If “Mental Illnesses” Aren’t Real Illnesses, What Are They?

Lawrence Kelmenson, MD
237
8994

Thomas Szasz explained that ‘mental illnesses’ are not really illnesses.1 This was verified by a meta-analysis of 107,000 studies that failed to find a biological marker for any mental illness.2 Yet this truth is not widely accepted. This is likely because he clarified what it isn’t, but not what it is, and it is something. He only said that they’re problems in living, which merely replaces one subjective label with another. Why are some ways of living called problems or illnesses, but not others? To find out why, I shall dissect out the different components of the APA’s definition of mental illness, and by process of elimination determine exactly what we mean by these concepts.

The APA says: “Mental illnesses are health conditions involving changes in thinking, emotion or behavior associated with distress and problems functioning in social, work or family activities”

Saying mental illness is a mental health condition is redundant/non-explanatory. It’s just the APA trying to get us to give in and accept that mental illnesses are real illnesses by saying it repeatedly.

Saying they’re certain thoughts, emotions, or behaviors seems to be valid (at least saying they’re certain thoughts or behaviors does, since there are but few emotions and we all experience them).

Saying they’re changes in thinking/behavior likely means changes from normal. But if this means rareness, then it’s invalid — Einstein used unusual thinking to develop the theory of relativity, yet wasn’t called mentally ill for that. Changes can’t mean extreme states, either, since extremely good piano players aren’t labeled as illAnd it can’t mean irrationality since most of us have beliefs not based in reality (such as mental illnesses being real illnesses); only some are considered ‘crazy.’

Distress isn’t definitive, since everyone endures sadness, frustration and anxiety. Though it varies in degree, life’s a struggle for everyone. It’s just that we’re raised/trained to only see certain ways of coping as mentally ill, and thus to only deduce that people who cope in these ways have issues and need help. If people listen to music or watch movies, we don’t assume they do it to cope with stress, but why else would they do it? As Maslow says: “Man is a perpetually wanting animal”3 whose actions are all driven by never-ending needs like food, safety, love, esteem and fulfillment.

Do the ‘mentally ill’ suffer more due to their symptoms? No — their symptoms aren’t forced on them by demons or brain illness; there’s no puppeteer controlling them. So symptoms must be voluntary (even if not fully aware of it) learned coping tools that became habits since they work for the person in some way, just as music or movies do for the ‘non-ill.’ As Szasz says: Symptoms must be “adaptive as some kind of life strategy, economic or interpersonal… or else he would have already changed it.”4 Our huge brains and free will enable us to choose from among endlessly diverse coping tools. Some are considered healthy and others are considered ill. Symptoms don’t cause distress; they’re just terms used to connote certain ways of coping with it. Which ways?

If I cope by engaging in music-listening or any activity to the exclusion of working or interacting with others, then I’ll be viewed as suffering from anxiety, schizophrenia, addiction, depression or OCD. Since listening to music can be healthy or ill depending on its context, mental illness can’t refer to certain types of thought or behavior, after all. So the only part of the APA’s ‘mental illness’ definition that’s objective fact, not value judgment, is: reduced functioning in work (job) or social (ways of interacting that society approves) areas. The DSM is a hodgepodge of unrelated coping styles that only have this one issue in common; that’s why it’s the only criterion needed by all its disorders.

Why did such a misleading, stigmatizing concept as mental illness evolve?

A society only thrives if its members give up the freedom to pursue their selfish wants at will, and instead work as a team to contribute to the common good, in exchange for the benefits of life in a safe/efficient society. Rousseau5 and Hobbes6 called this the social contract. Thriving societies deter members from harming each other via laws enforced by police, courts and jails. A society’s success also depends on people disapproving of those who put their own desires ahead of others; morals and ethics via religion achieve this end. But there’s a third type of social contract violator:

Societies invest many resources into socializing their kids (raising them to channel their free will into roles that promote society’s continuance). If they instead learn to cope in ways that entail not working, not developing society-sustaining relationships, or disrupting others’ efforts to do so, then society will weaken. For example, if people detach from a society that hurt them and choose to create their own reality, this may be adaptive for them but harmful to their society’s efficiency, since they probably won’t work or form families.

In the 1800s, many people opted to cope in ways other than socially integrating and cooperatively working toward the overall good (in other words, they went mad). This was perhaps because factory life was crowded, harsh, monotonous and thus painful/unrewarding. Foucault related how doctors excluded and confined them while spinning it as treatment of illness.7 This increased society’s efficiency by restricting it to those who worked as a team to uphold it. The high, dark, barred-window asylum walls were visible to all and thus ominously and authoritatively warned others not to follow these outliers’ paths. It’s not that they didn’t function due to illness; they were called ill due to functioning in ways that violated the social contract.

In the 1900s, psychiatry expanded its domain to include coping styles associated with only mild job/socializing issues. Each DSM invented new illnesses, which as time went by required less and less functional impairment (in 2013 its Global Assessment of Functioning was ended to assist this trend), so that more people could be targeted. Now everyone meets criteria for them. People who don’t defy the social contract are tricked into going to MDs to heal newly identified ‘illnesses’ that are merely annoying but unavoidable aspects of life such as painful feelings or their kids’ immaturity.

Modern psychiatry transforms these working adults into disabled ones by sedating/addicting them and fooling them into thinking they’re too ill to work. It also causes capable kids to be deprived of chances to learn skills needed to become productive to society. Patients are put on SSD/medicare so doctors can get paid monthly forever. Creating permanent clients is where the real money’s at.

Psychiatry’s main role now is thus to stop more and more able-bodied people from contributing to society, and to offer them society’s benefits that are contingent upon their not contributing. Psychiatry has mutated from feared enforcer to parasitic saboteur of the social contract on a huge scale — so it’s now an outlier that’s threatening society’s survival, and thus must be banished.

‘Mental illness’ is just a concept that evolved as a means to dehumanize people who coped in ways that didn’t help society thrive, so as to justify their forced removal from society. This also warned others that they too could be taken away by men in white coats if they did not join in and chip in. Perhaps people will be less easily lured into accepting their mental illness after learning its true meaning.

Show 7 footnotes

  1.  The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. Szasz, T, 1961, New York: Hoeber-Harper.
  2. “Why Has it Taken So Long for Biological Psychiatry to Develop Clinical Tests.” Kapur, S, et al, 2012 Molecular Psych 17, 1174-9.
  3. “A Theory of Human Motivation.” Maslow, A, 1943, Psychological Review 50(4)370-96.
  4. “Thomas Szasz on Freedom and Psychotherapy.” Wyatt, R, Psychotherapy.net, Dec 2000.
  5. The Social Contract. Rousseau, J, 1762.
  6. Leviathan. Hobbes, T, 1651.
  7. Madness and Civilization: A History of Insanity in the Age of Reason. Foucault, M, 1965, Random House, New York.

237 COMMENTS

    • Panic attacks can come from differing sources, depending on the individual- things that can range from Mg deficiency to “cerebral allergies” (“psychiatric” reactions to foods and inhalants), to various malfunctionings of the adrenal system, to things like PTSD, where they get conditioned into you, to speak of several examples. To successfully treat them, you need to know their origins and the treatments for each of them (at least beyond psychiatric drugging, which is dangerous in unskilled hands).

