Psychiatry's Valid but Dishonest Reconsiderations

By Vatz, Richard E.; Schaler, Jeffrey A. | USA TODAY, March 2008 | Go to article overview

Psychiatry's Valid but Dishonest Reconsiderations


Vatz, Richard E., Schaler, Jeffrey A., USA TODAY


MORE THAN HALF a century ago, Thomas Szasz shocked the world of psychiatry with his then, and still, electric book, The Myth of Mental Illness. Since that time, he has been unmasking the invalidity of psychiatric practice and its raison d'etre: the diagnosing and treatment of mental illnesses. His reasoning through scores of major works and over 1,000 articles, reviews, and letters has been based on a simple, but profoundly true, insight--mental illness and mental health and their derivative concepts are metaphors, since the mind is not an organ.

From that concept, the entire mental health establishment intellectually has been reeling, while occupationally profiting for the same five decades. Psychiatrically-based rhetoric has used schizophrenia as the prototype mental illness because it represents--at least in the lay public's mind--the most bizarre and inexplicable behavior of the "mentally ill" and, most important, some people labeled "schizophrenic" may have genuine brain disease. This constitutes a tiny percentage of those deemed "mentally ill," a population that psychiatry 'alleges has grown to more than a majority of the general population. Let there be no confusion about this claim of the discovery of brain disease, however. If persons called schizophrenic are discovered to have a lesion that correlates perfectly with their behavior, or clearly causes their behavior, a mental illness has not been discovered; rather, a new brain disease has been discovered.

Szaszian critics of psychiatric theory and practice tend to find the prototype mental illness to be in the "problems in living" category, first extensively discussed by Szasz. This would comprise the vast majority of the over 300 mental illnesses named in the current Diagnostic and Statistical Manual (DSM-IV-R) of the American Psychiatric Association. The National Institute of Mental Health, the primary sponsor of this finding--that more than 55% of the American population suffers from some mental illness over a lifetime--produced its conclusion, according to a June 7, 2005, article in The New York Times entitled, "Most Will Be Mentally Ill at Some Point," at a time conducive to complementing its efforts to promote lucrative screening and treatment for mental illness among all ages. The study involved nonmedical interviews conducted by nonphysician personnel. What constitutes "mental illness" is that which is approved by the Board of Trustees of the American Psychiatric Association (APA) for the latest version of the Diagnostic" and Statistical Maraud (DSM), now set for revision by 2010.

Studies such as these can lead to changes in the manual, which often varies according to politics of the profession. In 1973, pursuant to protests by the gay community and others, homosexuality was removed as a mental disorder, but self-diagnosed involuntary homosexuality--called "ego-dystonic" homosexuality--remained until it, too, was removed. There were no scientific studies which adumbrated the change, only unfriendly sociological phenomena. Thus, homosexuality exited as a disease the same way it came in. Homosexuality was classified as a disease for political reasons and it was declassified as a disease for political reasons. No other real disease has ceased being a disease. Its prevalence and incidence may have diminished--consider tuberculosis and small pox, for instance--but even if wiped off the face of the Earth, a disease remains a disease; it is not subject to political winds and changes.

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Such studies and surveys are the nonscientific Rosetta stone of the mental health community. There is no limit to the percentage of the population which can be said to be "mentally ill," since, as a metaphor, there is no way to confirm or disconfirm diagnoses (or the number of people who are mentally ill). Moreover, there is no limit to the variety of behaviors that successfully can be labeled as "mental illness," since there is no measurable criterion that eliminates such labeling or name-calling. …

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