Does Mental Illness Exist?

Wayne Ramsay, J.D.
An abbreviated version of this essay was published in the January 2019 Bulletin of the Int'l Society for Ethical Psychology and Psychiatry

    "As I have stated in an earlier chapter, in the natural world there is no such thing as mental disease or defect, but rather certain patterns of behavior to which, in a given social context, we apply certain names which enable us to talk about and to effect certain changes in the social relationships of those who exhibit them and to effect changes in the individuals themselves. At best, we are left to the imposition of purely arbitrary criteria in selecting such persons." Psychiatrist Philip Q. Roche, M.D., winner of the American Psychiatric Association's Isaac Ray Award for outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence, in his book The Criminal Mind (Farrar, Straus and Cudahy 1958), p. 253

    "mental disease...The very term is itself nonsensical, a semantic mistake.  The two words cannot go together except metaphorically; you can no more have a mental 'disease' than you can have a purple idea or a wise space." Psychiatrist E. Fuller Torrey, M.D., in his book The Death of Psychiatry (Penguin Books 1974), p. 36

    "In The Myth of Mental Illness, I took this semiotic bull by its metaphorical horns and showed that it was "bull" indeed: there is no mental illness." Psychiatry professor Thomas S. Szasz, M.D., in his book Psychiatry: The Science of Lies (Syracuse University Press 2008), p. 24

    "I have had to use several terms in this book that I am not comfortable with, but they are in common use and better ones do not exist or are not widely understood.   ...   Thus I refer sometimes to 'mental illness', although I do not consider that psychiatric conditions are usefully or validly regarded as illnesses."   Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., Senior Lecturer in Mental Health Sciences, University College London, UK, in her book The Myth of the Chemical Cure — A Critique of Psychiatric Drug Treatment (Palgrave Macmillan 2009), p. xi (Note on Nomenclature)

    "[T]here is no definition of a mental disorder. It's bullshit. I mean, you just can't define it." Allen Frances, M.D., chairperson of the Task Force that created two editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (1994) and DSM-IV-TR (2000), quoted by Gary Greenberg, "Inside the Battle to Define Mental Illness", Decembber 27, 2010, Wired magazine

    "[T]here is no such thing whatsoever as a psychiatric or psychological disease." Neurologist Fred A. Baughman, M.D., author of The ADHD Fraud: How Psychiatry Makes "Patients" of Normal Children (Trafford Publishing 2006), in his lecture at the Empathic Therapy Conference 2012, "The ADHD/​Stimulent Epidemic" (at the 33 minute, 2 seconds point), available for purchase on DVD at EmpathicTherapy.org

    "... we have argued, the existence of a disease of mental illness has never been established ... together we've amassed over seventy-five years of teaching mental health courses in graduate schools of social work to thousands of students and practitioners ... after more than ten decades of determined research and the expenditure of untold sums, no one can verify that madness is a medical disease. ...  There is, of course, the unpredictable but remote possibility that the psychiatric system produces it's 'Gorbachev,' a widely acknowledged leader and spokesperson who says plainly and loudly that the emperor has no clothes, that while many people could use help for their distress or have their disturbance contained to preserve our peace of mind, there is no mental illness."  Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., & David Cohen, Ph.D., in their book Mad Science—Psychiatric Coersion, Diagnosis, and Drugs (Transaction Publishers 2013), pp. 195, 301, 302, 328 (underline added)

    "Nobody should be diagnosed with mental illness." Paula J. Caplan, Ph.D., a psychologist, in her "Diagnosisgate" presentation at the annual conference of the National Association for Rights Protection and Advocacy (narpa.org) in Washington, D.C., August 23, 2015

    "Quite often, psychiatrists prefer to talk about a mental disorder, rather than a mental illness or disease, which is because psychiatric diagnoses are social constructs. ... psychiatrists have blown life into a social construct that is nothing but a variation of normal behavior and have given this construct a name, as if it existed in nature and could attack people." Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, in his book Deadly Psychiatry and Organized Denial (People's Press 2015), pp. 26 & 145

    "The conventional mental health industry goes to great lengths in an attempt to perpetuate the myth of mental illness ... ISEPP's goal is to dispel the myth of mental illness. ... The problems we've dubbed mental illnesses are about inter- and intra-personal, spiritual, existential, economic, and political matters, not real disease." Chuck Ruby, Ph.D., a psychologist and Director of the International Society for Ethical Psychology and Psychiatry (ISEPP), in the April 2018 ISEPP newsletter

    "[M]ental illnesses cause suffering, and evidence-based treatments are sparse. Indeed, the field has seen no significant pharmaceutical breakthroughs for many years. Biological causes remain elusive, and biomarkers non-existent.   ...   And common genetic variations with large effects on mental disorders are elusive. ... [T]he American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM)   ...   impinges on the territory of healthy mental function." Dr. Adrian Woolfson B.M., B.Ch. (Oxford University), Ph.D. (Cambridge University), "The biological basis of mental illness", Nature, 11 February 2019

