Wayne Ramsay, J.D.
All diagnoses and treatment in psychiatry assumes the validity of the concept of mental illness or mental disorder. Coverage for psychiatric and other mental health treatment in health insurance policies is based on the same assumption. However, many mental health professionals have questioned the validity of the concepts of mental illness and mental disorder.
The best known of these is psychiatry professor Thomas Szasz, M.D., whose book The Myth of Mental Illness was published in 1961.1
However, even before this, in 1958, Philadelphia psychiatrist Philip Q. Roche, M.D., who was winner of the American Psychiatric Association's Isaac Ray Award for outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence, in his book The Criminal Mind, said:
[I]n the natural world there is no such thing as mental disease or defect, but rather certain patterns of behavior to which, in a given social context, we apply certain names which enable us to talk about and to effect certain changes in the social relationships of those who exhibit them and to effect changes in the individuals themselves. At best, we are left to the imposition of purely arbitrary criteria in selecting such persons.2
In his testimony before the Mental Health Committee of the New York State Assembly (state legislature) on May 18, 2001, neurologist John Friedberg, M.D., said, “I do not believe in mental illness....Psychiatric drugs and electroshock inflict real injury in the name of treating fictive maladies.”3
In 2012, neurologist Fred A. Baughman, M.D., said “there is no such thing whatsoever as a psychiatric or psychological disease.”4
In 2018, Chuck Ruby, Ph.D., a psychologist and Executive Director of the International Society for Ethical Psychology and Psychiatry (ISEPP), said “The conventional mental health industry goes to great lengths in an attempt to perpetuate the myth of mental illness ... ISEPP's goal is to dispel the myth of mental illness....The problems we've dubbed mental illnesses are about inter- and intra-personal, spiritual, existential, economic, and political matters, not real disease."5
In 2013, in their book Mad Science, Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., and David Cohen, Ph.D., said:
…we have argued, the existence of a disease of mental illness has never been established...together we've amassed over seventy five years of teaching mental health courses in graduate schools of social work to thousands of students and practitioners...after more than ten decades of determined research and the expenditure of untold sums, no one can verify that madness is a medical disease....There is, of course, the unpredictable but remote possibility that the psychiatric system produces it's ‘Gorbachev,’ a widely acknowledged leader and spokesperson who says plainly and loudly that the emperor has no clothes, that while many people could use help for their distress or have their disturbance contained to preserve our peace of mind, there is no mental illness.6
In a lecture in 2015, psychologist Paula J. Caplan, Ph.D., said, “Nobody should be diagnosed with mental illness.” After her lecture I asked Dr. Caplan if she really meant nobody. She said yes and that is the reason the concept of mental illness itself is not valid.7
In 2015, in his book Deadly Psychiatry and Organized Denial, Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, said:
Quite often, psychiatrists prefer to talk about a mental disorder, rather than a mental illness or disease, which is because psychiatric diagnoses are social constructs....psychiatrists have blown life into a social construct that is nothing but a variation of normal behavior and have given this construct a name, as if it existed in nature and could attack people.”8
The Merriam-Webster Dictionary defines “social construct” as “an idea that has been created and accepted by the people in a society”.9 Physical realities are not social constructs. For example, cancer is not a social construct. Cancer is not a social construct because it exists whether we believe in it or not. On the other hand, “crime” is a social construct: There is nothing in nature that defines hurting or killing a person or an animal as wrong. Crime exists only because we define certain actions as crimes or our common agreement that certain things are crimes.
