‘Isn’t Everyone a Little OCD?’ The Epistemic Harms of Wrongful Depathologization

Lucienne Spencer,Havi Carel

doi:10.5195/philmed.2021.19

Abstract

This article develops the concept of wrongful depathologization, in which a psychiatric disorder is simultaneously stigmatized (because of sanist attitudes towards mental illness) and trivialized (as it is not considered a “proper” illness). We use OCD as a case study to argue that cumulatively these two effects generate a profound epistemic injustice to OCD sufferers, and possibly to those with other mental disorders. We show that even seemingly positive stereotypes attached to mental disorders give rise to both testimonial injustice and wilful hermeneutical ignorance. We thus expose an insidious form of epistemic harm that has been overlooked in the literature.

Highlights

In the philosophy of psychiatry, there is a wealth of research on the systematic mistreatment of people with mental health problems (Perlin 1992; Thornicroft 2006; Kidd 2019)
Our aim is to articulate a new harm, driven not by pathophobic attitudes but rather by what we term wrongful depathologization, which deflates the status of mental illness as legitimate or “real.” We further claim that wrongful depathologization is a unique form of epistemic injustice
By exposing the epistemic harm that arises from pathophobic stigmatization, the literature on epistemic injustice in psychiatry has already done much to amplify the voices of those with a mental disorder

Summary

Introduction

In the philosophy of psychiatry, there is a wealth of research on the systematic mistreatment of people with mental health problems (Perlin 1992; Thornicroft 2006; Kidd 2019). Recent literature has brought to light a insidious form of mistreatment that has been previously overlooked. This is epistemic injustice: the wrongful treatment of marginalized individuals qua epistemic agents. One manifestation of wrongful depathologization is the de-prioritization of psychiatric patients by health professionals in favour of “patients who are really ill” (Thornicroft 2006, 96) Another manifestation is the characterization of persons with mental illness as “just like everyone else,” yet labelled as “difficult,” “manipulative,” or “attention-seeking” (Thornicroft 2006, 94)

Objectives

Conclusion