The Manufacture of Madness

by Thomas Szasz

s/t: A Comparative Study of the Inquisition & the Mental Health Movement
In this seminal work, Dr. Szasz examines the similarities between the Inquisition and institutional psychiatry. His purpose is to show "that the belief in mental illness and the social actions to which it leads have the same moral implications and political consequences as had the belief in witchcraft and the social actions to which it led."

Genres: Psychology, Nonfiction, Mental Health, Psychiatry, History, Philosophy, Science

406 pages, Paperback

First published January 1, 1970

About the author

Thomas Stephen Szasz (pronounced /sas/; born April 15, 1920 in Budapest, Hungary) was a psychiatrist and academic. He was Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He was a prominent figure in the antipsychiatry movement, a well-known social critic of the moral and scientific foundations of psychiatry, and of the social control aims of medicine in modern society, as well as of scientism. He is well known for his books, The Myth of Mental Illness (1960) and The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement which set out some of the arguments with which he is most associated.

Reviews

[Erik Graff · Rating 5 out of 5]

This book really is a comparison between modern institutional psychiatry and the inquisitions against witches and Szasz manages four hundred pages of such without becoming overly redundant or facile.

The predication of "psychiatry" as "institutional" is vital to Szasz' arguments. Himself a psychoanalytically trained psychiatrist, he has no problems with voluntary contracts between individuals. What exercises his ire is coercion, stigmatization and the confusion of categories.

The primary categorical confusion discussed in this book is that of treating certain behaviors as if they were symptomatic of disease despite the lack of any testable evidence of aetiology. Much of what passes for "mental illness", the object of psychiatric attention, is not, by this standard, a medical condition at all--not, at least, if psychiatry is presumed to be a medical science. More properly, certain behaviors are representative of social conditions, their interpretations being instrumental to methods of social control.

Having been trained for a career as a psychotherapist myself and having, for at least a decade, expected to head in that direction, I have always found Dr. Szasz' works to be challenging. He may, along with such "anti-psychiatrist" figures as R.D. Laing, have contributed to my increasing disenchantment with the profession and failure to pursue that path.

One of the big issues in my social world is alcohol, some of my friends and relatives being identified as "alcoholics"--some contesting this identity, some embracing it. But what might this mean? Alcoholism is commonly treated as a genetic predisposition, stemming from upbringing or biology or both, the one reinforcing the other, fashionably conceptualized nowadays as a medical condition, a disease, whereas the more traditional view held it to be a moral condition, a sin. Szasz would question the category itself, seeing it as a questionable reification of a host of discourses and behaviors involving alcohol or its avoidance. Unless or until a certain aetiology can be demonstrated, the concept of "alcoholism", like that of the broader concepts of addiction or "addictive personality", confuses more than clarifies various modalities of the human condition. Yet, despite this, I find myself repeatedly falling back into the common sense of all of us living in a world where there are persons who suffer, or don't suffer, from alcoholism, addiction, schizophrenia, bipolarism, borderline personality disorder, ADHD, anorexia etc--despite the paucity of scientific evidence for the existence of such supposed diseases.

In order to impress his point upon the reader Szasz devotes much of this book to the exposition of conditions once considered as existentially defining, but now rejected. The primary condition treated is witchcraft, but lengthy attention is also given to negritude (as a medical condition related to leprosy), to homosexuality and to masturbative insanity. A similar exposition might be essayed as regards the various editions of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, homosexuality-as-disease, for instance, being a condition which has disappeared from its pages in my adult lifetime.

[David Gross · Rating 5 out of 5]

This book shows how the “mentally ill” category serves as a form of social control that has evolved directly from the category of “heretic.” Although psychiatry uses the language of medicine, it has been more commonly used as a justification for the involuntary incarceration and remolding of behavioral deviants. The “diseases” that psychiatry discovers are defined not by their nature as medical pathology, but by their behavioral symptoms which are defined as “disease” in order to prohibit or suppress them.

[Logan Albright · Rating 5 out of 5]

The 9th book I've read by Szasz and the best one yet. A brutal look at how, while the objects of persecution and torture have changed over time, the basic method has not. We used to lock up homosexuals, mutilate masturbators, and burn witches. Now we imprison, bully, intimidate, and drug the depressed, the anxious, drug users, gamblers, and those who hear voices that we cannot hear. Man's desire to destroy what is different has not become more enlightened, it has only changed its mask.

[Charlie · Rating 3 out of 5]

A free thinker's delight. What Szasz says in essense is that social engineering is no more fun from a modern and secular/"scientific" world view than it was from a religious/"moral" world view. The problem with the "enlightened" perspective (in power) down through the ages remains. The right and responsible people need witches and madmen to justify their rightousness and they need jails torture and death sentences to justify their resonsibility. A must read for anyone who has ever been incarcerated in a mental instituion against their will or lost loved ones in a holy crusade.

[Peter Schutz · Rating 5 out of 5]

“Man must forever choose between liberty and such competing values as health, security, or welfare. And if he chooses liberty, he must be prepared to pay its price.”

[Donald · Rating 4 out of 5]

"The Manufacture Of Madness" and "The Myth Of Mental Illness" are two of the most intriguing non-fiction books of the late twentieth century. Dr. Thomas Szasz presents a compelling argument that modern psychiatry has become all too accustomed to labeling any inconvenient behavior as an "illness." Exactly who decides what is "normal?" This book is wordy and difficult to wade through in parts, but Szasz makes his points well and his arguments are difficult to discard. This book would make an especially appropriate read for someone who is confused and on the verge of being declared mentally ill. It can't hurt them worse than whatever drugs will undoubtedly be prescribed for them.