My argument here is that “mental illness” is only a social construct, not a real disease. Mental illness exists only in the way crime exists and does not exist in the way cancer does. There is no evidence for mental illness or disorder as a biological fact rather than as a social construct:
In 1974, in his book The Death of Psychiatry, psychiatrist E. Fuller Torrey, M.D., wrote, “None of the conditions that we now call mental ‘diseases’ have any known structural or functional changes in the brain which have been verified as causal.”10
In 1988, Seymour S. Kety, M.D., Professor Emeritus of Neuroscience in Psychiatry, and Steven Matthysse, Ph.D., Associate Professor of Psychobiology, both of Harvard Medical School, said “an impartial reading of the recent literature does not provide the hoped for clarification of the catecholamine hypotheses, nor does compelling evidence emerge for other biological differences that may characterize the brains of patients with mental disease.”11
In 1992, a panel of experts assembled by the U.S. Congress Office of Technology Assessment concluded: “Many questions remain about the biology of mental disorders. In fact, research has yet to identify specific biological causes for any of these disorders....Mental disorders are classified on the basis of symptoms because there are as yet no biological markers or laboratory tests for them.”12
In 1996, psychiatrist David Kaiser, M.D., said “modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness.”13
In 1998 in his book Blaming the Brain: The Truth About Drugs and Mental Health, Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, said: “Contrary to what is often claimed, no biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients.”14
According to neurologist Fred Baughman, M.D., in 1999, “there is no scientific data to confirm any mental illness.”15
In 1999, in their textbook Neurobiology of Mental Illness, three psychiatry professors at Yale University School of Medicine (Dennis S. Charney, M.D. et al.) said “We have so far failed to identify bona fide psychiatric disease genes or to delineate the precise etiological and pathophysiological basis of mental disorders.”16
In 2000, in his book Prozac Backlash, Joseph Glenmullen, M.D., clinical instructor in psychiatry at Harvard Medical School, said “In medicine, strict criteria exist for calling a condition a disease. In addition to a predictable cluster of symptoms, the cause of the symptoms or some understanding of their physiology must be established....Psychiatry is unique among medical specialties in that...We do not yet have proof either of the cause or the physiology for any psychiatric diagnosis.”17
In 2001, in his book Commonsense Rebellion: Debunking Psychiatry, Confronting Society, psychologist Bruce E. Levine, Ph.D., said “no biochemical, neurological, or genetic markers have been found for attention deficit disorder, oppositional defiant disorder, depression, schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling, or any other so called mental illness, disease, or disorder.”18
In 2009, Allen Frances, M.D., chairperson of the Task Force that created two editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM IV (1994) and DSM IV TR (2000), criticizing the proposed Fifth Edition of this book published in May 2013, noted that “not even 1 biological test is ready for inclusion in the criteria sets for DSM V.”19 In 2013, in his book Saving Normal: An Insider's Revolt Against Out of Control Psychiatric Diagnosis, DSM 5, Big Pharma, and the Medicalization of Ordinary Life, Dr. Frances said “The powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive compulsive disorder or for any other mental disorders...We still do not have a single laboratory test in psychiatry....thousands of studies on hundreds of putative biological markers [for mental illness] have so far come up empty.”20
In a lecture at the University of New England in 2013, British psychiatrist Joanna Moncrieff, Senior Lecturer in Mental Health Sciences at University College London, said “There is just absolutely no evidence that anyone with any mental disorder has a chemical imbalance of any sort...absolutely none.”21
In 1991, in his book Toxic Psychiatry, psychiatrist Peter Breggin, M.D., said “there is no evidence that any of the common psychological or psychiatric disorders have a genetic or biological component.”22 Twenty-four years later, on the Coast to Coast AM radio show on February 9, 2015, Dr. Breggin said “There is no known physical connection to any psychiatric disorder. There is no genetically determined cause. It's all drug company propaganda, because the pharmaceutical industry with its billions of [advertising] dollars, and the medical industry, thinks you're more likely to take drugs if you think you have a genetic or biological disease.”
In 2015, in his book Deadly Psychiatry and Organized Denial, Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, said “it hasn't been possible to demonstrate that people suffering from common mental disorders have brains that are different from healthy people's brains.”23
So, if mental illnesses, mental diseases, or mental disorders or syndromes must have a biological etiology or cause to qualify as illness, disease, disorder, or syndrome, none have been proved to exist.
