The words we use to describe, diagnose, and label are often seen and treated as objective when it is important to remember that they are subjective. Psychiatrist and social critic Thomas Szasz challenged the medical establishment in the 1960s with his groundbreaking book, The Myth of Mental Illness. In this book, Szasz recounts how, in the 1870s, Neurologist Jean-Martin Charcot, the father of neurology, remade the word hysteric to be a physiological problem.1
Through Charcot’s power and influence, other doctors began to see hysteria as a “real” disease instead of something made up to get attention. According to Szasz, language is how we construct what illness is and what it means, and the language we use around mental illness is always subjective and embedded with our values. Before Charcot changed the meaning of hysteria in the medical world, people with hysteria were not taken seriously by doctors since their illnesses did not seem to originate in their bodies. If it was in the body, it was real. If it was in the mind, it was made up. Redefining the label of hysteria within the 1870s medical framework to a body illness from a fictional disease of the mind made hysteria legitimate in medicine because the values of the day were that illnesses happened in the body and not the mind. Charcot used his medical words to diagnose an illness in a way that reflected the agenda of the times. To this day, we want things to be considered real and not some sort of cultural creation of something, but we make these labels for a few reasons – to help with treatment, to help with insurance, and to help someone feel less alone in what they are experiencing. The label, however, is not the person, and you are not the label.
Szasz acutely points out that many psychiatrists refer to mental health problems as actual diseases of the mind,2 as if the mind were an actual organ like the brain. The mind is a construct that symbolizes perceptions, feelings, and thought processes. When we refer to the mind as having a disease, we should view it as symbolic language. When we choose to say “mental illness” to describe the mind as being sick, Szasz explains that we must pause and reflect on our illogic.3 To say that a mind is sick is like saying the real estate market is sick. In other words, what we are saying is only a metaphor and does not exist in the physical world.
The truth is the mind is a metaphor.
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