Thomas Szasz on Psychiatry

[MMMark]

Thurs. 12/06/21 13:07 EDT
.post #175
[url=Thomas Szasz on Psychiatry - #23 by baxter]

@baxter

[/url]“There was no evidence for a humoral imbalance causing illness, but the doctrine prevailed for two thousand years.”

Here he spends a lot of time harping on certain antiquated nonsense (humoral imbalance), as if psychiatry is the only area where nonsense has appeared. For example, in science, we had the flat earth, phlogiston and epicycles.

The title of the essay from which this quote is taken is MENTAL ILLNESS AS BRAIN DISEASE: A BRIEF HISTORY LESSON.
You omitted the preceding and following sentences, so let me now supply them:

@Thomas Szasz

Psychiatric practice today requires that doctors and patients ignore evidence and be ignorant of history. There was no evidence for a humoral imbalance causing illness, but the doctrine prevailed for two thousand years. There is no evidence for a chemical imbalance causing mental illness, but that does not impair the doctrine’s scientific standing or popularity.

Here are three of the four other instances of the expression “humoral imbalance”:

The idea that mental illness is a bodily disease dates back to the premodern medical conception of disease as a “humoral imbalance,” comically prefiguring the modern, supposedly scientific conception of it as “chemical imbalance.”

In the nineteenth century, the scientific concept of disease as lesion replaced the Galenic concept of disease as humoral imbalance.

More specifically, the humoral imbalance theory led Rush to employ "bleeding, purging, low diet, and the tranquilizing chair. "The tranquilizing chair was a chair-like contraption for confining the patient and rotating him until he became dizzy or lost consciousness. This was supposed to rebalance the circulation in the brain. It was but a small step from the nineteenth-century’s tranquilizing chair to the twentieth century’s tranquilizing drug, supposed to rebalance the chemical imbalance in the patient’s brain.

Szasz is “harping” on this, not “as if psychiatry is the only area where nonsense has appeared,” but rather to provide, consistent with the essay’s title, a brief history of (the psychiatric nonsense of) mental disease as brain disease.

@baxter

Of course all this harping would be relevant if only it weren’t for the fact that psychiatry can evolve with time.

But does going from

• attributing “mental illness” to “humoral imbalance”

to

• attributing “mental illness” to “chemical imbalance”

constitute “evolution”?

As Szasz writes, Plus ça change, plus c’est la même chose (“The more it changes, the more it’s the same thing”).

@baxter

“There is no evidence for a chemical imbalance causing mental illness, but that does not impair the doctrine’s scientific standing or popularity.”

This is surely untrue because administering a chemical imbalance (i.e. drugging someone) can alter their behavior and produce effects such as seizures and hallucinations.

But Szasz doesn’t write “There is no evidence for a chemical imbalance producing effects such as behavioral alterations, seizures, and hallucinations,” nor would he.

Szasz writes “There is no evidence for a chemical imbalance causing mental illness.”

Szasz does not deny that ingesting a drug can produce or induce a physiological effect. Clearly, if you introduce some chemical which penetrates the blood-brain barrier, the expression “chemical imbalance” becomes somewhat meaningful. What’s more, since you know what was introduced and in what amount, you clearly have evidence.

But this has nothing to do with psychiatry or “mental illness.” Psychiatrists don’t measure the neuro-chemical levels and ratios of acetylcholine, histamine, norepinephrine, dopamine, and serotonin, then, based on those numbers, make a diagnosis of “chemical balance” or “chemical imbalance.” If they did that, they’d be doing neurology, not psychiatry.

[list][] Neurologist: Clinical examination skills; empiricism; objectivity; surgery
[] Psychiatrist: Rich description of mental phenomena, well developed interviewing skills; understanding multiple causation; appreciation of individual differences; interpersonal context; psychological and behavioral therapies[/list] (Source)

Psychiatrists don’t perform bio-chemical testing.
Psychiatrists perform socio-behavioral labeling.

Then, after the “mentally ill” label has been officially applied, they assert, without evidence, that the “mental illness” is “caused” by a “chemical imbalance.” It’s the pseudo-scientific equivalent of attributing behavior to “humoral imbalance” or “demonic possession,” i.e., it’s pure quackery and psychobabble. It’s pure name-calling.

I find it ironic that Steve Wiseman summarizes Thomas Szasz’s work as “…simply words and definitions”. Does Wiseman think name-calling and slapping psychiatric labels on people constitutes bona fide medical practice? Does Wiseman think assaulting, incarcerating, poisoning, and torturing innocent persons constitutes bona fide medical practice? To “Dr.” Wiseman I say “Physician, heal thyself.”