Mental disorder as a puzzle for constitutivism

In the Nicomachean Ethics , Aristotle argues that the performance called for by being human is rational flourishing and a life that falls short of flourishing will fail to constitute a life lived in accordance with the norms governing human kind in virtue of its function. Against this constitutivist story, a puzzle arises: On Aristotle's criteria, it looks impossible for a person with a mental disorder to flourish. I consider whether this puzzle can be satisfactorily addressed without abandoning Aristotelian constitutivism. I regard this as a puzzle worthy of serious engagement because there is a tension between the adoption of Aristotelian virtue ethics as a normative backbone for applied ethics and the possibility that the theory would consign many, many people to being incapable of virtue or flourishing. I first set out the basic commitments of a constitutivist Aristotelian account and show how it generates the hypothesis that a person with mental disorder could never flourish. I then present two contemporary concepts of mental disorder—one from the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and one from philosopher George Graham's The Disordered Mind . I show that Graham's treatment of mental disorder supplies the basis for a compelling response to the puzzle for constitutivism. That response is rooted in his conceptualization of disorder as involving truncated rather than absent rationality. I suggest that Aristotle's discussion of death can be construed as supporting a second response. Finally, I discuss possible clinical implications under the auspices of caring constitutivism , which treats Aristotle's account of the human function as a basis from which ideals of rationality and recovery can be empathetically developed.