Arpaly (2005)
Introduction to Mental Disorders
Many psychiatrists equate mental disorders to diseases like diabetes.
This analogy suggests a significant distinction between mental disorders and other mental states (love, hate, etc.).
The author believes this analogy is misleading.
Commonalities between Mental Disorders and Other Diseases
Bipolar Disorder Example:
Treatment for bipolar disorder is comparable to treatments for diabetes.
Both conditions require commitment to treatment for better management.
Society should not associate shame with mental disorders as with physical diseases.
Both conditions can lead to significant outcomes ranging from inconvenience to serious health issues.
Key Differences between Mental Disorders and Diabetes
Conceptual Distinction
Mental disorders are often misrepresented as purely physical states.
Mental states (like love, beliefs, etc.) are tied to individual experiences and morals, differing from purely physical states.
Philosophical Implications
If mental states are merely biochemical, then the distinction between them becomes trivial, reducing meaningful discussions about mental disorders.
Hardware vs. Software Analogies
Equating mental disorders with diabetes is flawed, similar to equating hardware problems with software issues.
Different events (hardware vs. software) must be treated with different considerations despite both being physical entities.
Mental States: Warrant and Desirability
Mental states can be assessed as warranted (accurate) or unwarranted (inaccurate).
Example: Fear of bats is unwarranted, unlike warranted anger towards someone who has wronged you.
Non-mental bodily states do not possess this dimension of warrant.
Important distinction between desirable vs. unwarranted mental states, e.g., unwarranted guilt.
Mental Disorders and Layperson Understanding
Laypersons often view mental disorders as unwarranted mental states.
This interpretation can be both insulting and comforting due to societal stigma.
Diagnosis can invoke feelings of shame or relief depending on the context.
Complexity of Mental Conditions
Most mental conditions comprise a mix of warranted and unwarranted states.
Example of Hemingway:
Exhibiting both warranted beliefs (e.g., being a great writer) and unwarranted ones during manic episodes.
Content-Efficacious Causation vs. Reason-Responsiveness
Content Efficacy: Mental states can cause each other in ways that are meaningful and reflective of their content.
Example: A song's theme can evoke emotional responses from listeners.
Reason-Responsiveness: Processing messages involving logical implications (e.g., insult leading to inferred bad day).
Causal Relationships in Mental States
Mental disorders may stem from biological phenomena (like diabetes) or situations with content efficacy (like job loss anxiety).
Different types of causation exist, influenced by personal history, identifiable reasons, or pure external effects.
The Artistic and Moral Implications of Mental States
Mental conditions can evoke art, conscience, and moral concerns (e.g. the distinction between creativity in mania vs. a biological condition).
Labeling meaningful emotional states as disorders can be dehumanizing.
Moral Judgment Regarding Mental Disorders
Not all mental disorders absolve a person from moral responsibility.
Individuals displaying inherent malice (e.g., Antisocial Personality Disorder) retain culpability for actions.
Example Cases of Complex Disorders
Factitious Disorder: Individuals seeking sympathy by inducing symptoms.
Kleptomania: Behavior driven by both impulse control issues and deeper emotional needs such as attention.
Ethical Concerns Relevant to Mental Illness
Moral Imagination: Importance of recognizing how individuals differ in their experiences and the legitimacy of their emotional states.
Misunderstandings surrounding emotional distress can lead to societal harm.
Conclusion: The Importance of Acknowledging Individual Experience
Individuals with mental disorders deserve recognition of their emotional states as valid.
The metaphor of mental illnesses being akin to physical ailments (like diabetes) risks oversimplifying the human experience and its moral significance.