Nancy Potter: Philosophy and Mental Illness

Phil 398/Honors 331/341
Philosophy and Mental Illness
Hon 204
Tues, Thurs 11-12.15
Required Texts
· Girl Interrupted, Susan Kaysen
· Welcome to My Country, Lauren Slater
· Bias in Psychiatric Diagnosis, ed. Paula Caplan and Lisa Cosgrove
· Course Packet, e-Reserve (you must print articles and bring to class)

Course Description
What is a "mental illness" as compared to a "physical illness"? How can the mind be sick? Who makes decisions about what counts as normal and healthy functioning, and on what basis are such judgments make? What sorts of mental suffering or odd behavior are too great to count as part of the normal stress of life? When people suffer distress or disconnection from others, what exactly is wrong with them? How should the mentally ill be cared for? Or, is the framework of mental illness a form of social control? If so, why, and what should be done about it? These are the sorts of questions we will examine together in this course. Our readings consist of biological, constructivist, and antipsychiatric writings on the science, classification, and diagnosis of mental illness. We will also read numerous case studies and consider problems in universalizing diagnoses across cultures. Assignments in this course are designed to introduce students to the deep difficulties both in living well and in considering people to be living dysfunctionally; to engage students in critical thinking; and to allow you to develop a position on various aspects of a pathology or issue in mental illness that you are most interested in.

Course Requirements:
1. Class attendance and participation. Preparation for, and participation in, classroom discussions are an integral part of acquiring knowledge and understanding about the course materials. Students are expected to have read the assigned readings and to be prepared to discuss them. Classes will be largely discussion-oriented, and I will be keeping track of active participants, questions and comments that engage the material, and other indications of philosophical skill development that student participation offers.

2. Protocols. Each Tuesday (or Thursday, if we don't meet that Tuesday), two or three class members will present a brief (one page) summary of the main points of the previous week’s discussion. A Protocol should include the writers’ reactions, insights, and/or further reflections on points raised during class. For example, if you went home thinking an important question was unexplored, if a term was unclear, or if your views on something have changed as a result of the previous week’s class, you could include that in your Protocol. Protocols are written collaboratively and then they are typed and photocopied for the class and presented orally at the beginning of the week. The duty of writing the Protocol rotates among the members of the class, and a sign-up sheet will be passed around the first week of class.

3. Students will be required to write eight critical reading exercises. Due dates, explanation, and a sample evaluation checklist accompany the syllabus. CRs turned in late will automatically have five points taken off the total score. Late = after the class period the assignment is due.

4. Each student will write one short essay (2-3 typed double-spaced pages) in response to a question or set of questions I pose in class. Details will be handed out one week in advance of the due date.

5. Each student will write a final paper over some significant aspect of the course material (for example, the pathology of your choice, or an analysis of a problem in mental illness, such as the pathologizing and medicalizing of inner city youth.) The term paper will be written in two stages. A first version (a complete version, with an introduction and a conclusion--NOT A DRAFT--) will be handed in and commented on, and this will serve as the foundation for the final paper for the term. The first version should be 5-7 typed double-spaced pages in length, and the final paper should be 8-10 pages. The revised paper is expected to take into account the comments received and additional coursework since the first version was written. Students who elect not to turn in a draft on time forfeit the possibility of receiving an "A" on their final paper. Each of you must meet with me in person about your paper topic by no later than November 9.

Grades will be determined as follows:
Protocols: 20 %
Critical readings: 40 %
Short essay: 10 %
Final paper: 30 %
In the event of a borderline grade, I take into consideration the direction of your quality of work (i.e., whether your work has improved or declined over the term).
Be warned!

The class period. Class begins at the beginning of the class period and runs through the entire scheduled period. I expect students to make every effort to get to class on time and remain until class is over unless an exceptional circumstance prevents it. Consistent tardiness or early departures puts you at a disadvantage, is disrespectful to other class members, and suggests a cavalier attitude towards your own education. If you cannot meet the schedule as it is printed and outlined here, you should not take this course.