All diagnosis and treatment in psychiatry presupposes the existence of something called mental illness, mental disease, or mental disorder.  What is meant by disease, illness, or disorder?  In a semantic sense disease means simply dis-ease, the opposite of ease.  But by disease we don't mean anything that causes a lack of ease, since this definition would mean losing one's job or a war or economic recession or an argument with one's spouse qualifies as "disease".  In his book Is Alcoholism Hereditary? psychiatrist Donald W. Goodwin, M.D., discusses the definition of disease and concludes "Diseases are something people see doctors for. ... Physicians are consulted about the problem of alcoholism and therefore alcoholism becomes, by this definition, a disease" (Ballantine Books 1988, p. 61).  Accepting this definition, if for some reason people consulted physicians about how to get the economy out of recession or how to solve a disagreement with one's mate or a bordering nation, these problems would also qualify as "disease".  But everybody knows this is not what we mean when we use the word disease.  In his discussion of the definition of disease, Dr. Goodwin acknowledges there is "a narrow definition of disease that requires the presence of a biological abnormality" (Id).  In his book Psychiatry—The Science of Lies (Syracuse University Press 2008, p. 33), psychiatry professor Thomas Szasz, M.D., says "Disease is an abnormal condition of the body, impairing its function."  Dr. Szasz's definition of disease is consistent with the definition in Dorland's Illustrated Medical Dictionary, 32nd Edition (Elsevier Sanders 2012).  Dorland's is the most highly respected medical dictionary in existence.  Dorland's defines "illness" with a single word: "disease" (p. 914) and defines disease as follows (p. 527):

    dis.ease (dĭ-zēz) [Fr. dès from + aise ease] any deviation from or interruption of the normal structure or function of a part, organ, or system of the body as manifested by characteristic symptoms and signs; the etiology, pathology, and prognosis may be known or unknown. [underline added]

By this definition, if no abnormality of the body can be found, no disease or illness can be known to exist.  Unproved theories about etiology, pathology and prognosis are speculation.  In this essay and those that follow, I will show there are no known biological or bodily abnormalities causing so-called mental illness or mental disease and that therefore they have not been proved to exist.  Equally importantly, I will show so-called mental illness, disease, or disorder does not exist in even a non-biological sense other than as a way of expressing disapproval of some aspect of a person's behavior or thinking.
      The term "disorder" is often incorrectly used interchangeably with illness or disease.  In January 2012 I had a conversation with a "board-certified behavior analyst", a type of mental health professional separate from psychiatry, psychology, counselling, and social work I had not heard of before.  (See the Behavior Analyst Certification Board web site, bacb.com.)  She told me she was employed full-time working with autistic children in a public school.  When I questioned the reality of autism as a disease, she replied, "It's not a disease.  It's a disorder."  In Lecture 13 of his "Medical Myths, Lies, and Half-Truths" course (available on DVD at thegreatcourses.com), Steven Novella, M.D., a neurology professor at Yale School of Medicine, provides these definitions:

    The core myth of this lecture is that all diagnoses are the same and are equally valid, when the truth is that we arrive at these labels in very different ways. 
          For example, there are some diagnoses which we would call a disease, a disease like diabetes, which is a pathological disorder where we can identify that there is something specific malfunctioning in some specific part of the body that is leading directly to these signs and symptoms that make up the diagnosis.
          We also may use the term "disorder".  Now a disorder does not necessarily have any pathological change in any cells, but there is some problem with functioning that is identifiable.  So an example of a disorder would be attention deficit and hyperactivity disorder.
          Versus a syndrome: A syndrome is a list of signs and symptoms that tend to occur together.

The usual terms in psychiatry are illness and disorder.  An introductory section of the American Psychiatric Association's most recent Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition published in 2013 (DSM-5), under the headline "Definition of a Mental Disorder" says "A mental disorder is a syndrome..." (p. 20).  As Dr. Novella suggests, a diagnosis of "disorder" or "syndrome" is not as valid as diagnosis of a disease or illness because of the lack of a known biological cause or etiology.
      Joel Paris, M.D., Professor of Psychiatry at McGill University in Montreal, essentially admits the invalidity of the concepts of mental illness and mental disorder in his book Overdiagnosis in Psychiatry: How Modern Psychiatry Lost Its Way While Creating a Diagnosis for Almost All of Life's Misfortunes (Oxford University Press, 2015, pp. 3-4):

        Symptoms, when they cluster together, form syndromes. But without a specific etiology, syndromes are not diseases. Since most mental illnesses remain syndromes, psychiatry describes its categories as "disorders." In other words, they do not qualify as diseases in the same way that most medical conditions do. We sometimes forget that mental disorders are convenient labels that lack any ultimate degree of reality. [underline added]

