Szasz On The Myth Of Mental Illness

This semester, in my Landmarks in Philosophy class, I used Thomas Szasz‘s The Myth of Mental Illness as one of the three texts on the reading list (The other two were Mary Wollstonecraft’s Vindication of the Rights of Woman and William James’ Pragmatism.) Szasz’s argument that mental illness does not exist, that psychiatry is a pseudo-science was, as might be expected, fairly controversial; critics accused him of overstating his case and of drawing too sharp a boundary between the physical and the mental. Be that as it may, there are many, many acute insights in Szasz’s work; these continue to make reading his work a useful experience for any philosophy student.

Among these insights, in no particular order, are the following:

1. Reducing the mental to the physical comes at a cost of explanatory power. Especially when such reduction is merely offered in the form of a promissory note; many existing behavioral disorders still lack physical correlates in neurophysiology. The languages of the mental and the ethical often offer us richer and more useful explanations for understanding our fellow human beings than the language of the physical; many phenomena of social and ethical interest ‘vanish’ when subjected to the lens of the physical.

2. The so-called ‘mentally ill’ are engaged in a species of communication with us; it behooves us to try to translate their ‘speech.’ This leads to a consideration of a hierarchy of languages and a study of the metalanguage and object language distinction.

3. The category ‘mentally ill’ functions, all too often, as a catch-all category used to lump in socially undesirable behavior; what counts as desirable and undesirable is clearly a function of existing social prejudices.  The infamous DSM criteria often encapsulate such prejudices; unsurprisingly these need to be revised over time to accommodate such inclinations. (Remember that Dostoyevsky’s ‘Underground Man‘ was a ‘sick man.’)

4. A game-playing and rule-following model of human behavior offers us interesting and useful interpretations of social situations and interactions within them. (Wittgenstein’s notion of language as a kind of social game immediately comes to mind here and allows for a fruitful investigation of this claim.)

5. Medicine functions within a social, economic, political, and ethical context; the rights of patients and healers emerge within this context.  We should expect medicine to be practiced differently–with different medical outcomes–in different contexts. From this, a larger point about the social construction of science, scientific practice, and scientific knowledge can be seen to follow; the boundaries of science are very often informed by social and legal considerations. Consider, for instance, the testing of cosmetic products or new drugs on laboratory animals, experimental procedures which stand and fall depending on whether they have received legal sanction from the surrounding legal regime.

6. The autonomy and personality of the patient is a moral good worthy of respect; the practice of medicine and the relationship between the doctor and patient should be cognizant of this. (The notion of ‘informed consent’ in modern bioethics can be seen to be powerfully informed by such a consideration.)

Max Weber On The Ubiquity Of ‘Meaning’ In ‘Social Life’ And ‘Nature’

In “The Concept of ‘Following a Rule'” (Weber: Selections in Translation, ed. W. G. Runciman, Cambridge University Press, 1998, p. 107) Max Weber writes:

If we separate in our minds the ‘meaning’ which we find ‘expressed’ in an object or event from those elements in the object or event which are left over when we abstract precisely that ‘meaning,’ and if we call an enquiry which considers only these latter elements a ‘naturalistic’ one, then we get a broader concept of ‘nature,’ which is quite distinct from the previous one. Nature is what is ‘meaningless’ – or, more correctly, an event becomes part of ‘nature’ if we do not ask for its ‘meaning.’ But plainly in that case the opposite of ‘nature,’ in the sense of the ‘meaningless,’ is not ‘social life’ but just the ‘meaningful’ – that is, the ‘meaning’ which can be attached to, or ‘found in,’ an event or object, from the metaphysical ‘meaning’ given to the cosmos in a system of religious doctrine down to the ‘meaning’ which the baying of one of Robinson Crusoe’s hounds ‘has’ when a wolf is approaching.

In ‘The Concept of ‘Following A Rule’ Weber was concerned to provide an extended critique of the notion put forward by Rudolf Stammler that–roughly–‘social’ life could be demarcated from ‘nature’ on the basis of the criteria that social life was characterized by rule-following; it is this ‘following a rule’ which generates the meaning attached to social events; Robinson Crusoe, bound ‘only’ by nature and his own desires and constraints follows no such rules; his is not a social life; it is life lived in ‘nature.’ As Weber went on to argue, such a distinction was not enough; Crusoe’s existence on his isolated island could be interpreted to be bound by ‘rules’ too; the curious social scientist just had to look farther afield, perhaps at the laws of nature that Crusoe was bound by, perhaps the rhythms of a daily routine that best served his continued existence and survival. The boundaries between the ‘social’ and the ‘natural’ cannot be so easily drawn; the social cannot so easily be described by a logic different from that used to describe nature.

In the passage above, Weber notes that ‘meaning’ is far too loose a notion to do the work that such a distinction would seek to make it do; ‘meaning’ is ubiquitous depending on the perspectives and interpretations at play; we can read meaning into and out of natural events just as easily as we do with social ones. If we are determined to describe ‘nature’ as ‘meaningless’ we will not obtain ‘social life’ as its converse, but rather, just the ‘meaningful,’ which will not map on precisely to what we understand in normal practice by ‘nature.’ This is a point that should be familiar to those who struggle to provide theories of meaning in the philosophy of language; far too much is found ‘meaningful’–using explicitly linguistic units or otherwise–for one all-encompassing theory to do do justice to the concept.