Friday, December 5, 2008

The Philosophy of Mental Illness: What's New?

It is time for me to update my entry in the Stanford Encyclopedia of Philosophy on Mental Illness. I wrote it originally in 2001, and I did some updates in the bibliography in 2005.

It has 3 main sections:

1. Does Mental Illness Exist?
2. Is There an Objective Way to Classify Mental Illnesses?
3. When are People with Mental Illnesses Responsible for Symptomatic Behavior?

I am reluctant to cut these, but it's clear that I could add many topics, and I would want to update the existing sections. But how to prioritize? One of the most obvious missing topics is on making sense of psychosis and delusions; another is on the relation between psychiatry and cognitive neuroscience. But what else?

I'd appreciate suggestions from others on this. One thing to keep on mind is that the topic is philosophy of mental illness rather than the philosophy of psychiatry, and the original idea behind this was that it was a narrower topic, although thinking about it now, it is not so clear to me why this should be so.


JohnZSadler said...

Because you're structuring around questions, how about these?

What does mental illness tell us about the mind (brain)?

What does mental illness reveal about human ontology or being?

Is the distinction between mental illness and physical illness legitimate?

How does mental illness relate to the self or personal identity? Is my illness a part of me, or is my illness not-me? Should it be one way or another?

Good luck Christian!

Jason said...

Hi Christian,

Two areas that struck me as possibly benefiting from further discussion when re-reading your Encyclopaedia entry were:

1. To what extent does any definition of “mental illness” require a corresponding definition of “mental wellbeing,” and how could the latter definition ever aspire to value-neutrality when it is likely so deeply connected with a widely variable array of culture- or historically-specific ideas? To elaborate, would it be suffice to define “mental wellbeing” purely on the basis of the absence of painful or maladaptive symptoms, thoughts and behaviors, or also in reference to the presence of positive qualities such as compassion, insight, and equanimity? In this vein, Buddhist psychologist Jack Kornfield writes half-seriously in his latest book (“The Wise Heart”) about a “reverse DSM” which would define diagnostic thresholds to classify the existence of lovingkindness, patience, and other traits classically cherished as objectives of Buddhist training.

2. On the disease model of addiction, is it valid to argue the heuristic case that if a sufficiently large grouo of addicts can overcome their addictive behavior by understanding and responding to their condition as a “disease” (as the success of Alcoholics Anonymous and other 12 Step groups arguably demonstrates) that this disease understanding thereby equates to disease classification? Counter-claims to this argument might cite the role of personal choice in the perpetuation of addiction. But against this is the argument that personality disorders also include a behavioral component while still warranting widespread acceptance as mental illnesses, so why dismiss addiction on behavioral grounds? Maybe addiction is a personality disorder?
--Jason Thompson

s said...

Hi Christian,

In the multiple personality section your discussion on Hacking's influence on the classification of mental illness can be expanded by including some of his most recent arguments (Hacking 2007, 2006)
We know that making a distinction between human and natural kinds, Hacking (1986, 1991, 1995, 1998,1999) suggested that looping effects due to self-awareness are the characteristic of human kinds, and this makes them different from natural kinds. He cited mental illness as an example of human kinds. In his recent works, however, he abandons the notion of 'kind' in trying to account for the relationship between the classifications of sciences and the people that are subject to those classifications. Instead of focusing only on the relationship between the classification and the classified, by using the notion of ‘human kind’ in understanding how people are made up, he suggests, we should conceptualize a framework for analysis, the parameters of which include classification, people, institutions, knowledge, experts (Hacking 2006, 2007).
I believe this change in his thought is important in the sense that it opens us a new window to see the differences/similarities between mental illnesses and physical illnesses.
One question I have been thinking about recently is whether we can understand both mental and physical illnesses in the the framework of these five parameters, and what it says about the distinctions we are accustomed to make.

Serife Tekin

Hacking, I. 2007. Natural Kinds: Rosy Dawn, Scholastic Philosophy of Science.Antony O’hear (ed.). Cambridge: Cambridge University Press.

Hacking I. 2006. Kinds of People: Moving Targets. British Academy Lectures, the text of the talk read 11 April 2006.

metapsychologist said...

I've discovered that some projected SEP entries cover some of these issues:
--delusion (Lisa Bortolotti)
--psychiatry, philosophy of (Dominic Murphy)
--psychopathology, philosophical (George Graham and G. Lynn Stephens)
That makes my life easier!