Aleksandar Fatic

This paper examines the structural limitations of artificial intelligence in therapeutic and ethical contexts, drawing on modal logic as both analytical framework and case study. The paper contributes to the emerging discourse on medical AI ethics by arguing that the recent failures of AI therapy chatbots, including cases of serious harm to vulnerable users, are not engineering problems awaiting technical solutions, but rather reflect fundamental mismatches between computational architectures and the nature of human mental life. The distinction between propositional and modal logic illuminates this gap: while AI systems operate primarily within propositional frameworks, determining truth conditions for beliefs within fixed sets of circumstances, therapeutic intervention requires modal thinking that involves shifting entire constellations of possibility and impossibility by changing the circumstances themselves. Drawing on work in Modal Integrative Psychotherapy, the paper shows that effective therapeutic change requires what is called the "switching of modal worlds", a process that presupposes embodiment, temporality, and what phenomenologists describe as being-in-the-world. These features remain structurally inaccessible to computational systems, however sophisticated their linguistic outputs. The argument engages with recent findings on AI chatbot harms and addresses the epistemic opacity concerns raised in philosophy of technology literature on medical AI. The paper concludes with implications for AI ethics, the regulation of AI in mental health contexts, and the role of philosophical practice in an age of algorithmic systems.

While empathy is regularly seen as an integral aspect of any meaningful humanistic counseling and psychotherapy, the actual meanings attached to the concept vary widely. Such variance leads to different modalities of application of empathy in the humanistic helping professions, including psychotherapy. This paper discusses how far empathy actually involves the feeling of another’s feelings and what conditions and limitations apply to its role in the counseling process. Two central ideas are developed. First, empathy is predicated upon suffering and commiseration: the assumption of pain and deprivation is internal to the very concept of empathy, and Schopenhauer’s philosophy of the will provides the strongest account of why this is so. Second, empathy as a way of relating to another’s suffering is constitutive of the only morally justified community, namely the healing organic community. It is our capacity to cross-identify with other members through shared suffering thatcreates lasting, resilient communities. The paper concludes that any organic community is by nature therapeutic, and that much of what psychotherapy does is recreate the mechanisms of empathy and human care that were the foundation of pre-institutional human society.

Modesty is a practical virtue. The claim is that modesty's value lies not in constituting moral character but in enabling the quality of practical deliberation through which moral and practical character must be exercised, and that this positions modesty in a distinct category, grounded in Aristotle's framework, of dispositions that are conditions for the proper exercise of phronesis rather than expressions of moral excellence in their own right. What modesty corrects is the self-image protection imperative: a dispositional tendency to assign evidential weight to practical considerations in proportion to their compatibility with the agent's self-conception, structurally prone to self-concealment in ways that make ad hoc monitoring an unreliable corrective. Wolf's sanity condition identifies the type of epistemic failure this imperative produces, and Fischer and Ravizza's reasons-receptivity requirement specifies how that failure compromises responsible agency. The paper develops and replies to two objections. The first concerns endorsement theory: an agent can reflectively endorse concern for their self-image, making the imperative an endorsable value rather than a heteronomous constraint. The second comes from the Schopenhauerian direction: the excellent agent's self-image is not distorting their deliberation but calibrating it correctly, since their self-assessments are accurate. The reply to the second objection distinguishes the accuracy of a self-assessment from the rigidity with which it is held, and argues that Aristotle's own magnanimous agent, on the best reading of the Nicomachean Ethics, holds accurate self-knowledge provisionally rather than as a prior constraint on deliberation.

The contemporary discourse on trauma in practical philosophy, philosophical practice, and the various helping professions predominantly conceptualizes traumatic experience as inherently inhibitory and compromising to the quality of life. This paper challenges such reductionist framings by demonstrating the functional and epistemic necessity of trauma, particularly microtrauma, for socialization, personal transformation, and the development of what I call authentic sociality. Drawing on Heideggerian phenomenology, Lacanian psychoanalysis, and modal logic, I argue that both death and trauma serve crucial epistemic roles: they reveal our deepest values, restructure our interpretive frameworks of reality, and compel the kind of fundamental reprioritizations that conventional therapeutic approaches attempt to replicate artificially, without requiring the client to face existential limits directly. The encounter with death, whether one's own mortality or the loss of significant others, possesses a transformative epistemic power that transcends mere grief or sorrow, functioning as what I term an existential clarifier that exposes what genuinely matters beneath the diversions of everydayness. Similarly, trauma operates not simply as psychological damage requiring therapeutic repair, but rather as raw existential material for character formation, the ultimate meaning of which depends significantly on the organic quality of our social structures and our capacity for what I call modal thinking. I demonstrate how institutionalized, inorganic social environments amplify the traumatic potential of experience, while organic communities tend to metabolize trauma in reintegrative rather than destructive ways. The paper concludes by positioning Modal Integrative Psychotherapy as a philosophical approach that mobilizes the clarifying potential of death-awareness and traumatic experience without requiring clients to endure actual existential crises.

