminated the continuing refusal of psychiatry to understand the completeness of Szasz’s rejection of what he has called "the therapeutic state."

I am most disturbed by Henderson’s suggestion that Szasz is anti-Semitic, particularly by quoting Karl Popper and not Szasz himself. And Henderson’s statement that the book lacks a human rights perspective indicates that he has apparently not read Szasz’s work where he clearly rejects, for example, a "mental patient’s bill of rights" because it claims to give the mental patient all kinds of fake freedoms but not the real freedom that matters most: freedom from being labeled and treated as a mental patient.

Keith Hoeller, PhD
Editor, Review of Existential Psychology & Psychiatry
RKHoeller@aol.com
Seattle, Wash
1. Henderson SW, reviewer JAMA. 2005;293:240-241. Review of: Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics. FULL TEXT
2. Kuhn TS. The Structure of Scientific Revolutions. 2nd ed. Chicago, Ill: University of Chicago Press; 1970.

Letters Section Editor: Robert M. Golub, MD, Senior Editor.
JAMA. 2005;293:1978.

RELATED ARTICLES IN JAMA
Szasz Under Fire—ReplySchuyler W. Henderson JAMA. 2005;293:1978. EXTRACT FULL TEXT

Szasz Under Fire—Reply

In Reply: First and foremost, I have no reason to believe that Dr Szasz is anti-Semitic and every reason to believe that Karl Popper was not, and I regret any implication to the contrary. Rather, I was concerned that Popper’s letter, otherwise uncontextualized in the vituperative milieu of this book, could be read as an allusion to the anti-Semitism that has occasionally but notoriously lurked in criticisms of psychiatry, from both within and without.1

I was not surprised that there is disagreement between Szasz and his critics (a lack of which would have made for dull reading, and this book is certainly not dull). I was, however, startled by the vehemence of the invective and the degree to which many, but not all, of the parties refused this opportunity to think through and beyond various points of impasse. After all, the "continuing refusal of psychiatry to understand the completeness of Szasz’s rejection of. . . ‘the therapeutic state’" is simply matched by Szasz’s refusal to understand the rejection of his positions. Some differences cannot be reconciled, but I question whether Szasz and psychiatrists have entirely incommensurate paradigms, particularly since Szasz has practiced and taught as a psychiatrist, not without commendation.2

Because human rights are important to Szasz’s thinking and libertarian philosophies, I had noted that this book would have benefited from an expert in that field, just as the editor sought out experts in other areas pertinent to Szasz’s thinking. That Szasz might reject aspects of this perspective would be all the more reason to include such a voice.

Schuyler W. Henderson, MD
HendersS@childpsych.columbia.edu
Columbia University New York, NY

1. Frosh S. Freud, psychoanalysis and anti-semitism. Psychoanal Rev. 2004;91:309-330. CrossRef MEDLINE

2. Dewan M Presentation at: Liberty and/or Psychiatry? 40 Years After The Myth of Mental Illness: A Symposium in Honor of Thomas Szasz on his 80th Birthday; April 15, 2000; Syracuse: State University of New York. Available at: http://www.szasz.com/Dewan.htm.
Accessed March 9, 2005.

Letters Section Editor: Robert M. Golub, MD, Senior Editor.
JAMA. 2005;293:1978.

RELATED ARTICLES IN JAMA
Szasz Under FireKeith Hoeller JAMA. 2005;293:1978. EXTRACT FULL TEXT