Topic: Political Philosophy

Thomas Szasz, R.I.P.

By
Trevor Burrus

The Cato Institute is sad to report the death of the trailblazing and iconoclastic critic of psychiatry Thomas Szasz, professor of psychiatry emeritus at the Health Science Center, State University of New York and Cato adjunct scholar. He was 92.

Szasz advocated for individual liberty from a substantially different point of view than most libertarian intellectuals. Rather than focusing on economic arguments or political philosophy, Szasz focused on personal responsibility and how the institutions and practices of modern psychiatry fundamentally undermine the rights and responsibilities of individuals.

In the 1950s and 60s, psychiatry was in a dark place. Thanks to movies like One Flew Over the Cuckoo’s Nest, people are now aware of the profoundly disturbing practices that took place within the walls of mental institutions: lobotomies, electro-shock treatments, and involuntary medication. At the time, however, the practices were part of a profession that saw itself in a golden age. The emerging science of the brain disorders—which had been neatly categorized in the first edition, 1952, of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I)—seemed to promise the slow systemization and categorization of divergent behaviors into a predictable and scientific study of human behavior. Vague words like “neurosis” and “psychosis” were casually thrown about by doctors as objective classifications. If a doctor deemed someone to be “neurotic,” then he could be involuntary committed and subjected to the aforementioned tortures.

In some ways, this “golden age” of psychiatry parallels the false “golden ages” of other disciplines—times when too much knowledge was presumed and too much power granted. The command and control economies of the 20th century are an obvious example: Brilliant people “cracked the code” of the economy and all they needed for a more rational social order was better data and more control. Such overestimations of knowledge often precede claims for broader power. In some sense, Szasz’s war against psychiatry can be viewed in the same light as Hayek’s war against planned economies: an opposition to state-backed conglomerations of power masquerading under the pretense of knowledge.

The psychiatry profession has a lot of power. They can exonerate murderers by deeming them insane. They can institutionalize people against their will. And they do this all based on the trust the “system” has in their subjective determination of what is or is not an aberrant behavior.

Szasz had a problem with this system. As he wrote in the in the preface to the 50th anniversary edition of his most famous book, The Myth of Mental Illness:

I insisted that mental hospitals are like prisons, not hospitals; that involuntary mental hospitalization is a type of imprisonment, not medical care; and that coercive psychiatrists function as judges and jailers, not healers. I suggested that we view and understand “mental illnesses” and psychiatric responses to them as matters of law and rhetoric, not matters of medicine and science…If all “conditions” now called “mental illnesses” proved to be brain diseases, there would be no need for the notion of mental illness and the term would become devoid of meaning. However, because the term refers to judgments of some persons about the (bad) behaviors of other persons, the opposite is what actually happens: the history of psychiatry is the history of an ever-expanding list of “mental disorders.”

To expand on why Szasz believed mental illness to be a “myth”: If we call someone “mentally ill” without reference to a physical brain disorder but only as a “problem” with her behavior, then we are describing something that is difficult, if not impossible, to objectively quantify. We must invoke some norm to make our diagnosis more than a subjective opinion about “divergent” behavior. If homosexuality is a mental illness, then the norm of heterosexuality is presumed. If marital infidelity is a mental illness, then the norm of fidelity is presumed. Without any appeal an objective criterion we will inevitably institutionalize people based on our opinions about their personalities. As Szasz says, the obvious question always arises: “What kinds of behavior are regarded as indicative of mental illness, and by whom?”

Perhaps the most famous example of misusing the term “mental illness” is drapetomania, or “runaway slave syndrome.” But drapetomania was not the first misuse of mental illness, nor would it be the last. Szasz’s unique contribution to psychiatry was to continually refocus the question on whether there is a scientific, objective basis for asserting that certain “kinds of behavior are regarded as indicative of mental illness.” His unique contribution to libertarian thought was to focus on personal responsibility as the proper response to claims of “mental illness,” to be concerned about the involuntary incarceration of the “mentally ill” as an immoral deprivation of liberty, and to criticize the state as the most significant “whom” that defines mental illness.

