Case study: Is mental illness a myth?

To begin to get clear both about the nature of illness and why it matters, it will help to start with a particular challenge to a particular kind of illness: mental illness. In the ‘Myth of Mental Illness’, Thomas Szasz notoriously argued that there is no such thing as mental illness. Mental illness is an oxymoron, a contradiction in terms. One key argument runs as follows:

The concept of illness, whether bodily or mental, implies deviation from some clearly defined norm. In the case of physical illness, the norm is the structural and functional integrity of the human body. Thus, although the desirability of physical health, as such, is an ethical value, what health is can be stated in anatomical and physiological terms. What is the norm, deviation from which is regarded as mental illness? This question cannot be easily answered. But whatever this norm may be, we can be certain of only one thing: namely, that it must be stated in terms of psychological, ethical, and legal concepts… [W]hen one speaks of mental illness, the norm from which deviation is measured is a psychosocial and ethical standard. Yet the remedy is sought in terms of medical measures that – it is hoped and assumed – are free from wide differences of ethical value. The definition of the disorder and the terms in which its remedy are sought are therefore at serious odds with one another.[Szasz 1972: 15]

What follows if Szasz is right? If there is no such thing as mental illness, then it cannot be used as an excuse or as a reason to undermine responsibility? Szasz himself seems happy to accept that consequence, but should he be?

To make such a radical claim, and to make it seriously, Szasz needs a strong argument. What, exactly, does he argue? And is the argument a good one?

Reading

• • Szasz, T. (1972) ‘The myth of mental illness’ in The Myth of Mental Illness, London: Paladin

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