Mental Illness is a Myth

My aim in this essay is to raise the question ‘Is there such a thing as mental illness?’ and to argue that there is not.

The quote above are the first words in a thesis by Dr. Thomas Szasz titled, “The Myth of Mental Illness.” You may be surprised when I tell you that Szasz was a psychiatrist. Yes, oddly enough, he was a psychiatrist who didn’t believe in mental illness. After his essay was published in 1961, Szasz went on to write 35 books about the subject up to 2012, when he died at the age of 92.
Thomas Szasz

The purpose of this article is simply to introduce you to Dr. Szasz because, unfortunately, there are individuals who follow his beliefs. Szasz has long been the poster child for those who are skeptical – for those who don’t believe that mental illness exists. If you are diagnosed with a mental illness and find others don’t believe in your diagnosis, you may find much of their skepticism has its roots in the teachings of Dr. Szasz.

The writings of Dr. Szasz were suggested to me by a follower of Szasz’s philosophy. When I decided to follow the suggestion I swore to myself to keep an open mind. Well, I gave it my best shot. My original intent was to write an essay about the doctors’ thesis, but it was becoming too long. Instead, I have chosen to let the good doctor speak for himself with a little commentary from me.

Standing alone, I must admit that some of his arguments seem sound. For example,

The concept of illness, whether bodily or mental, implies deviation from some clearly defined norm. In the case of physical illness, the norm is the structural and functional integrity of the human body.

What is the norm deviation from which is regarded as mental illness? This question cannot be easily answered.

Fine. I can understand that, but then he goes off the deep end and states,

What may be obvious may be also poorly understood. This I think is the case here. For it seems to me that – at least in our scientific theories of behavior – we have failed to accept the simple fact that human relations are inherently fraught with difficulties and that to make them even relatively harmonious requires much patience and hard work.

If you are diagnosed with mental illness, he said the real problem is your diagnosis, which is masking the fact that you and your psychiatrist aren’t working hard enough to help you cope with society.

We may recall in this connection that not so long ago it was devils and witches who were held responsible for men’s problems in social living. The belief in mental illness, as something other than man’s trouble in getting along with his fellow man, is the proper heir to the belief in demonology and and witchcraft. Mental illness exists or is “real” in exactly the same sense in which witches existed or were “real.”

I believe I could have saved myself some time by posting only the paragraph above. It alone. says a lot about the man.

Yet, if man fails to take increasing responsibility for his actions, individually as well as collectively, it seems unlikely that some higher power or being would assume this task and carry this burden for him. Moreover, this seems hardly the proper time in human history for obscuring the issue of man’s responsibility for his actions by hiding it behind the skirt of an all-explaining conception of mental illness.

Once again, it’s the patients fault for not taking responsibility for his own actions.

What is implied in the line of thought set forth here is something quite different. I do not intend to offer a new conception of “psychiatric illness” nor a new form of “therapy.” My aim is more modest and yet also more ambitious. It is to suggest that the phenomena now called mental illness be looked at afresh and more simple, that they be removed from the category of illness, and that they be regarded as the expression of man’s struggle with the problem of how he should live. The last mentioned problem is obviously a vast one, its enormity reflecting not only man’s inability to cope with his environment, but even more increasing self-reflectiveness.

He gets a bit repetitive, doesn’t he? I’ll admit I do have an inability to cope with my environment. Mania and depression can do that to you….as long as you believe they exist, I guess.

Here is the final paragraph of his thesis,

Our adversaries are not demons, witches, fate, or mental illness. We have no enemy we can fight, exorcise or dispel by “cure.” What we do have are problems in living – whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. My argument was limited to the preposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflictions in human relations.

On Monday, I will continue with more commentary, rather than just provide quotes by Dr. Szasz. I will provide more information about Dr. Szasz and include commentary from some of his detractors. Until then I’d like to hear from you. What are your thoughts? Am I off base here? Does he provide valid arguments? How do his comments make you feel?

