Thomas Szasz

Thomas Stephen Szasz was a Hungarian-American academic and psychiatrist whose work made him one of the most forceful critics of institutional psychiatry in the second half of the twentieth century. He was born in Budapest, Hungary, on April 15, 1920, the second son of Jewish parents, Gyula and Lily Szász. In 1938, his family moved to the United States. Szasz studied physics at the University of Cincinnati, earning a Bachelor of Science, and then went on to receive an MD.

After medical school, Szasz completed his residency at Cincinnati General Hospital. From 1951 to 1956, he trained as a psychoanalyst at the Chicago Institute for Psychoanalysis. In 1956 he took a position at the State University of New York Upstate Medical University, where he served for most of his career as professor of psychiatry. He received tenure in 1962, with 24 months away for duty as a practicing psychiatrist in the U.S. Naval Reserve. He was also a distinguished lifetime fellow of the American Psychiatric Association and a life member of the American Psychoanalytic Association.

Szasz became best known as a social critic of the moral and scientific foundations of psychiatry. He was especially associated with the argument that, without a diagnosis of neurological disease or damage, a psychiatric diagnosis was meaningless. In 1958, he first presented his attack on “mental illness” as a legal term in the Columbia Law Review, arguing that mental illness was no more a fact bearing on a suspect’s guilt than possession by the devil. His best-known books, The Myth of Mental Illness in 1961 and The Manufacture of Madness in 1970, developed the ideas most closely tied to his name.

His thinking centered on freedom, responsibility, and the power of language. Szasz argued that people described as mentally ill had “problems in living,” not diseases in the same sense as neurological illness or bodily damage. He objected to what he saw as psychiatric labels being used to support power by authorities. In 1961, he testified before a United States Senate committee that using mental hospitals to incarcerate people defined as insane violated the patient-doctor relationship and turned the doctor into a warden. He opposed civil commitment and involuntary psychiatric treatment, while saying throughout his career that he was not anti-psychiatry. He believed in and practiced psychiatry and psychotherapy between consenting adults.

Szasz also criticized what he called the social control aims of medicine in modern society, as well as scientism. He wrote against the “therapeutic state,” where government and medicine combine to define people as “insane” or as “drug addicts.” In Ceremonial Chemistry in 1974, he argued that categories such as “drug addicts” and “insane” people served as scapegoats in ways he compared with earlier persecution of witches, Jews, gypsies, and homosexuals. His work kept returning to a plain but difficult question: when does care become coercion?

Szasz had two daughters. His wife, Rosine, died in 1971, a death his colleague Jeff Schaler described as a suicide. Szasz died on September 8, 2012, after suffering a painful spinal-compression fracture from a recent fall. He had previously argued in his writings for the right to die. His words still matter because they ask readers to look carefully at authority, diagnosis, consent, and personal responsibility, especially when the language of medicine is used to decide who is free and who is not.