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Elias and mental health/illness

Posted on by Stephen Mennell


Recently I joined a community called ResearchGate, which requires one to show one’s academic credentials before being admitted. (Although sometimes one wonders …)

The other day I responded to this question: “Does anyone have advice on where to look for theorizing about mental health/illness outside of the psy-disciplines – for example sociological theory?”

Since most of you can’t immediately access this site, I quote my response in full. I’m well aware of not being fully acquainted with what has been produced on this subject by the “Elias-community”, so I’m open to suggestions and corrections.

“For a sociologist who has worked in mental health / psychiatry for more than 30 years, this is an easy question, but only if taken literally. I recommend looking in Elias, Norbert, (2009), ‘Sociology and Psychiatry’, in Essays III: On Sociology and the Humanities (Dublin: UCD Press, 2009 [Collected Works, Vol. 16], pp. 159–79.
The article is mainly about the different perspectives sociologists (such as Elias) and psychiatrists generally have on people. For those unfamiliar with Elias’ sociology its very hard to do his views justice in a few words since they radically deviate from mainstream ways of looking at people and societies. For those acquainted with his work, most of what he says here is familiar, since they are recurrent themes throughout his vast oeuvre. Time and again he has criticized the tendency in philosophy and the humanities to regard people as basically separated from the social world – as we say – ‘around’ each individual, with which one may or may not ‘interact’. Psychiatry adopts a special version of what Elias calls the homo clauses (‘the dominant concept of the human being of contemporary industrial societies’) namely homo psychiatricus, which is:
“a human being stripped of most attributes that one might call ‘social’, such as attributes connected with the standing of his or her family, with educational attainments, occupational training and work, or national characteristics and identifications. The individual person is seen essentially as a closed system whose own internal processes have a high degree of independence in relation to what appear as ‘external’ or social factors. In general, the latter are evaluated as peripheral when a person is considered psychiatrically. They can be ‘taken off’ as it were, like a patient’s clothes in a doctor’s surgery.”

He recognizes – indeed his chef d’oeuvre is, among other things, about its ‘sociogenesis’ – people do experience themselves in this manner, and yet its not an adequate view. The individual cannot be separated from such things as his or her national identification; this is part of what people are. He goes on to illustrate this view with the example of the loss of a loved one of which it is impossible to say it either happens in or outside a person.

So, one might react in part to your question with the counter-question which sociology you mean. In my opinion it may be clear that ‘mental illness’ as it is commonly understood, belonging to the domain of psychiatry, provides insufficient common ground for a fruitful discussion from the perspective of this sociology. (There is common ground elsewhere, though, such as with psychoanalysis and developmental psychology – but that’s another story since those don’t primarily concern ‘mental illness’.)

Finally one might ask what you mean by ‘mental illness’. Schizophrenia, for instance, was considered to be mainly caused by ‘unhealthy’ family relations by a number of world-acclaimed psychiatrists as little as 30 years ago, until the pendulum ‘in the field’ swung back to a new version of the mainly biological view from the first half of the last century. Autism was ‘discovered’ only 69 years ago and has undergone baffling changes in the way it was interpreted in psychiatry. ‘Hysteria’ was the classic ‘female malady’ in the mid-nineteenth century and had all but vanished a century later. So ‘mental illness’ is obviously something else in different ages and societies. In sociological theorizing about it, one should not take ‘mental illness’ as a given. On the other hand, a social construction, such as Scheff, Goffman or Szasz would have it in the 1960s, it isn’t either: the phenomena which are labelled mental illnesses have a reality beyond such constructions.”