What is meant when it is asserted that someone is mentally ill? In this essay I shall describe the main uses of the concept of mental illness, and I shall argue that this notion has outlived whatever cognitive usefulness it might have had and that it now functions as a myth.
Thomas Szasz, Ideology and Insanity, 1970
Many of the most interesting developments in psychotherapy, psychology and psychiatry have come from people who had the capacity to rethink mental illness.
Before Thomas Szasz, in the 19th century, it was the work of Charcot, Janet and Freud (amongst others) who looked at hysteria and were able to understand that underneath the afflicted patient’s behaviour and symptoms were social problems that hadn’t been picked up and identified.
- These patients weren’t afflicted by random genetic disorders.
- They were people who had suffered traumatic experiences that were overlooked as doctors focussed instead on their disquieting symptoms.
Freud and Breuer rethought these ideas and psychoanalysis developed out of their work. An approach to the mind and psychological issues was developed that could be pursued through talking, through listening to the patient rather than performing painful treatments.
It became possible to rethink mental illness, to liberate the patient from their restricted lives and complicated symptoms.
Before Freud’s psychoanlysis it was much more common to employ suggestive treatments like hypnotism. Freud was able to rethink mental illness. Freud concluded that hypnotism exerted too great a suggestive influence on the patient. Freud stopped using hypnotism and developed a talking cure. All that had to happen was that the client came and talked and told the therapist what they were going through. The psychotherapy could work from that beginning. It is still the same today. Psychotherapy is a talking therapy..
Carl Jung rethought mental illness in ways that added to Freud’s ideas but ultimately doing so caused a breach in their relationship.
- Jung thought that our symptoms were to do with problems in our development, not just in terms of our past, our childhoods.
- But in terms of things that were getting in the way of us developing and living our lives more fully in the present and the future. This is often what we call a midlife crisis.
A midlife crisis is where the person no longer knows what happens next in their lives.
Depression forms because there is a loss of momentum and life stalls.
Perhaps there has been a life change, maybe children don’t need us so much anymore. How do you recover the capacity to live creatively, constructively, as you move forward?
When we stop finding ways to rethink and transform our lives we become stuck and that can be depressing.
When I assert that mental illness is a myth, I am not saying that personal unhappiness and socially deviant behaviour do not exist; what I am saying is that we categorise them as diseases at our own peril.
Thomas Szasz, Ideology and Insanity, 1970
In 1913, Jung and Freud broke off their working relationship. Jung found Freud’s attachment and focus on sexuality too restrictive. Jung rethought it. This would cost Jung in terms of his social world and his personal psychology.
The break with Freud caused Jung to have a long and lingering breakdown. Throughout it, Jung never stopped working and trying to understand what he was going through. Ultimately the insights that he gained from his breakdown, or his creative illness, furnished many of the insights that would reach fruition in his mature work.
There has always been a creative tension within psychiatry and psychotherapy
It is that tension that helps us to rethink mental illness. To come at the patient’s symptoms are afresh.
I have tried to show that the notion of mental illness has outlived whatever usefulness it may have had and that it now functions as a myth. As such, it is a true heir to religious myths in general, and to the belief in witchcraft in particular.
Thomas Szasz, Ideology and Insanity, 1970
It is always time to rethink mental illness
We can become accustomed to thinking that there are things wrong with us, that we have problems we can’t do anything about. But often our problems say more about things that have happened to us, than that there are things wrong with us.
When families go through traumas, difficult experiences that they don’t know how to process, the individual family members can start to behave in complicated and destructive ways.
Those individuals can then become the focus, rather than the original underlying problem. So in cases of divorce, in which a child becomes unhappy and problematic. the focus can switch to what is the problem with the child, rather than keeping attention on the problems that were being experienced in the family and which led to the divorce.
It can follow that a child becomes seen as the problem, and the underlying family problems get ignored. The child may end up being given a particular diagnosis, possibly ADHD or ODD (oppositional defiance disorder), they may be put on medication. But often the underlying problem is more to do with the problems in the child’s home which are going unnoticed than it is to do with the child. Once the child has become identified as the problem it can take a long time to find a way to out of that identification.
Left untended this can create a kind of self-fulfilling prophecy. So you might grow up to live and act destructively instead of being able to see the destructive problems behind the behaviour.
Mental illness is a myth, whose function is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.
Thomas Szasz, Ideology and Insanity, 1970
A psychiatric diagnosis can be helpful
It can provide useful information. It can also be stigmatising and shaming.
- How do you get out of the destructive cycle?
- How do you take a new look at yourself?
- How do you rethink mental illness in such a way as to give you the room to understand what’s happened to you?
People who are caught in these traumatising stigmatising self-fulfilling prophecies tend to end up developing very complicated lives. They feel alone, they can’t stay in relationships.
They may turn to addictive behaviours. Addictive behaviour isolates people and increases loneliness, and loneliness increases the tendency to use an addictive substitute. When an addict uses alcohol, ketamine, cocaine, sex, pornography, gambling or whatever their drug of choice is, they take a journey into the lonely world of addictive experience, instead of finding a way to connect with people.
When we connect with others we rethink mental illness
When we connect with people, we get the chance to rethink our lives and to rethink mental illness. To see that there was a problem in your life that you have been overlooking. It is never too late to rethink these things.
Whatever has brought you to think about trying psychotherapy now is quite possibly linked with a desire to rethink the way your life works. To understand the things that create problems and to find a confidential place in which these things can be thought about and worked through.
In myths, legends, and fairy tales, it is often the sudden appearance of some unexpected supernatural agent, a magical bird or a bolt of lightning, that breaks up the trajectory of the story and provides an outlet for new creativity, new possibilities.
Rethinking mental illness is the same. It starts with the impulse to find a way to rethink the way your life works.
In psychotherapy, the possibility of a connection is made with a therapist who is focused upon you, your problems, your situation. When we create these kinds of connections we may take ourselves away from the dark unhappy lonely destructive dysfunctional stigmatising shamed cycles that we tend to live in like hamsters on treadmills.
When we connect we give ourselves the chance to rethink mental illness.
Following from Sartre and Szasz, in the 1960s it was the work of Laing and Esterson in their pioneering book ‘Sanity, Madness and the Family’ which demonstrated that simply by talking to patients and their families they could understand the behaviour and symptoms of women who had been given the diagnosis of schizophrenia. The behaviour made sense when you took into account the moral complications within the families.
Our question is: are the experience and behaviour that psychiatrists take as symptoms and signs of schizophrenia more socially intelligible than has come to be supposed?
Laing and Esterson, Sanity, Madness and the Family, 1964
When we rethink mental illness, we give ourselves the chance to connect with ourselves, with another person. We take ourselves more seriously and constructively. We may start to find a way out of the restrictive patterns and psychological experiences that we tend to live in. We stop seeing symptoms as the problem.
Contact me to discuss further
If you feel stuck or that you cannot find the energy to get through the challenges you are facing now, then it might be helpful to talk about this.
I have been working with people on issues such like this for twenty years. My work is built around helping people to develop greater confidence in themselves, a better understanding of why you feel the way you do, and of helping you to develop confidence that you can manage these experiences without feeling out of control.
Contact me to arrange a free 15 minute conversation to discuss how my work might be useful to you.
I have a lot of experience of using telephone and online platforms and I would be pleased to hear from you.
Telephone: 01494 521311
Mobile: 07980 750376
Email: toby@tobyingham.com
