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Mental and Physical illness

Department of Psychological Medicine, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK

EDITED BY MATTHEW HOTOPF

Kendell (2001) begins his editorial on the distinction between mental and physical illness by quoting with approval Lady Mary Wortley Montagu's comment that "madness is as much a corporeal distemper as the gout or asthma". This suggests that he might be a physicalist, that is an advocate of the view that all facts about mind and mentality are physical facts, but at no point does he say this explicitly. He is critical of Cartesian dualism — without saying exactly why.

Kendell then makes a proposal of his own: "In reality, neither minds nor bodies develop illnesses. Only people (or, in a wider context, organisms) do so, and when they do both mind and body, psyche and soma, are usually involved". But he does not explain how the individual person, the mind and the body are supposed to be related to one another and how this would heal the Cartesian split, nor does he offer any arguments in favour of this suggestion. If illnesses can be attributed only to people and not to minds or bodies, then we might expect Kendell to want to talk only of illnesses in general, and not of two different types of illness, as he continues to do in this editorial. Astonishingly, in the very next sentence he appears to be endorsing Cartesian dualism, the view he has already rejected: "Pain, the most characteristic feature of so-called bodily illness, is a purely psychological phenomenon". If pain is a "purely psychological phenomenon", then it can have no physical component. So there is at least one purely psychological, non-physical phenomenon in the world — a fact that is incompatible with physicalism. But, apparently oblivious of this, Kendell again dismisses Cartesian dualism when he observes that "the differences between mental and physical illnesses... are quantitative rather than qualitative", a remark that suggests physicalism again. Just how could differences between mental and physical illnesses by quantified? How can phenomenal consciousness or ‘raw feelings’ (i.e. what it is like to have certain mental experiences, such as pain or pleasure, visual hallucinations or paranoid delusions) differ only quantitatively and not qualitatively from physical phenomena?

Kendell seems to teeter between Cartesian dualism and physicalism and he presents no arguments for an alternative to dualism that might lend support to his proposed changes in terminology.

REFERENCES

Kendell, R. E. (2001) The distinction between mental and physical illness. British Journal of Psychiatry, 178, 490-493.[Free Full Text]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Crichton, P. Search for Related Content PubMed PubMed Citation Articles by Crichton, P.