Late work. I do not routinely accept late work. Any papers, projects, or exams turned in later than the due date will be graded down. Once I have returned graded work, I will no longer accept any late work on that subject.

Missed classes. Class attendance is very important for the quality of work you do in the class. If you are prevented from attending a class session, please make prior arrangements with another student to borrow that classmate's notes from the missed class and to obtain any handouts or changes in the schedule. You have the responsibility of making clear to yourself what is expected of you in the course and when.

Incompletes. The grade of I (Incomplete) will be assigned only when the following three conditions have been met: when circumstances beyond your control prevent you from completing the required work, when the majority of the coursework has been completed, and when requested in writing before the due date of the final paper. Furthermore, in order for me to consider giving you an I, you must make specific arrangements with me before grades are due as to exactly how and when you plan to complete the course.

Academic honesty: Students are expected to adhere to our university's academic standards for honesty and integrity. These standards are stated at the beginning of the Undergraduate Catalog under "Code of Student Rights and Responsibilities. It makes clear that “academic dishonesty is prohibited at the University of Louisville. It is a serious offense because it diminishes the quality of scholarship, makes accurate evaluation of student progress impossible, and defrauds those in society who must ultimately depend upon the knowledge and integrity of the institution and its students and faculty.” You should pay special attention to Sections Five and Six where it defines terms and explains just what sorts of things count as academic dishonesty. It is your responsibility to know this code and comply with its requirements. Penalties for academic dishonesty include suspension and expulsion from the University. You can be sure that if I suspect any violations of this Code, I will take serious action. If you have any questions about what constitutes academic dishonesty, you are expected to ask me before any assignments, tests, or other course work are due.

Schedule of Meetings and Readings
Be aware that this schedule is subject to change, and you are responsible for finding out about any changes in sufficient time to prepare for class.

Week 1. Case Study: Bipolar Disorder
Aug 22, 24
Assigned readings:
· Kay Jamison, M.D., An Unquiet Mind, excerpt
· Francis Mondimore, M.D., Bipolar Disorder, excerpt
· Students should familiarize yourselves with the DSM-IV-TR before the next class period


Week 2. What is a Mental Disorder, Anyway?
Aug 29, 31
Assigned readings:
· Samuel Guze, Why Psychiatry is a Branch of Medicine, Chs. 1 & 4 (e-R)
· Jerome Wakefield, “On the Concept of Mental Disorder: On the Boundary between
Biological Facts and Social Values” (e-R)

Aug 31: Critical Reading Trial Run

Week 3. Case Study: Schizophrenia
Sept 5, 7
Assigned readings:
· Lauren Slater, Welcome to My Country, Chs. 1 & 3
· Grant Gillett, “Brain Pain: Psychotic Cognition, Hallucinations, and Delusions” (e-R)
· Jeffrey Poland, “Bias and Schizophrenia”, Ch. 18 (BD)

Due Sept. 5: 1st Protocol (and weekly hereafter)

Due Sept 5: Critical Reading #1

Week 4: Classification of Mental Disorders: Is This a Science or What?
Sept 12, 14
Assigned readings:
· John Sadler, Values and Psychiatric Diagnosis, Ch. 3 (e-R)
· Allan Horwitz, “The Extension of Mental Illnesses into the Community”, (e-R)
· Meadow Linder, “Creating Post-traumatic Stress Disorder: A Case Study of the
History, Sociology, and Politics of Psychiatric Classification”, Ch. 3 (BD)

Due Sept. 12: CR #2

Weeks 5 and 6. Criticisms of Diagnosis and Classification
Sept 19, 22; Sept 26, 28
Assigned readings:
· Thomas Szasz, "The Myth of Mental Illness" (e-R)
· Paula Caplan, They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal, Ch. 2 (e-R)
· Bias in Psychiatric Diagnosis, Chs. 1, 2, 8, 9, & 12
· Foucault, Madness and Civilization, excerpt (e-R)

