This article by Kristopher Nielsen has been published in Aeon. It begins:
“What exactly are mental disorders? The answer to this question is important because it informs how researchers should go about trying to explain mental disorders, how the public responds to people who experience them, and how we should go about developing treatments for them.
Despite the importance of this question, there’s little consensus on the answer. Some hold that mental disorders are brain diseases. Others argue that they’re social constructs used to medicalise aberrant behaviour. Some think that they’re evolutionarily adaptive behavioural responses that no longer work for us in a modern context. And some think that they’re errors or biases in our cognitive ‘coding’. Yet others believe that they’re just normal responses to terrible situations.
When I started my training as a clinical psychologist, I felt uncomfortable being exposed to these wildly different understandings of what exactly mental disorders are, and why they might or might not count as a disorder or a dysfunction. So, when I embarked on my PhD research, I decided to seek some clarity around this concept that serves as a foundational pillar for psychiatry, clinical psychology, and for so much of our discourse around mental health.
My starting observation was that what we take mental disorder to be is intimately related to how we think the human body and mind work, in a general sense. For example, a cellular biologist is more likely to take the view that mental disorders are brain diseases, compared with a sociologist, who might see the entire concept of mental disorders as a social construct. One’s understanding of how humans work influences one’s understanding of what it means for humans to be ‘dysfunctional’. In a silly example, if we got in a time machine, visited René Descartes, and asked him what mental disorders are, we might assume that his answer would be grounded in his dualistic understanding of the mind-body. Perhaps he would suggest that mental disorders represent corruptions of the soul, or maybe some sort of mechanistic breakdown in the soul communicating through the pineal gland.
This observation points to some interesting questions: might certain frameworks of human functioning be better than others at helping us to think about mental disorder? Might a more helpful view of human functioning produce a richer understanding of mental disorder? Narrowing the scope of my research, these questions brought me to a position known as ‘embodied enactivism’.
Embodied enactivism is a growing position in the philosophy of mind and cognitive sciences. It is a ‘biological’ position in that it recognises physiological processes vital in the quest to understand human behaviour, yet it places equal value on personal meaning and interpersonal scales of explanation. In this way, it manages to be non-reductionistic without ignoring the importance of our embodiment as biological creatures. It is this breadth of perspective that initially drew my attention to embodied enactivism as a framework of human functioning from which to consider mental disorder. Embodied enactivism sees the various scales of explanation relevant to understanding human behaviour as different aspects of the same dynamic whole – an organism standing in relation to its world …”
You can read more from here.