Introduction : the existence of mental illness -- The likeness argument -- The categorical argument -- Metaphor -- Two metaphors from physical medicine -- The metaphor of mental illness -- Attention deficit hyperactivity disorder, social construction, and metaphor -- Metaphors and models.

The very idea of mental illness is contested. Given its differences from physical illnesses, is it right to count it, and particular mental illnesses, as genuinely medical as opposed to moral matters? One debate concerns its value-ladenness, which has been used by anti-psychiatrists to argue that it does not exist. Recent attempts to define mental illness divide both on the presence of values and on their consequences. Philosophers and psychiatrists have explored the nature of the (...) general kinds that mental illnesses might comprise, influenced by psychiatric taxonomies such as the Diagnostic and Statistical Manual and the International Classification of Diseases, and the rise of a rival biological ‘meta-taxonomy’: the Research Domain Criteria (RDoC). The assumption that the concept of mental illness has a culturally invariant core has also been questioned. This book serves as a guide to these contested debates. (shrink)

Some illnesses, e.g. OCD and schizophrenia, corrupt the activity mediated by one's basic psychological framework but do not corrupt that framework itself. But some illnesses, e.g. psychopathy, corrupt that framework itself. Thus, whereas OCD and schizophrenia are structure-internal mental illnesses, psychopathy is a structural mental illness. Structure-internal mental illnesses can be alleviated, but structural mental illnesses cannot.

In this paper we aim to offer a balanced argument to motivate (re)thinking about the mental illness clause within the insanity defence. This is the clause that states that mental illness should have a relevant causal or explanatory role for the presence of the incapacities or limited capacities that are covered by this defence. We offer three main considerations showing the important legal and epistemological roles that the mental illness clause plays in the evaluation (...) of legal responsibility. Although we acknowledge that these advantages could be preserved without having this clause explicitly stated in the law, we resist proposals that deny the importance of mental illness in exculpation. We argue, thus, that any attempt at removing the mental illness clause from legal formulations of the insanity defence should offer alternative ways of keeping in place these advantages. (shrink)

In this surprising book, Allan V. Horwitz argues that our current conceptions of mental illness as a disease fit only a small number of serious psychological conditions and that most conditions currently regarded as mental illness are cultural constructions, normal reactions to stressful social circumstances, or simply forms of deviant behavior.

Practical and evidence-based, this unique book is the first comprehensive text focused on person-centered approaches to people with serious mental illness such as schizophrenia and bipolar disorder. It reflects a range of views and findings regarding assessment, treatment, rehabilitation, self-help, policy-making, education and research. It is highly recommended for all healthcare professionals, students, researchers and educators involved in general practice, psychiatry, nursing, social work, clinical psychology and therapy. Healthcare service providers, and policy makers and shapers, will find the (...) book's wide-ranging, multi-professional approach enlightening. 'Serious Mental Illness reflects a continued distancing from the outmoded and unsubstantiated belief that people with severe mental illnesses could not recover, and that they would respond positively only to goals and treatment plans chosen, designed and implemented by providers in order to prevent their further deterioration. Anyone with an interest in the concept of person-centered approaches will discover new ideas in this book. Indeed, anyone with an interest in person-centered approaches has to read this book. Not only is it the first such book on person-centered approaches, but it will serve as the gold standard in this topic area for years to come.' William A Anthony, in the Foreword. (shrink)

ABSTRACTSince 2004 in Australia, there has been a significant amount of interest in the issues of lawyers and mental illness. As a result there is now a substantial body of literature that examines...

In this paper I explore the way that mental illness stigma impacts epistemic credibility in people who have mental illness. While any kind of stigma has the potential to discredit a person’s epistemic agency, in the case of mental illness the basis for discrediting is in some cases and to some extent justifiable, for impairments in rationality, control, and reality perception can indeed be obstacles to participating appropriately in epistemic activities such as normal conversation (...) and public discourse. People with mental illness are still potentially subject to epistemic injustices, however, especially when we rely on stereotypes and fail to make complicated and nuanced judgments which are more accurate. In this paper, I explain some of the ways that people with mental illness may be subject to epistemic injustices, and I propose some suggestions for how epistemic injustice can be avoided. (shrink)

