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The Myth of Psychotherapy
s/t: Mental Healing as Religion, Rhetoric & Repression
258 pages, Paperback
First published January 1, 1978
About the author
Thomas Szasz
99 books329 followersThomas Stephen Szasz (pronounced /sas/; born April 15, 1920 in Budapest, Hungary) was a psychiatrist and academic. He was Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He was a prominent figure in the antipsychiatry movement, a well-known social critic of the moral and scientific foundations of psychiatry, and of the social control aims of medicine in modern society, as well as of scientism. He is well known for his books, The Myth of Mental Illness (1960) and The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement which set out some of the arguments with which he is most associated.
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Displaying 1 - 27 of 27 reviews
June 18, 2017
"More specifically, I shall try to show how, with decline of religion and the growth of science in the 18th century, the cure of sinful souls--which had been an integral part of Christian religions--was recast as the cure of sick minds, and became an integral part of medical science. My aim in this enterprise has been to unmask the medical and therapeutic pretentious of psychiatry and psychotherapy. I have done so, not because I think that medicine and treatment are bad things, but rather because in the so-called mental health field, I know that the psychiatric and psychotherapeutic mythology is now used to disguise deception and conceal coercion by psychiatric, patients, politicians, jurists, journalists, and people in general. Since people need myths to sustain their existence however, there must be restraints on the pursuit of demythologizing. Accordingly I have, in my life and in my writings, tried to distinguish between the use of myth to sustain a person's own existence and its use to deceive and coerce others. Objecting to the personal use of mythology in private or between consenting adults, is objecting to religious freedom. Objecting to the legal and political use of force and fraud--concealed and justified by a mythology--is objecting to religious persecution. One can, of course, believe in and defend freedom of religion without believing in the truth of any particular religion--theological, medical, or psychiatrical. And one can object to religious coercion even though one might believe that some or all of the goals of that particular religion (theological, medical, or psychiatric) are desirable. In either case, one would be for freedom and against coercion, not for or against religion or medicine or psychiatry."
"Instead of conquering what had been presented to him as mental diseases by curing these diseases, he conquered what is, in fact, the human condition by annexing it, in its entirety, to the medical profession." [On Freud)
"Psychotherapy is the name we give to a particular kind of personal influence. By means of communication one person identified as the psychotherapist exerts an ostensibly therapeutic influence on another person identified as the patient.... In countless other situations people influence one another but who is to say whether or when such interactions are helpful or harmful and to whom. The concept of psychotherapy betrays us by prejudging the interaction as therapeutic for the patient.... People try to influence one another constantly, the question that concerns those interested in psychotherapy is: what kind of influence do psychotherapists exert on their clients? People influence one another to support some values and oppose others. In the past they promoted such overt values as chastity, obedience, and thrift. Today they advocate such covert values as "the common good," "mental health," "welfare," Blanks that may be filled in with any meaning the speaker or listener desires. Herein lies the great value of these vague terms for the demagogue, whether political or professional. Just as a presidential candidate may talk about "restoring the nation's economy to a healthy condition" without specifying whether he is promoting a balanced budget or deficit financing, so a psychiatrist may talk about mental health without revealing whether he is promoting individualism or collectivism, autonomy or heteronomy... Often, however, attempts to treat a patient are really efforts to alter his conduct from one mode to another."
"It is impossible to compel a person to confront himself as a moral agent.... Although a particular moral practice may be beneficial when undertaken voluntarily, it is worthless or harmful when it is imposed on a person against his will."
"If he is to eschew coercion, then he must exclude from his practice those patients who, because of their own coercive tactics, render peaceful conduct toward them impossible." [On Luther]
"What all these methods had in common, and what is most important about them, is that each was at bottom a conversation between patient and doctor, and that this simple fact was disguised by a scientific-sounding Greek term that legitimized them as therapeutic interventions."
"Because that proposition of Freud's is epistemological nonsense, and because Freud must have gradually realized that it was, he had only two choices: he could abandon it and admit that human affairs belonged in the realm of morals rather than medicine; or he could redouble his efforts and insist ever more stubbornly that in psychoanalysis he had created a science of "mental life," a science that is "like any other" in its power to offer causal explanations for what it observes and influences. Freud chose the latter path."
"In Freud's view, persons do not act; they are moved by impulses that are largely unconscious. They are moved, moreover, in directions that are generally venal and vile. Freud's contention that man has no free will is pivotal to the rest of his theory. ... Freud then cites Martin Luther's immortal exclamation: "Here I stand, I can do no other!" to prove his point. Freud here argues either from bat thinking or bad faith or both. For it is clear that Luther's statement was a figure of speech: It was precisely because he could have acted otherwise but did not that his decision had the irresistible moral force it had. Freud either misunderstands this or denies it; it is difficult to know which would put him in worse light."
"He reinterpreted the fact that Oedipus did not want to kill his father and marry his mother. Actually, Oedipus did all he could to avoid doing so. That circumstance Freud transformed into his famous formula that denial is a type of affirmation. In other words, had Oedipus deliberately set out to do what he did, this would have proved that he wanted to kill his father and marry his mother; and had he set out to avoid doing so, that also would have proved that he wanted to do so.
According to the "manifest content" of the legend, Oedipus did not know that the man he killed was his father or that the woman he married was his mother. Freud accounted for that too, by postulating that "unconsciously" Oedipus did know who they were. If he had not, of course, his act would have been a tragic mistake rather than true patricide and incest.
The most damaging evidence against Freud's case, however, is the fact that he never considered Laius's role in the Oedipus legend. if it is psychologically legitimate to interpret all of Oedipus' actions as intention, it is not just as legitimate to interpret Laius' actions in the same way? If so, we should have to conclude that the original motive in this legend is Laius' desire to kill his son--that is, filicide. But Freud never suggested that fathers had a "Laius complex," consisting of a desire to kill their sons and keep their wives solely to themselves, and that such a "complex" is a universal trait of the human psyche."
"The mind, for example, becomes the "psychic apparatus," the passions the "id," the self the "ego," and the conscience the "superego." One could easily construct an entire glossary of the equivalents in ordinary language of the Freudian semantic masquerading as science."
"People have no conflicts and conflicting desires: instead, they have "complexes" and "ambivalences."
