Why the Myth of Mental Illness Lives On (Part 1)
Wayne Ramsay, J.D.
“The opinion that mental illness does not exist has been advanced by, among others, psychiatrist Thomas Szasz, sociologists Thomas Scheff and Erving Goffman, and psychologist Theodore Sarbin”.1 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 this:
I do not believe in mental illness. ... Psychiatric drugs and electroshock inflict real injury in the name of treating fictive maladies. ... My opinions are based on my years of experience with patients and review of records from all over the country as an expert witness in electroshock malpractice cases.2
In 2011, Steve Balt, M.D., a psychiatrist at the UCLA-Kern Medical Center in Bakersfield, California, acknowledged “some argue convincingly that mental illness is itself a false concept," citing an article by psychiatry professor Thomas Szasz.3 Dr. Szasz published his book The Myth of Mental Illness in 1961, which now in 2019 is 58 years ago. If mental illness is a myth, why do people still believe in mental illness?
One reason is the effects of repetition over time. The more often one hears a myth stated, the harder it is to bring oneself to use one's own powers of perception and reason to examine and question it. Almost everything we read in newspapers and magazines, and almost everything we see on television or hear on radio, and much of what we read on the Internet, discusses “mental illness” as if it were as real and valid a concept as heart disease or cancer. We tend to believe what those around us believe, and eventually “most of our stored misinformation is virtually [metaphorically] cast in concrete.”4
Another reason the myth of mental illness and other widespread myths persist is the risk to anyone who questions what almost everyone believes. Dare one be the first to declare the emperor has no clothes? People who clearly understand the mythical nature of a widespread belief risk the disapproval of others, or worse, if they speak the truth about these myths. Historians have said those questioning the concept of witchcraft in the 1690s when the Salem, Massachusetts witch trials took place risked being accused of being witches themselves. According to Peter Charles Hoffer, research professor of history at the University of Georgia, in his book The Salem Witchcraft Trials—A Legal History:
In the 1600s, popular or “vernacular” belief in witches was repeated in the writings of the most learned men. ... In the late sixteenth century, many educated men assumed that there was a spirit (invisible) world, and that the Devil and His witches could move freely through it. ... Everyone believed in witches ... no lawyers stepped forward during the [witch] trials to help the accused”, but if they had, the people making such accusations “would probably have accused the lawyers of witchcraft before long.”5
Just as lawyers speaking on behalf of defendants in the Salem, Massachusetts witchcraft trials of the 1690s would have been in danger of being accused of witchcraft themselves, as a lawyer representing or speaking in defense of people accused of mental illness today, a reaction I sometimes get is people accusing me of being crazy. As psychiatry professor Thomas Szasz says in his book Suicide Prohibition—The Shame of Medicine, “The individual who assumes the task of setting such dislocations aright runs the risk of being destroyed in the process.”6
A related reason for the persistence of the concept of mental illness is support by supposed experts—psychiatrists and psychologists—who make money and acquire professional prestige with the use of the concept. Their status as experts would be lost and their incomes would drop dramatically if the falseness of the concept of mental illness were widely and generally acknowledged. As Judi Chamberlin wrote in her book about psychiatry, “Leaving the determination of whether mental illness exists strictly to the psychiatrists is like leaving the determination of the validity of astrology in the hands of professional astrologers.”7 Support for a myth from those perceived as experts, even if they actually are not experts, makes a myth harder to question.
The inexplicit nature of the concept of mental illness also contributes to the perpetuation of this myth. Consider another myth: Can it really be proved evil spirits do not exist, and that they do not possess people? Even as perceived by those who believe in it, the concept of mental illness is as amorphous and difficult to pin down in specific terms as the idea of evil spirit possession. Some, like Millen Brand in an article in 1970 in The Journal of Contemporary Psychotherapy titled “Is Mental Illness a Myth?” argue against the notion that “because ‘mental illness’ isn't a medical or physical illness, it doesn't exist at all.”8 Psychologist Vernon W. Grant, Ph.D., in his book This Is Mental Illness, says this:
There is, again, a certain tendency in popular thinking to suppose that mental illness includes something more than the symptoms. Thus a person is said to be doing or saying certain things because is mentally ill. The illness, supposedly, causes him to act and speak as he does. ... It would be misleading, however, to say that the abnormal ways of feeling and perceiving are caused by “mental illness.” These ways of feeling and perceiving are the illness. Too often the term suggests a mysterious something behind the unusual behavior.9
Other mental health professionals argue there is a mysterious something behind, or causing, the person's behavior, or so-called symptoms, and that this mysterious something is a still undiscovered “chemical imbalance” in the brain or some other brain abnormality. They argue mental illness is, by definition, a disease of the brain, even if current science can find nothing wrong with the brains of supposedly mentally ill people. Mental health professionals can't agree among themselves about whether mental illness is physical or non-physical. Being a vague concept makes the concept of mental illness more difficult to disprove and reject than it would be if it were clearly defined.
Also helping to perpetuate the myth of mental illness is the desire of some people to avoid personal responsibility for their actions and their lives. These are the people who telephone or write to me hoping I will, as a lawyer, help them prove that because of their supposed mental illness they are not responsible for something they did. These also are the people who go to a mental health professional and in effect say “Doctor, make me happy”: It is much easier to swallow supposedly antidepressant pills than get a better education or a better job, or a better marriage or intimate relationship, or be cured of a serious health problem like cancer. People who neglect or mistreat their children sometimes rely on the concept of mental illness to relieve them of responsibility for how their children turn out as adolescents or adults. What have they done wrong? In many cases, the answer is plenty. But they prefer to believe a disease (mental illness) that “could happen to anyone” intervened and that “It's no one's fault.”
