The Myth of Mental Illness: The Feuchtersieben Version

Abstract

Ernst von Feuchtersieben is an eminent nineteen century Viennese psychiatrist who is almost completely ignored both by modern psychiatrists and historians of psychiatry. Flowever, he has recently been mentioned by Thomas Szasz who views him as his predecessor and ascribes to hiin his own thesis, namely, that mental illness is a mere myth (or at best a mere metaphor) which was introduced into psychiatry by Johann Heinroth. The present essay examines the question can Feuchtersieben be viewed as Szasz's forerunner. Szasz follows the individualistic principles rigorously and argues that all goal-directed individuals are autonomous—regardless of whether they stiffer while struggling towards their goals. Hence, Szasz excludes the mentally ill from the realm of medicine and renders immoral the psychiatrists who impose on them psychiatric diagnosis and treatment. For those who endorse in one and the same time both the principles of individualistic ethics and the common opinions concerning the autonomy of the mentally ill, the paradoxicality of the common opinions, in the light of Szasz's works, seems unsolvable. Feuchtersieben endorses (the Kantian version of) the individualistic ethics yet, sensitive to the paradox, he follows Solomon Maimon's critique of Kant and rejects, at times, Kant's dogmatic view of human freedom. He thus rejects both poles of the paradox as a myth (à la Lévi-Strauss) and offers an alternative approach instead of the paradoxical one. Fie recommends we view mental health and autonomy as regulative principles in the empirical domain. The physician, the educator, the clergyman and the legislator should cooperate in diagnosing and treating defects of both mental health and human autonomy. Szasz is therefore in error when he claims Feuchtersieben as his predecessor. The views concerning the mentally ill of these two are diametrically opposed. Moreover, I think Feuchtersleben's view is superior: indeed, whereas Szasz succumbs to or, at best, explains away the myths which prevail to the present day regarding the mentally ill, Feuchtersieben offers an explanation and a proposal of treatment.