According to a major health survey, nearly half of all Americans have been mentally ill at some point in their livesmore than a quarter in the last year. Can this be true? What exactly does it mean, anyway? What’s a disorder, and what’s just a struggle with real life?
This lucid and incisive book cuts through both professional jargon and polemical hot air, to describe the intense political and intellectual struggles over what counts as a “real” disorder, and what goes into the “DSM,” the psychiatric bible. Is schizophrenia a disorder? Absolutely. Is homosexuality? It wastill gay rights activists drove it out of the DSM a generation ago. What about new and controversial diagnoses? Is “social anxiety disorder” a way of saying that it’s sick to be shy, or “female sexual arousal disorder” that it’s sick to be tired?
An advisor to the DSM, but also a fierce critic of exaggerated overuse, McNally defends the careful approach of describing disorders by patterns of symptoms that can be seen, and illustrates how often the system medicalizes everyday emotional life.
Neuroscience, genetics, and evolutionary psychology may illuminate the biological bases of mental illness, but at this point, McNally argues, no science can draw a bright line between disorder and distress. In a pragmatic and humane conclusion, he offers questions for patients and professionals alike to help understand, and cope with, the sorrows and psychopathologies of everyday life.
Richard J. McNally is Professor of Psychology and Director of Clinical Training at Harvard University.
Table of Contents
An Epidemic of Madness? 1
Are We Pathologizing Everyday Life? 32
Can Evolutionary Psychology Make Sense of Mental Disorder? 69
Psychopathology as Adaptation? 97
Does Society Create (Some) Mental Disorders? 128
Is It in Our Genes? 159
Do Mental Disorders Differ by Kind or Degree? 184
So What Is Mental Illness Anyway? 212
What People are Saying About This
David H. Barlow
The meaning of madness has confounded us for centuries. Now, we learn that half the population meets criteria for mental disorders. In this lucid and erudite book, Richard McNally tackles the difficult questions of science, philosophy, and politics that bear on this issue. His answers will have a great impact on the study of psychopathology. David H. Barlow, Boston University
Paul R. McHugh
Richard McNally's book is the definitive description of the cultural impact of DSM-style empiricism in psychiatry, and the mostly rational but ultimately unsatisfactory approaches that have led to the state of confusion over the nature of mental maladies and mental health we have today. Although our present chaos will probably last at least a decade past the publication of the DSM-V in 2012, all who long for the replacement of this strange and primitive answer to the question 'What is Mental Illness?' will find some hope in McNally's analysis of new ways of thinking about caring for patients and understanding the mind. Paul R. McHugh, M.D., Johns Hopkins School of Medicine