capitalism

498 Szasz, Thomas (1920– )
understanding Dr. Szasz’s point of view, is that the expression
mental illness and its relatives are metaphors not for
problems special to medicine, but for problems of living
concerned with internal and external conflict involving
roles or games. In his 1990 book The Untamed Tongue, he
describes how he believes the concept of mental illness is
connected to social norms or expectations:
When a person fails to follow rules of conduct—that is, the
rules most people follow—we say that he is mentally ill,
and when he does not respond to conventional rewards and
punishments as we want him to respond—we say he is
seriously mentally ill.
He holds that, although real illness is physical and
defined by such bodily criteria as lesions and organic malfunctions,
what qualifies as mental illness can be almost
any behavior that is perceived as unpleasant, obnoxious,
or threatening to its author, others, or both. Historically,
behavior classified as mental illness or a form of mental
disorder has been wide ranging, including refusal to support
oneself through work, reckless gambling, drug habits,
unconventional sexual practices, dissatisfaction with one’s
physical appearance, impulsive violence, and political nonconformity
(as in the former Soviet Union).
“Classifying thoughts, feelings, and behaviors as diseases
is a logical and semantic error, like classifying the
whale as a fish,” he writes on his Web site (www.szasz
.com). For him, mental illness no more describes a species
of illness than decoy duck describes a species of duck. He
would contend, however, that although everybody knows
that decoy ducks are not ducks, people commonly think
that mental illness describes a species of illness. The
unquestioning belief in mental illness has profound social
consequences because it provides the justification for what
Dr. Szasz would describe as state-sponsored social control,
as when people labeled mentally ill are involuntarily hospitalized.
Although Dr. Szasz never denies that people can
have real problems coping with life and dealing with others,
he denies that those problems are properly regarded as
a form of illness. What is more, although he acknowledges
that some organic conditions, such as Alzheimer’s disease,
can influence thought and behavior, he argues that the
behavior is never a disease.
By asserting that the concept of mental illness is a myth,
Dr. Szasz intends, among other things, to reject a medical
frame of reference for describing, understanding, and
attempting to control people’s actions and habits. When
people regard actions and habits as illness, they are, he
insists, rejecting the conception of people as free and responsible
moral agents and accepting instead the conception of
people as patients and victims needing the intervention, at
times forced, of medical professionals. Because most people
have uncritically accepted the appropriateness of applying
medical concepts to disapproved behavior, we, as a society,
have replaced a moral-theological outlook with a therapeutic
one. By treating habits, actions, and complex social performances
as illnesses, we increase the power of psychiatrists
and other health care professionals while we devalue personal
freedom and responsibility. (Dr. Szasz’s influential
writings on drug prohibition illustrate his central thesis well.)
Because of his work and the actions of civil libertarians
and other social critics, there has been a growing uneasiness
about coercive psychiatry, leading to legal reforms that
have made it more difficult to hospitalize involuntarily
those labeled mentally ill. His writings are important not
only because they require people to question foundational
definitions in psychiatry, but also because they provide a
point of view for defending personal freedom and responsibility
against therapeutic paternalism.
See also Coercion; Drug Prohibition; Foucault, Michel; Psychiatry
Further Readings
RoE
Szasz, Thomas. Ceremonial Chemistry: The Ritual Persecution of
Drugs, Addicts, and Pushers. Rev. ed. Holmes Beach, FL:
Learning Publications, 1985 [1974].
———. Cruel Compassion: Psychiatric Control of Society’s
Unwanted. New York: Wiley, 1994.
———. The Myth of Mental Illness: Foundations of a Theory of
Personal Conduct. New York: Harper, 1961.
———. Our Right to Drugs: The Case for a Free Market. New
York: Praeger, 1992.
———. The Untamed Tongue: A Dissenting Dictionary. LaSalle, IL:
Open Court, 1990.
Vatz, Richard, and Lee Weinberg. Thomas Szasz: Primary Values
and Major Contentions. Buffalo, NY: Prometheus Books, 1982.