pSara Ahmed’s emWillful Subjects/em develops an account of willfulness as a site of simultaneous oppression and resistance: a diagnosis attributed to particular (not-quite-)subjects and to modes of behavior that are thereby diminished, pathologized, and controlled, and a “diagnosis” that may be positively affirmed as a way of living and doing otherwise. This essay puts Ahmed’s work on willfulness in conversation with María Lugones’ decolonial feminism, particularly her theory of active subjectivity. With Lugones, we offer, one can better understand the resistant (...) potential of willfulness, not simply as the willful subject possessing an oppositional “will of her own” (which risks reinscribing a unitary notion of the self), but rather, as exercising a different kind of subjectivity altogether—one that relies on multiplicity and arises through relationships across non-dominant difference. Extending the connections that Ahmed herself draws between willfulness and “madness,” we further explore the willful elements in experiences relating to mental illness and cognitive disability, categories of experience that we understand to be important (and undertheorized) aspects of what Aníbal Quijano has termed “the coloniality of power.”/p. (shrink)

Often understood as a dissolution of the ego, mental illness implies a process of deconstruction where the psychotic faces the most frightening limits one can encounter: the limits of perception, the limits of understanding, the limits of vulnerability, and above all, the limits of intersubjectivity. The present paper aims to explore mental illness phenomenologically, taking it as both a limited and an unlimited experience of intersubjectivity. On the one hand, mental illness is widely regarded (...) as a limited experience of intersubjectivity, for it alters and hence limits access to the Other. But on the other hand, it can equally be taken as an unlimited experience of intersubjectivity, because it opens up a new world to the psychotic that can be transposed into and improved through artistic expression. The present article will bring together these two dimensions in order to reflect on the limits of experience in general. To do so, I will first address the clinical studies of the analyst Marguerite Sechehaye and of Rosemarie Samaritter. By retracing Marguerite Sechehaye’s deconstruction of the ego in a case of schizophrenia that she successfully treated, I attempt to circumscribe three distinctive experiential layers that have been disturbed by her patient’s mental illness: (1) the affective layer, (2) the symbolic layer, and (3) the kinesthetic layer, which is indicative of the fact that our spatial presence and body movements are constitutive elements of our sense of self and of our being in the world. Second, I will focus on the relationship between art and schizophrenia, and subsequently on the limits of experience that a psychotic transcends when undergoing his/her illness. (shrink)

The intellectual journey on which I am about to embark, although not an unusual one in philosophy, may at first seem strange to those who are in the habit of looking to science for the answers to their big questions, including their philosophical questions. For I propose to shed light on the problematic relationship between two things, namely, mental illness and physical illness, by comparing their relationship to the relationship between two other things, namely, a rhyme for (...) the eye—which will be explained shortly for the benefit of anyone unfamiliar with this concept—and a rhyme for the ear. Yet these two pairs of things are not related in any way by subject-matter. In philosophy, however, this sort of deliberate dislocation can be beneficial. As Wittgenstein himself once remarked, ‘A philosophical] problem can be solved only in the right surrounding, we must give the problem a new surrounding, we must compare it to cases we are not used to compare [sic] it with.’. (shrink)

As a contribution to a wider discussion on moral discernment in theological anthropology, this paper seeks to answer the question “What is the impact of mental illness on an individual’s ability to make moral decisions?” Written from a clinical psychiatric perspective, it considers recent contributions from psychology, neuropsychology and imaging technology. It notes that the popular conception that mental illness necessarily robs an individual of moral responsibility is largely unfounded. Most people who suffer from mental (...) health problems do not lose the capacity to make moral decisions, and mental illness on its own rarely explains anti-social or criminal behaviour. Moreover, the assumptions of some scientists, that recent developments in neuropsychology and brain imaging suggest biological determinism, must be treated with caution. (shrink)

Can existential themes, such as anxiety, the will to die, or our simultaneous will to live forever be logically described? Does a literary language or philosophical and psychiatric term exist that can express phenomena nonreferential to the external world? In short, does a genre exist that can redefine the relationships between symbol and meaning? Drawing upon various theoretical perspectives developed by Michel Foucault, Ludwig Binswanger, Gaston Bachelard, and Karl Jaspers, this paper discusses the ability to depict life as we are (...) living it, whether it is a product of mental illness or a matter of normal schizophrenic imaginings. (shrink)

