Abstract
What is it to have a mental disorder? The paper proposes an ability-based view of mental disorder. It argues that such a view is preferable to biological dysfunction views such as Wakefield’s Harmful Dysfunction Analysis and Boorse’s Biostatistical Theory. According to the proposed view, having a mental disorder is basically a matter of having a certain type of inability (or: an ability that is not sufficiently high): the inability to respond adequately to some of one’s available reasons in some of one’s reasons-sensitive attitudes or actions, where the threshold of inability is determined by one’s being harmed. The relevant concepts of inability, reasons, and harm are sketched. The paper argues that the proposed view evades some problems of biological dysfunction views by remaining neutral on questions of causation and the evolution of the mind. Furthermore, it can capture better what is distinctively “mental” about mental disorder. On the proposed view, it is the rational relations among an individual’s attitudes and actions that are “disordered” and the relevant norms in mental disorder are the norms of reasons. As further merits, the view can account for degrees of disorder, incorporate biological as well as social aspects, and elucidate the relations among disorders, symptoms, and their causes.
References
Anscombe, Gertrude E. M. (1957), Intention (Boston, MA: Harvard University Press).
Boorse, Christopher (1975), “On the Distinction between Disease and Illness” Philosophy and Public Affairs, 5 (1), 49-68.
–––– (1976a), “What a Theory of Mental Health Should Be” Journal for the Theory of Social Behaviour, 6 (1), 61-84.
–––– (1976b), “Wright on Functions” Philosophical Review, 85 (1), 70-86.
–––– (1977), “Health as a Theoretical Concept” Philosophy of Science, 44 (4), 542-73
–––– (1997), “A Rebuttal on Health” in James M. Humber and Robert F. Almeder (eds.), What Is Disease? (New Jersey, NJ: Humana Press), 1-134.
–––– (2002), “A Rebuttal on Functions” in André Ariew, Robert C. Cummins and Mark Perlman (eds.), Functions: New Essays in the Philosophy of Psychology and Biology (Oxford: Oxford University Press), 63-112.
–––– (2011), “Concepts of Health and Disease” in Fred Gifford (ed.), Philosophy of Medicine (München: Elsevier), 13-64.
–––– (2014), “A Second Rebuttal on Health” Journal of Medicine and Philosophy, 39 (6), 683-724.
Bradley, Ben (2012), “Doing Away with Harm” Philosophy and Phenomenological Research, 85 (2), 390-412.
Broome, John (2013), Rationality through Reasoning (Malden, MA: Wiley-Blackwell).
Cooper, Rachel (2005), Classifying Madness: A Philosophical Examination of the Diagnostic
and Statistical Manual of Mental Disorders (Dordrecht: Springer).
Dancy, Jonathan (2000), Practical Reality (Oxford: Oxford University Press).
Davidson, Donald (1982), “Rational Animals” Dialectica, 36 (4), 317-28.
Edwards, Rem B. (1981), “Mental Health as Rational Autonomy” Journal of Medicine and Philosophy, 6 (3), 309-22.
Faucher, Luc & Forest, Denis (eds.) (2021), Defining Mental Disorder. Jerome Wakefield and His Critics (Cambridge, MA: The MIT Press).
Feinberg, Joel (1986), “Wrongful Life and the Counterfactual Element in Harming” Social Philosophy and Policy, 4 (1), 145-78.
Finlay, Stephen (2006), “The Reasons That Matter” Australasian Journal of Philosophy, 84 (1), 1-20.
Foucault, Michel (1965), Madness and Civilization: A History of Insanity in the Age of Reason (trans. Richard Howard; London: Tavistock).
–––– (1973), The Birth of the Clinic: An Archaeology of Medical Perception (New York, NY: Pantheon Books).
–––– (1977), Discipline and Punishment: The Birth of the Prison (trans. Alan Sheridan; New York, NY: Pantheon Books).
Gaete, Alfredo (2008), “The Concept of Mental Disorder: A Proposal” Philosophy, Psychiatry, and Psychology, 15 (4), 327-39.
Gertken, Jan & Kiesewetter, Benjamin (2017), “The Right and the Wrong Kind of Reasons” Philosophy Compass, 12 (5), 1-14.
Gibbard, Allan (2003), Thinking How to Live (Boston, MA: Harvard University Press).
Glennan, Stuart (2017), The New Mechanical Philosophy (Oxford: Oxford University Press).
Gould, Stephen J. & Lewontin, Richard C. (1979), “The Spandrels of San Marco and the Panglossian Paradigm: A Critique of the Adaptationist Programme” Proceedings of the Royal Society B: Biological Sciences, 205 (1161), 252-70.
Graham, George (2010), The Disordered Mind: An Introduction to Philosophy of Mind and Mental Illness (London: Routledge).
Heinz, Andreas (2014), Der Begriff der psychischen Krankheit (Berlin: Suhrkamp).
Hieronymi, Pamela (2005), “The Wrong Kind of Reason” Journal of Philosophy, 102 (9), 437-57.
