Ansvar og normalitet i psykiatrien: En videnskabshistorisk og empirisk funderet psykologisk undersøgelse af normalitetsdefinitioner i psykiatrien ud fra begrebet ansvar

This thesis investigates how the phenomenon of mental illness is understood historically in the psychiatric institution. The term and diagnosis “Psychopathy” will serve throughout as an example of general psychiatric challenges.
It is argued that mental illness should be understood as a relative phenomenon, because the involved theories about psychiatry, normality and responsibility, show that ideas about the nature of mental illnesses shift over time. This is contrary to the medical understanding, which the psychiatric field is founded on. It is further argued that a distinction between a statistical and an ideal definition of normality is essential to investigation of how understandings of mental illnesses evolve over time. The term responsibility serves as a tool for investigating how psychiatric paradigms about the normal and the pathological shift over time. Existential psychological theory show how the individual can be understood as ultimately responsible for its own life. An ‘Ethics of Responsibility’ serves as a perspective from which the psychiatric institution also has a responsibility for the patient. The theoretical review is summed up in a ‘Responsibility-Continuum’, which the conclusions are built on.
An empirical analysis is conducted of three groups of historical sources that have relation to the psychiatric institution: Diagnostic manuals, psychiatric textbooks and psychiatric legislation. There is a total of 13 sources, which are placed on the Responsibility-Continuum to show how they understand mental illness in regards to responsibility. The continuum illustrates three major conclusions discovered in the analysis: 1) The concept of psychopathy challenges the psychiatric subject, as the desire to categorise does not contain the psychopathic personality. This can be seen as an example of a general challenge for psychiatry as it challenges the medical and reductive foundation. 2) There seems to be a tendency of ascribing the patient with more responsibility the newer the empirical material is, which is also a tendency in the society. 3) The three groups of sources show different lines of development, as there is seen fewest differences between the diagnostic manuals and most differences in legislation. This indicates that the psychiatric research institution lacks a common understanding of mental illnesses in regards to responsibility which challenges the foundation of the psychiatric field.
The thesis suggests finally for a psychiatry focused less on reductive measurements and more on a psychological oriented psychiatry focusing on the whole.