The ancient maxim that justice must be "blind" expresses a commitment to procedural equality foundational to liberal political and legal philosophy. This paper argues that the blindfold metaphor reveals a deep tension at the heart of liberal theories of justice. Procedural blindness requires that morally relevant features of persons be systematically excluded from evaluative consideration. Yet genuine moral assessment, as practiced in functioning communities, is inherently character-sensitive rather than action-focused. Drawing on virtue ethics, relational egalitarianism, and phenomenological accounts of moral community, I argue that character-based evaluation constitutes the proper form of justice, not merely a permissible deviation from procedural ideals. The paper proceeds in four stages. First, I examine the philosophical foundations of procedural blindness and identify their origins in institutional rather than moral imperatives. Second, I develop an account of character-integrated evaluation as it operates within what I term "organic communities" bound by direct interpersonal relations. Third, I argue that procedural equality, far from securing fairness, systematically disadvantages those whose circumstances or character depart from institutional norms. Fourth, I show how character-sensitive justice can be rendered consistent with appropriate forms of equality by reconceiving equality relationally rather than distributively. The implications extend beyond criminal justice to democratic theory, where the demand for character-blindness in political evaluation impoverishes public deliberation.

When agents face the most consequential decisions in their lives, they engage in a form of reasoning which is categorically distinct from the reasoning that occupies nearly all of practical philosophy and nearly all of psychotherapy. I call this between-world reasoning, and I argue that the distinction between it and ordinary within-world reasoning corresponds to the distinction between modal logic and propositional logic as applied to lived experience. Within-world reasoning asks what to do given fixed constraints; it is the domain of cognitive-behavioural reframing, standard decision theory, and Aristotelian practical wisdom. Between-world reasoning asks whether to change the constraints themselves by transitioning to a different set of circumstances where the structure of possibility is altogether different; it is the domain of modal logic, where the operators of possibility and necessity range over different sets of circumstances rather than over different propositions within a single set. Drawing on Kripke semantics, Schopenhauer's metaphysics of representation, and clinical evidence from Modal Integrative Psychotherapy (Fatić 2025), I develop a formal characterisation of practical modal worlds, show that the accessibility relation governing transitions between them is non-transitive and non-Euclidean, introduce the geometry of motivation which governs structural decisions, and present three clinical cases as evidence that between-world reasoning is a real pattern of practical cognition. The framework provides resources for understanding why propositional psychotherapeutic interventions (reframing, insight, cognitive restructuring) fail when the problem is structural, why modal interventions (changing the client's objective circumstances) succeed where propositional approaches cannot, and why much of what clinical psychology classifies as impulsive or avoidant behaviour may in fact be between-world reasoning operating under constraint.

This paper develops the thesis, advanced in my earlier work on the phenomenology of sympathy (Fatic, 2026a) that institutions which systematically suspend sympathetic engagement are epistemically deficient in their capacity for moral judgement. The argument is here grounded in the specific institutional domain of criminal justice, where the structural exclusion of sympathetic perception is most pronounced and its consequences most severe. I argue that the modern criminal justice system, organized around the procedural application of general rules to categorized acts rather than the sympathetic perception of particular persons, exhibits a form of moral-epistemic blindness that undermines its claims to substantive legitimacy. This blindness is not a contingent failure of implementation but a structural feature of punitive rationality itself. Drawing on Husserl's analysis of empathy and intersubjective constitution, Scheler's phenomenology of sympathy, Levinas' account of the ethical encounter with the face of the other and the demands of the third party, Honneth's theory of recognition, an recent phenomenological scholarship on empathy and moral perception, the paper advances a conception of substantive institutional legitimacy that requires permeability to sympathetic awareness. The conclusion section moves beyond diagnosis to consider what sympathetically informed sentencing would require in practice, arguing that institutional design must incorporate structured encounter between decision-makers and those subject to their authority.

