Does Mental Illness Exist?

Does Mental Illness Exist?by Lawrence Stevens, J.D.All diagnosis and treatment in psychiatry, especially biologicalpsychiatry, presupposes the existence of something called mentalillness, also known as mental disease or mental disorder. What ismeant by disease, illness, or disorder? In a semantic sense diseasemeans simply dis-ease, the opposite of ease. But by disease we don'tmean anything that causes a lack of ease, since this definition wouldmean losing one's job or a war or economic recession or an argumentwith one's spouse qualifies as "disease". In his book Is AlcoholismHereditary? psychiatrist Donald W. Goodwin, M.D., discusses thedefinition of disease and concludes "Diseases are something people seedoctors for. ... Physicians are consulted about the problem ofalcoholism and therefore alcoholism becomes, by this definition, adisease" (Ballantine Books, 1988, p. 61). Accepting this definition,if for some reason people consulted physicians about how to get theeconomy out of recession or how to solve a disagreement with one'smate or a bordering nation, these problems would also qualify asdisease. But clearly this is not what is meant by "disease". In hisdiscussion of the definition of disease, Dr. Goodwin acknowledgesthere is "a narrow definition of disease that requires the presence ofa biological abnormality" (ibid). In this pamphlet I will show thatthere are no biological abnormalities responsible for so-called mentalillness, mental disease, or mental disorder, and that therefore mentalillness has no biological existence. Perhaps more importantly,however, I will show that mental illness also has no non-biologicalexistence - except in the sense that the term is used to indicatedisapproval of some aspect of a person's mentality. The idea of mental illness as a biological entity is easyto refute. In 1988, Seymour S. Kety, M.D., Professor Emeritus ofNeuroscience in Psychiatry, and Steven Matthysse, Ph.D., AssociateProfessor of Psychobiology, both of Harvard Medical School, said "animpartial reading of the recent literature does not provide the hoped-for clarification of the catecholamine hypotheses, nor does compellingevidence emerge for other biological differences that may characterizethe brains of patients with mental disease" (The New Harvard Guide toPsychiatry, Harvard Univ. Press, p. 148). In 1992 a panel of expertsassembled by the U.S. Congress Office of Technology Assessmentconcluded: "Many questions remain about the biology of mentaldisorders. In fact, research has yet to identify specific biologicalcauses for any of these disorders. ... Mental disorders areclassified on the basis of symptoms because there are as yet nobiological markers or laboratory tests for them" (The Biology ofMental Disorders, U.S. Gov't Printing Office, 1992, pp. 13-14,46-47). In his book The Essential Guide to Psychiatric Drugs,Columbia University psychiatry professor Jack M. Gorman, M.D., said"We really do not know what causes any psychiatric illness" (St.Martin's Press, 1990, p. 316). In his book The New Psychiatry anotherColumbia University psychiatry professor, Jerrold S. Maxmen, M.D.,said "It is generally unrecognized that psychiatrists are the onlymedical specialists who treat disorders that, by definition, have nodefinitively known causes or cures. ... A diagnosis should indicatethe cause of a mental disorder, but as discussed later, since theetiologies of most mental disorders are unknown, current diagnosticsystems can't reflect them" (Mentor, 1985, pp. 19 & 36 - emphasis inoriginal). In his book Toxic Psychiatry, psychiatrist Peter Breggin,M.D., said "there is no evidence that any of the common psychologicalor psychiatric disorders have a genetic or biological component" (St.Martin's Press, 1991, p. 291). It is sometimes argued that psychiatric drugs"curing" (stopping) the thinking, emotions, or behavior that is calledmental illness proves the existence of biological causes of mentalillness. This argument is easily refuted: Suppose someone was playingthe piano and you didn't like him doing that. Suppose you forced orpersuaded him to take a drug that disabled him so severely that hecouldn't play the piano anymore. Would this prove his piano playingwas caused by a biological abnormality that was cured by the drug? Assenseless as this argument is, it is often made. Most if not allpsychiatric drugs are neurotoxic, producing a greater or lesser degreeof generalized neurological disability. So they do stop dislikedbehavior and may mentally disable a person enough he can no longerfeel angry or unhappy or "depressed". But calling this a "cure" isabsurd. Extrapolating from this that the drug must have cured anunderlying biological abnormality that was causing the dislikedemotions or behavior is equally absurd. When confronted with the lack of evidence for theirbelief in mental illness as a biological entity, some defenders of theconcept of mental illness will assert that mental illness can existand can be defined as a "disease" without there being a biologicalabnormality causing it. The idea of mental illness as a nonbiologicalentity requires a more lengthy refutation than the biologicalargument. People are thought of as mentally ill only when theirthinking, emotions, or behavior is contrary to what is consideredacceptable, that