Review of an Important New Book

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D. Saul Weiner

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Jun 13, 2010, 6:20:50 PM6/13/10
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This is a review of the 2009 book The Depression Cure: The 6 Step
Program to Beat Depression without Drugs, by Stephen S. Ilardi, PhD.

Since you may be wondering why I have posted a review of a book about
Depression on a Paleo-Libertarian group site, I will address that
matter briefly now, lest you think that I have posted to the wrong
site or that this issue somehow lacks relevance. Dr. Ilardi, a
clinical psychologist and researcher, has developed an eclectic
treatment program for treating clinical depression, yet has explicitly
and repeatedly made the connection between the elements involved and
the way that they allow us to access the biological advantages of the
hunter-gatherer lifestyle (while also taking advantage of the many
blessings of modern living). This program should serve as a catalyst
for reassessing how we conceive of the Paleo lifestyle, how we ought
to promote it, and it also has practical implications for the
libertarian. For now, I will start by providing a brief overview of
the book. I will then come back to and explore more specifically the
book's implications for the Paleo-libertarian movement(s).

In the introduction, Ilardi documents the efficacy of what he calls
Therapeutic Lifestyle Change (TLC), the name for his program, with
results more than 3 times as good as standard interventions for
clinical depression. Every single patient who put the full program
into practice got better, as defined by experiencing at least a 50%
reduction in depressive symptoms and no longer meeting diagnostic
criteria for major depressive disorder by the end of treatment. What
is perhaps of even greater direct interest to many of the members of
this group, the program is also highly effective for those who are not
clinically depressed, yet prone to feeling blue at times. Moreover,
it can be used to reduce one's risk of developing clinical depression
(and related problems), or ideally, as a means to living a happier and
more productive life. Thus, the approach is more based on promoting
healthy living than fighting pathology, per se.

Ilardi goes on to document how drastically the incidence of depression
has increased in recent decades in the industrialized world. He also
points out that only one known group of Americans has not been hit by
the depression epidemic, the Amish, who have clung tenaciously to
their 18th century way of life. Likewise, assessments by Western
researchers of modern-day hunter-gatherer bands have shown an almost
complete absence of clinical depression among such groups.

The 6 components of the TLC program bring back the critical elements
we have lost as we have moved further and further away from more
primitive conditions and are as follows:
• Dietary omega-3 fatty acids
• Engaging activity (versus excessive mental rumination)
• Physical exercise
• Sunlight exposure (including a discussion of Vitamin D
supplementation)
• Social support (and avoiding isolation)
• Sleep

Ilardi provides an overview of clinical depression, both from a
symptom perspective and from the standpoint of brain/body functions
that get of whack, and risk factors. He covers treatment approaches
and is mostly critical of the use of pharmaceuticals (though he does
acknowledge their value in cases of severe depression and to a
minority of patients in general). He is critical of the Freudian
treatment approach, yet much more supportive of cognitive and
behavioral approaches. His assessments are consistently well-grounded
in research. Nevertheless, with all of the research showing the
benefits of proper nutrition, sunlight exposure, sound sleep, and so
forth, he and his research team have found it best to create a more
holistic program, which I have outlined above.

There is a separate chapter on each of the 6 components listed
earlier. While the writing is accurate and precise, it is
conversational in tone, not technical. A few technical matters are
shown in footnotes in the body of the book. In the back of the book
are (250) chapter by chapter notes. There is also an extensive
bibliography. So while the main text of the book will serve the
layman well, there is also the opportunity for the reader who wants to
dig deeper to learn more.

The last section provides step by step instructions for the reader to
implement the program over a 12-week period. Naturally, it would be
daunting to try to implement it all at once, so there is a phase-in of
the different recommendations. There is also a 20-question depression
scale to be filled out weekly, so that one can monitor his progress.
The book concludes with a chapter on troubleshooting. Clearly, the
TLC program has been "road-tested" and Ilardi does an excellent job of
anticipating many of the potential questions that readers are likely
to have. He indicates that in some cases patients may find it
beneficial to get the help of a therapist or coach in implementing the
program.

