I had the opportunity to talk with professor, Per Bylund, about entrepreneurship, Austrian economics, cryptocurrency, and intellectual property on the podcast. Listen below.Continue reading “Per Bylund on Entrepreneurship, Austrian Economics, Cryptocurrency, and Intellectual Property”
I had the great opportunity to interview one of Thomas Szasz’s close friends, Anthony Stadlen. Anthony is a psychotherapist working in London. It was a great honor and privilege to talk with Anthony. He was a close friend of Szasz. He has an incredible depth of knowledge and understanding of Szasz’s ideas. Listen below.Continue reading “Remembrances of Thomas Szasz with Anthony Stadlen”
I had another discussion with bitcoin philosopher, Daniel Drawisz, about bitcoin, Austrian economics, and courage. I’ll be doing these more in the future. Listen below or subscribe to the podcast.
Podcast link: https://anchor.fm/free-thoughtContinue reading “Part 2 of Bitcoin and Austrian Economics with Daniel Krawisz”
I had a chance to get on a call with bitcoin philosopher, Daniel Krawisz. Check it out below.
It is also available on the podcast https://anchor.fm/free-thoughtContinue reading “New Podcast Episode with Daniel Krawisz about Bitcoin”
By Scott McLain
(Warning: spoilers )
Despite its very positive reception from audiences and critics – including a deafening 8-minute ovation at its premiere at the Venice Film Festival – the film Joker, directed by Todd Phillips, has not been without its detractors. Several commentators and critics, predominantly from the English-speaking world, have called the film dangerous, irresponsible or insensitive towards people with mental illness. Such disapprovals reveal the ubiquity and centrality of the concept of mental illness itself in our society and, therefore, the corollary that mental illness should be categorized and treated like any other illness. No one seems to question this current dogma or even raise the possibility that what we call “mental illness” is rather a socio-political, legal, economic and spiritual phenomenon that is outside the field of medicine.
The controversial Hungarian-American libertarian psychiatrist Thomas Szasz (1920-2012) openly challenged this concept with the publication of his book The Myth of Mental Illness (affiliate link) in 1961. Szasz’s main thesis is that the term “mental illness” is a metaphor, since diseases are sensu strictissimo physical injuries of the body human, whether of its organs, its tissues or its cells. Such injuries can be measured with objective scientific evidence. However, when we refer to “the mind” or “the mental” we are referring to abstract and immaterial concepts, which, by definition, are outside the field of physical sciences. For example, you can buy or sell a house but you cannot buy or sell a home, except in metaphorical terms. By analogy, a brain is an organ that can get sick – eg Parkinson’s, epilepsy, neurosyphilis, etc. – but a mind cannot. When we use the term “mental illness” in reality we are referring either to “vital problems” and “internal and external conflicts”, which every human being knows too well, or to “extreme and socially disapproved of preferences and behaviors”.
My interpretation of Joker is Szaszian, since I interpret the acts of the eponymous protagonist as adaptive and intelligible behaviors when we take into account the gruesome tragedy that is his life story as well as his socioeconomic background. As soon as we reduce the character of the Joker to a series of neuronal synapses and chemical reactions, we dehumanize him.
The film begins by introducing us to Arthur Fleck, a lonely and very poor middle-aged man who lives in a hovel with his older mother. The Gotham City of this film could perfectly be the New York of the 70s of works by Scorcese like Taxi Driver or Mean Streets. Fleck is stuck in mandatory therapy sessions with a social worker. Both the “therapist” and the “patient” understand that the real purpose of this charade is to provide Arthur with prescriptions for his seven psychiatric “medications” whose function is to stun him at their harsh reality. His mother is constantly sending letters to Thomas Wayne, CEO of Wayne Industries and his former employer, 30 years before the start of the film. She firmly believes that he will remember her and that he will provide the means necessary to bring her and Arthur out of their hardship. Throughout the film, Arthur experiences periodic bouts of involuntary laughter, a condition called “the pseudobulbar effect.” We will return to this point later.
The existential predicament that Arthur finds himself in exacerbates over time. His boss fires him because of one of his co-workers who “lends” him a revolver for his “protection.” In one of the film’s most cathartic moments, Arthur is assaulted by three young financial workers on the subway during one of his fits of laughter. Once pushed to the limit, Arthur pulls out the revolver and takes out his assailants. Although not Arthur’s intention, this murderous act serves as a catalyst for a new bloodthirsty social movement whose slogan is “eat the rich.”
