Sanja Dembić

This book offers an ability-based view of mental disorders. It develops a detailed analysis of the concept of inability that is relevant in the psychiatric and psychotherapeutic context by drawing on the most recent literature on the concepts of ability, reasons and harm. What is it to have a mental disorder? This book contends that an individual has a mental disorder if and only if (1) they are-in the relevant sense-unable to respond adequately to their available (apparent) reasons in their thinking, feeling or acting and (2) they are harmed by the condition underlying or resulting from that inability. The author calls this the "Rehability View". This view can account for what is "mental" about mental disorders: it is the rational relations among an individual's attitudes and actions that is "disordered", and the relevant norms are the norms of reasons. This view is compatible with explanations of mental disorders in terms of biological dysfunctions, without reducing the former to the latter. The aim is not to offer just another conception of mental disorder, but to develop a systematic approach that incorporates insights from philosophy of psychiatry and adjacent philosophical disciplines. Philosophy of Mental Disorder will be of interest to scholars and advanced students working in philosophy of psychiatry, philosophy of mind, philosophy of action, ethics, and mental health.

What is it to have a mental disorder? The paper proposes an ability-based view of mental disorder. It argues that such a view is preferable to biological dysfunction views such as Wakefield’s Harmful Dysfunction Analysis and Boorse’s Biostatistical Theory. According to the proposed view, having a mental disorder is basically a matter of having a certain type of inability (or: an ability that is not sufficiently high): the inability to respond adequately to some of one’s available reasons in some of one’s reasons-sensitive attitudes or actions, where the threshold of inability is determined by one’s being harmed. The relevant concepts of inability, reasons, and harm are sketched. The paper argues that the proposed view evades some problems of biological dysfunction views by remaining neutral on questions of causation and the evolution of the mind. Furthermore, it can capture better what is distinctively “mental” about mental disorder. On the proposed view, it is the rational relations among an individual’s attitudes and actions that are “disordered” and the relevant norms in mental disorder are the norms of reasons. As further merits, the view can account for degrees of disorder, incorporate biological as well as social aspects, and elucidate the relations among disorders, symptoms, and their causes.