  1. Simple answer: There is no “they.” “They” are not “mislabeled”; “they” do not exist, period. Behavior is decontextualized and falsely categorized to mystify people and get them arguing over false issues, such as this. We need to understand that psychiatry is not a science or an art, it is a tool of repression, period, and hooking into its narrative in any way is a trap (or an excuse, depending on the circumstance).

    • Should LIttleTurtle say he has periods where he’s terrified to be in public, OldHead? I’m not being sarcastic.

      I could make a case for the term “narcissist” not as a disease,but a role played in many dysfunctional families. Did they include “Winged Monkeys,” “Scapegoat,” and “Golden Child” in the DSM5? Lol.

  2. People ought to read Szasz rather than quote him out of context. Then they could read Rousseau, Hobbes, and Foucault as well. Szasz wrote an entire book called “The Myth of Mental Illness.” But he also wrote several dozen other books. It’s a gross oversimplification to attribute to Szasz the idea that so-called “mental illnesses” are “problems in living.” That wasn’t his point. The main point, for Szasz, was that so-called “mental illness” is a myth, that is, that “mental illness” is a metaphor that psychiatrists use to label and to stigmatize others. Szasz was careful to distinguish between real illness and fake “mental illness.” “Mental illnesses” are not “problems in living.” “Problems in living” is one of the myriad excuses that psychiatrists use to justify and to conjure into existence fictitious diseases in order to legitimize their own practice. The key point for Szasz was that “mental illness” is not an illness like any other, such as cancer, diabetes, or malaria, but that psychiatrists “treat” “mental illnesses” as if they were real biological diseases. When Szasz referred to “problems in living” he was not attempting to justify the psychiatric activity of diagnosing fictitious diseases. He was doing precisely the opposite. His point was to show that there is no such thing as “mental illness,” and that it would be absurd to ask the question “If mental illnesses aren’t real, what are they?” Oldhead gets it right. To ask the question “If mental illnesses aren’t real, what are they?” is tantamount to wondering “If the Easter Bunny isn’t real, what is it?” It’s absurdity compounded by absurdity. There is no such thing as mental illness.

  3. Hi Lawrence,

    “..If I cope by engaging in music-listening or any activity to the exclusion of working or interacting with others, then I’ll be viewed as suffering from anxiety, schizophrenia, addiction, depression or OCD..”

    In present day terms, I would have thought that the problem would be supporting this type of lifestyle.

  4. Hi Lawrence,

    The mental institutions did come about at the same time as the industrial revolution when people existed in big anonymous groups. The institutions were also a very British type of invention.

    In Victorian times people went to great lengths to protect their image so I suppose if people displayed too much emotional outburst or stepped out of line they could be diagnosed as ill. But a lot of people might genuinely have broken under the pressures.

    In Ireland up to the 1970s people (mostly victims) were locked up in mental institutions for reasons of “moral conduct”.

    What is it? In present day terms I think it’s being under control or being dependent on the “mental health” services.

    I know that “The Mental Health Services” create very strong dependency.

    • The Victorian madhouses were abominable. But,honestly they imprisoned fewer people than today’s Madhouse Without Walls.

      One prisoner in the madhouse is one too many, but even when trapped in the System I didn’t beg friends outside to come in for treatment. A woman I know was miserable, lonely, sick from drugs, and frequently threatened suicide. She had a friend she begged to come in for “help.”

      I remembered thinking, “Good grief Cathy! We’re in Hell here. Why are you trying to recruit fellow sufferers!”

      In the story The Rich Man and Lazarus, the selfish rich guy who let sick Lazarus starve at his gate still wanted to keep his brothers out of the Hell he wound up in. That would make Cathy more selfish than Dives. Did she honestly think her life at the Mental Illness Center was meaningful or happy?

      Misery loves company.

  5. Lawrence, thank you for another thoughtful contribution. I enjoy your writing and always appreciate what you have to say. As you noted, there is no definition of “mental illness” or “mental disorder” that can withstand even mild scrutiny. No explanation of “mental illness” or “mental disorder” as a syndrome, illness, or disease holds up on either logical or scientific grounds. If we abandon the notion that psychological issues are medical illnesses, then how are we to think about them? I appreciate your take on this. I understand how conflicts between the individual and society, compounded by capitalism, can fuel psychological struggles. But I also think psychological struggles are so varied and sometimes so unique to the individual that there’s no grand theory that can be reasonably applied in any general way to the kinds of psychological issues that can be diagnosed using the DSM. For example, I have clients who pull their hair and pick blackheads on their skin, and are seeking help because they are distressed by the negative effects on their appearance. I have clients who are afraid of panic attacks that they think will cause them to have a heart attack and die. I have clients who have been catastrophically injured in car accidents who now cannot work or play with their kids. There are some social conflicts there, but also a lot of individual psychological concerns.

    You wrote that “mental illness” is “nothing more than a concept that evolved to serve a specific societal purpose/function.” Totally agree. And I agree that it’s important to understand what that function is, and we can use different lenses to do it. To me, there are two obvious functions served by promoting the concept of “mental illness.” First, by construing diagnoses in the DSM (published by the APA) as mental illnesses, psychiatry appears credible as a medical specialty and can claim domain over “mental health” and the drugs used to “treat mental illness.” Second, construing psychological issues as “mental illness” provides a rationale for the use of psychiatric drugs to “treat” them, which funnels billions of dollars to the pharmaceutical industry. Personally, I don’t think we need to look much beyond these two functions to explain the popularity of the “mental illness” concept today.

    • construing psychological issues as “mental illness” provides a rationale for the use of psychiatric drugs to “treat” them, which funnels billions of dollars to the pharmaceutical industry.

      There IS lots of money in weaponry (drugs) just as there’s money in attack aircraft, however although contracts can be canceled and renegotiated, the need to justify psychiatry OR the military in the eyes of the population is paramount; thus I would add

      Third, construing problems in living as “illnesses” removes the problem from the collective sphere, which would mandate immediate and (to the status quo) unacceptable changes in the structure of society, and relegates it to the status of an “individual” problem requiring an individual solution, if any, and the back burner in terms of any collective relevance or urgency.

  6. OK, part two:

    There are actually a number of issues on different levels being conflated here, all worth discussing but in need of some sorting out. I will again repeat my initial criticism of the implicit acceptance, not of terms but of the legitimacy of categories, however “mislabeled”; I again refer people to Dragon Slayer’s “Easter Bunny” example, which is not at all snide but perfectly descriptive of the seemingly unrecognized contradiction here.

    However I also note this important insight:

    the only part of the APA’s ‘mental illness’ definition that’s objective fact, not value judgment, is: reduced functioning in work (job) or social (ways of interacting that society approves) areas. The DSM is a hodgepodge of unrelated coping styles that only have this one issue in common;

    Gee, isn’t it nice of the corporate state to care so much about our ability to contribute to their bottom line, and develop the sort of dehumanized discipline in our personal lives which maximizes said contribution?