      The same definitions of disease (synonymous with illness) and disorder are given by Gwen Olsen, a former pharmaceutical manufacturer sales representative, in her YouTube.com video "Pharma Not in Business of Health, Healing, Cures, Wellness" (at the 5 minute, 48 second point). She also disputes the validity of the idea of a "disorder":

    We need to be aware of what the differences are between diseases, between disorders, and between syndromes.  Because if it doesn't have to be scientifically proven, if there are no tests, if there are no blood tests, CAT scans, urine tests, MRIs, if there is nothing to document that you have a disease, then you in fact do not have a disease: You have a disorder, and it has been given and has been diagnosed pretentiously.

Whether called an illness, disease, disorder, or syndrome, the reason responsibility for management, treatment, elimination, or cure is given to physicians (rather than for example police, clergy, psychologists, educators, or magicians) is belief in a biological cause.
      The idea of mental illness, disease, disorder, or syndrome as a biological entity is easy to refute:
      In his book The Death of Psychiatry (Penguin Books 1974, pp. 38-39), psychiatrist E. Fuller Torrey, M.D., wrote "None of the conditions that we now call mental 'diseases' have any known structural or functional changes in the brain which have been verified as causal."  In his book The New Psychiatry, Columbia University psychiatry professor, Jerrold S. Maxmen, M.D., says "It is generally unrecognized that psychiatrists are the only medical specialists who treat disorders that, by definition, have no definitively known causes or cures.  ...  A diagnosis should indicate the cause of a mental disorder, but as discussed later, since the etiologies of most mental disorders are unknown, current diagnostic systems can't reflect them" (Mentor 1985, pp. 19 & 36, italics in original).  In 1988, Seymour S. Kety, M.D., Professor Emeritus of Neuroscience in Psychiatry, and Steven Matthysse, Ph.D., Associate Professor of Psychobiology, both of Harvard Medical School, said "an impartial reading of the recent literature does not provide the hoped-for clarification of the catecholamine hypotheses, nor does compelling evidence emerge for other biological differences that may characterize the brains of patients with mental disease" (The New Harvard Guide to Psychiatry, Harvard University Press, p. 148).  In 1992 a panel of experts assembled by the U.S. Congress Office of Technology Assessment concluded: "Many questions remain about the biology of mental disorders.  In fact, research has yet to identify specific biological causes for any of these disorders.  ...  Mental disorders are classified on the basis of symptoms because there are as yet no biological markers or laboratory tests for them" (The Biology of Mental Disorders, U.S. Gov't Printing Office 1992, pp. 13-14, 46-47).  In a December 1996 Psychiatric Times article, "Commentary: Against Biologic Psychiatry", psychiatrist David Kaiser, M.D., says "modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness."  In his book The Essential Guide to Psychiatric Drugs, Columbia University psychiatry professor Jack M. Gorman, M.D., says "We really do not know what causes any psychiatric illness" (St. Martin's Press 1997, p. 314).  In his book Blaming the Brain—The Truth About Drugs and Mental Health (Free Press 1998, p. 125), Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, says: "Contrary to what is often claimed, no biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients." According to neurologist Fred Baughman, M.D., (Insight magazine, June 28, 1999, p. 13) "there is no scientific data to confirm any mental illness."  In their textbook Neurobiology of Mental Illness (Dennis S. Charney, M.D. et al., Oxford Univ. Press 1999, p. vii), three psychiatry professors at Yale University School of Medicine say "We have so far failed to identify bona fide psychiatric disease genes or to delineate the precise etiological and pathophysiological basis of mental disorders."  In his book Prozac Backlash (Simon & Schuster 2000, pp. 192-193), Joseph Glenmullen, M.D., clinical instructor in psychiatry at Harvard Medical School, says "In medicine, strict criteria exist for calling a condition a disease.  In addition to a predictable cluster of symptoms, the cause of the symptoms or some understanding of their physiology must be established.  ...  Psychiatry is unique among medical specialties in that... We do not yet have proof either of the cause or the physiology for any psychiatric diagnosis."  In his book Commonsense Rebellion: Debunking Psychiatry, Confronting Society (Continuum 2001, p. 277), psychologist Bruce E. Levine, Ph.D., says "no biochemical, neurological, or genetic markers have been found for attention deficit disorder, oppositional defiant disorder, depression, schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling, or any other so-called mental illness, disease, or disorder."  Allen Frances, M.D., chairperson of the DSM-IV Task Force (the committee that created the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (1994) and DSM-IV-TR (2000), criticizing the proposed Fifth Edition of this book scheduled for publication in May 2013, notes that "not even 1 biological test is ready for inclusion in the criteria sets for DSM-V" ("A Warning Sign on the Road to DSM-V", psychiatrictimes.com, June 26, 2009).  In his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, HarperCollins 2013, pp. 10, 11, 244), Dr. Frances says "The powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive-compulsive disorder or for any other mental disorders ... We still do not have a single laboratory test in psychiatry.  ...thousands of studies on hundreds of putative biological markers [for mental illness] have so far come up empty."  In 2011, Hagop Akiskal, M.D., Professor of Psychiatry at the University of California at San Diego, acknowledged that "Despite the diligent search for biomarkers for the so-called functional mental disorders during the past 100 years, nothing specific has emerged" ("Biomarkers for Mental Disorders: A Field Whose Time Has Come", psychiatrictimes.com, November 18, 2011).  In 2012, Connecticut psychiatrist Simon Sobo, M.D., acknowledged "We haven't yet discovered the etiology of any DSM-IV diagnosis" ("Does Evidence-Based Medicine Discourage Richer Assessment of Psychopathology and Treatment?" psychiatrictimes.com, April 5, 2012).  In a lecture at the University of New England on February 25, 2013, British psychiatrist Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., said "There is just absolutely no evidence that anyone with any mental disorder has a chemical imbalance of any sort...absolutely none" ("Joanna Moncrieff—The Myth of the Chemical Cure; The Politics of Psychiatric Drug Treatment", YouTube.com, at 53:52).  In 1991 in his book Toxic Psychiatry, psychiatrist Peter Breggin, M.D., said "there is no evidence that any of the common psychological or psychiatric disorders have a genetic or biological component" (St. Martin's Press, p. 291).  24 years later, on the Coast-to-Coast AM radio show on February 9, 2015, Dr. Breggin said "There is no known physical connection to any psychiatric disorder. There is no genetically determined cause. It's all drug company propaganda, because the pharmaceutical industry with its billions of [advertising] dollars, and the medical industry, thinks you're more likely to take drugs if you think you have a genetic or biological disease." In 2015 in his book Deadly Psychiatry and Organized Denial, Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, said "it hasn't been possible to demonstrate that people suffering from common mental disorders have brains that are different from healthy people's brains" (People's Press, p. 26).
      So if mental illnesses, mental diseases, or mental disorders or syndromes must have a biological etiology or cause to qualify as illness, disease, disorder, or syndrome, none have been proved to exist.
      What has happened is this: Biologically normal people can perform or engage in a very wide range of thinking and behavior, only a narrow portion of which is acceptable to people in any given society.  People, including psychiatrists, assume without proof that any thinking or behavior outside what is socially acceptable in any particular society must be caused by a biological abnormality.  This unfounded assumption results in people who think or do things others dislike being thought to have biological problems when in fact they have none.  When you falsely blame biological abnormality for behavior or thinking you dislike, you have created the myth of mental illness.
      It is sometimes argued that psychiatric drugs "curing" (stopping) the thinking, emotions, or behavior that is called mental illness, disease, disorder, or syndrome proves the existence of biological causes of these supposed illnesses, disorders, or syndromes.  Referring to psychiatric drugs, a psychologist once said to me "If the cure is biochemical, the cause must be biochemical."  This argument is nonsense for two reasons: First, aside from placebo effect, psychiatric drugs don't work, as I explain in Psychiatric Drugs: Cure or Quackery?  Second, stopping anything a person is doing by giving him a toxic, disabling drug proves nothing pathological about the behavior you are trying to stop: Suppose someone was playing the piano and you didn't like him doing that.  Suppose you forced or persuaded him to take a drug that disabled him so severely that he couldn't play the piano anymore.  Would this prove his piano playing was a disorder or was caused by a biological abnormality or illness that was treated or cured by the drug?  Most if not all psychiatric drugs are neurotoxic, producing a greater or lesser degree of general neurological disability.  So they do stop disliked behavior and may mentally disable a person enough he can no longer feel angry or unhappy or "depressed".  But this approach is destructive because it wipes out as much good as bad in a person's thinking, emotions, and behavior.  Calling it a "treatment" or "cure" is absurd.  Extrapolating from this that the drug must have cured an underlying biological abnormality that was causing the disliked emotions or behavior is equally absurd.
      When confronted with the lack of evidence for their belief in mental illness, disease, disorder or syndrome as a biological entity, some defenders of the concept of mental illness or disorder, etc., will assert that mental illness or disorder can exist and can be defined as a "disease" (or illness or disorder) without there being a biological abnormality causing it.  The idea of mental disease, illness, disorder, or syndrome as a nonbiological entity requires a more lengthy refutation than the biological argument.
      People are thought of as mentally ill or disordered only when their thinking, emotions, or behavior is contrary to what is considered acceptable, that is, when others (or the so-called patients themselves) dislike something about them.  One way to show the absurdity of calling something a disease, illness, disorder, or syndrome not because it is caused by a biological abnormality but only because we dislike it or disapprove of it is to look at how values differ from one culture to another and how values change over time.
      In his book The Psychology of Self-Esteem, Nathaniel Branden, Ph.D., a psychologist, wrote:

