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This book, on pleasure and pain, constitutes an attempt to extend Freud's excessively physico-physiological conception. It is full of originality o outlook and deserves the most thorough study.
The author, Hungarian in origin, studied medicine in Cincinnati. He completed his training at the Chicago Institute of Psychoanalysis, and subsequently taught there for five years. Before writing the present work he published a series of brilliant papers in a number of American psychiatric journals. The book is made easy to read by the clarity of the writing, the excellent lay-out, the abundant bibliography and the author and subject indexes.
Taking over an idea of Bertrand Russell's (A History of Western Philosophy, 1945), Szasz distinguishes private facts (acquired through introspection) from public facts (observed by others), and suggests that the data of psychology are related to the former. The traditional distinction between psychogenic pain and organic pain has long hindered medicine and psychiatry. One way of clarifying this problem, or at least of by-passing it, would be to distinguish affects as experienced by the self from the same facts seen and judged by an external observer. The analytical situation is particularly suitable for the study of both these aspects.
Szasz classifies pain as an affect, in the psycho-analytical sense of the term, and consequently it has also to be studied in relation to the ego. Like anxiety it is first and foremost an alarm signal; but whereas anxiety tells us about external danger or libidinal strivings, pain tells us about bodily disorder. It is a communication from one part of the organism which informs the nervous centres of too intense a stimulation or of a loss of body substance.
Initially, pain permits the infant to notify the adult of his need for help (the social or communicative meaning of pain). Later on pain can be directed towards the doctor or any other person. It can even change its meaning and express feelings of