"His [Freud's] life work, he says, has been devoted to lowering religion from the "upper floor" into the "basement"--that is, from inspiration to insanity. If he had only more time left in his life--says the base rhetorician posing as a scientific revolutionary--he would similarly degrade art and the other lofty accomplishments of the human spirit."
"The inconsistency between Freud's passionate anti-religious tirades and his profound commitment to Jewishness significantly highlights an important aspect of Freud's personality and productions, namely his anti-Gentilism.... Freud was, throughout his life, a [self-described] proud, chauvinistic, even vengeful Jew... Freud's son was a member of the Kadimah, a Zionist organization, and Freud himself was an honorary member of it.... One of Freud's most powerful motives in life was the desire to inflict vengeance on Christianity for its traditional anti-Semitism."
"Clearly, the idea that disagreement is a disease, and that he who defies authority is deranged and should be disposed of by the methods of social repression then in vogue, is very old indeed."
"Religion can be replaced only be religion." [Jung]
"Here, then, was the issue that lay at the bottom of the inevitable break and subsequent bad feelings between Freud and Jung: Was psychotherapy ... to be defined, practiced, and merchandised as a medical, scientific enterprise, or as a religious, spiritual one? Freud, as we know, opted for the former answer--preferring a Platonic lie to a plain truth--and is considered a great scientist. Jung, predictably, opted for the latter--preferring a simple truth to a convenient obfuscation--and is considered a great mystic."
Jung: "I still stand up for the inalienable rights of the individual since he alone is the carrier of life and is gravely threatened by the social leveling process today."
"Jung regarded both respectfully--religion as collective mythologies and neuroses as individual ones."
"In Jung's view religions are indispensable spiritual supports, whereas in Freud's they are illusory crutches."
Jung: "Analytical psychology... only helps us to find the way to the religious experience that makes us whole."
"All this betokens still another aspect of the implacable resolve of psychotherapy to rob religion of as much as it can, and to destroy what it cannot: contrition, confession, prayer, faith, inner resolution, and countless other elements are expropriated and renamed as psychotherapy; whereas certain observances, rituals, taboos, and other elements of religion are demeaned and destroyed as the symptoms of neurotic psychotic illnesses."
"The result of psychotherapy can thus only be that the subject is, or is not, converted or persuaded to feel, think, or act differently than has been his habit."
"Religion (morals and ritual), rhetoric (speech and gestures), and repression (constraint and punishment) are all matters of the utmost concern to every legal and political system."
"Insofar as the role of the state in relation to health is examined and articulated, it is usually in the spirit of naive medicalism, reflecting the false premise that in the area of treatment, unlike that of salvation, there are no fundamental conflicts between the individual and the state. As a result, the most varied interests have sought, in the name of health, to enlist the support of the modern state, They have all succeeded. ... The idea that the preservation and promotion of health are obligations the government owes its citizens has become, the whole world over, an article of faith compared to which the Medieval belief in Christianity is veritable skepticism."
"As a result, most people now believe it is a good thing that the state defines what is sickness and what is treatment and that the state pays for whatever treatment people need. What most people do not understand, indeed seem disinclined to understand, is that the state may, and therefore will, define as sickness whatever the people might want to do for themselves; that it may, and therefore will, define as treatment whatever the government might want to do to the people; and that it may, and therefore will, tax the people fir "medical" services that range from denying Laetrile to those persons who want it to imposing psychiatric imprisonment on those who do not want it. Clearly, the future scope of such "services" promises to include an array of therapeutic prohibitions and prescriptions of truly Orwellian proportions."
"Instead of conquering what had been presented to him as mental diseases by curing these diseases, he conquered what is, in fact, the human condition by annexing it, in its entirety, to the medical profession." [On Freud)
"Psychotherapy is the name we give to a particular kind of personal influence. By means of communication one person identified as the psychotherapist exerts an ostensibly therapeutic influence on another person identified as the patient.... In countless other situations people influence one another but who is to say whether or when such interactions are helpful or harmful and to whom. The concept of psychotherapy betrays us by prejudging the interaction as therapeutic for the patient.... People try to influence one another constantly, the question that concerns those interested in psychotherapy is: what kind of influence do psychotherapists exert on their clients? People influence one another to support some values and oppose others. In the past they promoted such overt values as chastity, obedience, and thrift. Today they advocate such covert values as "the common good," "mental health," "welfare," Blanks that may be filled in with any meaning the speaker or listener desires. Herein lies the great value of these vague terms for the demagogue, whether political or professional. Just as a presidential candidate may talk about "restoring the nation's economy to a healthy condition" without specifying whether he is promoting a balanced budget or deficit financing, so a psychiatrist may talk about mental health without revealing whether he is promoting individualism or collectivism, autonomy or heteronomy... Often, however, attempts to treat a patient are really efforts to alter his conduct from one mode to another."
"It is impossible to compel a person to confront himself as a moral agent.... Although a particular moral practice may be beneficial when undertaken voluntarily, it is worthless or harmful when it is imposed on a person against his will."
"If he is to eschew coercion, then he must exclude from his practice those patients who, because of their own coercive tactics, render peaceful conduct toward them impossible." [On Luther]
"What all these methods had in common, and what is most important about them, is that each was at bottom a conversation between patient and doctor, and that this simple fact was disguised by a scientific-sounding Greek term that legitimized them as therapeutic interventions."
"Because that proposition of Freud's is epistemological nonsense, and because Freud must have gradually realized that it was, he had only two choices: he could abandon it and admit that human affairs belonged in the realm of morals rather than medicine; or he could redouble his efforts and insist ever more stubbornly that in psychoanalysis he had created a science of "mental life," a science that is "like any other" in its power to offer causal explanations for what it observes and influences. Freud chose the latter path."
"In Freud's view, persons do not act; they are moved by impulses that are largely unconscious. They are moved, moreover, in directions that are generally venal and vile. Freud's contention that man has no free will is pivotal to the rest of his theory. ... Freud then cites Martin Luther's immortal exclamation: "Here I stand, I can do no other!" to prove his point. Freud here argues either from bat thinking or bad faith or both. For it is clear that Luther's statement was a figure of speech: It was precisely because he could have acted otherwise but did not that his decision had the irresistible moral force it had. Freud either misunderstands this or denies it; it is difficult to know which would put him in worse light."