At another key moment in the film, Arthur surreptitiously opens one of the letters his mother had written to Thomas Wayne. In it, Arthur discovers that according to his mother he is actually Wayne’s illegitimate son, the result of an affair between Thomas and his mother when she was still employed by him. When Arthur confronts Wayne directly during a Wayne Industries benefit gala, Wayne explains that his mother lost her job and was confined to the Arkham Asylum asylum due to her psychological instability. To make matters worse, Wayne claims that Arthur is actually adopted. Arthur refuses to believe it, but travels to Arkham and takes over his mother’s case file and discovers that everything that Thomas Wayne told him is true.
At this crucial moment in the film we see Arthur begin to transform into the Joker, the iconic incarnation of chaotic evil. He suffocates his mother in her hospital room. He murders in cold blood his former co-worker who loaned him the firearm. On national television, he blows the brains out of a famous pushy comedian who invited him on the show only to humiliate him in public. In one of the last scenes of the film, we see Arthur posing triumphantly atop a burning police car in front of tens of thousands of devoted admirers as he paints a malevolent smile with his own blood: Arthur Fleck is dead, he has born the Joker.
From my point of view, Arthur Fleck’s actions were entirely voluntary and instrumentally rational. In fact, the director makes us see how Arthur’s perceptions begin to sharpen more as soon as his access to his “medications” is cut off.
Could it be that Arthur suffered from a disease that science has yet to identify that has overruled his total free will and forced him to murder at will? It’s an unnecessarily complex explanation: human tragedy and human conflict serve to elucidate Arthur’s motives. If we reflect on this a bit, Arthur’s behaviors make sense, at least to him. Why does Arthur kill young people on the subway? Because they humiliated and assaulted him. Why does Arthur kill his mother? For revenge, for hatred, for betrayal. Why does Arthur kill comedian Murray Franklin? He says it himself explicitly: “you just wanted to make fun of me, just like the others.”
The observant viewer will notice the care and calculation with which Arthur acts throughout the film. He shows a lot of intelligence and planning to get close to Thomas Wayne, to dodge the police in the subway, and to kill Murray Franklin, for example. When it is revealed to us that his courtship with his neighbor Sophie was a “delusion” in his imagination, we note that Sophie’s imaginary presence does not interfere with the instrumentality of Arthur’s actions. After all, a delusion is a psychiatric term to refer to a false belief. But who does not have or has not had comforting false beliefs at some point in their life? In any case, we fully understand why Arthur would want to imagine having a girlfriend.
It is telling that the actor who plays the role of Arthur Fleck, Joaquin Phoenix, rejects the label of mental illness for his character. In an interview with the newspaper Abc Phoenix he states:
Personally, I don’t see Arthur as mentally ill but as a narcissist. In his head there is an idea of his place in the world and he does everything possible to achieve it 
I consider the greatness of Joker to be how Phillips and Phoenix make the viewer understand why the villain behaves the way he behaves, and in a beautiful, spectacular, dramatic, cathartic and uncomfortable as well as seductive way. I firmly believe that it is the great works of art, and not scientistic reductionism, that really helps us understand what at first appears to be unclear. Let’s remember, then, an unforgettable quote from the best screenwriter in history: “Although everything is madness, he does not stop observing method in what he says.” 
Originally published at: https://www.juandemariana.org/ijm-actualidad/analisis-diario/joker-una-interpretacion-szasziana
IN 2000, psychologist Jeffrey A. Schaler published a book that shook the foundation of the powerful addiction industry. His thesis was simple: people consume drugs and alcohol because they want to, not because they have a disease. The addiction industry, with annual revenues in the tens of billions of dollars, fought back ferociously against Schaler. Some former heavy drug users and drinkers also attacked Schaler for challenging the belief that their drug use was a biological compulsion, not an act of free will. Many in medicine and criminal justice — institutions wedded to the addiction theory, came not to praise Schaler but to bury him. But 20 years after its publication, Addiction is a Choice is still in print and stimulating discussion. In a review, Steven Slate, a researcher fellow with the Baldwin Research Institute, calls the book “a brilliant work, and…a serious must-read for anyone seeking the truth about this behavior we call addiction.” Dr. Schaler consented to an interview by Nicolas S. Martin on the 20th anniversary of the publication of his classic book.