I cannot really do justice to the book here in a short review, though
hopefully I have given a reasonable overview and many of you will be
motivated to read it yourselves. At this point, I will return to the
book's implications for the Paleos and libertarians and then address a
potential concern for members of this group.

For the Paleo, the clinical success of the TLC program in combating
depression and its explicit tie-in with the hunter-gatherer lifestyle
provides powerful reinforcement that we are on the right track. It
seems to me that most of the literature has emphasized the Paleo
advantages to physical health (e.g. weight management, avoidance of
diabetes, heart disease, cancer). While those benefits are, of
course, tremendously important all by themselves, the notion that the
benefits extend to the psychological realm, can really widen the
appeal of Paleo living to younger people who may not be struggling
with weight problems, but may be struggling emotionally, and who may
not be too worried about degenerative diseases that may not cause
significant issues for decades to come. It too may increase the
appeal of Paleo to women, who suffer disproportionately from
depression. Ilardi's research should also serve as a reminder that
when we promote the Paleo lifestyle, that we should not give short
shrift to areas such as exposure to sunlight, sound sleeping
practices, and the importance of social interaction.

For those who are familiar with the work of Weston Price, he too noted
that among the groups that he studied who had discovered ways to
obtain optimal nutrition, there were no "insane asylums". Likewise,
he frequently observed the great degree of happiness he found among
members of these populations, though he did not make clinical
measurements in this regard. Price's observations and conclusions
continue to be validated here, as they have been for years in his many
areas of research.

There is a great deal to be said for holistic approaches and
assessments, vis a vis the reductionist approaches favored by many
academic researchers. Researchers can argue endlessly about how one
compound can impact a clinical measurement (e.g. blood cholesterol
levels) over some period of time, and how this may (or may not)
produce health benefits or detriments down the road. However, if you
can demonstrate, as Price did, that eating in a certain way can
reliably produce wide dental arches in the young (and thus the
avoidance of crowded and crooked teeth) and prevent one's teeth from
rotting, this is prima facie evidence (pun intended) that these
cultures are doing something right. Likewise, a lifestyle that
promotes good spirits and resilience must be presumed to be a sound
one, in the absence of powerful countervailing evidence.

The significance of this book for the libertarian enterprise may be
less obvious, but I can think of at least 2 important implications.
As Toban noted in his recent article published on LRC, we cannot
afford to lose our great warriors too young due to "diseases of
civilization". In this regard, he noted the untimely demise of Murray
Rothbard. But perhaps the greater danger here is the loss of
libertarian intellectuals and activists due to pessimism and burnout
that can come about when fighting against such great odds for long
periods of time. Surely, to the extent that adopting the TLC program
can keep our energy high, our minds clear, and our optimism intact, we
will have a much greater impact. Finally, while individualism is a
foundational part of libertarian philosophy (though we certainly favor
cooperation and voluntary association), it is abundantly clear that
there is a strong (Paleo) need for people to feel that they are part
of a (moderately sized) group, with shared purposes and activities
[this is discussed in the section of the book covering social
support]. We will need to find creative ways to fulfill this need in
order for the movement to thrive. Some may find this in political
campaigns (such as Ron Paul's), while others may find that whole
enterprise to be counterproductive. Certainly, the ability to
communicate and interact through the Internet has helped a great deal
in overcoming the isolation we are prone to. Yet likely more work is
needed here.

I will conclude with one comment here to address a potential objection
from hard-core Paleo members reading this review. For some, the
nutritional program mentioned in passing above may sound less than
satisfying. All I can say here is that Ilardi has, out of necessity,
needed to be very selective here in terms of emphasizing the most
"value-added" elements of a treatment protocol for curing depression.
He knows well that if he tries to throw the kitchen sink at his
patients, too many will become overwhelmed and not be able to follow
through, when he is using a multi-faceted approach like this. In the
final troubleshooting chapter, he does discuss some additional steps
one can take if he is not making sufficient progress, and these
include decreasing sugar and increasing tryptophan intake.

