ABSTRACT

According to the medical model that prevails in the Western world, mental disorder is a form of illness, parallel to bodily illness, which can be diagnosed by a doctor on the basis of symptoms and administered treatments designed to “cure” it. However, it seems clear that how we understand “disorder” is influenced by cultural norms and values. Theorists associated with the so-called anti-psychiatry movement have gone so far as to claim that ‘mental illness’ simply is the accepted term for behaviors and experiences that are problematic or do not fit the cultural norm. In my view, however, this social-constructionist view downplays and obscures the very real difficulties encountered by subjects with mental disorder. I argue that rather than rejecting the medical model altogether, we should revise the model by utilizing insights from the enactivist approach in philosophy of mind. An appeal to the enactivist notions of autonomy, sense-making, and adaptivity, I propose, can help us to (a) account for mental disorder’s normative aspect, so that we can navigate a middle way between the medical model and an anti-psychiatry stance; and (b) understand the way in which the neurobiological, social, and existential dimensions of mental disorder are integrated.

摘要

根据西方世界盛行的医学模式，精神障碍是一种与身体疾病平行的疾病，医生可以根据症状进行诊断，并进行旨在“治愈”它的治疗。然而，我们如何理解“无序”似乎受到文化规范和价值观的影响。与所谓的反精神病学运动相关的理论家甚至声称，“精神疾病”只是有问题或不符合文化规范的行为和经历的公认术语。然而，在我看来，这种社会建构主义的观点淡化并掩盖了精神障碍患者所遇到的非常真实的困难。我认为与其完全拒绝医学模式，我们应该利用心灵哲学中生成主义方法的见解来修改模型。我建议，诉诸自主、意义建构和适应性的生成主义概念，可以帮助我们（a）解释精神障碍的规范方面，以便我们能够在医学模型和反精神病学之间找到一条中间道路姿态; (b) 了解整合精神障碍的神经生物学、社会和存在维度的方式。