Psychiatry’s guiding paradigm is that some extremes of mood are sufficiently severe that they constitute illness. This argument isn’t restricted to questions about diagnoses; a version of it plays out across multiple mental-health-related debates. At first glance, these can look like separate discussions, but they tend to boil down to the same central questions: Is happiness always the goal of mental health treatment? Emotions run particularly high around medication, and the same questions arise in the field of psychotherapy. The intervention being debated in this case is slower moving, but clinicians still disagree about the fundamental purpose of the talking cure.

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