Mental Health &Psychiatry:University lancashire

THE INFLUENCE OF PHENOMENOLOGY IN THE FIELDS OF PSYCHOLOGY AND PSYCHIATRY

Phenomenology as a philosophical method plays an important role in psychiatry and psychology today. This paper will discuss the philosophical history of phenomelogy, which development dated back to the early years of twentieth century and the importance of this discipline.

What is Phenomenology?

It is very crucial to look at the definition of phenomenology before going to the details about its role in psychiatry and psychology. Phenomenology comes from the Greek word “Phainömenon“ meaning “that which appears“ and logos meaning study. It is quite difficult for me to come with a meaning and definition of phenomenology. It is common for writers, historiographers, and researchers to come up with definition of the topic and also be prepared to justify it by clear conception, in case of phenomenology, it has been interpreted in many ways and even philosophers and academicals even went on an “intellectual war“. There were even accusations of misinterpreting and misunderstanding of this topic and i hope this paper will be able to come out with clear definitions of phenomenology. In later stages of my writing i will be coming back to discuss this “intellectual war“.

I will not in this paper define phenomenology as a standard definition. A standard definition is a definition that a group or experts accepted and are not questionable. As i pointed out above, phenomenology will be difficult to define in a sentence. I will define this in different senses. Phenomenology in the broad sense as described by the platform of 1913 (logische untersuchung – Husserl’s work the logical investigation). I will shed light on this investigation in later stages of my writing. Phenomenology in the strict sense, which in addition to cultivating in intuitive experience without limitation to sensationalistic sources, in this case, special attention here is the appearances, that is, to the essential ways in which objects of whatever nature appear subjectively in experience. In the strictest sense, phenomenology can be described as a study of appearances of an object and the way they are constituted in consciousness. i could say that phenomenology can be seen as a study of structures of consciousness as experienced from the first person‘s point of view. The central structure of an experience is its intentionality, the way it is directed through its content or meaning toward a certain object in the world. It is my wish that at the end of my writing and after looking at the research done on phenomenology, the definition of phenomenology will be clearer.

The major types of phenomenology
This paper will look briefly at two types of phenomenology. The first type is called the Pure Psychology, this pure psychology is a theoretical form of psychology. It is social and theorectial in form and can be termed as the biopsychosocial perspective.

The second type of phenomenology is called the Transcendental Phenomenology. This type of phenomenology studies how objects are constituted in transcendal consciousness, setting aside questions of any reaction to the natural word around us.
These two major types of phenomenology share a number of aspects of method and stance. Their focus on meaning, in the sense that intentionalities create lived conscious sense of an object of attention.Please note that intentionalities is not to be seen as the English word derived from intention. Intentionalities in this case are mental processes that can be described for instance, how we perceive (sight or hearing) and conceptual (speech or writing). Complex ways of understanding the perspective and intention of others (emphathy) is also included in the similarities between these two major types of phenomenology. This paper will elaborate more on empathy on Jasper’s work on phenomenology. In the role of phenomenology in psychiatry and psychology, we shall see that both types of phenomenology are preparatory to applications of thought in decision making. These major types of phenomenology are not only focused on the objects of attention but also interpret how the above described intentionalities work together. The phenomelogical concepts have a direct mode of refering to, what can be acknowledged at first hand experience for themselves and in the second hand empathy of what others experience.

Jasper’s approach on phenomenology
The influence of phenomenology in psychology and psychiatry without Jasper’s contribution would be kind of a fish mixing in an aquarium. It is very important to discuss Jaspers causal and meaningful connections before moving to his historic phenomenological approach in psychopathology. I can also say, that phenomenology contribute to the development of Jasper’s psychopathology. Jasper discovered that psychopathology need to be reinvented and to be rebuilt on a phenomenological foundation.

Concept of understanding
The method of understanding according to Jasper is a way to understand one’s state of mental health. Jasper brought “verstehen”(understanding) which is clasified in “Geistes wissenschaften” (Human Sciences). In “vestehen” (understanding) we are dealing with human phenomenon, not test theories, experiment or causal hypothesis. In order for me to show clearly the main features of understanding i will use a common example. A mother that just lost one of her closest relative started crying, her little daughter noticed that her mother is crying so she started crying as well. In this above mentioned example, her little daughter crying can be understood as crying out of empathy, that is, putting herself in her mother’s feeling. Lets come back and look why the mother is crying? There are two observable facts; the loss and the crying. We could say and understand that the mother cries due to the loss of a closest relative, but the connection here has nothing to do with causal explanation. Did the mother cry because of the experiences shared with closest relative or just because of the loss, or the fact that the closest relative will not come back anymore. As a matter of fact and as you can see observable facts are not enough to know the precise reason why the mother was crying. There are many things to adduce and to be taken into consideration.

Firstly, factualities are the most important things in an inquiry,as you will notice in the court of law. How do we define facts? Generally speaking, facts is a pragmatic truth, that actually takes place in space and time, it can be checked, confirmed or denied. With respect to understanding the facts meant here is our inner acts for example moods and experiences. Inner and subjective factualities do not exist as a perceivable fact. We noticed them from example from our articulations (verbal). The understandable of factualities can be referred to as a phenomenal of inner life of thinking.