    One of the prime tasks of the science of psychology is to provide definitions of mental health and mental illness. ...But there is no general agreement among psychologists and psychiatrists about the nature of mental health or mental illness—no generally accepted definitions, no basic standard by which to gauge one psychological state or other.  Many writers declare that no objective definitions and standards can be established—that a basic, universally applicable concept of mental health is impossible.  They assert that, since behavior which is regarded as healthy or normal in one culture may be regarded as neurotic or aberrated in another, all criteria are a matter of "cultural bias."  The theorists who maintain this position usually insist that the closest one can come to a definition of mental health is: conformity to cultural norms.  Thus, they declare that a man is psychologically healthy to the extent that he is "well‑adjusted" to his culture.  ...  The obvious questions that such a definition raises, are: What if the values and norms of a given society are irrational?  Can mental health consist of being well-adjusted to the irrational?  What about Nazi Germany, for instance?  Is a cheerful servant of the Nazi state — who feels serenely and happily at home in his social environment — an exponent of mental health? [Bantam Books 1969, pp. 95‑96, italics in original]

Dr. Branden is doing several things here: First, he is confusing morality and rationality, saying that respect for human rights is rational when in fact it is not a question of rationality but rather of morality.  So psychologically and emotionally locked into and blinded by his values is he that Dr. Branden is evidently incapable of seeing the difference.  Additionally, Dr. Branden is stating some of his values.  Among these values are: Respect for human rights is good; violation of human rights (like Naziism) is bad.  And he is saying: Violating these values is "irrationality" or mental illness.  Although their practitioners won't admit it and often are not even aware of it, psychiatry and "clinical" psychology in their very essence are about values—values concealed under a veneer of language that makes it sound like they are not furthering values but promoting "health".  The answer to the question Dr. Branden poses is this: A person living in Nazi Germany and well-adjusted to it was "mentally healthy" judged by the values of his own society.  Judged by the values of a society in which human rights are respected, he was as sick (metaphorically speaking) as the rest of his culture.  A person like myself however says such a person is morally "sick" and recognizes that the word sick has not its literal but a metaphorical meaning.  To a person like Dr. Branden who believes in the myth of mental illness, such a person is literally sick and needs a doctor.  The difference is a person like myself is recognizing my values for what they are: morality.  Typically, the believer in mental illness, such as Dr. Branden in this quoted passage, has the same values as I do but is confusing them with health.
      One of the most revealing examples is homosexuality, which was officially defined as a mental disorder by the American Psychiatric Association until 1973 but hasn't been since then, although some psychiatrists continued to think of homosexuality as a psychological or psychiatric abnormality or disorder for many years after that, and perhaps some still do.  For example, "Even Robert Spitzer, M.D., the chief developer of DSM-III and called by some the psychiatrist of our time, recommended reparative psychotherapy for homosexuality in 2003" (H. Steven Moffic, M.D., "How to End a Psychiatric Epidemic: The Redemption of Psychiatry", psychiatrictimes.com, June 11, 2012).  Homosexuality was defined as a mental disorder, a "Sexual deviation", on page 44 of the American Psychiatric Association's standard reference book, DSM‑II: Diagnostic and Statistical Manual of Mental Disorders (the 2nd Edition), published in 1968.  In 1973 the American Psychiatric Association voted to remove homosexuality from its official categories of mental disorder.  (See "An Instant Cure", Time magazine, April 1, 1974, p. 45).  So when the third edition of this book was published in 1980 it said "homosexuality itself is not considered a mental disorder" (p. 282).  The 1987 edition of The Merck Manual of Diagnosis and Therapy states: "The American Psychiatric Association no longer considers homosexuality a psychiatric disease" (p. 1495; note the confusion of "disorder" with "disease").  If mental illness were really an illness in the same sense that physical diseases are, the idea of deleting homosexuality or anything else from the categories of illness by having a vote would be as absurd as a group of physicians voting to delete cancer or measles from the concept of disease.  The fact that mental disorders can be created or eliminated by having a vote shows they are more like criminal laws than diseases.  Mental illness isn't "an illness like any other illness" because, unlike physical disease where there are physical facts to deal with, mental "illness" or "disorder" cannot be demonstrated to exist by reference to anything physical.  Unlike physical disease, mental illness or disorder is entirely a question of values, of right and wrong, of appropriate versus inappropriate.  At one time homosexuality seemed so weird and hard to understand it was necessary to invoke the concept of mental disease, illness, or disorder to explain it.  After homosexuals successfully demanded tolerance of their type of sexuality, it was no longer necessary and no longer seemed appropriate to explain homosexuality as a mental illness or mental disorder.  In 2003 the highest court of Massachusetts ruled in favor of a right under the state constitution for homosexuals to marry a person of the same gender (Goodridge v. Department of Public Health, 798 NE2d 941).  Later the highest courts of California (In re Marriage Cases, 183 P3d 384), Connecticut (Kerrigan v. Commissioner of Public Health, 957 A2d 407), and Iowa (Varnum v. Brien, 763 NW2d 862) did also.  Elected officials as high as U.S. President Barack Obama, a Democrat, criticized people who discriminate against or have negative attitudes towards homosexuals, as did many speakers at the 2012 Democratic Party Convention.  The 2012 Democratic Party Platform says "We support marriage equality and support the movement to secure equal treatment under law for same-sex couples."  On November 6, 2012 a majority of voters approved same-sex marriage by referendum in the states of Maryland, Maine, and Washington, the first time homosexual marriage was authorized by general election voters rather than by courts or state legislatures.  On June 26, 2015, the U.S. Supreme Court, by a 5 to 4 vote, ruled states are required by the Equal Protection Clause of the Fourteenth Amendment to issue marriage licenses to and recognize marriages between same-sex couples. In the span of a few decades, homosexuality went from being a mental illness or disorder to being a celebrated cause.  Not coincidentally, the theories about biological abnormalities causing homosexuality I used to hear are no longer heard.  As will become more apparent as we look at more examples, cultural values rather than biology define what is and is not a mental disorder.
      Biological abnormalities are no more responsible for today's so-called mental illnesses than they are, or were, for homosexuality.  Even if biological abnormalities were or are responsible for homosexuality and other supposed mental disorders, we wouldn't call them illnesses or disorders if we accepted those differences.  The defining characteristic of a mental disorder is simply disapproval.
_________________________________________________

