Abstract
What logic determines that to be frightened, overwhelmed or confused is to be ‘ill’ or have a ‘disease’? The place of ‘mental illness’ in Western culture is not a story of scientific discovery. It is a story of social control, political expediency, and professional imperialism (see, for instance, Parker et al, 1995), and associating the treatment of distress with medicine has concealed the element of social control by bestowing on it scientific objectivity and respectability. The illness metaphor for distress has become installed in Western culture to the extent that it is an idea which most people can hardly think about—it is an idea which most people can only think from. The medicalisation of mental distress has, according to Moncrieff (1997), ‘served to obscure the social processes that produce and define deviance by locating problems in individual biology. This obfuscation lends itself to the perpetuation of the established order by side-stepping the challenge that is implicit in deviant behaviour.’ This complaint is not new (see for example, Szasz, 1961; Read, Mosher & Bentall, 2004).
The pharmacological revolution of the 1950s and '60s conjured the illusion of administering specific cures for specific so-called ‘disorders’ such as ‘schizophrenia’, ‘depression’ and ‘anxiety states’, encouraging the view that psychiatry was indeed within the paradigm of physical medicine. Although a growing body of literature continues to discredit the medicalisation of distress, biological psychiatry has been boosted in the 21st century, first by ever more close association with general medical care, and second by the emerging fields of technology-enhanced neuroscience and genetics. Furthermore, despite the fact that these emerging fields have, to date, produced hardly a jot of evidence in support of the biological model of distress, the sheer enthusiasm and levels of funding encourage all but the most sceptical and well-informed to believe that they must valid enterprises.