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The difficulty with Szasz's book is to know how to take it. If one regards it as an essay in provocation, the intention of which is to disturb the complacency of the medical and psycho-analytical establishments by adopting a satirical stance towards their most cherished convictions and most basic assumptions, one must account The Myth of Mental Illness a success. Szasz, whose references reveal him as an admirer of Samuel Butler, has himself a lively sense of paradox, a talent for drawing unexpected analogies (e.g. between the contributions to human culture made by Charcot and Guillotin), and a refreshing freedom from inhibitions about making sweeping and unprovable generalizations (e.g. Freud's 'work was well recognized and eagerly accepted by contemporary scientists interested in the problems with which he dealt').
However, the indications are that Szasz wishes his book to be taken seriously, and that he believes himself to be putting forward a thesis of revolutionary importance to psychiatry, psychodynamics, and ethics. The present reviewer must however confess to a feeling that the central unifying theme has eluded him; as a result he is forced to restrict his comments to a number of particular propositions put forward by the author.
First, there is the myth of mental illness itself. Szasz's idea is that it is an illusion to suppose that persons suffering from psychogenic disorders are ill, and that this myth is held by physicians and patients for complementary and collusive reasons. It enables physicians to believe that everyone who suffers comes within their area of professional competence, an idea which enhances their social prestige, increases their power, and gives them opportunities for being patronizingly benevolent, while it enables 'patients' to evade the fact that their troubles arise from problems in living and failure to learn the rules of the game of life. In order to maintain this myth, sufferers have to pretend to be ill by developing symptoms