The papers of Stephen Toulmin and Alan Donagan raise questions about the nature of those human states that in Western societies have traditionally been called mental illness. Their remarks are directed principally at the basis of our understanding of those states, and the results of that understanding in the manner in which we relate to and deal with individuals who are troubled in their personal lives. In their logical arguments, which are based on assumptions, both authors broach the perennial human dilemma of reality, what is "real" as compared to what seems real, or what is social or personal reality, as opposed to phenomena that we can in some degree depend upon outside the perceptual and cognitive boundaries of a sociocultural system. I shall refer to Donagan's paper first.