Scan barcode
A review by mburnamfink
The Myth of Mental Illness: Foundations of a Theory of Personal Conduct by Thomas Szasz
3.0
Szasz makes a frontal assault on the power of psychiatry, arguing that mental illness is a myth and that the power accorded to psychiatrists to decide if people are legally responsible for their actions, have them committed to hospitals, and prescribe various psychotropic medications is fundamentally misfounded. The basic premise of his argument is that only organs can be sick, and the mind is not an organ. Rather, what we see as mental illness are the results of rule-breaking behavior by "mentally ill" people, an attempt to game their social interactions to receive the socially beneficial role of a "sick person" as accorded by Judeo-Christian morality and modern standards of care.
While there is some benefit to challenging the hegemony of mental illness (a recent paper says "Almost half of college-aged individuals had a psychiatric disorder in the past year."), Szasz's argument fails on two major grounds.
The first is modern understanding that cognitive events are linked to neurological events, or in other words, that mental illness are in some way brain disorders. We can draw a spectrum from something totally neurological--Parkinson's disease, to something totally psychological--Borderline Personality Disorder, say, and put things like schizophrenia, depression, bipolar, and their related pharmacological treatments and neurological origins somewhere between them. It's unfair to hold a book published in the late 1960s to modern beliefs, but again, Szasz doesn't have much to say about this.
The second problem is more damning: even if we accept Szasz's belief that the mentally ill are just playing the game of life by different rules, what is to be done with them? As any good historian of mental illness knows, the lines between insane, criminal, and sinful are far from clear. Psychiatry is the modern way of dealing with malcontents, of offering a source of power and authority that people can draw on to change their lives and social behaviors. Szasz might be right in his argument that psychiatry probably isn't medicine, and it certainly isn't science, but he doesn't engage with the notion that psychiatry is something, and that it performs a socially necessary role. Rather than assailing psychiatry as an evil system of fraud that makes people crazy, we must ask how unhappy people can be helped, how their complex problems can be untangled, and what resources are necessary for that to happen.
While there is some benefit to challenging the hegemony of mental illness (a recent paper says "Almost half of college-aged individuals had a psychiatric disorder in the past year."), Szasz's argument fails on two major grounds.
The first is modern understanding that cognitive events are linked to neurological events, or in other words, that mental illness are in some way brain disorders. We can draw a spectrum from something totally neurological--Parkinson's disease, to something totally psychological--Borderline Personality Disorder, say, and put things like schizophrenia, depression, bipolar, and their related pharmacological treatments and neurological origins somewhere between them. It's unfair to hold a book published in the late 1960s to modern beliefs, but again, Szasz doesn't have much to say about this.
The second problem is more damning: even if we accept Szasz's belief that the mentally ill are just playing the game of life by different rules, what is to be done with them? As any good historian of mental illness knows, the lines between insane, criminal, and sinful are far from clear. Psychiatry is the modern way of dealing with malcontents, of offering a source of power and authority that people can draw on to change their lives and social behaviors. Szasz might be right in his argument that psychiatry probably isn't medicine, and it certainly isn't science, but he doesn't engage with the notion that psychiatry is something, and that it performs a socially necessary role. Rather than assailing psychiatry as an evil system of fraud that makes people crazy, we must ask how unhappy people can be helped, how their complex problems can be untangled, and what resources are necessary for that to happen.