THE DEFINING CHARACTERISTIC OF MENTAL
DISORDER IS SIMPLY DISAPPROVAL _________________________________________________

      Homosexuality is not the only mental illness or disorder abolished by psychiatric fiat: Neurosis, once thought a common problem, was abolished with the publication of DSM-III in 1980.  DSM-III's Introduction (p. 9) says the concept of neurosis was abolished in part because "there is no consensus in our field as to how to define 'neurosis.'"
      Being too active as a heterosexual has also been considered a form of mental illness or disorder.  In a June 19, 2012 Psychiatric Times article, "History of Psychiatry—Hypersexual Disorder: An Encounter With Don Juan in the Archives", psychiatrictimes.com, Greg Eghigian, Ph.D., says that "Don-Juanism, or Don Juan syndrome, was indeed a recognized diagnosis that referred to forms of male hypersexuality.  In history, it was most commonly known as satyriasis."  He quotes physician Michael Ryan who in 1839 said—

    Satyriasis and nymphomania are diseases in which the sufferers evince an irresistible desire for copulation, as well as abuse of the reproductive functions.  The first disease attacks the male, the second the female.  M.Deslandes is of opinion, and I fully agree with him, that there is no real difference between these diseases and unbridled masturbation; and that both ought to be considered species of insanity.