NM: Addiction is now commonly understood to be a biologically-based compulsion, but you disagree. Could you summarize your view of addiction.
JS: As I’ve asserted for over 20 years, addiction is a choice. I’ve asserted, based on the core meaning of the word, that “addiction” means to say “yes” to something, to move towards it. And in my book I cite hundreds of years of usage in this sense. it just means you want to do something; it has nothing to do with compulsion, disease, or involuntariness. All of that was never considered — especially applied to drugs.
It was only in the early part of the 20th Century, in the movement that lead to the temperance era, that the meanings of addiction or alcoholism changed. People said that addiction meant loss of control, or involuntariness, as if a behavior could be done involuntarily, the way a person has an epileptic seizure. They also asserted that alcohol was an addicting substance like other drugs. With the federal narcotics act of 1914, all of these were asserted to be addictions caused by the substance itself. So, the remedy for preventing problems associated with abusive use was to make it illegal to possess and use the substance.
We must speak about the terms behavior and disease because they are also key to refuting the ideas that alcoholism and addiction are diseases. What does the word disease mean? It means a cellular abnormality, something in the physical structure of the body. A behavior is deportment, or the way one carries oneself, and is necessarily voluntary. Your behavior is what you choose. So, right off the bat, based on these operational terms and definitions, a disease cannot be a behavior. If we think about smoking, for example; smoking cigarettes is a behavior, but some of the possible consequences may be lung disease or chronic obstructive pulmonary disease. Those are diseases because they are abnormal changes in the cells of the body. They are certainly not choices.
Another thing to keep in mind as we go along with this discussion is that giving up destructive drug use is a matter of choice. When somebody decides to stop, they choose to stop. It’s the only way to stop. So, you have to think back to how a person began drinking or using drugs. They began by choosing to use drugs, which may have been a very irrational or self-destructive decision. There’s no doubt about that. And there also are many people who continue to use illegal drugs in meaningful ways to them. This use is a choice, not a disease. If it was a disease you couldn’t control yourself, and that’s what people are saying drug users can’t do. But as we talk I’ll elaborate on the research that shows that people have always been able to choose to stop or moderate their use of drugs for reasons that are important to them.
NM: You refer to the early part of the 20th century, which corresponds roughly to the Progressive Era, when there was a profound reversal of American opinion. It had previously been autonomy-based and transformed into paternalism. That change, which is one of the most important in American history, opened the door to the redefinition of drug use as addiction.
JS: I agree. And I think it is important to understand the context within which that emerged and developed. People were very unhappy. There was a lot of poverty, and the disparity between the haves and the have-nots was striking. There were terrible problems with the quality of food that was sold throughout the 19th and early part of the 20th century, particularly dairy and meat products. The incredible scientific work by Harvey Wiley, and the birth of the Poison Squad, met these problems head on. It you study some of the problems arising from food consumption, from the 1900s well into the 20th century, people were dying all over from tainted food. It was horrendous. Upton Sinclair’s book, The Jungle, documented this and shocked the public. You have to look at the whole environmental context within which people viewed food and drugs, and how their attitudes about drugs and alcohol were shaped. It was easy for them to find a scapegoat and say, “the drug made you sick.” Food made thousands of people sick. Also, many men were drinking very heavily and beating up their wives, breaking up their families, losing their jobs, and this was a terrible problem, after the Civil War and just prior to the temperance movement The Women’s Christian Temperance Union and similar groups, along with many ministers, were out to change the world. I can’t say that I blame them because they were upset. What they came up with is the idea that if you cut off the drugs or the alcohol, you would stop the problem. But they couldn’t do that: Prohibition was a complete failure. Tied to the idea that the substance caused the problem, was that the substance would make anyone who used it diseased. So, this idea of involuntariness associated with the alleged addictive quality of the substance became key to the new ideas about alcoholism and addiction that developed throughout the early 1920s and 1930s, leading to attitudes today.
NM: They focused more intensely on alcohol than on drugs because alcohol was much more detrimental socially.
NM: What were the consequences of unregulated drug use prior to the 20th Century? Was there social decadence and crime?