Actions is also a factor that we need to take into consideration during the process of understanding. It is a kind of outer manifestation of inner factuality like people always say actions speak louder than words.
Works as a products of activities is also a factor to be considered during understanding. Documents and testimonies are also very crucial in understanding, but in both cases we should de very careful on how we use them. Documents are the main ways to keep information, one need to know, what purpose, and under whose authority. Jasper explained that, there is a point in the practice of a good psychiatrist, when is psychological understanding is not only a methodical but an art, even as practiced physicians diagnostic activity is not only scientific practice but also an art. .Jasper went on to describe two main categories of understanding.
1. Understanding of someone’s mental well being, this is described as a static understanding (statische vestehen).
2. The genetic understanding (genetische vestehen) is how the primary state, that is, the well being of someone becomes secondary.
For Jasper understanding (vestehen) is referred to as an intuitive feeling and knowing (erklären) as objective and natural knowledge.
As described above understanding connections between understandable factualities is very complex but without a doubt very crucial to understand the inner factualities. If all these factualities, that i mentioned above is taken to full account during an inquiry or investigation, there is a high possibility of understanding the exact reasons why the above mentioned mother cried. This example of understanding can also be applied in practice. I will comment on this later on the role of phenomenology in psychiatry and psychology.

The historical concept of phenomenology by Karl Jasper
Phenomenology as a philosophical method was taken to another level by Karl Jasper during medical examination of medical patient, we have to distinguish between objective and subjective symptoms. Objective symptoms are all events that can be perceived by senses like reflexes, registrable movements, verbal expression, written productions and also very important to include the patient dellusional ideas and falscifications of memory. The subjective symptoms can not be perceived using sense organs but by transferring oneself, so to say into the other’s individual psyche, that is, by emphathy. The only way for the observer to gain this particular information described above is by participating in others person experience and not by an intellectual fact. The subjective symptoms include fear, sorrow and joy. We should not forget that the objective symptoms are very crucial because they are needed for preliminary assement but not conclusive and reliable for making final judgements. Jasper claimed that there is a widespread desire to base the study of mental disorder on only objective symptoms. It is clear to see that Jasper is not taking an antipsychiatry stance but tries to link mental disorder as an illness and not to deny the social cause which could be a factor.

The objective and the subjective symptoms need to be taken to account in order to get to the final realisation of a concept. Before an inquiry begins it is necessary to identify the psychic phenomena which are to be its subject, and differences, similarities and resemblences between them should not be confused. Jasper went on to say this preliminary work of representing, defining and classifying psychic phenomena as an independent activity, constitute phenomenology. During subjective analysis we should picture as an analyst or expert only what is present in the patient consciousness, all outmoded psychological construct or materialist mythologies should be excluded in our findings. Phenomenology require the freedom from preconception which is really difficult to acquire but practice makes perfect. This ability can be gained through training and prolong critical work and much effort.

After recognising this psychic phenomena, we need to characterise them and give the cenceptual form. It is important to compare and symbolise this psychic phenomena to other phenomenon, that we are aware of. According to Jasper, whoever is unwilling or incapable of actualising psychic events and representing them vividly and clearly can not acquire an understanding of phenomenology. In Jasper’s historic work on phenomenology he described the methods required to be used when carrying out phenomenology analysis.
1. Gestures, behaviour, expressive movements.
2. Questioning in order for patients to give their own experiences.
3. Written self descriptions.
When using these methods mentioned above, the information acquired or obtained from the patient may be chaotic, but we need to differentiate, give names to the phenomena that we come across. Classification in groups of the known phenomenas is needed in order to make comparison simple and that helps the analyst to get a quick resolution to the issues.

Psychic phenomena can be classified according to their phenomenological affinities with each other, in addition the boundaries of phenomenology should not be confused with anything else. Jasper went on to list those boundaries.
1. Phenomenology should concern itself only with actual experiences not with factors that underlie psychic events.
2. For everyone of its findings phenomenology must ask: has this actually been experienced?
3. Phenomenology has to present itself as the subject of consciousness.
4. Theorectical proposition must be excluded as phenomenology can not gain anything from theory.
5. External manifestation must be excluded.
6. Phenomenology has nothing to do with the origin of psychic phenomena.
7. Phenomenology must be kept seperate from what we call the genetic understanding (genetische vestehen) of psychic events.
It is very important to account for every psychic phenomenon that comes to light during investigation if these are not accounted for then our findings will not be accurate. There are other phenomenologists that contributed to the development of this descipline. I will be looking on this paper at other analysts contributions.

The central doctrine of Husserl’s phenomenology
Phenomenology as a movement and as a philosophical method needs the accreditation of Edmund Husserl. Husserl started his career as a mathematician and even wrote the philosophy of arithmetic in 1891. Husserl defines phenomenology as the scientific study of the essential structures of consciousness. The main focus of Husserl’s phenomenology is the thesis that consciousness is intentional which was also used by his mentor.Franz Brentano. According to Brentano, (1874, 88-89) in his book Psychology from Empirical Standpoint, I quote:-“ every mental phenomenon is characterized by what the scholastics in the middle ages called the intentional (and also mental) in existence of an object, and what we could call, although in not entirely unambigious terms, the refence to a content, a direction upon an object. (which is notto be understood here as meaning a thing), or immanent objectivity. Every Mental Phenomenon includes something as object within itself, although they do not do so in the same way. In presentation, something is presented, in judgement something is affirmed or denied, in love loved, in hate hated, in desire desired.”
It is clear to see from this Brentano quote that Husserl adapted the idea of intentionality from his mentor. Bentano went further to define Mental Phenomenon as phenomena which contain an object intentionally within themselves.

For Husserl every act of consciousness is directed at material objects, thus the phenomenologist can differentiate and describe the nature of the intentional objects of consciousness, which are defined through the content of consciousness. We have to note that one can describe the content of consciousness without the existence of that object. This literally means one can describe a dream clearly in much the same term as if one is experiencing it live.

