Central to the identity of modern medical specialities, including psychiatry, is the notion of hypostatic abstraction: doctors treat conditions or disorders, which are conceived of as “things” that people “have.” Mad activism rejects this notion and hence challenges psychiatry’s identity as a medical specialty. This article elaborates the challenge of Mad activism and develops the hypostatic abstraction as applied to medicine. For psychiatry to maintain its identity as a medical speciality while accommodating the challenge of Mad activism, it must develop (...) an additional conception of the clinical encounter. Toward elaborating this conception, this article raises two basic framing questions: For what kind of understanding of the situation should the clinical encounter aim? What is the therapeutic aim of the encounter as a whole? It proposes that the concepts of “secondary insight” and of “identity-making” can allow the clinical encounter to proceed in a way that accommodates the challenge of Mad activism. (shrink)

In 2020, M. Summa developed a promising approach to understanding the concept of illness. This approach combines a theory of organisms with Responsive Phenomenology to gain a concept of illness. Following on from this, the present article shows that the normative presuppositions can be further explicated and justified by drawing on the theoretical resources of Aristotelian naturalism as propounded by Michael Thompson. Aristotelian naturalism does provide a theoretical option to grasp the normative foundations of human life. However, this article argues (...) that Aristotelian naturalism requires another criterion besides human nature to make the concept of illness intelligible. Following John McDowell’s critique of Aristotelian naturalism, it will be shown that this criterion consists in the capacity for autonomy. From this a concept of illness is developed which describes an impairment of the self-regulated and autonomous realisation of the human form of life. (shrink)

This article sets out key contributions to the long-running debate about mental disorder from the ordinary language philosophy of the ‘Oxford School’. The distinction between definition and use of concepts underpinning ordinary language philosophy reframes the debate as a debate not just about mental disorder but about disorder in general, bodily as well as mental. The field work of ordinary language philosophy (focusing on the use of concepts as a guide to their meanings) shows that, attempts at elimination notwithstanding, there (...) is an essential evaluative element in the meaning of disorder, bodily as well as mental. The concept of disorder in the debate thus reframed presents a double challenge for analysis: to explain why disorder has evaluative connotations used of mental conditions but descriptive connotations used of bodily conditions. Philosophical value theory, derived by applying ordinary language philosophy to the language of values, provides a rich resource of ideas for meeting this double challenge. It meets the double challenge at the level of theory by allowing both aspects of the double challenge of disorder to be derived from a logical property that disorder shares with all other value terms. It meets the double challenge at the level of practice by supporting the development of a new approach to working with values alongside evidence in healthcare called values-based practice. Ordinary language philosophy, notwithstanding these several contributions, is no panacea. It helps us to make a start, no more and no less, in understanding mental disorder. (shrink)