–––– (2013), “The Use of Reasons in Thought” Ethics, 124 (1), 114-127.
Honoré, Antony M. (1964), “Can and Can’t” Mind, 73 (292), 463-79.
Jaster, Romy (2020), Agents’ Abilities (Berlin: de Gruyter).
Klocksiem, Justin (2012), “A Defense of the Counterfactual Comparative Account of Harm” American Philosophical Quarterly, 49 (4), 285-300.
Kratzer, Angelika (1977), “What ‘Must’ and ‘Can’ Must and Can Mean” Linguistics and Philosophy, 1 (3), 337-55.
Krickel, Beate (2018), The Mechanical World. The Metaphysical Commitments of the New Mechanistic Approach (Berlin: Springer).
Maung, Hane H. (2016), “Diagnosis and Causal Explanation in Psychiatry” Studies in History and Philosophy of Biological and Biomedical Sciences, 60, 16-24.
Melander, Peter (1997), Analyzing Functions: An Essay on a Fundamental Notion in Biology (Stockholm: Almqvist and Wiksell).
Mele, Alfred R. (2003), “Agents’ Abilities” Noûs, 37 (3), 447-70.
Millikan, Ruth G. (1984), Language, Thought and Other Biological Categories: New Foundations for Realism (Cambridge, MA: The MIT Press).
–––– (1989), “In Defense of Proper Functions” Philosophy of Science, 56, 288-
Murphy, Dominic & Woolfolk, Robert L. (2000), “Conceptual Analysis Versus Scientific Understanding: An Assessment of Wakefield’s Folk Psychiatry” Philosophy, Psychiatry, and Psychology, 7 (4), 271-93.
Murphy, Dominic (2020a), “Concepts of Disease and Health” in Edward N. Zalta (ed.), Stanford Encyclopedia of Philosophy, https://plato.stanford.edu/entries/health-disease/
Neander, Karen (1991), “Functions as Selected Effects: The Conceptual Analyst’s Defense” Philosophy of Science, 58 (2), 168-84.
Nordenfelt, Lennart (1995), On the Nature of Health: An Action-Theoretic Approach (2 edn., Dordrecht: Springer).
Parfit, Derek (1989), Reasons and Persons (Oxford: Oxford University Press).
–––– (2011), On What Matters (Oxford: Oxford University Press).
Prinz, Jesse J. (2004), Gut Reactions: A Perceptual Theory of the Emotions (New York, NY: Oxford University Press).
Rabenberg, Michael (2014), “Harm” Ethics and Social Philosophy, 8 (3), 1-32.
Raz, Joseph (2009), “Reasons: Explanatory and Normative,” in Constantine Sandis (ed.), New Essays on the Explanation of Action (Basingstoke, UK: Palgrave-Macmillan), 184-202.
Scanlon, Thomas M. (1998), What We Owe to Each Other (Cambridge, MA: Harvard University Press).
Shiffrin, Seana (2012), “Harm and Its Moral Significance” Legal Theory, 18 (3), 357-98.
Stalnaker, Robert C. (2014), Context (Oxford: Oxford University Press).
Stegenga, Jacob (2018), Medical Nihilism (Oxford: Oxford University Press).
Thomson, Judith J. (2008), Normativity (Chicago, IL: Open Court).
Tremain, Shelley (ed.) (2015), Foucault and the Government of Disability (2 edn., Ann Arbor, MI: University of Michigan Press).
Tsou, Jonathan Y. (2021), Philosophy of Psychiatry (New York, NY: Cambridge University Press).
Velleman, David (2000), The Possibility of Practical Reason (Oxford: Oxford University Press).
Wakefield, Jerome C. (1992a), “The Concept of Mental Disorder. On the Boundary between Biological Facts and Social Values” American Psychologist, 47 (3), 373-88.
–––– (1992b), “Disorder as Harmful Dysfunction: A Conceptual Critique of DSM-III-R’s Definition of Mental Disorder” Psychological Review, 99 (2), 232-47.
–––– (1999a), “Evolutionary versus Prototype Analyses of the Concept of Disorder” Journal of Abnormal Psychology, 108, 374-399.
–––– (1999b), “Mental disorder as a Black Box Essentialist Concept” Journal of Abnormal Psychology, 108, 465-472.
–––– (2000), “Spandrels, Vestigial Organs, and Such: Reply to Murphy and Woolfolk’s ‘the Harmful Dysfunction Analysis of Mental Disorder’” Philosophy, Psychiatry, and Psychology, 7 (4), 253-69.
–––– (2021), “Is the Harmful Dysfunction Analysis Descriptive or Stipulative, and Is the HDA or BST the Better Naturalist Account of Dysfunction? Reply to Maël Lemoine” in Luc Faucher and Denis Forest (eds.), Defining Mental Disorder. Jerome Wakefield and His Critics (Cambridge, MA: The MIT Press), 281-324.
Wright, Larry (1973), “Functions” Philosophical Review, 82 (2), 139-68.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Sanja Dembic