The rat motif continues. First, with this post at the New Yorker’s elements blog, called The Rats of NIMH, because who could resist?
Then with Allen Frances’s response, which came soon after the blog was posted.
As usual, I find your take irresponsibly Szaszian. Any dummy can point out the limitations of psychiatric dx- I have been doing it for 30 yrs. But it takes a callous indifference to pt welfare not to balance this in every single piece with a statement of its value for those who really need it. Donna really pegged you- ‘a plague rat who climbed on to the ship’. Please try to be a responsible trustee of pt welfare, not just a clever cheap shot artist. I fear for your immortal soul. You can be better than this.
[Donna is Frances’s wife, Donna Manning. To be fair to me for a second, I did report her comment in my book.]
I’m guessing that Frances is being a little facetious when he says he fears for my immortal soul; he has often accused me of believing in such a thing, and offered the counsel that my belief reflects an unbecoming naivete,so I think he’s trying to get double mileage out of that tweak. But I am sure he thinks I can be better than this. He may even wish that I was, given the extent to which he participated in my book.
More to the point, he is surely not being facetious when he says that it is irresponsible (and juvenile, he has said elsewhere) of me not to point out the value of psychiatric diagnosis whenever I point out its flaws. He’s absolutely right that I don’t do that. That may indeed be because I am a “clever cheap shot artist” with no regard for the public welfare. But on the other hand, a virtue that has to be reiterated at every turn is awfully fragile, and after a while, it just begins to sound like protesting too much.
But shorn of the condescension, I suppose it’s a fair criticism. Psychiatry, maybe more than other specialties, relies on confidence to be effective. Mental health treatments, drug and otherwise, hinge on the placebo effect, and there’s no question that this DSM-5 episode is undermining that confidence and thus may vitiate effectiveness. Perhaps I am a rat for saying this out loud. But I have to say even if that’s true, then I don’t think I’m the only plague rat on the ship, or the squeakiest.
“As usual, I find your take irresponsibly Szaszian.”
Funny that because now Frances says that Szasz did not really believe in what he wrote…
“I once put the question to its supreme test — 35 years ago while having dinner with Tom Szasz. I posed to Tom a hypothetical in which his son was having a transient psychotic episode, was hearing voices commanding that he kill himself, felt compelled to act on this, and refused treatment. As a father, would you stand by your libertarian principles or protect your son from himself, even if this required coercion. Tom smiled ruefully and said: ‘I am a father first and protector of human rights second.”
Dr. Szasz is obviously not here now to defend himself. Frances is a bullshitter.