      • I was out to get a job working in the “mental health” system once. In Virginia they had a human services training program for whatchamacall’ems, consumer user peers, and I was going to go to college and get “trained”. Most of these “peer” hotshots that were up there in the *cough, cough* movement in Virginia, where I was anyway, had been through it. Had I completed “training”, which I didn’t, I would have probably started, like some of them did, on one of these assertive community treatment teams. The thing I would have been hired to do, in all probability, would have been to make sure this person or that, judged needing intensive treatment, was taking his or her neurotoxins. I was never going to be a part of that pretense. I pulled out of the program eventually. I don’t think Virginia is unusual in this regard. The official “peer” movement is corrupt in this fashion, advancing compliant patients, and backing into a corner the defiant ones. My solution: The “mental health” system goes over there, and I certainly don’t want to work for it in any way, shape, or form. Go bribe anybody else.

  7. Well, aren’t we basically social creatures, and when we have those needs met, we feel reasonably good, and when we don’t, we feel bad. It’s built into our brains to make us feel bad, so we will be motivated to somehow get our needs met, and thus it makes us more likely to survive. Those who can’t get what they need feel bad, act differently, have internal conflicts, and when society, that is, people, don’t think it’s important to meet a certain person’s needs, then it suits them to label the aforesaid person as “ill” in some way, to label them, to help justify casting them on the scrap heap. Our social nature can go different ways, one competitive, where winners create losers, and the other cooperative, where each person is an asset. Maybe it is instinctive which way people choose, based on conditions, beliefs about what is valuable, or what may happen in the future.

  8. I haven’t carefully read all the comments here – therefore my apologies in case I am repeating something. As I see it, people do occasionally struggle with mental issues (“problems in living”) for which they seek ways of coping. However, ALL symptoms listed in the DSM (that is currently used to assign various disease labels) appear to happen as a continuum in the general population [reference: Understanding Psychosis and Schizophrenia (2017) by the British Psychological Society Division of Clinical Psychology]. It is just that as a result of specific life experiences, some people sometimes have extreme readings in some of the symptoms.

    As I see it, instead of assigning labels to people (which massively contribute to stigma), why not use some type of a coding system that can be used by doctors only to record an individual’s list of symptoms such as their level of stress, the level anxiety, fear, etc., so that the progress of the patient can be monitored. A code may look like A3S5W8. Once these numbers return to normal levels, the person can be considered as ‘recovered’ (or if someone doesn’t like the term ‘recovered’, they can consider that person as no longer needing further help for their “problems in living”). I think such a system (instead of the current DSM disease labeling) can go a long way in reducing stigma and would also reduce further progression of these conditions because the client would no longer believe that they have some kind of a “brain disease” (we need to remember that negative expectations lead to negative outcomes through “nocebo effects” – i.e., opposite of placebo effects).

    • why not use some type of a coding system that can be used by doctors only to record an individual’s list of symptoms such as their level of stress, the level anxiety, fear, etc., so that the progress of the patient can be monitored.

      Because psychiatry is not medicine, emotions are not symptoms, and unhappy people are not sick?

      • Hi Oldhead – I think you are being too extreme in denying people’s lived experiences. Regarding your reply:

        (i) psychiatry is not medicine: Of course psychiatry is not medicine, but there are other ways of helping people without giving psychiatric medicines.

        (ii) emotions are not symptoms – yes, but people sometimes feel psychologically agitated enough to be unable to go to work anymore, feel suicidal, etc., – they seek help, so there can be a system in place to bring back these emotions to ‘normal’ (functional) levels.

        (iii) unhappy people are not sick – I agree, but as I have stated in (ii), people have difficulties that THEY experience, and express the need for some type of help with. Unlike for physical conditions, they do not need any medicine, but some type of emotional assistance can help.

        If someone comes to you psychologically agitated and if this person has limited social support and spiritual support, what would you tell that person? – would you simply say “get over with it”? I would like to know.

          • Old head: As I see it, the intention of these discussions we are having at MIA is to ultimately generate ideas regarding how mental issues (let’s refer to them as “problems in living”) people have can be resolved. It is not about whether someone has said/not said something in previous comments, or about how good/bad someone’s comments are, etc. So, I am just asking you the simple question “If someone comes to you psychologically agitated what would you tell that person?” If you do not wish to answer, at least you can reflect on this. 🙂

  9. Lawrence and all

    I agree with several of Slaying the Dragon’s and Oldhead’s criticisms, however, they do not go far enough and leave out some vitally important points. This is especially true when looking at what is misguided and missing from Lawrence’s final concluding remarks.

    Lawrence you said: “Psychiatry’s main role now is thus to stop more and more able-bodied people from contributing to society, and to offer them society’s benefits that are contingent upon their not contributing. Psychiatry has mutated from feared enforcer to parasitic saboteur of the social contract on a huge scale — so it’s now an outlier that’s threatening society’s survival, and thus must be banished.”

    When you say psychiatry is “threatening society’s survival…,”what “society” are you referring to? Here you are missing the historical reality that Psychiatry has now become an essential institution in maintaining the current class based/profit system of capitalism.

    Psychiatry has become (especially over the past 4 decades) a key instrument of social control maintaining the status quo by disabling (through labeling, drugging and incarcerating) the potentially more volatile sections of society who are most harmed by the system, AND most likely to be part of a movement rebelling against it. Here I am referring to women, minorities, rebellious white working class youth, student rebels, and other non-conformists and system outliers. The very forces in society who formed the backbone of rebellions in the 1960’s.

    Secondarily, Psychiatry and their disease based/drug Medical Model focuses everyone’s attention on personal and/or genetic flaws in human beings as the cause of society’s lack of progress beyond the “dog eat dog”, “survival of the fittest” concepts of human nature promoted as a means to JUSTIFY the need for a class based/profit system. AND it further justifies accepting all the inequalities and the overall state of perpetual war as an unfortunate necessity of life given this so-called “fixed” state of human nature. Ashley Montagu called them “genetic theories of “original sin.””

    The current ruling classes propping up this capitalist system have totally written off certain sections of society as being no longer necessary to preserve their system. They DON’T CARE if inner city minorities ever work or become productive in society. They know their system is NOT CAPABLE of incorporating them into the mainstream of society with jobs etc. – so therefore, label them, drug them, shoot them, jail them, isolate them, but DON’T let them become a disruptive force in society. This is also true of the other more volatile sections mentioned above.

    So Lawrence when you say that “…Psychiatry’s main role now is thus to stop more and more able-bodied people from contributing to society…,” this completely misses the mark in not grasping psychiatry’s central role of “social control.”

    AND while “Slaying the Dragon” can make some good critical remarks about the myth of “mental illness,” his OVERALL analysis falls WAY SHORT of grasping an historical understanding of the actual power position and role that Psychiatry has in contemporary capitalist society, AND especially how it is being used to hold back social rebellion. He makes these errors because of his total uncritical worship of Thomas Szasz, which leads him to adopting the very same libertarian type political blind spots that plagued Szasz and prevented him from further advancing the anti-psychiatry cause when he was alive.

