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asz, T.S. (2002). Hayek and psychiatry. Liberty. 16: 19-20 & 24 (June). Reproduced at the Szasz site by permission of Liberty.omas Szasz is an Associate Editor at Liberty.

HAYEK AND PSYCHIATRY

Thomas Szasz

"Mises and Psychiatry," in the February Liberty, I showed that Ludwig von Mises failed to appreciate the incompatibility between thenciples of the free society that he espoused and the principles of psychiatry that he uncritically embraced.

edrich von Hayek has articulated the political philosophy of individual liberty and responsibility more fully than anyone else, but, as Iall show in this essay, he largely shared Mises's blind spot about psychiatry: Hayek's conception of the rule of law is incompatible withs recognition of the legitimacy of psychiatric coercions and excuses, in both civil and criminal law.

ccording to Hayek, "Under the rule of law, government can infringe a person's protected private sphere only as punishmentfor breakingannounced general rule" (emphasis added, 2). This assertion contains two parts, the first relating to punishment, the second, to general

es. Only the second part has received the attention it deserves from libertarians. The first part of the assertion, which emphasizes thate "government can infringe a person'sprotected private sphereonly as punishment" (my emphasis) has been curiously neglected byertarians. This neglect is especially significant, and astonishing, in view of the fact that more Americans are now deprived of liberty onerapeutic than on punitive grounds. Jurists and psychiatrists never tire of asserting that all coerced psychiatric interventions areerapeutic, not punitive.

nonpunitive sanctions would be excluded from among the legitimate powers of the government -- as Hayek recommended -- psychiatrywe know itwould disappear.

oathing and Losing Liberty

ychiatric diversion from the criminal justice system is a response to the need for social protection from individuals whose behavior isributed to madness (3). Such attribution is often the result of the individual's inviting psychiatric interference in his life, by actingrazy." Why do some people act that way? Because they do not know what to do with themselves and with their lives: they are aimless,nceited, incompetent, are faced with the consequences of earlier unwise choices, and are or feel helpless and dependent on others.ey try to unload their problems of making a life for themselves on the shoulders of others, typically family members or psychiatrists.

nless they can find a family member or friend willing to assume this burden for them, they often become defined as psychiatric patients.e result is a kind of psychiatric matrimony, in which liberty is replaced by another, higher good: the patient sacrifices his own liberty forcurity; and the psychiatrist sacrifices the patient's liberty -- and often some of his own as well -- for the domination he gains over thetient (4).

ayek recognized the problem that people who reject liberty pose for the free society. "It is very probable," he wrote, "that there areople who do not value the liberty with which we are concerned, who cannot see that they derive great benefit from it, and who will be

ady to give it up to gain other advantages; it may even be true that the necessity to act according to one's own plans and decisions mayfelt by them to be more of a burden than an advantage" (5).

ost institutionalized mental patients rank liberty-and-responsibility low on their scale of values. How should the philosopher of freedom --a system of laws committed to protecting individual liberty -- treat persons who instead of wanting to be free, want to be enslaved? Who

stead of wanting to be adults, want to be children or child-like? Both Mises and Hayek treat such persons as if they were, in fact, unfitr liberty because, like infants and imbeciles, they lack responsibility.

dividuals who complain of mental symptoms or irresistible impulses feel, or claim to feel, unfree with respect to certain experiences or

sires. Individuals confined in mental institutions are deprivedof much of their liberty. In both cases -- more obviously in the latter -- thectim" is "compensated" for his loss of liberty by a commensurate "relief" from the responsibility of having to lead his own life.

sanity: Condition or Strategy?

e weakness of Hayek's writings touching on psychiatry lies in his treatment of insanity as a condition, similar to infancy, rather than asstrategy, similar to imitation (6). It is important to note that psychiatry's assault on the philosophy of liberty has always focused at thisint, which is its Achilles heel -- that is, the notion that insanity annuals personal responsibility. For centuries alienists, mad- doctors, andychiatrists have claimed that, like infants and imbeciles, insane persons are not responsible for their behavior; and people in all walks of

e -- professionals and layman alike -- have increasingly embraced that claim. That is the basis for the near-universal acceptance -- byerals, conservatives, and even many libertarians -- of the legitimacy of psychiatric diversion from criminal responsibility. Hayek wrote:

he complementarity of liberty and responsibility means that the argument for liberty can apply only to those who can be held

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. Ibid., pp. 153-154.

opyright, 2002, Liberty Magazine.omas S. Szasz Cybercenter for Liberty and Responsibility:pyright 1998-2002 by the author of each page, except where noted. All rights reserved.

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