A one-man revolution

Hans Keller

In the history of human discovery (not to speak of such inhuman discoveries as how best to destroy people), it has always seemed of the nature of revolutions that single individuals start them and a lot of People are needed to bring them about — and this goes for scientific revolutions, moral revolutions, and aesthetic revolutions alike. The borders between the three are not always easy to trace, anyway: in The Theology of Medicine, Szasz — the first effective revolutionary destined to remain alone? — points out that while 'in the language of science we explain events' and 'in the language of morals we justify aCtions . . . the distinction between explanation and Justification is often blurred; and for a good reason. It is often difficult to know what one should do, what is a valid justification for engaging in a particular action. One of the best [he means worst] ways of resolving such uncertainty is to justify a particular Course of action by claiming to explain it. We then say that we have had no choice but to obey the Truth — as revealed by God or Science.'

Again, while Schoenberg discovered his twelve-tone method creatively and may thus be said to have invented it, he came to claim for it the validity of a scientific theory. It could indeed be maintained that what distinguishes great art from small art is that great art's inventions are discoveries: the human mind values itself most highly when it gets at the truth—which retains its small 't' in great art, but acquires Szasz's magical capital 'T' both in theology and in corrupted science that invests the scientist with Priestlike, ceremonial powers. Defrocking him with genuinely scientific zest, The Theology of Medicine (a collection of essays most of which have previously appeared) 'is addressed to those persons who understand the difference between why a priest wears a cassock and a surgeon a sterile gown, bet ween why an orthopaedic surgeon uses a cast and a psychoanalyst a couch. Unfortunately, many people don't.'

What Szasz's two books have in common — neither, disgracefully, yet published in this country, even though the first-listed came out two years ago — is what their titles have in common: they are speeches for the prosecution of the medical scientist's quasireligious treason, his urge to replace truth by Truth, and of our collusion in the operation: without it, the medical priests would be powerless. But ultimately, Szasz's prosecution is a defence — of the victims of, and refugees from, pseudo-scientific persecution, which he diagnoses as the dark modern age's successor to the religious persecutions of the past.

Thus, in Schizophrenia, Szasz argues that this so-miscalled disease was not discovered at all, but simply invented. 'The process I describe began during the Enlightenment and its true pioneers were the lateeighteenth-century alienists. However, these early inventors of "medical insanity" stand in the same relation to Kraepelin, Bleuler, and Freud —who made ours the age of "mental illness" — as the inventors of the internal combustion engine stand to Henry Ford and the other industrial and merchandising geniuses who made ours the age of the automobile.' As for schizophrenia itself, `Bleuler did not identify "just another disease", such as diabetes or diphtheria, but justified the established practice of confining madmen by compulsory hospitalisation. Bleuler was aware of this. In his monograph on schizophrenia he remarks: "Once the disease has been recognised, the question as to whether or not to institutionalise the patient must be decided." By whom? Clearly, Bleuler does not mean that it is to be decided by the patient! Hence, from the point of view of the "patient" who does not want to be confined in a mental hospital, the so-called "recognition of the disease" is obviously a harmful rather than a helpful act.'

Much of the essential thought of

Schizophrenia is, by now, quite widely known in this country, even though the book itself isn't: Szasz lectured on the subject a couple of years ago at the University of Essex, whereafter I asked him to summarise his lecture in a radio talk which came to form part of the series I produced on The State of Depth Psychology, subsequently published in the Listener — and the New Review, too, printed an extended essay of his on the selfsame subject. However, what I regard as both the most imaginative and the most closely reasoned chapter in the book was not included in any of these excerpts and extracts. Revealingly entitled Psychiatry and Matrimony: Arrangements for Living, it throws Szasz's sheer psychological insight into relief and shows that the single autobiographical phrase which occurs in these two books — 'Since I am a psychiatrist (of sorts) . . .' (The Theology of Medicine) — does Szasz the psychologist scant justice:

. .. just as the bonds of holy matrimony were loosened in the twentieth century, so were the bonds of psychiatric matrimony. One manifestation of this new 'permissiveness' was that the marriage partners were sometimes allowed to choose and reject each other; another was that after being united in matrimony, they could, if sufficiently motivated, divorce each other. . .

Only in this light — that is, by viewing the schizophrenic (or sometimes his relatives) as seeking a better psychiatrist, which is a wholly post-Kraepelinian and post-Bleulerian phenomenon, and so closely resembles the search of the unhappily married or recently divorced woman seeking a better husband (and vice versa) — can we understand certain novel features of modern psychiatry. Perhaps the most striking is the appearance and disappearance, often in quick succession, of promises of a new cure for schizophrenia (and other psychoses), each linked to the name of an ambitious and mendacious psychiatrist. These psychiatrists, armed with their new 'treatments' — which they offer to add to the 'armamentarium' of other psychiatric methods — promise to cure the schizophrenic, thus restoring, in one fell swoop, not only his mental health, but also his (and everyone else's) faith in psychiatric matrimony. Harry Stack Sullivan, Frieda Fromm-Reichmann, Marguerite Sechefiaye, John Rosen and Ronald Laing are among the best-known figures who have promised to effect cures of schizophrenia where others have failed; who, in other worlds, are like the man who promises a woman unhappily married once, twice, or several times, true happiness in a new marriage — to him . . . To put it bluntly but simply, as wives cannot recover from marriage so long as they have husbands, so mental patients cannot recover from psychosis (or any other mental illness) so long as they have psychiatrists. Thus speaks a professor of psychiatry who, in a de-mythologised academic world, would be a professor of psychology, with social psychology and advice on the problems of life as his specialities. But the fact that his psychological calibre is so little recognised that it isn't even contested is really his own fault: deeply suspicious of all 'meddling' with the human mind, he never describes his own psychological insights as such, and throughout these two books, as a careful reader, I only remember a single occasion when he actually uses the. term 'psychology' (as distinct from the bugaboo of 'psychiatry): 'Freud's fondness for pathologising psychology — that is, life itself . . .' Since Professor Szasz de-pathologises psychology, why doesn't he say so?

