An Approach to the Boundary Problem: Mental Health Activism and the Limits of Recognition

For several decades, philosophers of medicine and psychiatry sought to clarify the boundaries of illness by defining a scientific concept of disorder. This project, which has come to be known as naturalism, has met with considerable difficulties that cast doubt on its approach and presuppositions. The difficulties met in arriving at a naturalistic definition of disorder suggest the need for an alternative approach to the boundary problem. Prompted by engagement with the philosophy of social recognition and with recent developments in mental health activism this article provides a new approach to the boundary problem. This approach does not operate with the customary concepts of disorder, disease, distress, and dysfunction but with a different set of concepts that bring forth their own boundary conditions and judgments: The concepts of social recognition, social and individual identity, and unity and continuity of self. On the basis of the proposed approach, clarifying the boundary problem is not to be achieved by getting a handle on the definition and limits of the concept of mental disorder, but on understanding the addressees and normative limits of recognition and what this means for a wide range of mental health phenomena.