      Contrast this 19th Century view of insanity, or what is now usually called mental illness, with that of the late 20th Century after attitudes about sexuality had changed: The 1970s and 1980s saw the birth of a new psychiatric "diagnosis" which is called by various names.  One of the more popular terms for this new mental or psychiatric disease is ISD.  These three letters stand for Inhibited Sexual Desire.  A Reader's Digest article in 1989 says "Psychiatrists and psychologists say that lack of sexual desire—commonly called Inhibited Sexual Desire (ISD)—has emerged as the most common of all sexual complaints."  The article says research on ISD is insufficient because "ISD ... was identified as a clinical entity only in the past decade."  The article refers to people who have this problem as "ISD patients" (David Gelman, "Not Tonight Dear", Reader's Digest, June 1989, p. 33 at 33-34.  See also: Dr. Jennifer Knopf and Dr. Michael Seiler, ISD—Inhibited Sexual Desire, Warner Books 1990).  ISD was officially recognized as a mental illness or disorder for the first time in the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published in 1980.  It appeared in DSM-III's "Psychosexual Disorders" chapter as "Inhibited Sexual Desire" (p. 278) and "Inhibited Sexual Excitement" which the Manual says "has also been termed frigidity or impotence" (p. 279).  This supposed disorder was carried forward into DSM-III-R (1987) as "Hypoactive Sexual Desire Disorder" wherein it is defined as "Persistently or recurrently deficient or absent sexual fantasies and desire for sexual activity" (p. 293) and into DSM-IV-TR (published in 2000, pp. 539-541) under the same name and DSM-5 (published in 2013) as "Male Hypoactive Sexual Desire Disorder" (p. 440) and "Female Sexual Interest/Arousal Disorder" (p. 433).
     The above 1839 reference to "unbridled masturbation...that...ought to be considered [a] species of insanity", can be contrasted with attitudes about masturbation today.  An article in a popular women's magazine in 1989 says "Many doctors and therapists acknowledge that masturbation can improve both your physical health and your mental outlook" (Beverly Whipple and Gina Ogden, "Learning To Be Your Own Best (Sexual) Friend", Cosmopolitan magazine, September 1989, p. 122).  As psychiatry professor Thomas S. Szasz, M.D., says in his book The Second Sin (Doubleday 1973, p. 10): "Masturbation: the primary sexual activity of mankind.  In the nineteenth century, it was a disease; in the twentieth, it's a cure."
      At one time racism was common and accepted by most people as normal, but after racist attitudes were rejected, "those guilty of racism were considered to have a psychological disorder" (according to psychiatrist H. Steven Moffic, M.D., in his article "Psychism: Defining Discrimination of Psychiatry", psychiatrictimes.com, June 4, 2012).  At the March 1975 meeting of the American Orthopsychiatric Association, the Association's Committee on Minority Group Children said "Racism is probably the only contagious mental disease" (A. Herndon, "Racism Said to Be America's Chief Mental Health Problem," Psychiatric News, January 21, 1976, pp. 1, 30, cited in Szasz, Schizophrenia, The Sacred Symbol of Psychiatry, pp. 190 & 227).  Might racism be caused by a biological abnormality in the brain of a racist?  Can mental illnesses be the result of teaching or indoctrination?
      A cross-cultural example is suicide.  In many countries, such as the United States and Great Britain, a person who commits suicide or attempts to do so or even thinks about it seriously is considered mentally ill.  However, this has not always been true throughout human history, nor is it true today in all cultures around the world.  In his book Why Suicide?, psychologist Eustace Chesser points out that "Neither Hinduism nor Buddhism have any intrinsic objections to suicide and in some forms of Buddhism self-incineration is believed to confer special merit."  He also points out that "The Celts scorned to wait for old age and enfeeblement.  They believed that those who committed suicide before their powers waned went to heaven, and those who died of sickness or became senile went to hell—an interesting reversal of Christian doctrine" (Arrow Books Ltd., London, England, 1968, p. 121-122).  In his book Fighting Depression, psychiatrist Harvey M. Ross, M.D., points out that "Some cultures expect the wife to throw herself on her husband's funeral pyre" (Larchmont Books 1975, p. 20).  Probably the best known example of a society where suicide is socially acceptable is Japan.  Rather than thinking of suicide or "hara‑kiri" as the Japanese call it as almost always caused by a mental disease or illness, the Japanese in some circumstances consider suicide the normal, socially acceptable thing to do, such as when one "loses face" or is humiliated by some sort of failure.  Another example showing suicide is considered normal, not crazy, in Japanese eyes is the kamikaze pilots Japan used against the U.S. Navy in World War II.  They were given enough fuel for a one‑way trip, a suicide mission, to where the attacking U.S. Navy forces were located and deliberately crashed their airplanes into the enemy ships.  There has never been an American kamikaze pilot, at least, none officially sponsored by the United States government.  The reason for this is different attitudes about suicide in Japan and America.  Could suicide be committed only by people with psychiatric illnesses in America and yet be performed by normal persons in Japan?  Or is acceptance of suicide in Japan a failure or refusal to recognize the presence of biological or psychological abnormalities which necessarily must be present for a person to voluntarily end his or her own life?  Were the kamikaze pilots mentally ill, or did they and the society they come from simply have different values than we do?  Even in America, aren't virtually suicidal acts done for the sake of one's fellow soldiers or for one's country during wartime thought of not as insanity but as bravery?  As psychologist Edwin S. Shneidman says in his book The Suicidal Mind (Oxford University Press 1996, p. 5), "Some suicidal acts committed by people on what we call 'suicide missions' or who commit aberrant acts of terrorism are, when done by our side (in times of war), honored and rewarded by medals" (italics in original).  Why do we think of such persons as heros rather than lunatics? It seems we condemn (or "diagnose") suicidal people as crazy or mentally ill only when they end their own lives for selfish reasons (the "I can't take it any more" kinds of reasons) rather than for the benefit of other people.  The real issue seems to be selfishness rather than suicide.
      What these examples show is that mental "illness", "disease", "disorder" or "syndrome" is simply deviance from what people want or expect in any particular society at any particular time and is not the result of biological abnormality.  Mental "illness" or "disorder" is anything in human mentality greatly disliked by the person describing it.
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BECAUSE PSYCHIATRY ASSUMES BIOLOGICAL PROBLEMS
CAUSE "MENTAL DISORDERS", THE PROFESSION IS
BUILT AROUND A MISTAKEN PARADIGM _________________________________________________