Just as Freud used inspired metaphor and simile to pathologise psychology, so Szasz used inspired metaphor and simile towards de-pathologising it: psychiatry is more like matrimony than schizophrenia is like illness — 1 bet you that Szasz would accept my comparison between comparisons as a complete summary of his first-listed book. Despite his Hungarian background, the man who has discovered the concept of 'mental illness' to be a metaphor does in fact seem to me the most consistent living master of comparative thought in the English language. His latest, and perhaps his most pungent comparative elucidation of the. concept of 'mental illness' is not (yet) in print: on a

recent Australian lecture tour, he was invited to have a look at koala bears — whom, it struck him, we perceive and treat as we perceive and treat mental illness: they look like bears, and they are indeed called bears, but the fact remains that they aren't bears. Similarly, mental illness looks like an illness, we call it an illness. . .

That is the long and short of the Szaszian revolution, and perhaps we can now understand a little more clearly why it is destined to remain lonely, and why, nevertheless, its overall effect is bound to be stronger than that of mere brilliant eccentricity, as which the more civilisedly hostile part of the psychiatric world is, at the time of writing, endeavouring to isolate it.

When Freud turned things downside up, he placed himself firmly in the tradition of the Jewish revolutionary — from Moses through Jesus to Marx; in fact, his identification with Moses was near-conscious, and the one thing that was more religious than were all those religions he hated was the esoteric organisation of his psychoanalytic school. I am not sneering: it is doubtful whether his elemental discoveries could have made themselves felt in any other way, since they needed, to begin with, the support of what, retrospectively, we recognise as a psychiatric elite.

Schoenberg, just as preoccupied with Moses, was more ambiguous about his, or dodecaphony's, need for disciples: he loathed the concept of a compositional

school and refused to teach twelve-tone technique ('eine Privatangelegenheit', a pri. vate affair), yet demanded absolute pet' sonal loyalty from his overgrown pupils with the result that they imitated him whether he liked it or not. But again, the atonal and twelve-tonal revolution cot& hardly have taken place if the application ol Schoenberg's creative discoveries hat remained confined to his own work.

C. G. Jung, equally ambiguous, objectee to Jungians, yet founded Analytical PsY. chology, which would have been impossible without them, But then, he wasn't a revolutionary anyhow, playing the more amiable role of covering what Freud had discovered — covering it with a fairly flims) and transparent sheet, to be sure, for what was underneath was too hot to make a heavier blanket tolerable.

Now, Szasz has not discovered somethinE which is there, nor does he cover it up. 11c has discovered that something isn't there his revolution is of the same order a' Freud's would have been or might have been or would have been intended to be ii this religion-baiter had concentrated 011 and indeed confined himself to, the subject of what happens to be his only weak, poor') argued book — The Future of an Illusion There would have been no Freudian school in that case, nor would the lonely revolutio. nary have succeeded in abolishing religion nor should he have succeeded in doing so.

There will never be a Szaszian school, not will Szasz ever succeed in abolishing psychiatry, nor am I sure that he wants to: the essential difference between him and the Freud of The Future of an Illusion is that

while he is a self-confessed psychiatrist (01 sorts), Freud was an unconfessed high priest (of sorts). His unconscious religiousness

turned Freud into an unconditional enernY of religion, whereas Szasz's conscious par'

chiatry and psychoanalysis — he is, after all,

a practitioner, and his 'clients' (as he calls his patients) are mainly psychotics — inevit ably qualifies his objections to psychiatry',

and qualifies them very clearly: what he objects to is, essentially, the religion of

medicine, and of psychiatry in particular, including all its religious persecution. What he does not object to, needless to add, Is religion itself.

Two or three psychiatrists apart (literallY no more), the profession in this country has closed its ranks against him — the first sign,

perhaps, of the success of the lonely revolution that, at the same time, has stronglY

affected leading intellects all over the world, outside psychiatry proper, which Is temporarily shivering in its shoes, lest it be

put out of emotional and economic bus iness: the husband or bridegroom is worried and accuses Szasz of being a most unscl

entific moralist; at the same time, he hides

his own moralism behind degrading jargon. As The Theology of Medicine has it: 'Today, the universal solvent for guilt is science.. The replacement of conscience by science Is unscientific, for there is no science without values.