On Dr. Thomas Szasz:
I want to talk in some detail about Citizen’s Commission on Human Rights or the CCHR. The CCHR was created in 1969, founded by the Church of Scientology and by famous renegade psychiatrist Dr. Thomas Szasz.
The purpose of its founding was basically to create a legitimate front in the Scientologists’ war against psychiatry. Over the years, the CCHR has often downplayed or disavowed any connection to Scientology. It does that to increase its acceptability and to have its messages seen as rational and scientific, as opposed to religious and opposed to simply being a part of the Church of Scientology.
However, I want to challenge that. From day one, most or many of the senior leadership of the CCHR have been Scientologists. So, yes the CCHR is open to anyone of any type of religious persuasion, but the leadership and the majority of the participants are and always have been Scientologists.
The CCHR has continued from day one to be sponsored and financially supported by Scientology, including the International Association of Scientologists.
And these connections, you know the staffing connections, the people connections, the financial connections, become a lot more clear when we examine some of the internal CCHR and internal Scientology sources, as opposed to what the CCHR says on the outside for the public.
Here, for example, is a paper from 1978, Citizens Commission on Human Rights. This is a CCHR paper for internal distribution. It says, “If you were a Scientologist, your future track may be in danger.” It goes on to say that — they are talking about suppressive groups — “and we are well aware of exactly who on this planet has the technology to expose and eliminate them. And those Suppressive Persons know exactly what technology is the most deadly now available on this planet to harm a thetan.”
So listen to that. We’re talking about Scientology jargon, we’re talking about using the word “suppressive”, we’re also talking about using the word “thetan”, we’re talking about “technology”; these are all Scientology words explicitly within the CCHR document. It’s very interesting.
There’s also further material, and here’s another example. This is the magazine of the International Association of Scientologists, Impact Magazine, 24th Annual Anniversary, Issue 119.
And this is much more modern. It’s a few years old. And in this magazine, which is distributed to Scientologists internally, it talks about their new plan for psychiatry: “Global Vaporization.”1 And this is what it says, very casual, it says:
“This is Psychiatry: Global Vaporization. And it’s funded by grants from the IAS” — the International Association of Scientologists. “It is how CCHR is ripping the veil off psych drug fraud, psych drug deaths and obscene psychiatric profits, and is bringing an end to the psychiatric horror for millions.”
So again, there’s this casual interchangibility, this… “Yes, it’s an IAS-sponsored thing, the CCHR is doing it.” This is a very well-integrated situation here.
One of the things that the CCHR does, is it capitalizes deliberately on its name, “human rights.” And the rhetoric that this organization puts out pertaining to human rights is really quite staggering.
From the CCHR International website, the current President of the CCHR says, and I quote, “Our work aligns with the United Nations Universal Declaration of Human Rights, which reads in part, ‘No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.'”
It says, “All are equal before the law and are entitled, without any discrimination, to equal protection of the law.”
And it goes on to say, “Parents have a prior right to choose the kind of education that shall be given to their children.”
Now what’s interesting is, coming along and reading this, one would think, “This is a human rights organization. These people are very serious when it comes to international human rights.”
But in every one of those things I just mentioned, if you understand the beliefs that Scientology and CCHR have about psychiatry specifically, you’ll see that these words, from their point of view, are absolutely anti-psychiatry, and justify the attacking of psychiatry.
So the United Nations talks about people not being subjected to torture or to cruel, inhuman or degrading treatment. And we can all imagine around the world what that might look like in certain countries, and for certain groups of people. For the CCHR, their belief is that modern, safe, well-regulated, appropriate psychiatric practice in every big city, in every hospital, in every psychiatrist’s office around North America is actually “torture or cruel and inhuman or degrading treatment.”
So their definition of psychiatry and what psychiatry is, actually in their mind filters in to this human rights set-up that they have.
So, we read it and we think, “Wow, that’s impressive. It’s a human rights organization.”
But from their point of view, they are taking the language, they’re taking the rhetoric of human rights, and they’re twisting it to further substantiate, to further justify their completely off-base opinions and beliefs regarding psychiatry.
So to recap a little bit, the CCHR is not about human rights. The CCHR has taken the language of human rights, and it uses it to become more legitimate in the eyes of casual observers, and it uses it to justify its own efforts to destroy psychiatry.
And it’s actually the destruction of psychiatry, which we’ve talked about, in Scientology and now in the CCHR, that is ultimately their goal.
I want to read a little bit from a very interesting document that comes from the Citizens Commission on Human Rights. It’s an International Executive Directive, dated November 28th, 1989. And this is something that sort of sets up a sense of what their approach, and what their… what the things that are important to the CCHR really are. And this is a document that talks about what they call “Psych Losses,” which is… Basically, they say, “This new expanded Psych Losses stat opens the door to really cleaning up the field of mental healing, putting criminal psychs behind bars and getting their destructive practices outlawed. So it’s basically not about human rights, it’s about destroying psychiatry.
