on 22 May 2002
Following polemical and iconoclastic books such as The Myth of Mental Illness and The Manufacture of Madness, Szasz intensifies his attack on psychiatry by examining the specific concept of schizophrenia.
Szasz argues that schizophrenia is not a disease analogous to bodily diseases, such as cancer, TB, etc. While not denying that people labelled schizophrenic may suffer immense anguish, he is convinced that "There is...no such thing as schizophrenia".
Given that, according to Szasz, there is no evidence that schizophrenia has an organic basis, the existence of the concept functions to justify and legitimize society's various ideological agendas (such as locking people up against their will, and denying people responsibility for their actions). In developing such an argument Szasz empasizes that psychiatry is therefore not what it claims to be (i.e. a medical specialty) but is in fact an agent of social control.
Szasz begins the book by demonstrating that schizophrenia was a concept "invented" in the late 19th/early 20th century by Emil Kraepelin. Here began the "literalization of a metaphor". To say that a schizophrenic was sick or ill was no more than a metaphor indicating your disapproval, i.e. a value judgement. But in order for psychiatry to be recognised as a legitimate enterprise at a time when real medicine was making great progress in discovering real diseases, the metaphor was "transformed" into something "real" that a person "had".
Szasz also attacks so called "Ant-psychiatrists" - in particular R.D. Laing. His primary charge is one of hypocrisy: here is Laing like Szasz denying the existence of schizophrenia, but then going and treating it! This chapter on Laing is the weakest in the book. Firstly, Laing like Szasz, rejected the anti-psychiatry label which was bestowed upon him. Secondly, Laing did not treat schizophrenia as a disease; he emphasised quite rightly that individuals labelled schizophrenic suffer a great deal. Szasz's attack on Laing is unfair. Subsequent chapters develop a social constructivist account of schizophrenia.
Szasz's arguments remain highly controversial; yet if you feel he is wrong, there is a great deal in this book which you will need to refute. Whether you agree with his arguments or not Szasz requires to be taken seriously. Reading this book is a great place to start.