    Richard

    • The reason for the continued failure of antipsychiatry is precisely the confused kind of thinking that informs Richard’s political and historical perspective. It’s unfortunate, really, because he, and many others, are absolutely right about the coercive nature of psychiatry. This confused thinking is what has caused Szasz’s keen insights to be dismissed, ignored, or diluted all along. Thus one of antipsychiatry’s greatest allies and most insightful commentators is dragged under the bus by the very people who would most benefit from reading his books. I don’t agree with Szasz in every respect, but his libertarianism drives closer to the truth about freedom than the fanatical, utopian, socialist dogmatism that has been the downfall of many prior movements and will be the downfall of antipsychiatry as well. I write this as one who is also critical of Szasz’s libertarianism, but from the opposite direction. Instead of looking to 60s liberationism as a source of inspiration, antipsychiatrists would do well to develop a bit of historical perspective (something that Szasz did quite well), and look to original antipsychiatrists such as Karl Kraus. A broader and deeper historical and philosophical, not to mention literary, perspective is what enabled people like Kraus and Szasz to see psychiatry for what it is, namely a pseudo-scientific arm of the therapeutic state. Capitalism did not cause psychiatry. Psychiatry has flourished in socialist, communist, and fascist regimes, and as the United States drifts ever further away from its origins toward the aforementioned extremes, psychiatry grows and flourishes here as well. Does psychiatry prey upon the weak and the vulnerable in society? Of course. But it preys on the rich and the powerful as well. Psychiatry is no respecter of persons. Every single person is a potential victim of psychiatry. The marketing of madness does not discriminate. In fact, the therapeutic state spreads its tentacles over the entire world, and it draws into its gory jaws anyone who has not been immunized against its deceptions.

      • The reason for the continued failure of antipsychiatry is precisely the confused kind of thinking that informs Richard’s political and historical perspective.

        You’re biting off way more than you can chew here, you have little comprehension of Richard’s historical perspective as you’re too preoccupied with your own. “The continued failure of anti-psychiatry” is effected not by anyone’s abstract philosophy but as a result of the population being hypnotized by the PR and mind control machinations of the corporate state. However I believe the arena in which it is currently most effectively countered is that of basic civil rights law, but this still requires a militant mass struggle to make it successful..

        • I don’t see the antipsychiatry movement, so long as it exists, as a failure. Psychiatry is so pervasive, powerful, and invasive. It has the drug companies behind it, and the law and order people, not to mention the mental health movement. The fact that there is an antipsychiatry movement at all I see as a major success story. It may be the bug-a-boo of psychiatry, but so be it. Let psychiatrists beat themselves up over the matter.

        • I agree with both of you, Frank and Oldhead. I need to clarify what I mean by the failure of the antipsychiatry movement. I too believe that it is a success, even if there is just one person who opposes psychiatry. What I mean by the failure of the antipsychiatry movement is actually that psychiatry continues to grow and that its false notions continue to proliferate, or as Oldhead put it, there is “a population hypnotized” by psychiatry. It may indeed require a militant mass struggle to combat psychiatry, but the mobilization of such an effort will require something more than the antipsychiatry movement has been able to muster thus far. Ideas have consequences, and bad ideas or flimsy reasoning has consequences for antipsychiatry as well. I believe in the eventual success of antipsychiatry, and that everyone who justly opposes psychiatry has a part to play, even if his or her particular historical or political insensibilities prevent him or her from understanding how that success will really come about.

          • How do you prove a false hypothesis? As a movement antipsychiatry may have it’s challenges, but psychiatry has these pretenses of being a branch of medical science. Whatever God it may be that psychiatry has on its side, there’s a good chance that God isn’t science.

            I was at one time trying to work with a local “mental health” group, a group that was claiming, far from the truth, to be inclusive. Their FB page had something about how people wishing to work with them had to believe in this thing they called “mental illness”. Does anybody really think the “mental illness” deity is going to save psychiatry in the end?

            Bio/psycho/social some people say. Why bio? Primarily because of drug damage, that is, iatrogenic doctor caused damage. The idea that a psychiatric diagnosis makes a person genetically defective is as absurd as the idea that being born non-white, of non-European ancestry, does so.

            Take away the bio, and you don’t have medicine, you have fraud. Psychology/s aren’t something that can be damaged, although they can perhaps be exposed. “Mental illness” as a social disease is an abstraction (i.e. not literally a disease). Diseases that effect society are plagues, epidemics, viruses, and infections. Misbehaving is not, and cannot be, a disease.

  10. Psychiatry doesn’t really care about the labels, they are there as a method to use drugs to control behaviour, and in doing so, destroy peoples health. They are at one with their drugs and any type of creative thinking to work out how better to be, – save soft look marketing for more of the same – including to conceive of their own abolition… this is not allowed to even be in thought. Indeed it would be more evidence of ‘mental illness’. They have no where to go. To face up to the truth would be to empty themselves… in Greek: κένωσις kenosis. Only they would be receptive to their own disgrace of neurotoxic destruction. This can not be allowed to begin to happen. But it is there, lurking, ready to take hold on their conscience.

  11. I need help here…there is a lot of talk…I have a problem with panic attacks…
    do I have panic….do I have attacks…
    and what is causing these panic attacks…
    do I need help…where should I get help…
    what kind of help…I would like some help for this…
    it is causing a problem in my life…
    frankly I don’t care what szasz wrote…

    • In my observation, the best answers come from others who have panic attacks. They DO happen, but they don’t get better (as you have no doubt observed) by being labeled and blamed and having things done TO us! I don’t suffer from long-term repeated attacks, but I have had a few, and have also helped a lot of other people get through them and eventually reduce their frequency, mostly by listening to them and understanding what was going on behind the attacks. There is also an immediate intervention path involving things like meditation, food health, breathing, exercise, supplementation, etc. that many find helpful but that you will almost NEVER find any doctor (and especially any psychiatrist) telling you about. And of course, there is also the need to look at the big-scale SOCIAL issues that create so much of the anxiety that many if not most members of Western society feel – the need for employment, lack of healthcare, corruption in government, institutionalized violence, racism, sexism, and so on.

      One thing I HAVE found helpful in reducing years of chronic anxiety is to start recognizing that beneath my anxiety is ANGER and RAGE at how I have been treated. As I have learned to stop and SPEAK UP when I feel wronged or dismissed, I have had less and less experience of generalized anxiety about my life. Of course, I feel anxiety big time in the moment I take on my antagonist, but I feel SO much better when I just handle it in the moment it occurs – I feel self-respect and a sense of power, things I never felt much as a kid when I learned anxiety as a way of dealing with a world where I was small and my voice counted for little to nothing. That’s just my path, I’m sure there are many other paths, but the answer for me lay in identifying and feeling OK about my own RAGE regarding how I’d been treated as a kid, and feeling more and more OK about expressing my CURRENT rage (usually very respectfully, but not always) when I was feeling mistreated in the here and now.

      Hope that provides some useful perspective!

  12. Well, you can probably start by taking magnesium oxide,250mg. T.I.D., as the medical types say, while you look for a naturopathic or conventional practitioner experienced in dealing with these things. The magnesium salts are available at any drugstore. DON’T let anyone put you on benzos, as you can easily develop panic attacks during withdrawal.
    That might do for now. I’ve got to duck back into the bunker before the incoming gets too close.

  13. thank you bcharris and dr kelmenson….so I don’t have a mental illness…I should not see a psychiatrist….I should take magnesium…and my panic attacks are just something normal…how about cognitive behavioral therapy…I am in the trenches and am trying to understand what you all are talking about…I would like to know exactly what is causing my problem…and what I should tell my loved ones..

