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Taylor & Francis
Liberation by Oppression: A Comparative Study of Slavery and Psychiatry / Edition 1

Liberation by Oppression: A Comparative Study of Slavery and Psychiatry / Edition 1

by Thomas SzaszThomas Szasz
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Originally called mad-doctoring, psychiatry began in the seventeenth century with the establishing of madhouses and the legal empowering of doctors to incarcerate persons denominated as insane. Until the end of the nineteenth century, every relationship between psychiatrist and patient was based on domination and coercion, as between master and slave. Psychiatry, its emblem the state mental hospital, was a part of the public sphere, the sphere of coercion.

The advent of private psychotherapy, at the end of the nineteenth century, split psychiatry in two: some patients continued to be the involuntary inmates of state hospitals; others became the voluntary patients of privately practicing psychotherapists. Psychotherapy was officially defined as a type of medical treatment, but actually was a secular-medical version of the cure of souls. Relationships between therapist and patient, Thomas Szasz argues, was based on cooperation and contract, as is relationships between employer and employee, or, between clergyman and parishioner. Psychotherapy, its emblem the therapist's office, was a part of the private sphere, the contract.

Through most of the twentieth century, psychiatry was a house divided-half-slave, and half-free. During the past few decades, psychiatry became united again: all relations between psychiatrists and patients, regardless of the nature of the interaction between them, are now based on actual or potential coercion. This situation is the result of two major "reforms" that deprive therapist and patient alike of the freedom to contract with one another: Therapists now have a double duty: they must protect all mental patients-involuntary and voluntary, hospitalized or outpatient, incompetent or competent-from themselves. They must also protect the public from all patients.

Persons designated as mental patients may be exempted from responsibility for the deleterious consequences of their own behavior if it is attributed to mental illness. The radical differences between the coercive character of mental hospital practices in the public sphere, and the consensual character of psychotherapeutic practices in the private sphere, are thus destroyed. At the same time, as the scope of psychiatric coercion expands from the mental hospital to the psychiatrist's office, its reach extends into every part of society, from early childhood to old age.

Product Details

ISBN-13: 9780765805409
Publisher: Taylor & Francis
Publication date: 08/31/2003
Edition description: New Edition
Pages: 237
Product dimensions: 6.00(w) x 9.00(h) x 0.57(d)

About the Author

Thomas Szasz (1920–2012) was professor of psychiatry emeritus at the State University of New York Upstate Medical University in Syracuse, New York and adjunct scholar at the Cato Institute, Washington, DC. He was a prominent figure in the anti-psychiatry movement and a critic of the moral and scientific foundation of psychiatry.

Table of Contents

Introduction: Perilous Rescues1
1.Psychiatric Slavery: Legal Fiction and the Rhetoric of Therapeutic Oppression13
2.The Psychiatric Slave Status: From Dred Scott to Tarasoff35
3.Psychiatric Slavery as Public Health: Infection and Insanity55
4.Justifying Psychiatric Slavery: "Dangerousness" as Disease75
5.Jim Crow Psychiatry I: The Psychiatric Will and Its Enemies87
6.Jim Crow Psychiatry II: The Patient Self-Determination Act105
7.Expanding Psychiatric Slavery: Outpatient Commitment121
8.Glorifying Psychiatric Slavery: Therapeutic Jurisprudence147
Epilogue: "Liberty is the Prevention of Control by Others"165
Appendix I.The Power of False Truths: The Maternity Hospital and the Mental Hospital169
Appendix II.Victims of Psychiatric Slavery: A Sampler179
Selected Bibliography221

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