{"id":13692,"date":"2011-09-21T15:03:53","date_gmt":"2011-09-21T19:03:53","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=13692"},"modified":"2011-09-22T18:51:19","modified_gmt":"2011-09-22T22:51:19","slug":"rule-1","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/09\/21\/rule-1\/","title":{"rendered":"rule #1…"},"content":{"rendered":"\n
rule #1: never accept an invitation to go crazy…<\/font><\/strong><\/div>\n

I made up this rule for living in my early days of dealing with those patients we call Borderline [because of their propensity to achieve outlier status no matter how you approach them]. As it turned out, it was a better rule than I knew – one with a surprisingly wide range of applications [usually discovered in retrospect when you realize where something went very wrong]. I was thinking about my rule when I was remembering those days in the 1970s when I first came into psychiatry [like old men often do…<\/a><\/font><\/strong><\/u>] and I found myself reading through the Google Books<\/font><\/strong><\/u><\/a> pages from Thomas Szasz’s 1960 book, The Myth of Mental Illness<\/font><\/strong><\/u>. That was long ago, but I still remember how I first heard of Dr. Szasz. <\/p>\n

It was from a fellow resident in my first year residency. He was an aloof and somewhat argumentative guy, who asked odd philosophical questions in rounds. Not long after we started, I noticed something – he never had any patients. We were at Grady hospital in downtown Atlanta. In rounds, we got a census sheet and his list was very short. Then I noticed that in morning rounds after he worked, we never had new patients to discuss. If you don’t know what Grady hospital is, maybe you can’t really appreciate how extremely unlikely it is to have no new psychiatric patients on any day – a finding that transcends statistical possibility. One day at lunch, he started explaining to us about his hero, Dr. Szasz, and about the Myth of Mental Illness<\/strong> – how "these people" just needed to learn to take responsibility for their lives. I took the bait and asked him why he was in a psychiatry residency. I can’t recall what he said [because it made little sense], but I remember thinking it reminded me of Ayn Rand. Not long afterwards, the chief resident, having noticed the same thing on the census sheet, showed up early one morning after he worked, reviewed the charts from the night before, marched the resident and the charts to the Chairman’s office, and said that either he or this resident would be leaving on that very day. The chief resident stayed.<\/p>\n

The chief resident wouldn’t talk about it back then, but years later I ran into him at a meeting where he told me about the desperately ill patients this resident had sent home after lecturing to them about personal responsibility. He was still upset about it, near tears, so many years later. The resident tried to transfer to S.U.N.Y. where Dr. Szasz held court, but was turned down. He ended up finishing in Psychiatry in the north somewhere. I found him on the Internet in practice – just a bunch of those doctor rating sites with no data. One did say, "ease of scheduling an appointment: excellent."<\/p>\n

I later read one of Dr. Szasz’s books [or as much of it as I could tolerate]. I certainly am not going to try to summarize Szasz’s views because I couldn’t do it without arguing, a futile endeavor [following rule #1<\/font><\/strong>]. There’s a cogent Wikipedia<\/font><\/strong><\/u><\/a> summary and enough to get his point in Google Books<\/strong><\/u><\/a> if you’ve never encountered him before. In 1969, Szasz partnered with the Scientologists<\/font><\/strong><\/u><\/a> to form the Citizen’s Commission on Human Rights<\/font><\/strong><\/a>. The CCHR<\/font><\/strong> web site tirelessly keeps up with the controversy and mis-behavior in Psychiatry, actually covering many of the same thing I write about. There’s a difference in intent that’s obvious, but much of their information is accurate. The same might be said of Szasz. A lot of what he says is true, or at least in the range of truth, but his conclusions all roll to the same place – a system populated with demons. The patients are demons getting away with bad or irresponsible behavior disguised as mental illness. The psychiatrists are demons, controlling the patients with laws, diagnoses, medicines. Freud and Charcot created a system of lies to explain the lies of the patients. With Szasz, disease is reserved for things you can see at an autopsy.<\/p>\n

Back in my day, psychiatrists were targeted for psychoanalysis, involuntary hospitalization, not guilty by reason of insanity. Szasz preaches that mix of libertarianism that sides with unlimited freedom, but stands strong on the side of criminal justice. Suicide is a choice in a free society, Schizophrenia too. He’s a moving target … [whoops! almost broke rule #1<\/font><\/strong>]. Now, he’s in the anti-drug set [though he’s also on the side of unlimited access to drugs]. I’m mentioning him because he’s had a much more powerful impact on psychiatry than most of us would care to admit, more as symbol than anything else. Psychiatry is very easy to criticize and hard to defend, and Thomas Szasz has offered a safe haven for critics of multiple persuasions for over forty years. At times he’s like the court fool in a Shakespearean play – speaking the truth on the side. At other times, he’s an Elmer Gantry who can lead anyone anywhere any time. Here he is, after all these years, in the flesh:<\/p>\n

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rule #1: never accept an invitation to go crazy… I made up this rule for living in my early days of dealing with those patients we call Borderline [because of their propensity to achieve outlier status no matter how you approach them]. As it turned out, it was a better rule than I knew – […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-13692","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13692","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=13692"}],"version-history":[{"count":21,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13692\/revisions"}],"predecessor-version":[{"id":43012,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13692\/revisions\/43012"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=13692"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=13692"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=13692"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}