Mental illness: Fact or myth? Revisiting the debate between Albert Ellis and Thomas Szasz

Although it is widely accepted that mental illnesses affect millions of people worldwide, there is still disagreement among scholars about the facts of mental illness. The orthodox position is that mental illness is a fact; critics argue that it is a myth. Thomas Szasz was perhaps the most influential critic of mental illness while Albert Ellis was one of the most influential psychotherapists of the twentieth century. Yet, they disagreed about the facts of mental illness. Ellis argued that mental illness is a fact; Szasz argued that mental illness is a metaphor that we have mistaken for a fact. Both men were practicing psychotherapists: Ellis developed Rational Emotive Behavior Therapy and treated mentally ill clients as irrational thinkers; Szasz developed Autonomous Psychotherapy and treated clients as existential game-players who choose, or have been coerced into, the role of sick patient. Szasz vehemently disagreed with Ellis’s view that some people with serious mental illnesses should be institutionalized and treated against their will. While Ellis argued that mental illness is a convenient label for people who are a danger to themselves and others, Szasz argued that mental illness is a metaphor for moral problems in living and involuntary institutionalization and treatment are crimes against humanity. This paper, then, revisits the debate between Ellis and Szasz on the vexed topic of mental illness.