Thomas Szasz (1920-2012) was a Hungarian psychiatrist and author of many books, including his best known work, The Myth of Mental Illness (1961).
Almost a decade before collaborating with The Church of Scientology, Szasz argued that the science behind psychiatry is essentially scientism. For Szasz, the term mental illness points to a social myth rather than an absolute fact. To borrow from the lingo of postmodernism, he believes that the idea of mental illness is a historically relative discourse, located in networks of power/knowledge.¹
Written before Henri Ellenberger’s landmark publication, The Discovery of the Unconscious (1970), and around the same time as Michel Foucault‘s poststructural work, Histoire de la folie à l’âge classique (1961), Szasz’s The Myth of Mental Illness is often required reading for undergraduate courses in the Humanities at liberal-democratic universities.
Critics of Szasz’s perspective question his knowledge of genetics and neuroscience. And they point out that psychiatry, like any other science, is in a constant state of development. Depending on factors like the patient’s condition, the competency of the psychiatrist and the socio-political climate in which assessments are made, psychiatry may be used for good or ill. So it makes little sense to demonize it as a whole.
However, Szasz was prolific right up to his death. His later publications contain some sociological and philosophical insights but arguably reveal the unrealistically polarized views of a somewhat isolated but well-meaning humanitarian (e.g Schizophrenia: The Sacred Symbol of Psychiatry, 1988; Psychiatry: The Science of Lies, 2008).
Again, most recognized psychiatric associations have rejected his ideas, a situation not entirely unlike an orthodox Church marginalizing so-called heresies. This polarization of anti-psychiatry vs. psychiatry is unfortunate because it probably makes all involved parties more intransigent, lessening their ability to see other perspectives.
When someone or a tight group is convinced they’re absolutely right and outsiders are entirely wrong, constructive dialogue usually disappears. And when dialog disappears among the whole spectrum of human inquiry, not only psychiatry suffers, but also its clients.
Taking a more moderate approach than Szasz, I would agree that psychiatry may fall short in the interpretation of behavioral and physiological differences. At some point, difference is often construed as a disorder, and the “appropriate” diagnostic labels are applied to patients.² Many patients believe in this perspective and see themselves as medically “ill.”
However, in some cases we may be witnessing variation instead of disorder. And in some instances differences could be preliminary trials, as it were, for key evolutionary changes to our species.³
Unfortunately, the evolutionary idea is hard to prove because we might have to wait a thousand years before finding out if there’s anything to it. But if true or even partially true, I think this expanded perspective could dramatically change how some psychiatric patients see themselves, possibly making them happier.
So to return to Szasz, I don’t see him as totally wrong. He has been roundly critiqued on a point-by-point basis by psychiatrists. But his overall objection deserves some attention. Otherwise, psychiatry becomes a new religion, which isn’t science at all, but as Szasz and many others put it, scientism.
² To continue in a postmodern vein, the word “appropriate” is often uncritically used to reinforce current attitudes, beliefs and practices.
³ Along these lines, spiritual and parapsychological factors are often dismissed. We rarely hear about the possibilities of healing grace, demonic influence, the transfer of sin or bona fide mind-reading in psychiatry.