[Youri · Rating 5 out of 5]

"To defend the rights of alleged mental patients is experienced as an attack on the integrity of society. The tendency is to cast the defender into the role of a thoughtless (or worse) advocate of the "rights" of "sex-fiends" to molest little girls, or of "homocidal maniacs" to assault their neighbors. The fact that far more violence is committed against mental patients than by them does not matter. The action of the tribe, of the collective, of the State, is experienced as right; that of the independent individual, as wrong."

Though such violence against the 'insane' may no longer be of the same ostensive intensity and cruelty of Szasz's time, the tendency to label any aberrant behavior as indicative of mental illness is now increasingly common.

This makes Szasz's analysis and warnings just as relevant today as they were in his time.

[Joseph Newton · Rating 4 out of 5]

Interesting study of the role of the scapegoat in society across time and space. The author's central argument is that the inquisition never ended, but morphed into what we know today as Institutional psychiatry. The inquisitor of yesterday is today's institutional psychiatrist. The game remains the same, only the players have changed, or changed names atleast. "Just as the Inquisition was the characteristic abuse of Christianity, so Institutional Psychiatry is the characteristic abuse of medicine" (XXIX). Sociology of deviance; civil libertarianism; feminism; anthropology of medicine; psychiatric history; medieval history; humanism.

[Anthony · Rating 5 out of 5]

Fantastic and complex read.

[John Hancock · Rating 5 out of 5]

Brilliant. Well done Mr. Szasz. Of course I disagree with many of his political, religious, and historical analyses, but no one understood the truth about psychiatry like Szasz. Five stars.

https://psychiatricsurvivors.wordpres...

[Lydia · Rating 5 out of 5]

Possibly the biggest influence on me, career wise, so far, in that it made me want to be almost anything other than directly involved with the practice of Psychology/Psychiatry

[Sebastian Castellanos · Rating 5 out of 5]

One of the main strengths of this book is Szasz's ability to present a compelling and well-reasoned argument against the medicalization of mental illness. He uses historical examples and logical reasoning to challenge the idea that mental disorders are biologically based and should be treated with medication. Instead, he suggests that many of the behaviors labeled as mental illness are simply a natural response to life's challenges and should be dealt with through social and psychological means.

[Brassy Bottle · Rating 5 out of 5]

This man was brilliant. He saw right through the sham of the usual bollocks "men of medicine" enforce on their fellows. Or more accurately, on women since women are (as usual) at the bottom of the human heap. No wonder Official Psychiatric Institutions shunned him.

[Peter Strauss · Rating 5 out of 5]

A fair number of readers will find this liberating, and a fair number will turn away from it quickly. The latter group should hang in there, because agree or disagree, there is much food for thought. Is there a condition we could call mental illness?

[☘Misericordia☘ ⚡ϟ⚡⛈⚡☁ ❇️❤❣ · Rating 5 out of 5]

Сас Tомас
Фабрика безумия

[Neal Alexander · Rating 4 out of 5]

In Lausanne, the Museum of Art Brut has letters from asylum inmates asking to be released. One, from a former government official, is impressively laid out in flowing calligraphy. Another is in miniscule writing whose lines end at the ragged edge of its paper. In context, the contrasting letters both suggest that the writers are delusional, be it in the grandiose manner or the reclusive. This unfair conclusion reflects the predicament of asylum inmates who were incarcerated based on arbitrary medical opinions and from whom any appeal, irrespective of its merits, was simply taken as further grounds for detention.

The subtitle of this book is “A Comparative Study of the Inquisition and the Mental Health Movement”, and Szasz’ argument is that, in the early modern period, insanity replaced witchcraft as a justification for forcibly confining and torturing troublemakers, ostensibly for their own benefit. As he says “The basic similarity between the two situations is that the accusers can do no wrong, and the accused can do no right.”

Today's conventional discourse says that mental illness is like any other illness. Nevertheless, only mental illness costs one the right to consent, and this is perhaps Szasz’ most fundamental complaint. In the 50 years since this book was written, asylum populations have decreased in western countries, although the role of involuntary commitment has been partly taken by compulsory outpatient treatment.

[Helen O'Neil · Rating 5 out of 5]

This book is a retrospective of the history of madness in medieval and modern Western society, as well as the ways in which madness was viewed by people of different eras. It was very useful in helping me understand how our current beliefs about mental illness developed, and why they are inadequate to fully explain or understand the truth about mental illness.

The book is specifically about the Spanish Inquisition and its similarity to modern psychiatry, and while that simile has some veracity to it, there are some serious holes in the logic that raise troubling questions. Nevertheless, it's a fascinating premise, and insightful enough to warrant a reading of the book.

[Julie Hunter Boone]

Whew.

[Giulio]

Nell'edizione italiana curata da "Feltrinelli"
- I Manipolatori della pazzia. Studio comparato dell’Inquisizione e del Movimento per la salute mentale in America;

[Laura]

Heard about this in class, 7/8/08

[Tanya Van]

Detailed and facsinating history of the medicalisation of non conformity.

[Steve Woods · Rating 5 out of 5]

Outstanding