25 comments on Mental Illness is a Myth

  1. Wow, Bradley! This kind of thinking just knocks me over and infuriates me. I believe mental illness exists, but I don’t believe it is an excuse for bad behavior. I believe that if one wants to change and is honest with him/herself and Pdoc/tdoc, we can learn skills & tools (which can include meds) to help us live a better life to interact with the world around us. We can become responsible.

    A Pdoc once explains it to me this way: the brain can have several different kinds of storms. One more commonly known storm is epilepsy. When that storm rages it affects the person’s bodily functions and also their thinking ( a friend of mine has trouble with memory and thinking after this happens). A different neurotransmitter storm, bipolar, affects the mood regulation systems and thinking, memory and sometimes other things as well.

    Neither illness gives us the right to misbehave and hurt other people. We are responsible to learn how to get as well as we can and live good lives with family and the world we engage in. However, I do believe that some peoples minds have been so disrupted and destroyed that they really don’t understand the harm they are doing.

    To me, the dilemma is sorting them out–who are the ones who didn’t care to do the work to be as responsible a person as is possible for them to be — they are just self centered, non caring, and lazy (I’m not talking about sick people who can’t achieve this) and willingly hurt others. And who are the ones who are totally out of touch — their brains working on a different plane, a different reality totally foreign and truly can’t help the chaos they create?

    I totally disagree with this man.

    Good food for thought, Bradley

    1. Your comment made me think of a saying that is commonly used in AA, “You’re not at fault, but you are responsible.”

      When I first read his thesis, I immediately started typing away at this post. It seemed like I was going nowhere with it and I brought it up with my husband, Maurice. He told me it was obvious that I was very mad and I should sit on it for a couple of days. I wound up just using his quotes because anything I was trying to write was too long.

      There’s still more to say about Szasz, that I’ll do on Monday.I’ll include counter arguments also.

      As always, good comment.

  2. I do think that society has been quick in the past to label as mental illness behavior that was completely sane, in the sense of being a completely understandable response to unreasonable stressors. One example would be housewives in the 50s, stifled by their boring and restricted lives, diagnosed as neurotic, and drugged or “put away.” They were mad, but not “mad.” Same with PTSD. I find it amazing that every active combat soldier -isn’t- diagnosed with PTSD. Once homosexuality was considered a mental illness, right there in the DSM.

    The line keeps moving. Things once defined as mental illness no longer are. Has the functioning of the brain or genes or biochemistry changed? No. Just the definitions.

    I think the larger problem is in the general community, rather than within the ranks of the psychological practitioners. Numerous ludicrous theories such as the “Twinkie defense” have primed the public to see genuine disorders such as postpartum depression as loopholes, dodges to avoid consequences.

    Admittedly, with the definitions so fuzzy, it is possible for people to claim pathology where none exists. But the reverse is also happening – the denial of a problem in hopes that it will vanish in a puff of, I don’t know, disbelief? Rhetoric? Theories? Convenience?

    I look forward to reading your next post.

    Personal note: My mother-in-law doesn’t “believe in” depression and my mother thought I would get better once I found a good job.

    1. I’ve found that people who’ve gone through a difficult, situational depressed state have a hard time understanding those of us with chronic depression. They eventually shook it off so why can’t we. Sounds like you don’t want your mother-in-law or your mother to get their hands on one of the doctors books. Last thing you want is for them to feel validated.

  3. Well, I can sum my opinion up quite briefly. Denial. This man probably had mental illness and in proving mental illness doesn’t exist he proves he is just a flawed human. I kind of feel sorry for the sick bastard if nit for the people who buy/bought into this garbage.

    1. Good point. Reminds me of people loudly protesting against gays and marriage equality, only to later being found having sex in public restrooms

  4. Yes, “mental illness” is a struggle with environment. But why are we struggling? Seems like a bunch of circular reasoning to me, dearest Bradley!

  5. actually, as i have a degree in social-psychology, he is speaking from a different perspective completely. he is not speaking about the existence of mental illness as those suffering from it, the majority of those psychiatrists treating it, nor of the therapists and social workers and counselors treating patients.

    in other words, the perspective he was using to view the label of mental illness as it occurs in groups within societies AND not as it occurs in individuals of any given society. So, his perspective is not rooted in the view that the experience and visible symptoms of mental illness in the individual is the place of origin, the place to start treatment and maintenance.
    This is what most patients and psych doctors and therapists believe and use as a starting point.

