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No one, not even R.D. Laing, has sought to defend the freedom of disturbed people from inappropriate coercion with more rigour, tenacity and courage than has Thomas Szasz (1998). He has been heavily criticized, even vilified, for his pains but remains undaunted and, as the present paper testifies, is as sharp and trenchant as ever. Szasz's quest has the force of a mission and at times leads him into writing with intemperance, but I believe that his mission is justified and that we have reasons to be grateful for his voice.
In ‘Discretion as Power’ Szasz reiterates his basic philosophical stance in relation to psychotherapy. Psychotherapy, he maintains, is only morally acceptable if the patient's freedom of action is sacrosanct. There must be no coercion either by the therapist or by a third party who has the power to influence the procedure. His focus is less upon the unjustifiable moral and intellectual pressure of the practitioner's interpretations and injunctions than on the legal and financial restraints that can be imposed on the endeavour.
Szasz's thesis that coercion is never justified in any circumstances is difficult to sustain. A less extreme version of this - and one that, I believe, Szasz can easily defend - is that the degree of coercion by the state, the agencies of the state, and the contemporary dominance of the scientific idiom is harmful, immoral and unacceptable. In spelling out the ways in which this occurs - and providing us with actual examples - Szasz unveils the sloppy thinking and hypocrisy that allows much of the phenomena to pass unnoticed.
At times Szasz appears to underestimate the resilience of therapist and patient. For example, he writes ‘It is difficult for me to conceive of “good” psychotherapy - the patient willing and eager to embrace courage, integrity and responsibility - without the client paying for the service he receives-:’ There are very few situations in life, including psychotherapy, in which a project can be undertaken in i