Reframing mental illness

mental_health_page.jpgA recently concluded confererence at London’s Institute of Psychiatry has been debating the classification and boundaries of mental illness and has been challenging the traditional views of psychiatric medicine.

There have been longstanding critics of psychiatry, notably people like R.D. Laing and Thomas Szasz, who have argued that the medical concepts of mental illness are flawed, or that they are used to unjustly silence society’s outsiders.

More recently, psychiatric classification, and particularly the separation of mental disorder into diagnoses such as ‘schizophrenia‘ and ‘bipolar disorder‘ have been challenged by mainstream psychiatrists on the basis of scientific discoveries.

For example, an editorial in May’s British Journal of Psychiatry argued that that schizophrenia and bipolar disorder are on a continuum, based on genetic evidence that is increasingly showing that similar genes are found in people who receive either diagnosis.

Other criticisms, echoed at the recent London conference, have been based on the coherence of psychiatric definitions and how well they reflect the diverse experiences of people who live through mental distress.

The conference discussed how understanding the first-person conscious experience of mental illness (as opposed to, or in combination with, scientific measures) can make for a more accurate understanding, and hopefully, treatments for those in need.

This approach is known as phenomenology and was championed by a number of continental philosophers who argued that science will only ever give a partial explanation because objective measures always leave something of the ‘lived experience’ missing.

One increasingly popular view of psychosis, the reality-bending mental state that can involve hallucinations and delusions, suggests that it is not an all or nothing state as psychiatric diagnosis suggests, but a range of experiences that are distributed throughout the population.

Recent studies have typically reported that about 10-11% of the general population score about the average of psychotic patients in psychiatric wards, on measures of unusual thinking or perceptual distortion, despite not needing psychiatric help or becoming significantly distressed or disabled.

Link to details of the recent conference on ‘Phenomenology and Psychiatry for the 21st Century’.
Link to BBC News on the conference and the boundaries of madness.

One Comment

  1. Posted September 7, 2005 at 6:49 pm | Permalink

    Having had a psychotic epsiode, only one, fortunately, I find it relates very closely to many people’s experience of religion, and I had a lot of religion-related thoughts when I experienced it. I would suspect psychosis stems mainly from the amygdala, and can be brought on by lack of sleep or stress, as mine was. I think most people who believe in some form of religion with related religious experiences would fit into that 10-11%, as would most people under stress who seem to think whatever problem they face is a crisis, even though it’s only a work-related or relationship-related issue and not life or death. The brain interprets emotional issues in a very strange way at times.
    I was diagnosed as bipolar as a result of that episode. Seems to be the popular diagnosis of the moment.


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