Mental illness is still a myth.

In a memorable statement C. S. Lewis once remarked, "Of all the tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. . . . To be |cured' against one's will and cured of states which we may not regard as disease is to be put on a level with those who have not yet reached the age of reason or those who never will; to be classed with infants, imbeciles, and domestic animals." These words still apply to psychiatry today.

Anyone with an ear for language will recognize that the boundary that separates the serious vocabulary of psychiatry from the ludicrous lexicon of psychobabble, and both from playful slang, is thin and permeable to fashion. This is precisely wherein lies the richness and power of language that is inexorably metaphoric. Should a person want to say something sensitive tactfully, he can, as the adage suggests, say it in jest, but mean it in earnest. Bureaucrats, lawyers, politicians, quacks, and the assorted mountebanks of the "hindering professions" are in the habit of saying everything in earnest. If we want to protect ourselves from them, we had better hear what they tell us in jest, lest the joke be on us.

As far back as I can remember thinking about such things, I have been struck by the analogic-metaphoric character of the vocabulary of psychiatry, which is nevertheless accepted as a legitimate medical idiom. When I decided to discontinue my residency training in internal medicine and switch to psychiatry, I did so with the aim of exploring the nature and function of psychiatry's metaphors and to expose them to public scrutiny as figures of speech.

During the 1950s, I published a score of articles in professional journals, challenging the epistemological foundations of the concept of the mental illness and the moral basis of involuntary mental hospitalization. In 1958, as my book The Myth of Mental Illness was nearing completion, I wrote a short paper of the same title and submitted it to every major American psychiatric journal. Not one of them would accept it for publication. As fate would have it--and because the competition between psychologists and psychiatrists for a slice of the mental health pie was then even more intense than now--The American Psychologist published the essay in 1960. The following year, the book appeared. I think it is fair to say that psychiatry has not been the same since.

Responses to my work have varied from lavish praise to bitter denunciation. American psychiatrists quickly closed ranks against me. Official psychiatry simply dismissed my contention that (mis)behaviors are not diseases and asserted that I "deny the reality that mental diseases are like other diseases," and distorted my critique of psychiatric slavery as my "denying life-saving treatment to mental patients." Actually, I have sought to deprive psychiatrists of their power to involuntarily hospitalize or treat competent adults called "mental patients." My critics have chosen to interpret this proposal as my trying to deprive competent adults of their tight or opportunity to seek or receive psychiatric help. By 1970, I had become a non-person in American psychiatry. The pages of American psychiatric journals were shut to my work. Soon, the very mention of my name became taboo and was omitted from new editions of texts that had previously featured my views. In short, I became the object of that most effective of all criticisms, the silent treatment--or, as the Germans so aptly call it, Totschweigetaktik.

In Great Britain, my views elicited a mote favorable reception. Some English psychiatrists conceded that not all psychiatric diagnoses designate bonafide diseases. Others were sympathetic to the plight of persons in psychiatric custody. Regrettably, that posture rested heavily on the misguided patriotic belief that the practice of psychiatric slavery was less common in England than in the United States.

Not surprisingly, my work was received more …