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Pythiatism, the mental illness Jean-Paul Sartre attributed to Gustave Flaubert in his multivolume study, The Family Idiot, would be utterly fictitious according to the perspective to
psychiatrist Thomas Szasz, author of The Myth of Mental Illness, a short paper and a book by
the same name. He reasserted his theme, that mental illness does not exist except as metaphor,
in a later article entitled Mental illness is still a myth, stating that:
My critique of psychiatry is two-pronged, partly conceptual, partly moral and
political. At the core of my conceptual critique lies the distinction between the
literal and metaphorical use of languagewith mental illness as a metaphor. At
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the core of my moral-political critique lies the distinction between relating to
grown persons as responsible adults and as irresponsible insane persons (quasiinfants or idiots)the former possessing free will, the latter lacking this moral
attribute because of being "possessed" by mental illness. Instead of addressing
these issues, my critics have concentrated on analyzing my motives and defending
psychiatric slavery as benefiting the "slaves" and society alike. The reason for this
impasse is that psychiatrists regard their own claims as the truths of medical
science, and the claims of mental patients as the manifestations of mental
diseases; whereas I regard both sets of claims as unwarranted justifications for
imposing the claimants' beliefs and behavior on others.
He asks, Why do we make diagnoses?
There are several reasons: 1) Scientificto identify the organs or tissues
affected and perhaps the cause of the illness; 2) Professionalto enlarge the
scope, and thus the power and prestige, of a state-protected medical monopoly
and the income of its practitioners; 3) Legalto justify state-sanctioned coercive
interventions outside of the criminal justice system; 4) Political-economicto
justify enacting and enforcing measures aimed at promoting public health and
providing funds for research and treatment on projects classified as medical; 5)
Personalto enlist the support of public opinion, the media, and the legal system
for bestowing special privileges (and impose special hardships) on persons
diagnosed as (mentally) ill.
Everyone has noticed the growth in the number of purportedly abnormal behaviors to be treated
by the mental health monopoly over recent years, and the fact that there are always newer or
better psychotropic drugs to be prescribed for the classified mental illnesses. In fact the
classifications are often designed to match the specifications of the funding sources; to suit the
insurance industry and the government regulators. All in all, if we examine the developing
nosology set forth in the diagnostic manuals, and take note of the proliferation of subjective
diagnoses made with objective pretense, and the relationship of the classifications with a
developing moral codefor example, the morbid tendency of slaves to flee; neurasthenia due to
the stress of industrialization; purportedly immoral homosexuality and masturbation, included
and then excluded from the manuals or dismembered and tucked away in other classifications
the diagnostic manuals appear to be indexes to a fiction novel encompassing all aspects of
modern life.
To wit: civilization is an incurable disease, but its symptoms can be alleviated with a proper
regimen of psychotropic drug treatment and methodic counseling by licensed doctors. Further,
any intelligent and sane person patient enough to study the development and current plot of this
living novel (everybody is sick and needs doctors to help them) cannot help but conclude that it
is not being written by scientists.
Indeed, the very proliferation of diagnoses from a few to hundreds, right down to the malingerer,
the wandering fuguist with jet lag and coffee nerves, and the shy boy diagnosed with Aspergers
disorderor a vague position on the autism spectrum, is evidence that the good doctors do not
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have a scientific theory nor a clear conception of sanity. Once all the kids and adults are sorted
into their respective disorders, a normal person, other than a total madman, cannot be found, but
the classifications will be milked for hundreds of millions of dollars every year.
That, however, is not to say that the well intentioned therapists are not as helpful as priests or lay
practitioners or witch doctors, provided that the afflicted persons believe in the psychotherapy
cults. If the patients themselves are faithless, at least sane people, or those who cannot tolerate
misbehavior, can put disorderly people out of the way in institutions for the mentally ill.
Understandably, Szasz critique of his profession was not appreciated. It was a direct attack,
questioning the motives of everyone involved in the mental illness racket, excepting perhaps, the
neurologists who were looking for a causative organic link to mental anomalies. But then the
disease then would not be mental. Mental illness, on the one hand, is an euphemism
intended to relieve misbehaving people from blame for their condition; on the other hand, it may
deemed an insult to the dignity of the human being, whose essential difference from other
animals is the ability to think.
No doubt many psychiatrists have the best of intentions; they care for their patients and would
like to see them behave normally, at least to make the adjustments necessary to lead a
productive life; that is, one that adds to the gross national product at least to the extent that
others do not have to support them. But mandatory adjustment to the status quo disturbs people
who do not want to conform or who want the status quo to change. Yes, one of the main
categories in the Diagnostic Standards Manual is adjustment disorders.
Everyone has encountered mentally disturbed or deranged individuals; mental illness may be a
myth, but there is definitely something wrong with them, with their behavior. They do not fit
into our culture, the irresponsible insane persons (quasi-infants or idiots), and especially adults
possessing free will who therefore deliberately misbehave.
In any case, behavior is the key word. Is the misbehavior simply immoral, a moral issue rather
than a question of neurological malfunction?
As for psychiatry, it ought to be clear that, except for the diagnoses of
neurological diseases (treated by neurologists), no psychiatric diagnosis is, or can
be, pathology-driven. Instead, all such diagnoses are driven by non-medical, that
is, economic, personal, legal, political, or social considerations and incentives.
Hence, psychiatric diagnoses point neither to anatomical or physiological lesions,
nor to disease-causative agents, but allude to human behaviors and human
A critical mind, kind enough to acquit psychiatry of bad intentions, might even say the
psychotherapy profession is a symptom of the sick society it wants to cure, but lacks the means
to alleviate the basic anxiety terribly aggravated when philosophy, the queen of the hard and soft
sciences, was reduced to positivist psychology after the so-called Supreme Being was

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Quoted: Szasz, Thomas. Mental illness is still a myth. Society 31.4 (1994)

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