I have tried to show that the notion of mental illness has outlived whatever usefulness it might have had and that it now functions merely as a· convenient myth. As such, it is a true heir to religious myths in general, and to the belief in witchcraft in particular; the role of all these belief-systems was to act as social tranquilizers, thus encouraging the hope that mastery of certain specific problems may be achieved by means of substitutive (symbolic-magical) operations. The notion of mental illness thus serves mainly to obscure the everyday fact that life for most people is a continuous struggle, not for biological survival, but for a “place in the sun,” “peace of mind,” or some other human value. For man aware of himself and of the world about him, once the needs for preserving the body (and perhaps the race) are more or less satisfied, the problem arises as to what he should do with himself. Sustained adherence to the myth of mental illness allows people to avoid facing this problem, believing that mental health, conceived as the absence of mental illness, automatically insures the making of right and safe choices in one’s conduct of life. But the facts are all the other way. It is the making of good choices in life that others regard, retrospectively, as good mental health!
The myth of mental illness encourages us, moreover, to believe in its logical corollary: that social intercourse would be harmonious, satisfying, and the secure basis of a “good life” were it not for the disrupting influences of mental illness or “psychopathology.” The potentiality for universal human happiness, in this form at least, seems to me but another example of the I-wish-it-were-true type of fantasy. I do [*] believe that human happiness or well-being on a hitherto unimaginably large scale, and not just for a select few, is possible. This goal could be achieved, however, only at the cost of many men, and not just a few being willing and able to tackle their personal, social, and ethical conflicts. This means having the courage and integrity to forego waging battles on false fronts, finding solutions for substitute problems — for instance, fighting the battle of stomach acid and chronic fatigue instead of facing up to a marital conflict.
Our adversaries are not demons, witches, fate, or mental illness. We have no enemy whom we can fight, exorcise, or dispel by “cure.” What we do have are problems in living — whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. The field to which modern psychiatry addresses itself is vast, and I made no effort to encompass it all. My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.
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SZASZ, T. S. Malingering: “Diagnosis” or social condemnation? AMA Arch Neurol. Psychiat., 1956, 76, 432-443.
SZASZ, T. S. Pain and pleasure: A study of bodily-feelings. New York: Basic Books, 1957. (a)
SZASZ, T. S. The problem of psychiatric nosology: A contribution to a situational analysis of psychiatric operations. Amer. J. Psychiat, 1957, 114, 405-413. (b)
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SZASZ, T. S. Moral conflict and psychiatry, Yale Rev., 1959, in press.
 Freud went so far as to say that: “I consider ethics to be taken for granted. Actually I have never done a mean thing” (Jones, 1957, p. 247). This surely is a strange thing to say for someone who has studied man as a social being as closely as did Freud. I mention it here to show how the notion of “illness” (in the case of psychoanalysis, “psychopathology,” or “mental illness”) was used by Freud — and by most of his followers — as a means for classifying certain forms of human behavior as falling within the scope of medicine, and hence· (by fiat) outside that of ethics!
[*] Classics Editor’s note: In the original American Psychologist text the word “not” appears at this point. Dr. Szasz has informed me, however, that it “was a typo, which [he] corrected when [he] reprinted the piece, e.g., in Ideology and Insanity” (personal communication, 2002).