I've occasionally said that if unicorns don't exist, we can't have a real argument about what unicorns are like. But if that's right, how is Szaszian therapy possible? How can you practice psychotherapy if you don't believe in the existence of mental illness? An interview in Psychology Today has Szasz's wise response. He begins with this caveat:
My view is that there is no mental illness and
hence also no "therapy/psychotherapy." Therapy, then, is a particular
kind of human relationship (arrangement, contract), aimed at helping people
cope with their "problems in living." This makes it necessary to
reframe some of the questions you pose.
Here's part of Szasz's response to the interview's first question: "How would you
respond to a new client who asks: What should I talk about?'":
It was my practice to never meet with a prospective patient without
first speaking to him on the telephone. I used this opportunity to
ascertain the sort of help the client was seeking and to inform him of
the sort of assistance I was, and was not, offering. If these matters
are properly clarified, the question, "What should I talk about?" does
not arise, just as it does not arise in, say, the office of a divorce
lawyer meeting a client seeking a divorce. Nevertheless, a new client
may feel embarrassed, fearful, or tongue-tied for other reasons and
ask, "What should I talk about?" In such case I said, "How can I be of
help to you" or "What made you decide to come and see me (today)," or
This may seem underwhelming, but
my one dinner with Szasz was a highlight of my intellectual life.
Conversation that good doesn't even have to be called "therapy" to be
worth hundreds of dollars an hour.