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September 2, 1974

Might Makes the Metaphor

Author Affiliations

From the Department of Psychiatry, Upstate Medical Center, Syracuse.

JAMA. 1974;229(10):1326. doi:10.1001/jama.1974.03230480042026

RECENTLY, I participated in one of those now-fashionable symposia, in which a group of well-known (at least among their colleagues) psychiatrists enact the drama of Babel: each in his own jargon (largely incomprehensible to others) sets forth, in utter seriousness, the character, cause, and cure of mental illness. The meeting was heavy on biology, with elegant graphs and tables projected onto expensive screens demonstrating, with irrefutable scientific evidence, the genetic basis of alcoholism and antisocial personality.

My presence there was, I suppose, a symptom of the "schizophrenia" now affecting the psychiatric establishment itself. I refer to the fact that mental health professionals now display an equally intense interest in the view that mental illnesses are baffling brain diseases, and in the view that their names are malicious medical metaphors.

I do not smoke and usually do not mind if others do. However, as I was coming down with the flu