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It is customary to define psychiatry as a medical specialty concerned with the study, diagnosis and treatment of mental illnesses. This is a worthless and misleading definition. Mental illness is a myth. Psychiatrists are not concerned with mental illnesses and their treatments. In actual practice they deal with personal, social and ethical problems in living.
I have argued that, today, the notion of a person "having a mental illness" is scientifically crippling. It provides professional assent to a popular rationalization — namely that problems in living experienced and expressed in terms of so-called psychiatric symptoms are basically similar to bodily diseases.
Moreover, the concept of mental illness also undermines the principle of personal responsibility, the ground on which all free political institutions rest.
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Conclusions

 

Thomas Szasz

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I became interested in writing this book approximately ten years ago when, having become established as a psychiatrist, I became increasingly impressed by the vague, capricious and generally unsatisfactory character of the widely used concept of mental illness and its corollaries, diagnosis, prognosis and treatment.
Although (mental illness) might have been a useful concept in the nineteenth century, today it is scientifically worthless and socially harmful.
In non-psychiatric circles mental illness all too often is considered to be whatever psychiatrists say it is. The answer to the question, Who is mentally ill? thus becomes: Those who are confined in mental hospitals or who consult psychiatrists in their private offices.

 

Thomas Szasz

 

Because psychoanalysis emerged as a medical specialty concerned with the healing of the sick, it focused its attention on the pathological processes arising from the disruption of the adaptive capacities, and this subject matter was taken to be the totality of significant information concerning the structure of the personality. The diagnosis and treatment of mental illness is, however, a poor basis for the empiricism which a basic science requires. Mental illness, when it is seen in terms of the symptoms and syndromes which come to the attention of the psychotherapist, presents a picture of the personality which is readily fragmented and distorted out of proportion.

 

Paul Rosenfels

 

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.

 

Thomas Szasz

 

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.

 

Thomas Szasz

 

I started to work on this book in 1954, when, having been called to active duty in the Navy, I was relieved of the burdens of a full-time psychoanalytic practice... Within a year of its publication, the Commissioner of the New York State Department of Mental Hygiene demanded, in a letter citing specifically 'The Myth Of Mental Illness', that I be dismissed from my university position because I did not "believe" in mental illness.

 

Thomas Szasz