Customer Reviews

The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Revised Edition)

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Dr. Szasz'definitive work should be revisited by all mental health professionals in this new era of "managed care" and its resultant "new mental health system". Although I don't agree with everything that Dr. Szasz claimed in his groundbreaking book, it seems to me that those who considered him a quack and continued the medical model of mental illness for the last 4+ decades have not proven him wrong. We have miserably failed the "mentally ill", "mentally disordered", people with "problems in living", or whatever term one uses these days. The mental health system and its providers these days use the excuse of managed care to explain its failures, but would be better advised to read or reread Dr. Szasz's forewarning of 40 years ago. It is time to rethink the problem, and a good place to start is with the "Myth of Mental Illness"-before the death of the mental health system is upon us.

If you only read books on the pros psychiatry you cannot fully understand it. Thomas Szasz delves deeper into some historical truthes about this pseudo-science and gives a better view as to what psychiatry is. Never base your ideas on one book however, read up on both sides and form your own opinion on what is right or wrong. I can tell you that I will provide you with a roof over your head, a bed, 3 square meals a day, plenty of reading material to study, a chance to improve your physical conditioning and an opportunity to make lifelong friends and it sounds good right? Of course if I say that I am talking about prison, the luster seems to fade fast doesn't it...read both sides!

Though this book might be of paramount importance for those who desire to find an antithetical position to the "Doctors for the pathologizing of human behavior," I think it a terrible mistake to read this book with the assumption that understanding Szasz will be the result. Written early in his career, this book, like Beethoven's early symphonies, deserves not the attention it receives for the titilating title. I believe the influence of Karl Kraus caused the about face demonstrated by "The Myth of Psychotherapy" from the position outlined in "The Ethics of Psychoanalysis," both books he published later. For those that desire to find a summation of Szasz in one volume, I would recommend "Insanity."

Descriptive criteria aside, what is the essence of mental disorders? Are they merely physiological disorders of the brain, or, more precisely of its chemistry? If so, can they be cured by restoring the balance of substances and secretions in that mysterious organ? And, once equilibrium is reinstated - is the illness "gone" or is it still lurking there, "under wraps", waiting to erupt? Are psychiatric problems inherited, rooted in faulty genes (though amplified by environmental factors) - or brought on by abusive or wrong nurturance?

These questions are the domain of the "medical" school of mental health.

Others cling to the spiritual view of the human psyche. They believe that mental ailments amount to the metaphysical discomposure of an unknown medium - the soul. Theirs is a holistic approach, taking in the patient in his or her entirety, as well as his milieu.

The members of the functional school regard mental health disorders as perturbations in the proper, statistically "normal", behaviours and manifestations of "healthy" individuals, or as dysfunctions. The "sick" individual - ill at ease with himself (ego-dystonic) or making others unhappy (deviant) - is "mended" when rendered functional again by the prevailing standards of his social and cultural frame of reference.

In a way, the three schools are akin to the trio of blind men who render disparate descriptions of the very same elephant. Still, they share not only their subject matter - but, to a counter intuitively large degree, a faulty methodology.

As the renowned anti-psychiatrist, Thomas Szasz, of the State University of New York, notes in his article "The Lying Truths of Psychiatry", mental health scholars, regardless of academic predilection, infer the etiology of mental disorders from the success or failure of treatment modalities.

This form of "reverse engineering" of scientific models is not unknown in other fields of science, nor is it unacceptable if the experiments meet the criteria of the scientific method. The theory must be all-inclusive (anamnetic), consistent, falsifiable, logically compatible, monovalent, and parsimonious. Psychological "theories" - even the "medical" ones (the role of serotonin and dopamine in mood disorders, for instance) - are usually none of these things.

The outcome is a bewildering array of ever-shifting mental health "diagnoses" expressly centred around Western civilisation and its standards (example: the ethical objection to suicide). Neurosis, a historically fundamental "condition" vanished after 1980. Homosexuality, according to the American Psychiatric Association, was a pathology prior to 1973. Seven years later, narcissism was declared a "personality disorder", almost seven decades after it was first described by Freud.

Szasz is the father of the "anti psychiatry" movement and this is his best book - a riveting, mind boggling,scholarly read. Sam Vaknin, author of "Malignant Self Love - Narcissism Revisited".

Superb and fascinating. One of the most logical and outstanding works in psychiatry I've read in a long long time. Believable and academically shattering. I don't undertand some the comments in these reviews but I can tell you that the suppositions and the theories are accurate. Absolutely superb work that deserves serious attention and critical analysis.

