As many Catallaxy readers would’ve caught on by now, two major figures passed away over the course of the past week or so.
Ronald Hamowy (1937‑2012) was a Chinese‑born Canadian scholar whose career was closely connected with the life and times of some of the most famous figures in classical liberalism and libertarianism, including Ludwig von Mises, Friedrich Hayek, Murray Rothbard, Ralph Raico, Leonard Liggio and George Reisman.
Upon his arrival at the University of Chicago in 1960, Hamowy was initially book review editor and later editor of the libertarian student journal New Individualist Review (see here). It attracted some of the most authoritative figures in all of liberalism/libertarianism as contributing authors, and gained a wide audience in the US and overseas.
Hamowy was also widely known for his intellectual critiques of Hayek’s The Constitution of Liberty (for example, see here), based on what Hamowy saw as a nebulous distinction between ‘legitimate’ and ‘illegitimate’ state actions which are, however, equally founded on coercion, and was seen later in his career as a leading intellectual authority on Enlightenment history and the concept of spontaneous order.
Thomas Szasz (1920‑2012) is best known for his intellectual defences of bodily and mental self‑ownership, as part of the foundational principles of classical liberal thought.
Having famously once stated that ‘the self is not something that one finds, it is something one creates,’ Szasz was an unstinting critic of the medicalisation of behaviour as a means of social control, the grossly expensive and pointless ‘war on drugs,’ and health paternalism in America and the Western world more generally.
While such positions undeservedly delivered scorn from group‑think health practitioners over the years, it could be said that the power of Szasz’s arguments significantly contributed to an increasing awareness of the real and potential abuses by the state of individual rights in the name of ‘sound medical practice.’
For those interested, some further details on the life and works of these two greats can be found here and here (for Hamowy), and here and here (for Szasz).
It is the intellectual obligation of those of us left behind to grasp the torch of liberty passed on by the likes of these two key figures of twentieth‑century liberalism.
I disagree on Szasz. Libertarian he might have been but his anti psychiatry and anti mental illness writings probably discouraged many people from seeking treetment for what are well treatable illnesses, such as depression.
The greater problem is under trratment rather than over treatment of depression and some other illnesses.
Ken N
12 Sep 12 at 2:06 pm
I’m not so sure, Ken, my suspicion is that there is a creeping conflation of sadness with depression. Consistent with this, there are some NGOs and other bodies with vested interests in pushing the depression wheelbarrow. I could probably throw in other issues, such as ADHD, into the mix which I think could be prone to the issues that Szasz raises.
Julie Novak
12 Sep 12 at 3:54 pm
I’m with Ken, Szasz was dangerous. His lot were right about the diagnostic problems but for the wrong reasons. There never can be a clearly defined symptom set, either behaviorally or biologically, to clearly define a mental illness. We can’t define normal so by default we’re pushing shit uphill to define abnormal. There are approaches, the problem is not completely intractable but there reside some intrinsic limitations that make psychiatry an incredibly difficult undertaking.
Dead Soul
12 Sep 12 at 7:22 pm
see http://econfaculty.gmu.edu/bcaplan/pdfs/szasz.pdf saying that most mental illnesses are best modelled as extreme preferences, not constraining diseases, and are fully compatible with basic consumer theory.
It should be noted that Szasz did not deny that there is bizarre behaviour and that people have problems with living and with coping with each other.
Caplan’s best point is the range of desires and viewpoints is amazingly wide and one of the lessons of great novels and plays is that a character’s superficially inexplicable behaviour becomes intelligible once you see it from their perspective.
Caplan also reminds us of token economies. The first token economies were for chronic, treatment-resistant psychotic inpatients.
In token economies, tokens are earned by chronic, treatment-resistant psychotic inpatients for positive cooperation, self-care, attending to communal duties and activities, good academic behaviour, and less disruptive behaviour etc.
These tokens can be exchange at the canteen for sweets, cigarettes, journals, money, for services: breakfast in bed, having your room cleaned, activities; for passes for leaving the building or area, permission to stay in bed, and phone calls. In 1977, a major study showed the superiority of a token economy compared to standard treatment and specialized therapy.
Chronic, treatment-resistant psychotic inpatients even have well-behaved supply and demand curves. When, as one of several experiments, for 2 weeks patients were not paid any tokens for cleaning halls and other common areas, so few volunteered.
Caplan is at his weakest when he argues that the ability of drugs to change brain chemistry and behaviour does nothing to show that the initial behaviour was sick. If alcohol makes people less shy, is that evidence that shyness is a disease?
The truly bizarre and destructive behaviour that drugs temper suggest something deeper is going on and may just need a better description than illness.
Jim Rose
12 Sep 12 at 8:01 pm
The state has so far not had much success in controlling either drug use or suicide. Making suicide illegal raises difficulties in imposing a sentence, while attempting to prize the cabernet from my still living hands would be likely to end in tears, if only mine.
blogstrop
12 Sep 12 at 8:32 pm
I hadn’t heard of Thomas Szasz before, but I do spend a lot of time confined in the back of an ambulance with ‘psych’ patients, and I believe the vast majority of mental illness is simply bad behaviour that has been legitimised by a risk averse socialised health system.