"He reinterpreted the fact that Oedipus did not want to kill his father and marry his mother. Actually, Oedipus did all he could to avoid doing so. That circumstance Freud transformed into his famous formula that denial is a type of affirmation. In other words, had Oedipus deliberately set out to do what he did, this would have proved that he wanted to kill his father and marry his mother; and had he set out to avoid doing so, that also would have proved that he wanted to do so.
According to the "manifest content" of the legend, Oedipus did not know that the man he killed was his father or that the woman he married was his mother. Freud accounted for that too, by postulating that "unconsciously" Oedipus did know who they were. If he had not, of course, his act would have been a tragic mistake rather than true patricide and incest.
The most damaging evidence against Freud's case, however, is the fact that he never considered Laius's role in the Oedipus legend. if it is psychologically legitimate to interpret all of Oedipus' actions as intention, it is not just as legitimate to interpret Laius' actions in the same way? If so, we should have to conclude that the original motive in this legend is Laius' desire to kill his son--that is, filicide. But Freud never suggested that fathers had a "Laius complex," consisting of a desire to kill their sons and keep their wives solely to themselves, and that such a "complex" is a universal trait of the human psyche."
"The mind, for example, becomes the "psychic apparatus," the passions the "id," the self the "ego," and the conscience the "superego." One could easily construct an entire glossary of the equivalents in ordinary language of the Freudian semantic masquerading as science."
"People have no conflicts and conflicting desires: instead, they have "complexes" and "ambivalences."
"His [Freud's] life work, he says, has been devoted to lowering religion from the "upper floor" into the "basement"--that is, from inspiration to insanity. If he had only more time left in his life--says the base rhetorician posing as a scientific revolutionary--he would similarly degrade art and the other lofty accomplishments of the human spirit."
"The inconsistency between Freud's passionate anti-religious tirades and his profound commitment to Jewishness significantly highlights an important aspect of Freud's personality and productions, namely his anti-Gentilism.... Freud was, throughout his life, a [self-described] proud, chauvinistic, even vengeful Jew... Freud's son was a member of the Kadimah, a Zionist organization, and Freud himself was an honorary member of it.... One of Freud's most powerful motives in life was the desire to inflict vengeance on Christianity for its traditional anti-Semitism."
"Clearly, the idea that disagreement is a disease, and that he who defies authority is deranged and should be disposed of by the methods of social repression then in vogue, is very old indeed."
"Religion can be replaced only be religion." [Jung]
"Here, then, was the issue that lay at the bottom of the inevitable break and subsequent bad feelings between Freud and Jung: Was psychotherapy ... to be defined, practiced, and merchandised as a medical, scientific enterprise, or as a religious, spiritual one? Freud, as we know, opted for the former answer--preferring a Platonic lie to a plain truth--and is considered a great scientist. Jung, predictably, opted for the latter--preferring a simple truth to a convenient obfuscation--and is considered a great mystic."
Jung: "I still stand up for the inalienable rights of the individual since he alone is the carrier of life and is gravely threatened by the social leveling process today."
"Jung regarded both respectfully--religion as collective mythologies and neuroses as individual ones."
"In Jung's view religions are indispensable spiritual supports, whereas in Freud's they are illusory crutches."
Jung: "Analytical psychology... only helps us to find the way to the religious experience that makes us whole."
"All this betokens still another aspect of the implacable resolve of psychotherapy to rob religion of as much as it can, and to destroy what it cannot: contrition, confession, prayer, faith, inner resolution, and countless other elements are expropriated and renamed as psychotherapy; whereas certain observances, rituals, taboos, and other elements of religion are demeaned and destroyed as the symptoms of neurotic psychotic illnesses."
"The result of psychotherapy can thus only be that the subject is, or is not, converted or persuaded to feel, think, or act differently than has been his habit."
"Religion (morals and ritual), rhetoric (speech and gestures), and repression (constraint and punishment) are all matters of the utmost concern to every legal and political system."
"Insofar as the role of the state in relation to health is examined and articulated, it is usually in the spirit of naive medicalism, reflecting the false premise that in the area of treatment, unlike that of salvation, there are no fundamental conflicts between the individual and the state. As a result, the most varied interests have sought, in the name of health, to enlist the support of the modern state, They have all succeeded. ... The idea that the preservation and promotion of health are obligations the government owes its citizens has become, the whole world over, an article of faith compared to which the Medieval belief in Christianity is veritable skepticism."
"As a result, most people now believe it is a good thing that the state defines what is sickness and what is treatment and that the state pays for whatever treatment people need. What most people do not understand, indeed seem disinclined to understand, is that the state may, and therefore will, define as sickness whatever the people might want to do for themselves; that it may, and therefore will, define as treatment whatever the government might want to do to the people; and that it may, and therefore will, tax the people fir "medical" services that range from denying Laetrile to those persons who want it to imposing psychiatric imprisonment on those who do not want it. Clearly, the future scope of such "services" promises to include an array of therapeutic prohibitions and prescriptions of truly Orwellian proportions."
August 7, 2015
I have become increasingly disillusioned with traditional "talk therapy". A colleague gave me this book 20 years ago and this week, on vacation, decided to read it. I dismissed the book as nonsense then, without reading it and now regret not having done so.
It seems to me that the stories we tell ourselves as to the reasons we got here may be initially satisfying, but the magic comes in how, given our journey to the present moment, we do things differently.
Simply telling the story over and over to a therapist can't be the answer. Szasz was ahead of his time in recognizing this simple truth.
It seems to me that the stories we tell ourselves as to the reasons we got here may be initially satisfying, but the magic comes in how, given our journey to the present moment, we do things differently.
Simply telling the story over and over to a therapist can't be the answer. Szasz was ahead of his time in recognizing this simple truth.
August 6, 2017
Great book, heavy material on psychology and psychotherapy. It was interesting to hear of research done and truths behind mentally problems and how people think. I highly recommend this book if you can handle it.
September 4, 2014
Some interesting historical background to the advent of psychotherapy.
Flawed thinking when it comes to contemplating the nature of mental illness. Szasz assumes that patients are "fakers" and that they're deliberately "acting sick". It makes me wonder if he ever bothered to listen to people's experience of mental illness to test this assumption.
Even if mental illness is primarily a spiritual complaint as he asserts, surely it can still have an organic component? Where apart from our bodies would we be experiencing the symptoms of mental illness? In the air?
Flawed thinking when it comes to contemplating the nature of mental illness. Szasz assumes that patients are "fakers" and that they're deliberately "acting sick". It makes me wonder if he ever bothered to listen to people's experience of mental illness to test this assumption.