And “Psych Losses” is a fascinating, fascinating document. It’s basically kind of a participation program, or a “frequent flyer” program, or a points or loyalty… consumer loyalty program, that gives CCHR members and Scientologists particular points or particular rewards for certain behaviors that damage or destroy psychiatry.
So, for example, in here on page 3, when it comes to publishing books; it says, “You get ten points per page of material which exposes rotten spots in the field of mental healing, per 100,000 printing. Example: There have been several books published in the last year which have had chapters containing data about psychs, supplied by the CCHR. If one of these had ten pages of anti-psych materials, and the first printing was 50,000 copies, that would be 50 points. If the book was made successful, and then went into a second printing of 100,000 copies, that would be an additional 100 points.”
9:45 (end of Part 1)
…[If the book was made successful, and] then went into a second printing of 100,000 copies, that would be an additional 100 points.
There are further points for the distribution of information letters, pamphlets and broadsheets. It says, “These are publications exposing the crimes and abuses in the field of mental health, produced by CCHR groups, which are then distributed broadly to the public, either by handouts or by mail, etc. One point per page per 100,000 distributed.”
So you can start adding up your points!
CCHR often approaches people that possibly have had some difficult experiences within the field of mental health, possibly have been harmed or victimized by whomever or whatever, people that are frustrated, people that are hurting. The idea is to get them to talk about these experiences and to start a process against psychiatry.
So we have, for example, part of “Psych Losses” on page 4. You get points for “A signed and witnessed written statement or signed affidavit from the person telling his story (the victim himself or the surviving relative or guardian of someone killed, ruined or otherwise abused by a psych or other member of the field of mental health, or by a psych organization: 25 points.”
Listen to this language. It’s also true that they’re not just going after psychiatrists. We’re talking about psychiatric nurses, psychiatric administrators, or any type of worker within a mental health or a psychiatric organization.
So they go after people that they feel possibly have had a difficult experience. And they try to convince them to come forward and try to convince them, in a sense, to be a victim.
It gets better. And we’re getting into the big point hauls, now. Here we go: “An official indictment with formal criminal charges against a psych or a member of a psych organization or group or official by a government or police agency, based on a criminal complaint filed through the actions of a CCHR group. For each person charged with at least one felony charge: 1000 points. ”
“Criminal psych or mental health field rotten spot organization or official found guilty of a criminal charge: 5000 points.”
“Bonus: For each additional charge found guilty of: 1250 points.”
And here’s a neat one: For “Psych or mental health field rotten spot organization official sentenced to jail term.” For each year of the sentence you get an additional 500 points, if it’s your material within the CCHR that has caused this to happen. I feel like we could almost fly to Europe on this.
Finally, it talks about anti-psychiatry legislation. This is the creation of laws or the influence of laws at the level of politics. And the CCHR has done an awful lot of work in attempting to change laws to become very unfriendly to psychiatry. That’s the topic of a different discussion.
But here we go on page 7:
“Anti-psych legislation introduced which would limit the power, activities or funding, etc., of a psych or psych groups or activities. International level: 500 points. National level: 250 points. Regional or state level: 100 points, and local level: 50 points.”
There’s a lot more in here, and I think I’ve belabored this just to give a sense of what kind of direction the CCHR is truly coming from.
I don’t see a lot of human rights in that document that I just talked about.
These are individuals and this is an organization that wishes to destroy psychiatry and wishes to motivate its people to go along with that.
Looking at what we’ve already seen, the “Psychiatric Global Vaporization” … here’s another picture of “Psychiatric Global Vaporization”. (Shows.) Citizens Commission for Human Rights. So we’ve got a big CCHR brochure, we’ve got a big logo, and we’ve got the concept of global vaporization of psychiatry. So again, I don’t see a particular interest in human rights in the internal material that these people are talking about.
On New Years Eve 2006, the International Association of Scientogists had a big bash and the Scientology head honcho David Miscavige presented. Again he’s talking about a new effort to obliterate psychiatry: “Psychiatry: Global Obliteration.” This is something that can be seen on the Internet. It’s quite a disturbing speech, particularly because he starts to butt up against some images and some suggestions that are potentially violent.
Miscavige said his new campaign is to “break the dark spell cast across Earth by psychiatry. Our mental health budget adjustment kit, which essentially works like a smart bomb in that it sniffs out psych fuel lines and blows the funding mechanism. And in that way, to put it bluntly, we booby-trap the whole psychiatric eco system.”
