By pretending that convention is Nature, that disobeying a personal prohibition is a medical illness, they establish themselves as agents of social control and at the same time disguise their punitive interventions in the semantic and social trappings of medical practice.

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The concept of disease is fast replacing the concept of responsibility. With increasing zeal Americans use and interpret the assertion "I am sick" as equivalent to the assertion "I am not responsible": Smokers say they are not responsible for smoking, drinkers that they are not responsible for drinking, gamblers that they are not responsible for gambling, and mothers who murder their infants that they are not responsible for killing. To prove their point — and to capitalize on their self-destructive and destructive behavior — smokers, drinkers, gamblers, and insanity acquitees are suing tobacco companies, liquor companies, gambling casinos, and physicians. Can American society survive this legal-psychiatric assault on its moral and political foundations?

Like Karl Kraus, [Wittgenstein] was seldom pleased by what he saw of the institutions of men, and the idiom of the passerby mostly offended his ear—particularly when they happened to speak philosophically; and like Karl Kraus, he suspected that the institutions could not but be corrupt if the idiom of the race was confused, presumptuous, and vacuous, a fabric of nonsense, untruth, deception, and self-deception.

It is customary to define psychiatry as a medical specialty concerned with the study, diagnosis and treatment of mental illnesses. This is a worthless and misleading definition. Mental illness is a myth. Psychiatrists are not concerned with mental illnesses and their treatments. In actual practice they deal with personal, social and ethical problems in living. I have argued that, today, the notion of a person "having a mental illness" is scientifically crippling. It provides professional assent to a popular rationalization — namely that problems in living experienced and expressed in terms of so-called psychiatric symptoms are basically similar to bodily diseases. Moreover, the concept of mental illness also undermines the principle of personal responsibility, the ground on which all free political institutions rest.

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Parents teach children discipline for two different, indeed diametrically opposed, reasons: to render the child submissive to them and to make him independent of them. Only a self-disciplined person can be obedient; and only such a person can be autonomous.

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The episode in Sodom is undoubtedly the earliest account in human history of the entrapment of homosexuals, a strategy widely practiced by the law enforcement agencies of modern Western countries, especially those of the United States. In effect, the men of Sodom were entrapped by two strangers, who in truth were not travelers but angels, that is to say, God’s plain-clothesmen. These agents of the Biblical vice-squad wasted no time punishing the offenders.

The gist of my argument is that men like Kraepelin, Bleuler and Freud were not what they claimed or seem to be—namely, physicians or medical investigators; they were, in fact, religious-political leaders and conquerors. Instead of discovering new diseases, they extended, through psychiatry, the imagery, vocabulary, jurisdiction, and hence the territory of medicine to what they were not, and are not, diseases in the original Virchowian sense.