Even if mental illness is primarily a spiritual complaint as he asserts, surely it can still have an organic component? Where apart from our bodies would we be experiencing the symptoms of mental illness? In the air?
November 26, 2023
Years ago, my therapist recommended this book to me. At first blush, that might seem ironic: why would a therapist recommend a denunciation of her profession? But this is where I think Szasz is most misunderstood: he is not against talk therapy, he is against its framing as a medical treatment, as a science rather than an art. When he says that all psychiatry is religion, rhetoric, or repression, it sounds a bit like slander. But it's clear if you read the book that he is not against any of these: even repression has its place. What is society itself but collective repression put to good use? He just wants us to call a spade a spade.
I don't know how convincing Szasz would be to someone not already convinced of his argument. I was already in his choir before I read the book. I'm troubled by how our cultural pendulum has swung from therapy-as-stigma to therapy-as-panacea and therapy-as-requirement-of-"healthy"-adulthood. I believe therapy can be useful. I was *in* therapy for a few years, and I found it to be worth the time and money. But I also see the way that, as he predicted, it has increasingly become a kind of religion for the non-religious.
I love religion as an expression of boundless curiosity towards life's biggest questions, as a form of deep gratitude, and an open-ended creative endeavor. I am troubled by religion as dogma, as certainty, and as the one and only path. This too is how I feel about therapy. And let's face it: at least a pastor's "care for the soul" is accessible to the destitute. Not so the therapist's.
Szasz's strongest critique of psychotherapy is when it is used as a justification for nonconsensual "treatment" that in any other context would be deemed torture: electroshock, lobotomy, isolation and imprisonment, and so forth. Most of these treatments are no longer used, or at least much more rarely used, but his main argument applies to any nonconsensual treatment, including compulsory medication, which is every bit—if not more—common than it was when he was writing the book. He points out that we are likely only comfortable with this because of the presumption that the "treatment" is medical in nature, which he disputes.
His argument that psychiatry is not medical, but purely rhetorical and religious, breaks down in several ways. First, it's a bit out of date. Today, we have far more science to back up the medications and treatments that psychiatrists prescribe.
Second, he seems to misunderstand the way that much of modern medicine works. Szasz points out that, unlike with physical illness, mental illness is not connected to a specific pathogen or injury, and we have no idea if mental illnesses have physiological origins. Yes, there are cases where we have a clear pathogen that attacks or an injury that damages our body in some obvious and manifest way, and a doctor applies a specific treatment that addresses the specific issue to return the body to roughly where it was before.
But we also have plenty of cases where people indicate a set of invisible symptoms (pain, fogginess, a ringing in their ears), which the doctor is able to resolve through a course of treatment that works without anyone yet understanding the mechanism let alone the root cause of the symptoms. It's still science when you can consistently replicate the result... even if you don't know how any of it works. And psychiatry is still young. We are beginning to see more physiological analogs to psychiatric conditions.
So, even if I'm 100% on board for the argument that psychiatry is rhetoric, religion, and repression, I'm not sure I buy that psychiatry is *not* also medicine. ¿Por qué no los dos? Or los cuatro, I suppose.
Szasz spends most of the book lambasting psychoanalysts to make his case that psychiatry is not religion. This bit of history is as fun as any celebrity roast, but I'm not sure it's more than an extended ad hominem.
I don't know how convincing Szasz would be to someone not already convinced of his argument. I was already in his choir before I read the book. I'm troubled by how our cultural pendulum has swung from therapy-as-stigma to therapy-as-panacea and therapy-as-requirement-of-"healthy"-adulthood. I believe therapy can be useful. I was *in* therapy for a few years, and I found it to be worth the time and money. But I also see the way that, as he predicted, it has increasingly become a kind of religion for the non-religious.
I love religion as an expression of boundless curiosity towards life's biggest questions, as a form of deep gratitude, and an open-ended creative endeavor. I am troubled by religion as dogma, as certainty, and as the one and only path. This too is how I feel about therapy. And let's face it: at least a pastor's "care for the soul" is accessible to the destitute. Not so the therapist's.
Szasz's strongest critique of psychotherapy is when it is used as a justification for nonconsensual "treatment" that in any other context would be deemed torture: electroshock, lobotomy, isolation and imprisonment, and so forth. Most of these treatments are no longer used, or at least much more rarely used, but his main argument applies to any nonconsensual treatment, including compulsory medication, which is every bit—if not more—common than it was when he was writing the book. He points out that we are likely only comfortable with this because of the presumption that the "treatment" is medical in nature, which he disputes.
His argument that psychiatry is not medical, but purely rhetorical and religious, breaks down in several ways. First, it's a bit out of date. Today, we have far more science to back up the medications and treatments that psychiatrists prescribe.
Second, he seems to misunderstand the way that much of modern medicine works. Szasz points out that, unlike with physical illness, mental illness is not connected to a specific pathogen or injury, and we have no idea if mental illnesses have physiological origins. Yes, there are cases where we have a clear pathogen that attacks or an injury that damages our body in some obvious and manifest way, and a doctor applies a specific treatment that addresses the specific issue to return the body to roughly where it was before.
But we also have plenty of cases where people indicate a set of invisible symptoms (pain, fogginess, a ringing in their ears), which the doctor is able to resolve through a course of treatment that works without anyone yet understanding the mechanism let alone the root cause of the symptoms. It's still science when you can consistently replicate the result... even if you don't know how any of it works. And psychiatry is still young. We are beginning to see more physiological analogs to psychiatric conditions.
So, even if I'm 100% on board for the argument that psychiatry is rhetoric, religion, and repression, I'm not sure I buy that psychiatry is *not* also medicine. ¿Por qué no los dos? Or los cuatro, I suppose.
Szasz spends most of the book lambasting psychoanalysts to make his case that psychiatry is not religion. This bit of history is as fun as any celebrity roast, but I'm not sure it's more than an extended ad hominem.
July 19, 2016
Partly illuminating, partly not very interesting, mostly because after agreeing with the central premise I was not that interested in the particular history and career of psychoanalytic leading figures.
May 27, 2023
This is a good confirmation of what I had suspected and had some idea of.
I was surprised to see the angles that he took on psychoanalysis, and I'm glad that he did because referencing him looks better than referencing others who've made similar points. He doesn't write as an openly hateful person, and that's a great asset since writing as others have is incredibly unproductive.
