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The Myth of Mental Illness: Foundations of a Theory of Personal Conduct Paperback – February 23, 2010

by Thomas S. Szasz (Author)
4.5 4.5 out of 5 stars 819 ratings
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“The landmark book that argued that psychiatry consistently expands its definition of mental illness to impose its authority over moral and cultural conflict.”  — New York Times

The 50th anniversary edition of the most influential critique of psychiatry every written, with a new preface on the age of Prozac and Ritalin and the rise of designer drugs, plus two bonus essays.

Thomas Szasz's classic book revolutionized thinking about the nature of the psychiatric profession and the moral implications of its practices. By diagnosing unwanted behavior as mental illness, psychiatrists, Szasz argues, absolve individuals of responsibility for their actions and instead blame their alleged illness. He also critiques Freudian psychology as a pseudoscience and warns against the dangerous overreach of psychiatry into all aspects of modern life.

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  1. Print length
    368 pages
  2. Language
    English
  3. Publication date
    February 23, 2010
  4. Dimensions
    5.31 x 0.83 x 8 inches
  5. ISBN-10
    0061771228
  6. ISBN-13
    978-0061771224
  7. See all details
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Editorial Reviews

Review

“The landmark book that argued that psychiatry consistently expands its definition of mental illness to impose its authority over moral and cultural conflict.” — New York Times

“Enormously courageous and highly infomative, and it makes fascinating reading . . . bold and often brilliant.” — Science

“Controversial and influential . . . an iconoclastic work.” — Joyce Carol Oates, New York Times Book Review

“Szasz’s radical views on mental illness and drug addiction have been presented with great consistency and courage . . . I predict that Dr. Szasz’s work and thought will once again come to the fore: he takes the long view.” — Will Self, The Times (London)

“A classic.” — Salon.com

“A damning critique of mental illness . . . a classic work.” — Toronto Star

“Quite probably, Szasz has done more than any other man to alert the American public to the potential dangers of an excessively psychiatrized society.” — Atlantic Monthly

From the Back Cover

50th Anniversary Edition With a New Preface and Two Bonus Essays

The most influential critique of psychiatry ever written, Thomas Szasz's classic book revolutionized thinking about the nature of the psychiatric profession and the moral implications of its practices. By diagnosing unwanted behavior as mental illness, psychiatrists, Szasz argues, absolve individuals of responsibility for their actions and instead blame their alleged illness. He also critiques Freudian psychology as a pseudoscience and warns against the dangerous overreach of psychiatry into all aspects of modern life.

Product details

  • Publisher ‏ : ‎ Harper Perennial; Anniversary edition (February 23, 2010)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 368 pages
  • ISBN-10 ‏ : ‎ 0061771228
  • ISBN-13 ‏ : ‎ 978-0061771224
  • Item Weight ‏ : ‎ 9.5 ounces
  • Dimensions ‏ : ‎ 5.31 x 0.83 x 8 inches
  • Customer Reviews:
    4.5 4.5 out of 5 stars 819 ratings

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  1. Thomas Szasz

    Thomas Szasz

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Customer reviews

4.5 out of 5 stars
4.5 out of 5
819 global ratings

Top reviews from the United States

Terrence McCarthy
5.0 out of 5 stars Excellent read
Reviewed in the United States on February 5, 2024
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Well stated and supported book on the personal responsibility of your own choices. Explains why medicines are rarely the answer as its not a chemical issue, it is the choices of the individual. Brings hope that people do have control and are not " victims" of inescapable biology. That they themselves do have choices in life and are not at the mercy of errant genes or somehow the past is always causing a life to occur that the person does not want but cannot establish any control over. And the victim mentality.
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Bill Norwood
5.0 out of 5 stars Coping Vs. Illness
Reviewed in the United States on January 23, 2006
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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
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Mathew Knudson
5.0 out of 5 stars As a person with bipolar disorder, I love this book. Understand his subtlety and you will learn a lot.
Reviewed in the United States on January 3, 2015
Verified Purchase
I will start by saying I have Bipolar Disorder, and have struggled with it for many years.

I've had some time off recently, so I wanted to really investigate the science behind my disorder. I started with two books on mental health policy over the past 50 years ( "American Psychosis" for a negative take, and "Better but Not Well" for a more positive, mainstream take), then I read the latest psychiatric information about the disorder- the suspected genetic causes , the brain chemistry approach, the neurological evidence from the official peer-reviewed literature. I altogether found it unsatisfying. Everywhere I turned, it was always "While the specific mechanism is unknown, it is believed..." or "While specific genes cannot be found, it does seem to run in families..." Even the neurological explanation didn't seem able to distinguish cause from effect, or come up with any predictive mechanism. I began to really question the mainstream, so I read "Anatomy of an Epidemic", which was an excellent summary of all the research showing that the brain-chemistry model is ineffective. I even investigated my own medication, and found that Lamictal, the primary drug of choice for bipolar treatment, was found to be ineffective in 7 out of 9 clinical trials ( Of course GSK only published the positive two).