In general introduction to pure phenomenology (1931) Husserl distinguishes between the natural (plural noemata). Husserl refers to “noema” as the internal structure of mental act and the phenomenological stand point (epoche). “Epoche” the phenomenological reduction is meant to help get essence of mental acts by suspending all naive presuppositions about the difference between real and fictious entities. This phenomenological stand point can be achieved by way of a series of phenomenological reductions, which eliminate our experience from consideration. He proposed by bracketing the question of the existence of the natural world around us, that is, phenomenologists brackets out all questions of truth or reality and simply describe the contents of consciousness. According to Husserl the empirical content of consciousness should be eliminated and that our attention has to be focused on the essential features.

In his early work, Husserl defend the realist position by saying things that are perceived by consciousness are assumed to be not only objects of consciousness, but also the things themselves.

Other phenomenologists contributions to phenomenology
It is not only Husserl and Jasper that contributed to phenomenology as a philosophical method, we have Edith Stein who was Husserl’s student. She also link phenomenology with religion. Actually the Hindu and Budhist philosophers reflected on consciousness state that is achieved in a different meditative state.

During Edith Stein doctorate thesis, she worked on the problem of emphathy. She described empathy as the experience of the other’s conscience status. Stein linked phenomenology with religion by saying that some unique phenomena exist, as those of the saint. The soul was described by Stein as an inner circle, like a space with many residences, where the ego can move freely. She disagree with Husserl’s phenomenology that asserts a transcendence without God. According to Stein the Being is prior to the spirit.

Emmanuel Levinas phenomenology is somehow similar in some part. They both use alter ego to describe empathy. Levinas was exploring the meaning of intersubjectivity based on the three main points:
1. Transcendence
2. Existence
3. The human other
The phenomelogical description of intersubjectivity is based on our daily activities, that is, we create, enjoy and also suffer from the natural element of life and also carries on the social and economic transactions of daily life. Levinas claim with the response comes the beginning of language and this simply means dialogue happens through response. He also describe all consciousness to be consciousness of something. In this case consciousness is not what we experience only psychism, its meaningfulness, thoughts casting themselves towards something that shows itself in them.

Max Scheler was also like Stein student of Husserl and embrace the phenomenology of ethics in his book ‘In the Nature of Sympathy’, (1954), he used the cognitive view to describe emotions. He argued that emotions could be constructed as a source of knowledge and universal.

Martin Heidegger was also a scholar and student of Husserl was more interested in human existence in (Being and time, 1962) Heidegger agrees with his mentor Husserl that philosophical investigation should begin without presuppositions, but he abandoned consciousness and experience in his work. He also rejected any dualism in respect to mind and body.

Sartre phenomenology in Being and nothingness empasize on the philosophy of existentialism and reveals the experience of freedom of choice in case of choosing oneself or defining pattern of one’s past actions.

In 1940 Maurice Merleau-Ponty partnered with Sartre in developing phenomenology he emphasize on the role of body in human experience. He focused on body image, our experience of our body and its significance.

Influence of Husserl on other philonomenologists
As we can see from my writing Husserl has been an influence on many phenomenologists some of whom were his students even though some of his students rejected his work on transcedental phenomenology. According to Jasper (1911) paper “the analysis of first 1perception he referred to Husserl’s analysis i quote:- we give a second example from Husserl: ‘I see a thing, e.g this box, but i do not see my sensations. I always see one and the same box, however it may be turned and titled.’ The experience of the sensation always appears in consciousness. It remains the same intending-the box as its object-the same act. We have the total experience of perception to-and-fro of tilting box, changing parts, sensations, and constant and invariable ‘intending’ of the box. Jasper (1911)1963a, p.197.

From this quote above we could see that Jasper was relating to Husserl’s work on the analysis of false perception. He described how a matter on an intentional act can remain constant, even when the sensory content changes. Its is also very important to note that Jasper phenomenology is quite different from Husserl. Wiggins and Schwartz (1995) supported the view above that Husserl was a major influence on Jasper. They use the role of intuition in Husserl’s phenomenology. Husserl supports the descriptive and presuppositioness nature of phenomenology and they also argue that the Husserl approach demanding for an accurate descriptive taxonomy of mental state shares some similarities to Jasper’s view. Even though though Chris Walker disputes the influence of Husserl on Jasper. He supported his view by Jasper rejecting the eidetic approach of Husserl’s later phenomenology. He even went further to conclude that Jasper misunderstood Husserl’s early work on phenomenology so therefore, no real influence on Jasper.

Berrios also finds evidence of an influence from Husserl. He argues tha Jasper understood the conceptual scheme of mental state that Jasper learnt from Husserl why he was working in Heidelberg .

The influence of Husserl on Levinas can also be traced back in the theory of intuition in Husserl’s phenomenology a dissertation from Levinas that was supervised by Husserl. In the early essays Levinas credits Husserl for establishing as the foundation for essence and phenomenological reduction allows for intentionality which reconciles empiricism with rationalism.
As early as 1929, Levinas considered Husserl’s phenomenology to be dependant upon “I” a subjectively oriented phenomenology. This requires thought upon constitution for the “I”. The “I” must be seen in the intersubjective context because objectivity must be shared with others “I’s”. Levinas concludes that egological phenomenology must be subordinated to intersubjective phenomenology.

Sartre was also influenced from Husserl’s phenomenology even though he stated that he learnt it in French through the work of Levinas on Husserl’s phenomenology. We can say there is indirect influence on Sartre.