Miscavige goes on to say, and again talking about Scientology and the CCHR, “While it takes a psych eight years to earn his license, we’ve already yanked twenty-one in the last four weeks.”
Human rights indeed.
Dr. Wiseman: Thomas Szasz was born in Hungary in 1920 and moved to the United States with his family in the late 1930s to avoid the war.
He says in his book Szasz Under Fire from 2004 that he went to medical school not to practice medicine but just to learn medicine.
He then went into psychiatry residency not to become a psychiatrist but to qualify to become a psychoanalyst.
He writes that the role of the psychoanalyst is appealing to him because it would provide “a platform from which I could perhaps launch an attack on what I had long felt were the immoral practices of civil commitment and the insanity defense.”
Szasz says that even as an adolescent, he began to believe that the mentally ill are “not sick” and simply “exhibit behaviors unwanted by others who diagnose them as mad and lock them up.”
During his training as described, he studiously avoided dealing with profoundly disturbed or psychotic patients or patients that could possibly be so ill that they require hospitalization against their will. He didn’t want any part of it and basically chose to work with patients and complete his residency, not dealing with those folks whatsoever. So how he ever developed any kind of expertise in coping with severe persistent mental illness is impossible to tell.
Szasz’s issues come from a stance of libertarianism. And basically his argument is against the idea of coercion and the use of psychiatry as a tool of control by the state.
He says that mental illness is actually a myth to justify the appropriation of power and control by the state almost using psychiatry.
He says that we’re really not talking about an illness or condition. We’re talking about objectionable or questionable or bad behavior that the state wishes to control. And essentially by labeling this type of behavior as an illness or as a disease, the state then has the power through psychiatry to bring someone into the hospital against their will to treat them and to change that behavior against their will, so to speak, so that society benefits.
He wrote these kinds of ideas in his book The Myth of Mental Illness which was published in 1961 and that book is still by far what Dr. Szasz is known for.
It sounds impressive and it sounds interesting and it sounds very intellectual and it sounds challenging. But Szasz’s actual argument when we start to dig into it is none of the above.
In fact what he talks about, what he’s talked about in his entire career, as far as I can tell, are simply words and definitions.
Szasz has stated all along that genuine illness in his opinion, or genuine disease, is characterized by tissue pathology or really, objective findings, or demonstrable lesion. You can see a broken bone. You can see a cut. You can see gallstones in a gall bladder. And then you go in and you remove the gallbladder and treat that disease. So a very concrete understanding of what it is to have a disease or to have an illness.
He says that if you can’t find any of these objective findings or objective evidence or tissue pathology, then what you’re dealing with is not really a disease, not really an illness.
In this type of scenario, mental illness is of the mind. It has no specific physical findings. It has no specific defined physiological abnormality that you can scan and point a finger at. It has no simple or specific blood test that you can do that cinches a diagnosis.
And for Szasz, and of course this has been taken on big time by Scientology, therefore mental illness is not real illness.
Where it gets tricky is when Szasz starts to talk about how things can change. He says that if you actually at some point find a physical cause or a physiological cause for what you think is mental illness, then by definition it’s no longer mental illness. Then by definition it’s a physical or a neurological condition that’s best treated by a neurologist, and not a psychiatrist.
So in this way, no matter what we discover about the brain, about behavior, about psychiatric symptoms, about psychiatric illnesses or disturbance, no matter what’s discovered, the idea that mental illness should remain in the ghetto as a non-condition is completely underlined by Szasz’s reasoning. So, if we discover something physical that is behind psychiatric symptoms, it’s taken away from mental illness, it’s taken away from psychiatry.
And there’s Dr. Szasz on the sideline saying,”Well, all psychiatry does is treat conditions that aren’t real. Psychiatrists don’t treat real conditions.” But he by definition removes them from psychiatry. It’s an entirely circular logic. And it’s based on a radical mind-body dualism that came from Rene Descartes essentially, and has really been sort of shoved to the side in terms of a modern understanding of medicine.
But as you can see, it really is simply about definitions. What is illness? What isn’t? How am I going to define this as a real illness or not. And am I going to take this away from you or not? It’s not about the actual essence of what we’re talking about. It’s not about what a person with an illness or a disease or a condition or a symptom is experiencing, or how that is affecting them, or how they are able to function with it, or what is the appropriate treatment, or not. It’s all about definition. And that’s really all Szasz has to say.
Szasz doesn’t deny psychiatric symptoms. He doesn’t pretend that there are no such thing as psychiatric symptoms. But he says that such symptoms like depression for example, or anxiety for example, would merely represent what he says it is, as a problem in living. Or else, if it’s more behavioral, it could be a disagreeable or a problematic or a confusing or an inappropriate behavior that any of us are fully responsible for, as an adult human being.
