How Szasz Helps
I’ve long defended the Szaszian view that so-called “mental illnesses” usually boil down to extreme preferences. But even if the orthodox view is true, it could be harmful. As I’ve explained before, belief in the “chemical imbalance” model seems to foster a sense of hopelessness. If Szaszianism is a lie, it seems to be a noble lie.
Here is a recent relevant email from a reader, reprinted anonymously with his permission.
Hi Professor Caplan,
I understand you probably receive countless emails, so I sincerely appreciate you taking the time to read this.
I've read many of your books and keep up with your blog. While I love your insights on economics and politics, your writings on mental illness and Thomas Szasz were honestly life-changing for me.
Since I was a young teenager, I've suffered from OCD-like symptoms and crippling anxiety. My condition got to the point where obsessive checking and irrational paranoia ended up putting me in a depressed state. At its worst, I would most look forward to sleep — since that's when I could temporarily escape from my intrusive thoughts and worries. This defined my high school and early college experience.
But after coming across your “The Economics of Szasz” and Szasz's own The Myth of Mental Illness, I started to view my OCD and anxiety as a preference (it helped that I was studying economics in undergrad, so I was familiar with this sort of thinking at a basic level). Realizing that my crippling thoughts stem from my own actions and personal preferences, rather than being something imposed on me against my will, I began to dig myself out of my self-imposed hole. I ended up graduating from university with my degree in mathematics and economics, securing a respectable position in finance, and creating a new (and much more intellectually satisfying) social circle. In short, I am easily the happiest I have ever been in my life so far.
So, thank you. Thank you for quite literally fixing my life and putting me on the right path. More than simply being correct, your Szaszian thinking helped me in a material way. And I appreciate that.
All the best,
[redacted]
P.S. If you want to explore the thought of the great Thomas Szasz, I strongly recommend that you skip The Myth of Mental Illness, which is frankly his worst book. While seminal, Szasz took another ten years to reach his own mature position. No aspersion; Szasz simply had yet to figure out what he really thought. Instead, start with The Untamed Tongue, his best book of aphorisms (indeed, one of the best books of aphorisms by anyone). Then move on to Insanity: The Idea and Its Consequences, his best book overall. Whatever your personal state of mind, you will never see the human mind in the same way again.
This is wonderful and I'm so glad to hear the writer is doing well!
However I'm confused about how the logic is supposed to go here. The Szaszian model is, I thought, that people are depressed/anxious/etc because they *prefer* the life that affords them, for whatever reason. So in what sense can someone look at their situation, and after reading Szasz think "I guess I really just prefer depression", and use this as motivation to work on resolving their depression? This seems like clear evidence that they did *not* prefer depression!
I am very glad your reader was able to solve his own challenges and build a better life. Frankly, it sounds like he invented his own version of Cognitive Behavioral Therapy and implemented it. Most people would not have the creativity and force of will to do that without help.
Until I was middle-aged, I suffered from what some call Social Anxiety Disorder. I've always been a strong public speaker, but in one-on-one interactions I would freeze up. Couldn't handle small talk at all. I got paranoid about every word coming out of my mouth, thinking everything was disastrously clumsy and I was being judged for it. The casual interactions that are necessary in my line of work were too much for me. It was very limiting, both personally and professionally.
I had tried therapy in college and found it a total waste of time. Then when I was in my mid 40s, I found a CBT therapist who was great. His technique was to help you identify self-defeating patterns of thought and do various real-world exercises to subdue and conquer them. Pretty much what your reader describes. The CBT folks waste no time at all on exploring your childhood or what might be the cause of your problems; they go straight to fixing them, by helping you develop a kind of discipline over your thought processes, to end self-sabotage.
It took about 6 or 7 sessions and the "homework assignments" in between to change my life. I was thrilled but also wished I could have found that help when I was in my teens or twenties. There is quite a bit of empirical evidence backing the effectiveness of CBT approaches.
As for Szasz, I think he was one of the necessary critics to tear down useless approaches to psychology and therapy. [Most notoriously, Freudian therapy has been proven useless; Freud, like Marx, seems like nothing but a pseudo-scientific quack.] I'm not aware that Szasz built anything effective as a replacement. Whether "Social Anxiety Disorder" is a "mental illness" seems like an irrelevant battle over definitions. The relevant question is, if it's an unwanted condition or pattern of behaviors, can outside, expert interventions help address it? Such approaches are available now.