The concept of phenomenology from Husserl also add an influence on Edith Stein she said “not for nothing in the Husserl school that the emphasy was on examination of things without presuppositions, this brought her to a new sphere of phenomena.

The dispute about the concept of phenomenology has been a plague on phenomenology as a philosophical method even Husserl was upset that some of his students did not continue what he started but took a different path. He was not really happy that Jasper and Heidegger took a critical stance towards his new theories and also Stein who also rejected Husserl’s transcender phenomenology without God and also disregard with Heidegger emphasy on existence.

The contribution of the above mentioned phenomenologists has contributed to the phenomenology as a philosophical method both in Psychiatry and psychology.

The role of phenomenology in psychiatry
The word phenomenology is quite common today in the psychiatric literature, to the credit of Jasper, whose work contributed to the classification of mental disorders. The subjective aspect of clinical psychiatry in practice tend to mean the lived experience of patients.

In the French psychiatry, Eugene Minkowski explained how various basic pathological situations expressed specific alterations in the subjects relationships to time and space.

Bracken’s work on the analysis of “Dasein” offer new treatment methods in clinical psychiatry today. Phenomenology offers a methodically developed theory of human subjectivity, that is, indispensable to any attempt to understand, explore and treat psychiatric disorders.

The Mental Status Examination (MSE) is a practical approach psychiatry, it is generally known as a descriptive phenomenology. This mental status examination is a crucial part of clinical evaluation in pyschiatry. It is a structured form of observing and analysing a patient immediate or current state of mind, whereby the analyst or psychiatrists in this case empasize on appearances, attitude, behaviour, mood, affect, speech, thought process, thought, content, perception, cognition, insight and judgement, these can be seen as what Jasper described as subjective symptoms and objective symptoms ,which can not be obtained using sense organs by transferring oneself into the other individual, that is, by the way of empathy(subjective symptoms). The goal of the mental status examination is to acquire a comprehensive description of the patient, mental state. This allows clinician to make an accurate judgement, and we should note in order to make a correct judgement the concept of understanding need to be fully understood. In any inquiry that will lead to a final judgement, the factualities mentioned on this paper need to be fully considered. It is clear that accurate judgement leads to accurate diagnosis and treatment.

The mental status examination can be linked with the historical work on phenomenology by Karl Jasper. According to Jasper the only way to comprehend a patient’s experience is through his or her own description (empathy and non theoretical approach.

It is a key part of psychiatry assessment that systematic collection of data based on the patient’s behaviour during interview. These datas helped the analyst or psychiatrist to obtain evidence of symptoms and signs of mental disorders. The details obtained during mental status examination (MSE) is used, together with the biographical and information of the psychiatric history.

In the case of multiple personality disorder (MPD) clinical phenomenology was applied to characterized and categorised an unusual dissociative condition. During the study 100 recent cases of disorder was studied. The study documents shows the existance of clinical syndrome characterized by core of depressive and dissociative symptoms and a childhood history of significant trauma of child abuse.

The role of phenomelogy on psychology
According to Jasper subjective psychology is part of phenomenology. In subjective psychology own mind and various actions as a basis of psychology deductions. Phenomenology is being used today by psychologists in practice in the field of psycho analysis. Phenomenology also used by therapists as a way of treatment of patients.
Ludwig Binswanger introduce existential psychotherapy that he termed “Dasein analysis” based on Heidegger’s concept. Ludwig Binswanger an existential psychologist, suggested that in order to fully understand how existence feels which is at the heart of phenomenological approach, experiences need to be understood at three different levels.
1. Biological – in order for us to understand how existence feels, we need to be aware of our physical sensation such as pain and pleasure.
2. Social (mitwelt) – our social relations, that is, your thoughts and feelings that one receive is your experience and one should be aware of it.
3. Inner psychological experience (eigenwelt) – in understanding how existence feel, we need to understand our inner working of ourselves. This attempts to understand ourselves is termed the experience of experiencing oneself.
4.
Rollo May also worked on the existential perspective which can also be derived from Heidegger’s work. May believed that individual can only be understood in terms of their subjectivity sense of self, that is, higher consciousness in us, it raises the psyche and self to a nobler level. He believes that abnormal behaviour is a strategy used to protect the centre (subjective sense of self) against threat.

In psycho analysis and phenomenology we could say that neither posits a prior that humanity is the measure, good or bad, of all things, and admit any assumptions prior to what is shown by clinical experience. It is very clear that phenomenology can be applied or interpreted in different ways, but it is a very important descipline that an analyst, a psychiatrist or a psychologist need to understand in order to make a good judgement, and for a good judgement understanding the factualities is very important.

Conclusions
This paper has looked deep to the history of phenomenology as a philosophical method and the problem encountered in defining it. This paper has managed to define phenomenology in different perspectives and interpret it in such a way that could be easily understood. Steven Crowell said that the future prospects of phenomenology will depend on the talent in the field of psychology, psychiatry and future analysts who will it take up. I strongly agree with this view and we can also see the intellectual warfare that are plagued much of the its history as a positive influence in a descipline of phenomenology. Without the debates progress would not have been a reality. It is also clear that the intellectual warfare severe the personal relationship of academicals. Phenomenology would have not have been where it is today without the contribution of the above mentioned phenomenologists. I hope this paper will help to show the importance of phenomenology as a philosophical method in our society and also hope the views described on my paper would be beneficial to all humanity.

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Is Mental disorder an illness?
The purpose of this essay is to analyse the pro psychiatry and the anti pschiatry views. In my writing I will show the similarities, the differences of opinion, I will also elaborate on the” likeness argument”, show the Fulford’s view on the concept defination of bodily illness. The input of other experts on this debate will also be analysed. This paper is going to be neutral on the debate of mental disorder as an illness and the main categories of mental disorders that could be found in psychiatry textbooks of today will be briefly discussed.

