Introduction

Abstract

Jerome Wakefield's work is at the center of the contemporary debate as to the nature of mental illness (and the related question of psychiatry's scope and limits), a decades-old debate in both scientific and philosophical literature. His key proposal, the "harmful dysfunction analysis" of mental disorders (HDA thereafter), has been discussed at great length by scientists and philosophers alike. In psychology, discussions of Wakefield's proposal abound in special issues of journals (see, e.g., Journal of Abnormal Psychology [1999] and World Psychiatry [2007]), but although philosophers have commented on and criticized Wakefield's position on many occasions (see, e.g., Nordenfelt 2003;Bolton 2008;Gold and Kirmayer 2007;Murphy and Woolfolk 2000;Murphy 2006), no book or special issue of a major philosophy journal has been dedicated to the task of offering a survey of these critiques.With this volume, we propose to remedy that situation, and for the occasion, we have gathered together some of today's most eminent and up-and-coming philosophers of psychiatry to discuss Wakefield's position as well as its theoretical implications and empirical consequences. We hope that the resulting collection of chapters-with extensive replies from Wakefield himself-may be of interest to researchers and students in several related fields ranging from clinical psychiatry to social work, as well as philosophy of mind and philosophy of psychiatry. HDA: A PresentationHDA is the claim that "a disorder is a harmful failure of some internal mechanism(s) to perform a naturally selected ('designed') function" (Wakefield 2000, 253). This notion was originally presented by Wakefield in two papers published during the same year (Wakefield 1992a(Wakefield , 1992b. At first sight, each of these papers is quite different: one is a general presentation of HDA, contrasting it with rival conceptions of mental disorders. The other is a critique of the definition of mental disorders as "unexpectable distress or disability" that is used in the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) (published in 1987). In fact, these two articlesx Denis Forest and Luc Faucher offer two different perspectives on the implications of HDA: one is more philosophically oriented and deals with foundational issues; the other is more of a dialogue with medical research and practice and deals with the empirical consequences of theoretical choices, a type of research that the majority of Wakefield's subsequent publications can be grouped into (e.g., the two books coauthored with Allan H. Horwitz; Wakefield 2007, 2012). Since 1992, Wakefield has vindicated his thesis on many occasions, without revising it significantly. Critiques of HDA have tended to focus keenly on the terms "dysfunction" and "harmful," but "analysis" is no less important to understand the nature of his project. HDA is offered as a definition of what a mental disorder is, but it is also the outcome of the application of a method, the method of conceptual ana...