is, when others (or the so-called patientsthemselves) dislike something about them. One way to show theabsurdity of calling something an illness not because it is caused bya biological abnormality but only because we dislike it or disapproveof it is to look at how values differ from one culture to another andhow values change over time. In his book The Psychology of Self-Esteem, NathanielBranden, Ph.D., a psychologist, wrote: "One of the prime tasks of thescience of psychology is to provide definitions of mental health andmental illness. ...But there is no general agreement amongpsychologists and psychiatrists about the nature of mental health ormental illness - no generally accepted definitions, no basic standardby which to gauge one psychological state or other. Many writersdeclare that no objective definitions and standards can be established- that a basic, universally applicable concept of mental health isimpossible. They assert that, since behavior which is regarded ashealthy or normal in one culture may be regarded as neurotic oraberrated in another, all criteria are a matter of 'cultural bias.'The theorists who maintain this position usually insist that theclosest one can come to a definition of mental health is: conformityto cultural norms. Thus, they declare that a man is psychologicallyhealthy to the extent that he is 'well-adjusted' to his culture. ...The obvious questions that such a definition raises, are: What if thevalues and norms of a given society are irrational? Can mental healthconsist of being well-adjusted to the irrational? What about NaziGermany, for instance? Is a cheerful servant of the Nazi state - whofeels serenely and happily at home in his social environment - anexponent of mental health?" (Bantam Books, 1969, pp. 95-96, emphasisin original). Dr. Branden is doing several things here: First, he isconfusing morality and rationality, saying that respect for humanrights is rational when in fact it is not a question of rationalitybut rather of morality. So psychologically and emotionally lockedinto and blinded by his values is he that Dr. Branden is evidentlyincapable of seeing the difference. Additionally, Dr. Branden isstating some of his values. Among these values are: Respect for humanrights is good; violation of human rights (like Naziism) is bad. Andhe is saying: Violating these values is "irrationality" or mentalillness. Although their practitioners won't admit it and often arenot even aware of it, psychiatry and "clinical" psychology in theirvery essence are about values - values concealed under a veneer oflanguage that makes it sound like they are not furthering values butpromoting "health". The answer to the question Dr. Branden poses is:A person living in Nazi Germany and well-adjusted to it was "mentallyhealthy" judged by the values of his own society. Judged by thevalues of a society which respects human rights he was as sick(metaphorically speaking) as the rest of his culture. A person likemyself however says that such a person is morally "sick" andrecognizes that the word sick has not its literal but a metaphoricalmeaning. To a person like Dr. Branden who believes in the myth ofmental illness, such a person is literally sick and needs a doctor.The difference is that a person like myself is recognizing my valuesfor what they are: morality. Typically, the believer in mentalillness, such as Dr. Branden in this quoted passage, has the samevalues as I do but is confusing them with health. One of the most telling examples is homosexuality, whichwas officially defined as a mental disease by the American PsychiatricAssociation until 1973 but hasn't been since then. Homosexuality wasdefined as a mental disorder on page 44 of the American PsychiatricAssociation's standard reference book, DSM-II: Diagnostic andStatistical Manual of Mental Disorders (the 2nd Edition), published in1968. In that book, "Homosexuality" is categorized as one of the"Sexual deviations" on page 44. In 1973 the American PsychiatricAssociation voted to remove homosexuality from it's officialdiagnostic categories of mental illness. (See "An Instant Cure", Timemagazine, April 1, 1974, p. 45). So when the third edition of thisbook was published in 1980 it said "homosexuality itself is notconsidered a mental disorder" (p. 282). The 1987 edition of The MerckManual of Diagnosis and Therapy states: "The American PsychiatricAssociation no longer considers homosexuality a psychiatricdisease" (p. 1495). If mental illness were really an illness in thesame sense that physical illnesses are illnesses, the idea of deletinghomosexuality or anything else from the categories of illness byhaving a vote would be as absurd as a group of physicians voting todelete cancer or measles from the concept of disease. But mentalillness isn't "an illness like any other illness." Unlike physicaldisease where there are physical facts to deal with, mental "illness"is entirely a question of values, of right and wrong, of appropriateversus inappropriate. At one time homosexuality seemed so weird andhard to understand it was necessary to invoke the concept of mentaldisease or mental illness to explain it. After homosexuals made a bigenough spectacle of themselves and showed their "strength in numbers"and successfully demanded at least a small measure of socialacceptance, it