JS: I don’t think there was much drug-related crime because crime associated with drug and alcohol use was and is a product of prohibition. Make something illegal and you create a criminal class. In the 19th century, especially during the Civil War, people were miserable, and if they could make themselves feel better by drinking, of course they would do that. Alcohol use was considered a sin before it was widely considered a disease. That hardly stopped people from drinking heavily. The Civil War brought terrible misery to the lives of people from the North and South, during the war and its aftermath.
The idea that alcoholism is a disease originally came from Benjamin Rush, a prominent physician in the 18th century and signer of the Declaration of Independence, who proclaimed that drinking alcohol was a disease. But he also called any number of socially abnormal and problematic behaviors diseases. For example, he said that lying was a disease. One of his most famous proclamations was that having black skin was the result of a disease that he claimed was a congenital form of leprosy. A Black slave by the name of Henry Moss, who had white spots appear on his skin, was brought to Rush for examination. A physician today would call that vitiligo, which is a genetic disease, but Rush proclaimed that Moss was experiencing the spontaneous cure of his blackness. He said that all healthy, natural skin was white, and Black people had a disease that he named “negritude.” That diagnosis was used by Rush to advance the idea that Blacks and Whites should not intermarry because the disease would be spread. It was medicalized racism. We know that Rush’s ideas were nonsense, but it’s important to realize that this was the sort of thinking at the time. Benjamin Rush was a very influential speaker and rhetorician, especially in Philadelphia. He was taken seriously, even by Thomas Jefferson, but he was absolutely wrong. Rush had no scientific basis for his pronouncement. Thomas Trotter, a physician who attended the same medical school as Rush in England, also said alcoholism was a disease. But again there was no scientific evidence for the pronouncements by Rush and Trotter.
NM: Rush is known as the Father of American Psychiatry.
JS: That’s right. His portrait is still on the official literature of the American Psychiatric Association. This tells us something about who the people are who consider someone like this a hero today. Rush was a complete quack, and despite his claims — that he loved Black people and even the name “Africa” — he was a racist.
NM: I was reading historian Will Durant’s book, The Life of Greece, and came across this quote; “No civilization has found life tolerable without narcotics or stimulants.” Do you share Durant’s view?
JS: Yes. I’m not saying that life is tragic, but there certainly is a world of suffering that we’re all living in, and people find different ways of coping with that suffering. Religious belief, alcohol and drug consumption are ways of dealing with existential angst and suffering.
NM: James Madison, often called “the father of the constitution,” said that there hasn’t been any society in which people did not indulge in intoxicating substances like alcohol and opium.
JS: I agree. I think there are lot of myths about the Chinese opium war, for example. I don’t think it caused the disaster that some people have claimed. But why did and do people turn to opium and narcotics? To make their lives more bearable. Frankly, the rule, not the exception, is that most people have always been able to moderate their use of drugs like opium, heroin, cocaine, alcohol, and marijuana. Obviously, there are people who self-destruct using drugs and do too much, but there are also people who self-destruct and do too much in all walks of life. As you know, Nicolas, I have long argued for the complete repeal of drug prohibition. I personally would not think it such a bad idea to return to opium dens here in the country, the way it was in New York in the early part of the 20th Century, where people could go to relax.
Again, I don’t think people are hooked uncontrollably and biologically to opium or narcotics; people can and do quit when it is important enough for them to do so. I’ve proven that for myself. Not that I used narcotics for pleasure, but I was prescribed methadone for 15 years because of a serious back problem that I had. I had tried everything after a failed back surgery, and I couldn’t walk. I was a professor. At times I could not stand before my class, I couldn’t walk from class to class; the pain was absolutely horrendous. I had cortisone injections and every kind of pain drug you can imagine. Finally, a very good pain doctor prescribed methadone. I was on very high doses of methadone for 15 years because everybody develops tolerance. Over time it just doesn’t work as well is it used to, and I was up to 14 milligrams of methadone a day. Some people are on up to 100 milligrams of methadone a day. Then, this past December I said, “this is enough, I’m going to stop using this,” and some of my doctors said, “be careful, methadone is one of the worst drugs to get off of.” Many former heavy heroin users given methadone to try and wean off of heroin have said that giving up methadone was far, far worse than giving up heroin. I weaned myself off the drug in the course of about three months, and I quit completely. I had and have absolutely no craving, no desire for methadone, and it was easy to stop. However, I did have severe withdrawal symptoms, which I did not anticipate. Symptoms seem to vary from person to person. But I went through those. One of the worst was an inability to sleep for several weeks. I had crying episodes and severe gastrointestinal problems. My blood testosterone level went very low and I had to go on testosterone supplements, which have helped to restore needed muscle strength and stamina. I made it through and I’m glad I’m off it. One of the things I’ve learned is that methadone inhibits the healing of wounds, and my doctors confirmed this. I had a non-healing wound on my shin for 10 years. The top dermatopathology experts at Hopkins and everywhere were useless — nobody could help me. We confirmed it was not cancer, but they couldn’t understand why it was happening. Since I stopped the methadone this wound has been healing remarkably fast.
