Thomas Szasz and the Myth of Mental Illness
Persons said to have mental diseases…have reasons for their actions that must be understood; they cannot be treated or cured by drugs or other medical interventions, but may be helped to help themselves overcome
the obstacles they face. Thomas Szasz, The Myth of Mental Illness
In 1961 Thomas Szasz published a book entitled The Myth of Mental Illness. In this book, he basically argued that the psychiatric diagnosis of “mental illness” was a self-serving act of ego-aggrandizement and obedience to the System. He said it quite bluntly when he said that “it is a lie, an error…a naive revival of the somatic error.” It is “political and professional self-interest united in turning a false belief into a lying fact” (Szasz 2010).
Specifically, he said psychiatry is a System process that, much like the French guillotine, makes it easier for the condemned to die and easier for the executioner to carry out the deed. It makes it easier for “socially downtrodden — to be ill and die.” He says that the psychiatric and psychological diagnoses of something as a “mental illness” is a way to obscure the pain, suffering, and disjuncture that lies behind it. It is a way to obscure the “moral and political” (and dare we say economic and trauma-based) nature of “mental illness.” I would simply say it is a way to obscure the psychological and neurological damage done by The System. It is a way to press those who are damaged by the System into ignorance and self-deprecating silence so they can die quietly, without causing bothersome problems. As he says, psychiatry is “an arm of the coercive apparatus of the state. And this is why today all of medicine threatens to become transformed from personal therapy into political tyranny.”
In his book, Szasz used Shakespeare’s Macbeth to underline this point, suggesting that Lady Macbeth’s “mental illness” is the result of guilt and shame caused by the disjuncture of her own murderous acts, and not some medical disease that can be cured, as her husband hopes it would be.
Was he right?
Was the categorization of behavioural and emotional disturbances as mental illness a politically and egoistically motivated categorization designed to heighten the status of the profession and obscure trauma caused by the System. You can decide for yourself if you choose to pick up the book, but he makes a pretty strong case.
What about his notion that mental illness does not exist? He based this argument on the idea that a lot of what is typically described as a mental illness is not really an illness in the biological sense. That is, mental illness is not the body’s reaction to a disease1 of the body, specified or not, but a reaction to “problems of living,” as he put it.
He was only partly right about that. In some cases, there is no underlying pathology that one can point to. For example, a child that develops an attachment or anxiety disorder because his parents are never around cannot be said to have a disease or an illness. Rather, the child is experiencing an adaptive biological response to the actual (or potential) neglect of one if its Seven Essential Needs. I say adaptive here because the anxiety, whining, and clinging characteristic of a child struggling with attachment are not pathological but adaptive. They are the child’s active attempt to cajole the parents into staying. Suggesting that they are pathological in any way is the cardinal, formative, sin of psychiatry.
On the other hand, and this is important, nowadays we know that one’s environmental experiences (at home, at school, at work) impact the neurological constitution of the body’s brain and central nervous system. To put it simply, bad environments cause the brain to change, just like good environments do. Environments lead brain neurology, meaning they cause the brain to rewire. Bad environments can even cause brain damage if the trauma one experiences is sufficiently severe and chronic (see my working paper entitled Toxic Socialization).
At the point where chronic assault or neglect begins to change the wiring of the brain, we might be justified in saying that the child’s anxiety “disorder” is a mental illness. I say “might” here because it would be more appropriate, and less judgmental, subjective, and self-serving, to say the psychiatric “disorder” is a functional or dysfunctional adaptation to chronic psychic or physical assault, and chronic neglect of our essential needs. A functional adaptation would be one that leads, in the case of the anxious child, to the parent’s staying home more. A dysfunctional adaptation would be one that encourages the parents to separate from there needy child even more.
It has been almost sixty years since Thomas Szasz wrote his book condemning the psychiatric and psychological establishments for their self-serving misconceptualization of human psychic trauma. So, a reasonable question to close this off with is, “has anything changed?” Not for a long time, sadly; however recently, things have begun to change. When a client comes to see a psychiatrist or psychologist, these professionals used to ask the question “what’s wrong with you?” Now, however, they are beginning to ask the question “what happened to you?” (Richards, Tadzio 2019)
It’s a slow start, but the reconceptualization is beginning to pick up steam, and given the damage that has been done to so many people by erroneous psychiatric diagnosis, this is happening none to soon. When this reconceptualization finally inches its way to the accelerating curve of the exponential distribution of social change, it is going to revolutionize psychology and psychiatry so much that, word to the wise, those who continue to rely on outdated conceptualizations will come to be seen as liabilities to the discipline.
Articles in this series
- How environment creates the alpha male
- Healthy environment = healthy human
- The Seven Essential Needs — basic statement
- The Seven Essential Needs — advanced view
- The Seven Toxic Needs
References
DocDoc. n.d. “What is Illness: Symptoms, Causes, Diagnosis, and Treatment — Learn about medical topics on DocDoc.” DocDoc. Retrieved October 29, 2019 (https://www.docdoc.com/info/condition/illness/).
Richards, Tadzio. 2019. “Trauma Repair: How Brain Science Is Changing Social Service Delivery — The CUPS Example.” Alberta Views, October, VOLUME 22 NUMBER 8.
Szasz, Thomas. 2010. The Myth of Mental Illness. Harper Perennial.
Endnotes
1 A disease is a “affliction of a specific organ or the entire body due to a harmful microorganism such as bacteria or virus, injury, chemical imbalances in the body, exposure to toxins, and production of immature cells. Examples of diseases are cancer, fractures, diabetes, cirrhosis, and psoriasis, among others.” Note, these definitions are taken from (DocDoc n.d.)
Mike Sosteric is a sociologist and author of Rocket Scientists’ Guide to Money and the Economy and Rocket Scientists’ Guide to Authentic Spirituality. Find him on twitter @MikeSosteric and, for the more academic stuff, at academia.edu