Because of this focus on the state’s effect on social and scientific areas, rather than in just the economic and philosophical realms, Szasz’s work encourages libertarians to look to broader social criticisms of government. Szasz wisely questioned the implications of letting the government define “mental illness” and trusting the political forces that affect those determinations. As he wrote in The Myth of Mental Illness, “Debate about what counts as mental illness has been replaced by legislation about the medicalization and demedicalization of behavior. Old diseases such as homosexuality and hysteria disappear, while new diseases such as gambling and smoking appear, as if to replace them.”

There is something profoundly unsettling about the state having any say in defining “normality.” The state is never a passive player in these situations. Government officials have concerns and interests of their own that can fundamentally distort the perception of mental illness and “divergent” behavior. And, perhaps most importantly, the state has vast amounts of money it can use to fund research and institutions that skew the playing field in its favor. The medicalization of Attention Deficit Disorder in American public schools is perhaps the best recent example of this phenomenon. In retrospect, the mass overdiagnosis of ADD seems the inevitable result of a recalcitrant and monolithic public school system combined with a state-backed mental health establishment obsessed with psychopharmacology.

Despite the scathing criticism given to the book-length version of The Myth of Mental Illness (1961), Szasz’s critiques were arguably at the forefront of major changes in psychiatry that followed. Although many current psychology students have not heard of Szasz, they have assuredly read about the famous Rosenhan experiment. As documented in the essay “On Being Sane in Insane Places” (highly recommended), the Rosenhan experiment had eight sane, normal people admit themselves to mental institutions complaining of auditory hallucinations. They were then told to behave normally and try to convince the doctors that they were, in fact, sane. This proved nearly impossible to do. All behaviors were immediately categorized as manifestations their subjectively diagnosed “neuroses.” Moreover, whereas many of the other patients sensed that the subjects were planted there, the doctors could not be convinced.

As a result of Szasz’s work, One Flew Over the Cuckoo’s Nest, the Rosenhan experiment, and other work, American mental hospitals are no longer the horrific institutions of the 1950s. But things aren’t too much better. The most disturbing development is the total politicization of the mental health profession. As Szasz wrote in 2011:

Since that time [1961], the formerly sharp distinctions between medical hospitals and mental hospitals, voluntary and involuntary mental patients, and private and public psychiatry have blurred into nonexistence. Virtually all medical and mental health care is now the responsibility of and is regulated by the federal government, and its cost is paid, in full or part, by the federal government. In short, psychiatry is medicalized, through and through. The opinion of official American psychiatry, embodied in the American Psychiatric Association, contains the imprimatur of the federal and state governments.

Even as his scientific studies slowly go out of date, Szasz’s work will always underscore the fact that the state does not only control, it distorts. Sometimes it distorts so much that the world starts to look, well, kind of insane.

He will be missed.

For more, see Szasz’s 2003 address at the Cato Institute: Are Libertarian Principles and Psychiatric Practices: Are They Compatible?, and the Libertarianism.org lectures On Psychiatry and Religion and On Socialism and Health Care. Also, find more on Szasz at Reason here.

Topics: 
General, Health Care, Political Philosophy

Ronald Hamowy and the Lion’s Dentist

By
Walter Olson

As David Boaz has written, we mourn this weekend’s loss of one of the great libertarian scholars, Ronald Hamowy, a historian of scintillating erudition, acute judgment, and formidable breadth of interests. Bryan Caplan has an appreciation that includes a Liberty Fund link to the entire online run of the Hamowy-edited New Individualist Review (1961-68), by common consent the best libertarian student journal ever, and notes also the friendly intellectual quarrel that eventually arose between Hamowy and one of his own mentors, Friedrich von Hayek.

Hayek in his social theorizing didn’t always get everything right, but his fellow advocates of liberty weren’t always keen to point that out in print, for the same reason that there are few volunteers to perform dentistry on the lion. But if anyone can perform the delicate operation without fear of the jaws snapping shut, it is one who knows as of instinct how the lion thinks. Such was Hamowy, whose commitment to individual liberty was if anything more ardent than Hayek’s own, and who as a specialist in the Scottish enlightenment of Adam Smith, David Hume and Adam Ferguson had thought long and deeply about the conditions under which spontaneous orders emerge and freedom can generate successful social complexity.