My point again is that users can get off of drugs that other people say are so addicting that it isn’t possible to stop or moderate. But remember, there are many things in life that are challenging and difficult. I’d never go back to my adolescence, it was too difficult. Going to school, going to graduate school, getting married, going through divorce, raising children — life is full of challenge, dealing with serious illness, and that’s when everything is going well. So, we should not say or believe that giving up a drug is too hard because it’s uncomfortable to do so. We go through all kinds of uncomfortable things, and we accept this as life.
Read the rest of the interview at: https://medium.com/@smartnic/addiction-is-a-choice-51b615797452
From the Epilogue to, The Ethics of Psychoanalysis: The Theory and Practice of Autonomous Psychotherapy.
Learning to Practice Psychoanalysis
I have argued that the analytic relationship is like a game, with analyst and analysand its players. This view of the analytic procedure has implications, not only for its theory and practice but also for teaching it and learning it.
How do we learn to play games of skill and strategy? It is important that we be clear about the answer to this question, for what is true of games of this sort is also true of psychoanalysis. There are some things about games that can be taught and learned through the printed word and through didactic instruction; there are other things, however, that cannot and that must be acquired through practice.
What can be taught and learned formally are the rules of the game and the principles underlying the aim and structure of the game. I have tried to lay bare these two aspects of psychoanalysis. What cannot be taught and learned formally is how to play a particular game, in this case, how to be an analyst or an analysand. Indeed, it should be obvious that there are serious Limitations to doing anything of this sort. After all, one cannot tell players how to play a game; that is their business. It is the very essence of games that the players are free to play or not and, within the rules of the game, to play as they see fit. If a person is coerced-either to play against his will or to play in a certain fashion-then he is no longer a game-player (in the ordinary sense ); although such a player may appear to others as though he were playing a game, he will actually be “working,” not ‘playing.”
None of this is intended to deny that some ways of playing games are more effective than others. I merely wish to call attention to the crucial role of freedom in game-playing; a person whose moves in a game are regulated by others is considered a puppet or a robot. Players are ordinarily expected to be entirely free within the rules of the game. In keeping with this, a good player of almost any game will develop his distinctive style. How does this apply to the analytic situation?
Clearly, both analyst and analysand must be left free to conduct themselves as they see fit, as Iong as they keep within the rules of the analytic game. The competent analyst will thus develop his distinctive style of analyzing; this style is likely to vary somewhat from patient to patient and may also change as the analyst ages and is subjected to various experiences. The patient must, of course, be even freer to play the role of analysand as he sees fit than is the therapist to play the role of analyst. After all, the aim of the therapy is to observe and analyze the patient’s game-playing strategies; if the analyst tells him how to behave, what is there to analyze? The value of the psychoanalytic situation lies in constraining the patient only slightly and in a general way, that is, by certain game rules only, rather than by demands for specific acts of compliance.
In addition to learning the rules and principles of autonomous psychotherapy, the therapist who wishes to become proficient in this activity must practice it. The beginning therapist may profit from “supervision” of his work if the relationship between him and his supervisor is also autonomous, that is if the supervisor is the therapist’s agent.
What about the therapist’s personal analysis? Does it not help him to learn how to be an analyst? I have deliberately omitted discussion of this subject in earlier parts of this book and will not say much about it here.
I believe that it is generally helpful for the therapist to have a personal analysis, but let me add some qualifications. I have serious reservations about the value of coerced “training analyses,” practiced in conformity with the requirements of the various psychoanalytic organizations. Though such an “analysis” may help the therapist gain accre&tation, it is unlikely to help him become liberated from his inner constraints. Personal analysis, undertaken outside the juris&ction of an organized training system, is more likely to be personally helpful to the therapist. But here, too, we ought to be sober about what to expect. Having a “good analysis” does not make one a good analyst, nor does knowing one’s “blind spots” ensure him against analytic ineptitude.
