The diseased embodied mind: constructing a conception of mental disease in relation to the person

Temple Grandin, an Assistant Professor of Animal Sciences at Colorado State University, is well known for her designs of livestock-handling facilities, which are products of a different way of thinking attributed to autism.

Because many autistic children cannot develop relationships and/or initiate and hold a conversation with others, clinicians once thought these behaviors to be imitations of the behaviors presented by the child’s insensitive, cold “refrigerator mother”, who failed to establish a loving relationship with her child at infancy.

While I recognize some critics would question my use of the term disease to encompass conceptions of illness, as well as Nordenfelt’s definition of disease, it requires the reader to think about those evaluative or normative elements, which often goes unnoticed when specifically thinking about what is disease.

Value-laden and value-free conceptions of mental disease are considered when viewing biomedical and psychosocial models. The conception of mental disease, the subject of disease, and clinical (psychiatric) practice, i.e., diagnosing and treating patients with mental diseases, are the elements constructing medical models; the biomedical model focuses on an organic diagnosis and treatment (e.g., affecting a patient’s neurochemistry to treat depression) and the psychosocial model focuses on psychological and social ways to understand and treat the patient (e.g., psychotherapy is used to understand what social problems may contribute to the patient’s depression). I argue that both biomedical and psychosocial models are significant for treating patients with mental diseases–a holistic model.

Writers of the DSM-IV TR(2000) explain the first official attempt to gather information about mental illness in the U.S was “the recording of the frequency of one category–“idiocy/insanity” in the 1840 census,” American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, D.C.: American Psychiatric Association), p. xxv.

Often, clinicians relied on such analogies since they did not have the knowledge and tools to distinguish genuinely (cognitively) retarded 14-year-old adolescents from what we would now call an autistic 14-year-old. Clinicians at the time lumped together intellectual and social/emotional disorders without distinguishing the differences between them; thus, autism was understood to be an intellectual disorder in the same way mental retardation was understood.

Shortly after Kanner’s study, Asperger applied the term to children who developed obsessions for particular subjects, but who were extremely intelligent.