Modern natural science relies on laws uninfluenced by human desire or motivation. We use the same physical laws to explain why planes fly & crash, the same chemical laws to explain the therapeutic & toxic effects of drugs, and the same biological laws to explain how healthy cells maintain the integrity of the organism & how the cells can become cancerous and kill the host. We don’t have one set of medical theories to explain normal bodily functions and another to explain abnormal ones.
Except where that relates to psychiatry, that is. We have one set of principles to explain the functioning of a mentally healthy person and another to explain that of the unhealthy, or Mentally ill person. We attribute acceptable “rational” behaviors to reasons, but unacceptable “irrational” ones to causes. The mentally healthy person is viewed as an active agent; he chooses such as to marry his childhood sweetheart. In contrast, the “mentally ill” person is viewed as a passive body: As a patient, he is the victim of injurious biological, chemical, or physical processes acting upon his body, eg., diseases (of his brain), for example, of an “irresistable” urge to kill.
According to psychiatric theory, certain actions by certain people ought to be attributed to causes rather than reasons. When and why do we seek a causal explanation for personal conduct? When we consider an actor’s behavior unreasonable and don’t want to blame him for it. We look for excuses masquerading as explanation instead of simply an explanation that neither exonerated or incriminates.
Holding a person responsible for his act is not the same as blaming or praising him for it – it only means that we regard him as an actor, or moral agent.
The “mental patient” who attributes his misdeeds to “voices” – that is to an agent, other than himself, whose authority is irresistable – is not the victim of an irresistable impulse; he is an agent, a victimizer rationalizing his action by attributing it to an irresistable authority.
It is not by accident that, in all the of psychiatric literature, the is not a single account of a schizophrenic to be especially kind to his wife.
– adapted From Mental Illness: Psychiatry’s Phologiston by Thomas Szasz