In other words, I do not consider a personal analysis indispensable for competence in analyzing. lndeed, if the therapist’s analysis is autonomous, it can have only one effect: to set him personally free to do what he wishes. Some analyzed therapists may want to practice autonomous psychotherapy; others may prefer to practice differently. The notion that the psycho- therapist’s personal analysis is bound to make him a better analyst than he would be without it is illogical and probably untrue.
What the analyst needs more than anything else is genuine interest in doing analytic work and a readiness to enter into a relationship with his client on the basis of well-considered principles, rather than with an amorphous therapeutic intent. If such a person has also had a period of analytic work and is thus familiar with the analytic game from the point of view of the analysand as well, so much the better.
There is one more type of instruction that can be useful to prospective game-players, namely, advice about some aspects of the game-in our case, about certain recurrent types of the analytic situation. In conclusion, I shall offer some suggestions of this kind for those interested in practicing autonomous psychotherapy.
Forget That You Are a Physician
If you are a psychiatrist, do not let your medical training get in your way. If you are not medically trained, do not secretly aspire to be a doctor. If the service you propose to sell is analysis, you owe it to your clients and to yourself to be a competent analyst. Competence in another discipline for example, in medicine-is not an excuse for incompetence in the theory and practice of psychoanalysis.
You Are “Helpful” and. “Therapeutic” if Yar Fulfill Your Contract
Do not feel that you must comply with the patient’s requests for nonanalytic services. You are not responsible for the patient’s bodily health; he is. You need not show that you are humane, that you care for him, or that you are reliable by worrying about his physical health, his marriage, or his financial affairs. your sole responsibility to the patient is to analyze him. If you do that competently, you are “humane” and “therapeutic”; if you do not, you have failed him, regardless of how great a .trumani- tarian” you might be in other respects.
You Must Get to Know Your Patient
You must see the patient often enough and over a long enough period to get to know him well. There must be continuity in your relationship. To understand and master a new game, some players require more exposure to it than others. If you are a beginning therapist, you would do well to charge less and see your patient more often than you might otherwise. With your first few patients, have at least four weekly sessions and, if possible, five or six. If you see patients only three times a week, you may have difficulty following the moves in the game, and, if only twice a week, your chances of becoming a skilled autonomous psychotherapist are slim.
Do Not Let Yourself Be Coerced by “Emergencies”
If you have conducted yourself autonomously at the beginning of the treatment and have progressed satisfactorily to the contractual phase of the relationship, one of the major threats to the therapy is an ’emergency’. Remember your contract, and do not be coerced by an emergency to abandon it. It is unimportant whether the emergency is real or whether the patient is testing you to see whether you will maintain your analytic role. ( In any case, you will not be able to find out unless you do). Here is an example. The patient, a homosexual, is arrested by the police. Do you intervene? No; this is a problem for the patient and his attorney.
If you intervene in an emergency, you engage the patient in another game and vitiate your usefulness as analyst. For instance, your patient may be depressed; you may want to hospitalize him and treat him with electroshock. In my view, this is like interrupting a bridge game to advise your partner on managing his business or getting a divorce. The advice may be good, bad, or indifferent, but it is not part of the game of bridge. In the analytic game, once you step out of it, you may find it difficult or impossible to get back in again. This is an important characteristic of contractual psychotherapy, and both you and your patient must recognize it.
Do Not Misconstrue the Patient’s Feelings and, ldeas about You
What the patient feels and thinks about you is as ‘real” as what anyone else feels and thinks. Though it may be reasonable to label some of his feelings and thoughts “transference,” remember that, in doing so, conduct is being judged, not described. As a working hypothesis, assume that, in proportion as the patient is preoccupied with you as a person and as a source of approval and love, he is avoiding the responsibility for deciding what he wants to do with himself. He thus tries to solve the problem of having to give meaning to his life by attaching himself to the meaning you have given yours. You betray him if you encourage his doing so.
