Health and Disorder: A Conceptual Investigation
I am currently completing a monograph on the concept of disorder. This asks what makes a condition a disorder, as opposed to some non-pathological state (such as a moral failing, or normal variation). This is a project on which I have been working on and off for many years, and I have already made key contributions to debates in this area. My paper ‘Disease’ (2004) has become a seminal reference in these debates, and in 2020 I presented a plenary address on ‘The Concept of Disorder Revisited’ at the Joint Session (the main UK philosophy conference). Much of my recent work has concerned related issues. ‘Where’s the problem?’ (2017) Theoretical Medicine and Bioethics asks whether disorders have to be located ‘within’
affected individuals. ‘How might I have been?’ (2015) Metaphilosophy concerns how we might distinguish between a disorder and an aspect of self. The monograph I am completing brings together and completes my work on the concept of disorder.
Disentangling Mental Disorders
This project considers how mental disorders can be counted and how symptoms of disorder can be distinguished from aspects of selves. Given that nature provides no clear dividing lines, such issues require decisions as to how the domain of psychopathology might best be modelled. My project will (i) map conceptual options regarding the basic logic of psychiatric classification, (ii) develop a framework for understanding modelling and classification in psychiatry, (iii) explore broader implications—ranging from questions of personal responsibility and treatment ethics to the future design of diagnostic systems and disease statistics.
I aim to address three fundamental and interconnected questions:
· Q1: What are the ‘basic units’ of psychopathology? Does a psychiatric classification system aim to classify people, or disorders considered as abstract processes, or something else?
· Q2: How can mental disorders be counted? How can it be determined whether one patient has two (or more) disorders or just one complex problem?
· Q3: How can we distinguish between people and their disorders? Often, we do distinguish between a person and their illness; we may dismiss ill-judged comments made during a manic episode, ‘That’s his illness, not him speaking’. In other cases, though, notably personality disorders, it is harder to suppose that some ‘authentic person’ can be conceived of separately from the disorder.