Harmful Dysfunction and Mental Illness Why the latter is not the former

Abstract

In his essay ‘The Concept of Mental Disorder’ (1992), Jerome C. Wakefield puts forth a hybrid account of mental disorder that relies on the concept of ‘harmful dysfunction’, wherein ‘harmful’ is a subjective value term determined by social norms, and ‘dysfunction’ is the objective value-neutral counterpart that denotes the failure of a mechanism to perform as evolutionarily intended. In this paper, I begin by laying out the kind of commitments Wakefield is wedded to, which will demonstrate that Wakefield’s ‘harmful dysfunction’ account of illness critically fails to unify accounts of physical and mental illness. I claim this because the concept of mental dysfunction itself is not value-neutral like Wakefield assumes and needs it to be, which makes the view unworkable when applied to mental disorder. In its place I propose a model of human flourishing that will account for many different models of mental functioning.