Neil Pickering

in The Metaphor of Mental Illness

Published on behalf of Oxford University Press

Published in print December 2005 | ISBN: 9780198530886
Published online February 2013 | e-ISBN: 9780191754395 | DOI:

Series: International Perspectives in Philosophy & Psychiatry


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When a sceptic like Szasz calls mental illness a metaphor he means that the idea is incoherent. Metaphor may be taken to express this scepticism because it can be taken to be a reference to a wrong naming, or, as I have argued, to a categorization of something that seems to be wrong. There are ways of understanding what it might mean to call mental illness a metaphor that could in theory show something rather less sceptical. Metaphors may be said to use words in unusual senses, so that mental illness does not really mean what it seems at first to mean. Or metaphors are sometimes taken to be implicit similes (comparisons without their explicitly comparative words). Or what looks like a metaphor may, on further inspection, turn out to be a word taking on an unusual, but not completely inexplicable duty. Or what is called a metaphor may be without the life that a true (i.e. a living) metaphor has. It is, in this case, just a word with a history that involves metaphor, but that has now ‘died off into literalness’.

But I have argued that the meaning of metaphor is none of these. A metaphor is a wrong naming, that is to say, it involves the categorization of one thing as a kind or type of thing it isn't. So, the sceptic such as Szasz is right to claim that it expresses the incoherence that he believes marks out the notion of mental illness.

But he is mistaken if he thinks that just because mental illness is a metaphor, or incoherent because it involves categorizations that are wrong, that this shows that we should abandon the idea of mental illness. Some writers are explicitly or implicitly worried that such arguments as this confuse the work of the imagination with the task of science. But I hold there is something right about making the claim that the creative imagination, call it poetic if you will, lies close to the heart of medical science. Indeed, I shall say that the claim that madness is an illness, and that ADHD is an illness are examples of just such a creative imaginative leap. That is something I shall be considering in more detail in the last part of this book, starting in Chapter 6. In the next chapter, I shall consider two examples as a way of illustrating how the creative imagination may have a place not in psychological medicine, but in physical medicine.

Chapter.  9530 words. 

Subjects: Psychiatry

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