Thomas Szasz - Criticism

Criticism

Szasz's critics maintain that, contrary to his views, such illnesses are now regularly "approached, measured, or tested in scientific fashion." The list of groups that reject his opinion that mental illness is a myth include the American Medical Association (AMA), American Psychiatric Association (APA) and the National Institute of Mental Health (NIMH).

According to American psychiatrist Allen Frances, Szasz “goes too far and draws bright lines where there are shades of gray”. In particular, Szasz was right that schizophrenia is no “disease”, but that doesn’t mean schizophrenia is a “myth.” Szasz was also right that psychiatric diagnosis can be misunderstood and misused, but that doesn’t mean it can be dispensed with. Frances adds that Szasz was correct in defining many problems related to psychiatric diagnosis, but he doesn’t offer alternative solutions.

The effectiveness of medication has been used as an argument against Szasz’s idea that depression is a myth. In a debate with Szasz, Donald F. Klein, M.D explained:

It is that elementary fact, that the antidepressants do little to normals, and are tremendously effective in the clinically depressed person, that shows us that this is an illness.

But as the New England Journal of Medicine reported on January 17, 2008, in published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but perhaps only by a modest margin and for a brief period.

In the same debate Frederick K. Goodwin, M.D, asserts:

The concept of disease in medicine really means a cluster of symptoms that people can agree about, and in the case of depression we agree 80% of the time. It is a cluster of symptoms that predicts something.

Szasz argued that only mental illnesses are defined based on consensus and symptom clusters. It has been argued this is not the case. Critics claim physical illnesses such as Kawasaki syndrome (a disorder of the heart and blood vessels) and Ménière's disease (a disorder of the inner ear) are similarly defined.

There is also the criticism that many physical diseases were identified and even treated with at least some success decades, centuries, or millennia before their etiology was accurately identified. Diabetes is one notable example. In the eyes of Szasz's critics, such historical facts tend to undermine his contention that mental illnesses must be "fake diseases" because their etiology in the brain is not well understood.