So he’s not of the opinion that we can have a psychiatric condition that can affect our behavior, it can affect our perception, it can affect our belief, and therefore, when we act on that, that we’re in the throes of that illness, and that we’re not responsible. He believes that all of this stuff, no matter what happens, is simply behavior that we’re choosing at some level, that we’re communicating with at some level, and that we’re 100% responsible for it.
He would say that an auditory hallucination, and does say this, is simply someone experiencing their own thoughts, and describing them in a way as described as coming outside of their own head. So they’re just, they’re someone’s own thoughts, it’s nothing more than that. It’s not a symptom of a more profound disturbance. It’s just someone describing their own thoughts as coming from outside the head.
And paranoia, for Szasz, might be a mistaken belief chosen by someone, for a reason. And we’re not sure what that reason is. But it’s a choice. It’s a belief. Someone is making that choice. Someone is choosing that belief that someone is wanting to follow them, hurt them, and that’s all it is.
9:13 (End of Part 1)
Dr. Wiseman: Ssasz this spring turned 90 years old, and is still going strong, is still writing.
His ideas in his extensive published works have not meaningfully or significantly changed since the 70 years he was adolescent. In other words, for the better part of a century, his ideas have essentially stayed static, and what he believed about mental illness and psychiatry as a teenager is exactly what he is still writing about today.
He’s basically dismissed fifty years of development in neuroscience, since the publication of The Myth of Mental Illness, and he’s basically not internalized or not learned from or not bought into the changes, the profound changes in our understanding of and treatment of medical conditions and psychiatric conditions over the past fifty years.
I want to examine some of these in a little bit more detail, to start to give some actual, sort of modern day examples of why Szasz’s thinking breaks down, and what we really should be thinking today.
I want to talk about delirium.
And delirium in a medical point of view, from a medical point of view, is a significant disruption to higher sort of cortical brain physiology on account of a general medical condition, drug or medication effect, or withdrawal, or toxin exposure.
Basically delirium is a sort of a confused state, a state where someone’s level of consciousness is fluctuating, where they may have disorientation, they may have perceptual abnormalities such as visual or auditory hallucinations. This is the condition where people are picking bugs out of the air, or picking bugs off their hospital clothes.
It can lead to misinterpretation of events around them, and paranoia. This is a condition where you can have what’s called illusions where you’re laying in your hospital bed and look at the clock. Instead of seeing the clock you see it kind of morph into, for example, a devil’s head or a devil’s face. You can become very scared and start to believe that there’s something going on, that your life is in danger. And you can start acting upon that.
Delirium is actually quite dangerous. Certainly elderly people who are delirious in hospital, if you sort of plot what happens to them afterwards and well beyond when they recover and well beyond when they go home. Their mortality rate is considerably higher than those who haven’t had delirium.
The treatment of delirium is to find and correct the underlying medical or physiological cause that is driving those symptoms, whether that be a drug that has been introduced, a drug that has been withdrawn, whether that has been complications from a surgery, whether someone had been on a cardiopulmonary bypass machine and is now delirious afterwards, whether someone is withdrawing from alcohol in hospital. You find the reason, the underlying medical reason, and you correct it.
But you also manage the symptoms using psychiatric medicine, and you keep that person comfortable and safe. And that may also include actually restraining someone, for their own safety. Someone is in the intensive care unit which is a frequent area where people become delirious. They can be highly disturbed, they can be pulling out lines, they can be pulling out wires. They can be putting themselves in a great deal of danger. And sometimes unfortunately, restraint does need to happen.
So, the thing with Szasz is that he would say there’s no still specific tissue lesion, there’s no demonstrable or measurable part of delirium that you can point a finger at. There’s no specific type of disturbance that can be measured. And so maybe delirium is a myth. Maybe delirium is just like “mental illness” because you can’t quantify it, you can’t measure it. It’s not there in a way that you can scan it and take an x-ray of it.
And that would probably be news to all of the surgeons and all the medical specialists who work very hard with these patients and who see delirium on a day-to-day basis.
Conversely, Szasz might actually argue that in delirium, these hallucinations and this paranoia does have a medical cause. Maybe he is going to buy into the fact that there is a physiological disturbance underlying these symptoms. And maybe he’s going to buy that.
But then he’s in a situation where he’ll go to someone with schizophrenia and he’ll say, “Well, your hallucinations and your paranoia are identical to the delirious person’s, but yours are a myth. They’re not based on any problem in your brain. They’re not based on any physiological disturbance. That’s you having a problem in living. But this person over here in the ICU with the exact same symptoms, well that’s based on a medical condition, that’s based on a disruption of the physiology of your neurons in your brain right now.