This paper explores decision-making as a form of existential loss, specifically as the “death” of unchosen alternatives. Building on existential and phenomenological approaches to choice, I argue that making a decision is fundamentally about leaving possibilities behind rather than embracing a single path. Healthy decision-making requires the capacity to mourn these losses and to tolerate the coexistence of unchosen alternatives in the world. By contrast, the narcissistic personality exhibits a pathological relationship to decision-making characterised by the need to annihilate rejected options and those who represent them. Contemporary research has identified various subtypes of narcissism, including grandiose and vulnerable presentations (Pincus & Lukowitsky, 2010; Miller et al., 2011), though this paper focuses on the fundamental structural features common to narcissistic pathology rather than its diverse phenomenological manifestations. This analysis has implications for both philosophical practice and psychotherapy.

This paper argues that sympathy constitutes an epistemically necessary condition for adequate moral judgement in situations involving other persons. Drawing on Max Scheler's phenomenology while challenging his restrictive conclusions, I demonstrate that sympathetic perception provides irreplaceable access to morally relevant features of situations that rational deliberation alone cannot secure. The analysis extends to institutional contexts, showing that bureaucratic structures which systematically suspend sympathetic engagement exhibit epistemic deficiency regardless of procedural sophistication. Engaging recent phenomenological scholarship on empathy and intersubjectivity, the paper advances a conception of moral perception wherein affective and cognitive dimensions are internally related rather than externally combined.

Psychotherapy lacks agreed formal foundations. Competing theoretical schools produce measurable clinical outcomes without consensus on the formal structure of psychological change, and without such foundations the discipline cannot adjudicate between theoretical claims at any level deeper than empirical outcome comparison, distinguish genuine structural change from symptomatic management, or explain why approaches with incompatible ontological commitments sometimes yield equivalent results. Modal logic is proposed here as providing those foundations in the model-theoretic sense articulated by Suppes (1967): not as a reducing theory that would dissolve the clinical level into formal axioms, but as a specification of the abstract structures that psychotherapy’s theoretical dimension instantiates, sufficient for internal coherence and systematic development without entailing completeness or uniqueness. The modal system governing practical psychological modality is derived on substantive grounds, establishing that the system is KD, with seriality holding globally and reflexivity, transitivity, symmetry, and the Euclidean property each failing globally while admissible locally. Local reflexivity is grounded in a formally defined atomic proposition s recording whether a configuration is self-sustaining through its operative mechanism, which unifies the otherwise heterogeneous cases of therapeutically consolidated and pathologically entrenched configurations under a single formal criterion. Two formal models are developed, of agoraphobic constriction under cognitive-behavioural exposure treatment and of obsessional neurosis under psychoanalytic working-through, with four propositions stated and proved, including results on formal inaccessibility of therapeutic goals from initial configurations and on minimum path lengths that formally ground the structural necessity of graduated intermediate work. A formal adequacy class for KD-frames of practical psychological modality is explicitly defined. Therapeutic transitions are characterised as link-addition operations in the graph-transformer framework of van Benthem (2011), with precondition structures enforcing the non-transitivity of the accessibility relation at the level of programme executability. The structural parallel with deontic KD is shown to be substantively informative without transferring the known paradoxes of deontic logic, which are artifacts of the normative rather than the descriptive practical interpretation.

Professional ethics codes in psychotherapy instantiate deontological frameworks that privilege rule specification over character cultivation, yet empirical research demonstrates that therapeutic effectiveness depends primarily on relationship quality rather than adherence to procedural protocols. This paradox reveals structural inadequacy in contemporary approaches to professional responsibility. This paper argues that the paradox cannot be resolved within deontological frameworks because authentic empathy, understood through Schopenhauer's metaphysics as recognition that suffering constitutes the Will's essential nature, necessarily transcends contractual boundaries that presuppose the principium individuationis. The argument proceeds through three interconnected stages. First, Schopenhauerian compassion provides metaphysical foundation for understanding empathy as ontological recognition rather than psychological technique. Second, virtue ethics frameworks address the irreducible role of phronesis in navigating moral complexity that rule application cannot accommodate. Third, philosophical counseling exemplifies character based professional practice demonstrating how practitioners can maintain ethical integrity without reducing responsibility to rule compliance. The paper engages situationist challenges, addresses character assessment concerns, and demonstrates that professional ethics requires virtue frameworks acknowledging the constitutive rather than merely instrumental role of practitioner character in achieving therapeutic goods. This reconceptualization addresses the contemporary crisis in psychotherapy marked by increasing rates of therapeutic failure, burnout, and ethical violations that additional rules cannot solve.

