Thomas Szasz & Toxic Theology
The late American psychiatrist Thomas Szasz is a polarizing character. People either love his theories, or they place the entire blame for the current mental health crisis in America on his shoulders. Others blame his colluding with the founder of Scientology L. Ron Hubbard for the anti psychiatry movement of the 1950s and 1960s.
An example of such criticism comes from author Ron Powers in his book, No One Cares About Crazy People, a book where he pours his heart out about the plight of modern psychiatry and his family's tragic experience with it. Powers says that Szasz was “perfectly equipped to spearhead a one man revolt against the orthodoxies of psychiatry… he transformed himself into a stinging force of nature and debate, or at the keys of a typewriter. No barrage of argumentation could sway him from his adamantly crafted line of reasoning, which again and again equated efforts to reach people in psychosis, particularly government-sponsored efforts with the menace of state-sponsored coercion” (Powers, 2017).
Powers is not alone as a critic of Szasz and his theories. Thomas Szasz appeared only as a footnote in my undergraduate psychology textbooks as if the Ph.D. authors were acknowledging some glimmer of validity in his arguments, but we're somehow reluctant to give him anything more than a nod. These dismissive references immediately registered on my there's-something-here-you're-not-telling-me-about radar. So I picked up a copy of Szasz’s seminal work The Myth of Mental Illness.
There's much to say about Szasz’s theories; perhaps more than can be covered in just one episode. But notably, Szasz’s articulation of the connection between coercion in Judeo-Christian theology and clinical mental health keenly identifies the potential for toxic theology to negatively impact psychological well-being - a connection that spoke directly to my personal experience.
Key Theories of Thomas Szasz
Let's start with an overview of Szasz’s most controversial theory. It is summed up in the inflammatory title of his most famous work The Myth of Mental Illness. Central to Szasz’s thesis is that the phrase “mental illness” is simply a metaphor for the challenges of life. Modern psychiatry in his view, represents the medicalization of human suffering. He compares this to the historical time period when non-normative behavior resulting from psychological distress was religionized, explained away with concepts like demon possession, sinfulness, and witchery. Similarly, in modern times, the secularization of the West has resulted in psychiatry taking over where religion left off in this paternalistic regulation of socially unacceptable behavior. He prefers to refer to the psychological distress that manifests itself in what we would call depression and anxiety as “problems and living” (Szasz’, 1961) arguing that psychiatric conditions are not viral or pathogenic in the same way that blood-borne and organismic diseases are.
Instead, Szasz discusses how the challenges of playing by the rules of socially designed behavioral games can result in psychological suffering, and manifest in conditions severe enough to bring an individual (or to have an individual be brought) to a psychiatrist's office. He also says that emotion-laden behaviors and complaints of psychological pain from individuals in distress are really just a form of bodily communication when linguistic communication fails to adequately address the problems in living that the patient is experiencing. And as Ron powers identified in the quote mentioned earlier, Szasz even goes so far as to call psychiatry a coercive arm of the state, as if the American mental health industry is doping people up, just like the World State was doing with Soma in Aldous Huxley's Brave New World (my analogy, not Szatsz’s).
Szasz also uses the word “hysteria” a lot. This is a rather reductive term. It's not used in the field of mental health anymore in favor of more precise nomenclature for psychological states that include symptoms of depression, anxiety and, mania. He also talks a lot about “malingering”. Malingering is when an individual pretends to be unwell as a strategy for avoiding the challenges of adult responsibility and social functioning.
For anyone who has experienced the pain of seeing a family member suffer psychologically, or for those who have lost a loved one to suicide, or to those of us who have come close ourselves, Szasz can sound unempathetic at times (to say the least). And it's easy to get lost in these criticisms and miss the brilliance of some of Szasz’s arguments. One such argument concerns the implications of Judeo-Christian theology on clinical mental health.
Toxic Theology
If you've been following my work over the past year, you'll know that this is a matter close to my heart. I'm concerned about the phenomenon of Religious Trauma Syndrome in newly disillusioned members of new religious movements and closed religious communities. I've also written about coercive psychology as it appeared in the religious group of my upbringing, using Robert Jay Lifton’s, framework for ideological totalism and thought reform.
