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February 1971

The Manufacture of Madness.

Arch Gen Psychiatry. 1971;24(2):191. doi:10.1001/archpsyc.1971.01750080095017

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If one were to accept seriously some of the brilliant insights in Thomas Szasz's new book, one would think we were in 1984 ahead of schedule. Szasz's grandiose thesis proposes that the mental health movement, in particular institutional psychiatry (rather than freely contracted office psychiatry), is the modern counterpart of the inquisition. "In open as well as closed societies," he writes, "the institutional psychiatrist has long been in the business of putting under lock and key deviant citizens categorized as mentally ill."

Indeed, there are recent news reports of dissenting writers being "hospitalized" in the USSR; one well-known American psychiatrist has now proposed "legislated psychotherapy." But Dr. Szasz is less concerned with the actual quality of institutional services than the dynamics of social control, of the relationship between the oppressor and the oppressed. He has a long history of concern about the possibility of

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