Is Mental Illness a Myth?

Some people think the mental health field is a complete hoax, and if you are going to work in mental health or recieve treatment, then it’s important to keep this perspective in mind. People forget that therapy, as we understand it, is less than 100 years old. In the 60s, there was something called the anti-psychiatry movement which was based on the view that psychiatric treatment was actually harmful to patients, not helpful in any way. Some of this was based on the fact that treatments for the mentally ill were completely inhumane. Lobotomies, electroshock therapy, and horrible living conditions were common. Some would argue that mental health hospitals are still inhumane, even today.

A classic text in this school of thought is called The Myth of Mental Illness by Thomas Szasz, in which he argues that it doesn’t make sense to categorize psychological problems as diseases. Dr. Szasz thought that there is a rigid distinction between the mental and the physical. He was concerned that the whole idea of mental health is counter to the values of autonomy and individual responsibility. He also talked about the field as something that is used to impose social norms and control. His insights support an idea that some critics share— what is “wrong” with people mentally, is actually just a symptom of what is wrong with their culture. For example, S don’t put an anxious person on Xanax, because they are only anxious about the world because the world is not as it should be. The anxiety is a normal reaction to abnormal circumstances.

There’s a lot of truth in this critique. For example, homosexuality used to be considered a mental illness. Women used to be considered “hysterical” and the cure for this affliction was something called “physician-assisted paroxysm,” which is just a fancy term for doctors helping their patients orgasm to relieve them of their symptoms. We look at this now, and all of us consider it to be backwards, but in 50 years, what are the outdated mental health practices that we consider to be cutting edge today?

In my view, mental health professionals, or anyone for that matter, can appreciate Thomas Szasz’s work, integrate it into their own philosophical orientation and still believe that mental illness exists. A lot of psychiatric medication is not effective without therapy and a lot of mental disorders that get treated nowadays can be cured without medication. I am not sure the evidence is exactly in his favor.

I don’t think that the field is at odds with the values of autonomy or individual responsibility either. High levels of what is called internal locus-of-control is associated with better mental health outcomes. Locus of control is the degree to which people assign power over the outcome of the events in their lives. If the locus-of-control is internal, people believe that they are in control. When it’s external, they believe they are a victim to larger circumstances, broadly speaking. And while some psychotheorists and researchers emphasize systems and cultural components, at the end of the day, they are therapists and not sociologists. They believe in individual transformation. So Dr. Szasz’s idea that psychotherapy is at odds with the values of freedom and autonomy it doesn’t seem to be true.

The value in questioning whether or not mental illness is real is in the fact that it helps reinforce humility from the practitioner's perspective. Therapists are human beings. They are just as flawed as anyone else, just as susceptible to arrogance, ignorance, illness or bias. The real question is... to what extent is the person sitting in front of me actually ill, or to what extent am I imposing my own beliefs about is normal or acceptable or “healthy” onto them? And if you are someone who is receiving therapy, you should also be conscious of this dynamic as well.

If you are curious about making a change, or if you want to practice authenticity in a safe, comfortable atmosphere, reach out to me for a free consultation.