But as I addressed in my book A Voice from Inside, some of my concerns apply to Abrahamic religions in general. Mine is not an argument for dogmatic atheism. Nor do I suggest that everyone abandon the benign elements of religion that enable them to balance their very human need for social connection and meaning in life. My argument is that religion can at times shrine psychological schemas that have significant implications on wellbeing, whether this is by providing frameworks for hope and purpose that some find useful as coping mechanisms, or conversely, by raising unhealthy cognition, to the level of the sacred.
This is where Thomas Szasz shines. Chapter 10 of The Myth of Mental Illness is titled, “The Ethics of Helplessness and Helpfulness” (Szasz, 1961). Hitting the nail right on the head, a subheading on page 165 is called “Biblical Rules Fostering Disability and Illness” (Szasz, 1961). He starts the section this way:
“Jewish and Christian religious teachings are bound in rules that reward sickness and stupidity, poverty, and timidity, in short disabilities of all sorts. Moreover, these rules and their corollaries threatened penalties for self-reliance and competence, and for pride in health and well-being” (Szasz, 1961).
Lest his readers get too defensive right off the bat, he reassures his reader that he is not arguing that this is the whole essence of the Bible. However, he says:
“The religious history of the West illustrates how, by taking one or another part of this work, it is possible to support or oppose a wide variety of human behaviors” (Szasz, 1961).
Szasz isn't trying to make a theological argument here, but simply drawing connections between theology and the behavior of persons who profess to be religious and who follow the rules of Christianity. He continues:
“The motif that God loves the humble, the meek, the needy, and those who fear him, is a thread running through both the Old and New Testaments. Man's fear of being too well off lest he offend God and make him envious is deeply ingrained in the Jewish religion. It is an element common to most primitive religions, that is, religions in which man conceives of God in His own image that God is like man, only more so. The deity is a kind of superman with his own needs for self-esteem and status, which mortal men are enjoined to threaten at their own peril. This attitude, which is basically a dread of happiness generated by a powerful fear of envy is fundamental to the psychology of the person seriously committed to the Judeo Christian ethic"” (Szasz, 1961).
Szasz is saying that because the deity of the Judeo Christian religion is man-like in that he has needs for self-esteem and can be jealous at times, a power differential is created, in which the penitent must submit to the more powerful player in the game, namely, God.
In order to avoid igniting the fear-inspiring envy of God, the penitent has to take humble and self-effacing actions. Szaszs goes on to apply his game-playing theory of mental illness (which I'll explain in more detail later) to the relationship between man and God. He says:
“The power differential between the two players is crucial, for it alone can account for the fear of envy. In a dominant-submissive relationship, only the submissive of the pair needs to fear arousing the envy of his partner. The dominant player has no such fears, because he knows that the other is powerless to injure him seriously” (Szasz, 1961).
In this dominant-submissive relationship, the possibility exists to ignite the envy of the dominant player in the game. As a result, the Judeo-Christian rhetoric instructs religionists to value poverty, timidity, and humility to avoid igniting the envy of God. Szasz goes on to compare this relationship to that of an oppressive marital relationship. He continues:
“The Open acknowledgment of satisfaction is feared only in oppressive situations. For example, by the much suffering wife married to a domineering husband. The experience and expression of satisfaction, joy, contentment, are inhibited lest they lead to an augmentation of one's burden” (Szasz, 1961).
In other words: don't show yourself to be too happy, contented, or well-off in the presence of this dominating player in the game for fear that they add to your burden, ask you to do more, or dominate you further. It's a bit like at work when you are laughing and joking with your co-workers; having a good time. Then when the boss appears, you immediately pretend to be absorbed in strenuous work. You no longer show yourself to be happy and to be having a good time, so that you can avoid being given any more tasks for the day.
Szasz continues:
“The fear of acknowledging satisfaction is a characteristic feature of slave psychology. The well-worked slave is forced to labor until he is exhausted. To complete his task does not mean that his duties are finished and that he may rest. On the contrary, it only invites further demands. Conversely, although his task may be unfinished, he might be able to influence his master to stop driving him and to let him rest if he exhibits the appropriate signs of imminent collapse, whether genuine or contrived” (Szasz, 1961).
As a result of this power dynamic,
“Qualities associated with helplessness become actual advantages…In certain situations, these rules prescribe that when man is healthy, independent, rich, and proud, then God shall be strict with him and punish him. But should man be sick, dependent, poor, and humble, then God shall care for him and protect him…it might seem that I have exaggerated this rule. I do not believe so” (Szasz, 1961).
