Abolishing the Concept of Mental Illness: Rethinking the Nature of Our Woes

182 Pages·2018·1.239 MB·English

by  Richard Hallam

ABOLISHING THE CONCEPT
OF MENTAL ILLNESS
In Abolishing the Concept of Mental Illness: Rethinking the Nature of Our Woes, Richard
Hallam takes aim at the very concept of mental illness, and explores new ways of
thinking about and responding to psychological distress.
Though the concept of mental illness has infiltrated everyday language, academic
research, and public policy-making, there is very little evidence that woes are caused
by somatic dysfunction. This timely book rebuts arguments put forward to defend
the illness myth and traces historical sources of the mind/body debate. The author
presents a balanced overview of the past utility and current disadvantages of
employing a medical illness metaphor against the backdrop of current UK clinical
practice.
Insightful and easy to read, Abolishing the Concept of Mental Illness will appeal
to all professionals and academics working in clinical psychology, as well as
psychotherapists and other mental health practitioners.
Richard Hallam worked as a clinical psychologist, researcher, and lecturer until
2006, mainly in the National Health Service and at University College London and
the University of East London. Since then he has worked independently as a writer,
researcher, and therapist.

ABOLISHING
THE CONCEPT OF
MENTAL ILLNESS
Rethinking the Nature
of Our Woes
Richard Hallam
First published 2018
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2018 Richard Hallam
The right of Richard Hallam to be identified as author of this work
has been asserted by him in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book has been requested
ISBN: 978-1-138-06764-6 (hbk)
ISBN: 978-1-138-06313-6 (pbk)
ISBN: 978-1-315-16124-2 (ebk)
Typeset in Bembo
by Keystroke, Neville Lodge, Tettenhall, Wolverhampton
CONTENTS
Acknowledgements vii
1 Introducing the issues 1
2 Thomas Szasz and the myth of mental illness 22
3 ‘Mental’ and ‘bodily’ causes of woes: a brief history 43
4 ‘Major depression’: the creation of a mythical disease 57
5 Agency, rationality, and the concept of mental illness 80
6 Medicalisation: resistance or replacement? 103
7 Well-being and mental health 124
8 A future without the concept of mental illness 144
Index 171

ACKNOWLEDGEMENTS
I am grateful for the astute comments and editorial suggestions of Glenn Shean,
Chris Lee, and Gary Brown on early versions of the manuscript, and for innumerable
conversations with other colleagues and friends.

1
INTRODUCING THE ISSUES
Absurd! How can you abolish mental illness? I used to have a mental health problem
myself. My great-uncle spent years in an asylum and he was definitely insane!
The title of this book invites the reader to question the meaning of words in
common use and to imagine a future in which we stop referring to mental illness.
We have given up thinking about people as being ‘possessed by the devil’. Perhaps
it is time to think differently about how to describe and explain the causes of our
woes. At present, we seem content to leave it to experts to declare whether or not
we are ‘mentally healthy’. The bleak terminology of mental disease or illness is
reserved for rather obvious departures from ‘mental health’, but the idea of patho-
logy is still present in watered-down terms such as ‘psychological disorder’ or
‘mental health issue’. Mental health professionals may rely on little more than
answers to a questionnaire measuring ‘psychological symptoms’ to justify giving
out a diagnostic label. If a problem seems to be a ‘serious’ one, a person’s suffering
or difficulties will be matched against criteria set out in manuals for diagnosing
‘psychiatric illness’.
The idea that the ability to live well has something to do with health and illness
has infiltrated our social institutions to a remarkable degree. We have been invited
to suppose that ‘mental illness’ is illness, in other words, like a physical illness, some-
thing that we either have or don’t have. Mental ill-health encompasses a huge range
of undesirable states of being, personal failings, and unacceptable behaviours. I will
refer to them using the generic word ‘woes’, without assuming that the latter share
anything in common with respect to their causes or how the woeful person experi-
ences them. Rather than adopt the phrase ‘a problem in living’, which implies a
problem for a particular person, I have chosen the word ‘woe’ to refer to a state of
affairs that is social as well as personal. In its archaic use, a woe was a lament about