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Happy Birthday, Szasz

szaszfaceToday is Thomas S Szasz’ 94th birthday. When I discuss the Szasz-ian view that mental illness is a myth, virtually no one accepts this view as the truth. Even when they are reasonably intelligent people, they do not understand what this even means. They tend to think that this is a hypothesis, or that I do not understand how grave a threat mental illness can be.

But, I think certain facts are obvious. Most people are really dumb. Half the people have IQs below 100. Half the people in India have IQs below 82. You have to remember that someone with an IQ of 100 is still way below someone at the top of the IQ pyramid. The difference between him, and someone whose IQ is 100 is the difference between the person with an IQ of 100 and a chimpanzee. Is it even plausible that the judgment of the large majority of the people of what constitutes normal behavior is likely to be true? Does a chimpanzee know how a man behaves and how he ought to behave?

People do not know that in the mid-19th century, the slaves who ran away were believed to have drapetomania. Drapetomania, of course, was a disease that caused the slaves to run away. A physician Samuel Cartwright believed that drapetomania was caused by:

Two classes of persons were apt to lose their Negroes: those who made themselves too familiar with them, treating them as equals; and on the other hand those who treated them cruelly, denied them the common necessaries of life, neglected to protect them, or frightened them by a blustering manner of approach.

If drapetomania was not caused by either of these, Cartwright had a prescription:  they can be cured by “whipping the devil out of them.” There was another disease dyaesthesia, which caused the slaves to shirk toil.  This is hilarious, but wait.

How did these diseases go out of fashion? When people decided that slaves are people too, and have equal rights. Homosexuality was considered a mental disorder till recently, and it is still considered a mental disorder, perhaps by most human beings. How was homosexuality “de-classified”? When homosexuals acquired sufficient political power and demanded that they should be treated equally. Masturbation was considered a mental illness not too long ago, and the most influential psychiatry text in the United States classified it as a mental disorder till 1938. How did this go out of fashion? When people understood that almost everyone engages in it.

My point is that there is a consistent pattern in these classifications and “de-classifications”. Perhaps if nerds acquire sufficient political power, they might stop considering Asperger syndrome as a mental disorder. But, that is unlikely because nerds do not have the political instinct.

The fact is that most people are idiots, and the view that anger is mental illness or that depression is mental illness, or that sleeplessness is mental illness does not have any more validity than the view that the slaves that shirk toil have dyaesthesia. When some diseases go out of fashion, other diseases emerge, and that is about it. No matter how many times you tell people that this is true, they are not convinced that this is true. Why? I do not believe that such mistakes are innocent. But, why do people want to believe this? This story might suggest some answers:

“Consider the case of a European psychiatrist who counseled many couples referred to him in which one of the spouses experienced “morbid jealousy.” Most cases were husbands who had delusions that their wives were sexually unfaithful, and these delusions destroyed the fabric of trust required for harmonious marriage. Because he believed that extreme jealousy was a psychiatric illness that could not be cured, his most common recommendation was that the couples separate or divorce. Many couples followed his recommendations. Because he was keenly interested in the subsequent fate of his patients, he routinely contacted them after a number of months had passed. To his astonishment, he discovered that many of the wives of his patients had subsequently become sexually involved with the very men about whom their husbands had been jealous! Some of these women actually married the men who were the objects of their husbands’ suspicions. In many cases, the husbands must have been sensing signs of infidelity. But because the wives proclaimed innocence and declared that their husbands’ jealousy was irrational, the husbands ended up believing that the problem was in their heads. The problem of signal detection is how to identify and correctly interpret a partner’s betrayal in an uncertain social world containing a chaos of conflicting clues.”

What could have happened? The wives either had to admit that the husbands were right, or claim that there was something wrong with the husbands who never trusted them. Human nature being what it is, it did not “occur” to them that the problem was within themselves. 

Szasz argued that involuntary hospitalization is a tactic to stigmatize or punish people and that there is nothing more to it. Rightly so. These mistakes are by no means innocent. What people call mental illness is either brain injury, or malingering, but more often conflicts between people. But, Szasz pointed out an important aspect of human relationships:

In human relationships, conflict is the norm. Harmony requires the utmost co-operation, patience and intelligence of everyone concerned. It is not surprising that harmony is hardly the norm because these traits are not common. I think these are rarer than genius.                                                                


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