Your Life and. Work Situation Must Be Compatible with the Practice of Autonomous Psychotherapy
If you practice autonomous psychotherapy, you will have to exhibit an attitude of “live and let live” toward your patients. It will be difficult for you to do this if you are coerced and harassed by others or if, outside your analytic practice, you engage in activities that require you to coerce and harass others. For example, if you are a resident in a state hospital or a candidate in an analytic institute, how will you be able to leave your patients alone when your superiors do not leave you alone? Will you be able to let your patients become freer than you are yourself?
Perhaps you will conclude that the only way you can be your own master is to be in full-time private practice. There is much to be said for this. Unfortunately, however, it is difficult to spend all one’s time practicing analysis. If you see eight or ten patients day in and day out, the chances are that the level of your work may not be consistently high. A good solution to this dilemma is to combine analytic work with other activities compatible with it, for example, with teaching, research, or writing.
Do Not Take Notes
The psychoanalytic relationship is a personal encounter. You are not doing anything to the patient-at least no more than he is doing to you. You are not the observer and he the observed. Both of you play dual roles as participants in a relationship and as observers of it. What effect would note-taking have on your relationship with your mother, wife, or friend? Thus, do not be oblivious to the metacommunicative implications for the patient of your act of note-taking.
In any case, ask yourself why you want to take notes. To help you remember what the patient tells you? It will not do that, but not taking notes might. To record a case history? What will you do with it? To record material for research purposes? You can jot down what you think you will need after the interview or at the end of the day. If you are uncertain about the sort of thing you will need, notes will serve no purpose; a detailed account of the patient’s “productions” is a useless document.
You Are Responsible for Your Conduct, Not for the Patient’s
This is the central principle of autonomous psychotherapy. You are not responsible for the patient, his health (mental or physical), or his conduct; for all this, the patient is responsible. But you are responsible for your conduct. You must be truthful; never deceive or mislead the patient by misinforming him or withholding information he needs. Do not communicate about him with third parties, whether or not you have his consent to do so. Make every effort to understand the patient by trying to feel and think as he does. Finally, be honest with yourself and critical of your own standards of conduct and of those of your society.
In sum, you must be an analyst.
– Thomas Szasz, 1965
Originally posted at: https://www.upstate.edu/psych/pdf/szasz/epilogue-advice-to-therapists.pdf
Here’s a link to a testimonial of someone that underwent electroshock treatment. He is a friend of a friend of mine. At 21, he had 30 rounds of shock. (He’s 28 in this video.) If you are uncomfortable clicking links, google “Kenny electroshock video”. Although the doctor kept insisting that the shock would help, he says he would never wish it on his worse enemy.
From The Ethics of Psychoanalysis by Thomas Szasz:
Psychoanalysis is not a medical treatment, but an education. It is not like getting cure of a disease, but rather like getting to know another person well or learning a foreign language or a new game. How long does each of these take? It is with this kind of human experience that analysis must be compared. Thus, it can be understood why the analytic enterprise , by its very nature, precludes speed. This does not mean, however, that, to be useful, every analysis must last three, four, or more years. There is another fundamental misunderstanding in the expectation that, with greater knowledge and skill, analysts ought to be able to increase the speed of analyses. It lies in not realizing that the duration of a particular analysis depends, neither on the nature of the patient “mental illness” nor on the efficiency or inefficiency of the “treatment” used (though this plays a part), but rather on the patient’s needs and wishes to continue to receive “analytic education.”
Perpetual graduate students do not necessarily make the best scientists nor always the worst. Conversely, students who drop out of school early or who complete their education rapidly may do much or little with what they have learned; some may continue a process of self-education, whereas others may soon forget whatever they have learned. The situation is similar in psychoanalysis. Some analyses last long and ought to last long because of the sort of person the patient is; others are and ought to be relatively short. It is a grave mistake to link the effective- ness of analysis with its duration. In fact, the two are nearly unrelated. Some persons learn more rapidly than others, whether in school or in analysis. The same is true for analysts; some work more quickly than others.
In sum, the duration of a particular analysis reflects two things: the needs of the patient and the personal styles of the analyst and analysand as analytic game-players. We should expect this and not superimpose on analysis concepts and values alien to it. Only under such conditions can psychoanalytic treatment be an authentic and autonomous encounter between analyst and analysand.
Featuring Joanne Greenberg (bestselling author of “I Never Promised You a Rose Garden”), recovered for over fifty years. Interviews with Peter Breggin, Robert Whitaker, Bertram Karon, and Catherine Penney. Directed by Daniel Mackler.