On the Social Utility of Psychopathology

Nathaniel Pallone argues that, whatever else is true of psycho-pathology, it serves purposes which are socially useful. Whatever else is true of its clinical treatment, such treatment functions as a form of social regulation. In societal terms, such treatment may serve purposes quite other than the relief of psychological disease or even the remedy of psychological disorder. If psychopathology had not emerged naturally, society might have needed to engender psychopathogenic conditions both to fulfill socially useful purposes and to elicit that subtle mechanism for social regulation we term "psychotherapy." Pallone constructs his argument by summing up the evidence for two points which apply to all psychotherapeutic practice: that the relief of psychopathology is in no dependable way associated with psychotherapeutic treatment; and that in all schools of psychotherapy, the only clear-cut criterion for terminating treatment is the limit of the patient's financial resources.What surprised me in this manuscript is the stark simplicity with which Pallone constructs his argument [that] society acquires the license to create unlimited [psychological] disease, to define this disease as intolerable, to finance armies of disease alleviators providing 'treatments' that are in even more profound contradiction with each other than were the religions of old.... The illustration[s] make Pallone's argument crystal clear. - Ivan Illich, from the Preface