We often hear that certain mental disorders are disorders of the brain, but it is not clear what this claim amounts to. Does it mean that they are like classic brain diseases such as brain cancer? I argue that this is not the case for most mental disorders. Neither does the claim that all mental disorders are brain disorders follow from a materialist world-view. The only plausible way of understanding mental disorders as brain disorders is a (...) fairly modest one, where we label brain differences we find in mental illness as pathological based on their link to mental dysfunction. How many mental disorders will turn out to be brain disorders on this understanding is an empirical question. (shrink)

Philosophy of Mental Illness The Philosophy of Mental Illness is an interdisciplinary field of study that combines views and methods from the philosophy of mind, psychology, neuroscience, and moral philosophy in order to analyze the nature of mental illness. Philosophers of mental illness are concerned with examining the ontological, epistemological, and normative issues arising from […].

In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris (...) to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. (shrink)

PERRON A and HOLMES D. Nursing Inquiry 2011; 18: 191–204Constructing mentally ill inmates: nurses’ discursive practices in correctionsThe concepts of discourse, subjectivity and power allow for innovative explorations in nursing research. Discourse take many different forms and may be maintained, transmitted, even imposed, in various ways. Nursing practice makes possible many discursive spaces where discourses intersect. Using a Foucauldian perspective, were explored the ways in which forensic psychiatric nurses construct the subjectivity of mentally ill inmates. Progress notes and individual interviews (...) constitute discursive spaces within which nurses construct patients’ subjectivities. Progress notes provide a written (and permanent) form of discourse, while interviews set the space for a more fluid and contextual form of discourse. We identified five types of subjectivities – the (in)visible patient, the patient as risk, the deviant patient, the disturbed patient and the disciplined patient. These subjectivities were rooted in various types of discourses circulating in the selected setting. Despite the multiple discursive dimensions of forensic psychiatric nursing, progress notes remain the main formal source of information regarding nursing care even though it is not representative of the care provided nor is it representative of nurses’ complex discursive practices in corrections. (shrink)

WHO suggests mental ill health in terms of depression to be the highest ranking disease problem in the developed world in 2020–2030 and claims a public health approach to be the most appropriate response. But some argue that the alarming reports on mental ill health have their ground in the methods of inquiry themselves and refer to medicalization as an important issue. The aim of this article is to explore and illuminate the issue of what is meant by (...) mental health and mental ill health and what it means that mental ill health is a major public health problem. Basically, two understandings and aspects of public health exist: a ‘reductionist’ and a ‘holistic’ with connections to different theories of health. These diverging understandings may lead to quite different public health responses, and they may have different consequences with regard to medicalization. It is concluded that we need more clearly elaborated ways to think about public health so that the increased attention to mental ill health as a public health problem does not in itself lead to medicalization in terms of just medical treatment. Otherwise, we risk losing the importance of public health as an overarching social and political instrument. (shrink)

This book is psychiatry's reply to the diverse group of antipsychiatrists, including Laing, Foucault, Goffman, Szasz and Bassaglia, that has made fashionable the view that mental illness is merely socially deviant behaviour and that psychiatrists are agents of the capitalist society seeking to repress such behaviour. It establishes, by the use of evidence from historical and transcultural studies, that mental illness has been recognised in all cultures since the beginning of history and goes on to explore (...) the philosophical and medical basis for psychiatry's diagnosis and treatment of mental illness. Finally, it tackles two issues where psychiatry has recently been seen as at odds with the values prevailing in society: involuntary hospitalization and the insanity defence. The Reality of Mental Illness does not pretend to offer simple answers to the complex problems it discusses, but will leave the reader with a much greater understanding of psychiatry's aims, practices and problems. (shrink)

How might critical realism provide a better metatheoretical framework to understand the complex causality behind experiences of mental illness? How do we understand the agency of people suffering from mental illness? Prior work on critical realism and disability has argued that critical realism helps move past one or another form of reductionist explanations for illness, whether that is biological, environmental or psychological. But using a critical realist framework to study mental illness also raises (...) issues about the agency of people whose rational capacities are thought to be diminished. In this article, I present the life history of one of 26 young adults I interviewed as part of a project on resilience. Because interviews reveal the complex causal forces in any person's life, they remind us that scientific explanations should not be reductionistic. Human agency can be diminished by biological illness, power structures in psychiatry, and cultural categories of mental illness diagnoses. But a critical realist framework allows me to explore how people who experience mental illness still exercise their capacity to reflect on the moral ends to which to direct their actions. (shrink)