    Szazs I not looking at individuals experiences’ in a society. He is looking at the experiences of groups labeled as having mental illness in a society. the function of a group in a society and it behavior is completely different than that of the individual. Therefore, in this socialpsychological perspective, the label mental illness is viewed as a social construct, similar to the social construct that old white men should be in business and run corporations, etc. Or that women are never as capable as men. Or that african-americans are lazy, shiftless. These labels used to describe particular groups in a society are actually used as social constructs to organize, sort, prioritize the society and this is done by those in the position of power and for the reason of preserving their positions in power and maintaining the status quo. From this perspective of mental illness as a construct to maintaining the status quo of those in power, and as a label of a specific group, you can now see how his arguments make more sense, because they are not about the experiences of the individuals, but about the experience of that group of labeled individuals as a means of preserving the status quo.

    Talcott Parsons provides us in sociology with a framework that applies to all groups/socieities/individuals……this framework is named A.G.I.L., which stands for Adaptation, then Goal Attainment, then Integration and last Latent Pattern Maintenance.
    The way this works is that any group or individual will Adapt to the pressures of the environment they are in. Once they Adapt, they then attempt to reach thier Goals, such as enough food, shelter, procreation, etc depending on the group. Once their Goals are met, they now Integrate the newly Adapted behaviours into their everyday life to continue to have their Goals met. The final step is now Latent Pattern Maintenance, where even after the original reasons for the initial Adaptation are no longer existant, and the behaviour is no longer needed, it still continues as a sort of habit even though it is no longer necessary. This continues with all Adaptations, until the environment changes the pressures to create new Adaptations which will then be used to achieve Goals, then Integrated and finally continued when no longer necessary as Latent Pattern Maintenance.

    Szazs was speaking from this kind of perspective, rather than from the truly psychological perspective, which is NOT the perspective of the group that carries the label of Mentally Ill, but is the study/treatment of the Individuals experiences of life instead.

    Please do not misunderstand me, I am not supporting Szazs–I am only explaining the difference between what he was discussing v what most people who experience mental illness individually experience. In my college years, I once had to write a paper that attempted to prove or disprove whether the suicidality of women in the ’70’s (sylvia plath, the yellow wallpaper, the bell jar, etc and the common use of lobotomy and ect treatments) whether it was a social construct or an individual experience. The class had heavily taught that it these behaviours in women at that time were a social construct to keep the women from changing their status in society and preserve the status quo. although opposing evidence was also shared and discussed. I was the only student to argue that it was not a construct designed to preserve the status quo. I instead argued that it was a true illness, biological in nature (added to at times by life experiences) as was already discovered in the ’70’s that schizophrenia was only biological. My argument was that therefore most mental illness experienced by the individuals was an actual physical issue that medicine has not yet deciphered to treat effectively, so treatment by existing structures is used instead, such as therapy, meds that get switched all through life. I was the only person to get the highest score, and a page long note from prof that she completely was opposed to, but thought i presented a solid argument that was well defined.

    My point is, I don’t agree with szazs, but I understand what he is saying and that it is from a different viewpoint. And it is still valid from that viewpoint and does not have to undermine a viewpoint that comes from the individual psychological problem.

    1. Hi kat. Does he make this more clear in any of his books? I ask because that is not the impression I get from his essay at all. I know I shouldn’t judge him by his followers, but one of them told me how evil psychiatric centers are as well as medications. When I asked about the people I see at the beach every day talking to themselves, which doesn’t bother me, but I am concerned that they are so sunburned that their skin is dry, cracked and bleeding. Their response was basically “if they die, they die. Their still better than being locked into a psych hospital. Does this follow Szasz’s theory or have they misunderstood?

      I know he co-founded the CCHR and when I look at the viewpoints of the Scientologists they are all about the individual. Is this different than their original stance?

      ” My argument was that therefore most mental illness experienced by the individuals was an actual physical issue that medicine has not yet deciphered to treat effectively,” This makes sense to me, but was this not one of his complaints – that people are being treated in the hopes that someday physical evidence will prove a medical illness exists?