    • A support system is a must Littleturtle. One apart from the MI System. You may be forced or even choose to attend a “mental wellness” center. A good escape plan is essential.

      Do volunteer work in the community. I volunteered 4-8 hours a week in Portland (Indiana!) I did it on my own but refused to do the organized kind put together by the center since it caused the people to treat us like morons or children.

      Maybe joining Emotions Anonymous. Actually much of what passes for mental illness are emotional addictions. (Bad habits really hard to break.)

      If you are religious attend any extra functions your church or synagogue offers. Maybe talk to your clergy or church counselor.

      Use meet up to find clubs of people with shared hobbies or interests nearby.

      On your own you can do some reading and journaling or dilettante art for emotional release. On Feeling Good by David Burns helped me. While Burns does not openly question the bio-model he obviously prefers talking to pills in most cases. Because it’s a book, not an emotionally abusive “therapist” you can always put it down if you don’t find the recommended techniques helpful.

      Above all eat right, drink enough water, keep regular bedtime hours, and get enough exercise!

    • Turtle. Your panic attacks are probably not of psychic origin. I was suggesting the magnesium salts to see if it were to keep you from getting any more anxious while seeking more competent assistance, than me. If we were face to face, I’d ask you assorted questions that would seem strange in a psychiatric interview, such as whether you’re frequently bothered by cramps (another sign of low Mg levels), since being pretty much unable to send samples to a lab, I’d have to make guarded inferences about what might be true, so I’d know what to deal with, particularly since Mg levels aren’t readily determined with the present lab tests.

  14. Some of us in ΝΥΞ take issue with the idea of “symptoms” as learned behaviors/coping mechanisms, and applying this to all experiences of extreme states (so-called “mental illnesses”).
    Cognitive distortions, dissociation and emotional dysregulation, all of which we (the authors of this comment) experience, are not learned behaviors.
    They are responses to our environment based on our own individual neurotype.
    With the exception of dissociation, how would cognitive distortions and emotional dysregulation “work” for us?
    Those two are things we have had to cope *with*.
    And thanks to our own “brain-weird” we are able to use dissociation as a safeguard against psychosis.
    Our multiplicity has liberated us. It has been a strength and a gift without which we would not be where we are today:
    Not dependent.
    Not victims
    Not slaves.
    Not fools.
    Not dead.

    Just, us.
    -Serenity

    ***
    I want to address a problem with this entire conversation happening in the comments; not just the article.

    We’re all asking “does ‘mental illness’ exist?”, but has anyone decided what we mean by “exist”?

    Take numbers for example.
    Numbers don’t exist objectively on their own. They’re not tangible “real” things that exist like rain and nails. Instead, they’re useful illusions that help us make sense of the world around us.

    Mental illnesses “exist” in the same way numbers, dreams and ideas exist.
    They’re concepts. They are artificial constructs we make in our head to describe other things that go on in our head.
    That’s about it.

    They “exist”; just in a different way.
    The problem begins when society starts treating “mental illnesses” as though they are objectively real; “an illness like any other”.

    They aren’t disease entities.
    They’re just a bunch of things that happen in our head that can sometimes make life difficult.

    I don’t want to get into it here, but where it REALLY gets problematic isn’t when they treat certain neurodivergences as “illnesses”; it gets REALLY bad when docs and laypeople start treating “mental illnesses” with the same seriousness and gravity as though they were Mortal Sins.
    -Liberty

    ***
    I feel that you, Dr. Kelmenson, mean no disrespect to anyone; genuinely, I do. However, were I a more sensitive reader, I would hear your words as a slight bit condescending.
    “Psychiatry” has told us (my sisters and I) nothing.
    When they’ve tried to, we’ve laughed at it.
    As Seri said, we are not fools.
    All my sisters and I have come to believe about ourselves we constructed from our own lived/learned experiences, borrowing here and there from studies, theories, conceptual models, the shared experiences of others and many such things.
    “Psychiatry” cannot tell us anything.
    Only people can.
    People are flawed, imperfect and limited; but when they have letters after their names they are treated as infallible.
    To put it playfully:
    “We didn’t buy their product; it fell off the truck.”
    My sisters and I have found psychiatry to be useful for our purposes.
    It’s importance ends there.
    For us it is a means to an end.
    We are not ill, we are not sick.
    We have the brain we have, and we will have no other.
    If we want to live in this world, it will be in this body, with this brain.
    That is our choice.
    This means we welcome and accept all the difficulties and such what come with having a brain such as ours.
    -Pride

  15. we do not know that much about the brain and mind…we just don’t know enough…
    and most people are under a lot of stress and want a pill for everything…
    brains are inflamed and people don’t feel good…they will get a pill or a drug or anything to get relief..
    you will have to get rid of a lot more than psychiatry….you will have to fix the way people are living..

  16. “If Mental Illnesses aren’t real, what are they?”

    They are what they always were. Unknowns.

    Of course as the good doctor understands, the original unknowns have broadened into known territory. The mistake the good doctor then makes is to forget about the original unknowns and depict the whole mess as known territory.

    This must be I assume because the good doctor is making his dollar from this mess but

    The good doctor is missing the point, the fundamental point, of his own question.

    Ah well. Reel em in, as they say.

  17. “If I cope by engaging in music-listening or any activity to the exclusion of working or interacting with others, then I’ll be viewed as suffering from anxiety, schizophrenia, addiction, depression or OCD.” No, actually those of us who do cope by engaging in music listening and interacting with others are also defamed by psychiatrists, I do have proof of exactly this in my medical records.

    But I do somewhat agree, “Psychiatry’s main role now is thus to stop more and more able-bodied people from contributing to society, and to offer them society’s benefits that are contingent upon their not contributing. Psychiatry has mutated from feared enforcer to parasitic saboteur of the social contract on a huge scale — so it’s now an outlier that’s threatening society’s survival, and thus must be banished.”

    I very literally was told to “quit all activities and concentrate on the meds,” bad advise I did not follow.

    I will point out that psychiatry’s actual primary function today is profiteering off of covering up child abuse, according to their own medical literature, and my family’s medical records. And this is not beneficial to society at large. To the contrary, society is now controlled by satanic pedophiles.

    https://realitieswatch.com/putin-west-controlled-satanic-pedophiles/

    https://www.youtube.com/watch?v=cRuKmxQSPSw&t=1178s

    Absolutely you are correct, psychiatry must be banished, their pedophile protection and empowerment profiteering is destroying Western civilization.

  18. Ok. Mental illness does not exist. What is going on with a woman hearing voices telling her to kill herself or others and certain she is the queen of England and has computer chips in her body?
    She has no history of trauma, was not living in poverty, was not oppressed. She just woke up one day feeling really sick and terrified by what was happening to her.
    What is this then and how should it be handled?

    • She is suffering from social marginalization. The things she says are at some level true.

      Her social marginalization may have started decades ago.

      The remedy is always political consciousness raising and political activism. Once people know that their efforts are needed, they can become very effective.

    • truth,

      The answer to your question of what is “this”: this is “madness”.

      “Madness” is the generic concept in philosophy to study a class of human and social phenomena that challenge rationality and common sense.