And I can imagine Szasz in court being cross examined: “Well which of these hallucinations, Doctor, is caused by physiological disturbance? What about that hallucination? What about this paranoia? What about paranoia in that person? So this one is a myth, this one is a problem with living, Doctor? That what you’re saying is that this one is a physiological disturbance based on delirium?”
It falls apart, and it makes sense, and either these types of symptoms arise from genuine real physiological disruption of brain functioning or they’re a problem of living. But you can’t have identical symptoms and identical behavioral disturbances at times with the origin of one being a myth and the origin of another being a medical condition. It makes no sense. And to my knowledge Szasz has not really talked a lot about delirium, and I can understand why.
Another example that’s kind of similar is if Thomas Szasz and I were in this office together right now, and somehow we decided to smoke a whole lot of crystal meth, and then for good riddance we decide to follow that by using a bunch of ketamine to come down. There’s a good chance that along the way, one or both of us would become agitated, or impulsive, or paranoid, or starting to hallucinate. There’s a good chance. The reason why is because of the specific effects of the molecules of the crystal methamphetamine and the molecules of the ketamine at specific receptors in our brains. So we would have these psychiatric symptoms because of the physiological, the specific physiological effects of those particular drugs, those particular molecules, these particular receptors, and particular areas of the brain. We wouldn’t become paranoid and hallucinate if we were sitting here drinking herbal tea. It’s not about doing a behavior that leads to this. It’s due to specific molecules having a specific effect.
9:05 (end of Part 2)
But if you have someone, let’s say, who develops the same symptoms of agitation, of hallucination, of paranoia, of sleeplessness, and let’s say that person hasn’t done crystal meth, hasn’t done ketamine, and hasn’t done any drugs whatsoever, what would Szasz say about that?
I think that he would probably say that there’s no evidence that those symptoms in that person are caused by abnormal activity at any brain receptors. He’ll say there’s no evidence. You can’t scan it. You can’t measure it. You can’t see it on an x-ray. So therefore it’s not there. Therefore it’s not an illness. Therefore it’s a problem in living. Therefore someone’s choosing it. Therefore it’s a behavior.
So again you’ve got identical symptoms that on one hand can clearly and are clearly and do clearly get caused by physiological disturbance, physiological activity, in this case drugs. And you’ve got other symptoms that are identical, that Szasz would shrug his shoulders and say, “Well, they may be identical, but there’s, I don’t see a physiological thing, therefore it’s completely separate.”
And that truly makes no sense. In reality, in this hospital around me right now, and in dozens of other hospitals all over North America, many, many people with substance-induced psychotic symptoms are effectively managed, effectively treated and effectively kept safe by psychiatrists and the colleagues of psychiatrists.
Our colleagues in neurology are experts in their field, and I would certainly have nothing against a neurologist looking after me or anyone else that I cared for. But most neurologists would not think for a minute that they were particularly qualified or particularly prepared to treat acute psychosis arising from the use of drugs or from delirium. These are physiological causes of the psychotic symptomatology, but no neurologist that I know of would want to own that. That is the realm of the psychiatrist.
And that really shows how out of touch Szasz is, in terms of what his understanding of what a psychiatrist does.
Every day in this hospital and elsewhere, our colleagues in surgery and medicine call psychiatrists, call teams of psychiatrists to assess and manage delirium on the surgical wards and on the medical wards. That includes identifying the physiological and the medical sources of the symptoms as they are being treated. Psychiatrists are the expert in that.
Szasz’s rigid categorization of symptoms and problems as either mind-based; i.e., mental illness or mythical illness; or brain- or body-based, is simply a non-entity in modern medical practice.
The question is do you want to understand and help a patient or do you want to fight over particular words or particular definitions of illness or treatment? And I think that the answer is pretty clear.
Just looking at some other examples of illness, and the modern idea of illness, and there being a whole lot of different ways of looking at it other than Szasz’s, that are perhaps a lot more appropriate, we get to hypertension or high blood pressure.
In hypertension, you can’t see it, there’s no tissue pathology, you only can measure it on a continuous scale, when you go to the pharmacy, or you go in to see your doctor. And the definition of the condition is purely committee-driven decision.
Do you have the disease of hypertension when your blood pressure is 130 on 80? Do you have it when your blood pressure is 135 on 85? Do you have it if one of those figures is taken in the pharmacy and the other one is taken in the doctor’s office? Do you have it if one of those figures is taken at home? How many assessments do you need at a certain level before you make the diagnosis? Is it just one time of an elevated blood pressure? Is it three times? Is it ten times? These are all questions that have been settled essentially by committees of experts looking at data and figuring out where to draw the lines.
In Szasz’s world, hypertension is not an illness. Yet it’s something that millions and millions of people are treated for every single day. Billions of dollars are spent on medications and other treatments for it. And it’s an extremely important part of every day medical practice.
