Thomas Szasz’s The Myth of Mental Illness (1961) is perhaps the most famous critique of psychiatry. Many people, through either their lived experience of being labeled as mentally ill and/or through their critical thinking, agree with Szasz—concurring that it is not only logically false but also damaging to medicalize our emotional difficulties, disruptive behaviors, and problems in living.
Myths include unfounded beliefs and fictional narratives used to explain frightening natural phenomena. Those of us who agree with Szasz that “mental illness” is a myth will often put quotes around the term to bring attention to its problematic nature. Should we also be bringing attention to the problematic nature of the term “mental health”?
Before discussing psychiatry’s myth of mental health, it is important to understand exactly what Szasz actually meant by the myth of mental illness.
The Myth of Mental Illness
Establishment psychiatry and its mainstream media apologists—owing to both ignorance and malevolence—routinely mischaracterize the essence of what Szasz meant by the myth of mental illness.
Szasz was in no way questioning the reality that human beings can have painfully debilitating emotional difficulties, seriously disruptive behaviors, and what he called “problems in living” which can be quite catastrophic. While establishment psychiatry and its apologists have attempted to portray Szasz as either in denial of this suffering or lacking compassion for it, this is completely untrue.
Instead, Szasz argued that it is a logical error to label debilitating emotional difficulties, seriously disruptive behaviors, and overwhelming problems in living as medical conditions. While the myth of mental illness meets the psychological needs of some individuals and the political needs of many societal authorities, Szasz argued that it is a damaging metaphor that disempowers people and legitimizes onerous coercions and social controls.
What intellectually separates Szasz from most psychiatrists, past and present, is his knowledge of history, politics, analytic philosophy, and logic. He was very concerned with how language is used to control others. One of Szasz’s most famous quotes is: “In the animal kingdom, the rule is, eat or be eaten; in the human kingdom, define or be defined” (The Second Sin, 1973). Szasz cared about what George Orwell cared about, which is how language can be used by authorities to oppress and tyrannize.
In 1960, a year prior to the publication of his controversial book, Szasz published an article in the American Psychologist called “The Myth of Mental Illness,” in which he makes his position clear. He begins by stating: “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.” The myth of mental illness, he tells us, is this: “All problems in living are attributed to physicochemical processes which in due time will be discovered by medical research.”
Critics of Szasz have routinely based their discrediting of him on their unsubstantiated declaration that science has now proved Szasz wrong, claiming that psychiatry has now found biological correlates for what they have labeled as mental illnesses. However, not only does research contradict this claim, any psychiatric patient knows that their diagnoses were not based on any brain scan, blood test, or any biological markers because, outside of mainstream psychiatry’s imaginative hypotheses, there are none that scientific research has replicated and validated.
When each of psychiatry’s biological theories gets debunked and eventually discarded by establishment psychiatry—as was recently the case with the serotonin imbalance theory of depression—establishment psychiatry proposes another biological theory. And so for psychiatry critics, it is a perpetual game of whack-a-mole.
Even though establishment psychiatry is repeatedly proven wrong on each of their biomarker theories, they are clever to continue promoting their general biological theories, which compel critics to engage in debunking them. Establishment psychiatry cares little about losing every battle as long as they win the war of focusing on an issue that distracts society from the more important one: Even if a biological marker is found for a human variation that creates tension for society, this is not evidence that such a variation is a mental illness.
Specifically, if enslaved African Americans who attempted to flee slavery—infamously diagnosed by physician Samuel Cartwright as having the mental disorder of drapetomania—had been found to have a biological marker that differentiated them from those who did not attempt to flee, would such a hypothetical biological marker have proven that fleeing slavery was a mental illness? When psychiatry, not all that long ago, was declaring homosexuality to be a mental illness, even if biological differences between homosexuals and heterosexuals had been found, would that have been proof that homosexuality was a mental illness? And today, while no biological markers have ever been found for people who have heard voices, would such a finding justify a declaration that voice hearers are mentally ill? Put another way, there obviously are biological differences between males and females, but does that fact lead to a conclusion that one of these genders is mentally ill?
The Myth of Mental Health
Szasz pointed out that living has always been an arduous process, but today the hardship for many people in affluent societies is not so much the struggle for biological survival but navigating the “stresses and strains inherent in the social intercourse of complex human personalities.” The idea of “mental illness,” Szasz tells us, obscures the reality that life is a continuous struggle for a “place in the sun,” “peace of mind,” or some other human value. Szasz concluded: “Sustained adherence to the myth of mental illness allows people to avoid facing this problem, believing that mental health, conceived as the absence of mental illness, automatically insures the making of right and safe choices in one’s conduct of life.”
