Organic pathology
Physical ailments are much easier to recognize than mental disorders. For example, a person with the flu has a fever, aches and pains, and other recognizable signs; there are laboratory tests that can determine whether a person with a sore throat and a fever has an infection. A doctor can successfully treat the illness based on prior experience treating others with the same symptoms.
Psychic pathology
But what of mental disorders? It would seem that the same methodology used to classify physical ailments would, in principle, be useful to identify mental illness. However as Karl Jaspers noted in the early 20th century, “In psychology as in psychopathology there are very few, perhaps no, assertions which are not somewhere and at some time under dispute.” (Jaspers, K. transl. Hoenig, J & Hamilton, M.W. General Psychopathology Volume I Baltimore: Johns Hopkins University Press 1997)
Last year, at about the time the new Diagnostic and Statistical Manual of Mental Disorders (DSM 5) was released, I wrote a post about diagnosis and the need for more information about the causes of mental disorders.
Foucault
According to Foucault, the underlying assumptions in the classification of illnesses in general are: 1) the ‘essentialist’ postulate which defines an illness an entity, or essence, which generates the classifiable signs and symptoms; 2) the ‘naturalist’ postulate in which one can describe illnesses in the same terms as botanical species; there is an underlying set of permanent features that describe an illness, but variations may exist.
The crux of the matter
I’ve been puzzling over the following paragraph for hours. I think it represents the key to how Foucault frames his idea of mental illness:
“If mental illness is defined with the same conceptual methods as organic illness, if psychological symptoms are isolated and assembled like physiological symptoms, it is above all because illness, whether mental or organic, is regarded as a natural essence manifested by specific symptoms. Between these two forms of pathology, therefore, there is no real unity, but only, and by means of these two postulates, an abstract parallelism. And the problem of human unity and of psychosomatic totality remains entirely open.” (Foucault, M. translation, Sheridan, A. Madness, The Invention of an Idea New York, Harper Perennial Edition 2011 p. 11)
I interpret this to mean that his two postulates provide a link between psychological and organic pathologies, only if both types of illness are in fact discrete entities. This view of illness does not address the issue that the make up of a human being consists of interaction between mind and body.
For those who are more familiar with Foucault’s philosophy, I would appreciate knowing if there is another interpretation of the above paragraph.
Back to diagnosis
If the idea of mental illness as a discrete entity is not philosophically sound, how can the current means of diagnosing them be valid?
The next question
With what does Foucault replace the conventional idea of mental illness?
It certainly seems to contradict what Foucault later postulated with regard to the way people are self governed within society, which I know may seem to be a side-step to the left, but he became very much of the mind that mind and organism were under functioning as a whole. Except that Foucault was an existentialist, and I always find that particularly philosophy to be troublesome because it presupposes that mental state follows the development of physical, and it clearly is not the consensus anymore, taking into account the developments since in the understanding of genetic memory.
Food for thought as always Jack. Hope all is well with you.
WR
YF
M
Thanks, M.
This is the first work that I’ve read of Foucault’s. The title, Madness, is what grabbed me. I’m interested in all takes about that subject. The liner notes cite this book as delineating “the profound shift that occurred in Foucault’s thought during this period [1954-1962].” Since I’m blogging as I read (I seem to be awfully slow on the uptake, at least in this book), I haven’t gotten to the position that Foucault shifted to. I did peek ahead and I think you are correct in saying that he considered the mind and body as a whole.
As always, you amaze me with your range of knowledge and your versatility. I’ve been a little behind in keeping up with your MpoWriMo and other blogs. I do hope you take care of yourself.
Warm Regards,
your friend,
Jack
Hi Jack,
Foucault is cited a lot within works dealing with sociology, particularly with regard to the functioning of social structures and governance. I dealt with Foucault as part of the first year of my degree programme. I’ll be interested to keep up with further insights you have. I’ve been a bit remiss with WP for some time now, so much going on that I’m only just beginning to find the time again myself to catch up with friends here, and with updating content. My main focus has been the photography and the poetry, other writing has taken a back seat for a while until I’m a little more settled in life.
It’s nice to catch up with you finally. You take care too.
Warm regards
Your friend
M
These are serious questions for someone only recently concerned with Klee’s magic tricks. For what, Jack, do we use medical diagnosis. As seen with the recent changes to the Diagnostic Manual, not just individuals and families, but providers, businesses and entire professions depend on how we split the hair.
Other than the social significance, we want to know what’s wrong because it is the nature of our nature. Some of us will nurture and some condemn. Some of us will heal and some will cure. It depends on our diagnosis. That is, what we have brought to the visible of the invisible.
That’s me, THGg, interested in many different things, hopefully integrating them when I can.
Very, very good question about diagnosis. Indeed, how else would the medical profession treat the masses? It does seem that physical illnesses are more amenable to being classified as entities. In Freud’s day, that was not the case for mental illnesses, even though efforts to classify mental disorders were under way in his day.
But there is a problem in classification of mental illnesses as discrete entities as Foucault begins to say.
In terms of DSM 5, forgetting for the moment, the enormous interest and influence of big pharma and others who stand to profit from the new classifications, the science just is not there to support the cause and effect of the majority of mental disorders. Not to mention the fact that some ‘disorders’ are essentially variants of the norm.
Knowing ‘what is wrong’ is certainly important. But – and I assume this is part of the philosophy of the healing garden – it is more important to have your eye on what is right, and not only what is right for certain symptoms, but for the whole body.
I would appreciate knowing more about your philosophy of the healing garden, especially if I am not correct in the above statement.
Thanks for your comments, as always, THGg.
best
Jack
It’s very chicken and egg, Jack. Perhaps you need to see a doctor about a social disease. That is, is it an illness of our society, our manner of diagnosing and treating disease; or an individual aberration. From what? In either case. More significant to us presently in the Healing Garden is the capacity for self correction. Of the individual. Of the organization.
I say to myself at 3:00am, I don’t feel so well. I go through a list of what I ate. Review my commonest ailments. By dawn, if ‘signs’ (auguries, perhaps) worsen, I may consult a professional (professional what? Diagnostician?). There are no quick cures to healing in our Garden. Each of us has our own ‘not right’, and for each of us there is a path to be teased out. This is the place of time in healing.
Gauss provided us the mathematics to turn healing into time and sell it by the tenth of the hour in doctor visits. We’ve achieved what the ancient Greeks feared: We’ve abstracted number and time until there is nothing left. Gauss built a superhighway into Probability, Statistics and even Algorithms by toying with the prime number 17. We got insurance companies, statistically average lethal doses for a 150lb 21 year old white male, computer programs that can tailor cancer therapy to your genomic type, and statistical justifications for the most inhuman research imaginable.
The healthy question is, what to do with all the extra time.
I’m not exactly sure what you mean, THGg. But I agree that each of us must listen to our own bodies and find our own path to feeling better, with help if necessary. And not just help, we need to question the person offering the ‘cure’ or the way to feel better and not blindly accept his or her verdict or course of treatment.
j