Back in the mid-80’s, I was one of a few, fortunate psychiatrists in Massachusetts in charge of administering the just-released atypical antipsychotic medication clozapine. In our clinic, its use was still limited to a small number of carefully-selected patients with schizophrenia who had not responded to any of the conventional antipsychotic agents.
Harry was one of my first clozapine patients. He had been an inpatient for much of his adult life, and was widely thought to be a “lost cause.” For many years, Harry had been tormented by threatening “voices” urging him to harm either himself or others. He had become a shrunken wreck of a man, pacing the halls with a haunted look on his face, and confined to the inpatient unit with little hope of a normal life.
Clozapine changed all that for Harry. After a few months of treatment, the voices quieted down, and we were able to discharge Harry from the hospital and arrange for placement in a neighborhood residence. As I described in an earlier essay, Harry actually went on to earn his driver’s license.
But, in the world of mental illness deniers, I was the deluded one. There is no such thing as schizophrenia, these critics claim. Mental illness itself is a “myth”, as famously (or infamously) argued by the late psychiatrist, Thomas Szasz. (Disclosure: Dr. Szasz was one of my teachers during residency). At most, the deniers claim, what psychiatrists call “mental illness” is nothing more than a socially-constructed label, or a misguided metaphor. According to mental illness deniers, the term “schizophrenia” does not identify a “real disease”, like cancer or coronary artery disease; rather, it is a term grounded in a mistaken theory of disease, based on an agenda of social control and coercion. Szasz argued, to his dying day, that only bodily disease is “real”. For him, a “diseased mind” was a contradiction in terms. Szasz argued that classifying thoughts, feelings, and behaviors as diseases was a category mistake, like classifying the whale as a fish.
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I was unhappy to read that within living memory a psychiatrist was denying that mental illness was real.
I have got used to some people of my acquaintance telling me that “it’s all in your head” and not arguing because their view is so entrenched.
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