Emasculation in the Sermon on the Mount
According to Szasz, one of the most famous examples of fostering dependency and disability is Jesus' famous Sermon on the Mount. In a small table on page 170 of The Myth of Mental Illness, he compares biblical texts with their corollaries in his logical interpretation.
From Matthew chapter five: “Blessed are the poor in spirit, for theirs is the kingdom of heaven”. And then in the other column, “Man should be poor in spirit. In example, stupid and submissive. Do not be smart, well-informed, or assertive” (Szasz, 1961).
And then the beatitude “blessed are the meek, for they shall inherit the earth”. His interpretation: “Man should be meek. In example passive, weak, submissive, do not be self-reliant” (Szasz, 1961).
The third example he gives: “Blessed are the pure in heart, for they shall see God” His interpretation: “Man should be pure in heart, that is naive, unquestioning, loyal, do not entertain doubt” (Szasz, 1961).
The box is followed by an explanatory paragraph:
“Stated in this form, it is evident that these rules constitute a simple reversal of rules generally governing rewards and punishment for man on earth. As a result, defects and deficiencies are codified as positive values” (Szasz, 1961).
Szasz even cites Matthew chapter 19, verse 12, which when seen from this perspective certainly is a jarring passage. From the New Revised Standard Version, “There are eunuchs who have been so from birth. And there are eunuchs who have been made eunuchs by others. And there are eunuchs who have made themselves eunuchs for the sake of the kingdom of heaven“.
Szasz then discusses how this theology can make its way into the therapy room. An individual who is unable to care for themselves emotionally and materially and function in a sustainable way in society may seek assistance from a psychotherapist. “Much of psychoanalytic psychotherapy may revolve around the theme of uncovering exactly who taught the patient to behave in this way, and why he accepted such teachings. It may then be discovered that religion, society, and parents have conspired, as it were, to inculcate this code of conduct, even though it is so tragically ill-suited to the requirements of our present social conditions” (Szasz, 1961).
Personal Reflections from a Religious Trauma Survivor
This chapter of The Myth of Mental Illness speaks to the potential of toxic theology to impact mental health outcomes. When personal disempowerment is enshrined in sacred verse entwined with an anxious attachment to God, it can be particularly difficult to challenge. Deconstructing these messages, or at least moderating them by way of some sort of theological gymnastics, will be necessary if they are at the root of an individual's inability to cope.
Thomas Szasz discussion was particularly validating for me, as I know it will be for many other survivors of religious trauma syndrome. Of course, Religious Trauma results from the existential crisis of the loss of faith and the interpersonal conflict of leaving and perhaps shunning by a tight-knit religious group. But at the cognitive level, thought processes may remain that stymie an individual's recovery; cognitive distortions drawn from unambiguous sacred texts.
Despite the lack of empathy and dismissiveness of Thomas Szasz, I've actually found that the The Myth of Mental Illness has been part of my recovery. Szasz is sometimes like an indelicate but firm father, brazenly refusing to accept any sort of medical diagnosis and putting the responsibility squarely back on the shoulders of the individual who suffers.
Psychological suffering is a matter of language to Szasz. Complaints of psychological distress result from a lack of linguistic skills. An individual is forced to complain of illness, instead of assertively communicating needs to change their social environment. This has been repeated in other theories, such as Albert Ellis's Rational Emotive Behavioral Therapy (REBT), wherein assertive communication skills are taught to the client and communication modeling is performed, so that an individual can learn the language skills needed to impact their social environment and bring beneficial mental health outcomes. Szasz isn't all wrong in his theory of language.
Also, Szasz’s theory of game playing is insightful. When individuals have challenge learning societally created behavioral rules, or abiding by those rules, they need to be taught to the client through psychotherapy. Szasz appeals to the therapist on page 248, “this implies candid recognition that we treat people by psychoanalysis or psychotherapy not because they are sick, but first because they desire this type of assistance. Second, because they have problems in living for which they seek mastery through understanding of the kinds of games which they and those around them have been in the habit of playing. And third, because as psychotherapists, we want and are able to participate in their education, this being our professional role” (Szasz, 1961).
Albeit harsh at times, and perhaps uninformed about the biological correlates of certain types of psychological suffering, Szasz’s approach can be framed quite optimistically. The client can retain hope that they can learn the language and rules needed to master the societal games they are presented with. Or else, find a new game to play.
References:
Powers, R. (2017) No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America. New York. Hachette Books.
Szasz, T (1961) The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. New York. Harper & Row
