What Is Mental Illness?

by Richard J. McNally

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.

Genres: Psychology, Mental Health, Nonfiction, Philosophy, Mental Illness, Reference

288 pages, Hardcover

First published January 15, 2011

Reviews

[E · Rating 4 out of 5]

There are two extreme views of mental illness and they are found in different cultures. On one end of the spectrum there are countries like Bangladesh, where mental illness is something to be deeply ashamed of. People there are loathe to admit they have any sort of psychological disorders because such an admission would imply they are raving lunatics who deserve to be shut away in an asylum. On the other end of the spectrum are countries like the United States, where mental disorders are frequently seen as explanations for thousands of various of behaviors - everything from hallucinations to high energy levels to a fear of snakes. With such broad definitions, white Americans qualify as the most mentally ill people on earth. (According to the National Institute of Mental Health, FIFTY PERCENT of the population has been or will be mentally ill at some point.) These two extreme views are both problematic because both cause unnecessary suffering. Leaving a clinically depressed person untreated can do great harm, while diagnosing a person's normal reaction to hardship as clinical depression can deform their coping mechanisms. There has to be a middle ground.

Although he might not phrase it that way, Richard J. McNally seeks that middle ground. As an American psychiatrist active in the field - and a frequent consultant to the DSM - he considers himself a "friendly critic," skeptical not for the sake of cynicism but empiricism. His book is highly readable and highly informative.

[David · Rating 4 out of 5]

Disclaimer: I know and like the author.

Just in time for the DSM-V (ETA 2013) Rich McNally presents an erudite analysis of issues of definition and classification of mental illness. The level of scholarship is very high as he takes on Wakefield's harmful dysfunction analysis of mental disorder, the question of whether personality disorders should be rated dimensionally rather than categorically, whether molecular genetics research is shedding light on subtyping of schizophrenia, how cultures shape expression of pathology, why mental illnesses have not diminished in prevalence via natural selection, and much more.

The writing and thinking are clear, but this is not an entry-level book IMO. Unless you can (and care to) keep straight social causation vs. social construction, adaptation vs. exaptation, pathoplastic vs. pathogenic effects, etc., it may be slow going at times.

[Science For The People]

Featured on Skeptically Speaking show #116 on June 12, 2011, during an interview with author Richard McNally. http://skepticallyspeaking.ca/episode...

[Patsy · Rating 4 out of 5]

This is a very informative book about a lot of different aspects of mental illness. I found it very interesting.

[The Distracted Bee · Rating 3 out of 5]

I'm personally giving this book 3 stars because it was very heavy on the science side, and more textbook-like than I had hoped.

Also, even though it's only 6 years old, a lot of the information is quite dated! In the mental illness arena, there's still so much to discover. I found the first few chapters helpful in identifying certain illnesses, but was frustrated at what limited information there was. McNally focuses on the inability of the DSM-IV to qualify diagnoses, and I wonder what he thinks of the newer DSM-5 (2013).

This book would no doubt be helpful to those looking to be experts in the field, but for the common layman, it's too dry for words.

[Julian Meynell · Rating 3 out of 5]

This is an interesting book, which is an exploration of what mental illness is from a psychological instead of a philosophical perspective, although it is informed by that. It covers off the ground well and various approaches. In the end it does not really answer the question it poses, which is fare enough. A good and thoughtful book, but even though it is really meant to be a substantive book, ends up reading more like a survey.

[The Book : An Online Review at The New Republic]

WHERE DOES PSYCHOLOGICAL health end and mental illness begin? This is the question that Richard J. McNally, a Harvard psychologist, asks in his new book. Should we worry about the sanity of the author for assigning himself this thankless task?Read more...

[Caitlin · Rating 4 out of 5]

Good book for people who are inclined to look at mental illness through a sociologist's or biologist's eyes. Book reads a little slow through the middle but ends well.