Ultimately, however, Szasz makes a much weaker case than could otherwise be made if he had actually believed in a system that provided a basis to objectively condemn these ersatz ethical systems. This is easily fixable, so readers who believe in such things can just doctor his thinking as they read.
I was surprised to see the angles that he took on psychoanalysis, and I'm glad that he did because referencing him looks better than referencing others who've made similar points. He doesn't write as an openly hateful person, and that's a great asset since writing as others have is incredibly unproductive.
Ultimately, however, Szasz makes a much weaker case than could otherwise be made if he had actually believed in a system that provided a basis to objectively condemn these ersatz ethical systems. This is easily fixable, so readers who believe in such things can just doctor his thinking as they read.
Read
February 3, 2022I find it impossible to rate this one especially since I disagree with Dr. Szasz for the most part so I will just share my thoughts on it.
It's worth the read if you're really interested in mental health.
Dr. Szasz was very passionate, seems to have been well intentioned and was both right(on few matters) and terribly wrong and offensive(on many others). He makes some good points if one considers the state of psychiatry, psychology, psychotherapy, government and society at that time. On the other hand, he makes numerous interpretations and predictions that are at their best questionable and malicious and purposely shallow at their worst. To that add anecdotal evidence, unfounded accusations, cherry picking and a large number of conclusions that lack falsifiability and it can become easy to dismiss him.
It's a good exercise in challenging beliefs, good reminder of how much the fields have evolved and last but not least, a reminder of the mistakes that were made along the way, some beyond terrible and abusive.
All in all, the book is a weird mix of rants, accusations, conspiracy theories and wild exaggerations and brief accounts of the true horrors committed and scams employed in the early ages of psychiatry and psychology as well as the flaws of Freud's work. Dr. Szasz's was an extreme, but arguably necessary voice in his time.
All this left me a bit resentful and annoyed, but I'm still looking forward to tackling his Myth of Mental Illness.
It's worth the read if you're really interested in mental health.
Dr. Szasz was very passionate, seems to have been well intentioned and was both right(on few matters) and terribly wrong and offensive(on many others). He makes some good points if one considers the state of psychiatry, psychology, psychotherapy, government and society at that time. On the other hand, he makes numerous interpretations and predictions that are at their best questionable and malicious and purposely shallow at their worst. To that add anecdotal evidence, unfounded accusations, cherry picking and a large number of conclusions that lack falsifiability and it can become easy to dismiss him.
It's a good exercise in challenging beliefs, good reminder of how much the fields have evolved and last but not least, a reminder of the mistakes that were made along the way, some beyond terrible and abusive.
All in all, the book is a weird mix of rants, accusations, conspiracy theories and wild exaggerations and brief accounts of the true horrors committed and scams employed in the early ages of psychiatry and psychology as well as the flaws of Freud's work. Dr. Szasz's was an extreme, but arguably necessary voice in his time.
All this left me a bit resentful and annoyed, but I'm still looking forward to tackling his Myth of Mental Illness.
April 13, 2018
Interesting thesis if somewhat repetitive and somewhat all-inclusive. Also, there are times the author for instance go against theories by saying they do not provide corroborating scientific evidence, while doing exactly the same in respect to some of his own views.
The history of Mesmer, Freud and Jung as connected with the main thesis is rather interesting (though it would be better to read I believe separate books about them instead - Jung's autobiography as an example is an excellent book). It is a shame though that Szasz can mention so many times, contrastingly, "Religion" and "Science" without giving philosophic theories/definitions of the two, appealing rather to some commonsensical understanding of each and every reader.
Instead he is much more interested in reiterating exactly the same thing in gazillion different ways.
Looking at my own comments above, I should really have given this book only 2 stars, but since I appreciate the author's "guts" and some of his original ideas, I decided it merits a third one.
The history of Mesmer, Freud and Jung as connected with the main thesis is rather interesting (though it would be better to read I believe separate books about them instead - Jung's autobiography as an example is an excellent book). It is a shame though that Szasz can mention so many times, contrastingly, "Religion" and "Science" without giving philosophic theories/definitions of the two, appealing rather to some commonsensical understanding of each and every reader.
Instead he is much more interested in reiterating exactly the same thing in gazillion different ways.
Looking at my own comments above, I should really have given this book only 2 stars, but since I appreciate the author's "guts" and some of his original ideas, I decided it merits a third one.
May 31, 2020
I absolutely hate this book. It might be the worse one I’ve read in college. Szasz does nothing but insult psychotherapy ways that have been shown to work- even if the treatments use the placebo effect. He claims many “mentally ill” patients are claiming to have something wrong with them, when in fact, they are just fakers and liars. It frustrates me to read this book.
March 23, 2021
I can’t think of another book I finished and then wanted to immediately reread. This should have been required reading before grad school and should be a prereq for anyone entering mental health, behavioral health, medicine, psychiatry, and law. I listened to it so will reread in print and add notes. I was hooked from the very beginning until the last line.
July 7, 2024
The author of over four hundred articles and nineteen books (including The Myth of Mental Illness), Szasz challenges the medical model that has been superimposed on what he describes as “talk therapy,” most represented by psychoanalysis. Taking the time to step through the earlier approaches to dealing with individual afflicted by “mental illness,” he suggests that psychotherapy has metamorphized into medical treatments. The author invests significant time in recounting the historical events and individuals that have brought us to this point. Rhetoric has been presented as remedy to mental issues, and the focus of “curing souls” has resulted in an ersatz religious approach to addressing such problems. In reviewing the precursors to psychotherapy, Szasz reviewed mesmerism (suggesting the curative power of magnets, which was debunked but remained popular), Heinroth’s approach to seeking results through repression, and early electrical treatments as proposed by Wilhelm Erb, Julius Wagner-Jauregg, and even Sigmund Freud as an early proponent of such practices.
