Pierre-Henri Castel

It is no easy task to answer Jerry Wakefield’s comments, for I feel at risk of merely pitting two major paradigms in the history and epistemology of psychiatry against each other: the one historical/anthropological, the other epistemological/naturalistic. Fortunately, Wakefield and I do share enough to find a middle ground. This commonality should allow me to reconcile his opinions and mine, by dissipating a few misunderstandings, and also to state more clearly why I am dubious about some of his proposals. First, let me repeat that, in my argument, the lived experience of having an inner mental space is not primarily a psychological phenomenon—at least in the..

Before broaching our main subject, and exploring why, among all disorders of the mind, obsessive-compulsive disorders have a place apart, I would like to start from a dilemma that is well-known to historians interested in mental disorders. According to one approach, a mental illness X is considered as a bona fide or ‘genuine’ illness if, and only if, it originates from a disturbance of the brain. Its neurobiological form is in this case considered as invariant, whatever cultural veneer might give it a different aspect in accord with historical and local settings. The assumption is that this veneer does not, properly speaking, have any deep grounding in reality...