Dr. Thomas Szasz and The Myth of Mental Illness

By Ofer Zur, Ph.D.

While many of us might have difficulty digesting and espousing Szasz’s passionate beliefs, others of us can relate to Szasz’s own famous words:

“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 God talks to you, you are a schizophrenic.”

Before, I started graduate school, one of my classmates committed suicide. It was a horrific shock for all who knew him, and completely unexpected. I began my doctoral program with the moral imperative to do everything in my power to ensure that none of my patients would ever kill themselves.

Twenty-five years later, I am more educated, older, and a LOT wiser. I have met so many who were suffering, who wanted only to end their pain. Less than three years ago, I lost one of my dearest friends, also a clinician, to suicide. It ripped my heart open, but unlike my earlier experiences with suicide, I did not judge her.

For years, I followed the ethical imperative to use “No Suicide” contracts with suicidal patients. Then, several years ago, I read some of the works of Thomas Szasz. And, while Szasz and I disagreed about many things, I have come to really admire his thoughts on the nature of suicide. Suicide is not against the law. And, no matter how painful it may be to survive the suicide of a friend, patient or family member (and believe me, it is), the right to end one’s own life resides with each individual.

Thomas Szasz, who died at age 92 on September 8, 2012, was the author of The Myth of Mental Illness and dozens more and had long been the scourge of the psychiatric establishment. Over nearly five decades Szasz, an MD, argued passionately and knowledgeably against involuntary commitment of the mentally ill, against the war on drugs, against the insanity defense, against the use of medications to “cure all ails,” and for the right to commit suicide. Most controversial of all has been his repudiation of mental illness as an accurate label to describe problems of living.

Regardless of whether one agrees with Dr. Szasz’s views on psychiatry, I believe that it is important that every psychologist, social worker, family therapist, counselor and psychiatrist at least becomes familiar with his critical views.

Here are some of Szasz’s highly controversial ideas:

  • Psychoanalysis is a moral dialog, not a medical treatment.
  • Emotional and psychological symptoms do not reflect diseases of the brain and, therefore, are not indicators of mental illness.
  • Involuntary psychiatric intervention is likened to imprisonment and is unethical and immoral.
  • Suicide is an issue of personal responsibility rather than organizational liability. It is an act of choice, not a reflection of disease.
  • The general public believes that if all human problems are defined as symptoms of disease, they become maladies remediable by medical measures and are easily resolved.
  • Child molestation, domestic violence and many other abhorrent behaviors are crimes, not sicknesses.
  • Separation of medicine and the state is necessary for the protection and promotion of individual liberty, responsibility and dignity.
  • In many ways public health projects have the potential to impact many lives, but guarantee little to each individual.

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