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Are Mental Illnesses Natural Kinds or are they Socially Constructed? February 18, 2009

Posted by daw0157 in Medicine, Science & society, Social science.
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This post is coming a bit late after my presentation on mental illnesses way back on 18 Dec 2008.  With the rather large gap between presentation and post, I think it will be worthwhile to recap both the material presented and the flow of the lively discussion we had.

The question that I tried to explore and explain was the notion of mental illnesses, and whether or not they would be considered natural kinds (they happen because they happen) or socially constructed (as a society, they were created to fill some role or need).  This question is important because as we define and categorize mental illness in the United States right now, about 1/4 of the population(*1) over 18 years old suffers from a diagnosable mental illness.  Having a better understanding of these mental illnesses is beneficial to many different aspects of our life, from how we understand them, to how we treat the illness, to how we treat the person afflicted with the illness.

I started the presentation by asking the class if anyone had ever heard of depression.  The unanimous decision was that the class had heard of it, and was under the assumption it was truly a natural kind of mental illness.  Next I asked if the class had heard of Drapetomania, and of course no one had, because Drapetomania is no more than Louisiana’s attempt at scientific racism.

The example is a little ridiculous and in the debate of mental illnesses and their validity as natural kinds, depression is very well understood to be natural and something like Drapetomania could not be any more socially constructed. I used this example for the sole reason of drawing two lines in the sand to show the great range between illnesses that would be discussed.

There are a few unique positions that have been well researched and documented. These “sides” of the argument have proven to encapsulate the general opinions of people who have attempted to propose solutions to the problem.

The first opinion would be that of Thomas Szasz. According to Szasz the mainstream view in the West is that the changes in our description and treatment of mental illnesses are a result of our increasing knowledge and greater conceptual sophistication. On this view, we have conquered our former ignorance and now know that mental illness exists, even though there is a great deal of further research to be done on the causes and treatment of mental illnesses.

The strongest opposing view of mental illnesses being natural kinds is led by the philosopher Dominic Murphy. According to Murphy mental illness is a concept like pest, weed, and vermin. Weeds and vermin are not natural kinds, but they are made up of natural kinds that can be explained empirically. Furthermore, whether something counts as a weed or a vermin depends on human interests in a way that allows the class to grow over time, or vary across projects. Concepts that are sensitive to human interests in this way are open-ended — things may fall into them (or drop out of them) as human interests change over time. Folk thinking does not determine in advance whether a species is a pest, nor does it make scientific investigation of a species of pest into a normative endeavor. (*2)

Classifying mental illness has proved a continued problem, because of the vague understanding we have of their affects on a person. There are certain controversial disorders that have proven to be difficult to classify such as: homosexuality, psychopathy, personality disorders, and attention deficit disorder. Currently we diagnose mental illnesses by their symptoms rather than their causes. This led to some questions for discussion:

– Is it possible for any classification scheme of mental illness to be purely scientific?
– Do our classification schemes in psychiatry always rest on some non-scientific conception of what should count as a normal life?
– Why aren’t neurological disorders like Alzheimer’s classified as mental illness?

Some interesting websites and readings that I found are listed below. They are rather impartial and more concerned with delivering information.

Stanford Encyclopedia of Philosophy
Stanford Encyclopedia of Philosophy
Dominic Murphy’s book “Psychiatry in the Scientific Image” reviewed
The Social Construction of Mental Illness and its Implications for the Recovery Model

 

*1 – Cool Nurse is Cool
*2 – pp. 98-99, Psychiatry in the Scientific Image

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Comments»

1. ews8704 - February 20, 2009

I find this topic really interesting, and I really liked your presentation. =)
In a funny way, this debate sort of resonates with me:
A friend of my family is elderly, lives alone and has gotten very lonely. He’s always been very creative, and now he’s started weaving elaborate stories about how people visit him and communicate with him telepathically. His family sought medical attention after the police called, saying he was just sitting on his neighbor’s porch, waiting for one of his imaginary friends to come. His family feared the worst had him checked out by a variety of doctors, who all came back with nothing. He wasn’t sick, just old, imaginative, and lonely.
Since then, his family has been amazingly supportive and open-minded, and they have started recognize his imaginary world as “real.” If its real to him, they figure, why shouldn’t it be real to us, too? They’ve decided its better to learn and ask him about his new life instead of writing it off as mental illness.
I really like this approach: Should his delusions really be considered “weeds” that must be plucked, just because they are not “normal?” Who am I to say that his world isn’t legitimate? I’m human, after all, so my senses are fallible, too.
And now that he’s surrounded by his (imaginary?) loved ones, our friend isn’t so lonely anymore.


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