ABSTRACT
The mental-illness metaphor views persistent psychological challenges, such as depression and anxiety, in terms of the qualities and features of physical illness. This chapter tracks the origins of this metaphor, its further bolstering by the categorical and associative links provided by synecdoche and metonymy, and then its consolidation into common ways of speaking. It explores the manner in which the practices surrounding physical illness—such as diagnosis and treatment—the roles of key players—such as patients and nurses—and the places involved—such as wards and hospitals—have been transplanted onto approaches to psychological distress without considering the appropriateness of the fit. The metaphor has become so strongly embedded in mental health systems that alternative approaches—such as recovery or relational approaches—struggle to find room to move. The types of subsequent harms discussed include psychosurgery, institutionalization and false explanations.
