Few other issues show a convergence of Right and Left so far-reaching, while still allowing both sides to adhere to their politics and maintain a sense of total opposition. A hero is born for one side at the same moment that the axe of justice falls for the other, and so it seems that everybody wins.
But it might also be that something has been lost. Cosseted by such a firm consensus, could we even recognise true dissent if we saw it? Correction, 14 May the original version of this article stated that Szasz was a Republican. The more accurate designation is Right-wing libertarian. They are spreading like branching plants across the globe. Should we rein cities in or embrace their biomorphic potential?
Josh Berson. Thinkers and theories. Some see Plato as a pure rationalist, others as a fantastical mythmaker. His deft use of stories tells a more complex tale.
Tae-Yeoun Keum. Stories and literature. Alison Garden. All the stories we have are flawed. Animals and humans. If humans were to disappear from the face of the Earth, what might dogs become? And would they be better off without us? Jessica Pierce. Human evolution. It might be the core of what human brains evolved to do.
Philip Ball. Mad, or bad? In the past, such basic false truths were religious in nature. In the modern world, they are medical and political in nature. In the same autobiographical sketch from , published as part of the collection Szasz Under Fire: The Psychiatric Abolitionist Faces his Critics , edited by Jeffrey Schaler, he recalls: The analysts passionately believed that they were treating real diseases, never voiced objections against psychiatric coercions, and believed that criminals were mentally ill and ought to be treated, not punished.
These beliefs were an integral part of their self-perception as members of an avant-garde of scientific, liberal intellectuals. Dr Thomas Szasz pictured at his 90th birthday seminar in London. His role is to protect the state from the troublesome citizen. All means necessary to achieve this are justified by the loftiness of this aim. The situation in Germany under Hitler offers us a picture — horrible or idyllic depending on our values — of the ensuing political tyranny concealed behind an imagery of illness, and justified by a rhetoric of therapy.
Naturally, he used the insanity label to make the case: Fanon reminds us that not so very long ago, a congress of psychiatrists was distressed by the criminal propensities of the native population. We should take care that in it does not become the name of a nervous disease. He attacked its foundations and practices and questioned its medical legitimacy. By asserting this, Szasz is not denying the existence of the conditions that psychiatrists call mental illness, or the suffering and distress experienced by people with these conditions.
Rather, he is denying the classification of these conditions as medical diseases. It follows from this particular definition that the only sort of disease that can exist is physical. By definition, a disease of the mind is impossible. Disease requires a physical lesion; the mind is nonphysical. Ergo, the mind cannot be diseased. This is a logical deduction; the conclusion follows from the premises.
If the conditions we call mental illnesses are not diseases, then what are they? Szasz argues that they are in fact problems in living, human conflicts, and unwanted behaviors. In actual practice they deal with personal, social, and ethical problems in living. He argues that the concept of mental illness undermines the principle of personal responsibility, which is the ground on which all free political institutions rest.
In this lifelong critique of mental illness as a myth, Szasz simultaneously maintained an interesting counterfactual conditional. In logic, a counterfactual conditional is an if-then statement indicating what would be the case if something were true, although it is not true. While insisting that mental illnesses are in reality problems of living and not diseases, he also argued that if the conditions we call mental disorders are found to have an underlying neuropathology, then it would prove that mental disorders are actually brain disorders, and the whole notion of mental illness was erroneous and superfluous to begin with.
Szasz did not believe that mental disorders are brain disorders. He alleged until the end of his life that an underlying pathology for psychiatric disorders had not yet been demonstrated, but he was willing to entertain it as a hypothetical possibility.
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 psychiatrists, physicians, and other scientists hold this view. 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.
In due time, with refinements in medical technology, psychiatrists will be able to show that all mental illnesses are bodily diseases. It verifies it. The physician who concludes that a person diagnosed with a mental illness suffers from a brain disease discovers that the person was misdiagnosed: he did not have a mental illness, he had an undiagnosed bodily illness. The result of such discoveries is that the illness ceases to be a form of psychopathology and is classified and treated as a form of neuropathology.
If all the conditions now called mental illnesses proved to be brain diseases, there would be no need for the notion of mental illness and the term would become devoid of meaning. One can clearly see some assumptions at work here. For Szasz the notions of mental illness and brain disease are mutually exclusive. A condition can be either a mental illness or a brain disease-it cannot be both; it can have either a psychopathology or a neuropathology-it cannot have both.
This exclusivity springs from the fact that for Szasz mental illness is nondisease disease in only a metaphorical sense and psychopathology is nonpathology pathology in only a metaphorical sense. It is a matter of logic that a condition cannot be nondisease and disease or nonpathology and pathology at the same time. Szasz treats the concept of mental illness very literally as being purely a disease of the mind and thereby an impossibility.
This notion harks back to an old and outdated view that was generated from a psychoanalytical outlook of mental illness, which was the dominant psychiatry paradigm in the s, when Szasz came up with his critique.
For the most part, disease is understood largely in terms of suffering and functional impairment, which may or may not be associated with a structural lesion. Szasz TS. Creswell M. J Theory Soc Behav ; 38 : 23— Reply to Slovenko. Schaler JA. Open Court, Kendell RE. The myth of mental illness. Shorter E. Still tilting at windmills: Commentary on … the myth of mental illness. Psychiatr Bull ; 35 : —4.
Routledge, Siebert A. Brain disease hypothesis for schizophrenia disconfirmed by all evidence. Ethical Human Sci Serv ; 1 : — The Medicalization of Everyday Life.
Syracuse University Press, Francis A. Harper Collins, Healy D. California University Press, Horowitz AV. Creating mental illness. University of Chicago Press, Oxford University Press, Whitaker R.
Broadway Books, The Therapeutic State. Prometheus Books, Antipsychiatry: Quackery Squared. Benning TB. Western and indigenous conceptualizations of self, depression, and its healing. Int J Psychosoc Rehabil ; 17 : — Okello ES, Musisi S. Depression as a clan illness eByekika : an indigenous model of psychotic depression among the Baganda of Uganda. World Cult Psychiatry Res Rev ; 1 : 60— Fabrega H.
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