This is the 2007 version. Click here for the 2017 chapter 12 table of contents.

Mental Disorders as "Harmful Dysfunctions"

Whether or not mental disorders are caused by biological problems is almost irrelevant to the issue of how they should be handled by society. From the standpoint of legal and social policy makers, the most important issue is whether a person poses a danger to himself or herself or to others. Wakefield (1992) proposed that mental disorders should be called harmful dysfunctions. This label would recognize that two things define abnormal behavior of the sort that requires psychological or psychiatric intervention:

How did Wakefield propose to re-define "mental disorders"?

—Some part of the biological/behavioral system of a person is not working right (there is a dysfunction).

—The dysfunction threatens to harm somebody...either the person with the problem or other people, or both.

Wakefield notes that the concept of mental disorder is "on the boundary between biological facts and social values." It is on the boundary because, as noted above, many "mental disorders" are accompanied by identifiable biological problems. However, this is not enough to define a mental disorder. A person who is tone deaf (unable to carry a tune) probably has a defect in part of the brain, but such a person is not dangerous to anybody, would not be judged as having a mental disorder, and would not be expected to seek therapy. Only those people with harmful dysfunctions are likely to end up in a clinical setting, being treated for their abnormal behaviors.

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