Thursday, August 5, 2010

"Words to the Wise"

As I write this, I am sitting in a computer lab with a copy of Thomas Szasz's "Words to the Wise". It's an utterly fascinating collection of quotes and sound-bites on a wide-ranging collection of topics by one of the most controversial authors in the field of clinical psychology. Some of the quotes I agree with; others I don't. All, however, are thoughts worth considering. Despite the format, it's one of the most thought-provoking books I've seen in a long time.

Ten of the quotes more relevant to today's autism issues:


If a person ingests a drug prohibited by legislators and claims that it makes him feel better, that proves that he's an addict.

If he ingests a drug prescribed by psychiatrists and claims that it makes him feel better, that proves that mental illness is a biomedical disease.


When and why do we say that a behavior is caused rather than willed?

We say that chemicals in the brain cause depression and suicide; but we don't say that chemicals in the ovaries or testicles cause lust and marriage.


The child cannot match the adult in most accomplishments. Hence, we reward him for effort as well as achievement. Yet, the child must learn that what counts in life is not effort but achievement. The child over-rewarded for effort may grow up to seek approval for trying instead of for succeeding. This dooms him to failure. If he succeeds, he succeeds only at trying hard. If he fails, he fails miserably.


When a woman finds having a fetus in her body annoying, she can abort it by taking an abortifacient drug or having a surgical abortion.

When a woman finds having a child in her home annoying, she can abort his persona by having a child psychiatrist give him a chemical straitjacket.


Diagnoses are not diseases.
Diagnoses are names, human fabrications.
Diseases are phenomena, facts of nature.


Demonstrable bodily lesion is the gold standard of medical diagnosis. Without practical convertability into gold, the value of paper money rests only on faith. Without conceptual convertability into bodily lesion, the diagnosis of disease rests only on faith.


A patient with cancer says: "If I had refused my surgeon's suggestion that I have my tumor removed, the cancer would have killed me."
A patient with depression says: "If my psychiatrist had let me refuse the electroshock treatment he recommended, I would have killed myself."
The difference between these two sentences sums up the difference between bodily illness and mental illness.


Three principal rules of conduct:

1. The Golden Rule: Do onto others as you want them to do unto you.

2. The Rule of Respect: Do unto others as they want you to do unto them.

3. The Rule of Paternalism: Do unto others as you in your superior wisdom know ought to be done unto them in their own best interests.


Formerly, debasing the Other by calling him a "nigger" was considered politically correct: the speaker was viewed as a protector of the race or nation from those bent on defiling it.
Today, debasing the Other by calling him "sick" is considered politically correct: the speaker is viewed as a protector of the debased person's best mental health interests and of the nation from a danger to the public health.
Replacing the former rhetoric by the latter is considered moral progress.

Today, everyone claims to be working for the patient's best interests. No wonder the patient is in deep trouble.


Note that I selected these quotes based on relevance, not agreement. I don't, as a matter of fact, agree with a lot of Szasz's thinking. This said, he's an incredibly thought-provoking author. In this blog post, I'm not going to take a stance on any of these. Instead, I'm going to give an "assignment" of sorts to each of my readers.

Read these quotes. Think about them. What does each of them mean? What do they imply? Is this statement -- or implication -- accurate? Is Szasz right or wrong? Why?

Then post an explanation here, answering at least one of these questions for at least one of these quotes. Feel free to do so anonymously or pseudonymously. I don't care about that (although I will delete SPAM posts or personal attacks). If you aren't the first to reply to this, also reply to at least one of the previous replies.

My own replies here will be mostly playing "devil's advocate", issuing responses also intended to make people think and facilitating discussion. Unless I state specifically that a position is my own personal belief, please don't think that it is. I will likely issue arguments against your position even if I agree with it.

The point, after all, is to get people thinking about this sort of thing.

In addition to the obvious, this exercise should give you a pretty good idea of why I highly reccommend this book. It has nothing to do with agreement (although I strongly agree with both the contents and sentiments of many of the quotes, this cannot be said about many others). It has everything to do with the way the book makes you think.

Oh, and it's a treasure mine for anyone who wants quotes for articles, the beginnings of book chapters, and the like. Lots of grade-A quotes here... which is the entire point of the book.

Edit: Added a link.

5 comments:

  1. An interesting counterpoint to join Szasz's analysis is here.

    But just watch out for Big Pharma...

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  2. Indeed. The nidotherapy paper looks very interesting. I've printed a copy and am reading with interest -- expect a further reply when I'm done.

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  3. Here is my Szasz quote for today and attempt to answer your questions:

    The child cannot match the adult in most accomplishments. Hence, we reward him for effort as well as achievement. Yet, the child must learn that what counts in life is not effort but achievement. The child over-rewarded for effort may grow up to seek approval for trying instead of for succeeding. This dooms him to failure. If he succeeds, he succeeds only at trying hard. If he fails, he fails miserably.

    Keeping in mind, relevance not argument:

    Children cannot do the same things as adults, so to hold them to the same standards as adults is not good while they are still children.

    Actions are things in the world. Effort is a thing in the mind. Since we cannot know a person's effort from looking at them, we can only judge from the achievement.

    If the child is rewarded for effort (shaping behaviour, shaping thought)...

    How often do we say that we get better at trying harder other than the thing we want to achieve?

    Both the child and the adult are a construct. Only accomplishments by persons are real.

    I think he implies that it doesn't matter what the person is seeking approval for: it means that he or she seeks approval and that they are more in the "machine"/working for the "man".

    We have not a measure of our own accomplishments.

    To reward the child for effort without accomplishment or accomplishment without effort gives him a not very strong mental sense, if we talk about how to prepare him/her as an adult.

    But surely accomplishments must have a context and a world view to ground them into something? And be meaningful to the person?

    Think: how it is relevant to autism.

    It's obvious and it's slippery ...

    We have this idea of a healthy man, a healthy woman and a healthy adult. The healthy adult is more like a healthy man than a healthy woman, yet the healthy adult has traits of both sexes/genders.

    I would say it would be the same about any split characteristic.

    Thinking of Simone de Beauvoir on transcendence and immanence.

    Socrates: yay for nidotherapy. "Achieving a better environmental fit".

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  4. One piece of commercial SPAM deleted.

    Adelaide, your interpretation of the meaning of that particular quote is very different from mine. I won't say that it's wrong (the nature of the book prevents contextual variables from providing definitive evidence), but that's highly relevant.

    In the interests of discussion, however, that's not terribly important. The most important parts are the last two questions: Is Szasz right or wrong? Why?

    Socrates: Finished the article. Excellent, excellent piece. I may blog on it sometime; in the meantime, I see it being added to my list of "papers to routinely cite".

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  5. One commercial SPAM comment deleted.

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