The Student Room Group

Szasz and the 'myth of mental illness'

Has anyone ever come across the work of Thomas Szasz? He has some very extreme views on psychiatry, i.e. that it's politically and financially motivated and more importantly that the whole concept of mental illness is vacuous.

Any thoughts or opinions on his ideas?
I've not read him but a lot of psychology seems bunk to me for the following reason:

Say someone is diagnosed with clinical depression. This is a recognised mental disorder. My problem with this is that it assumes the person has some kind of malfunctioning in their brain. But even if they do I don't think that qualifies depression as a disease because, at least some of the time, people are depressed because the world is BAD (parents dying,debt,breaking up with partner) and this causes a change of brain conditions. But it seems utterly pointless to call this a disease. In essence psychologists start reifying everything when they shouldn't.
Original post by beepbeeprichie
I've not read him but a lot of psychology seems bunk to me for the following reason:

Say someone is diagnosed with clinical depression. This is a recognised mental disorder. My problem with this is that it assumes the person has some kind of malfunctioning in their brain. But even if they do I don't think that qualifies depression as a disease because, at least some of the time, people are depressed because the world is BAD (parents dying,debt,breaking up with partner) and this causes a change of brain conditions. But it seems utterly pointless to call this a disease. In essence psychologists start reifying everything when they shouldn't.


Completely off topic but hey, I'll bite.

I've been depressed - clinically, yes, diagnosed by several sources - since I was 16. My parents are still alive, I got my first partner at 21, we lived comfortably, I was not abused and nothing tragic or disturbing happened to me at all. There is no worldly reason for me to be depressed other than there is a crossed wire or over/under application of chemicals in my brain. Depression doesn't need to have a physical cause, it can be organic, as with other mental disorders.
Reply 3
Original post by beepbeeprichie
I've not read him but a lot of psychology seems bunk to me for the following reason:

Say someone is diagnosed with clinical depression. This is a recognised mental disorder. My problem with this is that it assumes the person has some kind of malfunctioning in their brain. But even if they do I don't think that qualifies depression as a disease because, at least some of the time, people are depressed because the world is BAD (parents dying,debt,breaking up with partner) and this causes a change of brain conditions. But it seems utterly pointless to call this a disease. In essence psychologists start reifying everything when they shouldn't.

I suppose one could argue that the cause of the problem does not deny its existence.

That is, stress can cause higher blood pressure and could potentially trigger a heart attack. If one has the heart attack, the fact that it was caused by an external factor does not deny the heart attack as the result of an illness.

The same could be said for clinical depression. If, for example, a death triggered clinical depression in a person, the fact that it was caused by an external factor could, similarly, not deny its existence as an illness.
Original post by kiss_me_now9
Completely off topic but hey, I'll bite.

I've been depressed - clinically, yes, diagnosed by several sources - since I was 16. My parents are still alive, I got my first partner at 21, we lived comfortably, I was not abused and nothing tragic or disturbing happened to me at all. There is no worldly reason for me to be depressed other than there is a crossed wire or over/under application of chemicals in my brain. Depression doesn't need to have a physical cause, it can be organic, as with other mental disorders.


That's fine and not inconsistent with what I said. I only said that in some cases psychologists seem to start making things exist which actually don't.
Original post by beepbeeprichie
That's fine and not inconsistent with what I said. I only said that in some cases psychologists seem to start making things exist which actually don't.


In some cases I agree with you, not in the case of depression though. A better example would be something like borderline personality disorder - a 'real' mental illness but it's essentially just a slapped on label for people they can't be bothered to deal with any more. It encompasses low moods, fear of abandonment, anxiety, self harming behaviour and more which most people will turn around and say is just a list of depression symptoms.

The DSM V is also going to have a few new MH terms in it that I personally don't agree with at all.
Original post by najinaji
I suppose one could argue that the cause of the problem does not deny its existence.

That is, stress can cause higher blood pressure and could potentially trigger a heart attack. If one has the heart attack, the fact that it was caused by an external factor does not deny the heart attack as the result of an illness.

The same could be said for clinical depression. If, for example, a death triggered clinical depression in a person, the fact that it was caused by an external factor could, similarly, not deny its existence as an illness.


That cuts pretty nicely to the heart of it and it's a good argument but I'm still not comfortable with the conclusion that all depression can legitimately be labelled as a disease. One reason for this is that it seems to me that disease requires something to be going wrong in the body. In your case of stress and the heart attack this is fine (stress causes hypertension causes hardening of arteries etc) and in some cases depression as well (perhaps some genetic cause/alcohol etc) but in many cases not. In some cases the body is just responding to the world (like eyes responding to light) and not that there is anything wrong with it. My question to you is thus: how can you distinguish some cases of depression from the body responding to stimulus in a normal everyday way? Why is depression from a loved one dying not as rational/normal as seeing green when you look at the grass?
Reply 7
Original post by kiss_me_now9
Completely off topic but hey, I'll bite.

I've been depressed - clinically, yes, diagnosed by several sources - since I was 16. My parents are still alive, I got my first partner at 21, we lived comfortably, I was not abused and nothing tragic or disturbing happened to me at all. There is no worldly reason for me to be depressed other than there is a crossed wire or over/under application of chemicals in my brain. Depression doesn't need to have a physical cause, it can be organic, as with other mental disorders.