      1. it actually is comparing apples to oranges. lets say the apples are the individuals with a similar experience of mental illness as true and real in their lives. (psychology)

        then lets say the oranges are the whole basket of apples inside the dominant culture, and thus are not the ‘norm’ of the society. rather they are a group created to help those in power stay in power and thus maintain the current status quo. any group becomes thusly marginalized, and thus rarely gains power or ability to initiate change for their group on the whole.

        so, dealing with and discussing a whole subculture is a different thing entirely than accepting and dealing with individuals at the individual level, and helping them to function within the dominant culture.

        This doesn’t make either perspective wrong, they are just each discussing a different structure of society. Individuals and marginalized groups both exist, but the discussion of each is not related. they are viewing different things. This does not mean he is right or wrong in his beliefs, but it does mean he is viewing the the sub culture not the individuals in it.

  6. i said some things badly above… (second paragraph, above) .ie ‘oranges are entire basket of oranges and are the dominant culture, the norm. the apples that make up a small amount in the basket, the sub culture, is a group with little power and the dominant culture wants to maintain this to preserve the status quo.’ (sociological).

    the following I should have included above for clarity, but instead add it now. (i also apologize for getting up on my soapbox. i think i am now plenty covered in flakes, and should get down for now 🙂 )

    so this discussion of szasz is on the sociological plane, how the sub group can function or become a social construct by labeling theory and then can be used by those in power to maintain power by denying it to sub groups with no power. this perspective, of the maintenance of power, is shown to exist by the same small groups continuing to be marginalized. sociological perspectives deal with power, status quo, and function and purpose of small sub groups/cultures within the larger culture in maintaining the larger cultures place in society.

    the conversation of one who is suffering from a mental illness (psychological/psychiatric) (dx’d or not) is an entirely irrelevant conversation to the sociological. The psychological perspective attempts to see the members of the group labeled as ‘mental illness’ by sociologists as individuals who are not different except that they tend to perceive the shared world differently at different time and situations. thus the psychological perspective attempts to identify the underlying issues (social or med or psychological) and to help individuals adapt more successfully, in an individual/individual setting.

    so, the psychological perspective is focused on AGIL (adaption, goal attainment, integration, and latent pattern maintenance) for the survival of the members of the group labeled as ‘mentally ill’ in the larger society. this also means, the sociological perspective is also focusing on AGIL, The sociologists are trying to keep the groups that have been labeled and are being used by the power elite to be able to blend more into the mainstream–but on the group level.

    1. and oh, i know nothing of CCHR or Scientology (other than I don’t really get it, and think it seems a little strange…but that is just me). also, i have not read much about him, but do remember reading some at some point in college. apparently he did not make a big impact on me 😉

    2. You make some very interesting points. I, too, took my degree in Sociology and Psych., and I have to admit this man had me so dizzy from his circular reasoning that I could not see past my own irritation at what his message was saying. Thank you for a much more thought out response. As opposed to mine 🙂

      1. I’m embarrassed because I’m still not getting kats responses even though they are well thought out and presented. Maybe its because I became so angry when reading his essay.. It will be interesting to read all your comments after tomorrows post.

        1. It is probably because you are in a state of what I call “shock and awe”. It typically occurs when someone says something really brilliant or, more often, really stupid. And, this guy had no right to have called himself an M.D. let alone a psychiatrist. He was clearly confused about the concept.

    3. OK kat, I think I got it. Maurice had to help me a little. Basically you are saying that he is looking at the issue from a sociological point of view, not the individual. An example being “Little girls love ice cream.” From a sociological point of view that statement may be correct. Mary likes chocolate ice cream. On an individual level it is important that Mary prefers chocolate, but on the grand scheme of things, the sociological point of view, that one individual is not important to the overall equation. Do I have it right?

      Even though I believe he may have been talking about the big picture, I still think he is applying it to the individual as well. To me, the mere title of the essay “The Myth of Mental Illness” speaks to the individual, as well as the group.

