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Thomas Szasz is one of the most well-known critics of the medicalisation of mental illness. He has been an outspoken critic of scientism and has targeted psychiatry as a pseudo-science. In the absence of objectively observable biological pathology, mental illness (such as schizophrenia) should be labelled illness.
Thomas Szasz is one of the most well-known critics of the medicalisation of mental illness. He has been an outspoken critic of scientism and has targeted psychiatry as a pseudo-science. In the absence of objectively observable biological pathology, mental illness (such as schizophrenia) should be labelled illness.
Thomas Szasz is one of the most well-known critics of the medicalisation of mental illness. He has been an outspoken critic of scientism and has targeted psychiatry as a pseudo-science. In the absence of objectively observable biological pathology, mental illness (such as schizophrenia) should be labelled illness.
Second Opinion (2009, 4th edition): Online Case Studies by John Germov & Maria Freij
Thomas Szasz and the Myth of Mental Illness
Thomas Szasz, a psychiatrist and academic, is one of the most well-known critics of the medicalisation of mental illness. In particular, he has been an outspoken critic of scientism and has targeted the profession of psychiatry as a pseudo-science. In his influential The Myth of Mental Illness (1960, 1961), originally published as a journal article and then expanded upon in a book of the same title, he argues that mental illness is a social construct and that what psychiatrists label mental illness is in fact what society has labelled deviant. He argues that, in the absence of objectively observable biological pathology, mental illness (such as schizophrenia) should be labelled illness. For Szasz, mental illness is a social artefact, and has no scientific basis. For example, in some cultures the experience of hallucinations is highly valued, while in Western societies it symbolises a mental disorder (Dammann 1997). Many behaviours that have previously been regarded as deviant no longer arefor example, homosexuality, hysteria, and nymphomania (in the past, sexually active non-married women could be considered nymphomaniacs and forced to undergo sterilisation for their own good) (Szasz 2003). Szasz highlights psychiatrys sordid past as a supporter of lobotomy as a treatment for schizophrenia and draws parallels between the persecution of minority groups and the treatment of mentally deviant people. Szasz argues that schizophrenia is not, in fact, a disease, because it cannot be identified through an autopsy and cannot be pathologically defined or measured. His point is that psychiatry has invented illness, as there is a lack of evidence of biological disease. To this day, the vast majority of mental illnesses contained in the Diagnostic and Statistical Manual of Mental Disorders have no known pathological diseaseas Szasz notes, weve been waiting a long time for the underlying diseases to be discovered. (In fact, the irony is that if biological diseases were found for mental illnesses, such conditions would cease to be mental illnesses and would instead be brain diseases and would become the province of other medical specialities such as neurology: Dammann 1997.) Szasz contends that psychiatry is not a real science and not a genuine branch of medicine. In a secular society, he argues, psychiatrists help humankind deal with lifes big questions. Essentially, psychiatry, under the guise of being a science, acts as an agent of social control. Szasz opposes use of the insanity defence in legal proceedings and the involuntary treatment and hospitalisation of patients labelled as mentally ill. Szaszs controversial arguments have prompted a large volume of criticism (see Dammann 1997 for a good summary of the major criticisms made of Szaszs myth-of-mental-illness thesis). Most notable, Szasz has been criticised for relying on Cartesian dualism, whereby diseases are either physical or psychological, but not both. In the context of holistic approaches to health and illness, and growing acknowledgment of the social determinants of health, his reliance on positivist and causal relationships appears problematic. Moreover, few people deny that many people diagnosed with mental illnesses are actually suffering. In response, Szasz does not dispute the existence of mental suffering; rather, he denies that it is a disease and that psychiatry is best placed to treat it. Szasz responds to arguments that he is anti-psychiatrist by maintaining that he is not opposed to the practice of psychiatry if it involves consenting adults, is non-coercive, and has no state involvement.
Sociological reflection Where do you stand in the mental-illness-is-a-myth debate?
References Dammann, E. J. 1997, The Myth of Mental Illness: Continuing Controversies and their Implications for Mental Health Professionals, Clinical Psychology Review, vol. 17, no. 7, pp. 73356
Szasz, T. S. 2003, The Myth of Mental Illness, transcript of lecture held at UCE Birmingham on 7 December 2003 http://www.hcc.uce.ac.uk/ccmh/thomas_szasz_transcript.pdf
Szasz, T. S. 1971, The Manufacture of Madness, Routledge & Kegan Paul, London.
Szasz, T. S. 1961, The Myth of Mental Illness, Holber-Harper, New York.
Szasz, T. S. 1960, The Myth of Mental Illness, American Psychologist, vol. 15, pp. 11318 http://psychclassics.yorku.ca/Szasz/myth.htm
Thomas S. Szasz M.D. Cybercenter for Liberty and Responsibility http://www.szasz.com/index.html