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Recovery of People with Mental Iillness: Philosophical and Related Perspectives. Edited by Abraham Rudnick. Oxford University Press. 2012. £44.99 (pb). 344pp. ISBN: 9780199691319

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Recovery of People with Mental Iillness: Philosophical and Related Perspectives. Edited by Abraham Rudnick. Oxford University Press. 2012. £44.99 (pb). 344pp. ISBN: 9780199691319

Published online by Cambridge University Press:  02 January 2018

Debbie Mountain*
Affiliation:
Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK. Email: debbie.mountain@nhslothian.scot.nhs.uk
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2014

This multi-author book attempts to pull together philosophical and related concepts relevant to recovery. The first section describes first-person accounts written from differing perspectives of recovery. Much of this courageous writing describes an evolving sense of self.

The historical chapters give interesting accounts of how the practices of Tuke and Pinel supported people with mental illness to strive to achieve self-control and self-determination. The epistemological considerations challenge conventional knowledge platforms and advocate constructivism as an approach to engage professionals in supporting outcomes as personally defined by users. Constructivism acknowledges that people are complex living systems and proactive agents who participate in their own life and that intrapsychic and interpersonal processes are dynamic and connected. How people appraise themselves and events has an impact on what they do. Therefore, notions of adaptation, reorientation and integration are important and need to be attended to. This crucial process of reflection provides opportunities for the self to be interpreted. We are, however, all capable of making mistakes about our own good, and our capacity for self-deception is high. Metacognition is proposed as a mechanism by which we can critically evaluate our welfare. Thinking how professionals could engage with people with mental illness to develop metacognitive activity is useful, especially at a time when clinical guidelines have the potential to reduce professionals to technicians.

Many philosophers make assumptions about mental illness that bear no relation to the harsh challenges that many people with mental illness have to face in their daily lives. This makes their opinions appear superficial. Many readers may wince to read the assertion that disregarding sanity-preferring attitudes makes us better connected to each other. Also, the narrative of psychiatry as a mechanism for social control is rehearsed without questioning its validity for contemporary Western culture. Indeed, epigenetics (not mentioned at all) helps us to understand the complicated influences that social factors have on mental illness. A good position would be ‘what is a good life’ and ‘what is required for human flourishing’. This is touched on but not developed.

Overall, it is an interesting book packed with wide-ranging concepts and diverse perspectives, their relevance varying depending on the background of the reader. The authors’ styles vary, so it does not flow well if read from cover to cover. Some of the chapters are contradictory, requiring cognitive appraisal of the topic of recovery by the reader. This process is greatly helped by the introduction and overview of the sections by the editor. Disappointingly, the book makes no mention at all of the thorny issues of capacity, risk and compulsion. This leaves the fascinating topic of the philosophical aspects of recovery rather soft and one-sided.

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