RE: Schizophrenia and Szasz

Tony Earl (
Mon, 22 Feb 1999 09:15:17 -0800

Wonderful letter John! I've been reading the postings coming across this
list waiting for something useful or insightful or well constructed. Your
letter is the first thing I've seen that makes me want to stay on this list.
Unfortunately, I don't think I'm the intended audience of your letter, but
for what it's worth, you have my applause and complete attention.


-----Original Message-----
From: []On
Behalf Of
Sent: Sunday, February 21, 1999 8:04 PM
Subject: Schizophrenia and Szasz

Dear List Subscribers,
It is with some reluctance that I write this lengthy posting.
I am concerned about this issue and its effect on Kelly's work ever being
as we further divide an already small group of people familiar with the work
off George Kelly.
At present, I am bothered by recent postings regarding schizophrenia for
which I have responded more than others in support for the continued use of
the construct of schizophrenia for medical treatment. I was responding to
argument previously that the construct of schizophrenia should be eliminated
or replaced with a new label. I considered it useful as a construct
imperfectly identifying a group of people whom hear and see things and who
respond to medication. After medication, the group I see no longer hears
sees things and report that they feel they now feel "normal." I work only
with severely chronic psychotic individuals and try to help them to be able
live in the community. I wanted to discuss their construction of the world
pre and post medication as well as floridly psychotic and lucid. I was met
with discussions that were simply pre-emptively anti-psychiatric. Use of
medication was broadly categorized for all patients to be a bad thing and
there was no point in discussing it as schizophrenia did not exist. Because
of money spent by drug companies, research was invalid. Individuals for
it had an effect apparently were exceptions and my own individual findings
a personal scientist) were not valid. Apparently, those that agreed with an
anti-psychiatry standpoint had more valid opinions than those doctors
(apparently money grubbing uncaring people) that were not anti-psychiatry.
The quest for invalidating information of any other belief comes complete
conspiracy theories of suppressed information. Those who blindly followed
tenets of psychiatry were fools. Those who championed anti-psychiatry were
geniuses and noble (all profits from anti-psychiatry books are probably sent
to a non-profit organization). I also am sure that none of these anti-
psychiatrists received tenure on the basis of this research and are probably
I guess I had always believed and questioned both poles of this
but I was wrong. I also subsumed both the works of the psychiatrists and
anti-psychiatrists under a larger construct called the medical field and
both. Perhaps I was wrong.
I also received my most recent NAPCN newsletter in which I would learn
that Thomas Szasz will be a keynote speaker at a NAPCN conference.
this is an acknowledgenment that this is the correct point of view.
posted was also an APA resignation letter from a doctor putting down the
of Dr. Torrey who has empowered parents groups (NAMI) in the United States
over the years to battle psychiatrists and get people out of hospitals and
into quality mental health centers rather than the streets. He publishes a
now prestigious report evaluating the quality of mental health systems for
each of the 50 states and a smaller section evaluating programs
internationally. I am surprised to see this letter call him part of the
establishment. He, Dr. Lamb, Fountain House, Dr. Beard, Bill Anthony, and
others in the field of psychiatric rehabilitation and psychosocial
rehabilitation would be amazed at this current promotion after years of
I respect the work of Thomas Szasz. His work pushes an envelope asking
questions about categorization in the field of psychiatry. Unfortunately it
is not a new set of questions or groundbreaking work (the myth of Mental
Illness was written in 1961 (6 years after Kelly). His work builds on this
collecting comments on research of those currently disenchanted with the
classification theory research. He is a lightning rod. Dr. Szasz's work is
preemptive. It is also impermeable to the usefulness of the psychiatric
approach where it can be useful. It is work that has suffered badly from
"hardening of the constructs." I believed it wholly until I started working
with those with schizophrenia.
Dr. Szasz's work has always been subsumed under my own personal construct
system. I go back and read it periodically. I use it as I do the Catholic
Church and Planned Parenthood regarding abortion and birth control. Neither
forms my opinion, but I still go back to them to check the poles.
Now apparently, this list and the conference suggest that this is accepted
Kellian and consistent with Personal Construct Psychology? I think not.
I went back to Kelly's original work (1955- Volume 2) and looked what he
to say about medication (pgs 612-614, .756-766). I list all the pages in
index linked to medication. In his 2 volume set, Kelly lampooned the
model of classification, behaviourists, mechanists, psychodynamics, and just
about everyone else in the quest to push people to examine the individual
not blindly applying some single template to all man. It seems he wanted to
keep open to the idea of applying any and all theories non-pre-emptively to
used by the personal scientist. He did not discard any theory that might
use in some range of convenience. He also made clear that he was a
in practice….
In volume 2 of his work he addresses medication and the physician. He

