IN THE 1950 DEBUT of "What's My Line," one of the panelists was a psychiatrist named Dr. Richard Hoffman. Producer Gil Fates explained the selection as follows: "We figured if as a psychiatrist he could probe the deepest secrets of a patient's libido, as a panelist he wouldn't have too much trouble with a contestant's occupation, but it didn't work out that way."
That may have been the first time a television producer attributed magical powers to a psychiatrist, but it certainly was not the last. Nor has the situation improved any in the ensuing 35 years. From entertainment to news, television is enthralled, awe-struck, and dazzled by the mysteries of virtually anything that smacks of psychiatry or psychology.
In television series we have endless examples of docu-dramatized antisocial acts psychologized and psychoanalyzed with the inescapable conclusion that perpetrators of terrible acts such as child abuse or murder are in need of "help" -- i.e. psychiatric help.
Any television viewer who makes a habit of watching morning news shows, talk shows, and news-magazine shows is bound to think we are a country suffering an epidemic of psychiatric "illnesses." This year viewers of such shows have witnessed a seemingly endless parade of psychiatric experts informing us about "compulsive gambling," "eating disorders," "anxiety disease," and even jogging, working, shopping, and sex "compulsions" and "addictions." And so it goes, on and on.
Many of the conclusions stated on these shows are stunning. Witness just a few from shows so far this year:
*"Over 12 million Americans suffer from some form of anxiety disease." -- Hugh Downs on "20-20"
*"(There are) more than 2,000 cases of multiple personality . . . illness." -- Mike Wallace on "60 Minutes"
*"We have an awful lot of people out there who are suffering biochemical disorders of the brain for which they have no responsibility." -- Phil Donahue These quotes have much in common:
*Every one is a statement made on a show that makes a pretense of being "news" rather than "entertainment."
*Each statement reflects the views of orthodox psychiatric "experts."
*All of these statements present as scientific "fact" what might well be only a scientific fiction. Watching these shows, no one would ever know that in the professional journals of mental-health workers, civil libertarians, lawyers and even psychiatry itself there is increasing controversy whether, in either scientific or legal terms, "mental illness" can be meaningfully said to exist.
This view holds that for an "illness" to be scientifically meaningful, it must somehow be capable of being approached, measured or tested in a scientific fashion, as through a blood test or an electroencephalograph. If it cannot be so measured -- as is the case of most of what is termed "mental illness" -- then the phrase "illness" is at best a metaphor and at worst a myth, and that therefore "treating" these "illnesses" is an equally amorphous and unscientific enterprise.
Further, this view holds, those psychiatrists who, on television, claim to have discovered, named and cured a brand new "mental illness" every other week, carry with them onto the airwaves an unspoken assumption. That assumption is that the "mental illness" they say their patient suffers from is deterministic -- that it forces these patients to act in the unpleasant ways they do. And we have never seen a talk show host challenge that assumption. Never have we seen even a suggestion to one of these psychiatrists that perhaps his patient's behavior is simply rewarding to the individual while being reprehensibly antisocial.
Before the surgeon general issued a report connecting smoking and lung cancer, exhaustive research was done establishing at least an extremely high probability that the two were connected. That is how a physical disease was treated -- through observation and empirical proof. Yet when psychiatrists assert the existence of a new mental "disease," where is the empirical evidence to support the claim? If we are to consider mental disease to be like physical disease, we ought to have biochemical or pathological evidence. Otherwise, mental diseases are not just like physical diseases and should not be so considered.
On television, everything can now be a psychiatric "illness" as long as there are psychiatrists willing to "diagnose" and "treat" it. The behavior some psychiatrists call "impulse disorders" is a case in point. These involve any of a seemingly bottomless pit of behaviors which are enjoyable or rewarding (such as eating, gambling or working long hours), but which, when indulged in to excess, may result in pain to the individual or his family.
Talk shows from "Hour Magazine" to "Donahue" as well as the news and entertainment shows like "Today" and "Good Morning America" regularly present reports and interviews with psychiatrists and psychologists on the latest behavioral "ailments." The doctors -- MDs and PhDs -- invariably label the behaviors as "illnesses" which are therefore uncontrollable and comparable to alcoholism or drug addiction. Child molesters and murderers are thus depicted as poor "patients" who are not responsible for their "sick" behavior.
There is never any attempt made on the part of the television hosts to force these "experts" to present the evidence that allegedly demonstrates the presence of disease. Nor do the television personalities ask for evidence that e people are, in fact, unable to control their behavior. We are given only the self-evident "proof" that people who engage in such "sickening" behavior could not willingly do such horrible things to themselves or others. The audience is led to believe that such "victims of disease" are worthy of the public's sympathy and financial support.
It is important to keep in mind that while the discovery of a new medical disease, such as AIDS, is a rare event, hardly a month passes without the discovery of a new "mental disease" -- or the discovery that a condition once considered a mental disorder by psychiatrists (such as homosexuality) no longer is a disease.
This phenomenon, of course, feeds the news media's insatiable hunger for "news," especially "scientific breakthroughs." Psychiatry and television are thus made for each other, each pandering to the other's superficial and sensationalistic approach to the age- old dilemmas of the human condition.
The Donahue show provides some revealing illustrations regarding two of the newly discovered "diseases": "pathological gambling" and "sexual addiction."
Phil Donahue has endeared himself to the American public with his style of cutting through to the heart of controversial issues, but his hard-nosed skepticism stops at the door of psychiatric disorders. When he interviewed former Baltimore Colt, Art Schlichter, who gambled away more than $600,000 as a result of the "disease" of "pathological gambling," one expected some tough questions for Schlichter and his doctor, psychiatrist Robert Custer.
