The physician’s erroneous diagnosis is not proof that the term “mental illness” refers to a class of brain diseases. 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. In due time, with refinements in medical technology, psychiatrists will be able to show that all mental illnesses are bodily diseases.” This contingency does not falsify my contention that mental illness is a metaphor. When a person hears me say that there is no such thing as mental illness, he is likely to reply: “But I know so-and-so who was diagnosed as mentally ill and turned out to have a brain tumour. 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. 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. Many contemporary psychiatrists, physicians, and other scientists hold this view. 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. In his 1960 article “The Myth of Mental Illness,” Szasz wrote 4: 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. Szasz did not believe that mental disorders are brain disorders. 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. 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. In this lifelong critique of mental illness as a myth, Szasz simultaneously maintained an interesting counterfactual conditional.
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 actual practice they deal with personal, social, and ethical problems in living.” 3 (Szasz’s critique of psychiatry extends to a moral and political dimension as well. “Psychiatrists are not concerned with mental illnesses and their treatments.
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. Minds can be ‘sick’ only in the sense that jokes are ‘sick’ or economies are ‘sick.’” 2 Psychiatric diagnoses only mimic medical diagnoses. This is what Szasz means when he says that this claim is “an analytic truth, not subject to empirical falsification.” 1 Because mental disorders are not diseases in the literal, physical sense, they can only be diseases in a metaphorical sense. This is a logical deduction the conclusion follows from the premises. Disease requires a physical lesion the mind is nonphysical. It follows from this particular definition that the only sort of disease that can exist is physical.īy definition, a disease of the mind is impossible. For Szasz, diseases are demonstrable anatomical or physiological lesions, and he frequently refers to Virchow’s notion of cellular pathology as the basis of disease.
Rather, he is denying the classification of these conditions as medical diseases. 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. Szasz’s basic contention is that mental illness is a myth. A significant body of discourse on the notion of mental disorder by psychiatrists and non-psychiatrists alike has been centered on understanding and responding to his critique. Although most psychiatrists remain unconvinced of his arguments, Szasz has been very influential by virtue of being psychiatry’s arch-adversary. He attacked its foundations and practices and questioned its medical legitimacy.
Despite being a psychiatrist himself, Thomas Szasz was a lifelong ferocious critic of the institution of psychiatry.