Same thing with cholesterol levels. What are the currently accepted guidelines for appropriate cholesterol and lipid levels? Have they changed over the past fifteen or twenty years? Absolutely. Have they gone up, the cut-offs? Have they gone down? Will they stay the same today, tomorrow? What will they be in twenty years?
In Szasz’s world, we’re inventing illness. We don’t look at cholesterol under a microscope and say, “There it is, there’s the problem.” We define, ourselves, what is a reasonable or healthy or normal level of cholesterol and we go from there. But that changes, that shifts, and there’s nothing physiologically different between a level of X and a level of X plus .002. But that may be the difference in whether you’re treated or not, whether you’re diagnosed or not.
It’s also interesting to look at some of our medical colleagues in cardiology, and their interest in one of our conditions or illnesses: depression. What they’ve found over the years is that the presence or absence of depression is one of the strongest indicators of how well someone does, or will do, after having a heart attack. Even with the exact same heart attack, and the exact same physiological function, and the exact same lesion in one’s heart, and the exact same problem with the heart muscle, the patient with depression is going to have a greater risk of dying from a cardiovascular-related disease, going forward, than the person without depression. And cardiologists now see depression as a cardiac risk factor.
And what they do is they treat depression and they ask psychiatrists to consult and to treat depression. Because what the cardiologist wants more than anything is his or her patient to not have another heart attack, and to be well from a cardiac point of view.
So even though the hearts are exactly the same, it’s the presence and absence of depression that makes the difference in terms of how well someone will do from a cardiac point of view.
That’s modern medicine. And that’s the reason why members of my department work very, very closely with members of the Department of Cardiology in taking care of patients. And Thomas Szasz has nothing to say about that.
8:31 (end of Part 3)
Dr. Wiseman: He also has nothing to say about pain. And pain is what brings more people to see doctors—medical doctors, family physicians, specialists—than any other symptom or any other problem.
Pain is not in itself a diagnosis, and Szasz would say, “Well pain, you know, you can’t scan it, you can’t really measure it, you can’t x-ray, it, you can’t see, you know, tissue pathology that is pain itself, so pain’s not an illness, pain’s not a disease.” He may want to say that, but does that mean that it’s not medically important, or that it’s not important for doctors of all types to want to work with patients with pain and to treat that condition or treat that problem?
Whether you call it an illness or a disease or not makes no difference, and I would challenge Szasz in asking him, “Have you ever seen a migraine? What is the tissue pathology of a migraine? What is the scan of a migraine? How do you know that someone is having a migraine?”
Well, because they tell him. Because they say, “My head hurts. Because I feel sick. Because I just vomited. Because there’s a light that goes across my visual field.”
Szasz can’t see any of that objectively. But he doesn’t go around, and the CCHR doesn’t go around, and Scientology doesn’t go around saying that a neurologist is a pseudo scientist because he or she makes a large part of their living treating people with migraines.
Szasz doesn’t talk about all of the “functional” conditions that have basically become very, very common in society. He doesn’t talk about fibromyalgia which affects two to four per cent of the population. He doesn’t talk about chronic fatigue syndrome, he doesn’t talk about interstitial cystitis, the sort of chronic inflammatory-type symptoms in the bladder. He doesn’t talk about irritable bowel syndrome. All of these problems do not have any sort of demonstrable tissue pathology. All of these problems, according to Szasz, are myths, and are problems in living, that are simple sort of symptoms that people perhaps are choosing, or that they represent something, or that, you know, they’re not sort of real medical problems.
But yet Szasz and Scientology does not accuse rheumatologists of being pseudo doctors because they treat fibromyalgia. He doesn’t say that a urologist is a pseudo doctor because that urologist treats interstitial cystitis. And he doesn’t say the same thing about gastroenterologists, who make a large portion of their living scoping people with irritable bowel symptoms. He doesn’t say that. Psychiatry is the only one that is singled out, and I think that is inappropriate.
This is modern, integrated medicine. Szasz remains out of touch and out of date. And what he ultimately does is he argues from ignorance. And this is actually called the argument from ignorance, which is if we don’t know something, if we are yet to discover something, if the state of our knowledge is not quite where we can see a specific marker for depression on a functional MRI scan, if we cannot see a specific genetic lesion in schizophrenia, that somehow that means there aren’t any, or there won’t be any or there can’t be any, and that these conditions don’t have any physiological basis. It’s an argument from ignorance.
And unfortunately, the central nervous system is by far the most complex part of the body and probably the most complex aspect of the entire known universe.
4:22 (end of Part 4)
Dr. Wiseman: We’ve talked a little bit so far about Dr. Thomas Szasz being wrong, and about him being essentially out of date. We haven’t talked about Dr. Thomas Szasz’s hypocrisy, however, and that, in my opinion, is probably the most egregious issue against him that is coming up as we look at this topic.
