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.


Albert Ellis Thomas Szasz Rationality Mind Mental illness 


Compliance with Ethical Standards

Conflict of interest

I worked in New York with Albert Ellis in the 1970s and with Thomas Szasz in Syracuse (NY) intermittently from 1985 until his death in 2012. I organised lecture tours to Australia for Ellis in 1979 and Szasz in 1986. There are no other conflicts of interest to report.

Ethics Approval

This paper has been read and approved by the Chair of MGSM Ethics Committee, Macquarie University, Professor Steven Segal. No human subjects were involved in the preparation of this theoretical article.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: American Psychiatric Association.CrossRefGoogle Scholar
  2. Burstow, B. (2015). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave Macmillan.CrossRefGoogle Scholar
  3. Cohen, B. M. (2016). Psychiatric hegemony. London: Palgrave Macmillan.CrossRefGoogle Scholar
  4. Davies, J. (2013). Cracked: Why psychiatry is doing more harm than good. London: Icon Books.Google Scholar
  5. Ellis, A. (1957a). Rational psychotherapy and individual psychology. Journal of Individual Psychology, 13(1), 38–44.Google Scholar
  6. Ellis, A. (1957b). How to live with a neurotic. New York: Crown.Google Scholar
  7. Ellis, A. (1967). Should some people be labelled mentally ill? Journal of Consulting Psychology, 31, 435–436.CrossRefPubMedGoogle Scholar
  8. Ellis, A. (1973). Humanistic psychotherapy: The rational-emotive approach. New York: McGraw-Hill.Google Scholar
  9. Ellis, A. (1977) [1962]. Reason and emotion in psychotherapy. Secaucus, NJ: Citadel Press.Google Scholar
  10. Ellis, A. (1980). The fact of mental illness. Rational Living, 15(2), 13–19.Google Scholar
  11. Ellis, A. (2004). The road to tolerance. Amherst, NY: Prometheus Books.Google Scholar
  12. Ellis, A. (2010). All out! An autobiography. New York: Prometheus Books.Google Scholar
  13. Ellis, A., & Szasz, T. (1977). (DVD) A debate between Albert Ellis and Thomas Szasz: Mental illness, fact or myth?. Baldwin, N.Y.: William E. Simon.Google Scholar
  14. Hospers, J. (1956). An introduction to philosophical analysis. London: Routledge & Kegan Paul.Google Scholar
  15. Insel, T. (2013). Director’s blog: Transforming diagnosis. Retrieved from
  16. Jacobs, S. (1989). Karl Popper and Albert Ellis: Their ideas on psychology and rationality compared. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 7(3), 173–185.CrossRefGoogle Scholar
  17. Kirk, S. A., Cohen, D., & Gomory, T. (2015). DSM-5: The delayed demise of descriptive diagnosis. In S. Demazeux & P. Singy (Eds.), The DSM-5 in perspective: Philosophical reflections on the psychiatric babel. Dordrecht, NL: Springer.Google Scholar
  18. Kupfer, D. J. (2013). Chair of DSM-5 task force discusses future of mental health research. Public statement, released May 6.Google Scholar
  19. Kutchins, H., & Kirk, S. A. (1997). Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. London: Constable.Google Scholar
  20. Mead, G. H. (1934). In C. W. Morris (Ed.), Mind, self and society: From the standpoint of a social behaviorist. Chicago: Chicago University Press.Google Scholar
  21. Popper, K. R. (1972). Objective knowledge: An evolutionary approach. Oxford: Oxford University Press.Google Scholar
  22. Quine, W. V. (1951). Two dogmas of empiricism. The Philosophical Review, 60(1), 20–43.CrossRefGoogle Scholar
  23. Ryle, G. (1983) [1949]. The concept of mind. Harmondsworth: Penguin.Google Scholar
  24. Schaler, J. A. (Ed.). (2004). Szasz under fire: The psychiatric abolitionist faces his critics. La Salle: Open Court.Google Scholar
  25. Spillane, R. (1980). RET’s contribution: An argument for argument. Rational Living, 15(2), 3–7.Google Scholar
  26. Szasz, T. S. (1965). The ethics of psychoanalysis: The theory and method of autonomous psychotherapy. New York: Basic Books.Google Scholar
  27. Szasz, T. S. (1973). Ideology and insanity: Essays on the psychiatric dehumanization of man. New York: Marion Boyars.Google Scholar
  28. Szasz, T. (1987). Insanity: The idea and its consequences. New York: Wiley.Google Scholar
  29. Szasz, T. (1996). The meaning of mind: Language, morality and neuroscience. Praeger: Westport Connecticut.Google Scholar
  30. Szasz, T. (2004). Faith in freedom: Libertarian principles and psychiatric practices. New Jersey: Transaction Publishers.Google Scholar
  31. Szasz, T. (2007). The medicalization of everyday life. Syracuse, NY: Syracuse University Press.Google Scholar
  32. Szasz, T. (2008). Psychiatry: The science of lies. Syracuse, NY: Syracuse University Press.Google Scholar
  33. Szasz, T. S. (2010) [1961]. The myth of mental illness: Foundations of a theory of personal conduct. New York: Harper Perennial.Google Scholar
  34. Tolman, C. W. (Ed.). (1992). Positivism in psychology: Historical and contemporary problems. New York: Springer.Google Scholar
  35. Whitaker, R., & Cosgrove, L. (2015). Psychiatry under the influence: Institutional corruption, social injury, and prescriptions for reform. New York: Palgrave Macmillan.CrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.Macquarie Graduate School of ManagementMacquarie UniversitySydneyAustralia

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