      The situation was aptly summed up in an article in the November 1986 Omni magazine (Gurney Williams III, "Psychofashion", Omni magazine, November 1986, p. 30):

    Disorders come and go.  Even Sigmund Freud's concept of neurosis was dropped in the original DSM-III (1980).  And in 1973 APA [American Psychiatric Association] trustees voted to wipe out almost all references to homosexuality as a disorder.  Before the vote, being gay was considered a psychiatric problem.  After the vote the disorder was relegated to psychiatry's attic.  "It's a matter of fashion," says Dr. John Spiegel of Brandeis University, who was president of the APA in 1973, when the debate over homosexuality flared.  "And fashions keep changing."

      What is wrong with this approach is describing people as having a psychiatric disease, illness, disorder, or syndrome only because he or she doesn't match up with a supposed diagnostician's or with other people's idea of how a person "should" be in standards of dress, behavior, thinking, or opinion.  When a person's behavior violates the rights of others, it must be curbed or stopped with various measures, criminal law being one example.  But assuming nonconformity or disliked behavior must be caused by biological abnormality only because it is contrary to currently prevailing values makes no sense.
      One reason we do this is we do not know the real reasons for the thinking, emotions, or behavior we dislike.  When we don't understand the real reasons, we create myths to provide an explanation.  In prior centuries people used myths of evil spirit or demon possession to explain unacceptable thinking or behavior.  Today most of us instead believe in the myth of mental illness.  Believing in mythological entities such as evil spirits or mental illnesses gives an illusion of understanding, and believing a myth is more comfortable than acknowledging ignorance.
      Because psychiatry is based on the assumption biological abnormality causes what is thought of as mental illness or disorder, the profession is predicated upon a mistaken paradigm.  As psychiatry professor Thomas Szasz says in his book The Second Sin (Anchor Press 1973, p. 99), trying to eliminate a mental illness by having a psychiatrist work on your brain is like trying eliminate cigarette commercials from television by having a TV repairman work on your TV set.  Biological "treatments" make no sense if the problem is not biological, and psychiatry has utterly and completely failed to prove what it "treats" is the result of biological abnormality.  Looking for biological causes of "mental disorders" is like looking for electronic causes of bad television programs. 
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LOOKING FOR BIOLOGICAL CAUSES OF MENTAL DISORDERS
IS LIKE LOOKING FOR ELECTRONIC CAUSES
OF BAD TELEVISION PROGRAMS _________________________________________________

      What if we did find a biological cause of a supposed mental illness, mental disorder, or mental disease or "syndrome"? In the words of psychiatry professor Thomas Szasz:

    Of course, there is no blood or other biological test to ascertain the presence of absence of a mental illness, as there is for most bodily diseases. If such a test were developed (for what, theretofore, had been considered a psychiatric illness), then as I noted earlier, the condition would cease to be a mental illness and would be classified, instead, as a symptom of bodily disease. [A Lexicon of Lunacy, Transaction Publishers 1993, p. 33] 

      Examples of actual biological disease that cause mental changes are brain cancer, stroke, and bacterial or viral infection of the brain. Are these changes thought of as mental illness, mental disease, or as mental disorders or syndromes? No: Mental changes caused by known biological abnormality, or disease, are thought of only as symptoms of bodily disease. Since nothing can be a true illness, disease, disorder, or medical syndrome without a biological abnormality, "mental illness," "mental disorder" and "mental disease" and similar terms are oxymorons: They are internally contradictory, nonsensical terms.
      Calling disapproved thinking, emotions, or behavior a mental illness or disorder might be excusable if mental illness was a useful myth, but it isn't, because an incorrectly diagnosed problem usually leads to counterproductive solutions.  Rather than helping us deal with troubled or troublesome persons, the myth of mental illness distracts us from the real problems that need to be faced.  Rather than being caused by a "chemical imbalance" or other biological problem, the nonconformity, misbehavior, and emotional reactions we call mental illness, disease, disorder, or syndrome are the result of difficulties people have getting their needs met and the behavior some people have learned during their lifetimes.  The solutions are teaching people how to get their needs met, how to behave, and using whatever powers of enforcement are needed to force people to respect the rights of others.  These are the tasks of education and law enforcement, not medicine or therapy.

Recommended Reading

Thomas S. Szasz, M.D., The Myth of Mental Illness (Dell Pub. Co. 1961)

Thomas S. Szasz, M.D., The Second Sin (Anchor Press 1973)

E. Fuller Torrey, M.D., The Death of Psychiatry (hardcover: Chilton Book Co./paperback: Penguin Books, Inc. 1974)