If you are saying that you were completely satisfied 100% about all the aspects of your life and you still suffered from depression than fair enough, if not then I think the question to ask is if you had been living your dream life i.e you had all the friends and money in the world, perfect physical health, had the perfect job for you, a loving family and you felt loved and appreciated would you still have been depressed?
Original post by Mr.mAddd
If you are saying that you were completely satisfied 100% about all the aspects of your life and you still suffered from depression than fair enough, if not then I think the question to ask is if you had been living your dream life i.e you had all the friends and money in the world, perfect physical health, had the perfect job for you, a loving family and you felt loved and appreciated would you still have been depressed?


That's precisely what I said - I'll repeat it again. There is no physical or emotional cause for me being depressed. I have had a very nice life; bullied a bit as a kid but from 14 I've had the same lovely group of friends, family all together, everything I needed and most that I wanted, I am in perfect physical health apart from the depression and I'm studying what I love.
Reply 9
Original post by kiss_me_now9
In some cases I agree with you, not in the case of depression though. A better example would be something like borderline personality disorder - a 'real' mental illness but it's essentially just a slapped on label for people they can't be bothered to deal with any more. It encompasses low moods, fear of abandonment, anxiety, self harming behaviour and more which most people will turn around and say is just a list of depression symptoms.

The DSM V is also going to have a few new MH terms in it that I personally don't agree with at all.


Could you elaborate on which terms you're uncomfortable with? I've been looking into DSM-5 and there seems to be a lot of contention - Frances Allen says that it medicalises normality.
Reply 10
Original post by beepbeeprichie
That cuts pretty nicely to the heart of it and it's a good argument but I'm still not comfortable with the conclusion that all depression can legitimately be labelled as a disease. One reason for this is that it seems to me that disease requires something to be going wrong in the body. In your case of stress and the heart attack this is fine (stress causes hypertension causes hardening of arteries etc) and in some cases depression as well (perhaps some genetic cause/alcohol etc) but in many cases not. In some cases the body is just responding to the world (like eyes responding to light) and not that there is anything wrong with it. My question to you is thus: how can you distinguish some cases of depression from the body responding to stimulus in a normal everyday way? Why is depression from a loved one dying not as rational/normal as seeing green when you look at the grass?

Aha. That is an excellent question. Indeed, I've wondered this as well. Is 'mania' an illness, or a frame of mind? Should the treatment for depression be making their lives more pleasant or medication?

Have you ever seen the film 'Harvey', by the way? This is a film that really tried to address that question.
Original post by turkishdisco
Could you elaborate on which terms you're uncomfortable with? I've been looking into DSM-5 and there seems to be a lot of contention - Frances Allen says that it medicalises normality.


There's a few I'm not on board with. Grief, for example. I believe you'll probably have read this already :tongue: http://www.psychologytoday.com/blog/dsm5-in-distress/201202/dsm-5-the-barricades-grief but that kind of thing. There's no need to medicalise what is a natural and healthy process for humans, even animals grieve in a similar fashion and the length of time it takes is entirely individual. Too many GPs give out ADs like they're candy anyway so giving them another excuse to throw them out is not going to be good, especially with the side effects that they have (which would probably last the same amount of time as the spell of grieving, with some counselling or just a healthy adaptive way of coping).

Secondly, I don't like some of the new child 'disorders'. Bipolar disorder in children before the DSM-IV was pretty much unheard of and I still don't believe that it manifests much before 16/18 unless in very very rare cases. Bipolar drugs themselves are devastating and to give them to a child - whether they're 5 or 15 - is abhorrent. As with all things though, times change and the new trend maybe 'disruptive mood dysregulation disorder'. Temper tantrums. Let me put it this way; if I was a child when the DSM V with that in came out, I'd have been medicated up to my eyeballs. I had terrible temper tantrums, so did my sister, as did most of the people I knew back then. They're just a part of growing up and if anything a reflection of your parents skills not your mental health. Personally this one scares the **** out of me.
http://www.psychologytoday.com/blog/dsm5-in-distress/201110/should-temper-tantrums-be-made-dsm-5-diagnosis
Original post by kiss_me_now9
There's a few I'm not on board with. Grief, for example. I believe you'll probably have read this already :tongue: http://www.psychologytoday.com/blog/dsm5-in-distress/201202/dsm-5-the-barricades-grief but that kind of thing. There's no need to medicalise what is a natural and healthy process for humans, even animals grieve in a similar fashion and the length of time it takes is entirely individual. Too many GPs give out ADs like they're candy anyway so giving them another excuse to throw them out is not going to be good, especially with the side effects that they have (which would probably last the same amount of time as the spell of grieving, with some counselling or just a healthy adaptive way of coping).

Secondly, I don't like some of the new child 'disorders'. Bipolar disorder in children before the DSM-IV was pretty much unheard of and I still don't believe that it manifests much before 16/18 unless in very very rare cases. Bipolar drugs themselves are devastating and to give them to a child - whether they're 5 or 15 - is abhorrent. As with all things though, times change and the new trend maybe 'disruptive mood dysregulation disorder'. Temper tantrums. Let me put it this way; if I was a child when the DSM V with that in came out, I'd have been medicated up to my eyeballs. I had terrible temper tantrums, so did my sister, as did most of the people I knew back then. They're just a part of growing up and if anything a reflection of your parents skills not your mental health. Personally this one scares the **** out of me.
http://www.psychologytoday.com/blog/dsm5-in-distress/201110/should-temper-tantrums-be-made-dsm-5-diagnosis


That's great, thanks for your reply! I do find it strange that Allen Frances actually led DSM-IV, and yet he is so critical of DSM-5 - DSM-IV added 68 disorders to the list!

Do you think there comes a certain point where we shouldn't add any more disorders?

(I've written a blog entry about the DSM if you want to check it out!).

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