Table Of ContentHOW TO RETHINK MENTAL
ILLNESS
The world of mental illness is typically framed around symptoms and cures,
where every client is given a label. In this challenging new book, Professor
Bernard Guerin provides a fresh alternative to considering these issues, based
in interdisciplinary social sciences and discourse analysis rather than medical
studies or cognitive metaphors.
A timely and articulate challenge to mainstream approaches, Guerin asks
the reader to observe the ecological contexts for behavior rather than diag-
nose symptoms, to find new ways to understand and help those experiencing
mental distress. This book shows the reader:
• how we attribute ‘mental illness’ to someone’s behavior
• why we call some forms of suffering ‘mental’ but not others
• what Western diagnoses look like when you strip away the theory and
categories
• why psychiatry and psychology appeared for the first time at the start
of modernity
• the relationship between capitalism and modern ideas of ‘mental illness’
• why it seems that women, the poor and people of Indigenous and non-
Western backgrounds have worse ‘mental health’
• how we can rethink the ‘hearing of voices’ more ecologically
• how self-identity has evolved historically
• how thinking arises from our social contexts rather than from inside our
heads.
Offering solutions rather than theory to develop a new ‘post-internal’
psychology, How to Rethink Mental Illness will be essential reading for every
mental health professional, as well as anyone who has either experienced a
mental illness themselves, or helped a friend or family member who has.
Bernard Guerin is Professor of Psychology at the University of South
Australia, teaching social and community behavior, and language and dis-
course analysis. Most of his research is now focused on working alongside
communities, primarily on issues of responding to racism, mental health,
mobility, sustainability of communities and attachment to country. He has
worked in partnership with Indigenous Australian, Māori, Somali refugee
and migrant communities. His broader goal has been to integrate social and
community psychology with other social sciences into an interdisciplinary
framework for practical analysis and intervention.
HOW TO RETHINK
MENTAL ILLNESS
The Human Contexts behind
the Labels
Bernard Guerin
First published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2017 Bernard Guerin
The right of Bernard Guerin to be identified as the author of this work
has been asserted by him in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Names: Guerin, Bernard, 1957- author.
Title: How to rethink mental illness : the human contexts behind the
labels / Bernard Guerin.
Description: New York, NY : Routledge, 2017. | Includes bibliographical
references and index.
Identifiers: LCCN 2016044341| ISBN 9781138207295 (hbk : alk.
paper) | ISBN 9781138207301 (pbk : alk. paper) |
ISBN 9781315462615 (ebk)
Subjects: LCSH: Mental illness. | Thought and thinking.
Classification: LCC RC460 .G84 2017 | DDC 616.89—dc23
LC record available at https://lccn.loc.gov/2016044341
ISBN: 978-1-138-20729-5 (hbk)
ISBN: 978-1-138-20730-1 (pbk)
ISBN: 978-1-315-46261-5 (ebk)
Typeset in Bembo
by Swales & Willis Ltd, Exeter, Devon, UK
CONTENTS
List of tables vii
List of figures ix
Preface xi
Acknowledgements xiii
1 Which behaviours are judged as ‘mental illness’
and why are they called ‘mental’? 1
2 Contextual analysis for mental health 35
3 Contextualizing language and thinking (cognition)
for mental health 59
4 Deconstructing the DSM 93
5 Mental health in modernity 129
6 Belief and rationality, some thought disorders,
and self-identity 155
7 Contexts for societal oppression: being female,
poor, or with a refugee background 175
8 Contexts of devastation: Indigenous mental health
and colonization 199
Index 233
TABLES
1.1 Typical observations and conclusions about people 8
1.2 Examples of the use (and misuse) of taxonomic
clustering 19
2.1 Ways that contexts or causes for behaviour can be
hidden, leading to a false attribution of a ‘mental’ cause 40
2.2 Social properties of three broad categories of
relationships 44
3.1 One way to rethink language use (talking, writing,
or thinking) as an embedded social activity 64
3.2 Tests to give you a clue that words are being used
(behaviour which is shaped by audiences) rather than
the real (non-word) reality (behaviour shaped by the
consequences of what the world does to you) 70
3.3 Translating some main tenets of cognitive theory into
a contextual observation approach 76
3.4 Proposed ‘dysfunctional’ cognitive biases with the
cognitive model description and a contextual or
discursive account 82
4.1 Conflicts in everyday life with some strategies
to overcome 97
4.2 The main behaviours for each of the key ‘mental’
disorders culled from the DSM-5 101
viii Tables
4.3 The main DSM ‘disorders’ with some strategies that
might have been functional in the original ‘normal’
contexts 103
4.4 The behaviours found in the DSM descriptions put
into an alphabetical sequence 112
4.5 DSM behaviours grouped into possible contextual
strategies 116
4.6 Scenarios in which behaviours might be named as a
‘mental illness’ 123
5.1 Effects of capitalism on behaviour and the properties
which constrain our lives in modernity 135
5.2 Possible links between modernity and modern mental
health issues 146
6.1 Some suggestions to explore when having unwanted
thoughts which lead to suffering 164
6.2 Suggestions for stopping unwanted thoughts 165
6.3 The main issues of ‘self-control’ which need a radical
rethinking 169
7.1 Unequal contexts for women 183
7.2 Unequal contexts for poor or low socio-economic
status people 186
7.3 Common contexts you will observe for the diverse
range of people with a refugee background 188
8.1 Alternative contexts of BPD symptoms from the
DSM given by research participants 222
FIGURES
1.1 Observations with and without context 12
1.2 Traditional classification systems with more details
and how to replace the current psychiatric classifications
with an external contextual system 22
2.1 Ways in which analysing contexts can present dangers
from hidden contexts or contexts that are not easily
observed, highlighting three common dangers 42
2.2 Common way to consider traumatic events in history,
with two alternatives 53
8.1 Possible pathways to better health outcomes from
being on Country 218