Moving historically into the topic of psychotherapy proper, the author sees the psychoanalytic method as franchising the “Freudian myth,” selectively engaging in the story of Oedipus Rex, employing the parts of the story that suited his theory while ignoring the rest. The Oedipus complex, as proposed by Freud, became the core of his “therapeutic” approach. Szasz suggests that Freud’s primary accomplishment was in his ability to sell his theories, his gift as a rhetorician. The author even spends some time chronicling Freud’s actions as “the Jewish Avenger,” proud of his Jewish heritage (even to the point of joining a Zionist organization) yet totally abandoning it as a religion. Carl Gustav Jung started out in much agreement with Freud yet moved away from Freud’s intensely secular (even anti-religious) view to become, as the author suggests, a “pastor without a pulpit.” Jung moved away from classical Christianity as he could not accept the Trinity nor the traditional Catholic explanation of the Eucharist. Even so, Jung saw religions as indispensable spiritual supports, while Freud described them as illusory crutches.
Szasz closes this fascinating book by addressing the influences of medicine, religion, and power as integral resources for psychotherapy. Suggesting that the psychotherapist does little more than talk, he challenges the thought that the psychotherapist is even treating the patient at all. He states, “It would be more accurate to say that the ‘patient’ in psychotherapy treats or is a therapist, because he treats himself” (p. 190). A chapter is included with a diverse collection of so-called “treatments” that are subsumed under the term psychotherapy, including sex therapy (as with Masters and Johnson), nude group work (touted by Abraham Maslow), and scream therapy, among many other questionable practices.
The author finally makes the case that psychotherapy cannot be termed therapy, since nothing takes place beyond talking. He makes the following powerful statement: “The promiscuous use of the term psychotherapy is an important sign of the debauchment of the language of healing in the service of dehumanizing and controlling persons by technicizing and therapeutizing personal relations” (p. 208). Szasz offers a new term that he feels more accurately describes the interaction between individuals in the healing process – iatrologic (coined by Aeschylus, which means “healing wsords”). Existing under the mantle of rhetoric and logic, it would represent an art, not a science. The author ends in stating that the focus of this change could result in “resurrecting the human soul from the therapeutic grave in which our technological age has buried it, and preserving the dignity and discipline of art from modern man’s insatiable passion for professionalism” (p. 208).
Moving historically into the topic of psychotherapy proper, the author sees the psychoanalytic method as franchising the “Freudian myth,” selectively engaging in the story of Oedipus Rex, employing the parts of the story that suited his theory while ignoring the rest. The Oedipus complex, as proposed by Freud, became the core of his “therapeutic” approach. Szasz suggests that Freud’s primary accomplishment was in his ability to sell his theories, his gift as a rhetorician. The author even spends some time chronicling Freud’s actions as “the Jewish Avenger,” proud of his Jewish heritage (even to the point of joining a Zionist organization) yet totally abandoning it as a religion. Carl Gustav Jung started out in much agreement with Freud yet moved away from Freud’s intensely secular (even anti-religious) view to become, as the author suggests, a “pastor without a pulpit.” Jung moved away from classical Christianity as he could not accept the Trinity nor the traditional Catholic explanation of the Eucharist. Even so, Jung saw religions as indispensable spiritual supports, while Freud described them as illusory crutches.
Szasz closes this fascinating book by addressing the influences of medicine, religion, and power as integral resources for psychotherapy. Suggesting that the psychotherapist does little more than talk, he challenges the thought that the psychotherapist is even treating the patient at all. He states, “It would be more accurate to say that the ‘patient’ in psychotherapy treats or is a therapist, because he treats himself” (p. 190). A chapter is included with a diverse collection of so-called “treatments” that are subsumed under the term psychotherapy, including sex therapy (as with Masters and Johnson), nude group work (touted by Abraham Maslow), and scream therapy, among many other questionable practices.
The author finally makes the case that psychotherapy cannot be termed therapy, since nothing takes place beyond talking. He makes the following powerful statement: “The promiscuous use of the term psychotherapy is an important sign of the debauchment of the language of healing in the service of dehumanizing and controlling persons by technicizing and therapeutizing personal relations” (p. 208). Szasz offers a new term that he feels more accurately describes the interaction between individuals in the healing process – iatrologic (coined by Aeschylus, which means “healing wsords”). Existing under the mantle of rhetoric and logic, it would represent an art, not a science. The author ends in stating that the focus of this change could result in “resurrecting the human soul from the therapeutic grave in which our technological age has buried it, and preserving the dignity and discipline of art from modern man’s insatiable passion for professionalism” (p. 208).
April 13, 2021
Thomas Szasz's book, The Myth of Psychotherapy is a wonderful book about the sociology and history of psychiatry. In this book, he attacks the idea of mental illness, and then goes on to talk about psychiatry and psychoanalysis in the general. I am not a psychiatrist nor am I a psychologist, but I am deeply interested in psychology, and therefore I found immense utility from reading the explanation of his ideas, and subsequently his attack on mental illness, and more fundamentally in this book, the psychotherapeutic industry.
He lays many argument, but this is his fundamental thesis: The term 'illness' is only applicable to corporeal ailments, and therefore there is no such thing as mental illness; and the term 'therapy' is only applicable to physico-chemical interventions, and therefore no amount of talking should be said to be therapeutic; and finally, most of the body of knowledge we have come to call 'psychotherapy' is not really therapy, and it's an abuse of the medical profession and an encroachment on the rights of persons.
Dr. Szasz anticipates that there will be much reservations on our sides, especially in the times of writing onwards: This is because we have come to accept psychotherapy as a solution to many of the 'ailments,' especially those we deem to be 'mental' or spiritual. And so, he adopts the excellent strategy of going over the history of therapy of the human psyche. Starting from the mystiques of old, to Socrates, to Aristotle, to the Catholics and then the Protestant reformation, and then the rennaisance with a focus on Franz Mesmer and his new science of animal magnetism. From the general outlook, we come to understand that the field can be diffused with quackery. He then dives for the kill. What Freud did, and then what Adler, and Jung further polished, was a new framework by which we can explain the human mind, and the conditions by which we have come to call neuroses. This new linguistic framework is glittery and new and so value-laden, that we have been blind to its vacuousness. In this book, he inspects the whole field of psychotherapy and shows us how much of it is mere rhetoric; how much of it is equally wish-fulfillment as it claims to have characterized our behaviours. These little bits of details and nuances, when looked at in the grand scheme of things show us how poor of substance this whole theory is.
The author does not claim that psychiatry is not a viable medical field, since cosmetic surgery requires a physician as well. But he criticizes the representations of those things we now call neuroses, and how quickly they are multiplying, and the proliferation of mental illnesses and conditions deemed to be ailing the mind because society has been more intolerant of (e.g. masculinity, https://www.apa.org/monitor/2019/01/c...) is a prophecy on Szasz's part, to which he claimed was considered before him by Socrates, Aristotle, Aquinas, and Martin Luther as well.