This article provides an overview of current knowledge about the relationship between mental illness, violence, homicides, and suicides, with a view towards crafting sensible public policy options for reducing gun violence towards self or others. With this knowledge as a backdrop, the limitations of the federal National Instant Background Check System as both over-inclusive and under-inclusive in identifying people with mental illness who pose potential risks are discussed. Finally, the article describes emerging approaches for identifying and (...) removing firearms from persons who pose potential risks of gun violence towards self or others, including Extreme Risk Protection Orders and other options. (shrink)

Hegel reads the poet Novalis as an expression of terminal irony, a pathological case of Gemüt, where the conscious mind is alienated from reality and turns its negativity inwards on the contents of its own natural soul. The condition of self-feeling, presented in Hegel’s “Anthropology”, is a self-consumption that manifests itself somatically in the physical disease (consumption) from which Novalis dies. The poet’s literary production represents a pathological fixation that impedes the dynamic organicity of Hegelian Science. As such, Novalis’s (...) class='Hi'>mental illness and death constitute an expression of romantic irony and an ongoing threat to Hegel’s philosophy. (shrink)

There has been considerable recent philo- sophical work on the nature of mental illness. Two..

Psychiatrists assert that mental illness is a physiological brain disorder. The anti-psychiatry movement refutes this on grounds of lack of evidence claiming that mental illness is socially defined. Len Bowers offers a rational, objective and philosophical critique of the theories of mental illness as a social construct and concludes that, though sometimes misguided, they cannot be wholly rejected. This critical scrutiny of a controversial and keenly-debated issue will be of interest to psychologists, social workers, (...) psychiatrists, sociologists and professionals in paramedical disciplines. (shrink)

This seminal early work of Foucault is indispensable to understanding his development as a thinker. Written in 1954 and revised in 1962, _Mental Illness and Psychology _delineates the shift that occurred in Foucault's thought during this period. The first iteration reflects the philosopher's early interest in and respect for Freud and the psychoanalytic tradition. The second part, rewritten in 1962, marks a dramatic change in Foucault's thinking. Examining the history of madness as a social and cultural construct, he moves (...) outside of the psychoanalytic tradition into the radical critique of Freud that was to dominate his later work. _Mental Illness and Psychology _is an important document tracing the intellectual evolution of this influential thinker. A foreword by Foucault scholar Hubert Dreyfus situates the book within the framework of Foucault's entire body of work. (shrink)

This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as “mental illness,” take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its (...) members within posthuman emotional ecologies in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that “uncivilizes” mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health. (shrink)

Disability scholars have argued that the disadvantage of disability is caused primarily by social factors and calls out for social change as a matter of justice. But what about psychiatric disability? While noting several factors that make psychiatric disability a special casethe mentally ill individuals unreliability of judgment and instability of functioningSara Goering argues that much is gained by viewing mental illness through the lens of social oppression and workingtoward recognition of individuals with mental illness as (...) equal members of the human community. (shrink)

Mental Illness in Ancient Medicine: From Celsus to Paul of Aeginatraces the history of conceptions of mental disorder in Graeco-Roman medical writings, from the 1st century BCE to the 7th CE, with detailed studies of all significant authors.

I present a dilemma which depressive behavioral pathology poses for both Humean and non-Humean theories of motivation and value. Although the dilemma shows that neither theory can be considered adequate in its standard form, I argue that if the Humean theory is modified so as to embrace a richer notion of satisfaction than it currently does, it can solve the problem which depression poses for it and, thus, the dilemma can be avoided. Embracing a richer notion of satisfaction not only (...) solves this problem, it also extends the scope of the Humean theory in a potentially dramatic way, by extending the explanatory reach of moral psychology to issues often thought to fall outside its scope, namely, issues in moral psychopathology. (shrink)