Here is Daniel Klein, reviewing a 2005 volume in which Hamowy takes issue deftly with the master on several issues notably (from my perspective) including the evolution of law:

The final critical essay concerns Hayek’s tale of the common law. Hayek’s idea of spontaneous order is most prominently applied to the complex workings of the economy — “the incredible bread machine” — but also finds application in the evolution of customs, language, law, and science. Hayek was keen to show the viability of capturing a dynamic system of law under the conceptual umbrella of spontaneous order. In making his case, he portrayed the English common law as such a system. Hamowy looks hard at the history and character of English common law, and concludes that Hayek’s historic tale fails on two counts: first, its substance was not all that libertarian, and second, its evolution was not all that spontaneous. Hamowy advises us against citing the English common law as an example of spontaneous-order law.

Hamowy’s scholarship was full of such unexpected, fearless, and provocative acts of judgment.

Topics: 
General, Political Philosophy

Is Government like Immigrants?

By
David Boaz

In his speech last night, President Obama listed a lot of groups of people whom we shouldn’t blame for “all our problems”:

We don’t think the government can solve all our problems. But we don’t think that the government is the source of all our problems, any more than are welfare recipients, or corporations, or unions, or immigrants, or gays, or any other group we’re told to blame for our troubles.

He’s right to discourage scapegoating. But there’s a category error here. Government is not just a group of people distinguished by their place of birth, or sexual orientation, or economic organization. Government is defined by its power to use force to achieve its purposes. Gays and immigrants don’t have such power. Neither do corporations or unions or welfare recipients.

No one blames governments for “all our problems.” Indeed, libertarians should be the first to remember, as Dr. Johnson told us,

How small, of all that human hearts endure,
That part which laws or kings can cause or cure!

But the introduction of force into human relationships does cause many problems. Taxes reduce incentives and distort decisions, not to mention limiting our freedom. Government spending likewise distorts economic decisions. Government regulation impels people to expend resources in ways that don’t best serve consumer desires. Central bank manipulation of the money supply introduces massive distortions into economic decisionmaking, often bringing about cycles of boom and bust. Drug prohibition, conscription, tariffs, punitive taxes, the exclusion of people from social and economic life on the basis of their race or gender or religion or sexual orientation—a large part of the activities of modern governments do cause many of our problems.

So President Obama is right to warn us against blaming our problems on “any other group,” just as President Clinton was right to warn us in his own acceptance speech 20 years ago not to blame “them—Them, the minorities. Them, the liberals. Them, the poor. Them, the homeless. Them, the people with disabilities. Them, the gays.” But blaming government is not equivalent to that kind of scapegoating.

When we “blame government,” we’re doing two things:

1. We’re pointing to specific policies that caused problems such as the financial crisis or prohibition-related crime or failing public schools.

2. We’re blaming the process of government, which necessarily involves coercion, predation, politicization, the diversion of resources to less-valued uses, and thus a reduced standard of living.

That’s not scapegoating. It’s analysis. It’s economics, history, political theory, and sociology.

Topics: 
Government and Politics, Political Philosophy

Theory and Practice in the Austrian School

By
Jason Kuznicki

This month’s Cato Unbound looks at the Austrian school of economics. Specifically, how do Austrian insights apply to the “real” world—not just theory, but economic history and policy?

In his lead essay, Professor Steven Horwitz argues that Austrian economists are making important and under-appreciated empirical contributions. The Austrian school even stands to teach mainstream economics a good deal about how to conduct empirical work and interpret it properly.

To discuss with Horwitz, we have invited three other distinguished economists, each of whom has been influenced by the Austrian school—while ultimately settling elsewhere methodologically: Bryan Caplan, George A. Selgin, and Antony Davies.

As always, Cato Unbound readers are encouraged to take up our themes, and enter into the conversation on their own websites and blogs, or on other venues. We also welcome your letters. Send them to jkuznicki at cato dot org. Selections may be published at the editors’ option.

