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The Meaning of Psychiatric Disorders

Mental illness, according to Szasz, does not exist. Of course the experiences and behaviors that are labeled mental illness do exist. Their conceptualization as mental illness, however, is misleading and conceals the real issues. If that is so, how must these experiences and behaviors be understood?

According to Szasz they are problems in living and interpersonal conflict which are inherent to human life. Psychiatry strips these problems of their essentially moral and political character. Psychiatrists absolve people of responsibility for these problems. As responsibility can be a difficult and heavy burden, psychiatrists and patients serve each others’ interests by creating this mystification, at least in this respect. This way Szasz explains the upsurge in behaviors that are called psychiatric. More and more people are being absolved of their responsibilities. The sacrifice that patients must make for this is losing their autonomy and being turned into unassertive children who are not responsible for their own behavior.

This reasoning rests on three premises which I will regard more closely below:
  1. Experiences and behaviors that are labeled mental illness are nothing other than problems in living and conflicts.
  2. There is an essential difference between bodily illnesses and psychiatric disorders. “Physical illness is usually something that happens to us, whereas mental illness is something we do (or feel or think).” (Law, Liberty, and Psychiatry, p. 17)
  3. As illness is something for which a person cannot be held responsible, the essential, implicated manipulation of the conceptualization of these problems and conflicts as “mental illness” is to absolve people of responsibility for behavior for which they are in fact responsible.
Below I will first discuss the connection between problems in living and psychiatric disorders (3.4.1). Next the problem of causality versus responsibility will be discussed, first regarding physical disease (3.4.2) and then regarding psychiatric disorders (3.4.3).
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