This article starts with the medical-juridical notion of mental illnesses, as conceived at the emergence of Psychiatry in the late eighteenth century. lt, then, attempts to look into the difficulties of supporting this concept along the changes made by the paradigms of Medicine in the two subsequent centuries. lt points out the Psychiatry's progressive "emptying" process and, therefore, the occupation of its gap by new and rising disciplines in the late nineteenth century: Neurology and Psychoanalysis. It tries to show how the latter, though grown out of Medicine, manages to become radically selfgoverning within this field. lt supports the thesis that such a movement toward self-govemment, started by Freud and undermined by his direct followers, is retrieved and completed by the lacanian rereading of Freud's writings. Though such a rereading, and as part of the self-goveming process, the psychoanalytical notion of clinical structure ends up replacing the old medical one of (mental) illnesses conceming most ways of behaviour and existence that had been Psychiatry's objects since the seventeen-hundreds. Once the normative oposition health x illness (normality x abnormality) makes room for a mere set of altemative possibilities - lacking real grounds for value judgement among such alternatives - further ethical implications are brought about. The author suggests that the assumptions of contemporary Psychoanalysis can contribute to a theoretical grounding for the so-called Psychiatric Reform.
Mental illness; medicine; anthropology; Psychiatric Reform; psychoanalysis; Lacan; Pinel