Mental illness being a social construct and not a real illness, disease, syndrome, or disorder is illustrated by the fact that homosexuality was once considered mental illness or disorder but is not now in 2019. Homosexuality was officially defined as a mental disease or disorder on page 44 of the American Psychiatric Association's standard reference book, DSM II: Diagnostic and Statistical Manual of Mental Disorders (the 2nd Edition), published in 1968. In 1973, the American Psychiatric Association voted to remove homosexuality from its official diagnostic categories of mental illness.24 So when the third edition of this book was published in 1980 it said “homosexuality itself is not considered a mental disorder.”25 The 1987 edition of The Merck Manual of Diagnosis and Therapy states: “The American Psychiatric Association no longer considers homosexuality a psychiatric disease.”26 If mental illness were really an illness in the same sense that physical illnesses are, the idea of deleting homosexuality or anything else from the concept of illness by having a vote would be as absurd as a group of physicians voting to delete cancer or measles from the concept of disease. But mental illness isn't “an illness like any other illness.” Unlike physical disease where there are physical facts to deal with, mental “illness” is entirely a question of values, of right and wrong, of appropriate versus inappropriate. After homosexuals successfully demanded acceptance of their sexual orientation, it no longer seemed appropriate to call homosexuality a “disorder.”
If anyone should be able to define what is and is not a mental disorder, it is Allen Frances, M.D., chairperson of the Task Force that created the 1994 and 2000 editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). According to Dr. Frances, “there is no definition of a mental disorder. It's bullshit. I mean, you just can't define it.”27
Actually, you can: The defining characteristic of a mental illness or disorder is simply disapproval: Anything in a person's mentality that most people greatly disapprove of qualifies. This is true whether it is homosexuality or unusual political or religious beliefs, or anything else. For example, when the “New Hampshire Hospital was established, in 1842...in the first year, more than a quarter of admitted patients suffered from an ‘overindulgence in religious thoughts,’ with several claiming to be prophets”.28 Political dissidents have been committed to mental hospitals in the Soviet Union and China29 — and the USA: When I observed commitment hearings in Washington, D.C., many were “White House cases,” people who went to the White House to protest something and were involuntarily “hospitalized.”
Today's almost universal belief in mental illness can be compared with another, at one time, almost universal belief that was also only a social construct: witchcraft. Belief in witchcraft resulted in the infamous Salem witchcraft trials and the conviction and execution of supposed witches. A witch was defined as a person who was in league with the Devil and had supernatural powers. There actually were no such persons. Just as it was impossible to be a witch, it is impossible to be “mentally ill” in a genuinely biological, medical, or scientific sense. Scientific determination that a person is mentally ill is as impossible as scientific determination that someone is a jerk. Calling someone mentally ill or disordered reveals an attitude rather than stating a fact.
What if we did find a biological cause of a supposed mental illness or disorder? Were that to happen, psychiatry professor Thomas Szasz once said, the finding of a physical cause would make the problem a physical illness, and whatever mental changes occurred as a result would be symptoms of bodily disease.30 For example, brain cancer, stroke, and bacterial or viral infection of the brain are not usually considered causes of mental illness even when they cause abnormalities in thinking or behavior. Since nothing can be an “illness” (or disease or syndrome or disorder) without a biological abnormality, and the finding of a biological abnormality makes the problem a physical illness rather than a mental illness, “mental illness” is actually an oxymoron or nonsensical term.
People can and do experience debilitating depression, anxiety, obsessions, compulsions, phobias, panic attacks, hallucinations, and delusions, and they may be violent or suicidal, but there is no evidence the reason is usually or typically biological abnormalities or, in other words, illnesses.
Because “mental illness” is an invalid concept, all laws predicated on “mental illness” should be repealed or invalidated by courts. Nothing should ever happen because of diagnosis of fictitious disease.
(1) Thomas S. Szasz, The Myth of Mental Illness (Harper & Row 1961).
(2) Philip Q. Roche, The Criminal Mind (Farrar, Straus and Cudahy 1958), p. 253.
(3) John M. Friedberg, M.D., “Neurologist John M. Friedberg on ECT”, May 18, 2001, http://ectjustice.com/neurologist-john-m-friedberg-on-ect/, accessed January 5, 2019.
(4) Fred A. Baughman, M.D., in his lecture at the Empathic Therapy Conference 2012, “The ADHD Stimulant Epidemic”, at 33 minute, 2 seconds point, available on DVD at EmpathicTherapy.org.