According to the Princeton Medical Dictionary, illness is defined as impairment of normal physiological function affecting part or all of an organism. My so called common defination illness can be defined as a state of poor health. This defination of illness that I described above may appear too simple but in later stages of my writing I will be back to elaborate on the defination.

ANTIPSYCHIATRY VIEWS ON MENTAL ILLNESS
The term antipsychiatry was first used by David Cooper, the movement in which Ronald D Laing, Thomas Szasz and other leading prominent antipsychiatrists support.
Thomas Szasz is one of the prominent to attack psychiatry primarily on the conceptual reasons that mental disorders are not illnesses but a myth. Thomas Szasz did not go deeply to define mental illness but shows how psychiatrists, physicians and other scientists describe it, i.e, there is a neurological defect that will be found for all mental disorders and mental illnesses are not different from body diseases. In elaborating more about body diseases he described that a lession in part of the central nervous system will not lead to complex bit or strange behaviour but to paralysis or blindness.

Let us take a closer look at the above Princeton definition of illnesses, that is illness can also be perceived to be a change of normal physiological function. This simply means that all diseases and illnesses should be as a result of physiochemical processes. In order for me to make this clear, I will use an everyday example to describe, smoke inhaled contains carbon monoxide (co), and has a stronger affinity to red blood cells than oxygen, that is, carbon monoxide block the transport to oxygen to the brain or to all parts of the body and the concentration quantity could result in a disease. This example mentioned above is a physiochemical that can be well explained and also similar to Thomas Szasz’s example with the central nervous system. For the antipsychiatry movement mental illness is not considered to be a physiochemical process but a social problem (for example coping with life). The propsychiatry community disagree with the assumption that there is a physiochemical process that is linked with mental disorders. Mental disorders are most cases not differentiated from the body illness. This definition of mental illness according to antipsychiatry view on mental illness is unnecessary and misleading.
Mr Szasz, regards the medical model of mental illness as an ideological justification for coercion. It is a way of excusing violence against mental patients by representing it as a treatment. Psychiatry cannot be justified medically or morally. He quoted the Philosopher John Stuart Mill to support this view :

"The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warranty."

According to the antipsychiatry view, it is a precondition of a free society that we do not force help on one another. We must be free to make our own choices and decide what is in our own best interest. In a society pledged to the advancement of individual freedom and responsibility, the State, the family and the medical profession must restrict themselves to offering help. And the law should prevent psychiatry forcing help on unwilling people. There is a view to replace the illness model of mental disturbances with an analysis in terms of meanful (but perharps unconscious) communication. Hysteria is for example a psychological disorder that manifest itself as a physical illness, this is passived in the anti psychiatry community as a dramatised representation of the message, my body is not functioning well. Also depression is described as a dramatisation of the proposition that am unhappy.

Thomas Szasz said, “no behaviour or misbehaviour is a disease or can be a disease.”
Thomas Szasz in most cases use the “likeness argument” to describe his views, that is, before a mental disorder can be called illness, it must have features of physical bodily illness, so change of a behaviour will not be a disease or an illness.

If people are behaving or thinking in disturbing way that is not a mental ilness or disease and do not even consider schizophrenia any disease becuase he believes that disease or illness must somehow be capable of being approached, measured, or tested in scientific fashion.
According to him psychiatrists are nothing but "soul doctors", the successors of priests , who deal with the spiritual "problems in living" that have troubled people forever, even though he is a Professor of Psychiatry.

He also thinks that separating people who behave differently and considering them mental is a social control system, which disguises itself under the claims of scientificity and thinks its kind of secular state religion.
He states that mental illness, madness and even many crimes are created or defined by cultural controls, morals and "real world" views of big science, religion and government, similar to heretics, pagans, and sinners before the industrial revolution. Szasz does not say that compulsory psychiatry is always harmful to the patient. His basic case is that it is incompatible with a free society. He says, in fact, that some increase in liberty gained by outlawing compulsion, might be at the cost of the impaired health or even death of some people who, he says, make themselves ill, or who want to kill themselves. Szasz says, that Freedom, entails the right to make the 'wrong' choice.

The are are also psycholologists and sociologists that believes mental disorders are learned abnormalities of behaviour. Schneider also define neurotic illness and personality disorders as an abnormal varieties of sane mental life, the British psychologist Hans Eysenck share this view (the psychological model).

The French philosopher Michel Foucault also argued that the medical model was an invention by man in the nineteenth century in response to the needs of the industrial revolution. The purpose of this version of antipsychiatry is to legitimise what the society seems to be deviant, dangerous or abnormal (political control modules). The unconcious mind models defines mental life as a product of unconcious mental activity.
The American Sociologist, Thomas Scheff describe the label model as a characteristic of mental disorder are no more than a response of the individual to be labelled as deviant or abnormal. The late Scottish R.Laing describes the hidden meaning models as hidden meaningfulness of apparently meaningless behaviour.
Szasz concludes that mental illness being different in meaning from body illness, is a myth.

PROPSYCHIATRY VIEW ON MENTAL ILLNESS
I would like us to take a closer look at my so called common man definition of illness, that is, state of poor health. Are people suffering from mental illness in a state of poor health? One of the prominent support of psychiatry is R.E Kendell , he works on the concept of diseases and opposes Professor Szasz’s point on view. The propsychiatry community believes that the mental illness existence should not be questioned at all because it exists. He attacked the antipsychiatry prominent like Szasz by saying “it is equally meaningless to assert either that something is, or it is not, illness unless one has a clearly defined concept of illness.

