Faculty: Dr. Jeffrey A. Schaler
Office: Ward 216
Telephone: (301) 585-5664 in Silver Spring, Md.
E-mail: Jschale@American.edu
Office hours: (by appointment)

Course Description

"Although we may not know it, we have, in our day, witnessed the birth of the Therapeutic State. This is perhaps the major implication of psychiatry as an institution of social control," (Szasz, 1963).

We tend to take for granted the benevolence of psychiatry and its scientific explanations for deviant behavior. Yet psychiatrists, psychologists, social workers and other members of the "mental health" profession assert that people can be "treated" against their consent for "mental illness," as if "mentally ill" persons have real diseases, (this despite the fact that people with "real" diseases such as cancer, diabetes, and heart disease, have the right to refuse medical treatment). Moreover, individuals are absolved of responsibility for their criminal actions based on psychiatric/psychological explanations for their behavior. Guilty persons are treated by the state and members of the mental health profession as if they are innocent. Other people are treated as if they are guilty of a crime, when in fact the only "crime" they have committed is to deviate in their behavior from the established norm.

Controversy regarding the scientific and constitutional legitimacy of such practices has evolved for years. Those supporting psychiatric paternalism argue that "mentally ill" people need to be protected from themselves. Critics contend such practices are anathema to a free society¬and have more to do with law, ethics, and politics than medicine and science.

In this course we investigate the arguments of writers most critical of the "therapeutic state." We do so to further our understanding of the unholy matrimony that has developed between the mental health and legal professions. Topics include the insanity defense, competency to stand trial, involuntary treatment and commitment procedures. Lecture and discussion format.

Course Objectives

1. To understand contemporary psychiatric/psychological ideas regarding abnormal behaviors, explanations for these behaviors, and treatment policies implemented on the basis of these explanations.
2. To provide students with methods to evaluate the scientific validity of psychiatric/psychologically-based treatment for abnormal behavior.
3. To examine the moral, ethical, and political nature of contemporary psychiatric/psychological ideas regarding abnormal behavior.
4. To explore the ways in which psychiatric/psychological explanations for abnormal behavior are used to exculpate individuals of responsibility for their actions, and deprive individuals of their constitutional right to due process.
5. To investigate the legal implications of a "therapeutic state."

Required Texts and Readings
Cohen, D. (1990). Challenging the therapeutic state: Critical perspectives on psychiatry and the mental health system. The Journal of Mind and Behavior, 11 (Nos. 3 & 4).
Edwards, R.E. (1982). Psychiatry and ethics. Buffalo, N.Y.: Prometheus Books.
Szasz, T.S. (1989). Law, liberty, and psychiatry. Syracuse, N.Y.: Syracuse University Press.
Szasz, T.S. (1988). The myth of psychotherapy. Syracuse, N.Y.: Syracuse University Press.

Course Requirements and Grades 
Test 1	 					20%
Mid-term examination				30%
Test 2						20%
Final examination				30%
				 	Total = 100%

* Clear and accurate writing will be taken into account in assigning grades, as well as participation in class discussions. Material discussed in class, or in films, and not in any of the readings, may form the basis for questions on the examinations. One grade reduction for over five class absences. Students are responsible for anything covered in class during their absence. Readings must be completed by the session to which they are assigned. Additional readings may be assigned during the course.

Academic Integrity Code

"Standards of academic conduct are set forth in the University's Academic Integrity Code. It is expected that all examinations, tests, written papers, and other assignments will be completed according to the standards set forth in this code. By registering, you have acknowledged your awareness of the Academic Integrity Code, and you are obliged to become familiar with your rights and responsibilities as defined by the Code. Violations of the Academic Integrity Code will not be treated lightly, and disciplinary action will be taken should such violations occur. Please see me if you have any questions about the academic violations described in the Code in general or as they relate to particular requirements for this course."

Class  Schedule

Date			Topic						Reading

January 11		The Problem of Psychotherapy			Szasz MOP
January 14		Rhetoric & Religion as Remedy			MOP vii - 42
January 18		Precursors of Psychotherapy			MOP 43-81
January 21		Mesmer to Freud					MOP 82-100
January 25		Paradigm of Psychotherapy			MOP 101-137
January 28		Freud and Jung					MOP 138 178
February 1		Politics of Psychotherapy			MOP 179-208
February 4	Test 1 
February 8		Psychiatry as Science				LLP 1-38
February 11		Psychiatry as a Social Institution		LLP 39-90
February 15		Psychiatry and the Criminal Law			LLP 91-148
February 18		Film
February 22		Review
February 25	Mid-term examination 
March 1			Psychiatry and Constitutional 
			Rights						LLP 149-192
March 4			Psychiatry and Public Policy			LLP 193-237 
March 8		No class
March 11		No class
March 15		Therapeutic State/Obsolescence of the		CTS Leifer
			Schizophrenia Hypothesis			CTS Sarbin
			Therapeutic Professions 			CTS Gergen
			Name Game					CTS Brown
March 18		Subjective Boundaries				CTS Mirowsky
March 22		Brain Damage and Neuroleptics			CTS Breggin
			Political Economy of Tardive			CTS Cohen &
 			Dyskinesia					McCubbin
March 25		Electroshock					CTS Frank
			False Accusations of Sexual Abuse		CTS Coleman
March 29		Test 2 
April 1			Behavior in a Vacuum				CTS Peele
April 5			Some Myths About "Mental Illness"		PE Moore
April 8			Refusal of Psychiatric Treatment		PE Macklin
April 12		Psychotropic Drugs as Therapeutic Agents	PE Klerman
April 15		The Problems that Will Not Go Away		CTS Szasz
April 19		Film
April 22		Review
May 3 		Final examination 11:20 am to 1:50 pm