Traditionally, debates between psychiatrists and
anti-psychiatrists have centered around the appropriateness of positivist
models of psychological disorder. According to positivism, the cause
of unusual or distressing mental states is to be found in biological
abnormalities. This paper suggests that anti-psychiatry often challenges
positivism by opposing accounts of social causation to those of physical,
biological disease without first questioning the adequacy of positivist
accounts of physical illness itself. Using the work of philosopher of
medicine, Georges Canguilhem, I wish to elaborate a non-positivist account
of physical disease, which can then be applied to debates in mental health
to redefine the terms within which the role of biological abnormalities
can be thought. Applying Canguilhem's definition of pathology, the
paper argues for a conception of mental illness in which the scientific
identification of biological abnormalities is useful, but not in itself
sufficient. Finally, these arguments are related to recent work involving
cognitive therapy approaches to voice hearing and schizophrenia.
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