'A psychological construction of the apparent facts may fit ever so neatly;
but so may a physiological construction. Now the question is: is this a
for the psychologist or for the physician, or is it a case which neither
should attempt to treat alone? The really important question to ask is:
can each of these two types of practitioners do for the client and what is
likely to happen to the client if either or both of them fails to do
The answer to that question should make clear the answer to the practical
question of when each discipline should seek the professional collaboration
the other.' (pg 614)

In 1966, Kelly himself talked of the problems of diagnostic classification
(Clinical Psychology and Personality- Brendan Maher- 1969- The Role of
Classification in Personality Theory- pgs 289-300). His arguments were
occurring prior to DSM-II, which would be published in 1968. DSM I was a
terrible document published in 1952. This was a speech in which Kelly spoke
to the American Psychiatric Association. This was probably as DSM II was in
draft form or getting ready. He was a part of the debate and not on the
fringes. Kelly was working to make a difference to the field. He had
from the quality and usefulness of his work which was ahead of its time.
In 1980, DSM III began to eliminate many of the fuzzy unreliability of
theoretical concepts and replaced the concept of neurosis and others with
observable behaviors. DSM IV continues this. Lots of people were involved
this writing.
I am not sure Kelly would still continue to advance these arguments today
if they are new. DSM IV is here to stay. Perhaps ICM will come. Whining
wishing change is not going to help. Kellian concepts of classification are
not likely to catch on and move to widespread use displacing DSM. So.. how
PCP'ers make use of the DSM?
Increasingly, the current work is becoming less relevant to me. This is
particularly true as less and less is done to adapt and expand research to
real world of practice. I work in the field of non-traditional mental
I have worked with adolescents and adults. I have integrated Kelly's work
find it helpful. I have followed Kelly's students. I especially like the
work of Don Bannister, Larry Leitner, Alvin Landfield, Dennis Hinkle, James
Mancuso, Jack Addams Weber, and others. They have influenced me.
I also use the work of RET, cognitive-behaviourists, dialetical theory, and
others. I fear I am beginning to see less utility in the proponents of the
field adapting and influencing the field.
I have subscribed to the Journal of PCP (who knows what the title is now)
since the beginning in order to support current research. I thought it was
great to expose others to Kelly's ideas. I thought it was important for
Kellians to look outside for new ideas although I was concerned about
the ideas down. Integrated theories could be subsumed.
On the other hand, I am not sure that the anti-psychiatry movement is
necessarily consistent and equal with Kelly's ideas. Psychiatry, by Kelly's
own admission, was outside the range of conveniance of the theory. Anti-
psychiatry is one possible construct system of the health field. While I
support PCP, I will not support the statements I have seen on this list. I
also really am embarrassed and disappointed at the thought that someone
actually believe that medication research, brain research, and schizophrenia
have not advanced the plight of this group. The research and the
effectiveness of new medications (I do not get this from journals) on real
people is amazing and is a long way from the mid-1970's. I fight ignorance
schizophrenia daily as I watch my clients afraid to reveal their illness and
communities battle against housing of the mentally ill. Many ignorant
community people also believe schizophrenia does not exist and that these
crazy people are dangerous. They believe schizophrenics are faking it or
coddled. This is not an academic argument. I know the needed housing our
program and others create to get people out of the hospital. I did not
to see these statements on a list of learned people.
I am also bothered at the elitist confirmatory bias of those on the list of
theory of "scientists."
Szasz as keynote speaker and these comments have bothered me enough to
to renew my NAPCN membership along with the Journal Subscription, which I
had since issue one. It may mean nothing to anyone but… I am hoping that
will continue to evolve but at present I will return to the original works.
want to read about what can do the most for my clients. I have not recently
read anything in the field of PCP that makes a difference to the
in the community. This includes works that benefit the person with
schzophrenia or the treatment provider. Please let me know what I have
in practical treatment or the person with schizophrenia. In fact, the field
of psychology has given me little to improve the chances of keeping housing
for the mentally ill (cognitive behaviourists and RET excepted). On the
hand, I have found much more useful applications and developments from the
field of psychiatry for those they call the "schizophrenic" in the last two
three years. Saying otherwise, flies in the face of the data I have seen in
the field with actual people. I use these developments along with
psychological interventions and conceptualizations to assist my clients to
I do not think that equating Kelly with anti-psychiatry is a good
It is this juxtaposition by NAPCN and not the work of Szasz that bothers me.
I think this is dangerous. If it is not biased, is there a counterpoint to
the keynote?
Please enlighten me as to why I am I am incorrect.

Most Sincerely

John Fallon