What makes “a new mental illness”?: The cases of solastalgia and hubris syndrome. Cosmos and History, 2009. Part 1.

This is a paper I wrote a few years back – a confluence of some of the work on the conceptual basis of “mental illness” (work for the MA in Philosophy and Ethics of Mental Health from University of Warwick) with my interest in (and scepticism about) solastalgia and hubris syndrome.
Its a long article, so I will reblog in three parts. The whole thing is also available in PDF

What makes “a new mental illness”?: The cases of solastalgia and hubris syndrome.

ABSTRACT: What is a “mental illness”? What is an “illness”? What does the description and classification of “mental illnesses” actually involve, and is the description of “new” mental illnesses description of actually existing entities, or the creation of them?  “Solastalgia” is a neologism, invented by the Australian environmental philosopher Glenn Albrecht, to give greater meaning and clarity to psychological distress caused by environmental change (Albrecht et al 2007) The concept received some coverage in the international mass media in late 2007 (Thompson, 2007) Much of this described solastalgia as “a new concept in mental illness”, a description endorsed by Albrecht himself. The doctor and former British Foreign Secretary, Lord Owen, has coined the phrase “hubris syndrome” to describe the mindset of prime ministers and presidents whose behaviour is characterised by reckless, hubristic belief in their own rightness. This paper uses both the concept of solastalgia and the related concepts Albrecht posited of psychoterratic and somaterratic illnesses and hubris syndrome as a starting point to explore issues around the meaning of mental illness, and what it means to describe and classify mental illness. These issues illustrated tensions between natural and social philosophy, with the nature and status of psychiatry as a scientific, “value-free” enterprise or a humanistic, “value-laden” one discussed. Should “the distress caused by environmental change” be deemed a mental illness? Could it thereby included in catalogues of mental illnesses such as DSM-IV and ICD-10? The process whereby the psychiatric establishment defines and categorises mental illness is described, and as well as examining whether solastalgia and hubris syndrome meets these criteria, those criteria are compared to more critical views of psychiatry and the nature of mental illness. The approaches of Szasz, Boorse, Fulford, Canguilhem and other thinkers to issues related to mental illness are discussed. Finally it is suggested that the language of mental illness is increasingly used for rhetorical purposes, and that caution should be exercised in extending the label of illness to the phenomena of solastalgia and hubris syndrome.

Keywords: Psychiatry, mental illness, philosophy of medicine, philosophy of science, Szasz, Canguilhem

INTRODUCTION: THE CASE OF SOLASTALGIA

Solastalgia is a neologism, invented by the Australian environmental philosopher Glenn Albrecht, to give greater meaning and clarity to environmentally induced distress (Albrecht et al, 2007) Albrecht had worked for some time as an environmental activist and advocate in the Hunter Region of New South Wales. Open cut coal mining and the construction of new power stations had transformed this formerly pastoral landscape. Many area residents who were concerned about specific environmental issues contacted Albrecht to discuss these. In the course of these interactions he began to notice that a wider distress at the extent of local environmental change was evident. Influenced by various environmental thinkers (Rapport 1999) who linked man-made environmental stress leading to “land-sickness” (which, unlike other environmental stresses, did not lead to an environmental recovery) with psychic stress among the population of the particular environment, he developed the concept of solastalgia. Ethnographic studies among residents of the area identified the following themes:

Their sense of place, their identity, physical and mental health and general wellbeing were all challenged by unwelcome change. Moreover, they felt powerless to influence the outcome of the change process. From the transcript material generated from the interviews the following responses clearly resonate with the dominant components of solastalgia _ the loss of ecosystem health and corresponding sense of place, threats to personal health and wellbeing and a sense of injustice and/or powerlessness. (Albrecht et al, 2007, S96)

Postulating “nostalgia” as a place-based distress, with the distress being due to absence from the loved place, Albrecht observed that “people who are still in their home environs can also experience place-based distress in the face of the lived experience of profound environmental change.” (Ibid., S96)He had also coined the concept of a “psychoterratic” illness, one in which psychological symptoms are induced by land sickness: “the people of concern are still ‘at home’, but experience a ‘homesickness’ similar to that caused by nostalgia. What these people lack is solace or comfort derived from their present relationship to ‘home’, and so, a new form of psychoterratic illness needs to be defined. The word ‘solace’ relates to both psychological and physical contexts.” (Ibid,. S96) The concept received some coverage in the international mass media and in the “blogosphere” in late 2007 (Thompson 2007)

Much of this described solastalgia as “a new concept in mental illness”, a description which, while not originated by, was endorsed by Albrecht himself. A rating scale was developed which purported to provide a means of measuring Environmental Distress (Higginbotham et al, 2007.) This was an 81-point instrument, with a mix of yes-or-no statements and five-point scales. One subscale measured solastalgia, and the researchers assessed the validity of solastalgia scores in predicting other aspects of environmental distress. The overall aim of the research has been described as follows:

