The Myth of Mental Illness: Dr. T. Szasz. Secker and Warburg. 35s. 337 pp.

Towards the turn of the 19th century, Charcot and Freud instituted a major change in the classification of the sick and the well, when they assigned at least some of those previously described as “malingerers”—since no organic physiological cause for their behaviour could be found—to the ranks of the sick. This began a revolution in medical and lay thought, one which is still continuing today, a revolution in attitude towards people whose behaviour problems cannot be satisfactorily accounted for by organic conditions, and who are currently termed “the mentally ill”.

It is Szasz’s contention that this “reclassification” should never have occurred. Or, as he unfortunately prefers to say, that mental illness is a “scientifically useless and socially harmful myth” that should be abandoned immediately.

Szasz shows quite clearly that people do not “have” mental illnesses in the way that they have physical illnesses, and he analyses, in particular, hysterical behaviour at some length to show that such behaviour can be regarded as a type of communication, a move in a complicated interpersonal game, but not as the “product” or “symptom” of a disease. Hysterical action is action: it is not a series of happenings for which the hysteric is ultimately not responsible, and Szasz declares that to reward hysterical action with an allocation to the “sufferer” of the privileges and status of the “sick” is to encourage them to persist with this type of communication, to continue to play this type of interpersonal game. To exemplify his approach, he considers the “illness” of hysteria in detail:

“. . . Hysteria is a form of non-verbal communication, making use of a special set of signs. It is a system of rule-following action, making special use of the rules of helplessness, illness and coercion . . .”