The arguments in the literature for and against "mental illness", are shown to founder on the lack of a thorough analysis of the sense of "illness" itself. Such an analysis is developed in the present study in three main stages. STAGE ONE: The ordinary use of "dysfunction" is examined. The term is shown to imply a particular kind of value judgement, derived, in respect of objects, from the purposes of living things for them. STAGE TWO: The sense of "illness" is interpreted from examples of physical illness by comparing and contrasting it with "dysfunction". An important logical link with "action" is identified, which provides an interpretation of the particular kind of negative evaluation implied by "illness". The relationship between "illness" and "disease" is examined in terms of this negative evaluation. STAGE THREE: The results of stage two are generalised from "physical illness" to "mental illness" by way of the notion of "action". "Mental illness" is examined as illustrated by examples of four main kinds of condition - organic psychosis, neurosis, addiction and functional psychosis. In respect of the first of these, "mental illness" is shown to be similar in its logical properties to "physical illness"; in respect of the remaining three, it is shown to be different, but in three quite distinct ways. In each case, however, the properties of "mental illness" are derived consistently with the interpretation of "illness" developed from examples of physical illness in stage two. "Mental illness" and "physical illness" are thus shown to be logically equivalent. In a concluding section, the implications of this result for the debate about "mental illness" are examined.

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The present work seeks to explain the process by which anxiety was transformed from a trope of nineteenth-century existential theology into the medicalized conception we have today. The dissertation begins in the 1840s with the Danish philosopher Søren Kierkegaard. In his attempt to resolve a series of debates within German idealist philosophy regarding the nature of evil and its impact on human freedom, Kierkegaard argued that anxiety was an intermediate stage between the awakening of man's potential for freedom and its manifestation in the form of sin. On the basis of this reading, Kierkegaard concluded that anxiety was the psychological manifestation of humanity's collective guilt for original sin. Despite the psychological idiom of his account, then, anxiety remained remained for Kierkegaard an irreducibly theological category. Chapter two of the dissertation examines two very different approaches to anxiety in the early twentieth century. For Sigmund Freud, anxiety was nothing more than the expression of libidinal conflicts, especially the Oedipal complex/fear of castration. Although it is commonly believed that Freud's understanding of anxiety underwent a dramatic shift toward the end of his career, I demonstrate that little of substance changed. Martin Heidegger, by contrast, applied Kierkegaard's existential understanding of anxiety to his ontological analysis of being. For Heidegger, anxiety was a "mood" that guided human beings to authenticity. Heidegger's phenomenological approach to human being strongly influenced the Swiss-German psychiatrist Ludwig Binswanger. On the basis of his clinical experience at Bellevue, his family owned sanatorium, Binswanger came to believe that there was a somatic reality to the subjective accounts of anxiety advanced by the philosophers. More than just a mood, anxiety was a concrete medical disorder with an array of psychosomatic symptoms that required diagnosis and treatment. In this way, Binswanger played a significant role in transforming anxiety from an abstract philosophical idea into material medical reality. Chapter four examines examines the work of the German-Jewish neurologist Kurt Goldstein, whose 1935 work The Organism drew extensively on Heidegger and Binswanger to develop a fully realized medical account of anxiety. Drawing on his treatment and rehabilitation of brain-injured soldiers in World War I, Goldstein observed that severe neurological injuries were accompanied by especially acute bouts of anxiety. Alongside the traditional understanding of anxiety as "objectless," Goldstein argued that it was also a somatic process than could be observed and quantified like any other. Goldstein's conclusions placed anxiety at the heart of a comprehensive account of the meaning and significance of biological life. In the years during and immediately after World War II, anxiety became a privileged mode of expression in American medicine and culture. The final two chapters of my dissertation explain how the medical conception of anxiety proliferated across multiple disciplines in postwar America, including theology, literature, and psychotherapy. I then demonstate the way in which anxiety was co-opted into the Cold War struggle against the Soviet Union. Figures like Arthur Schlesinger, Jr., Reinhold Niebuhr, and, especially, Rollo May argued that anxiety was the price Americans had to pay for many of the values they held most dear - above all, freedom and creativity. If Americans appeared vulnerable in comparison to the Soviet Union, he asserted, that was only because Soviet society was fundamentally unfree. Rather than trying to eliminate anxiety, Americans should aim to harness its creative potentiality and channel it toward productive ends. Anxiety thus became part of the Cold War armory, another weapon in the struggle for liberty and prosperity.