Toban Wiebe

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Jul 2, 2010, 1:31:18 PM7/2/10
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I'm really glad to see that you got this book review on LRC today: http://www.lewrockwell.com/orig6/weiner11.1.html

I've been meaning to thank you for posting this. I bought the book and gave it to someone who needs it.

Mary H

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Jul 2, 2010, 1:41:26 PM7/2/10
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Hi Toban,
I put my son on a paleolithic diet~~
 
The results were simply astounding.
He was born normal but after vax, antibiotics,  and the commercial diet, he became 100% autistic
below the one percentile
 
I  changed him from a processed diet to a paleo diet, low carb version
 
He went from being 100% handicapped, to complete  recovery
 
I need to write a book!
Mary

Toban Wiebe

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Jul 2, 2010, 1:59:30 PM7/2/10
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That's pretty amazing. I'm not very familiar with autism, but I suspect that it's not the thing you ever recover from. Would mainstream medicine consider it an unexplainable 'miracle'? You should start by writing an article for LRC, or as a guest post for Mark's Daily Apple or Free the Animal. Get the word out online now but keep the book option open as well.

Mary H

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Jul 2, 2010, 2:22:56 PM7/2/10
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Hi Toban,
 
these kids are "sick"
 
they are Vitamin D deficient
 
then you assault them with shots, antibiotics
the body breaks down
 
so you go from having a "normal" kid to a sick , constantly sick child
 
when I did paleo, everything changed
 
I did LOW CARB paleo
mary
ps thanks for the suggestions and yes i'm going to do something
even a youtube video

Todd S.

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Jul 3, 2010, 7:25:39 AM7/3/10
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On Jun 13, 6:20 pm, "D. Saul Weiner" <dsa...@aol.com> wrote:
> This is a review of the 2009 book The Depression Cure: The 6 Step
> Program to Beat Depression without Drugs, by Stephen S. Ilardi, PhD.

I can personally vouch for the anti-depressive effects of a paleo
approach to health. For roughly 3 years after I bought my fixer-upper
house, I sat around and did nothing with it. Nothing with my life,
nothing at all. I put on 30lbs and sat around playing video games. I
knew I was depressed, but I was damned if I'd go to a shrink. I
finally got enough gumption worked up to try to lose some weight, and
I found out about the paleo crowd and came across MDA. I embarked on
that journey, and saw some pretty amazing results. Most amazing -
even before the pounds really started to drop - was the change in my
attitude and demeanor. Everyone noticed it. It wasn't long before I
was already registered for classes to finish the degree I had
abandoned some 8 years earlier - and making plans for post-graduate
studies. I have plans drawn up for several room remodels in my house,
and have even started a backyard vegetable garden.

I realize I don't need to "sell" anyone here on the paleo lifestyle,
but this particular thread resonated with me.

D. Saul Weiner

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Jul 6, 2010, 10:02:06 PM7/6/10
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A doctor is treating autism and other childhood disorders with the
GAPS diet with good success:

http://www.westonaprice.org/childrens-health/1379-gaps.html


Have heard good reports for autism using this potent detoxifier as
well:

http://zeoliteautismstudy.com/home/
> ...
>
> read more »- Hide quoted text -
>
> - Show quoted text -

Karen DeCoster

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Aug 16, 2010, 9:23:49 PM8/16/10
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Saul --

I don't mean to be dissing your extensive work/research here, but, I
must ask when I hear this topic arise: why the constant attention to
Depression? Do you really believe this is a disease, or a choice? I
don't mean to oversimplify this topic, but I see so much stuff on
depression lately - incl. on LRC - and it raises my eyebrows.
Certainly, I think that eating poorly and living a life that lacks
movement and exercise may contribute somewhat to depression, but more
in the sense that people begin to loathe themselves, their body, their
boredom, pitiful life. Perhaps the carb lifestyle does trigger this in
otherwise "normal" people for short periods. But, people go through
weird periods in their lives - and who doesn't? - and they immediately
jump on the "I'm depressed" bandwagon. Isn't this a bit overdone, and
even childish?

