Thomas Szasz

As the dominant social ethic changed from a religious to a secular one, the problem of heresy disappeared, and the problem of madness arose and became of great social significance. In the next chapter I shall examine the creation of social deviants, and shall show that as formerly priests had manufactured heretics, so physicians, as the new guardians of social conduct and morality, began to manufacture madmen.

The disease concept of homosexuality—as with the disease concept of all so-called mental illnesses, such as alcoholism, drug addiction, or suicide—conceals the fact that homosexuals are a group of medically stigmatized and socially persecuted individuals. ... Their anguished cries of protest are drowned out by the rhetoric of therapy—just as the rhetoric of salvation drowned out the [cries] of heretics.

Our adversaries are not demons, witches, fate, or mental illness. We have no enemy whom we can fight, exorcise, or dispel by "cure." What we do have are problems in living — whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. The field to which modern psychiatry addresses itself is vast, and I made no effort to encompass it all. My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.

If you talk to God, you are praying; If God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; If you talk to the dead, you are a schizophrenic.

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.

People often say that this or that person has not yet found himself. But the self is not something one finds; it is something one creates.

We speak of a person being “under the influence” of alcohol, or heroin, or amphetamine, and believe that these substances affect him so profoundly as to render him utterly helpless in their grip. We thus consider it scientifically justified to take the most stringent precautions against these things and often prohibit their nonmedical, or even their medical, use. But a person may be under the influence not only of material substances but also of spiritual ideas and sentiments, such as patriotism, Catholicism, or Communism. But we are not afraid of these influences, and believe that each person is, or ought to be, capable of fending for himself.

This connection, at once semantic and conceptual, between unorthodoxy and sodomy, was firmly established during the late Middle Ages, and has never been severed. It is as strong today as it was six hundred years ago. To be stigmatized as a heretic or bugger in the fourteenth century was to cast out of society. Since the dominant ideology was theological, religious deviance was considered so grave an offense as to render the individual a nonperson. Whatever redeeming qualities he might have had counted for naught. The sin of heresy eclipsed all contradictory, personal characteristics, just as the teachings of God and the Church eclipsed all contradictory empirical observations. The disease called “mental illness”—and its subspecies “homosexuality”—plays the same role today.

The Nazis spoke of having a Jewish problem. We now speak of having a drug-abuse problem. Actually, “Jewish problem” was the name the Germans gave to their persecution of the Jews; “drug-abuse problem” is the name we give to the persecution of people who use certain drugs.

There is a fundamental similarity between the persecution of individuals who engage in consenting homosexual activity in private, or who ingest, inject, or smoke various substances that alter their feelings and thoughts—and the traditional persecution of men for their religion. ... What all of these persecutions have in common is that the victims are harassed by the majority not because they engage in overtly aggressive or destructive acts, ... but because their conduct or appearance offends a group intolerant to and threatened by human differences.

The crime [homosexuality] was subject to punishment by both secular and ecclesiastical courts—just as now it is subject to punishment by both penal and psychiatric sanctions.

In the animal kingdom, the rule is, eat or be eaten; in the human kingdom, define or be defined.

As the base rhetorician uses language to increase his own power, to produce converts to his own cause, and to create loyal followers of his own person—so the noble rhetorician uses language to wean men away from their inclination to depend on authority, to encourage them to think and speak clearly, and to teach them to be their own masters.