Chapter

The sciences on mental order/disorder and related concepts Normality, meaning, natural and social norms

Derek Bolton

in What is Mental Disorder?

Published on behalf of Oxford University Press

Published in print February 2008 | ISBN: 9780198565925
Published online February 2013 | e-ISBN: 9780191754401 | DOI: http://dx.doi.org/10.1093/med/9780198565925.003.0002

Series: International Perspectives in Philosophy & Psychiatry

The sciences on mental order/disorder and related concepts Normality, meaning, natural and social norms

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Mental disorder and related concepts such as normality, function and meaning are the subject matter of sciences ranging from biology though to sociology, and the next broad topic, for Chapter 2, is what they have to say about them. Three points are noted about the sciences ‘basic to psychiatry’, including psychology, neuroscience and genetics. First, they search for causes of the conditions of interest, typically as defined by the psychiatric manuals; second, for this purpose it is immaterial whether these conditions are considered as disorders or not, and third, at least two of them – psychology and genetics – tend to be antithetical to the notion of disorder as discontinuous with the normal, or as meaningless/non-functional. Another basic science considered, neuroscience, has no notion of order/disorder independent of what derives from the distinction drawn at the psychological/behavioural level. In current models of psychopathology constructed in these basic sciences it is notable that meaningful/functional strategies typically play crucial roles, sometimes alongside other causal factors, including brain disease or lesion, or genetically based temperamental characteristics. These two characteristic features of the current science – that meaning has a causal role, and explanatory pluralism – are both signs of a paradigm shift that has been in progress roughly since the middle of the last century and which is crucial for the line of thought about mental disorder being pursued in this essay.

The next main theme in Chapter 2 is that increasingly the biobehavioural sciences are embedded in evolutionary theory. From an evolutionary point of view, what stands out is the essential linkage between behaviour and specific environments and task demands, and the process of more or less successful adaptation to more or less benign or adverse environments. In this context, what sense can be made of mental disorder? While behaviour may be more or less adaptive relative to specific environments and task demands, and this for a variety of reasons, the idea that some behaviour is just ‘disordered’ has no clear rationale. Beyond the behavioural and brain sciences, the social sciences abound with theories of social functions and order, providing further scope for understanding what mental disorder may be. Sociological theories of mental disorder are relatively rare but they were prominent in the 1960s critiques of psychiatry and their influence continues. The sociological theories naturally tended to construe mental disorder as a kind of social deviance. This has much to be said for it, but it passes over distinctions among kinds of social deviance, some attributed to issues such as criminal intent and others to mental disorder, and it also passes over distinctions within mental disorders, in particular between the ‘behavioural’ disorders associated with antisocial activity, and emotional and other disorders that are characterized more by high levels of personal misery and help-seeking. A related problem is that problems at the individual level are not the focus of – are invisible to – social science and for this reason its grasp of what psychological dysfunction means is limited.

Having reviewed some main approaches of the sciences to concepts involved in mental disorder, Chapter 2 concludes with considering the norms which demarcate order from disorder, and specifically the validity of the old natural/social distinction. On this topic the basic sciences have not much to say: they are interested in causes, not norms. Norms of function can be defined in an evolutionary theoretic framework, but here the ‘naturally evolved’ and the ‘social’ are blurred, and both of these factors also involve individual differences. There are three kinds of factor involved in the design of human action – the evolutionary biological, the cultural, and individual agency – and each of them corresponds to a way of interpreting function and dysfunction, and hence order and disorder.

Chapter.  24195 words.  Illustrated.

Subjects: Psychiatry

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