(5) Chuck Ruby, Ph.D., April 2018 Bulletin of the International Society for Ethical Psychology & Psychiatry, https://psychintegrity.org/wp-content/uploads/2018/11/Apr-2018.pdf, accessed January 5, 2019
(6) Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., & David Cohen, Ph.D., Mad Science (Transaction Publishers 2013), pp. 195, 301, 302, 328, italics in original, underline added.
(7) Paula J. Caplan, Ph.D., “Diagnosisgate”, conference of National Association for Rights Protection and Advocacy (narpa.org), Washington, D.C., August 23, 2015.
(8) Dr. Peter C. Gøtzsche, Deadly Psychiatry and Organized Denial (People's Press 2015), pp. 26 & 145.
(9) “Social construct”, Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/social%20construct?utm_campaign=sd&utm_medium=serp&utm_source=jsonld, accessed January 5, 2019.
(10) E. Fuller Torrey, M.D., The Death of Psychiatry (Penguin Books 1974), pp. 38-39.
(11) Seymour S. Kety, M.D. & Steven Matthysse, Ph.D. in Armand M. Nicholi, Jr. (ed.), The New Harvard Guide to Psychiatry (Harvard University Press 1988), p. 148.
(12) The Biology of Mental Disorders (U.S. Gov't Printing Office 1992), pp. 13, 14, 46, 47.
(13) David Kaiser, M.D., “Commentary: Against Biologic Psychiatry”, Psychiatric Times, December 1996, http://www.psychiatrictimes.com/bipolar-disorder/commentary-against-biologic-psychiatry, accessed January 5, 2019.
(14) Elliot S. Valenstein, Ph.D., Blaming the Brain: The Truth About Drugs and Mental Health (Free Press 1998), p. 125.
(15) Fred Baughman, Insight magazine, June 28, 1999, p. 13.
(16) Dennis S. Charney, M.D. et al., Neurobiology of Mental Illness (Oxford Univ. Press 1999), p. vii.
(17) Joseph Glenmullen, M.D.,, Prozac Backlash (Simon & Schuster 2000), pp. 192, 193.
(18) Bruce Levine, Ph.D., Commonsense Rebellion (Continuum 2001), p. 277.
(19) Allen Frances, M.D., “A Warning Sign on the Road to DSM V”, Psychiatric Times, June 26, 2009, http://www.psychiatrictimes.com/diagnostic-and-statistical-manual-mental-disorders/warning-sign-road-dsm-v-beware-its-unintended-consequences, accessed January 5, 2019.
(20) Allen Frances, M.D., Saving Normal (Harper¬Collins 2013), pp. 10, 11, 244.
(21) “Joanna Moncrieff—The Myth of the Chemical Cure; The Politics of Psychiatric Drug Treatment”, https://www.youtube.com/watch?v=IV1S5zw096U, at 53 minutes, 52 seconds point, accessed January 5, 2019.
(22) Peter Breggin, M.D., Toxic Psychiatry (St. Martin's Press 1991), p. 291.
(23) Dr. Peter Gøtzsche, Deadly Psychiatry and Organized Denial (People's Press 2015), p. 26.
(24) “An Instant Cure”, Time magazine, April 1, 1974, p. 45.
(25) American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III - 1980), p. 282.
(26) Merck Manual of Diagnosis and Therapy, 15th edition, 1987, p. 1495.
(27) Allen Frances, M.D., quoted by Gary Greenberg, “Inside the Battle to Define Mental Illness”, Wired Magazine, December 27, 2010, https://www.wired.com/2010/12/ff_dsmv/ , accessed January 5, 2019.
(28) Rachel Aviv, “God Knows Where I Am”, in M. Kaku (ed.), Best American Science Writing 2012 (HarperCollins 2012), p. 246-247.
(29) Richard J. Bonnie, LL.B.,“Political Abuse of Psychiatry in the Soviet Union and in China”, J.Am.Acad.Psych.Law 30:136-44 (2002), http://jaapl.org/content/jaapl/30/1/136.full.pdf, accessed January 5, 2019
(30) Thomas S. Szasz, Lexicon of Lunacy (Routledge 1993), p. 33.
“There is no such thing as mental illness”, Stefan Molyneux, YouTube.com (2011)
THE AUTHOR, Wayne Ramsay, is a lawyer with the Law Project for Psychiatric Rights (PsychRights.org).