How is “mental health” defined by establishment psychiatry and psychology? In large measure it is defined by adjustment, adapting, coping, and complying with the demands being placed on us, and doing so without burdensome unpleasant emotional states and disruptive behaviors.
The American Psychological Association defines mental health as “a state of mind characterized by emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life.” The American Psychiatric Association defines mental health as “effective functioning in daily activities resulting in productive activities (such as in work, school or caregiving) . . . healthy relationships [and] ability to adapt to change and cope with adversity.”
Is adjustment to societal demands without unpleasant emotional states and disruptive behaviors in fact health, or is it a state that is valued by many psychiatrists, psychologists, and those at the top of the societal hierarchy?
Is Adjustment Evidence of Mental Health?
“Yet many psychiatrists and psychologists refuse to entertain the idea that society as a whole may be lacking in sanity. They hold that the problem of mental health in a society is only that of the number of ‘unadjusted’ individuals, and not of a possible unadjustment of the culture itself.”—Erich Fromm, The Sane Society (1955)
Not only Fromm, but many renowned critical thinkers—including Jiddu Krishnamurti, Aldous Huxley, R.D. Laing, and others—have observed that adjustment to an irrational, insane, and dehumanizing society quite logically can result in an irrational, insane, and dehumanizing individual.
Only a profoundly uncritical thinker would celebrate adjustment in of itself without a critical analysis of what one is adjusting to, but perhaps being a profoundly uncritical thinker is the most important criterion for being a thought leader in establishment psychiatry and psychology.
Many Mad in America readers can attest to the quality of their life dramatically improving to the extent that they stopped “good behavioral adjustment” to dehumanizing environments, be it a dysfunctional family or a traumatizing psychiatric hospital.
Szasz championed freedom, dignity, and autonomy, and refused to adjust to dehumanizing institutions and environments that he had personally experienced as subverting these values. Those institutions and environments that he had personally experienced and rebelled against included not only establishment psychiatry but also totalitarian communism. While the punches thrown by establishment psychiatry at Szasz do not land, a more valid criticism of Szasz is that he, unlike Erich Fromm, did not also attack the dehumanizing nature of corporate-capitalism along with his attacking establishment psychiatry and totalitarian communism.
My experience is that most people, outside of establishment psychiatry and psychology, resonate with the idea that the “world has gone crazy,” and they have their own experiences of various spokes on the societal wheel that are irrational, insane, and dehumanizing, often absurdly so. There are countless examples of such spokes, but here are few:
In a sane society, would we have prisons-for-profit? By 2022, the Sentencing Project reported that in the United States, 27 states and the federal government incarcerated 90,873 people in private prisons, representing 8% of the total state and federal prison population. So, we have a society in which corporations such as Corrections Corporation of America and the GEO Group will increase their profits if increasing number of Americans are incarcerated.
In a sane society, would medical treatment itself be the third leading cause of death? A 2016 BMJ study, along with similar evidence reported in STAT, reveals that iatrogenic deaths caused by medical error such as incorrect medications, surgical mishaps, wrong diagnoses killed more than 250,000 Americans a year, making it the third-leading cause of death (after heart disease and cancer).
In a sane society, would we have a drug called an “antidepressant” that has an FDA warning stating that it increases the likelihood of suicidality, and which studies show that more of its users report sexual dysfunction than report reduced depression?
The reality is that most of the spokes in the societal wheel have become threats to our humanity. The classic responses to threat that mental health professionals talk about are fight or flight, with some adding the third “f” of a freeze reaction. However, there is a fourth “f” that most mental health professionals omit, a reaction that is the most common reaction by most mental health professionals, which is fawning—complying or adjustment.
Establishment psychiatrists and psychologists generally view the ability to adjust to environments as “mental health,” and many of them do not question whether or not their own adjustment to their sick professional environment has rendered themselves sick. Aldous Huxley in Brave New World Revisited offers a description of the type of “well-adjusted” individuals that characterize many mainstream psychiatrists and psychologists: “They are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness . . . . living without fuss in a society to which, if they were fully human beings, they ought not to be adjusted.”
Is “Relative Freedom from Anxiety” Evidence of Mental Health?