I shall consider reading his The Myth of Mental Illness: Foundations of a Theory of Personal Conduct next. This is such a great book, and it's really eye-opening.
He lays many argument, but this is his fundamental thesis: The term 'illness' is only applicable to corporeal ailments, and therefore there is no such thing as mental illness; and the term 'therapy' is only applicable to physico-chemical interventions, and therefore no amount of talking should be said to be therapeutic; and finally, most of the body of knowledge we have come to call 'psychotherapy' is not really therapy, and it's an abuse of the medical profession and an encroachment on the rights of persons.
Dr. Szasz anticipates that there will be much reservations on our sides, especially in the times of writing onwards: This is because we have come to accept psychotherapy as a solution to many of the 'ailments,' especially those we deem to be 'mental' or spiritual. And so, he adopts the excellent strategy of going over the history of therapy of the human psyche. Starting from the mystiques of old, to Socrates, to Aristotle, to the Catholics and then the Protestant reformation, and then the rennaisance with a focus on Franz Mesmer and his new science of animal magnetism. From the general outlook, we come to understand that the field can be diffused with quackery. He then dives for the kill. What Freud did, and then what Adler, and Jung further polished, was a new framework by which we can explain the human mind, and the conditions by which we have come to call neuroses. This new linguistic framework is glittery and new and so value-laden, that we have been blind to its vacuousness. In this book, he inspects the whole field of psychotherapy and shows us how much of it is mere rhetoric; how much of it is equally wish-fulfillment as it claims to have characterized our behaviours. These little bits of details and nuances, when looked at in the grand scheme of things show us how poor of substance this whole theory is.
The author does not claim that psychiatry is not a viable medical field, since cosmetic surgery requires a physician as well. But he criticizes the representations of those things we now call neuroses, and how quickly they are multiplying, and the proliferation of mental illnesses and conditions deemed to be ailing the mind because society has been more intolerant of (e.g. masculinity, https://www.apa.org/monitor/2019/01/c...) is a prophecy on Szasz's part, to which he claimed was considered before him by Socrates, Aristotle, Aquinas, and Martin Luther as well.
I shall consider reading his The Myth of Mental Illness: Foundations of a Theory of Personal Conduct next. This is such a great book, and it's really eye-opening.
July 1, 2026
I'd read several of Freud's books in my teens, and it would have been good if I had some of the missing context that Szasz provides. For example, there's the famous case of Anna O. (a pseudonym for Bertha Pappenheim), and Szasz notes that despite initial improvement, the patient actually got worse after treatment. I didn't want to take Szasz's description at face value, but checking with Wikipedia, I see the following comment regarding her therapist:
Given how the patient's therapist felt about the patient, I tend to believe that Szasz's account that the patient herself thought the therapy did more harm than good is quite justified. The patient did go on to live a very fruitful life as an activist for women's rights in pre-Nazi Germany, and she managed to bring a group of Jewish children from the orphanage to Great Britain to escape persecution.
Szasz's book led me to doing a quick check on the life of the therapist, Josef Breuer, and his Wikipedia entry had a section that had historical context that put the writings of Szasz and Freud into perspective:
In evaluating Szasz's writings, I think it's important to take Szasz's own life as context, and on this Wikipedia states:
I find it ironic that the patient, though certainly mentally ill at one point, was ultimately more resilient than her therapist's family, and the family of the therapist who critiqued her therapist. That said, I remain grateful to Szasz for raising important questions about the origins and underpinnings of the system he critiqued.
Breuer [the therapist] promptly handed Pappenheim's care over to a colleague. He would have no more to do with her. Freud's initial encouragement to continue his talking therapy was met by Breuer's insistence that he'd had quite enough of hysterical women and wanted nothing more to do with them. It would be another four years before Sigmund Freud could persuade him to once again attempt psychotherapy or to deal with women diagnosed as hysterical, and a further six years passed before Breuer was willing to publish on the subject of the talking cure.
Given how the patient's therapist felt about the patient, I tend to believe that Szasz's account that the patient herself thought the therapy did more harm than good is quite justified. The patient did go on to live a very fruitful life as an activist for women's rights in pre-Nazi Germany, and she managed to bring a group of Jewish children from the orphanage to Great Britain to escape persecution.
Szasz's book led me to doing a quick check on the life of the therapist, Josef Breuer, and his Wikipedia entry had a section that had historical context that put the writings of Szasz and Freud into perspective:
His [the therapist's] daughter Dora later committed suicide rather than be deported by the Nazis. Another one of his daughters, Margarete Schiff, perished in the ghetto of Theresienstadt on September 9, 1942. Breuer's granddaughter, Hanna Schiff, died while imprisoned by the Nazis.
In evaluating Szasz's writings, I think it's important to take Szasz's own life as context, and on this Wikipedia states:
Szasz had two daughters. His wife, Rosine, died in 1971. Szasz's colleague Jeff Schaler described her death as a suicide. Szasz ended his own life on September 8, 2012, after suffering a painful spinal-compression fracture from a recent fall.
I find it ironic that the patient, though certainly mentally ill at one point, was ultimately more resilient than her therapist's family, and the family of the therapist who critiqued her therapist. That said, I remain grateful to Szasz for raising important questions about the origins and underpinnings of the system he critiqued.
December 23, 2023
I. THE PROBLEM OF PSYCHOTHERAPY
1 The Myth of Psychotherapy: Metaphorizing Medical Treatment
2 Persuading Persons: Rhetoric as Remedy
3 Curing Souls: Religion as Remedy
II. THE PRECURSORS OF PSYCHOTHERAPY
4 Franz Anton Mesmer: Metaphorizing Magnetism
5 Johann Christian Heinroth: Repression as Remedy
6 Wilhelm Erb, Julius Wagner Jauregg, and Sigmund Freud: Electrical Treatment
III. THE PARADIGM OF PSYCHOTHERAPY
7 The Psychoanalytic Movement: Franchising the Freudian Faith
8 Psychoanalysis as Base Rhetoric: Oedipus, from Rex to Complex
9 Sigmund Freud: The Jewish Avenger
10 Carl Gustav Jung: Pastor Without a Pulpit
IV. THE POLITICS OF PSYCHOTHERAPY
11 Psychotherapy: Medicine, Religion, and Power
12 Psychotherapy and Language: Contemporary Uses and Abuses
In Freud's view, persons do not act; they are moved by impulses that are largely unconscious. They are moved, moreover, in directions that are generally venal and vile.