I believe this is one of the most important books in the history of psychiatry. The book is ground-breaking and establishes a new parardigm and organizing concept for many "mind" disciplines. Dr Szasz's ideas are timeless, revolutionary and common sense - not to be contrued as a criticism. Indeed many revolutionary ideas are simple and obvious and I think that is exactly why this book and Dr Szasz must be taken seriously. I am speaking behind the times when I say this because the book is nearly 40 years on the market. However Dr Szasz is as relevant today as ever. Institutionalized persecution of "different" behaviours has evolved beyond the ridiculous to the absurd. Dr Szasz's characterization of this as a "war on personal responsibility" is important from a medical and a moral perspective, as a challenge to the popular notions of "inner child", the gowing "victim" industry (e.g. gambling and shopping "addictions", among many many more) and similiar conceptual garabage.

The Myth of Mental Illness creates for the reader a reference point for cross diciplinary thinking in sociology, linguistics, philosophy of mind and science, psychology, history and or course medicine. The concepts are true to human beings as self-responsible moral agents and consistent with the North American work-ethic. Dr Szasz is commended for his insight and understanding of a pyschiatric industry gone mad. The book should be part of Amazon's "Well Worth Reading" displays.

I really liked this book. I first heard of it when I listened to a radio interview of Dr. Szasz in San Francisco in the late '90's. Intrigued with his claims I tried to check the book out of the library but it wasn't available locally and so had to be obtained from quite far away. After reading it, I was amazed that this book was not readily available in most libraries.

If you are trying to decide whether or not to purchase this book by reading these reviews (and a few of them are much, much better at analysis than I could ever be), you might want to do what I often do with controversial works. First, I take a look at the star counts and see how polarized they are. As of the time of this writing, only one out of sixteen reviews was other than a one or a five star rating and that one was rather academic. This polarization usually indicates to me that the work is both loved and hated and unsupported by middlin' opinions.

You might also want to take a close look at at the "personal" remarks made by the one star supporters to see if there is a common thread that runs throughout. In this case, many of these reviewers are/were convinced of their own mental difficulties.

But, what did I think of the book? I was facinated by the subject matter but was not very impressed with the writing as I found it a little difficult. But, I slog through even the most difficult books if I think there is a gem to be mined and this book is a real haul. (This is why I love Chesterton but hate his writing.) A comment George MacDonald made that could have been said about Szasz's book is "Truth is truth, whether from the lips of Balam or of Christ." I think Szasz is on to something but really doesn't have the whole picture of the human condition in focus. As far as I can discern, he denies the existence of the Spiritual realm and hence would not consider that people could be oppressed from without by bonafide demons. When Christ sent out his diciples to proclaim the Gospel (the first time), he gave them authority over two things: physical illnesses and demons. I already agree with Szasz about the former. He should look into the latter and revise his book accordingly.

I shall now have to read his other books.

An entire different slant on mental illness. this is a must read for anyone interested in the field. It will wipe away the certainty that clouds the entire mental health picture.

I bought this book 8 or 9 years ago when I was a 22-year-old student who roamed the earth forming tidy little opinions on everything I came across. This book fit perfectly into my own opinions, which amounted to telling those who are "mentally ill" to buck up or learn self-control. I don't want to get out of bed some days, but I do. I want to spend more than I have to get things that I want, but I don't. I'm scared sometimes, but I deal with it. Its part of growing up as a responsible person. I thought that as a society we could not tolerate excuses for laziness and failure to control ones desires or fears. The last thing I thought we needed was a massive cradle for the country in the form of the psychiatric community.
Now I am a 30 year old attorney. After 8 tumultuous years I have been diagnosed with Bipolar Depression. I see now how Thomas Szasz's book gave me the intellectual ammunition I needed in support of my prior, ignorant (literally, not pejoratively) views on the subject. I just didn't know. But I didn't allow for the fact that there might be a world of experience beyond what I had dealt with to that point in my life. Now I have found out the hard way. I can't blame people for buying into this book, I did myself. I can only say that if you do find yourself agreeing with this book, suspend judgment until you have met and at least become somewhat acquainted with individuals who are mentally ill or read more books on the subject with an actual open mind, meaning acknowledging that you may not know yet what a mental illness is or what a diagnosed person is dealing with. Of course, this probably would have been beyond me when I was 22 and reading this book. But I'll say it anyway for the one or two exceptional people out there.

Now, well into my seventh decade of close, (obviously nonprofessional) dealings with a variety of persons with diagnosed/diagnosable "/mental illness/;" and eleven years after my first reading of Myth...; and reading and taking value from 40 relevant books by the following, I take further instruction from Szasz's knowledge, authority and sensibility: Anon(OCD), Amador,X, BacklarP, Breggin,P, "RoyC"(OCD), Davis,L, Engel,B, Feingold,B, Flach,F, Forward,S, Fumento,M, Glasser,W, Glenmullen,J, Gorman,J, Gottesman,I, Grossman,F, Harvey,P, Hedaya,R, Keefe,R, Landau,E, McKee,W, Miller,A, Moskovitz,R, Papalos, Paris,J, Perlmutter,A, Pfeiffer,C, Podvoll,E, Richette,L, Rosen,L, Sacks,O, Salzman,L, Torrey,EF, Walker,S, Wyden,P&B.