There are many definitions of illness in medicine but lack agreed definitions of illness in general. It is extreme difficult to produce a unified and acceptable definition of illness. Back in the ancient days symptoms and signs are also noted as disease. There are diverse definitions of illness, for example, the Lord Cohen’s definition of illness. This definition from Lord Cohen does not cover positive abnormalities like superior intelligence, which also is a deviation from the norm. Deviation (reduction) of iron (fe2+) from the norm in the blood leads to less oxygen molecules not binding to it and that could result in a state of poor health. This given example above, define illness to a certain extent but fits perfectly to Lord Cohen’s definition and I believe personally that this is inadequate because superior intelligence and other beneficial deviation are not illnesses.

Mr Scadding defines illness in another way not as physiochemical process that needs to manifest but by its consequences. The definition of illness as a condition in which one suffers is also not adequate because man can suffer without getting ill. Mr Scadding described the concept of biological disadvantage, that is, anyone suffering from a body illness or mental illness produces some kind of biological disadvantage although he did not explicitly explain what he meant by “Biological Disadvantage.”

As we can see from the pro and antipsychiatry disagrees about the meaning of bodily illness, Szasz define bodily illness by anatomical and physiological terms and defined mental illness by norms that are ethical, social and legal, and do not fit the features of physical bodily illnesses, this point highlighted why mental illness is a myth for Szasz, while Kendell define bodily illness as norms relating to ”biological disadvantage” and that this mental illnesses fit the features of physical bodily illnesses. Mr Kendell says, if any definition needs to be accepted for the definition of illness then it should be Scadding’s definition (the concept of biological disadvantage). As I described earlier Mr Scadding did not explain deeply what he meant by biological disadvantage. I can also prove that Scadding’s biological disadvantage is also inadequate. Is biological disadvantage a negative expression? Should everything that produces a significant biological disadvantage considered as an illness? Everything depends how one interprets biological disadvantage. According to Mr Kendell the concept of biological disadvantage is the best definition. Mr Kendell say that “there is enough evidence to show that Schizophrenia and manic – depressive and some sexual disorders carry and intrinsic biological disadvantage. With this point Mr Kendell stress on a link or similarity of mental illness and a physical illness and also show clearly that mental disorder is an illness because some mental disorders if not all share features of a physical or bodily illness. He cautioned not to describe all mental disorders having similarities of physical illness. He used the “likeness argument” like Szasz but reach a different conclusion. Propsychiatry like Kendell, believes that mental disorder is an illness and a reality and should be treated as an illness.

It is also fascinating to show the similarities opinions between the pro and antipsychiatry community which is quite uncommon in “pro and anti discussions.” I will be elaborating on the similarities and their core differences.
Kendell concludes mental disorder is an illness and a reality based on the above description of biological disadvantage.
SIMILARITIES BETWEEN THE PROPSYCHIATRY AND ANTIPSYCHIATRY

Firstly they agreed that the concept of mental illness is the problem whereby the pro side agreed that mental illness is an illness and the anti side as a myth.
Both sides agree that mental illness is more obscure in meaning than bodily illness.
Mental illness is more value-laden in Kendell’s paper.
It’s also fascinating that the conclusion is really similar but the closing is different, because the pro and anti side support some kind of moral boundaries, for example, absurd claims that all happiness and all undesirable behaviour are manifestations of mental illness and Kendell says that psychiatrists should know the boundaries and need to consider where there is sphere of responsibility end.
Thomas Szasz specifically argues that the concept of mental illness by norms that are psychosocial, ethical, and legal whereas Kendell says mental illness is more value-lading.
Szasz does not say that compulsory psychiatry is always harmful to the patient agreeing with Kendell on this point.

DISAGREEMENTS BETWEEN PROPSYCHIATRY AND ANTIPSYCHIATRY

What definition or the meaning of bodily illness that should be accepted, Thomas Szasz takes bodily illness to be defined by anatomical and physiological norms, and mental illness in meaning and definition fails to fit the templete of body illnesses, whereas Mr Kendell defines body illnesses as anything that can produce a significant or kind of biological disadvantage which he associated with reduced life fatality and this fits in with the templete of body illnesses.
Szasz concludes that mental disorder is not an illness but a myth.
Kendell concludes that mental disorder as an illness should not be questioned because it is a reality.

FULFORD ANALYSIS ON THIS DEBATE
According to Fulford, some mental disorders possess similarities with bodily disorders while some do not. Medical Practioners emphasize more on the similarities and the antipsychiatry views highlight the differences from bodily diseases. As you have seen from my writing so far, that there are similarities and differences between them. Most people put schizophrenia and dementia as part of the bodily medicine and if for example schizophrenia is a genuine illness, Szasz argued the concept of mental illness fall with it. Fulford’s point of view is to show that body illness concept is not all that clear in defination as it shows on Szasz and Kendell’s paper. He also notes the terminology used to describe mental illness contribute to some of the avoidable discussions. There are different types of mental disorders and these disorders are really more diverse than bodily illnesses.

The symptoms of bodily disorders, for example, are pains or dizziness etc, while mental disorders are the disturbance of the emotion. Mental disorder variable status as illness, the further it is from bodily illness the easier it is for disagreements. The further the bodily disorder is, the more it affects its status as a mental illness. The value-ladeness of mental disorder is crucial.