To review, Szasz is a man who has been writing for fifty years from a libertarian perspective, arguing for self-determination and against state interference in matters such as behavioral control.
Szasz rejects, and has always rejected, state authority to detain or hospitalize and treat a person against his or her will. Szasz has always rejected psychiatry’s apparent role in making this happen by labeling questionable behaviors as an illness, hence justifying state interference and control. And Szasz has also rejected any provision of medical or psychiatric treatment without full, informed consent, and thereby free choice by the recipient. So we’ve reviewed that.
Szasz also, in addition to this, has been a founding director of the Citizens Commission on Human Rights since 1969. He’s allowed himself to receive awards and recognition from the CCHR over the years. He has allowed his arguments and his writings to serve as the intellectual foundation for the CCHR’s and Scientology’s war against psychiatry. He’s encouraged that.
About this, he’s merely stated in public that he is not a Scientologist, and as an atheist he’s in support of any religion which opposes the same aspects of psychiatry that he opposes himself.
Dr. Thomas Szasz is the embodiment of the concept of “The enemy of my enemy is my friend.” My question is, “So how is this so bad?” Let’s explore that. I want to talk about what in Scientology is called the “Introspection Rundown.”
In the mid-1970s, L. Ron Hubbard announced that he had “made a technical breakthrough which possibly ranks with the major discoveries of the twentieth century.” Another bit of Hubbard’s trademark modesty.
He was describing essentially a process by which to handle a psychotic break. He noted that the psychotic break, or someone developing acute psychotic symptoms such as delusions or hallucinations or gross disturbance in perception, behavior, was the last of the unsolvable conditions that can trap a person. And thanks to his Introspection Rundown, “The last reason to have psychiatry around is gone.”
So to clarify, by the 1970s, L. Ron Hubbard is proposing a specific treatment protocol for a potentially dangerous condition usually managed by specialist-level physicians, and in a hospital. In his bulletin of January 23rd, 1974, Hubbard told his followers, “You have in your hands the tool to take over mental therapy in full.” Frightening.
The essence of the Introspection Rundown is isolation and destimulation. Essentially, the person who is undergoing the IR has his or her case run by a case supervisor, and the protocol is that nobody else should have access or contact with the person involved. The individual stays isolated and silent except for the frequent auditing sessions that he or she has with the case supervisor. 
Given that it’s Scientology, there’s likely some nutritional aspects to this and likely they throw some high doses of vitamins at the person, but there would be no traditional psychiatric medications offered to an individual on the Introspection Rundown under any circumstance.
Where this becomes interesting to our story, is that the key to the Introspection Rundown is that it is the case supervisor who decides when to end this period of enforced isolation. That is, the psychotic person undergoing the IR loses his or her right under Scientology protocol to choose when to leave that isolation room and to choose the nature of the treatment that he or she gets on an ongoing basis.
This is not some kind of esoteric point. It’s entirely obvious from all of the bulletins that Hubbard produced, bulletins that are still in force in Scientology. And we can see this very clearly.
To determine the end point of someone’s enforced isolation in the IR, the supervisor in charge has to, according to Hubbard and according to Scientology protocol, indirectly communicate with that person to find out whether they are capable of taking responsibility at this point or not. And that’s, you know the example they give in the Introspection Rundown is using a note. And according to the IR document, the note might be something like, “‘Dear Joe, What can you guarantee me if you are let out of isolation?’ If Joes answer shows continued irresponsibility, the supervisor must write back something along the lines of, ‘Dear Joe, I’m sorry but it’s no go on coming out of isolation yet. Your actions threaten the survival of hundreds of people indirectly.'”
The IR goes on to state, “When it is obvious the person is out of his psychosis and up to the responsibility of living with others, his isolation is ended.”
And these words, as I have just mentioned, are all contained within the Technical Bulletins of Scientology, Volume 10 from 1991. These are still in force and in play in Scientology.
Elsewhere in these protocols, supporting the Introspection Rundown, it is stated, “With someone in a psychotic break, it is necessary to isolate the person for him to destimulate and to protect him and others from possible damage. There comes a point where the case supervisor must decide to release the person from isolation.” The case supervisor release the person from isolation. “To do this the case supervisor must know that the person can take responsibility for his actions as regards others as well as towards himself.”
So thinking about what Szasz says, this is becoming very interesting.
The current consent form used in Scientology has a lot to do with the Introspection Rundown, and it’s kind of a blanket consent form, but it specifically talks about the protocols of the Introspection Rundown and the specifics, just because of these very thorny control and responsibility and coercion issues.