Another reason is our discomfort with ignorance. When we don't understand the real reasons for something, we often create myths to give us an illusion of understanding. Believing a myth is more comfortable than acknowledging ignorance. For example, ancient man did not understand the why behind rain and therefore created the myth of the Rain God. As man gained a knowledge of meteorology and hence a true knowledge of the why behind rain, the Rain God was no longer needed, and the Rain God idea was discarded. Earlier in human history, being baffled by the thinking and behavior of some people, people theorized the existence of evil spirits or demons and created the myth of demon possession, the belief that people behaved strangely or wrongly because they were possessed by evil spirits. In the words of A. John Rush, M.D., “Deranged behaviors were typically considered curses from the gods by the Ancients... During the Dark Ages, Western civilization returned to beliefs in possession and supernatural forces as explanations for psychiatric disorders.”10 Today we attribute thinking or behavior we dislike and don't understand to mental illness. However, mental illness is just as much a myth as curses by gods or possession by evil spirits. Often we just don't know why people think or act as they do. Rather than acknowledge our ignorance, which makes us uncomfortable, we create myths such as evil spirits or mental illnesses to provide an explanation.
Why aren't all crimes considered mental illnesses or the result of mental illness? Some people do say “all criminals are sick.” However, for those of us who don't agree with this viewpoint, the difference between crime and mental illness typically is this: When we feel we understand the motives behind the disapproved behavior, we make the behavior a statutory offense. When we do not understand the motives behind disapproved behavior, we cover up our ignorance of these motives by creating a myth—the myth of mental illness—and say mental illness caused the behavior — and punish the supposedly mentally ill person with involuntary “hospitalization” or an involuntary outpatient commitment order, and forced psychiatric “therapy” such as “involuntary medication”, or involuntary guardianship of his person and property. The myth of mental illness deludes us into believing we understand the reasons for disliked behavior that we in fact do not understand.
Another reason for continued belief in mental illness is drug company advertising designed to convince everyone mental illness is biologically caused. Marcia Angell, M.D., former editor-in-chief of the New England Journal of Medicine, in her book The Truth About Drug Companies—How They Deceive Us and What To Do About It approvingly quotes bioethicist Carl Elliott saying “The way to sell drugs is to sell psychiatric illness.”11 Psychiatrist Colin A. Ross, M.D., makes a similar comment in his autobiographical book The Great Psychiatry Scam—One Shrink's Personal Journey: “Whatever makes mental illness be biological sells drugs.”12 In Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, psychiatrist Allen Frances says —
Psychotropic drugs are now among the very top best sellers for the drug companies. Their stock prices would be cut by more than half were it not for the antipsychotics, antidepressants, stimulants, antianxiety agents, sleeping pills, and pain meds. ... At the very top of the Pharma hit parade are the antipsychotics at a resounding $18 billion a year.13
Do you think drug company executives and advertising departments will tell the depressing truth about their products if widespread awareness of the truth would cause their company stock to be worth less than half what it is now? It is more likely they are determined to maintain the myth that mental illness is biological and to hide the harm done by psychiatric drugs so they can continue to earn huge profits from selling them. Advertising mental illness as biological when it is not to sell more psychiatric “medications” is unethical, but as Dr. Angell warns us in The Truth About Drug Companies, “Drug companies are in business to sell drugs. Period.”14 And drug companies have huge advertising budgets.
1 Judi Chamberlin, Own Our Own: Patient-Controlled Alternatives to the Mental Health System(National Empowerment Center 1977), p. 8
2 John Friedberg, M.D., https://ectjustice.org/neurologist-john-m-friedberg-on-ect, https://web.archive.org, archive date: February 19, 2017, accessed August 5, 2019
3 Steve Balt, M.D., “Is the Criticism of DSM-5 Misguided?”, psychiatrictimes.com, December 22, 2011
4 I borrow this phrase from Donald G. Smith, How to Cure Yourself of Positive Thinking, E. A. Seemann Publishing, Inc., Miami, 1976, p. 73.
5 Peter Charles Hoffer, The Salem Witchcraft Trials—A Legal History(University Press of Kansas 1997), pp. 4, 78, 87, 89, 90
6 Thomas Szasz, M.D., Suicide Prohibition—The Shame of Medicine(Syracuse University Press 2011), p. 105
7 Judi Chamberlin, Own Our Own(note 1, above), p. 9
8 Millen Brand, “Is Mental Illness a Myth?”, The Journal of Contemporary Psychotherapy, Summer 1970, Vol. 3, p. 13
9 Vernon W. Grant, Ph.D., This Is Mental Illness(Beacon Press 1963), p. 4, italics in original
10 A. John Rush, M.D., “Diagnosis of Affective Disorders” in Depression Basic Mechanisms, Diagnosis, and Treatment(Guilford Press 1986), p. 2
11 Marcia Angell, M.D., The Truth About Drug Companies—How They Deceive Us and What To Do About It(Random House 2005), p. 88
12 Colin A. Ross, M.D., The Great Psychiatry Scam—One Shrink's Personal Journey(Manitou Communications, Inc. 2008), p. xv
13 Allen Frances, M.D., Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life(HarperCollins 2013), p. 104
14 Marcia Angell, M.D., The Truth About Drug Companies—How They Deceive Us and What To Do About It(Random House 2005), p. 250