EP05 Point/Counterpoint 05 - Our Larger Mission As Therapists - Cloe Madanes and Thomas Szasz

Point/CounterPoint 05 from the Evolution of Psychotherapy 2005 - Our Larger Mission As Therapists

Featuring Cloe Madanes; with discussant Thomas Szasz, MD

Moderated by Bernhard Trenkle, Dipl. Psych.

How can we make our practice and our care systems more humane and more reflective of our democratic values? How can we deal with social justice issues and make a difference? How can we bring our therapeutic skills to bear on the broader common good?

Educational Objectives:

1. To describe the dilemmas in our systems of care.
2. To name three ways in which every therapist's practice can be more humane. 

Outline:

Introduction of Cloe Madanes

• Introduced as a major contributor to family therapy and author of influential books.

• Expresses gratitude and nervousness, citing admiration for Dr. Thomas Szasz and influence from Frankl and Erickson.

• Began her career in the 1960s–70s, working with figures like Jay Haley and Gregory Bateson.

Freud’s Legacy and the Shift Away from Real Abuse

• Freud originally linked mental illness to childhood abuse but recanted under backlash, shifting focus to the child’s imagination (Oedipus complex).

• Cloe argues this diverted therapy from real trauma and damaging relationships.

• Emphasizes that relationships can harm or heal, and therapy must focus on relational change.

Critique of Modern Psychotherapy

• Criticizes Big Pharma and managed care for reducing therapy to quick, impersonal protocols.

• Warns against over-medication and misdiagnosis without understanding social context.

• Raises concern over proposed school mental illness testing and coercive practices.

Clinical Cases and Therapeutic Techniques

• Describes using paradox and relational reframing to treat suicidal and epileptic patients.

• Emphasizes understanding family dynamics over diagnostic labels.

• Advocates for therapy as a tool for justice and healing, not pathology.

Dr. Thomas Szasz’s Response

• Supports Cloe’s views, arguing mental illness is a social myth, reinforced by labeling.

• Criticizes psychological testing as props for maintaining this myth.

• Claims the concept of mental illness serves political and institutional power.

Economic and Political Control

• Compares mental health institutions to religious authorities of the past.

• Says the industry is driven by money and state power—not patient care.

• Advocates a libertarian model: adults choose their treatment; children need medical oversight.

Concerns About Medication

• Audience raises issue of helping medicated patients.

• Cloe recalls therapy before antipsychotics; acknowledges the challenges medications create.

• Dr. Szasz warns that allowing therapists to prescribe would destroy the profession.

Therapy, Social Justice, and Basic Needs

• Audience asks about therapy for low-income families.

• Cloe links therapy to social activism and human rights, not just symptom relief.

• Argues therapy allows people to hope and should be free from medical coercion.

Final Thoughts and Call to Action

• Cloe urges support for the Council for the Human Rights of Children.

• Encourages therapists to take action against abuses and promote freedom in therapy.

• Dr. Szasz calls again for a libertarian approach and resistance to medicalization.

• Session ends with a shared call for therapists to advocate for patient rights and social change.