Instead, "pathological gambling" was conclusively presented as a "disease" that causes people to gamble uncontrollably. Schlichter and Custer offered no evidence that could lead to the conclusion that the behavior was caused by anything that could be reasonably termed "disease." They only presented the social and financial problems often caused by irresponsible gambling.
Yet, at no point did Donahue question the nature of this "disease" or the conclusion that Schlichter could not control himself. Nor did Donahue think to ask -- if Schlichter in fact had no control over his behavior -- how he managed to avoid betting on his own team's games, which would have probably resulted in his expulsion, not just suspension, from the National Football League.
Indeed, Donahue was so convinced, he himself volunteered that "this is a disease which has ended marriages and lives." He showed nothing but sympathy for his guest and his callers who claimed to be similarly afflicted.
In a Donahue show on "sexual addiction" psychologist Patrick Carnes, discoverer of this "disease," claimed that certain excessive sexual behaviors (including nymphomania and sometimes rape) were "illnesses." ("J. R. Ewing is our nation's leading untreated sex addict," said Carnes.) He did admit that there was no way to biologically distinguish between sexual addicts and non- addicts, but said that "one of the ways that you can tell if an addiction is there is when . . . it is more important to have that behavior than your family's welfare, their job, their values."
Despite these blatantly non-medical diagnostic criteria, Donahue, true-to-form on matters psychological, never challenged Carnes on his allegation that this was an "illness." Neither did he question any claims that these so-called "addicts" have no control over their sexual behavior. Nor did he raise the possible danger of the use in court of sexual-addiction defenses, already being raised in some rape cases.
However deferential Donahue may be to psychiatrists and psychologists, it is ABC's "20-20" which wins the competition as the least inquisitive on mental health matters. There appears to be no human problem that "20-20" is not willing to present as a sad and disturbing "mental illness" currently being "treated" by a miraculous new "cure." "Anxiety disease" was the most recent such item, consistently portrayed as an authenticated disease, like any other.
When Barbara Walters interviewed John Hinckley's parents last year, almost as an afterthought, she asked if the Hinckleys had anything to say to James Brady or the other shooting victims. Hinckley said that he hoped they could "accept the fact that John did it because of this illness . . . ."
When a cancer victim or a diabetic commits a crime, physicians do not claim their illness made them do it. Yet psychiatrists would have you believe that mental illness is an illness "like any other illness" and that therefore no blame can be attached to those who suffer from it. At the same time, they insist that this "disease" is different from all other diseases in that it affects the mind, and thus compels victims to do the nasty and illegal things they often do. They conclude that the lack of blame associated with having this "disease" should be extended to the behavior that makes this disease unlike all other diseases.
Yet Walters did not ask -- no television personality ever asks -- why, if schizophrenia is "like any other illness," "it" compels its victims to attempt murder.
Hugh Downs is the perfect complement to Barbara Walters. He served on the insanity- plea review panel of the National Mental Health Association, the only major national panel, including the one appointed by the American Psychiatric Association, to recommend retaining the plea as currently constituted. On one "20-20" segment Downs reported, simply, "The insanity plea is a valid plea."
In a recent "20-20" story on Electroconvulsive Therapy (ECT) or shock therapy, ABC's usually excellent medical expert, Dr. Tim Johnson, presented conflicting evidence on the effects of ECT, yet summarized it as proving shock treatment "medically very safe." But neither the evidence available on the issue nor the evidence presented on the program itself would have warranted so favorable a conclusion. Moreover, nowhere in the story was there any discussion of the psychiatric use of ECT where adequate information on the risks was not provided to the patients, or worse, of the coercive use of ECT, the administering of shock therapy to people who do not want it.
Perhaps the most surprising fact one finds in looking at television's love affair with psychiatry is that not even TV's top interviewer, Ted Koppel, is immune to what we now offer as a new disease: "inquisitorial paralysis," or almost total inability to ask psychiatrists tough questions. A recent "Nightline" focused on a National Institute of Mental Health (NIMH) study purporting to measure the extent of psychiatric "illnesses" afflicting the American public.
Reciting the NIMH's "findings" that about 20 percent of the American public is suffering from demonstrable "mental illness," giant-slayer Ted Koppel meekly acquiesced, relating as fact the shocking NIMH "discovery" that "29 million adult Americans suffer from some form of mental illness." Koppel asked no questions about the validity or accuracy of the surveys, but did indicate his awe at discussing "these terribly complex mental diseases."
The willingness, perhaps even eagerness, on the part of the network reporters to be gulled by psychiatric explanations of human beings and their problems is astonishing -- especially given their well-earned reputations for hard-hitting investigative analyses in other areas of public concern in their efforts to satisfy the public's "right to know."
Perhaps television thrives on controversy and debate only in politics. There is a wide- spread public belief that people whose behavior is harmful to themselves or others could not be freely choosing to do what they do, but must instead be in the grips of some disease that psychiatrists can diagnose and cure. But until the television journalists stop sighing with wonderment at psychiatric "diagnoses" and "treatments" and start challenging the "experts," the public will not wake up and see that the psychiatric emperor has no clothes. $90By Richard E. Vatz, Lee S. Weinberg and Thomas S. Szasz; Richard Vatz is associate professor of rhetoric and communication at Towson State University in Baltimore. Lee Weinberg is associate professor of legal studies at the University of Pittsburgh. They are the authors of "Thomas Szasz: Primary Values and Major Contentions." Szasz, professor of psychiatry at the State University of New York in Syracuse, is the author of "The Myth of Mental Illness."