UIUC PSYC 238 - Szasz (1961) - The Myth of Mental Illness (6 pages)

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Szasz (1961) - The Myth of Mental Illness



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THE MYTH OF MENTAL ILLNESS THOMAS S SZASZ State University of New York Upstate Medical Center Syracuse M Y aim in this essay is to raise the question Is there such a thing as mental illness and to argue that there is not Since the notion of mental illness is extremely widely used nowadays inquiry into the ways in which this term is employed would seem to be especially indicated Mental illness of course is not literally a thing or physical object and hence it can exist only in the same sort of way in which other theoretical concepts exist Yet familiar theories are in the habit of posing sooner or later at least to those who come to believe in them as objective truths or facts During certain historical periods explanatory conceptions such as deities witches and microorganisms appeared not only as theories but as self evident causes of a vast number of events I submit that today mental illness is widely regarded in a somewhat similar fashion that is as the cause of innumerable diverse happenings As an antidote to the complacent use of the notion of mental illness whether as a self evident phenomenon theory or cause let us ask this question What is meant when it is asserted that someone is mentally ill In what follows I shall describe briefly the main uses to which the concept of mental illness has been put I shall argue that this notion has outlived whatever usefulness it might have had and that it now functions merely as a convenient myth MENTAL ILLNESS AS A SIGN OF BRAIN DISEASE The notion of mental illness derives it main support from such phenomena as syphilis of the brain or delirious conditions intoxications for instance in which persons are known to manifest various peculiarities or disorders of thinking and behavior Correctly speaking however these are diseases of the brain not of the mind According to one school of thought all so called mental illness is of this type The assumption is made that some neurological defect perhaps a very subtle one will ultimately be found for all the disorders of thinking and behavior Many contemporary psychia trists physicians and other scientists hold this view This position implies that people cannot have troubles expressed in what are now called mental illnesses because of differences in personal needs opinions social aspirations values and so on All problems in living are attributed to physicochemical processes which in due time will be discovered by medical research Mental illnesses are thus regarded as basically no different than all other diseases that is of the body The only difference in this view between mental and bodily diseases is that the former affecting the brain manifest themselves by means of mental symptoms whereas the latter affecting other organ systems for example the skin liver etc manifest themselves by means of symptoms referable to those parts of the body This view rests on and expresses what are in my opinion two fundamental errors In the first place what central nervous system symptoms would correspond to a skin eruption or a fracture It would not be some emotion or complex bit of behavior Rather it would be blindness or a paralysis of some part of the body The crux of the matter is that a disease of the brain analogous to a disease of the skin or bone is a neurological defect and not a problem in living For example a deject in a person s visual field may be satisfactorily explained by correlating it with certain definite lesions in the nervous system On the other hand a person s belie whether this be a belief in Christianity in Communism or in the idea that his internal organs are rotting and that his body is in fact already dead cannot be explained by a defect or disease of the nervous system Explanations of this sort of occurrence assuming that one is interested in the belief itself and does not regard it simply as a symptom or expression of something else that is more interesting must be sought along different lines The second error in regarding complex psychosocial behavior consisting of communications about ourselves and the world about us as mere symptoms 113 114 THE AMERICAN PSYCHOLOGIST of neurological functioning is epistemological In other words it is an error pertaining not to any mistakes in observation or reasoning as such but rather to the way in which we organize and express our knowledge In the present case the error lies in making a symmetrical dualism between mental and physical or bodily symptoms a dualism which is merely a habit of speech and to which no known observations can be found to correspond Let us see if this is so In medical practice when we speak of physical disturbances we mean either signs for example a fever or symptoms for example pain We speak of mental symptoms on the other hand when we refer to a patient s communications about himself others and the world about him He might state that he is Napoleon or that he is being persecuted by the Communists These would be considered mental symptoms only if the observer believed that the patient was not Napoleon or that he was not being perseucted by the Communists This makes it apparent that the statement that X is a mental symptom involves rendering a judgment The judgment entails moreover a covert comparison or matching of the patient s ideas concepts or beliefs with those of the observer and the society in which they live The notion of mental symptom is therefore inextricably tied to the social including ethical context in which it is made in much the same way as the notion of bodily symptom is tied to an anatomical and genetic context Szasz 19S7a 1957b To sum up what has been said thus far I have tried to show that for those who regard mental symptoms as signs of brain disease the concept of mental illness is unnecessary and misleading For what they mean is that people so labeled suffer from diseases of the brain and if that is what they mean it would seem better for the sake of clarity to say that and not something else MENTAL ILLNESS AS A NAME FOR PROBLEMS IN LIVING The term mental illness is widely used to describe something which is very different than a disease of the brain Many people today take it for granted that living is an arduous process Its hardship for modern man moreover derives not so much from a struggle for biological survival as from the stresses and strains inherent in the social intercourse of complex human personalities In this context the notion of mental illness is used to identify or describe some feature


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