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The Definition of Mental Illness

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EN
In this paper, some difficulties connected with the notion of 'mental illness' are presented. Firstly, the author concentrates on the conditions necessary for creating a good definition of mental illness and demonstrates the presence of two groups of criteria, which are in opposition to one another and cannot be reconciled. Next, relating to 'conceptual map' of mental disorders (following B. Fulford), common characteristics of psychiatric conditions are sketched out. On the basis of these analyses, the sources of such a diversity of perspectives on mental illness are located (from biomedical model to anti-psychiatry movement). The author points out that these definitional problems stem from accepting the implicit model of physical illness and the hope for naturalization of psychopathological disorders. The limitation of this biomedical perspective is presented by promoting the thesis that mental illness is a kind of metaphor. However, the consequences of such assumptions are different than those of Thomas Szasz' sceptic position. It means that the trouble with the concept of mental disorder is part of the dynamics of scientific research and discoveries and especially medical practice, where extra-theoretical factors are important part supporting official theories and therapeutic methods.
EN
The text provides a description as well as an analysis of mental disorders as socially constructed entities while focusing on the category of normality not only in its medical sense but also in social and cultural one. Our methodology has to be understood as rooted in social constructionism. We work with concepts created within social anthropology and semiotics but also existentialist psychotherapy or Mad Studies. When postulating mental disorder as a topic of social anthropology, we suggest that mental disorder is one of the key concepts behind the social and cultural understanding of normality: normality in regard to emotions, thinking, and behaviour is to a great extent defined negatively – that is, by what it isn't – with mental disorder being one of its major opposites. Normality in Western societies is significant mostly in the areas of mental health, sexuality, and gender whereas these areas may overlap; being different in terms of sexuality or gender may be – and often is – interpreted as a sign of a mental disorder. As for our findings, on a general level we suggest that the binary between the normal and unproblematic on the one hand and a disorder on the other hand is arbitrary. The border between the two categories has to do with social and cultural rules more than with actual medicine. More specifically, we describe a physician as a constructor who puts individual signs together and forms diagnoses which can change their structure, shift, or even break down completely. Researching mental disorders as a part of the socially constructed reality allows us to see the power dynamics and questionability of seemingly natural categories such as health and illness, or normality and abnormality.
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