This paper develops an enactive approach to mental illness by equating it to a failure of adaptivity. Mental illness as inadaptivity can manifest in one of three ways: (1) by effectively limiting the range of activities that an individual can undertake, i.e. a narrowing of one’s world, (2) by creating an irreconcilability between the individual’s subjective experience and the objective world, thereby preventing the subject’s successful achievement of her goals, and (3) by creating a gulf between the individual’s personal world and the world of interpersonal relations. It is then argued that this approach is superior to competing reductionist approaches to mind, since these views must reduce consciousness to a mere epiphenomenon. Consequently, they are incapable of properly classifying mental illnesses, since such classification requires inescapable references to consciousness and phenomenological descriptions of lived experience. Furthermore, these reductionist approaches are incapable of explaining the success of mindfulness-based treatment approaches in psychiatry, which depend upon the ability of consciousness, through altered focus, to produce changes in neural circuitry. In other words, they depend upon the causal efficacy of consciousness.