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