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Mind, Brain and Mental Illness

  • Leslie Stevenson (a1)
Abstract

The distinction between mental illness and bodily illness would seem to presuppose some sort of distinction between mind and body. But dualist theories that the mind is a substance separable from the body, or that mental events could occur without any bodily events, raise ancient conceptual problems, which I do not propose to review here. What I want to do is to examine the psychiatric implications of materialist theories, which hold that the mind is the brain, or a function of the brain. If all character has a basis in chemistry, can we still attribute some mental distress to character and some to chemistry, as if the two categories were different?

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1 Frankl Victor E., ‘Reductionism and Nihilism’, in Beyond Reductionism, Koestler and Smythies (eds.), (London: Hutchinson, 1969), 399.

2 Stevenson Leslie, ‘Applied Philosophy’, Metaphilosophy I, No. 3 (1970), 258267.

3 Smart J. J. C., Philosophy and Scientific Realism (London: Routledge and Kegan Paul, 1963), 107.

4 Armstrong D. M., A Materialist Theory of the Mind (London: Routledge and Kegan Paul, 1968), 1.

5 See the translations from Brentano in Realism and the Background of Phenomenology, Chisholm R. M. (ed.), (Glencoe: The Free Press, 1960). Although Brentano's criterion will agree with the Cartesian one for most mental phenomena, there may be sensations such as pain which are conscious but without intentionality, and (if Freud was right) there may be desires which are unconscious but are desires for something.

6 ‘The Factors of Insanities’, in Selected Writings of J. Hughlings Jackson, Taylor J. (ed.), (London: Hodder and Stoughton, 1932). The passage is quoted by SirSymonds Charles in ‘Disease of Mind and Disorder of Brain’, British Medical Journal 5191 (2 07 1960), 15.

7 Smart J. J. C., ‘Sensations and Brain-Processes’, Philosophical Review 68 (1959), 142.

8 Op. cit. note 4, 41.

9 Op. cit. note 4, 57.

10 Macklin Ruth, ‘Mental Health and Mental Illness: Some Problems of Definition and Concept Formation’, Philosophy of Science 39, No. 3 (1972), 346.

11 Op. cit. note 10, 357–358.

12 Macalpine Ida and Hunter Richard, ‘The Pathography of the Past’, Times Literary Supplement 3758 (15 03 1974), 256257.

13 Drury M. O'C., The Danger of Words (London: Routledge and Kegan Paul, 1973), Chapter 2, ‘Science and Psychology’.

14 Peters R. S., The Concept of Motivation (London: Routledge and Kegan Paul, 1958), 12.

15 Szasz T. S., The Myth of Mental Illness, new and abbreviated edition (London: Paladin, 1972), 155156.

16 Szasz thus presupposes that explanation by reasons is not a form of causal explanation; cf. Peters in op. cit. note 14.

17 Strawson P. F., Individuals (London: Methuen, 1959), Chapter 3, ‘Persons’.

18 Szasz , op. cit. note 15, 102103.

19 Szasz T. S., Ideology and Insanity (Harmondsworth: Penguin, 1974), 13.

20 Miller Henry, ‘The Abuse of Psychiatry’, Encounter 34, No. 5 (05 1970), 26.

21 Stafford-Clark D., Psychiatry for Students Vol. I (London: Allen & Unwin, 4th edn, 1974), 180. See also Gattozzi A. A., Lithium in the Treatment of Mood Disorders (Rockville, Maryland: National Institute of Mental Health, 1970, revised 1974).

22 Glen A. I. M. and Reading H. W., ‘Regulatory Action of Lithium in Manie-Depressive Illness’, The Lancet 7840 (1 12 1973), 12391241.

23 Davidson Donald, ‘On Mental Events’, in Experience and Theory Foster L. and Swanson (eds.) (London: Duckworth, 1970); ‘The Material Mind’, in Logic, Methodology and Philosophy of Science, IV, Suppes et al. (ed.) (Amsterdam: North-Holland, 1973); ‘Psychology as Philosophy’ in Philosophy of Psychology, Brown S. C. (ed.) (London: Macmillan, 1974).

24 Nagel T., ‘Physicalism’, Philosophical Review 74 (1965); Taylor C., ‘Mind-body Identity, a Side Issue?’, Philosophical Review 76 (1967); Fodor J., Psychological Explanation (New York: Random House, 1968), Chapter 3.

25 Davidson D., ‘Causal Relations’, Journal of Philosophy 64 (1967), 691703. On the basis of this insight, Davidson can argue that explanation by reasons if a form of causal explanation after all (contra Peters)—see his ‘Actions, Reasons and Causes’, Journal of Philosophy 60 (1963), 685700.

26 Glover J., Responsibility (London: Routledge and Kegan Paul, 1970), 119.

27 Flew A., Crime or Disease? (London: Macmillan, 1973), 7071.

28 For more discussion of the concept of illness, see Margolis J., Negativities: The Limits of Life (Columbus, Ohio: Charles E. Merrill, 1975), Chapter 7.

29 Stafford-Clark , op. cit. note 21, 102103.

30 Laing R. D. and Esterson A., Sanity, Madness and the Family (London: Tavistock, 1964), preface to second edition (Harmondsworth: Penguin, 1970), 12.

31 As Drury points out in talking of ‘the fallacy of the alchemists’ in Chapter 1 of op. cit. note 13.

32 Op. cit. note 13, Chapter 5, ‘Madness and Religion’.

33 Previous versions of this paper have been read at the Philosophy Club in the University of St Andrews, at the State University of New York at Albany, and at the Western Psychiatric Institute and Clinic in the University of Pittsburgh. I am grateful to the discussions on those occasions, and to Adam Morton, Tom Nagel, Peter Railton, Richard Rorty, and Alan Spiro at Princeton, for criticisms which have saved me from many errors. I am also indebted to the University of St Andrews for a period of sabbatical leave, and to the Philosophy Department of Princeton University for encouraging me to come as a Visiting Fellow.

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