Topics: 
Cato Publications, Finance, Banking & Monetary Policy, General, Political Philosophy

After the Welfare State

By
David Boaz

Cato senior fellow Tom G. Palmer, who is lecturing about freedom in Slovenia and Tbilisi this week, asked me to post this announcement of his new book, After the Welfare State, published through the efforts of Students for Liberty and the Atlas Economic Research Foundation. Check out this 57-second video introduction:

The book is directed at young people, and Students for Liberty is distributing 125,000 copies on college campuses. Tom’s introduction begins:

Young people today are being robbed. Of their rights.  Of their freedom.  Of their dignity.  Of their futures.  The culprits?  My generation and our predecessors, who either created or failed to stop the world-straddling engine of theft, degradation, manipulation, and social control we call the welfare state.

Contributors to the volume include experts from Great Britain, Sweden, Italy, and Greece, as well as Cato’s own Palmer and Michael Tanner.

Learn more about After the Welfare State—and download a free PDF immediately–here.

Topics: 
International Economics and Development, Political Philosophy

Hayek Wasn’t a ‘Free Market Marxist’

By
Alberto Mingardi

Why can’t liberals provide a fair portrait of a thinker they disagree with? It was a reasonable prediction that Mitt Romney’s choice of Paul Ryan as his VP appointee would ignite a discussion over the first principles of politics and the role of government in society. So far, however, it hasn’t been much of a discussion: rather, we shall speak of a goofy attempt to graft the practice of smearing the enemy from day-to-day politics to the realm of political thinking.

David Boaz has wisely commented upon Adam Davidson’s piece on Hayek. Even more surprising is a blog post from historian Timothy Snyder in the New York Review of Books. Professor Snyder sees Mr. Ryan as aiming to revive an “outdated ideology”—as  “taking some of the worst from the twentieth century and presenting it as a plan for the twenty-first.”

What he finds outdated is, basically, Hayek’s allegiance to the principle of limited government. Revealingly, he maintains that “Austria became a prosperous democracy after World War II because its governments ignored Hayek’s advice and created a welfare state.” Linking the economic performance of Western democracies after WWII to the institutions of the welfare state (a national health care service, compulsory education, unemployment insurance et cetera) is at best naive.

Making “provisions for citizens in need” may be “an effective way to defend democracy” from the temptations of populism and authoritarianism but this doesn’t say much per se. Which provisions? Provided by whom? For the benefit of whom? The answers to these questions aren’t trivial.

What is most surprising in Snyder’s piece is how he portrays Hayekianism as the opposite of what it is. He writes:

Like Marxism, the Hayekian ideology is a theory of everything, which has an answer for everything. Like Marxism, it allows politicians who accept the theory to predict the future, using their purported total knowledge to create and to justify suffering among those who do not hold power.

You may wish to make a caricature of a thinker. A successful caricature should, however, resemble the subject, at least a little.

A cursory glance at the titles of Friedrich von Hayek’s books should be enough to understand that what he was preoccupied with was precisely the hubris of decision-makers who pretend to predict the future and manage it. Hayek’s best known paper is poignantly entitled “The Use of Knowledge in Society.” His last book was called The Fatal Conceit. His best work in history of ideas bore, as a subtitle, a reference to the “abuse of reason.”

Hayek was convinced that “no human mind can comprehend all the knowledge which guides the actions of society.” What he stressed, over and over and over, are the inherent limitations of our knowledge, that politicians and regulators, being human beings, share with the rest of us. He was skeptical even of the “purported total knowledge” of his own discipline, economics, as he claimed that “the curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”

Hayek defended individual liberty, precisely because the future is unpredictable.

The case for individual freedom rests chiefly on the recognition of the inevitable and universal ignorance of all of us concerning a great many of the factors on which the achievement of our ends and welfare depend. It is because every individual knows so little and, in particular, because we rarely know which of us knows best that we trust the independent and competitive efforts of many to induce the emergence of what we shall want when we see it.

For Hayek,

If man is not to do more harm than good in his efforts to improve the social order, he will have to learn that in this, as in all other fields where essential complexity of an organized kind prevails, he cannot acquire the full knowledge which would make mastery of the events possible. He will therefore have to use what knowledge he can achieve, not to shape the results as the craftsman shapes his handiwork, but rather to cultivate a growth by providing the appropriate environment, in the manner in which the gardener does this for his plants.