But I've always seen depression as a choice. People make choices to be
depressed, do nothing, be bored, sleep, slack off, and generally, just
refuse to live life. I've known these folks, and most of all, I lived
with one who raised me - my mother. A manic-extreme sort of depressive
person, I watched her, for years and years, make the choice to be
bored/angry/hurt/bitchy/depressed/deprived, and I watched her make the
choice to drive everyone away from her. She refused to be happy, and
instead went out of her way to make sure she was "depressed." I made
all of the opposite choices, and yes, they were conscious choices on
the part of both of us. As an 80-ish geriatric, now, that has only
intensified.

p.s. -- as to the 6 components of the program, too much "social
support" and "avoiding isolation" would ..... make me
depressed! :--)

Richard Nikoley

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Aug 16, 2010, 9:29:36 PM8/16/10
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Personally, either a glass of single malt, a massive beef based meal, or both always does the trick for me.

Recounting your mom's behavior reminded me of a quote, though used in a completely different context.

"I'm not happy unless you're not happy." - Billy Beck

--
Richard Nikoley
http://www.freetheanimal.com
- Sent from my iPhone

Mary H

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Aug 16, 2010, 9:32:38 PM8/16/10
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I found an interesting site that has a bit to say about depression and dysglycemia..
 
The authors' thesis is that "depression" is caused by dysglycemia and insulin resistance (both the result of a sugary/carby diet and lack of exercise)
 
 
click on "articles" and enjoy!

Richard Nikoley

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Aug 16, 2010, 10:19:40 PM8/16/10
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On a more serious note, Julia Ross, interviewed a coupla times by Jimmy Moore and who wrote The Diet Cure and The Mood Cure uses isolated amino acids (some compete, so she isolates) to essentially curb cravings and improve mood. She had an 80ish % success rate with drug/alcohol addiction and then went off on her own. 

She says you can accomplish the same results just eating a LOT of protein, but that it takes a lot. Presumably when you've deprived yourself for years, it does. 

Sent from my iPad

Mary H

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Aug 16, 2010, 10:52:40 PM8/16/10
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Glutamine for carb cravings

Toban Wiebe

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Aug 17, 2010, 12:40:50 AM8/17/10
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Karen, good point. Doesn't Szasz question the whole idea of mental illness? It does seem that depression is a kind of catch-all label or bandwagon for anyone who's unhappy (I wonder what the role of pharma has been here...) Still, I think depression is real and can be caused by poor nutrition. Lierre Keith's story is good evidence on its own.

Mary H

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Aug 17, 2010, 12:44:59 AM8/17/10
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see the australian website
their sentiment exactly
they think that mental illness is in large part insulin resistance and dysglycemia
with low carb, most probs go away according to research

Joshua Katz

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Aug 17, 2010, 11:17:43 AM8/17/10
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I tend to agree with Karen, but I'd add that a big part of "mood
disorders" and "psychiatric illness" is the fact that we, as a
society, have constructed a world that is just plain unsuited to the
way we evolved. So long as you do not live in accordance with your
nature, you will experience these 'diseases' and, from your
perspective, they'll seem like real diseases. Luckily, it is
possible, much of the time, to adjust what you do even if society is
nuts.
> ...
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> read more »

Karen DeCoster

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Aug 17, 2010, 9:44:52 PM8/17/10
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Richard - this describes my Mom: "I'm not happy until you're
miserable...." Whoops! Sorry, Mom, no cigar. I believe in anti-role
models......