      Our problem with psychiatry is that it describes madness (= exaggeration of one’s usual character, amplification of one’s grey zones that are kept below the surface in normal people), nevrotic behaviors (obsessions, phobia…) and abnormal states of mind (depressive, anxious, psychotic) as forms of “mental illness”. Such concept is fatally flawed, deceiving, and dangerous, being used as a sociomoral sleight of hand to remove misfits from society on the ideological grounds that they are “ill”.

      While antipsychiatry sacralizes madness, psychiatry trivializes it. For AP, madness is an integral part of human nature that should be celebrated in a positive, creative, passionate, intelligent way. For biopsychiatry, madness is an illness like any other; still a very mysterious one indeed, but psychiatists are going to understand it sooner or later. Traditionally, psychiatry has interpreted madness as an illness like any other, whereas antipsychiatry has interpreted it following an existential/phenomenological approach, viewing it as an understandable reaction to insane/untenable social relationships.

      • This person feels “mad” in the most terrifying and suicidal way. There is nothing
        Brilliant, creative, or positive to be celebrated in feeling completely unlike her usual self, pounded by waves of agitation and weirdness. This isn’t some enjoyable hypomanic state. It is crushing panic, inability to function, all drug and stress injury induced.

  19. ok…lets talk some about what might help those persons suffering with anxiety and depression..
    we have been talking about what words not to use…and down with drugs…and down with psychiatry..and down with biology….is there any help with dietary interventions using TRYPTOPHAN..maybe the serotonin neurotransmitter system is important for our happiness…what do you all think about this biology talk…are there any WORDS here that you don’t like…please tell me…

    • I have found mindfulness-based meditation very helpful. Also talking about traumatic experiences to someone who cared. I had a great therapist for a while back in the 80s who actually LISTENED to me and asked good questions and helped me sort out what had happened to me and what it meant. I have read a LOT of self-help books and tried to apply them.

      I have also done work to help other people, including advocacy work to try and change the system. It required me to face my own fears, because I was working for someone else rather than just myself, and I was willing to do for them what I was afraid to do for me.

      Those are just some things that worked for me. The biggest problem with psychiatry isn’t the drugs, it’s lumping everyone who feels similarly into the same group and expecting the same thing will work for all of them. Everyone is different, and different things work for different people.

      — steve

  20. Frank, I really appreciate your thoughtful responses. I should, not, however, have used the example of a “soldier” bc it connects to PTSD.
    If a regular housewife going to a malaria infested country and has this reaction to Lariam (events like this have been documented), there is obviously a physiological or neurological injury at play. This is a case of “spontaneously sick”.
    Like children given SSRIs for test anxiety that suddenly have psychosis or suicidal thoughts- this is drug induced….

    • It’s not “spontaneous” if it’s a drug effect. It is iatrogenic, that is, physician caused. Had the physician not prescribed the drug, no neurological damage, no adverse effect.

      As she wouldn’t want to have malaria, this must be an awfully tricky subject, and hopefully she was fully informed before she consented to take the drug. It is obviously a potentially dangerous drug. Still, if there were other drugs, any other method of dealing with the problem (malaria), they should have been considered.

      • Yes, you are correct. What I am referring to is “iatrogenic”, physician caused through drug injury.

        When these iatrogenic “effects” including hallucinations, delusions, abnormal thoughts, psychosis, agitation, depression develop after ingesting drugs and remain, is the person suffering from “mental illness” caused by neurological damage? Is this not “real”?

  21. The contents of this article makes sense.

    My own preferred perspective is to see “mental illness” as a social construct whose utility is to “explain” disturbing behaviors for which causes are ignored.

    When physical, biological, psychological, social or spiritual causes are unknown (intentionally or not), we resort on the idea of “mental illness”. Such idea has the same sociomoral purpose as witchcraft in religious times. Explaining abnormal/strange/disturbing behaviors by “mental illness” is analogous to explaining meteorological woes by “Aeolus”.

    Labeling someone as mentally ill has the effect of ontological/experiential nullification. It’s a way to manage the fear and anguish originating from the realization that other fellow humans are all a reflection of our own mad/sinful nature.

    As regards the fact that mental illnesses are not real illnesses because no biomarkers were found, well I consider this an indirect verification of the myth of mental illness, in the way Szasz explained it. The problem with “it” is essentially a linguistic/logic one. I have two ways to formulate the problem:

    1. There is no such thing as “mental illness” except by metaphor; we can no more have a “mental illness” than we can have a “salty light”, a “jealous courtyard”, a “depressed pair of pants” or a “sexually transmitted career”. Those are linguistic category mistakes, which could be demonstrated by set theory, lexical combinatory, or simple Porphyrian trees.

    2. The concept of mental illness is self-contradictory in the context of a positivist medical science abiding with a Virchowian standard of disease. Again, we could analyze the validity of this statement with the tools of philosophy of language.

    I guess we need some bit of epistemology, or theory of knowledge, to understand why “science” could nevertheless appear to find some confirmation for phenomena loosely defined as “mental illnesses/diseases/disorders/conditions”.

    • Wow. I like how you think. 🙂 E.F. Torrey, before he went over to the dark side, used the notion of a “purple idea” as an example of the incongruence of “mental health” language.

      Do you have any thoughts on the best way(s) to delegitimize the psychiatric narrative in the public mind, strategically or otherwise?

        • I will email you forthwith, if I do indeed have it correct. Sorry for the interruption in our communication, it was indeed a tired time…

          There are Facebook groups out there but I consider using Facebook to be insane, especially for us, as it’s primarily a tracking/surveillance site that data banks your personal info & god knows what else. But there are some new developments you should be interested in. (And you even have a copy of The Death of Psychiatry by Torrey, cool. I just hate to spend the money.)

          • I know an AP adept who is a synesthete, too. But it is irrelevant.

            “Purple idea” is a metaphor. “Mental illness” also. The problem is that psychiatrists make a litteral use of this figure of speech. As Ron Leifer explained, “The basic problem with the medical model is that people take it literally rather than understanding it as the metaphor it is.”

            Metaphor is a central figure in poetry. It basically consists in comparing things by changing without prior warning the ordinary meaning of words. Poetry and science use diametrically opposed types of language. Thus, using the metaphor of mental illness in a scientific context is awkward.

            You know, mad people typically use a poetic/symbolic/religious parlance, which is filled with metaphors. The irony is, they are being diagnosed by failed scientists and failed poets. The psychiatrized are often failed artists themselves, although the maddest ones might well be some of the rational and curious human minds, two essential qualities of the scientific worker. Well, like the French existentialist psychiatrist Eugène Minkowski (of Polish origin) remarkably said (translated):

            “The mad are not out of their minds as often as we think, perhaps even they are never out of their minds.”

  22. Arguably, most mental disorders are an issue of toxins plus stress. When you cannot perceive reality correctly due to a short-term toxic reaction (including drugs and toxic chemicals) you are left with an unexplainable and traumatic experience which you cannot place. Barring drugs, being traumatized with gaslighting can be devastating but it’s less effective. Having such experiences repeatedly leaves you with more and more you cannot explain. Your mind will reach for anything that makes sense, and then you are left looking crazy. Sadly, this is a desired effect sometimes for criminals and domestic abusers. We ruled out genetic cause for mental disorders in the 1940’s at the Nuremberg Trials.