Due Sept 19: CR #3

Due Sept 26: Short paper
Weeks 7 and 8. Case Study: Depression
Oct 3, 5; [Oct. 10, no class]; Oct 12
Assigned readings:
· Andrew Solomon The Noonday Demon: An Atlas of Depression, , Chs. 1 & 2 (e-R)
· Slater, Welcome, Ch. 4
· Sarah Sweeney, “Depression in Women” (BD)

Due Oct 3: CR #5
Last day to withdraw: Oct. 12

Week 9: Pharmaceutical Companies
Oct 17, 19
Assigned readings:
· David Healy, Let Them Eat Prozac, excerpt (e-R)
· Breggin and Breggin, The War against Children, excerpt (e-R)
· Lauren Slater, Prozac, excerpt (e-R)
In-class video: Selling Sickness

Due Oct 17: CR #5

Week 10. Substance Abuse and Addiction
Oct 24, 26

· The AA Big Book, excerpt (e-R)
· TBA
· Herbert Fingarette, Heavy Drinking: The Myth of Alcoholism as a Disease, excerpt (e-R)

Due Oct 24: CR #6

Weeks 11 and 12. Case Study: Personality Disorders
Oct 31, Nov 2; Nov 7, 9
Assigned readings:
· Slater, Welcome, Ch. 2
· Susan Kaysen, Girl, Interrupted

Due Oct 31: CR #7

Nov. 9: Deadline for meeting with me to discuss your final paper

Week 13. Women as Patients Tell Their Stories
Nov 14, 16
Assigned readings:
· Slater, Welcome, last chapter

In-class documentary: Dialogues with Madwomen

Weeks 14 & 15 Medical Anthropology and Cultural Differences
Nov 21 [Thanksgiving break]; Nov 28, 30
Assigned reading:
· TBA

Due Nov. 21: Final paper, first version

Due Nov. 28: CR # 8

Due Monday Dec. 11 by noon [in my mailbox]: Final Paper,
including first version and comments


The Critical Reading Exercise:
The critical reading exercises constitute 40% of your course grade. For each time a critical reading is assigned, complete the steps below. In all three steps, make specific references to the text in order to anchor your readings in the material at hand. You may select any one text from that week's assigned readings (although I sometimes eliminate one because it doesn't work as a CR as well), but be sure to identify which one you are critiquing.

Step One: Read the text at a comfortable pace to get an overall meaning from the text. After reading, reflect on your initial reactions to the text (pay attention to gut-level reactions, intuitions, and emotions.) Cite the particular part of the text (e.g. paragraph and page number) where you have the strongest gut-level response and describe your reaction specifically. Also cite and describe a passage in the text where you have little response.

In completing Step One, allow the writer to "get to you"; allow yourself to have a knee-jerk reaction to the text. Your feelings at this point need not be supported; however, be sure to explain what you mean and to write clearly so that your reactions are understandable. If you have trouble pinpointing your response, freewrite to discover your feelings with regard to the text. You may include any personal associations with the text at this point in your reading process.

Step Two: Read the text at a slow pace, paying special attention to the questions that pop into your mind. Often, we ignore our questions and differences when we read, but in this case, you want to become keenly aware of your own point of view. Be skeptical of persuasion--or be inquisitive about a writer's ideas and claims; mark passages in the margin which raise questions in your mind. After reading, go back and write out your most important questions with regard to the text, aiming for a list of five fully developed and clearly articulated questions. As you develop each question, be sure to cite the page where your questions come up and explain the author's specific idea at this point as well as your own.

Make sure to fully write out the implications of your questions, in order to uncover tangential questions which bear on the issue or idea at hand. Fully articulated questions often take up several lines. The focus in this step should be to engage with the text and to think critically and keenly about the writer's ideas in the context of other course materials, lectures, discussions and personal experience.

Step Three: Go through the text a third time, this time considering your responses in Steps One and Two. Judge the text as you go along on its strengths and weaknesses. Identify the greatest strength of the piece, and also the greatest weakness. Convey your reasoning for each of those judgments, being careful to give a balanced critique. Suggest steps which the author could take to address the text's greatest weakness. Make sure to summarize your judgment and provide examples so that a reader unfamiliar with the text can understand your basic perspective and have enough information to decide whether or not to read the original piece.