So what I’m talking about is what’s called “Church of Scientology Flag Service Organization (hereinafter referred to as “the Church”) Agreement and General Release Regarding Spiritual Assistance.”  Scientology actually calls the Introspection Rundown “an intensive rigorous religious service,” which is interesting because it’s designed specifically for people who are psychotic, which is a psychiatric or a medical condition.
9:04 (end of Part 5) I think Dr. Wiseman misspoke here. Although the person in isolation is supposed to communicate with the C/S with notes (per HCOB 20 February 1974R Introspection RD Additional Steps), the auditing steps of the IRD are done by an auditor, who is under the direction of the C/S.  This document is available here: http://www.xs4all.nl/~jeta/scn/scans/Introspection-Release.html
In the consent form, it explicitly states, “The Case Supervisor will determine the time period in which I will remain isolated, according to the beliefs and practices of the Scientology religion. I further specifically acknowledge that the duration of any such isolation is uncertain, determined only by my spiritual condition, but that such duration will be completely at the discretion of the Case Supervisor.”
So with the Introspection Rundown, looking at this material, we have an acknowledgement that those who are suffering from psychotic symptoms may pose a direct or indirect threat to themselves or to others, that such a person must be isolated and managed for his own and for others’ protection, that when that person is isolated and undergoing the IR he or she does not have a choice to continue with the treatment or not. Its nature and duration, once started, is solely at the discretion of the Case Supervisor.
The consent form for the IR is presented and signed before anyone actually is psychotic. This is something that is signed early on. It is not something that someone who needs to do an IR like this minute, or they’re talking about psychotic symptoms, you know, yesterday or today, will sign it. This is something that is done ahead of time. So it’s basically a blanket consent for treatment or for management of a condition that has not yet arisen.
So basically by signing it, you are signing away your rights ahead of time, when the nature of such a decision or the consequences of such a decision is far more difficult to appreciate.
And this consent form that is used does not come close to providing informed consent. Nowhere on that form does it say, for example, that most other people in society, most other groups in society, most other professional organizations in society, see a psychotic break as a medical or a psychiatric problem or emergency.
So, you’re not informed that while some people see it as a spiritual issue, other people see it as a medical issue. There’s no discussion of the risks of untreated psychosis or the natural progression of an untreated or a poorly treated psychotic break.
There’s no discussion of the medical or the psychiatric options versus the Introspection Rundown options. So that’s not informed consent that you can compare choices. And there’s also no discussion of the side effects or potential side effects of the Introspection Rundown protocol, which again may include isolation, may include high doses of vitamins, may include all sorts of potentially medically destabilizing things happening.
So we would, getting back to Dr. Szasz, we would challenge Dr. Thomas Szasz right now to identify any meaningful way that the Introspection Rundown of Scientology differs morally from traditional coercive psychiatric practice. We would ask him why he has given his support, legitimacy and sustenance to this organization for over forty years when this policy has been on the book, this IR policy has been on the books and has been very publicly practiced by Scientology for many, many years.
We finally call on Dr. Szasz, before his death, to renounce Scientology institutional practices, including the IR, that are obviously and grossly contradictory to the very core, the very essence, of Szasz’s own beliefs and intellectual efforts for the past seventy years.
He cannot, he cannot believe what he believes and not denounce Scientology for the exact same reasons as he has denounced psychiatry.
Wrapping this conversation up, the issue of the Introspection Rundown is not some theoretical or esoteric concept. The consent form that I’ve quoted from, that we’ve been talking about, has actually been dubbed by some as “the Lisa Clause.” And this is named after Lisa McPherson, who was a young Scientologist who died in 1995 after undergoing the Introspection Rundown through Scientology in Clearwater, Florida for seventeen days. At the time of her death, Lisa was gaunt, bruised, unkempt, dehydrated and septic. She apparently later succumbed to a pulmonary embolism, or a blood clot, in her lungs. The civil case in Lisa’s death was only settled in 2004, nearly a decade after she passed away. This is a real issue.
There are other reports that are coming out and other documentation of psychotic symptoms and psychotic breaks and serious psychiatric compromise being “handled” within Scientology, and made grossly worse by Scientology practice. Again I would refer you to My Billion Year Contract  by Nancy Many who writes incredibly powerfully of undergoing a period of psychosis within the Church of Scientology, and how that was managed and how she was harmed basically by what these practices were.
I would also point out another small book, but very interesting book, by Aaron Gottfried, and the title of this book is The Psychiatrist Who Cured the Scientologist . And this is again Mr. Gottfried’s descent into bipolar mood disorder, within the context of his being managed and treated and supervised by Scientology. Again it’s a very, very distressing and disturbing thing to read. And I would encourage people to look at that.
7:28 (end of Part 6) My Billion Year Contract  The Psychiatrist Who Cured the Scientologist