  23. I have a great idea, let’s abandon these skinny little threads and start fresh.

    OldHead talks about the PS (psychiatric survivor) or PI (psychiatric Inmate) or PO (psychiatric outmate) playing a leadership role.

    More specifically that would be anti-psychiatry survivors/inmates/outmates — but this does not preclude professionals, “allies,” etc. forming their own organizations; nor does it preclude the possibility of a coalition between AP survivor projects and those primarily composed of others. No matter what we need our own self-determining voice, as there are basic differences between those who have experienced psychiatric oppression and those who have come to anti-psychiatry via other roads, and will never be able to speak for us rather than in solidarity with us.

    On another note, this thread is pretty disturbing. Lately it’s primarily been unnecessarily intolerant “leftists” I’ve taken issue with. However Dragon Slayer also seems to be going off the deep end with his attempts to deny the genocide of indigenous people, as well as hurling pretty insulting remarks directed at socialists and Marxists (and women). On the other hand Richard says There is no scientific evidence to back up the existence of such an “evil” force. This also falls short of a convincing statement, as there is never “scientific” proof for non-physical phenomena, nor should science be our god. Still we don’t need to scrap one set of myths for another.

    Again it seems that people are looking for points of division rather than unity, and this too often degenerates into puerile personal nastiness. I don’t know the solution.

  24. “It used to be a political tool and still is to some degree”

    For me, it always was, and all that it is.

    I consider the DSM to be the “grail” of psychiatry. Without the possibility to make diagnoses, psychiatrists lose their relevance in clinical work and medicine.

    Medication is the “Holy Grail” of psychiatry. Without the possibility to prescribe remedies, psychiatry not only loses its pertinence as a medical specialty, but also its financial ties with the pharmaceutical industry.

    But we are missing the point completely. The “Holy Spirit” of psychiatry is coercion, treatment, coercive treatment. Beyond bogus diagnoses and miracle pills, what really matters is treatment, care, taking charge of. Treatment is not prevented by diagnoses however uncertain, nor by therapies however ineffective and harmful.

    COERCION is the cornerstone of the whole psychiatric edifice. As David Cohen (UCLA professor of social work, also MIA writer) argued, coercion gives an intellectual free-pass for psychiatry’s outlandish theories. Power supports psychiatric knowledge, not the other way around. Psychiatrists don’t need a shred of evidence to ascertain the efficacy of emprisonment. They don’t need sophisticated biological theories to account for the high level of success of industrial grade electric shock to the brains of those who have to be subdued unlawfully or their memory erased. The be all and end all of psychiatry is behavior control.

    And since psychiatry claims to act benevolently, and proceeds against the will of people, then psychiatric treatment has been for centuries, and still is today, torture. It always will be so, because unwanted help amounts to torture. Psychiatry is inherently tyrannical.

    Basically, it serves nothing to criticize psychiatry on scientific or medical grounds. The theoretical foundations of psychiatry have been thoroughly dissolved in past decades, but psychiatry still survive as pure power. While it may help to terminate the modern Inquisition by exposing its “grail,” it must always be accomplished through the perspective of total annihilation, not reform. Did you happen, Lawrence, to read some of Philip “Behavoriator” Hickey’s articles? “Stigmatization of Psychiatry and Psychiatrists” is undoubtedly one of his best.

    David Cohen, again, suggested in a French conference (he’s perfectly bilingual, and I am French-speaker myself) to stop criticizing psychiatry, just label it as pure propaganda, and then see who profit from it.

  25. @Antipsychiatric ReprisOwl

    [there was no symbolic reply button, so I’ve put it here]

    Thanks for sharing your explanation of a metaphor. I am not alien to the fact that the term “mental illness” is metaphorical. Although I would much prefer if people adopted the similie, the nudist cousin of the metaphor, and said, if they really had to, that madness was *like* an illness.

    I don’t have any personal hangups about being told I am suffering from something akin to an illness. Especially these days because I recently learnt from an article on here by Moncrieff, that dementia sufferers were also suffering from something illness-like. But which, like schizophrenia (and back in the days of Kraepelin the two were considered to be the same thing) has not been established in science as a bone fide illness. We could then make an imaginative and modern-day Malthusian leap, and put forward the idea that dementia is a conglomeration of poor coping skills, and a self-willed attempt to abscond from adult responsibilities…

    You write that “poetry and science use diametrically opposed types of language.” The field of physics, for instance, is very dependent on metaphor. That is why I can say “black hole” and have no actual progressed understanding of the science, but nonetheless be understood, in a referential sense.

    Using metaphors in scientific contexts is nothing untoward, or unprofessional. It’s unavoidable.

    I don’t go in for romanticising suffering. But because of how language works, all kinds of wonderful things can happen when listening to a mad person chuntering at full pelt. Our brain’s find patterns. In the absence of stimuli, our brains go into overload. When the stimuli is intense, we can feel like something amazing is happening.

    And if we feel like something amazing is happening, then something amazing is probably happening.

    ” And the prank- quean nipped a paly one and lit up again and redcocks flew flack-
    ering from the hillcombs. And she made her witter before the
    wicked, saying: Mark the Twy, why do I am alook alike two poss
    of porterpease? And: Shut! says the wicked, handwording her
    madesty. So her madesty aforethought set down a jiminy and
    took up a jiminy and all the lilipath ways to Woeman’s Land she
    rain, rain, rain.”

    • rasselas.redux,

      Let me explain why poetry and science use diametrically opposed types of language.

      Science is basically common sense applied with an extreme level of rigor. The langage of science is rigorous. Its logic ought to be flawless: as per the law of identity, once the meaning of a term is given, the term retains its meaning beyond subjective, relative, arbitrary considerations. Science works with “statements”, not “sentences”, and the meaning of statements depends on “enunciation” – that is, the “context” in which a statement is formulated. The context must be declared in a way that leaves no room for uncertainty and randomness. No stone must be left unturned at every single step of the scientific inquiry. The fact that science uses analogies, models and fancy wordings, is no contra-indication to the implied rigor of its method.

      Poetry leaves full room for interpretation and creativity. Meaning imparted to words is expected to vary with the subjective context. The poet uses figures of speech to play dough with the linguistic material. The art of poetry works with “sentences”, whose meaning depends on grammar. In poems, grammatical rules can be loosen up at will, notably by syntactic tweaking and inversion. The litterary sense usually serves as a background to evoke a more subtle, profound message, picture, feeling, understanding. The fact that poetry can aptly convey reliable truths about the world, is no contra-indication to the implied laxness of its ways and means.

      To help cut on prospective confusion, it’s not a case of all-or-nothing between the two. There are such notions as interdependency, structuralism, dialectical reasoning, etc. Order, homogeneity, stability, determinism, are conditions for novelty, creativity, originality, freedom. “Necessity is the mother of invention”, the proverb says. Determinism, emergence, contingence, are natural principles of this mysterious, albeit lawful, Universe. Scientific knowledge is arrived at with its share of imagination, adventure, trial and error, boldness, madness. Think of mad geniuses who revolutionized our understanding of the world, or successful artists who exhibit self-destructive patterns, only to trap their own gifted and prolific minds into a phenomenological dead end.

      • Yes, I understand that scientific writing and poetry are two different ways of using langauge. I’m perplexed as to why you feel the need to hammer that home.