was no longer necessary and no longer seemedappropriate to explain homosexuality as a disease. A cross-cultural example is suicide. In many countries,such as the United States and Great Britain, a person who commitssuicide or attempts to do so or even thinks about it seriously isconsidered mentally ill. However, this has not always been truethroughout human history, nor is it true today in all cultures aroundthe world. In his book Why Suicide?, psychologist Eustace Chesserpoints out that "Neither Hinduism nor Buddhism have any intrinsicobjections to suicide and in some forms of Buddhism self-incinerationis believed to confer special merit." He also points out that "TheCelts scorned to wait for old age and enfeeblement. They believedthat those who committed suicide before their powers waned went toheaven, and those who died of sickness or became senile went to hell -an interesting reversal of Christian doctrine" (Arrow Books Ltd.,London, England, 1968, p. 121-122). In his book Fighting Depression,psychiatrist Harvey M. Ross, M.D., points out that "Some culturesexpect the wife to throw herself on her husband's funeralpyre" (Larchmont Books, 1975, p. 20). Probably the best known exampleof a society where suicide is socially acceptable is Japan. Ratherthan thinking of suicide or "hara-kiri" as the Japanese call it asalmost always caused by a mental disease or illness, the Japanese insome circumstances consider suicide the normal, socially acceptablething to do, such as when one "loses face" or is humiliated by somesort of failure. Another example showing suicide is considerednormal, not crazy, in Japanese eyes is the kamikaze pilots Japan usedagainst the U.S. Navy in World War II. They were given enough fuelfor a one-way trip, a suicide mission, to where the attacking U.S.Navy forces were located and deliberately crashed their airplanes intothe enemy ships. There has never been an American kamikaze pilot, atleast, none officially sponsored by the United States government. Thereason for this is different attitudes about suicide in Japan andAmerica. Could suicide be committed only by people with psychiatricillnesses in America and yet be performed by normal persons in Japan?Or is acceptance of suicide in Japan a failure or refusal to recognizethe presence of psychological abnormalities which necessarily must bepresent for a person to voluntarily end his or her own life? Were thekamikaze pilots mentally ill, or did they and the society they comefrom simply have different values than we do? Even in America, aren'tvirtually suicidal acts done for the sake of one's fellow soldiers orfor one's country during wartime thought of not as insanity but asbravery? Why do we think of such persons as heros rather thanlunatics? It seems we condemn (or "diagnose") suicidal people as crazyor mentally ill only when they end their own lives for selfish reasons(the "I can't take it any more" kind of reasons) rather than for thebenefit of other people. The real issue seems to be selfishnessrather than suicide. What these examples show is that "mental illness" issimply deviance from what people want or expect in any particularsociety. "Mental illness" is anything in human mentality greatlydisliked by the person describing it. The situation was aptly summed up in an article in theNovember 1986 Omni magazine: "Disorders come and go. Even SigmundFreud's concept of neurosis was dropped in the original DSM-III(1980). And in 1973 APA [American Psychiatric Association] trusteesvoted to wipe out almost all references to homosexuality as adisorder. Before the vote, being gay was considered a psychiatricproblem. After the vote the disorder was relegated to psychiatry'sattic. 'It's a matter of fashion,' says Dr. John Spiegel of BrandeisUniversity, who was president of the APA in 1973, when the debate overhomosexuality flared. 'And fashions keep changing'" (p. 30). What is wrong with this approach is describing people ashaving a psychiatric "disease" or "illness" only because he or shedoesn't match up with a supposed diagnostician's or with otherpeople's idea of how a person "should" be in standards of dress,behavior, thinking, or opinion. When it involves violating the rightsof others, nonconformity with social norms or values must be curbed orstopped with various measures, criminal law being one example. Butcalling nonconformity or disliked behavior a "disease" or assuming itmust be caused by a disease only because it is unacceptable accordingto currently prevailing values makes no sense. What causes us to dothis is not knowing the real reasons for the thinking, emotions, orbehavior we dislike. When we don't understand the real reasons, wecreate myths to provide an explanation. In prior centuries peopleused myths of evil spirit or demon possession to explain unacceptablethinking or behavior. Today most of us instead believe in the myth ofmental illness. Believing in mythological entities such as evilspirits or mental illnesses gives an illusion of understanding, andbelieving a myth is more comfortable than acknowledging ignorance. Calling disapproved thinking, emotions, or behavior amental illness might be excusable if mental illness was a useful myth,but it isn't. Rather than helping us deal with troubled ortroublesome persons, the myth of mental illness distracts us from thereal