Before broaching our main subject, and exploring why, among all disorders of the mind, obsessive-compulsive disorders have a place apart, I would like to start from a dilemma that is well-known to historians interested in mental disorders. According to one approach, a mental illness X is considered as a bona fide or ‘genuine’ illness if, and only if, it originates from a disturbance of the brain. Its neurobiological form is in this case considered as invariant, whatever cultural veneer might give (...) it a different aspect in accord with historical and local settings. The assumption is that this veneer does not, properly speaking, have any deep grounding in reality... (shrink)

It is no easy task to answer Jerry Wakefield’s comments, for I feel at risk of merely pitting two major paradigms in the history and epistemology of psychiatry against each other: the one historical/anthropological, the other epistemological/naturalistic. Fortunately, Wakefield and I do share enough to find a middle ground. This commonality should allow me to reconcile his opinions and mine, by dissipating a few misunderstandings, and also to state more clearly why I am dubious about some of his proposals. First, (...) let me repeat that, in my argument, the lived experience of having an inner mental space is not primarily a psychological phenomenon—at least in the.. (shrink)