        The point I made was really just a nittygritty correction to the claim you made that science didn’t rely on metaphorical language.

        In fact, much of science relies on a completely different language entirely, namely mathematics.

        I used the example of “black hole” in physics, because we all know the metaphorical term, but who knows or comprehends the complex maths?

        Much of science is so complex that we rely on science writers to condense the complex maths into a narrative written in a language we understand, and that process is as artful as writing a poem.

        And that is why we have been gifted with metaphors like “black hole” and burdened with the metaphorical “chemical imbalance”.

        “Poetry leaves full room for interpretation and creativity.”

        As does good science. A formal scientific study always ends with a conclusion and a kind of process of thinking aloud, speculating about what the results might mean. The results are interpreted and reams have been written about how various biases come into play.

        “Think of mad geniuses who revolutionized our understanding of the world, or successful artists who exhibit self-destructive patterns, only to trap their own gifted and prolific minds into a phenomenological dead end.”

        Well, Nietzsche went mad after he’d set out to the world how to intellectually rise above the masses. But I go with the scientists who speculate he was suffering from syphilis that had reached his superman brain, rather than put it down to burn-out or niacin deficiency. So while he does definitely attract the “genius” label, he wasn’t a mad genius when putting his thoughts to the page. I can’t think of any others off the top of my head. I’m fatigued after an 8-mile hike down canal paths. I expect there are numerous 10 Mad Genius lists out there.

        Now you are talking about “successful artists who exhibit self-destructive patterns”… like say, Sylvia Plath (the fairy goddess of moroseness) or Charles Bukowski (the drunk savant)…

        Earlier you were suggesting that people with schizophrenia were “failed poets” because they talked in a way that was highly ambiguous and metaphorical. Although, in my experience, most don’t. I accept some do. And this you speculate means that they are failed artists.

        But if any artist is producing work, then surely they are succeeding?

  26. At the risk of adding yet another view to this long train – it took a couple of hours to read it thru – and adding to the confusion – let me offer this. When I began training as a psychotherapist I was attracted to the Mental Research Institute’s (MRI – Haley, Watzlawick, etc) take on problems; that most problems are attempted “solutions” to some other life difficulty that hasn’t been successful; and some of us began writing the word “problem”, or “depression”, or “panic”,etc in strikethrough (which I don’t seem to be able to do on this site). I later discovered it was the “sous-rature” style of Heidegger and Derrida, the view that the word was “under erasure”. This is the Easter Bunny dilemma that others raise, if there are no mental health disorders then what are these woes? It seemed to me that this view enabled me (and others) to stop pulling the noose of diagnosis tighter, and review such situations as wrongly formulated. My friends in psychiatry insisted I pull the noose of diagnosis tighter. Later I was encouraged by Solution Focused Brief Therapy, and by simply exploring the preferred future there was no need to know of the problem, and I found problems (under erasure) dissolved literally like sugar in water as people began realising their preferred future.
    Lawrence, you offer an analysis of the reason d’être for psychiatry pulling the noose tighter as changing historical conditions. If I get it – once it was to warn others that there is no escape from the factories of industrialisation (you can’t get out of the social contract that way!); but this has mutated into a disabling profession thats become parasitic on producing increasing numbers of disabled. You cite Foucault, and no doubt you are aware of his analysis (eg Society must be Defended) that since Machiavelli governments have moved resources here and there that have contributed to the thriving of some sectors of the population and the decline of other sectors of the population. As I understand it he gives the psychiatric rationale as “we can detect dangerousness at 50 paces, so allow us to lock these people up” (Society must be Defended). Todays world is, presumably, perceived by psychiatry as more dangerous, and hence more people are disabled – you got to admit their strategy is simple – get the people pulling their own nooses tighter.
    You cite the social contract theories of Rosseau, Locke, Hobbes, as a rational behind the politics of this. But have you looked at Wittgenstein? The social contract theories stem from Descartes individualism – I can know my own mind, but not others, with certainty. From this individuals got together like some sort of Rotary club. But Wittgenstein reverses all this – you don’t join society you are already part of it! And I know your mind better than my own. Consider pain. In fact I know you are in pain immediately (most of the time); I don’t make an inference you are from your grimacing or because I have an internal Theory of Mind that I consult to understand you. I react as if I myself was in pain (especially my kids), no pause here for interpretation. I comes out of we. Dan Siegel has this neurological terms. Indigenous cultures have this as central – ubuntu in Zulu, whanuangatanga in NZ Maori, Shimcheong in Korean. If we are to recover as a culture – from greedy individualism in all its forms, we must humble ourselves to our indigenous people. Social contract theories are surrendered, ethics first (Levinas).
    So we see in Seikkula’s Open Dialogue a “treatment” that utilises this sense of “we-ness” or dialogicity. If there’s one thing we know, anyone coming near a psychotic (in strikethrough) person with an agenda, is treated with suspicion – and the most successful treatment is those where the “alliance” is good. If we look back at Pinel in Paris he tried to manipulate people into change by having Pussin rattle chains etc. He gave birth to psychiatry. But when we look back at Tuke in York, he built relationships of respect. Like Soteria he advocated lay treatment. No giving them a noose.
    Its now a hundred years since Wittgenstein, but he said it would take that long before he was understood. We are seeing glimpses of the Wittgenstein philosophy of mind permeating our intellectuals wine bars and cafes today, and the disappearance of Descartes…

  27. It appears that an industry has been created by the APA and pharmaceutical lobbyists. Mental illness seems to be nothing more than a label created to financially benefit those involved. Perhaps Psychiatrists role should be to habilitate dangerous non conformists into society without sedating and addicting them to drugs. It is important to encourage free thought and unique methods to deal with life’s problems, however we still cannot allow behavior that threatens the safety and advancement of Society on the whole.
    Thank you Dr. Kelmenson for your unique theories.

    • I agree Ray D. That’s what the judicial system is for.

      As a law-abiding citizen who volunteers at the hospital, helps her ailing relatives, and visits neighbors who are homebound due to sickness I deeply resent being labeled “Bipolar” like some violent murderous criminal! What have I done to deserve to have Dr. Torrey malign my character on national television? (No, I’m very much in touch with reality. He warned the public that all those his profession has labeled SMI are a menace to society and should be locked up/physically damaged without a trial.)

      Answer: I saw a psychiatrist, took the SSRI he offered, had a horrible reaction and have been punished ever since!

      I no longer have mood swings–since tapering off my “cocktail” with no offline support system. Apparently mind-altering drugs can cause mood swings. Yet I’m struggling to find work with no history of gainful employment–in my mid-forties. Struggling to integrate myself into mainstream society. “Mental health” centers segregate, they do not integrate.

      I live in constant fear that the truth about my damning diagnosis will leak out and I will be locked up or shunned. Like the self righteous villain of Les Miserables my pursuer is relentless. “Once a thief always a thief.” “Once a bipolar always a bipolar.”

      In my case–and there are many like me–I didn’t even have to steal. No law was broken. Yet my “soul doctor” declared me incompetent and dangerous. Then drugged me into a stupor inducing daily–sometimes hourly seizures.

      I no longer consider myself mad (crazy) but I’m very angry. And I feel it’s justified.