According to a major health survey, nearly half of all Americans have been mentally ill at some point in their lives—more than a quarter in the last year. Can this be true? What exactly does it mean, anyway? What’s a disorder, and what’s just a struggle with real life?
This lucid and incisive book cuts through both professional jargon and polemical hot air, to describe the intense political and intellectual struggles over what counts as a “real” disorder, and what goes into the “DSM,” the psychiatric bible. Is schizophrenia a disorder? Absolutely. Is homosexuality? It was—till gay rights activists drove it out of the DSM a generation ago. What about new and controversial diagnoses? Is “social anxiety disorder” a way of saying that it’s sick to be shy, or “female sexual arousal disorder” that it’s sick to be tired?
An advisor to the DSM, but also a fierce critic of exaggerated overuse, McNally defends the careful approach of describing disorders by patterns of symptoms that can be seen, and illustrates how often the system medicalizes everyday emotional life.
Neuroscience, genetics, and evolutionary psychology may illuminate the biological bases of mental illness, but at this point, McNally argues, no science can draw a bright line between disorder and distress. In a pragmatic and humane conclusion, he offers questions for patients and professionals alike to help understand, and cope with, the sorrows and psychopathologies of everyday life.
The meaning of madness has confounded us for centuries. Now, we learn that half the population meets criteria for mental disorders. In this lucid and erudite book, Richard McNally tackles the difficult questions of science, philosophy, and politics that bear on this issue. His answers will have a great impact on the study of psychopathology.
Richard McNally's book is the definitive description of the cultural impact of DSM-style empiricism in psychiatry, and the mostly rational but ultimately unsatisfactory approaches that have led to the state of confusion over the nature of mental maladies and mental health we have today. Although our present chaos will probably last at least a decade past the publication of the DSM-V in 2012, all who long for the replacement of this strange and primitive answer to the question 'What is Mental Illness?' will find some hope in McNally's analysis of new ways of thinking about caring for patients and understanding the mind.
Compassionate and insightful.
McNally, an adviser on the Diagnostic and Statistical Manual of Mental Disorders, calls himself a "friendly critic" of psychiatry. In eight compact, well-written chapters, he points out the high prevalence of mental disorder in the United States, the tendency to create diagnoses to fit with new pharmaceuticals, and the blurred line between distress and disorder that allows grief to be labeled depression and high spirits [labeled] mania. McNally explains how homosexuality was removed from the list of disorders, how posttraumatic stress disorder was added, how the "recovered memory" phenomenon rose and fell, and much more. Together, biology, culture, politics, economics, and religion determine what is and isn't normal. Essential for mental-health professionals, this remarkable book will give diligent lay readers a grasp of genetics, evolutionary psychology, and diagnostic controversies.
McNally's book is essentially an extended critique of the DSM, for which he serves as an advisor...[He] begins by asking if we are pathologizing everyday life...One thing that I particularly appreciated about this book is that McNally doesn't take any sides when describing...hypotheses about the origins of mental illness, allowing the reader to draw his or her own conclusions. Those conclusions will probably be mixed and inconsistent, and that's okay. You get the real sense that he is truly committed to the alleviation of mental suffering...It's a clear, thorough, and lively accounting of the problems facing mental health and its practitioners today, and will prove a fascinating read to scientist and layperson alike.
McNally's wide-ranging and extremely readable book is quite sane, and vastly illuminating...Perhaps the most profound insight in What Is Mental Illness? has to do with the role of culture. McNally presents a clinically nuanced, historically rich, and anthropologically informed discussion of how mental illnesses are expressed...The next DSM edition, the fifth, is now in the works. To judge by the heated controversy within academic and advocacy circles generated by interim progress reports, its unveiling in 2013 will doubtless shine an uncomfortable spotlight on the psychiatric profession and spark plenty of debate. McNally's masterful synthesis will help us understand the discussion, and thereby help us to understand ourselves.
- 288 pages
- 5-1/4 x 8 inches
- Belknap Press
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