Normal and Abnormal: Georges Canguilhem and the Question of Mental Pathology

Traditionally, debates between psychiatrists and anti-psychiatrists have centered around the appropriateness of positivist models of psychological disorder. According to positivism, the cause of unusual or distressing mental states is to be found in biological abnormalities. This paper suggests that anti-psychiatry often challenges positivism by opposing accounts of social causation to those of physical, biological disease without first questioning the adequacy of positivist accounts of physical illness itself. Using the work of philosopher of medicine, Georges Canguilhem, I wish to elaborate a non-positivist account of physical disease, which can then be applied to debates in mental health to redefine the terms within which the role of biological abnormalities can be thought. Applying Canguilhem's definition of pathology, the paper argues for a conception of mental illness in which the scientific identification of biological abnormalities is useful, but not in itself sufficient. Finally, these arguments are related to recent work involving cognitive therapy approaches to voice hearing and schizophrenia.