The essay examines the central role that pleasure plays in a wide range of conceptualisations of happiness or ‘good life’, from Epicurean hedonism, to Christian asceticism, to contemporary cases of pastoral and philosophical counselling. Despite the apparent moral chasm between hedonists and ascetics, a look at the practices promoted by Epicurus and the Christian monastic fathers reveals striking similarities. The reason is that, at a fundamental level, both parties agree that one should reject the vulgar pleasures that society glorifies, and develop a refined attitude that seeks the appropriate and natural pleasures, while ignoring the harmful or unnecessary ones. And such an attitude can only be acquired through moral training, either by philosophical instruction and reflection, or by pastoral counselling. We highlight some important parallels regarding the connection between pleasure and happiness, as conceived by Epicureans and monastic fathers of the Eastern Orthodox Church. We begin by discussing elements of Epicureanism that can also be found in its rival philosophical schools and Christianity, mainly the emphasis on forming the right conception of happiness and acting in accordance with it. We then examine the connection between morality and happiness in the Christian Orthodox monasticism. We argue that Christian ascetic ethics not only condone some types of pleasures, but in fact require them as elements of happiness in this life that play an instrumental role for the Christian soteriological dogma. The argument has wider philosophical significance because it shows that pleasure is indeed a fundamental conceptual ingredient of happiness across different normative ethical contexts.

In lieu of an abstract, here is a brief excerpt of the content:Why Narcissists Are Morally ResponsibleAleksandar Fatic, PhDIn his insightful commentary of ‘Narcissism as a moral incompetence,’ Professor Pies proposes several principal objections to my line of argument. First, Pies mentions that I embrace a Platonic essentialism and a ‘binary’ view of narcissism, whilst in fact narcissistic traits present themselves in degrees, within a continuum of pathology.Let us clarify the meaning of essentialism. When applied to the phenomenology of narcissism, Platonic essentialism would imply that there is an idea, or ideal, of ‘pure’ narcissism, which governs our cognition of narcissistic phenomenology. Without an ‘essentialist’ understanding of what narcissism as a more or less pure phenomenon would look like, it would make no semantic or logical sense to speak of various ‘types’ or ‘degrees’ of narcissism. In the 1940s, in The Concept of Mind, Gilbert Ryle offered the now infamous logical analysis of ‘false’ and ‘true coins’: if there were not true coins of which we had some idea, it would be logically impossible to speak of counterfeit coins (McDermid, 2004; Ryle, 1949, pp. 94–99). There are shoddily produced coins that bear only a vague resemblance to the original idea or mint of the real coin, however, for each we would ultimately have to decide whether the resemblance is sufficient for it to be considered a real coin. Shoddily produced coins represent various ‘degrees’ of resemblance of the idea, or form, of a coin, but to call them coins, and to decide whether they are true coins or not, it is a logical presupposition that we must first have an ‘idea’ of what an ‘ideal’ real coin is like. This, at its core, is essentialism.There is no escape from this type of essentialism in any rigorous argument, because Platonic essentialism is the foundation of the very meanings of the concepts we use. Plato’s ideas are paradigms, where the particular instantiations of their qualities are called ‘phenomena’ (Sedley, 2016; Taylor, 2016). Thus, the nuanced expression of ideas or forms in their various phenomena is the very substance of the essentialist theory of ideas. It appears that Professor Pies is also a Platonic essentialist, as am I.So why is it often impossible in clinical practice to ascribe necessary and sufficient conditions to narcissism? Well, let us remember Rosenhan’s experiments (1973). Rosenhan illustrates how the same individuals were diagnosed with very different disorders by different clinicians at roughly the same time, and how healthy individuals, once they had been instructed to ‘fake’ psychotic symptoms, remained under the same or more serious [End Page 177] diagnoses even when they stopped pretending and behaved completely normally. The reason for the arbitrariness of psych-diagnoses is the insufficiency of the psych-diagnostic language, including the actual diagnostic criteria, a kind of Lacanian ‘lack’ that is built into the very structure of psychodiagnostics (Ruti, 2008), and not a metaphysics behind such use of diagnostic language, whether it is essentialist or non-essentialist. Whether a particular patient actually has NPD or not in practice comes down to a consensual judgement—one that has been notoriously lacking in the history of psychiatry (Verhaeghe, 2008, pp. 71–125).Second, Pies suggests that empathy is ‘a complex, multidimensional construct comprising cognitive and affective components.’ I do not think this is a correct understanding of empathy. In fact, it is a conceptual revision of the original concept of empathy, which is one of a moral emotion (Kauppinen, 2014). What Pies calls ‘cognitive empathy,’ namely the ability to recognize and influence the emotions of others is an entirely different quality capacity that has recently been called ‘emotional intelligence’ (e.g., Conte, 2005). Many Cluster B personality disorders are characterized by an exceptionally high emotional intelligence and an almost complete lack of empathy, which allows them to use their emotional intelligence to manipulate and mistreat others. Surely such emotionally intelligent, but highly malignant strategies would not be considered ‘empathy.”Relatedly, Pies objects to Slote’s alleged view that only actions arising from factual empathy are morally justifiable. This is a ‘naturalist fallacy’ in reading Slote. The natural fallacy is a confusion between the ‘is’ and the ‘ought.’ Slote actually argues that only actions that are consistent with...