The concept of bodily illness is not that straight forward as we can see from the above analysis. It is very important that we take the diversity, distance from bodily disorder, variable status as illness and degree of value-ladeness, when analysing disorders. The value-ladeness is a notion that value orientations and biases of an intistitute, a discipline or culture coshape the way scientific questions are framed, date selected, interpreted, rejected, methodologies are devised, explanations are formulated. Some theories are always under determined by observation, the analyst biases will fill the epistemic gap which makes any assesment to a certain degree value-ladding.

MAIN CATEGORIES OF MENTAL DISORDERS
It is also very important that we briefly describe the main categories of adult mental disorders by so doing it will share light on the likeness argument that Szasz and Kendell use to describe their views.

Organic disorder- in general any disorder that is caused by known pathological condition of an organic structure may be categorised as an organic mental disorder. The propsychiatry believe most serious or psychotic mental disorder will be proving to have an organic cause, for example, delirium, which is caused by known physical dysfunction of the brain. Organic hallucinations, that is, when people show size distortion, coloured and moving objects. Frontal lobe syndrome is also an example of organic classification.
Alcohol or drug use disorders – this is a disorder in which pathological behaviour changes are associated with the regular use of substances (cocaines, alcohol) that affect the central nervous system.

Psychotic disorders – this mental disorders in which the personality is seriously disorganised and a person contacts with reality and often experiences delussions. The charactericts of this disorder are associated with bizzare behaviour.

Affective disorders – this kind of disorders are called depressive disorders and is characterised by a consistent alteration in mood and affecting thoughts, emotions or behaviours. They are often associated with biological symptoms like reduced sleep, sexual disorder, flight of ideas and pressure of speech.

Anxiety disorders – are groups of disorders which affect behaviour, thoughts, emotions and physical health. Anxiety disorder can also coexist with physical disorders and sometimes referred as neurotic disorders, for example, panic attack, phobias and hysterical state (composive disorders).

Disorders of vegetative functions – vegetative functions are those bodily processes with maintance of life, for example, nutritional, metabolic and endocrine functions including eating and sleeping. Disorders of this functions can lead anorexia nervosa and bulimia.

DISTINCTION BETWEEN DISEASE AND ILLNESS
It is very important to look at Boorse’s work on the distinction between diseases and illnesses. This will assist us in understanding the concept, as this is an important issue in the propsychiatry and antipsychiatry views. He recognise that mental illness to be the problem and call for a better defination of bodily illness because he believe that by having a better defination for bodily illness, this will enhance the general understanding of mental illness.

Boorse also recognise the value-ladeness of mental illness and call for a value-free science. He argues that the main problem of mental disorder is the terriorial ambitions and that there should be kind of boundaries. This view is also taken in the propsychatry and antipsychiatry community. He also wrote further by showing distinction between illness and disease. He defined illness in terms of biological disadvantage and siding with Kendell and Scadding definations and identified diseases as scientific medical theory.

This distinction made by Boorse made it easier to define illness as a disease, which is “serious enough of incapacitating”. Another advantage of the distinction is also the easy understanding, that is, to be ill is to be in a bad condition, and all other things being equal.

In my writings i discussed about the “likeness argument” in which the propsychiatry and the antipsychiatry community used to describe their views. Fulford wrote about this but did not directly criticize the “likeness argument”. I will be taking a closer look at the “likeness argument” and the reality of mental illness by Neil Pickering.

“THE LIKENESS ARGUMENT”
Pickering also recognised that mental disorder as an illness is a fundemental issue in the philosophy of psychiatry and he believes the best way of resolving this issue either propsychiatry or antipsychiatry is the “likeness argument”. It states that mental illness exists or does not, depending on the extent to which mental illnesses, for example, schizophrenia is like universally accepted disease. The feature of schizophrenia will decide whether they are illnesses or not. He referred to the debate between the propsychiatry and the antipsychiatry as a dispute.

If the features of the so called mental illness have similarities with the physical illnesses then the “likeness argument” will hold. Pickering also raise the doubt whether the likeness argument will hold, stating that his paper will not favor the propsychiatry and antipsychiatry view like Szasz and Kendell.
According to Pickerring, there are two forms of “likeness argument”. Any mental illnesses having features of physical illness will be classified as illness and when this feature does not exist, it will be wrong to categorise them as mental illnesses. Is described these two forms of the “likeness argument” as a paradigm and the generic approaches.
There are numerous authors that support the paradigm approach, an example is, Ausubel. He states that the malad adaptions and malad adjustments in physical disease, also exist in personality disorders and concluding it to be a disease and we could take this view from Ausubel as a propsychiatry view using the paradigm approach of the “likeness argument”. Fulford also announces that he will argue “cholera, ataxia, and paralysis” via “pain to mental illness”.
The generic form or approach shows abstractions from that of bodily illness. Culver believes that there is no fundemental difference between physical malladies and mental malladies and his defination of mallady contains no bodily or physiological process.
Pickerring raise his doubt about the “likeness argument”, that hold the views of the propsychiatry and antipsychiatry view as a failure. He believe the “likeness argument” was created to resolve the dispute between the two sides (pro and antipsychiatry) but the dispute still continues.
According to Fulford work on Szasz and Kendell he states that even though both manage use “likeness argument”, still they fail to reach similar conclusions and the dispute lives on.
Pickering discribes the weak objections to the “likeness argument”. He wrote “human conditions such as schizophrenia are illnesses or are – not – by virtue of their features.” These features are not enough because the human decisions and interest plays a deciding role.
He described the strong objection to the “likeness argument” by using alcoholism and schizophrenia stating that the “illness like” disappears when we tend to describe it as a failure of self monitor just like Frith explains in his paper.
Pickering went on to conclude that the “likeness argument” that the pro and antipsychiatry used to describe their views failed because the “likeness argument” stand for resolving the dispute and does not really help conditions like schizophrenia, whether to be seen as illness or not and he says that the “likeness argument” must fail.

