Books by "Thomas G. Gutheil"
3 books found
Originally called mad-doctoring, psychiatry began in the seventeenth century with the establishing of madhouses and the legal empowering of doctors to incarcerate persons denominated as insane. Until the end of the nineteenth century, every relationship between psychiatrist and patient was based on domination and coercion, as between master and slave. Psychiatry, its emblem the state mental hospital, was a part of the public sphere, the sphere of coercion.The advent of private psychotherapy, at the end of the nineteenth century, split psychiatry in two: some patients continued to be the involuntary inmates of state hospitals; others became the voluntary patients of privately practicing psychotherapists. Psychotherapy was officially defined as a type of medical treatment, but actually was a secular-medical version of the cure of souls. Relationships between therapist and patient, Thomas Szasz argues, was based on cooperation and contract, as is relationships between employer and employee, or, between clergyman and parishioner. Psychotherapy, its emblem the therapist's office, was a part of the private sphere, the contract.Through most of the twentieth century, psychiatry was a house divided-half-slave, and half-free. During the past few decades, psychiatry became united again: all relations between psychiatrists and patients, regardless of the nature of the interaction between them, are now based on actual or potential coercion. This situation is the result of two major ""reforms"" that deprive therapist and patient alike of the freedom to contract with one another: Therapists now have a double duty: they must protect all mental patients-involuntary and voluntary, hospitalized or outpatient, incompetent or competent-from themselves. They must also protect the public from all patients.Persons designated as mental patients may be exempted from responsibility for the deleterious consequences of their own behavior if it is attributed to mental illne
Management of Violent Behavior
by American Psychiatric Association, Thomas Kidd, Kernberg
1988 · American Psychiatric Pub
The is a compilation of articles from Hospital and Community Psychiatry on the management of the violent patient.
Understanding the history of psychiatry requires an accurate view of its function and purpose. In this provocative new study, Szasz challenges conventional beliefs about psychiatry. He asserts that, in fact, psychiatrists are not concerned with the diagnosis and treatment of bona fide illnesses. Psychiatric tradition, social expectation, and the law make it clear that coercion is the profession's determining characteristic. Psychiatrists may "diagnose" or "treat" people without their consent or even against their clearly expressed wishes, and these involuntary psychiatric interventions are as different as are sexual relations between consenting adults and the sexual violence we call "rape." But the point is not merely the difference between coerced and consensual psychiatry, but to contrast them. The term "psychiatry" ought to be applied to one or the other, but not both. As long as psychiatrists and society refuse to recognize this, there can be no real psychiatric historiography. The coercive character of psychiatry was more apparent in the past than it is now. Then, insanity was synonymous with unfitness for liberty. Toward the end of the nineteenth century, a new type of psychiatric relationship developed, when people experiencing so-called "nervous symptoms," sought help. This led to a distinction between two kinds of mental diseases: neuroses and psychoses. Persons who complained about their own behavior were classified as neurotic, whereas persons about whose behavior others complained were classified as psychotic. The legal, medical, psychiatric, and social denial of this simple distinction and its far-reaching implications undergirds the house of cards that is modern psychiatry. Coercion as Cure is the most important book by Szasz since his landmark The Myth of Mental Illness.