The Age of Madness

A long, long time ago when I was a resident in psychiatry at the Upstate Medical Center in Syracuse, New York, I remember Tom Szasz’ enthusiasm for his “new book.” It was going to be a collection of stories and autobiographies by individuals who had been subjected to psychiatric oppression, and he was as enthusiastic about it as I had ever seen him. The idea was to present psychiatry from the victim’s point of view.

It was shortly after the publication of his libertarian psychiatric classic, The Myth of Mental Illness; perhaps he had published Law, Liberty and Psychiatry as well. I was just plugging away on my first novel, and naturally I was excited to see what he would come up with from the world of fiction and autobiography.

Now, a decade later, Szasz with his customary tenacity has finally come out with The Age of Madness. Its scope has vastly increased, and it contains a wide variety of documents calculated to familiarize the reader with the long history of psychiatry as an abusive institution. We have the fictional and autobiographic presentations he had originally intended as the backbone of the book, including a number of good ones I had never seen. But the arena is now much larger, beginning with Daniel Defoe’s 1728 journalistic outcry against

"...the vile Practices now so much in vogue among the better Sort, as they are called, but the worst sort in fact, namely the sending of their Wives to Mad-Houses at every Whim or Dislike, that they may be more secure and undisturbed in their Debaucheries...."

Very possibly, Szasz has unearthed one of the very first documents to show that institutional psychiatry, from its earliest inception, has made particular victims of women.

Most disturbing to many readers will be the “testimonials” from the psychiatrists themselves. Szasz has put together as self-incriminating a collection of “scientific papers” as one is likely to see. We find the great liberator of mental patients, Philippe Panel, praising the use of terror and lashes and that wonderful father of American psychiatry, Benjamin Rush, advocating the use of his own innovative method:

"Cures of patients, who suppose themselves to be glass, may easily be performed by pulling a chair, upon which they are about to sit, from under them, and afterward showing them a large collection of pieces of glass as the fragments of their bodies...."

This, incidentally, is one of Rush’s more delicate gestures of intimidation. Compare it to bleeding, threats with a knife, the spinning chair, cold water down the ampits and so on.

For those who wonder about the origins of lobotomy, there’s a piece by Egas Moniz, who received the Nobel Prize for it; and then there is Cerletti’s description of how he adapted electroshock from the slaughter houses of Italy where it had its own particular use. The book ends more modernly on the same theme with a report from Medical World News on the use of a curare-like paralyzing drug whose suffocating effects have been found useful as a means of behavior modification in California prisons and hospitals.

The book is not entirely morbid. Listen to this delightful quote from Austrian Karl Kraus, one of the many authors with whom I was unfamiliar:

"Our loyal psychiatrists are rather like good dogs—they protect house and yard, and ‘clean up’ the most diffcult’bones for their masters. If a person walks at a rapid pace, they conclude that he is a thief. A dog’s reliability does not lie in the reliability of his opinion, but in the fact that he gives one. In any case, its threatening bark helps create an impression of authority."

In addition to many obscure but interesting authors, there are also selections from more familiar ones, from Chekhov to Erving Goffman, the the sociologist. Unaccountably missing are pieces from Ken Kesey’s One Flew Over the Cukoo’s Nest as well as selections from a lesser-known novelist who will go unmentioned, except for the by-line on this review.

The Age of Madness was intended as a companion piece to back up Szasz’ other books. It can also be enjoyed in its own right or as a reference for anyone interested in a libertarian critique of men who declare other men mad.

But don’t use this book as an introduction to Szasz, since it contains so little of his own writing. Sometimes he can be rough going, and a good beginning might be his selected papers, Ideology and Insanity, along with this new one, The Age of Madness. Both are in paperback and will cheaply entertain you into a profound fear of psychiatry.

Reviewed by Peter R. Breggin, M.D. / Psychology (372 pages) / BFL Price $2.95