CONCLUSIONS
I have been able to analyse the propsychiatry stance and the antipsychiatry point of views. I also show the similarities and their core differences, also included the Fulford view on the concept defination of bodily illness, that disagree with the pro and antipsychiatry view, that is, the position that Kendell and Szasz took, I went further to lay out the main categories of mental disorder that could be found in the propsychiatry textbooks of today. In my writing also took a brief look on Boerse’s work and discussed the “likeness argument” that is being used generally to describe the pro and antipsychiatry views. The pickering work on the the antipsychiatry debate shows that the debate is still well alive and that we have not really come to a convincing conclusion that both sides accept, that is, the pro psychiatry and antipsychiatry.
After looking closely at the propsychiatry and antipsychiatry opinions and point of views i totally believe their contributions to this topic has done more good than harm to the mental illness debate. It is obvious to see whether you are propsychiatry or antipsychiatry, that there are positive things and negative things from both sides and there are people that feel good after checking with their psychiatrists and those that feel bad after visiting their doctors. I do not have any problem with psychiatrists trying to create harmony between families, husbands and wives assisting people to find thier feet. It is a free choice of man, the freedom to visit the psychiatrist or their psychologist. It is our fundemental right to decide our fate.

The pharmeceutical company of today is a million dollar company and their lobbyist in the government can make a life terrible for an ordinary man. It is an enterprise that needs to be under the strict control of government due to moral and ethical reasons. I made this point because it is common nowadays that people take medicine for headache and due to side effects they become depressive and then after being depressive they will need an anti-depressant. Like Szasz said during his student days at the medical school there were only five or six mental disorders, today we stop counting. The lobbyist can influence our politicians who we voted for to represent us. A wrong decision regarding legallisation of a drug, let it be bodily or mental illness can be fatal to our existence.

There are social problems that man face sometimes that lead to difficulties in coping with life. What we need as a mankind in this kind of situation is personal support and word of encouragement. We should be the best critic of ourselves and like Mr Kendell said there are people that can cope with their social problems better than the trained psychiatrist or psychologist and that we should not believe that all unhappiness in man’s life need medication.
Finally, the debate between the pro and antipsychiatry is still well and alive. My paper is not written to take sides on this debate but to prove that this discussion has not reached a concluding end, that is, a genaral acceptance that mental disorder is an illness or not. Watching Szasz on television last week, he still defends the antipsychiatry view that mental disorders are not illnesses. My question would be is there any kind of compromise that can be achieved between the pro and antipsychiatry community or the discussion will be transfared to the next coming generation of pro and antipsychiatry? This debate i call it a clash of views and is a fundemental issue in philosophy in general. Neil Pickering’s paper also shed light on my personal assumption, that is, mental disorder to be categorised as mental illness has not reached a concluding and acceptable end and the debate continues.
What i find fascinating is the similarities on both sides, especially the conclusions, everyone on this this debate the pro and anti even a neutral observer like me agree on a point that there is a moral responsibility that a psychiatrist need to adhere to, not all the problems we face can be resolved using medication, tolerance, freedom and a world free of corruption. Human race survive tough times and we as humans can contibute to the improvement of the race and also capable of destroying this race. As long as we follow moral and ethic sky, is not just only the limit for man, they are many advances that man is going to be made, and will be surprise to us. Sometimes mankind, we often underestimate our power to build and also to destroy. Am not saying that we are God, we all know what an atomic bomb can do, and dynamites are man made weapons. Anything that we do be it for finding resolution to mental illness or a assisting a patient, we need to abide by the rules of moral and ethic.

REFERENCES
Oxford Textbook of Philosophy and Psychiatry (Bill Fulford, Tim Thornton, George Graham)
Princeton University Online Library
R:E Kendell 1975 (The concept of diseases British Journal of Psychiatry)
Szasz 1960 (The myth of mental illness)
www.antipsychiatry.org (Jeffery Masson)
www.nusaap.net
Fulford (1989)
www.youtube.com (Szasz)
Encyclopedia of psychology
National institute of mental health
Boorse,C (1975)
Neil Pickering (the likeness argement and reality of mental illness)
Ausubel (1967)
Culver (1982)
Frith (1992)
John Stuart Mill
Schneider
Hans Eysenck (the psychological model)
Michel Foucault
Thomas Scheff (label models)
R.Laing (hidden meaning models)
Lord Cohen (defination of diseases)
Scadding (defination of illness)

Does the tragic event in germany support Szasz idea? .
Stefan T the german guy that started shooting randomly yesterday and his acts claims more than 15 lives was suffering from a depression.He was on a therapy at the local clinic before the shoot out.
After investigation and interwiew conducted from a recognised german newspaper,it was stated that stefan was dealing with personal issues like loneliness,failed relationship with a girlfriend and failure to make progress at school.
The above mentioned personal problems is what Szasz said need to be tacked before rushing to clinic.The personal issues cant be diagnosed and treated like a disease and no medication in the world will resolve those personal issues.
According to Szasz, if the personals problem can be resolved,then no need to rush to doctors.

My question is if psyschologist helped stefan to resolve his personal issues i.e helping him socializing(meeting new friends) and eventually having a new girl friend.could those innocent people that lost their life yesterday be alive today.

Mental illness is not a sickness?The discussion will go on for a long period of time and more research needed in this field because life can be saved.

Dr Bamijoko-Okungbaye Abiola
Author