Psychiatry is not the science of unhappiness

Psychiatry risks losing its conceptual boundaries as the scope of its concern expands to include all forms of human unhappiness. This editorial argues that the discipline must distinguish clearly between illness and adversity, recognising that not all suffering is pathological. Drawing on historical and contemporary debates - from Jaspers' foundational dualism to Engel's biopsychosocial model, and from diagnostic inflation to the medicalisation of social distress - the paper contends that integration without limits leads to dissolution. Psychiatry's legitimacy depends not on the eradication of unhappiness but on the understanding of illness and the protection of those whose suffering has crossed the threshold of disease.

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Publication Details

Journal
BJPsych Bulletin
Published
2026-01-15
DOI
https://doi.org/10.1192/bjb.2025.10211
Primary Topic
Mental Health and Psychiatry
Type
article
Field-Weighted Citation Impact
0.00
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article

Psychiatry is not the science of unhappiness

Carlos Herreros de las Cuevas
BJPsych Bulletin
Mental Health and Psychiatry
article

Psychiatry is not the science of unhappiness

Carlos Herreros de las Cuevas
article en

Abstract

Psychiatry risks losing its conceptual boundaries as the scope of its concern expands to include all forms of human unhappiness. This editorial argues that the discipline must distinguish clearly between illness and adversity, recognising that not all suffering is pathological. Drawing on historical and contemporary debates - from Jaspers' foundational dualism to Engel's biopsychosocial model, and from diagnostic inflation to the medicalisation of social distress - the paper contends that integration without limits leads to dissolution. Psychiatry's legitimacy depends not on the eradication of unhappiness but on the understanding of illness and the protection of those whose suffering has crossed the threshold of disease.

BJPsych Bulletin
Universidad de La Laguna (ES)
Reduced inequalities
Openalex Percentile: Top 87%
Mental Health and Psychiatry
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