Does this sound like a man that had an answer for everything, or wanted to propose a grand plan for society as a whole? Hayek’s worldview does not have much of a following among intellectuals, not least because it doesn’t see “knowledge” as a monolith. For Hayek, knowledge is dispersed in society, it is by and large “know-how” hence it belongs as much to the little guy on the street than to the Yale professor. The free market economy is a process by which these different pieces of knowledge somehow are put together to the good of society. Professor Snyder portrays Hayek as a “reacting” against national socialism and communism. It is an elegant way to dismiss him, by claiming that “precisely because they [Hayek and Rand] were reacting, they flew to extreme interpretations.”

Reality fascinates profound thinkers, as it may either ignite or terrify common people too. But the economic calculation debate, in which Hayek and his mentor Ludwig von Mises were the main actors, was not a mere “reaction:” it was, as brainy socialists at the time acknowledged, a discussion over the possibility of economic planning. Hayek stumbled upon a more refined understanding of the role of knowledge in society, while participating in that debate—this is certainly true. But he was not a political copywriter, as Professor Snyder seems to believe.

As an Italian, I envy the fact that until next November Americans will be having a discussion over the fundamental pillars of their political state. Neither Obama-Biden nor Romney-Ryan are political thinkers: they are politicians, and the very fact they have (some) convictions is rare enough to be praised. But it is good and exciting that the electoral contest will bring people to go back to basics and, perhaps, try to make sense of what this Hayek guy or that Rawls guy actually meant.

It is, however, rather depressing to see such a systematic misrepresentation of Hayek’s ideas. Let’s assume it is due to genuine ignorance.  We shall then recommend some links to liberal chastisers of Mr. Ryan, so that they may know better what they disagree with.

  • The Universitad Francisco Marroquin has made available online this collection of interviews with Hayek.
  • This 1984 Cato Policy Report provides a quick introduction to some of the core themes in Hayek’s thinking.
  • Hayek’s Nobel lecture is a short but intriguing introduction to his thought.
  • Arch-liberal George Soros has a short appreciation of Hayek’s ideas, that was initially delivered in a conference at the Cato Institute.

I (and many others) would have quarrels with some of Soros’s points, but perhaps his article may suggest that critics of Hayek’s “free market Marxism” pause for a moment before rushing to their keyboard.

Topics: 
General, Political Philosophy

Hayek in the New York Times

By
David Boaz

Sunday’s New York Times magazine included an article by Adam Davidson of NPR, “Prime Time for Paul Ryan’s Guru (the One Who’s Not Ayn Rand).” I thought when I read it that if you’re going to call an economist “largely ignored,” you should at least mention that he won a Nobel Prize so readers could judge your claim. But incredibly, Davidson left that fact out.

Now Richard Epstein has taken him to task at greater length and explains how much more sophisticated Hayek’s understanding of markets was than those of his contemporaries. Epstein writes:

But it is utterly inexcusable to overlook, as Davidson does, Hayek’s enduring influence.  A year after the Road to Serfdom came out, Hayek published his 1945 masterpiece in the American Economics Review, “The Use of Knowledge in Society,” which has been cited over 8,600 times. In this short essay, Hayek explained how the price system allows widely dispersed individuals with different agendas and preferences to coordinate their behaviors in ways that move various goods and services to higher value uses.

Alas, Davidson’s dismissive account of Hayek does not mention even one of Hayek’s major contributions to weaning the United States and Great Britain from the vices of centralized planning. Thus Hayek’s 1940 contribution to the “Socialist Calculation” debate debunked the then-fashionable notion that master planners could achieve the economic nirvana of running a centralized economy in which they obtain whatever distribution of income they choose while simultaneously making sound allocations of both labor and capital, just like in Soviet Russia.

Hayek exposed this fool’s mission by stressing how no given individual or group could obtain and organize the needed information about supply and demand conditions throughout the economy.

Epstein goes on to examine the contributions that Hayek made to economists’ – and policymakers’ – understanding of planning, contracts, and competition. Too bad his article didn’t appear in the New York Times.

More on the Times’s misunderstandings of Hayek here and here. More on Epstein – plus George Soros and Bruce Caldwell – on Hayek here.

Topics: 
General, Political Philosophy

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