Contrast the essentialist and the constructionist approaches or models of mental illness, including the subtypes and varieties of each. What would each have to say about the causes of mental illness? Which approach to you agree with more and why?

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The essentialist view of mental illness sees it as emerging from clearly identifiable and isolated factors related to brain chemistry, physiology, and the like. The essentialist model sees mental illness as analogous to physical illness, with a clearly defined etiology, symptoms, and suggested therapeutics. As the other answer suggests, it is best understood through the lens of the Diagnostic and Statistical Manual (DSM), which provides a detailed taxonomy of the various manifestations of mental illness. The essentialist view implies that mental illness can best be treated by isolating the problem and addressing the symptoms with the use of psychiatric drugs. These drugs have grown dramatically in their popularity in recent years.

The constructionist view is rooted in the idea of social construction, the idea that many aspects of our world, behaviors, norms, and ideas, aren't essentialist but emerge from the complexities of our social arrangements. In this sense mental illness is not necessarily "real" but can be seen as emerging from an individual's experiences: upbringing, socialization, traumas, etc. Some constructionists even go so far as to argue that an individual doesn't really have a "mind" of their own but that thoughts are acculturated and dependent on language, something which is imposed on a person from outside as they develop in a given social sphere.

In all likelihood, mental illness is best understood as a synthesis of these views, partly a question of chemistry and physiology and partly a result of a person's engagement with their society.

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An essentialist view of mental illness states that mental illness is a state that exists independently from society and that it can be defined objectively and is caused by neurological issues or by lifetime experiences. Essentialists would argue that people have mental illness because they exhibit a concrete set of behaviors and that these behaviors define mental illness. They would also argue that if, for example, a drug cures or alleviates the symptoms of a mental illness, that illness exists in objective terms. The DSM, or Diagnostic and Statistical Manual used to diagnose mental disorders, follows this model. The "hard" essentialist model regards mental disorders as types of diseases, while the "soft" essentialist model regards mental disorders as a psychological state. 

On the other hand, constructionism argues that mental illness was created by society to label people insane if they have behaviors that deviate from social norms. People in this camp have a broader view of how deviant behaviors are defined in society, and they believe that if people break the sociological standards made by society, those people are construed as insane. The subtypes of constructionism are causal construction, in which social factors help bring about a mental disorder, and constitutive construction, in which social factors help define it in the first place. 

Both models likely have some validity in explaining many mental illnesses. For example, while the biochemistry of people with mental disorders might be different (supporting an essentialist approach), people with mental disorders might also act differently than others and be labeled as different (supporting constructionism).


Raphael van Riel. What Is Constructionism in Psychiatry? From Social Causes to Psychiatric Classification. Psychiatry. 2016; 7: 57. Published online 2016 Apr 18. doi: 10.3389/fpsyt.2016.00057 PMCID: PMC4834349. 

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