Jerome Wakefield

Jerome Wakefield is an American philosopher of psychiatry and social work scholar based at New York University. In "The Concept of Mental Disorder" (1992) he proposed the harmful dysfunction analysis, on which a condition is a disorder only if it involves a failure of some internal mechanism to perform its naturally selected function and that failure is harmful by social standards. The hybrid of a factual and an evaluative condition became a central reference in debates about the concept of disease and psychiatric diagnosis.

Key ideas

• A disorder is a harmful dysfunction: both conditions are required.
• Dysfunction is a factual matter: a mechanism failing to do what it was naturally selected to do.
• Harm is an evaluative matter, judged by social values.
• Diagnostic criteria that ignore context can mislabel normal responses, such as sadness after loss, as disorders.

Major works

• "The Concept of Mental Disorder: On the Boundary Between Biological Facts and Social Values" (1992, American Psychologist)
• The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (2007, with Allan V. Horwitz)

In the conversation

• Debate Health cannot be defined without values, and Boorse’s statistical theory shows it by trying Dima Nasser · 3 replies
• Question Deafness: disease, disability, or difference? And who gets to decide? Dima Nasser · 4 replies
• Question What is Wakefield’s “harmful dysfunction” account, and why do psychiatrists still argue about it? Elif Yıldız · 3 replies