Núñez de Prado Gordillo, Miguel (2023) Broken Wills and Ill Beliefs: Szaszianism, Expressivism, and the Doubly Value-Laden Nature of Mental Disorder. [Preprint]
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Abstract
Critical psychiatry has recently echoed Szasz’s longstanding concerns about medical understandings of mental distress. According to Szaszianism, the analogy between mental and somatic disorders is illegitimate because the former presuppose psychosocial and ethical norms, whereas the latter merely involve deviations from natural ones. So-called “having-it-both-ways” views have contested that social norms and values play a role in both mental and somatic healthcare, thus rejecting that the influence of socio-normative considerations in mental healthcare compromises the analogy between mental and somatic disorders. This paper has two goals. Firstly, I argue that having-it-both-ways views fail to provide a compelling answer to Szasz’s challenge. The reason is that what is essential to Szasz’s argument is not that mental disorder attributions involve value judgements, but that mental attributions in general do. Mental disorders are thus doubly value-laden and, qua mental, only metaphorically possible. To illustrate this, I construe Szasz’s view and Fulford’s having-it-both-ways approach as endorsing two different kinds of expressivism about mental disorders, pointing out their different implications for the analysis of delusions. Secondly, I argue, against Szaszianism, that Szasz’s rejection of the analogy is relatively irrelevant for discussions about the appropriateness of medicalizing mental distress. Specifically, I draw from socio-normative approaches to the psychopathology/social deviance distinction and mad and neurodiversity literature to argue that a) it is still possible to distinguish social deviance from psychopathology once we reject the analogy; and b) that both medicalizing and normalizing attitudes to mental distress can harmfully wrong people from relevant collectives.
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| Item Type: | Preprint | ||||||
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| Additional Information: | Accepted for publication in Synthese | ||||||
| Keywords: | Expressivism; Philosophy of Psychiatry; Critical Psychiatry; Mental Disorder; Social Normativity; Delusion | ||||||
| Subjects: | General Issues > Causation General Issues > Determinism/Indeterminism General Issues > Ethical Issues Specific Sciences > Medicine > Psychiatry Specific Sciences > Psychology General Issues > Values In Science |
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| Depositing User: | Dr. Miguel Núñez de Prado | ||||||
| Date Deposited: | 09 Nov 2023 21:46 | ||||||
| Last Modified: | 09 Nov 2023 21:46 | ||||||
| Item ID: | 22756 | ||||||
| Subjects: | General Issues > Causation General Issues > Determinism/Indeterminism General Issues > Ethical Issues Specific Sciences > Medicine > Psychiatry Specific Sciences > Psychology General Issues > Values In Science |
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| Date: | 9 November 2023 | ||||||
| URI: | https://philsci-archive.pitt.edu/id/eprint/22756 |
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