Some quotes:

"I wish...to reintroduce freedom, choice and responsibility into the conceptual framework and vocabulary of psychiatry."

"Mental illness is not something a person has, but is something he does or is."

"...little doubt...that both Freud and Sullivan were correct in identifying painful memories, their repression, and their persistent operation, as significant antecedents in the personal and social behavior of hysterically disabled individuals."

"An integral part of this scientific ethic is the principle that knowledge...must not...be kept a secret by a small group and used as a source of power to mystify and control, stupefy and dominate, other individuals or groups."

"It is important to understand clearly that modern psychiatry - and the identification of new psychiatric diseases - began not by identifying such diseases by means of established methods of pathology, but by creating a new criterion of what constitutes disease."

"The reclassification of non-illnesses as illnesses has, of course, been of special value to physicians and to psychiatry as a profession and social institution. The prestige and power of psychiatrists have been inflated by defining ever more phenomena as falling within the purview of their discipline."

"The phenomenology of body illness is indeed independent of the socioeconomic and political character of the society in which it occurs. But this is emphatically not true for the phenomenology of so-called mental illness, whose manifestations depend upon and vary with the educational, economic, religious, social, and political character of the individual and society in which it occurs."

"...To exhibit, by means of bodily signs - say, by paralyses or convulsions - the idea and message that one is sick is at once more impressive and more informative than simply saying: `I am sick.'"

"(Some) religious teachings...reward sickness and stupidity, poverty and timidity - in short, disabilities of all sorts..." "...the sick person is entitled to help simply because he is sick..."

"...the obligatory nature of the care required generates a feeling of helplessness in the person from whom help is sought. If a person cannot, in good conscience, refuse to provide help - and cannot even stipulate the terms on which he will supply it - then truly he becomes the help-seeker's slave."

"...the hysteric plays at being sick because he is afraid that, if he tried to participate competently in certain real-life activities, he would fail."

"The hysteric's seeming ignorance of what he is doing may also be interpreted as his not being able to afford to know it..."

"...It is precisely those who play these games (of hysteria and mental illness) most skillfully whose performances are likely to prove successful and whose identities will therefore be authenticated as sick..."
"The principal alternative to this dilemma lies...in abolishing the categories of ill and healthy behavior..."

"...even if one could brush aside the pathogenic or pathologic mechanisms, one would have persons who are not at all well-suited to a complex interpersonal environment..."

"...(The) Ganser syndrome... is the strategic impersonation of madness by a prisoner...the patient, being under charges from which he would be exonerated were he irresponsible, begins, without being aware of the fact, to appear irresponsible."

"In the case of malingering, hysteria, and the Ganser syndrome - and, indeed, in all cases of so-called mental illness - psychiatrists actually confirm the patient's self-definition as ill and so help to shape his illness."

"...let me emphasize only that investing hope in religious faith is perhaps one of the best psychological investments a person can make..."

"In the individualistic, autonomous "psychotherapy" which I prefer, the patient himself defines what is good or bad, sick or healthy."

"...our goal should be to enlarge his (the patient's) choices by enhancing his knowledge of himself, others, and the world about him, and his skills in dealing with persons and things."

Comments:

One can take inspiration from the prescient application of Szasz' theory in Helen Keller's story, wherein her live-in teacher, who never heard of Szasz, challenged family opposition and transformed, Helen, who had neither vision, nor hearing, nor speech, nor discipline, into an educated individual superbly valuable to herself and to her society. Surely today's professionals would find her superbly diagnosable.

I believe that the case workers, nurses, social workers, ward assistants, housekeepers etc. have been, to varying degrees using Szasz' principles all along. And Glasser seems to have capitalized on this as expressed in his 1965 book, Reality Therapy. All personnel who had any contact with his confined patients were required to attend the meetings. Teamworking, they realized remarkable success.

My sister, before her passing with cancer in 1991, had been a housekeeper at Maryland's Springfield State Mental Hospital for about 20 years. Fed-up with mopping up one patient's urine she decided to teach this, no doubt "exquisitely diagnosed," individual how to use a urinal. It was easy, and that solved the problem. And, she conducted a spiritual group for the patients, and she counseled them individually, and, in some cases, she had more success than the professionals with enabling them to return home.

Hopefully Szasz' and others' illustrations of psychiatrists' huge cost to our society, combined with the present declines in mental health care funding, will eventually lead us to no longer simple-mindedly admire or gloat about our young who obediently strive to become doctors (perhaps psychiatrists).

There should someday exist a book version for the cognitively-disabled, the less educated and the less-English-language-competent.

It was painful chopping 5000 words out of my booknotes to write this 1000-word review. A wealth of critical information not here is in the book.

Bill Norwood