All Thomas Szasz really says here is that we can't view mental illness, that is to say, the major mood disorders and psychoses, as normal diseases. We can't pretend that mental illness is some exogenous force that is totally irrelevant of the victim's life experiences, the victims traumas and tragedies, and the victim's behaviors. In fact, new research into the pscychosocial explanation finds very strong evidence for the importance of these things in predicting the incidence of mental illness. And if its true, as Szasz argues, that there is this very strong psychosocial element, then therapy to understand these issues and perceptions and to allow the patient to change behavior is the best option for treatment. Again, research shows the efficacy of Psychotherapy in general as well as CBT specifically.

Finally, I can say he is 100% correct in his assertion that much of psychiatry is inhumane. Involuntary treatment, and even the attitude that certain ways of life are "right" and other ways "bad," are means of controlling people. They are a way for society to get rid of undesirables and call it compassion, and on the other side, an escape valve for the oppressed. A key piece of evidence for this is that "homosexuality" was a mental illness for a long time, something we would scoff at now; that was a means of social control, not a means of helping the patient. Healing can only occur in an atmosphere of respect and dignity, where the doctor respects the patient's rights and autonomy, and where the patient takes responsibility.

The book is quite plodding at points, but if you skip his abstract explanations and jump straight to the examples he gives, it is very clear. While I'm not convinced that all mental illness is purely a construction, I think Szasz hits the nail on the head for the general direction Psychiatry has moved.
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Top reviews from other countries

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JG
5.0 out of 5 stars Critique astucieuse et érudite de la psychiatrie
Reviewed in Canada on December 19, 2023
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Une analyse du phénomène psychiatrique qui va au-delà des platitudes couramment entendues au sujet de la santé mentale et de ce que l’on prétend appeler « maladie mentale ».
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Miguel Angel Cisneros Saucedo
1.0 out of 5 stars What a disappointment
Reviewed in Mexico on November 26, 2021
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I must say that I am deeply disappointed by Szazs comments on Christianity. On page 169, Szasz cites Luke 18:18-30 to claim that Christianity goes against being "healthy, independent, rich, proud".
So, is this passage really endorsing the "sick, poor, dependent, and humble"? Let's find out.

In this passage (Mat. 19:16-26), it should be known that only God is good. Only God, and not good works, is the only source of eternal life. In dictating to "keep the commandments" Jesus wants people to recognize that they are sinners. No one, except Jesus, could be able to keep the commandments of the law. The commandments only serve to reveal sin. They are not to be fulfilled or please God. In verse 21, Jesus now reveals the problem of that specific man: because of his greed he did not keep the commandments. This demand of Jesus is NOT an absolute requirement for discipleship (Zacchaeus offering only half of his possessions; Luke 19:8-9). There is nothing in this entire passage that refers to "sickness" or claims of lack of health.
However, Christ can rightfully make requisitions in regard to giving up earthly possessions and distributing them as donations, in short, Jesus can denounce anything that prevents the person from recognizing himself as a sinner and criminal before God, and assume that divine wrath was poured out on the cross for his/her injustices.
The central point of Jesus is that wealth gives a false sense of security in this life, which prevents the tranquility granted by a spiritual state of surrender.
Finally, Jesus demanded that the young man sell his things, not give them away! For me, this is a clear invitation to the free market and philanthropy. Here Szasz assumes without any justification that not being "wealthy" is in some way humiliating, "painful" and "self-damaging". Nowhere can we see Jesus demanding that men must be "sick, poor, dependent, humble".

Then, Szasz quotes the famous, and often misinterpreted, sermon on the Mount as illustrating Bible rules "fostering dependency and disability". He says: "This passage articulates most clearly the basic rules by which the Christian God plays His game with Man". First of all, Szasz "paraphrases" the passage from Matt. 5:1-12. His resulting interpretation is, then, that man should be "stupid, submissive, not smart, well-informed, or assertive; passive, weak, not self-reliant; naive, unquestioningly loyal and no entertain doubt".

Okay, first of all, Szasz eliminates the word "Blessed" to fit his narrative, and this is because in each case Jesus says that those whom the world considers unhappy or unlucky are actually blessed because a reward awaits them. Jesus describes the characteristics of those who will inherit the kingdom of heaven because they respond to the gospel with faith. Here the poor, what they do not have is the egoism and arrogance of people like Szasz who believe that their efforts and merits have given them a special social position.
By "meek" Jesus is referring to those who are not arrogant because they understand that they are sinners, not better than anyone else and that only through repentance and faith can they be saved.
By "pure of heart" Jesus is referring to those whose sins have been forgiven through the sacrifice of Christ when he received all the divine justice and punishment that all sinners deserved.

So, NO, Jesus never claimed anything that Szasz mentioned. In fact, it is Sasz who is naive, pusillanimous, and emotional, just like Freud, Sartre, and Nietzsche.
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Berretto a sonagli
5.0 out of 5 stars Brilliant
Reviewed in Italy on December 13, 2023
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The ideas expressed in this book by Thomas Szasz are truly revolutionary, even if – sometimes – they are expressed in a too technical language. I sincerely hope that his effort was not in vain and that psychiatry will be recognized – as soon as possible – as unscientific.
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Akki@
5.0 out of 5 stars True gem...
Reviewed in India on November 29, 2020
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A must read for beginners in this field and also for people who wish to specialise for that matter.
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Client d'Amazon
5.0 out of 5 stars A must read
Reviewed in France on April 6, 2020
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Life changing book, asking the essential questions about the nature of the so called mental illnesses and the great confusion between a metaphore and the words that compose it
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