problems that need to be faced. Rather than being caused by a"chemical imbalance" or other biological problem, the nonconformity,misbehavior, and emotional reactions we call mental illness are theresult of difficulties people have getting their needs met and thebehavior some people have learned during their lifetimes. Thesolutions are teaching people how to get their needs met, how tobehave, and using whatever powers of enforcement are needed to forcepeople to respect the rights of others. These are the tasks ofeducation and law enforcement, not medicine or therapy.THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has includedrepresenting psychiatric "patients". He has published a series ofpamphlets about various aspects of psychiatry, including psychiatricdrugs, electroshock, and psychotherapy. His pamphlets are notcopyrighted. You are invited to make copies for distribution to thoseyou think will benefit.1996 UPDATE:"... modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness." David Kaiser, M.D.,Commentary: Against Biologic Psychiatry, December 1996 PsychiatricTimes.1997 UPDATE:"We really do not know what causes any psychiatric illness." Jack M.Gorman, M.D., Professor of Psychiatry at Columbia University, in hisbook The Essential Guide to Psychiatric Drugs - Third Edition (St.Martin's Press, New York, 1997), p. 314. The same statement in the1990 edition was quoted above in Mr. Stevens' article, "Does MentalIllness Exist?"1998 UPDATES:"Contrary to what is often claimed, no biochemical, anatomical, orfunctional signs have been found that reliably distinguish the brainsof mental patients." Elliot S. Valenstien, Ph.D., Professor Emeritusof Psychology and Neuroscience at the University of Michigan, in hisbook Blaming the Brain: The Truth About Drugs and Mental Health (TheFree Press, New York, 1998), p. 125."...there are no external validating criteria for psychiatricdiagnoses. There is neither a blood test nor specific anatomiclesions for any major psychiatric disorder." From a letter datedDecember 4, 1998 by Loren R. Mosher, M.D., a psychiatrist, resigningfrom the American Psychiatric Association.1999 UPDATES:"... all 5 million to 6 million children on these drugs [forhyperactivity] are normal. The country's been led to believe that allpainful emotions are a mental illness and the leadership of the APA[American Psychiatric Association] knows very well that they arerepresenting it as a disease when there is no scientific data toconfirm any mental illness." Neurologist Fred Baughman, quoted inInsight magazine, June 28, 1999, p. 13 (underline added)."...there is no evidence that these mental illnesses, such as ADHD,exist." Psychiatrist Peter Breggin, quoted in Insight magazine, June28, 1999, p. 13. ADHD is attention deficit hyperactivity disorder.2000 UPDATES:"In medicine, strict criteria exist for calling a condition adisease. In addition to a predictable cluster of symptoms, the causeof the symptoms or some understanding of their physiology must beestablished. ... Psychiatry is unique among medical specialties inthat... We do not yet have proof either of the cause or the physiologyfor any psychiatric diagnosis. ... In recent decades, we have had noshortage of alleged biochemical imbalances for psychiatricconditions. Diligent though these attempts have been, not one hasbeen proven. Quite the contrary. In every instance where such animbalance was thought to have been found, it was later provenfalse. ... No claim of a gene for a psychiatric condition has stoodthe test of time, in spite of popular misinformation." JosephGlenmullen, M.D., clinical instructor in psychiatry at Harvard MedicalSchool, in his book Prozac Backlash (Simon & Schuster, New York,2000), pages 192-193, page 196, and page 198."A disease is a condition that has a known cause and can be identifiedby one or another set of laboratory tests." Miryam EhrlichWilliamson, Fibromyalgia: A Comprehensive Approach, 2000, Chapter 1."There is no evidence that any psychiatric or psychologial disorder iscaused by a biochemical imbalance." Peter R. Breggin, M.D., in hisbook Reclaiming Our Children (Persues Books, Cambridge, Mass., 2000),page 139."First, no biological etiology has been proven for any psychiatricdisorder (except Alzheimer's disease, which has a genetic component)in spite of decades of research. ... So don't accept the myth thatwe can make an 'accurate diagnosis.' ... Neither should you believethat your problems are due solely to a 'chemical imbalance.'" EdwardDrummond, M.D., Associate Medical Director at Seacoast Mental HealthCenter in Portsmouth, New Hampshire, in his book The Complete Guide toPsychiatric Drugs (John Wiley & Sons, Inc., New York, 2000), pages15-16. Dr. Drummond graduated from Tufts University School ofMedicine and was trained in psychiatry at Harvard University.2001 UPDATE:"Remember that no biochemical, neurological, or genetic markers havebeen found for attention deficit disorder, oppositional defiantdisorder, depression, schizophrenia, anxiety, compulsive alcohol anddrug abuse, overeating, gambling, or any other so-called mentalillness, disease, or disorder." Bruce Levine, Ph.D. (psychologist),Commonsense Rebellion: Debunking Psychiatry, Confronting Society(Continuum, New York 2001), p. 277.




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