Freud's contention that man has no free will is pivotal to the rest of his theory.
Here, then, was the issue that lay at the bottom of the inevitable break and subsequent bad feelings between Freud and Jung: Was psychotherapy... to be defined, practiced, and merchandised as a medical, scientific enterprise, or as a religious, spiritual one? Freud, as we know, opted for the former answer—preferring a Platonic lie to a plain truth—and is considered a great scientist. Jung, predictably, opted for the latter—preferring a simple truth to a convenient obfuscation—and is considered a great mystic.
1 The Myth of Psychotherapy: Metaphorizing Medical Treatment
2 Persuading Persons: Rhetoric as Remedy
3 Curing Souls: Religion as Remedy
II. THE PRECURSORS OF PSYCHOTHERAPY
4 Franz Anton Mesmer: Metaphorizing Magnetism
5 Johann Christian Heinroth: Repression as Remedy
6 Wilhelm Erb, Julius Wagner Jauregg, and Sigmund Freud: Electrical Treatment
III. THE PARADIGM OF PSYCHOTHERAPY
7 The Psychoanalytic Movement: Franchising the Freudian Faith
8 Psychoanalysis as Base Rhetoric: Oedipus, from Rex to Complex
9 Sigmund Freud: The Jewish Avenger
10 Carl Gustav Jung: Pastor Without a Pulpit
IV. THE POLITICS OF PSYCHOTHERAPY
11 Psychotherapy: Medicine, Religion, and Power
12 Psychotherapy and Language: Contemporary Uses and Abuses
In Freud's view, persons do not act; they are moved by impulses that are largely unconscious. They are moved, moreover, in directions that are generally venal and vile.
Freud's contention that man has no free will is pivotal to the rest of his theory.
Here, then, was the issue that lay at the bottom of the inevitable break and subsequent bad feelings between Freud and Jung: Was psychotherapy... to be defined, practiced, and merchandised as a medical, scientific enterprise, or as a religious, spiritual one? Freud, as we know, opted for the former answer—preferring a Platonic lie to a plain truth—and is considered a great scientist. Jung, predictably, opted for the latter—preferring a simple truth to a convenient obfuscation—and is considered a great mystic.
March 30, 2022
This is almost like a whistleblower on psycho-analysis psycho-therapy and modern psychiatry methods. Damn! The intricacies of how this profession is based on very shaky grounds is alarming and yet re-assuring.
Reassuring in the sense that most of today’s psychological theories can be taken with a grain of salt 🧂.
Makes me wonder how all that pain and hurt in the world will be effectively dealt with? 🧐
Is it through using cognitive behavioural therapy, psycho-analysis, transactional psychology or evolutionary psychology?
Is it through working to accept our true selves and dark shadows, or is it by being productive (yet broken) individuals in society?
Don’t know the answer. Maybe the truth is somewhere in the middle of all this!
God guide us and ease our hearts 🤲
Reassuring in the sense that most of today’s psychological theories can be taken with a grain of salt 🧂.
Makes me wonder how all that pain and hurt in the world will be effectively dealt with? 🧐
Is it through using cognitive behavioural therapy, psycho-analysis, transactional psychology or evolutionary psychology?
Is it through working to accept our true selves and dark shadows, or is it by being productive (yet broken) individuals in society?
Don’t know the answer. Maybe the truth is somewhere in the middle of all this!
God guide us and ease our hearts 🤲
March 22, 2020
Es un libro que comienza bien, comienza con buenos argumentos. Lamentablemente, a mitad del libro pierde objetividad. Además que es un estudio bastante obsoleto, pues sus opiones sobre Jung, son desmentidas después de la información que hay sobre su relación con Sabina Sipelrein. El libro se basa más en determinar la validez de una teoría más por la persona que por su solidez. Llega incluso al absurdo irracional de descalificar a Freud que hasta utiliza su orgullo judío contra él, en un tiempo de antisemitismo.
February 10, 2020
Muy interesante su postura frente a la psicoterapia. Le da con palo a Freud, Jung y otros....y a pesar de to ser simpatizante del psicoanálisis realmente sus puntos críticos son muy lógicos y dan para pensar y discutir bastante al respecto.
Primer libro que leo de este autor pero, definitivamente, no será el último.
Primer libro que leo de este autor pero, definitivamente, no será el último.
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December 8, 2023La crítica más elocuente a Freud. Un libro sencillo pero no simple, ligero pero no superfluo, la introyección que logró Szasz de la práctica psíquica hace que disponga de la materia con maestría y claridad para exponer sus avenencias y discrepancias en la creación de una destreza que observa las emociones desprendidas de la sensación inmediata del hombre. Inmensa introyección del método.
November 4, 2021
Izglītojošs ekskurss psihoterapijas vēsturē. Kāds lērums skarbu vārdu psihoanalīzes tēviem. Un noslēgumā tomēr nenolaupīta cerība, ka vārdi spēj būt dziedinoši. Vienīgi aicinājums to nesaukt par medicīnu un zinātni - bet par mākslu. Psihoterapija kā māksla. Apsvēršanas vērts piedāvājums.
March 2, 2019
Hey, someone had to.
May 6, 2021
Gave me a completely new outlook on psychotherapy. Such a good analysis
September 4, 2022
Worth the read as it is a secular summation of the religion of psychotherapy. BEWARE dear pilgrim before reading…there are explicit parts that may need to be skipped.
January 13, 2025
great book.
April 13, 2023
At once fascinating in its thesis and utterly boring when working with it. Szasz may not have cared, however, as he comes back time and time again in this book to provide sociological and historical considerations of the founders of psychotherapy and how flawed they were in comparison to the ideas they touted. Even if one ultimately rejects the criticism of Szasz, it is important to see that his work was substantial in making the field of psychiatry and psychology do better for the people they claim to be fiduciaries of. Szasz comes before the heyday of Evidence Based Medicine that sought to separate therapy from placebo, and I will have to see if more of his library has responses to this approach.
December 4, 2012
You almost feel bad for Freud by the time Szasz is done with him. From time to time the author tries to connect dots that I'm not quite sure are connectable, but overall he does a great job in his criticism.
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