The status of photography within medical arts or humanities is still insecure. Despite a growing number of published photographic essays that disclose illness experience of an individual and how illness affects close relatives, these works have received relatively little scholarly attention. Through analysis of Joshua Lutz’s Hesitating Beauty which documents his mother who was suffering from schizophrenia, this article will explore how the photographic essay attempts to reconstruct a dialogue between mother and son out of fragmented, broken and (...) undeveloped communications, and in the process how it challenges representation itself, on which it is dependent. The focus of the analysis is on identifying and illuminating the intimate space that opens between the photographer and the photographed person and that provides new forms of communication as well as uncovers existing forms of knowledge that is shared between them. This paper will also assess the political and cultural significance of such representation. (shrink)

sirThis is the third time hospitalised mentally ill patients have voted in Israeli elections.In 1996 the law was changed so that patients, including those in psychiatric hospitals, could participate in elections while hospitalised.Until that year, hospitalised patients could participate in elections only if released from the hospital to vote at their local polling stations.The ability of mentally ill patients to participate in the democratic process has aroused interest over a long period of ….

When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers treating her are (...) obligated to try to stop her. Yet it has been suggested that death by suicide can be a part of the natural course of a severe mental illness. Accordingly, if the perceived naturalness of the deaths occurring in connection with non-voluntary passive euthanasia speaks for their moral permissibility, it could be taken that a similar reason can support the moral acceptability of the suicidal deaths of non-competent psychiatric patients. In this article, I consider whether the suicidal death of a non-competent psychiatric patient would necessarily be less natural than those of physically ill or injured patients who die as a result of non-voluntary passive euthanasia. I argue that it would not. (shrink)

This chapter offers a novel defence of Szasz’s claim that mental illness is a myth by bringing to bear a standard type of thought experiment used in philosophical discussions of the meaning of natural kind concepts. This makes it possible to accept Szasz’s conclusion that mental illness involves problems of living, some of which may be moral in nature, while bypassing the debate about the meaning of the concept of illness. The chapter then considers the (...) nature of schizophrenia and the personality disorders (PDs) within this framework. It argues that neither is likely to constitute a scientifically valid category, but that nonetheless their symptoms can be scientifically explained. It concludes with a discussion of the way in which Cluster B or ‘bad’ PDs involve failures of virtue or character, and argues that this does not preclude them from being appropriately treated within contemporary, multidisciplinary, mental health services. (shrink)

This paper will explore both the ways in which the practices of self-care, specifically related to mental health, have emerged as responses to the increasingly precarious status of life after the economic shocks of the Global Financial Crisis, whilst also looking to the work of Silvia Federici and Kathi Weeks to propose models for immanent critique of these practices. Although it cannot be taken as a pure origin, post-GFC mental health discourse has increasingly seen mental health discussed (...) as a form of resilience to precarity. Furthermore, practices of self-care, and psychological forms of treatment such as cognitive behavioural therapy have become vehicles for the intensification of personal resilience in the face of systemic crisis. If self-care involves an inward looking and depoliticised subject, surely political emancipation lies elsewhere. The possibility of some alternative to our present state of affairs, where self-care increasingly appears as a form of ‘voluntary servitude,’ that is to say, a form of self-subjugation with serious political risks, must surely be taken as a continual project for those engaged in critical inquiry. Then again, to suggest that those engaging in self-care are simply reproducing neoliberal subjectivity would surely miss the ways in which such forms of self-preservation might appear as unavoidable for the individuals in question. Through an engagement with their work—and one that draws parallels between their strategic critiques of reproductive labour broadly speaking, and the more specific area of mental illness and neoliberal governmentality—the question of the “necessity” of self-care will be brought into alignment with the possibilities of its practicality. (shrink)

Thomas Szasz has wrestled with the following question: Does mental illness even exist? Here, I sketch two provocative papers by Szasz and detail his reasons for criticizing the concept ‘mental illness.’ I will proceed to highlight where I think Szasz’s writing is philosophically dubious, despite its role in forcing us to think critically about ‘mental illness.’ I will conclude that his argument is best left behind as an antiquated take on neurodivergence. Finally, I will (...) propose what I think is a more promising alternative to Szasz’s view that there is a myth around mental illness. There is a myth indeed, and it involves what is often meant by ‘mental.’ With new developments in embodied cognition, I will ask us to revisit the concept of ‘mental illness,’ to correctly diagnose the problematic myth that must be confronted by the psychiatric community, and to explore what the myth of the mental means for neurodivergence. (shrink)