“But ‘let us beware,’ says Dr. Fromm, ‘of defining mental hygiene as the prevention of symptoms. Symptoms as such are not our enemy, but our friend; where there are symptoms there is conflict, and conflict always indicates that the forces of life which strive for integration and happiness are still fighting.’” — Erich Fromm quote in Aldous Huxley’s Brave New World Revisited
The phenomenon that mainstream mental health professionals commonly call symptoms of mental illness are in fact simply human reactions, often to perceived threats. Not only do mainstream mental health professionals routinely adjust/comply/conform/fawn in response to threats, but they often deny the reality that their humanity is being threatened. When other people respond to threats with fight, flight, and freeze, mainstream mental health professionals label their actions as mental illnesses such as anxiety, depression, substance abuse, disruptive behavioral disorders, and various dissociative states; however, these states evidence, as Fromm points out, “that the forces of life which strive for integration and happiness are still fighting.”
During certain periods of U.S. history, it is more or less easier for mainstream mental health professionals to deny the irrational, insane, and dehumanizing nature of U.S. society. Currently, we live in one of those periods when even people “talented” in psychological denial and chemical numbing are having difficulty not experiencing high levels of anxiety.
Specifically, the ICE violence frighteningly reminds many Americans of dictatorships throughout history that have terrorized its citizens; and this violence, along with prosecutorial reprisals and economic assaults, have created an extremely high level of anxiety for many people. In addition to enormous anxiety, many Americans now feel embarrassment and even shame over how the world views the United States. Americans wake up every day, unsure of anything except that their leader will do something embarrassing that creates a threat to their security; for example, claiming he had been cheated out of the Nobel Peace Prize, and then stating, in the manner of a petulant young child, that because he didn’t get the prize, “I no longer feel an obligation to think purely of Peace.” The idea of petulant young child in charge of a nuclear arsenal is quite a threat.
All of this is to say that nowadays, establishment psychiatry’s idea of “mental health” as meaning freedom from high-levels of anxiety is especially insane.
What Then Besides the Mental Health Ideology?
“I want to feel something strongly.”
“When the individual feels, the community reels,” Lenina pronounced.
“Well, why shouldn’t it reel a bit?”
“Bernard!”
—Aldous Huxley, Brave New World
Mainstream psychiatry and psychology offer an ideology that fits some people, but not many others who don’t believe that health equals: “good behavioral adjustment,” “freedom from anxiety” and “effective functioning in daily activities resulting in productive activities (such as in work, school or caregiving), and the “ability to adapt to change.”
This mental health ideology may fit people who prioritize an absence of uncomfortable emotions, even to the point of chemically numbing them, and who prioritize adjustment, even to the point of denying dehumanizing aspects of their environment.
However, the mental health ideology does not fit people who prioritize justice, freedom, art, being fully human, and loving all of life, because such people recognize that these priorities are not possible without uncomfortable emotions and without rebellion against dehumanizing environments.
The following are some of the key values that make it difficult to accept the mental health ideology:
- Valuing critical thinking about what environment one is being asked to adjust to, and if it is dehumanizing, then valuing maladjustment.
- Valuing all of our human emotionality, including what mainstream psychiatry and psychology labels as symptoms of mental illness—such as overwhelming anxiety, anger, boredom and sadness.
- Valuing the fuel of anxiety, anger, boredom and sadness as vital energy for fighting for justice, creating art, having empathy and compassion, and being fully human.
- Valuing the necessity of an unsettling altered state as a prelude to valuable transformations, including letting go of an ego attachment that is interfering with a true connection with one’s own being and to life.
- Valuing love—rather than biological-chemical-electrical-psychological manipulations—when trying to help others who are so overwhelmed by their emotionality that their reactions lack wisdom and result in destructive or self-destructive behaviors.
To be human means that at various times in our lives we will have overwhelming emotional reactions that sometimes result in disruptive behaviors. The mental illness/mental health ideology is a narrative that treats these states in the manner of cancer, which means eradicating and eliminating them as quickly as possible.
In contrast, a very different ideology sees our overwhelming emotional reactions not as evidence of pathology to be eradicated and eliminated as quickly as possible, but instead as energy sources which, with wisdom and love, can result in meaningful insights, beneficial transformations, and valuable contributions.
In a pluralistic society, people have the right to their own opinion, philosophy, religion, and ideology, which means that people have the right to adopt the mental illness/mental health ideology, but they also have the right to reject that ideology in favor of another that they find more interesting, satisfying, and joyful.
