Online research in philosophy

The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question "How should I live?" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process.

Recently I wrote a review for the Louisville Courier-Journal newspaper of Professor Elyn Saks' memoir of life while secretly suffering from schizophrenia. I did not mention the parallels between my life and Professor Saks'. I also have a successful career as a law professor. I accomplished it while harboring the secret I have the severe mental illness bipolar disorder (formerly known as "manic-depressive illness"). Why did I hide my condition for so long? Mainly I kept quiet due to the fear of stigma. Sadly, people today stigmatize more than they did fifty years ago. They need to realize that a history of mental illness is not a moral failing, and that it is a chronic condition like any "physical" disease. Although most with severe mental illness pose no threat to anyone, stereotypes unduly link violence with mental illness. The vast majority of those with mental illness like Professor Saks and me are not violent; a very small portion of the level of violence in society is attributable to people with mental disorders. Why have I now chosen to tell my story? I write, as did Professor Saks, to show people can be effective members of society in high-level and often stressful jobs despite their psychiatric conditions. I wish to be accepted for who I am, a person with a full and satisfying professional and personal life, and not have to endure stigma or doubt as to my ability to perform. While not all with mental disorders flourish as Professor Saks and I have done, we show what is possible. How many other successful individuals with mental illness who for now remain silent, probably due to stigma concerns, are out there? Perhaps each of us should look at those in the offices next to us, or our friends and neighbors, and wonder which of these people secretly live with a severe mental condition.

Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real. CiteULike Connotea Del.icio.us What's this?

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.

Radical psychiatrists and others assert that mental illness is a myth. The opening and closing portions of the paper deal with the impact such argument has had in law and psychiatry. The body of the paper discusses the five versions of the myth argument prevalent in radical psychiatry: (A) that there is no such thing as mental illness; (B) that those called ?mentally ill? are really as rational as everyone else, only with different aims; that the only reasons anyone ever thought differently was (C) because of unsophisticated category mistakes or (D) because of an adherence to the epistemology of a sick society; and (E) that the phrase ?mental illness? is used to mask value judgments about others? behavior in pseudo?scientific respectability. Reasons are given for rejecting each of these versions of the argument that mental illness is a myth.

Conceiving mental disorder -- Disorder of mental disorder -- On being skeptical about mental disorder -- Seeking norms for mental disorder -- An original position -- Addiction and responsibility for self -- Reality lost and found -- Minding the missing me.

I shall begin with the "anti-psychiatry" view that the lack of a physical basis excludes many familiar mental disorders from the category of "illness". My response to this argument will be that anti-psychiatrists are probably right to hold that most mental disorders do not involve any physical disorder, but that they are wrong to conclude from this that these mental disorders are not illnesses.