On Aug 16, 9:29 pm, Richard Nikoley <rniko...@gmail.com> wrote:
> Personally, either a glass of single malt, a massive beef based meal, or both always does the trick for me.
>
> Recounting your mom's behavior reminded me of a quote, though used in a completely different context.
>
> "I'm not happy unless you're not happy." - Billy Beck
>
> --
> Richard Nikoleyhttp://www.freetheanimal.com
> - Sent from my iPhone
>

Karen DeCoster

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Aug 17, 2010, 9:48:10 PM8/17/10
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Toban - Szasz turns that shit on its ear. I am a Szaszian -- and long
before I ever heard of him. There is no mental illness - only choices.
Choices between being strong and being a wimpified "victim." I am sick
and tired of excusemongering and bullshit to "explain" one's erratic
beahvior.

Karen DeCoster

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Aug 17, 2010, 9:53:32 PM8/17/10
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"we, as a society, have constructed a world that is just plain
unsuited to the way we evolved." No argument with that - I call it
unsustainable (voluntary) insanity. When I was diagnosed with a rare
"autoimmune disease," I said -- fuck that shit. I'm not going to be a
limp, pantywaist victim sucking down Big Pharma's junk juice like
everyone else....I am going to cure myself. And I did. And at 47 I am
going on, oh, about........27. Turning back time was fun and easy. Too
fucking easy, in fact. Mental strength and attitude is everything.
When I deal with my mother I smile because I know I triumphed where
she gave up and sold out to misery. I admit I have no patience for
that bullshit.

Mary H

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Aug 17, 2010, 9:53:52 PM8/17/10
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Maybe she was deficient in Omega 3s? And/or B vitamins?

D. Saul Weiner

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Aug 18, 2010, 9:17:06 PM8/18/10
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Karen, I am glad that you brought this topic up and that it is
generating some discussion. I considered discussing the Szaszian view
in my article, but didn't think I could do it justice in that
context. I am not sure I can here, either, but I will mention a few
things that come to mind.

I would agree that some cases of mental illness may be due to weak
character and insufficient personal accountability. But Szasz goes
WAY too far in generalizing it to be akin to an absolute rule (while
admittedly, he is countering many who have gone too far in the other
direction).

I am convinced that many cases of mental illness do not fit Szasz'
model. Do people who suffer from Seasonal Affective Disorder have a
breakdown in character in the fall/winter? What about the mothers
with post-partum depression? (And, by the way, wasn't it great when
Tom Cruise said that Brooke Shields should use nutrition, not meds,
even though he was pilloried for saying it?).

What about the schizophrenic? Do people just wake up and decide to be
catatonic and hear voices one day? A lot of these people have been
cured through nutrition (see the work of Abram Hoffer here). Likewise
many people with bipolar are overcoming that nightmare through
nutrition.

A lot of people suffering from these conditions are highly motivated
to get well, but in many cases are not aware of promising alternative
approaches. Ilardi, the author of the book I reviewed, says that the
vast majority of his students come to his class thinking that drugs
are the best approach for treating depression. Where do you suppose
they got a crazy idea like that? Ilardi talks about how detrimental
rumination is but says that when he brings it up to patients, few are
aware that they are doing it much less have any idea how to overcome
that tendency.

Barbara Stitt wrote a wonderful book a little while back called Food &
Behavior: A Natural Connection. She discovered this connection
through personal experience, as a result of becoming hypoglycemic (may
be similar to what Mary H has pointed out, though I will have to
research further). She discovered proper diet and orthomolecular
nutrition as a result. She worked as a parole officer. After
learning this, she would instruct her charges on these matters and
their rate of recidivism was much, much lower than those of other
parole officers. Many of us would be inclined to look down on
criminals (other than the faux criminals such as pot smokers) but this
type of finding tells me that many people can turn their lives around
when presented with good information.

