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Rationality without reason and the aetiology of mental illness

Wrexham Maelor Hospital, Clwyd

For over three centuries we, in Western societies, have lived in an Age of Reason. The accepted wisdom is that decision-making must be a purely rational process devoid of emotion and underpinned by objective knowledge. This article draws attention to the invasion of human affairs by an ideology which makes deliberate use of one kind of rationality to the exclusion of all others. Changes in work and its organisation have been particularly driven by economic rationality which allows no thought for the effects on individuals. The clinical evidence centres around four specific cases which are presented against a background of the business practices current in the control of work. It is argued that these have a deleterious effect on mental health, especially for those psychologically disposed to respond faithfully to management calls for greater teamwork and commitment.