      1. ya that was the main point. if you look at things sociologically, it is about small groups within the dominant group, being controlled by the power structure to maintain its own survival at the expense of the smaller groups.

        but on the individual psychological level, the needs of the individual are the needs that need to be met, in order to help the individuals gain more social status, power, and therefore, ultimately the entire small group gains power and is not marginalized and is accepted into the dominant group.

        so, he could have been saying that an individual is not mentally ‘ill’…they just have more difficulty than the dominant group of coping, which is to say, they have not adapted well, and therefore is not truly an illness. it does not mean they don’t need help, meds, therapy, etc. those things help the adaptation issues. and during the majority of his writings, it was prior to the knowledge we have today on a variety of mental difficulties, such as we know now that bipolar is related to several genes, that schizophrenia is a kind of malstructured brain, that ptsd is trauma related, but also the person must have a gene(s) that are keyed to lean that way under trauma in the first place. When he wrote most of his books, this knowledge had not yet been discovered, and may be why he seems to be denying mental illness as an illness rather than as a construct to control this group by the power structure. if he had had the knowledge of mental issues that we do today, perhaps he would have felt that some mental problems are organic (naturally occuring) and that some are both environmental and traumatic, etc. it is hard to say when most of his writing is so out of date with what we know today.

        1. It’s hard to say. He was writing articles up until 2010, so he must have at least heard of some of the advancements and he was so adamantly opposed to medication. He was also last interviewed in 2010

  7. Don’t get off that soapbox, you’re doing a great up there. Still a little confused but I think I understand what your saying and see it as well, yet, I still see him targeting the individuals. Hopefully on Monday I’ll be able to make my concerns more clear. I’ll bring up more about the CCHR (Citizens Commission on Human Rights) and his connections with Scientology. I look forward to your comments then.

  8. I have to get out three little letters before I can properly respond to the idiocy that is this man’s train of thought, and they are WTF!!!!!!!! That was my initial reaction to what this man, this psychiatrist is putting forth. Personally, I liked this part:

    “It is to suggest that the phenomena now called mental illness be looked at afresh and more simple, that they be removed from the category of illness, and that they be regarded as the expression of man’s struggle with the problem of how he should live. The last mentioned problem is obviously a vast one, its enormity reflecting not only man’s inability to cope with his environment, but even more increasing self-reflectiveness.”

    How humans should live? Mental and physical health are moral problems? Am I reading this right? I have Bipolar disorder Type I with psychotic features (and its rapid cycling), PTSD, Agoraphobia, and Panic disorder because I am having an ethical dilemma…. And is he saying that we are becoming more self reflective, or less as we are stuck in this oozing miasma called life that we find it hard to manage. I am so confused by this individual’s circular logic that I have become dizzy. I have a degree in Sociology and in Psychology, and everything this man’s has written or said flies in the face of the more conventional idea that sometimes brains get sick just like every other part of the body.

    I would say thank goodness he is gone into the great plasma pool in the sky (not very Buddhist of me), however the fact stands that he has been recorded stating his opinion that mental illness and/or defect does not exist. He has written books and papers and lectures based on the very same premise. His ideas are dangerous to the community of people who do live with mental health issues, because (being as paranoid as I am) i can just see some way out there right winger scratching his head, and saying to himself “If mental illness doesn’t exist then why are we shelling out all this money on research and developing new medications.” And the he scratches his ass and thinks about some more.

    Eventually, these ideas will filter into the minds of our leaders and a whole bunch of them are dumb enough to buy into it. It’s already open season here on the mentally ill. What ever you do, If you visit my city, act as normal as possible or you will be shot. Most likely in the back as you turn to run or walk away from the confrontation.

  9. Wow. Clearly this post got to a lot of people. Great post Brad. What struck me was his statement: My argument was limited to the preposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflictions in human relations.
    In that it is almost as if he has circled back to the witches. What is a witch – the old kind, not our present day witches – but someone who has turned his/her back on all that is good and is now in league with the Devil – in other words the ultimate immoral person. I don’t think he’s gone that far afield from the middle ages.
    What a horrible body of work he has left behind. I shudder to think of the people who’s lives he damaged and may continue to damage.

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