Richard Nikoley

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Aug 18, 2010, 9:30:42 PM8/18/10
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Very interesting, Saul.

I just can't get past the notion that nature didn't evolve misfits. I'm no expert, no authority, but I wonder what results i'd get with mental patients if I prescribed a 16 oz steak per day.

Sent from my iPad

Joshua Katz

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Aug 19, 2010, 7:53:19 AM8/19/10
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For what it's worth, I'd point out that Szasz doesn't actually say
that, at least not in his later works. A person identified as having
a 'mental disorder' might be sick - but not with a mental disorder.
If they are sick, it's with a neurological disorder not yet
identified. He points to syphilis, which was previously identified as
satanic possession. If you lived before the germ theory, you might
have been a skeptic and said "there is no such thing as demonic
possession." To which people would have said "are you kidding? Do
you see what that guy's doing? What do you think, he's choosing to do
that?" The point is, if there is no disease, then it's not a disease,
and if there is, then there are already specialties capable of
treating it. So what are psychiatrists doing? They're treating
people who expressly don't have an identifiable disease. If we find a
brain thing going on with schizophrenics, then they'll start being
treated by neurologists. He makes a further point about involuntary
treatment, of course.

I know how different I started to feel when I got certain nutritional
factors in line. I continue to encourage the school I work for to
consider serving healthier food in the dining hall. They serve a
'student friendly' menu, with lots of fried foods and carbs. I also
encourage them to give students a spoonful each of cod liver oil and
brewer's yeast in the morning.
> ...
>
> read more »

D. Saul Weiner

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Aug 19, 2010, 1:57:00 PM8/19/10
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I'll tell you, I find myself reluctant to criticise Szasz, because he
has done so much great work for liberty (against coercion in
psychiatry, opposing the Drug War, warning against the Therapeutic
state, and basically promoting the separation of medicine and state).
Moreover, I find much to criticize in (even non-coercive) psychiatry.
But on this issue, I think that he has missed the mark. It would be a
shame if this misstep undermines the causes he has promoted for so
many years.

I have long believed that if we had a free market in medicine, then we
would see the practices that produce the most benefit at the least
cost rise to the top. Psychiatry as it is now practiced could not
survive in that environment.

Joshua Katz

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Aug 20, 2010, 10:09:34 AM8/20/10
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Certainly, I disagree with him at times as well, although I'd label
myself a Szaszian before anything else when it comes to theories of
mind and such. However, I'd appreciate if you'd specify your
objection here. Do you find that what I said doesn't accurately
portray Szasz's beliefs, and so your prior objections stand, or do you
find what I said here to be objectionable? I'm curious, because I
don't agree with the view you challenged in your previous post, but I
generally think that the Szasz I present is true - if it's not, I'd
like to learn that.

Of course, I entirely agree with your last statement - and if
psychiatry as we practice it could not survive, then how is Szasz
wrong? If you'd favor something like the 'talking cure' then I might
agree with you, if certain Freudian assumptions are dropped, but we
need to careful about the harm done by suggestion planting and so on,
and I don't see why we'd need any form of psychiatry to do that. A
philosopher with a bit of training could do it just as well.

By the way, here's a thought that's occurred to me recently. I
believe, for instance, that a person craves salt when he is depleted
of certain trace minerals - and that we overdo salt because our
refined salt doesn't actually fill the need. So, what about drugs?
Why do some teenagers crave cocaine? Could it be that Ridilen (sp)
could actually help that teenager?
> ...
>
> read more »

D. Saul Weiner

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Aug 20, 2010, 4:43:37 PM8/20/10
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I admire Szasz from the standpoint of policy. I disagree with some of
the things that he has to say about mental illness, though I haven't
studied his work exhaustively and cannot rule out the possibility that
I may have misconstrued some of his views. I am afraid that your
previous objection has not clarified matters for me.
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