In this paper I discuss John Searle?s selective view of intentionality of mental states, and place it in the context of impairment to personal identity that occurs in mental illness. I criticize Searle?s view that intentionality characterizes some but not all mental states; I do so both on principled and on empirical grounds. I then proceed to examine the narrative theory of self, advanced by Paul Ricoeur, Marya Schechtman and others, and explore the extent to which the theory fits a more generalized view of intentionality that would apply to all mental states. This discussion is followed by a brief consideration of the way in which the modern DSM-based psychiatric diagnosis and treatment, reductively and mechanistically, dispenses with the issues of?strong ontology?, namely the life events and values that mental states might in fact reach for, even when ostensibly without reference. In this sense, DSM-inspired psychiatry is based on a Searlian view of mental states. It is contrasted with the narrative theory of self which, rather than defining madness by clusters of symptoms, seeks to understand the underlying ontology of reference by looking for both the initial script of the person?s?life narrative? and for ruptures and knots in that narrative that might give rise to madness. Finally I discuss and evaluate the perspective of personality enhancement through counseling aimed at repairing the personal narrative. nema

The need for philosophical practice to integrate various methods, both conceptual and those based on the use of emotions, raises the question as to whether its methodology is necessarily eclectic, in terms of the collection of various methodologies used in philosophy, or whether there is a way to move beyond eclecticism. This is the main subject of this paper. In other words, the question is whether there is such a thing as an ‘integrative’ methodology and, if so, what distinguishes such a method from mere eclecticism. In this text, we define the methodological procedure of integrativeness as the process of systematizing perspectives into an orientational answer to the demands of a specific problem. What differentiates such an approach from mere summation is a new contribution that results from a synergistic and systematic meeting of positions and argumentations whose final result differs from its initial elements. Diversity in the form of a multidimensional relationship towards life and the world results in numerous perspectives, which is a value that should be cultivated and integrated into a reflective and actional perception of the world.

This chapter discusses the relationships between the nominalist nature of psychiatric diagnoses, as described by Paul Verhaeghe, and the modal logical context of psychotherapy. The nominalist view portrays psychodiagnosis as storytelling, rather than medical diagnostics, and offers various narrative and, by extension, metaphysical possibilities for the inculcation of logical modality in the conceptualization of psychotherapy, including the idea of changing modal worlds, or possible worlds, as key elements in Modal Integrative Psychotherapy.

Abstract:In this paper, I suggest that the moral incompetence in narcissism is associated with a particular type of emotional incompetence, namely the incompetence to experience the moral emotions, such as empathy, solidarity, loyalty, or love. I then move on to discussing the ethical ramifications of this incompetence, primarily from the point of view of sentimentalist ethics, and conclude that emotional incompetence does not in fact reduce the moral responsibility of a narcissist person, whether diagnosed with Narcissistic Personality Disorder or not. My argument is based on the three criteria of moral responsibility proposed by Philip Pettit, namely those of value relevance, value judgment, and value sensitivity. I suggest that a sentimentalist ethical perspective entails that the satisfaction of two of the mentioned criteria (awareness of the social meaning of one’s choices and sufficient control of one’s actions) constitutes a moral obligation for the agent to satisfy the third criterion, namely to develop the appropriate moral sensibility and competence to actually choose morally correctly. This type of structure of obligation elucidates why narcissism is at the same time a moral failure and a psychopathology. At the same time, my argument portrays narcissism as a particular type of personality disturbance that almost uniquely reaffirms the role of moral re-education as the psychotherapeutic approach. This conclusion points to a potential revival of some of the precepts of Pinel’s affective psycho-pathology, dating back to the very beginnings of the psychotherapeutic clinic.

