Mental health and human minds: Some theoretical criteria for clinical psychiatry

When it comes to the topic of mental illness, there are three broad areas of concern that are of interest to all of us as human beings—and to the theorists, researchers, and clinicians who wish to offer help—besides knowing what our symptoms are. First, we might be interested in finding out some normative facts about ourselves as individuals, such as whether or not we are mentally healthy, perhaps to what extent, and how this should affect our motivations. A second area of concern involves descriptive facts our minds. In what ways do we deviate from typical human psychological nature, and what implications does this have? A third concern is about diagnosis, the familiar labels like ‘bipolar 1’ and ‘obsessive compulsive’ which inform our very being. Ought any of these apply to us? Clinical psychiatry, understood broadly as a practice which integrates science, theory, and clinical observation for the purpose of understanding and promoting mental health, is the most vital tool we have for answering these questions, and combatting the suffering caused by mental illness. Without a critical understanding of what good clinical reasoning consists in, however, it is simultaneously our most dangerous tool. Without it, we risk amplifying suffering rather than combatting it, by failing to distinguish and respond appropriately to illness and health. This project examines the nature of clinical reasoning from a theoretical perspective, by proposing some conditions for a discipline which pays heed to psychiatry’s dual nature as a science and as an evaluative system—with the hope that a proper understanding of mental illness and mental disorder will follow from an understanding of the enterprise of clinical psychiatry itself