How well a psychoterratic syndrome such as solastalgia captures the essence of the relationship between ecosystem health, human health and control (hopelessness and powerlessness) and negative psychological outcomes. (Albrecht et al 2007, S97-8)

In discussing the results of the validation of the Environmental Distress Scale (EDS), Higginbotham et al observed that

As measured through the EDS, the concept of solastalgia appears to give clear expression, both philosophically and empirically, to the environmental dimension of human distress. This has not been achieved previously. We might further consider whether or not the experience of solastalgia is essentially the primary process underlying the EDS measurement as a whole. In other words, solastalgia may well account for most of what we have measured under the rubric of environmental distress. (Higginbotham et al, 2006, p. 252)

It should be noted that the concept of “solastalgia” has emerged from a context of thinking among environmentalists and environmental philosophers about the relationship between the “natural environment” and “psychic stability.” Albrecht has described how his thought evolved under the influence of the American environmentalist Aldo Leopold, who in the 1940s described links between environmental problems and psychic states (Leopold 1949) This tradition seems to be separate to that which has linked psychiatry and philosophy in recent years, focusing on making connections between the health of the environment and the health of individual human beings and drawing parallels between medical and ecological approaches. (Kristjanson and Hobbs, 2002)

Solastalgia was described as a “new mental illness” in the wider media coverage of the phenomenon (Thompson, 2007). As outlined above, Higginbotham et al suggested that solastalgia did underlie the environmental distress they had measured, and argued that the validation of their rating scale appeared to support viewing solastalgia as a clear expression of environmental distress. They did not take into account the process whereby psychiatry, as a medical specialty, defines and “accepts” a phenomenon as a “mental illness.” Nor did it take into account the philosophical issue of what a mental illness actually is, and whether or not solastalgia could be classed as one. This therefore allows us to review the topic with solastalgia in mind as an exemplar of a proposed “new mental illness.”

The case of hubris syndrome

David Owen, ennobled as Lord Owen, qualified as a medical doctor and subsequently entered UK politics. Minister for Health and Foreign Secretary in Labour Governments of the 1970s, he later was a co-founder of the Social Democratic Party in the 1980s and Special Representative to Bosnia-Herzogovina in the 1990s. In recent years he has written widely on the interaction between medical illness and politics (Owen 2008a)

In these writings, he has introduced the concept of “hubris syndrome.” (Owen, 2008b), described as follows :

Hubris syndrome is associated with power, more likely to manifest itself the longer the person exercises power and the greater the power they exercise. A syndrome not to be applied to anyone with existing mental illness or brain damage. Usually symptoms abate when the person no longer exercises power. It is less likely to develop in people who retain a personal modesty, remain open to criticism, have a degree of cynicism or well developed sense of humour. Four heads of government in the last 100 years are singled out as having developed hubris syndrome: David Lloyd George, Margaret Thatcher, George W Bush and Tony Blair. (Owen, 2008b, p. 428)

Owen describes hubris syndrome as inextricably linked with power, and indeed requiring the person to be in a position of high, if not supreme, political office. He also argues it is related to the length of time an individual is in power, and “evolves and is in a continuum with normal behaviour.” Owen suggests a checklist of thirteen symptoms, of which a “three or four should be present before any diagnosis is contemplated.” Here four of those symptoms are given:

– a narcissistic propensity to see the world primarily as an arena in which they can exercise power and seek glory rather than as a place with problems that need approaching in a pragmatic and non-self-referential manner

– a predisposition to take actions which seem likely to cast them in a good light, taken in part in order to enhance their image

– a disproportionate concern with image and presentation

– a messianic manner of talking about what they are doing and a tendency to exaltation in speech and manner (Ibid., p. 428)

Owen describes how not all politicians, even those who achieve the highest office, succumb to hubris syndrome. He discusses the careers of United States President Harry S Truman and British Prime Ministers Clement Attlee and James Callaghan as examples of twentieth century leaders untouched by hubris. In more detail, he discusses the behaviour of Lloyd George, Thatcher, Blair and George W Bush, with particular reference in the case of the latter two to their approach to the Iraq War of 2003. He argues that hubris syndrome is associated with very considerable mortality and morbidity worldwide, as leaders take major decisions, especially in relation to war and peace, recklessly. He distinguishes between hubris syndrome and personality disorders, and very firmly states his conviction that a neurochemical, neuroscientific approach is required to elucidate the causes and prevent the occurrence of hubris syndrome:

It is my hope that neuroscientists will consider hubris syndrome within the broad basis of a systems-orientated approach and examine whether prolonged leaders’ stress associated with noradrenergic and dopamine systems with some predisposing factors may affect this system in ways not dissimilar to the resetting experienced by the long distance runner after a prolonged period of running. A resetting of the dopamine system might provide an explanatory hypothesis underpinning of the hubris syndrome. (Ibid., p. 432)