Youth antisocial behaviour is frequently considered to be displayed by children and adolescents who suffer from behavioural disorders. Consequently, attempts to reduce ASB have increasingly comprised mental health interventions. Moreover, early signalling of children at risk and early prevention of behavioural problems are regarded as crucial remedies. Critical investigations of these developments, however, are in particular concerned with the consequent medicalization of society and the behaviour exhibited by infants, children and adolescents. Consequently, the new Dutch youth law even refers to (...) demedicalization as a central aim. From an ethical point of view, this article critically discusses the meaning and relevance of the medicalization reproach in the context of ASB. The aim is to show that the term medicalization can reasonably be attached to three different developments: the biomedical turn, an increase in youth mental health care and early signalling and prevention. The ethical implications of these developments, however, are diverse, referring to both risks and benefits. By itself, neither the term medicalization nor demedicalization carries a self-evident normative meaning. Therefore, a careful ethical analysis is needed to reveal which social developments are actually recommendable or disadvantageous. (shrink)

The COVID-19 pandemic has had a widespread effect on the thoughts, emotions and behavior of millions of people all around the world. In this context, a large body of scientific literature examining the mental health impact of this global crisis has emerged. The majority of these studies have framed this impact in terms of pre-defined categories derived from psychiatric nosology, such as anxiety disorders, depression or post-traumatic stress disorder. These constructs often fail to capture the complexity of the actual experiences (...) of the individuals being studied; more specifically, they describe these experiences exclusively in terms of disease, while neglecting their potentially adaptive or “salutogenic” aspects. Similarly, discussion of psychological assistance for these individuals has largely been confined to a reiteration of “evidence-based” psychological or pharmacological techniques which can be delivered using remote access technology. In the context of the COVID-19 pandemic, these approaches are likely to be of mixed efficacy. Conversely, “negative emotions” or distressing psychological experiences may actually be functional in the setting of a disaster or crisis, serving to minimize harm, maximize social coherence and compliance, and facilitate adherence to safety measures. The limitations of the “conventional” approach are, to a certain degree, inherent to the prevailing medical model of mental health. Beyond these considerations lies the concept of “salutogenesis,” a term which refers to the innate capacity of individuals to create and maintain health and well-being in the face of adversity. Using principles derived from the second wave of positive psychology, particularly its emphasis on the totality of human experience and the possibility of deriving meaning and character growth from suffering, this paper conceptually analyses the relevant aspects of salutogenesis and PP2.0, and proposes an alternate approach for addressing mental health concerns during the COVID-19 pandemic. Such an approach, while acknowledging the utility of the conventional medical-psychotherapeutic model in specific cases, reduces the risk of medicalizing human experience, and provides individuals and communities with opportunities for growth and adaptation. The benefits of this proposal could potentially extend far beyond the current crisis, offering an opportunity for the field of psychiatry and mental health research to move away from a purely “disease-centered” model. (shrink)

Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger’s phenomenology and hermeneutics to provide guidance for medical professional–patient interactions. (...) The phenomenological approach espoused emphasizes the particular, contextual nature of such interactions, and thus is opposed to abstract, theoretical principles. Heidegger’s hermeneutics provides a philosophical approach to communication that may guide the back-and-forth interpretation that should happen between medical professionals and patients to achieve effective communication. (shrink)

Despite the emerging evidence base to support the therapeutic potential of creative writing and poetry for a variety of mental health problems, the therapeutic potential of poetry for people who have experienced psychosis remains poorly understood. The paper argues that by considering psychosis as meaningful poetics, this epistemological shift has the potential to foster curious inquiry and increase opportunities for meaningful dialogue. The paper introduces and explores the concept of the ‘poetic wavelength’, building on the previously established notion of the (...) psychotic wavelength, which proposes that others need to ‘tune in’ to what is being communicated through psychosis. The concept of the poetic wavelength suggests that the reading and writing of poetry may support this process of ‘tuning in’ both for those experiencing psychosis and those working therapeutically with them. (shrink)

This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as “mental illness,” take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its members within posthuman emotional ecologies (...) in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that “uncivilizes” mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health. (shrink)

Recent scholarship in medical humanities has expressed strong concern over the ability of pharmaceuticals companies to medicalize discomfort and subsequently invent diseases. In this article, I explore the clinical debates over the ontology of the sinus headache as a possible counter-case. Extending Foucault’s concept of principles or rarefaction, this paper documents the efforts of clinicians to resist the pharmaceutically-provided understanding of the sinus headache. In so doing, it offers institutions of rarefaction and rarefactive assemblages as useful heuristics for the exploration (...) of disease legitimization discourse. (shrink)

In February 2010, the American Psychiatric Association (APA) launched their DSM-5 website with details about the development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The APA invited “the general public” to review the draft diagnostic criteria and provide written comments and suggestions. This revision marks the first time the APA has solicited public review of their diagnostic manual. This article analyzes reported speech on the DSM-5 draft diagnostic criteria for the classification Posttraumatic Stress (...) Disorder. It demonstrates how textual standardization facilitates the cultural portability of the DSM-5 diagnostic criteria such that a community of speakers beyond the borders of the APA come to be seen as exemplary speakers, writers, and revisers of the professional style. Furthermore, analysis shows how co-authoring practices recontextualize the “voice” and persona of putative patient reported speech on Criterion D2. As a consequence of textual standardization, spoken discourse becomes recontextualized as the product of scientific inquiry and the organization of psychiatric knowledge. (shrink)

The dominance of the medical-model in American psychiatry over the last 30 years has resulted in the subsequent decline of the “talking cure”. In this paper, we identify a number of problems associated with medicalized psychiatry, focusing primarily on how it conceptualizes the self as a de-contextualized set of symptoms. Drawing on the tradition of hermeneutic phenomenology, we argue that medicalized psychiatry invariably overlooks the fact that our identities, and the meanings and values that matter to us, are created and (...) constituted by our dialogical relations with others. While acknowledging the importance of medical and pharmaceutical interventions, we suggest that it is only by means of the dialogical interplay of the talking cure that the client can both recognize unhealthy and self-defeating ways of being and be opened up to the possibility of new meanings and self-interpretations. (shrink)