Mental disorders, brain disorders and values
نویسنده
چکیده
The debates about the normativity ofmental disorders and about the distinction between somatic and mental disorders have long been closely linked. This is very obvious in Szasz, who claims that there can only be brain disorders, no mental disorders and that so-called mental disorders are really problems in living. The implication of the latter claim is that people who have mental disorders are really people whose behavior and emotions depart from societal expectations. One might therefore be tempted to think that the normativity claim and the claim that mental disorders are really brain disorders stand and fall together. This is indeed what Stier claims. “Because of the normative nature of psychiatry, mental disorders cannot be completely reduced to neuronal or molecular processes.” (Stier, 2013, p.8) But how close is the link between normativity and irreducibility really? I agree with Stier that ascriptions of mental disorders are intrinsically normative, and that what counts as a mental disorder has to be decided at the mental rather than at the brain level is also correct. However, the normativity claim and the claim that physicalism does not imply that all mental disorders are brain disorders can and should be separated for two reasons: First, we do not need the appeal to value judgments to justify the importance of the mental level in description and explanation. Second, we need to invest significant normative judgments in any kind of ascription of disease or disorder, not just in the range of the mental.
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