The conclusion summarizes the ways in which Modal Integrative Psychotherapy (MIP) may be seen as revolutionizing conventional psychotherapy by introducing the idea of “switching modal worlds”, not just within the subjectivity of the client, but also “worlds”, as sets of circumstances described in modal logic, within which subjective experience occurs. Such a shift of emphasis from an essentially subjectivist position to a fundamentally more ambitious conceptual approach to both lived experience and psychotherapy challenges certain conventional norms, including the blurring of the distinction between “reality” and “subjectivity” and the notion of how different experiential worlds might or might not be called into actual experience by the use of MIP technique.

Joseph Agassi’s last book, The Philosophy of Practical Affairs, offers a comprehensive look at key philosophical topics and doctrines with a common focus on the role of rationality, the evolution of rationality and the relationship between rationality and akin phenomena. A key topic he addresses is the relationship between rationality and magic. This dichotomy reverberates on a number of areas of applied philosophy, including philosophical practice and philosophically informed psychotherapy. Agassi’s views on magic offer a fundamentally rationalist view of the phenomenon of magic, however they open up significant inroads into nuanced insights of how magic can be seen as a cognitively significant complement to rationality in the strict sense.

The paper examines the concept of individual and collective value identities based an emotionalist understanding of values. The main perspective it discusses is one where emotions are the most important practical instruments for the clarification of individual and collective values. The argument implies that moral emotions are not irrational, but have a logic of their own which can reliably pinpoint the persons’ value system; emotions are thus crucial building blocks of an ethics which is able to enhance personal and moral identity. This particular ecology of moral emotions is pivotal in crisis periods, such as the global pandemics, wars or system crashes, either economic, or political, security, diplomatic or cultural. In the current circumstances, where the already shaken individual and collective values throughout the world have been shaken by the Covid 19 pandemic, understanding identities as fundamentally couched in moral emotions may be critical to saving our cultures and our legacies of social and moral capital.

This chapter focuses on how language, and what Ludwig Wittgenstein calls “language games”, are factored into everyday thinking, psychotherapeutic interventions, and the modal theory of therapy. The way in which psychological structures that are reflected in language are played out in the therapeutic narrative reveals not just the difficulties faced by the person in therapy, but also the moral assumptions and confusion that require a particular philosophical resolution in the intimate community between the therapist and client. The chapter discusses how the nature of therapeutic community as a value community influences the client’s and the therapist’s perceptions and use of language and, in turn, how the growing quality and intimacy of that community is articulated in the therapeutic narrative.

The paper deals with a perspective of Christian philosophy on artificial memory erasuse for psychotherapeutic purposes. Its central question is whether a safe and reliable technology of memory erasure, once it is available, would be acceptable from a Christian ethics point of view. The main facet of this question is related to the Christian ethics requirement of contrition for the past wrongs, which in the case of memory erasure of particulary troubling experiences and personal choices would not be possible. The paper argues that there are limits to the ethical significance of contrition in the writings of the leading Christian fathers on the theme, where excessive suffering and inability to forgive oneself for one’s actions is an impediment to the achivement of tranquility of mind and spiritual redemption, rather than a prerequisite for it. The paper thus concludes that there is no hindrance in principle from the Christian ethics point of view to pursuing a voluntary and selective memory erasure as a psychotherapeutic technique once a fully adequate technology is available.

The paper discusses the conceptualisation of mental disorder as a representation, rather than an illness, and relates this perspective to the modern understanding of mental health as a healthy »narrative« or life story. The author proceeds to briefly consider the evolution of concepts of illness in psychiatry and a gradual reappearance of Lacanian psychoanalysis and psychiatry. The key concepts of Lacanian psychotherapy pave the way to a growing together of standard psychotherapy and modern philosophical practice within the novel concept of integrative psychotherapy.