ABSTRACT
Psychiatry has long been plagued by a stubborn, inconvenient fact: the knowledge regarding the nature of mental distress remains elusive. The search for a mechanistic, aetiological understanding of mental distress, be it psychological, neurological, genetic or otherwise, has been frustrated time and time again (Grob 1998). As such, psychiatry lacks basic knowledge of its object. This ignorance risks undermining the aspirations of the profession and inducing a legitimation crisis. A looming threat, psychiatry’s ignorance is not a mere absence of knowledge. Rather, it has a palpable presence, which is redolent in psychiatric discourse, professional reforms efforts and antipsychiatry critiques. Thus, more so than other medical specialities, psychiatrists must formulate ways to manage ignorance and mitigate its effects. Indeed, the resilience of American psychiatry over the past 150 years, despite the problems in its knowledge base, is a testament to the more or less successful strategies it has developed to domesticate its ignorance.
