The Structure of Mental Disorder

Abstract

The present trend towards an atheoretical statistical method of psychiatric classification has prompted many psychiatrists to conceive of “mental disorder”, or for that matter any other psychopathological designation, as an indexical cluster of properties and events more than a distinct psychological impairment. By employing different combinations of inclusion and exclusion criteria, the current American Psychiatric Association's scheme (called DSM-III) hopes to avoid the over-selectivity of more metaphysical systems and thereby provide the clinician with a flexible means of dealing with a wide diversity of cases. In the hope of redirecting future inquiry, the paper will argue: (1) that this recent trend might appear to be clinically beneficial, but in point of fact it is riddled by unsound theoretical conclusions which leave the field without a deeply reaching base for understanding and treating mental disorder, and (2) that, a fortiori, “mental disorder” is best conceived as not a cluster of properties and events, nor a metaphorical reaction to a breakdown in social interpersonal relations, but as a deeply laid condition characterized by the absence of an imaginally integrated system.

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