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?

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.

If, nevertheless, textbooks of pharmacology legitimately contain a chapter on drug abuse and drug addiction, then, by the same token, textbooks of gynecology and urology should contain a chapter on prostitution; textbooks of physiology, a chapter on perversion; textbooks of genetics, a chapter on the racial inferiority of Jews and Negroes.

Religious and medical propaganda to the contrary notwithstanding, I hold some simple truths to be self-evident. One of these truths is that just as the dead do not rise from the grave, so drugs do not commit crimes. The dead remain dead. Drugs are inert chemicals that have no effect on human beings who choose not to use them. No one has to smoke cigarettes, and no one has to shoot heroin. People smoke cigarettes because they want to, and they shoot heroin because they want to.

In the natural sciences, language (mathematics) is a useful tool: like the microscope or telescope, it enables us to see what is otherwise invisible. In the social sciences, language (literalized metaphor) is an impediment: like a distorting mirror, it prevents us from seeing the obvious. That is why in the natural sciences, knowledge can be gained only with the mastery of their special languages; whereas in human affairs, knowledge can be gained only by rejecting the pretentious jargons of the social sciences.

Our adversaries are not demons, witches, fate, or mental illness. We have no enemy whom we can fight, exorcise, or dispel by "cure." What we do have are problems in living — whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. The field to which modern psychiatry addresses itself is vast, and I made no effort to encompass it all. My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.

My contention is that the psychiatric perspective on homosexuality is but a thinly disguised replica of the religious perspective which it displaced, and that efforts to “treat” this kind of conduct medically are but thinly disguised methods for suppressing it.

As the dominant social ethic changed from a religious to a secular one, the problem of heresy disappeared, and the problem of madness arose and became of great social significance. In the next chapter I shall examine the creation of social deviants, and shall show that as formerly priests had manufactured heretics, so physicians, as the new guardians of social conduct and morality, began to manufacture madmen.

Although both the natural and moral sciences seek to understand the objects of their observation, in natural science the purpose of this is to be able to control them better, whereas in moral science it is, or ought to be, to be better able to leave them alone. The morally proper aim of psychology, then, is self-control.