I am uneasy with the forced detention and examination by a psychiatrist that is now mandated under the guise of ‘duty of care’ for those whose behaviour may cause others to believe that the person has self-destructive tendencies.
Eddystone
12 Sep 12 at 8:37 pm
We have had a version of this argument before. Right now, I want to make just these points.
1. More people in Australia die from suicide than motor accidents. Most suicides are mentally Ill. The figure usually quoted is 85%
2. Depression is treatable in the great majority of cases by medication and/or CBT. Schizophrenia is more difficult but also controllable by medication. ECT -shock therapy – is remarkably effective for depression but probably underused because of One Flew Out of the Cuckoos Nest and other films, as well as the scientologists and the anti-psychiatry movement.
3. My fear is that because of misleading information some will not seek treatment. As a result, they case face a miserable life or death.
I urge everyone to learn about all this stuff because chances are you will know someone effected at some time.
The best lay book – I have read most of them – is Andrew Solomon: Noonday Demons.
Ken N
12 Sep 12 at 10:30 pm
That’s pretty well balanced Ken. Difficult to disagree with that.
.
13 Sep 12 at 11:18 am
EddyStone you’re no libertarian if you detain innocent people for a living.
Brachar
13 Sep 12 at 2:09 pm
Thomas Szaz is a nutter. Overmedicalisation is one thing but if organic retardation exists so does mental illness (ultimately due to some organic cause). We are machines and machines can malfunction.
jtfsoon
13 Sep 12 at 5:34 pm
This summarises the difficulties. Diagnosis is all over the place. But brain malfunctioning does occur, tailored medication can help, and the issues are not all volitional or socially-constructed. Moderate to severe malfunctioning is a tragedy if not assisted in some way and it does affect many families who are shell-shocked at what happens.
However, the other side of the coin, the medicalisation of human experience, is something to be aware of and to resist where it is reasonable to do so. Sociologists of knowledge, such as Berger and Lucknam (going from memory here), looking at how societies ‘construct’ realities, and phenomenologists who look at how individuals conceive and act out their own realities (R.D. Laing took this up, also Garfinkel in the U.S.) and Szasz too, all had some contribution to make here, but it’s babies and bathwater – careful what you do and don’t keep here, otherwise you end up with schizophenogenic mothers and other nasties of personal and medico-social demonisation.
Elizabeth (Lizzie) B.
13 Sep 12 at 7:01 pm
However, the other side of the coin, the medicalisation of human experience, is something to be aware of and to resist where it is reasonable to do so.
Liz, this text seems up your alley. Read it last week. Great. “Beyond Human Nature” by Jesse Prinz. A wealth of anthropological data illustrating how varied human behavior is. He goes after gene centrism, nativism, and does some brilliant analyses of various social and developmental psychology experiments.
There is too much medicalisation of behavior and there is a backlash occurring. It is not common from the professions but from the people at large. About bloody time, the USA data on prescription drug usage for behavioral issues is outrageous. The USA is either filled with the mentally ill or its psychiatric community has gone mad.
Dead Soul
13 Sep 12 at 7:40 pm
Yes, thanks for the reference DS, I will try and catch up with it.
The medicalisation of behaviour is a real issue, especially for children and the aged, two groups who don’t have much power to speak for themselves and who are reliant on carers who may also be serving their own interests in pushing medicalisation. With children, we also have the issue of possible alterations in brain functioning due to repetitive audio-visual behaviours, aligned with motor function, as in electronic gaming for example, that can impact on behaviour too. Plus the loss of socialisation and outlets for natural physical exuberance that then becomes diverted into alternate behaviours and mental pathways. All additional to the changes in interaction in families. Difficult.
Elizabeth (Lizzie) B.
13 Sep 12 at 7:53 pm
Szasz was onto something, but his ideas were picked up by people like Laing and the Scientologists and taken right off the graph.
Another interesting aspect is the cultural context of mental illness. Even within Europe, there are significant differences in behavioural norms which at the extremes can cause people to be, or not be, considered mentally ill. When you range further, such as into Asian or Pacific island cultures, the rules are different again. Intriguing stuff.
johanna
13 Sep 12 at 9:57 pm
Another interesting aspect is the cultural context of mental illness. …
It would do mental health professionals the world of good if they spent more time reading anthropology than so much guff that comes out of the relevant bioscience literature. They might then learn that human adaptability is remarkable in its range and no less remarkable than the range of possible human behaviors. Hayek recommended economists study anthropology, most of us should make it part of our reading. But make it anthropology that isn’t trying to prove something about human nature! eg. PoMo anthro, evol. psych. Just observational, look and learn.
Dead Soul
13 Sep 12 at 11:15 pm
They go hand in hand DS.
Try describing the earliest forms of cooperation or trade, or even how early Governments formed.
.
14 Sep 12 at 12:31 am