Philosophy of Psychiatry

I have spent a lot of the summer reading in a mish-mash of areas that
are new to me to gear up for a capstone course in Science, Technology,
and Society that I’ll be teaching in January called “What Sorts of
People Should There Be?”.  The course will try to thread together
work on the history of eugenics with reflection on contemporary uses of
medical and biotechnology.  Much of the reading has been in
disability studies, and a chunk of it on psychiatry.  So much for
background.

What I was wondering about was why there is so little work by
philosophers on psychiatry.  The history of psychiatry seems to
have flourished over the past 30 years to be a respectable
sub-discipline in the history of medicine, and there is also a healthy
presence in reflecting on that history and on current trends of
anthropologists and sociologists.  But work by
philosophers–either of science, or of cognitive science–seems
scant.  Why is that?  Philosophers did, true, join in
discussions of the status of psychoanalysis in the 80s and 90s, and
there has been a lively involvement in related issues, such as that
over memory and trauma.  But we don’t seem to have found our way
very far into what seems to me a potentially rich and rewarding part of
the sciences of the mind.  Is it because psychiatry is a part of
medicine and, in general, philosophical work on medicine from a cog sci
/ sci perspective is swamped by that from bioethics?  Something
else?  Or is there a wealth of material out there that I just
haven’t bumped into yet? 

0 Comments

  1. There is an *enornmous* amount of material on philosophy of psychiatry. Think of Greg Currie’s work on delusions; following it up will quickly lead you into a very active world of people doing related work. George Graham had a recent review of work on psychopathology in APQ (Graham’s work on schizophrenia, with and without Stephens, is very much worth checking out). I work in this area, and there is far too much for me to read. Jennifer Radden’s recent edited book, *Philosophy of Psychiatry* will give you a start.

  2. Rob Wilson

    Neil, thanks. I’ll check out the Radden collection, which I haven’t seen. But I did have in mind the work of Currie (and for that matter Davies and Coltheart) on delusion and of Graham on psychopathology, and their very selectivity in what they touch on in psychiatry gives rise to the puzzle. I remember when George Graham and Lynn Stephens started the series on philosophical issues on psychopathology with MIT Press, and when SPP held somewhat related sessions on psychopathology in the late 90s / early 00s. That seemed like a start, but then it just didn’t seem to flourish in the way in which other forays into thinking about the mind in which philosophers have been involved did. So we have some work on particular psychopathologies, some on DSM IV, and more recently a little more on psychopharmacology (e.g., Carl Elliott’s work). In terms of broader thinking about psychiatry as a discipline, of the split between experimental and clinical traditions in psychology itself (and not in psychiatry), and of the connection of both to how we conceptualize the mind, there just doesn’t seem that much there. Or at least the “enormous amount of material on phil of psychiatry” just doesn’t have the visibility that that on (say) the history of psychiatry has, or the philosophy of neuroscience has. In the back of my mind was the suspicion that instead of the kind of broader sweep that at least I haven’t seen has been work by those influenced by Foucault (and not just or even necessarily Madness and Civilization), such as Hacking.

    If you have any other sources here (e.g., bibliography or course syllabus), please send it on or post it. –raw

  3. I don´t know why but seems paradoxical becuase knowing about the mind/brain workings from a patient-based approach is a specie of reverse enginnering so useful to understand and explain the organization and function of a system (brain) and what is suppose to do.

    When we encounter a deluded patient we can suspect something on the non-anomalous belief formation in healthy people, when we encounter a schizophrenic we can understand a litle more about intentional planning in non-clinical patients… maybe the historical neglect (well, this is an oversimplification becuase since ancient times philosophy is dealing with mental illness) concerning psychiatry in philosophy is because clinical patients, their families and society need solutions, therapeutic responses and not too much theoretical analysis about categories, disorders… But now that medicine is so advance and sohisticated relative to other periods in history, and theoretical issues are still puzzling practioneers… philosophy (must) have a say.
    I suscribe what Professor Levy says and add the following philosophers of psychiatry (with himself count) Bill Fulford, Philip Gerrans, Thomas Metzinger.

  4. Daniel Weiskopf

    Rob, one major recent work that looks at psychiatry as a discipline, particularly at the foundations of psychiatriac classification systems, is Dominic Murphy’s 2006 book, _Psychiatry in the Scientific Image_ (MIT Press). That might be the sort of thing you’re looking for.

  5. edouard machery

    Rob,

    Welcome to the blog!

    Following up on Dan’s comments, you should find Dominic Murphy’s book interesting.

    I should also note that my colleague, Ken Schaffner, is finishing a book  on schizophrenia. This should include some broader discussion of psychiatry, the nature of explanation, and the relation between psychiatry and neuroscience, genetics, etc. On this topic, Ken (together with Peter Machamer, me and a couple of psychiatrists from the med school) is putting together a workshop on how neuroscience, genomics, etc. can inform the classification of the next DSM.

    As far as I know, current philosophy of psychiatry focuses on 3 topics:
    – What are the correct explanations of delusions?
    – What is the nature of psychiatric classifications? How to improve on them?
    – How should psychiatry be related to other sciences, such as neuroscience and genomics?

    Any other important topic?

    Edouard

  6. -Darwinian psychiatry: wether psychopathology is better view as a state that promotes adaptations with some biological advantadge or a defect or deficit of normal functioning… why evolve?

    -Comparative psychiatry: do animals have mental disorders?

    -Discussions of what is normal/anormal in mental functioning

    -nurture/nature debate: mental disorders are heritable or experience dependent?

  7. Rob Wilson

    Here’s a useful comment from George Graham, whom I emailed earlier today; the book he refers to is the Oxford Handbook of Philosophy and Psychiatry, which is in press, and which I thoroughly look forward to getting!–raw

    **********

    You are wrong about there being little work on the philosophy of psychiatry. There are several ways in which to recognize this contrarian point. One consists of taking a look at a new book with Oxford (see attachment)that I have helped to produce, with Bill Fulford
    and Tim Thornton, and its huge bibliography, and I do mean huge, and
    detailed range of contents. The field of philosophy of psychiatry is abundant with contributions.

    Another way consists in noticing the number of talented philosophers
    who have contributed to topics in the philosophy of psychiatry. Again,
    the Oxford book guides one through that literature — the names.

    Finally, another method consists of recognizing that a number of journals have published special issues in the area, including MIND AND LANGUAGE as well as THE MONIST; and a journal is published by Johns Hopkins in the field, PHILOSOPHY, PSYCHIATRY, AND PSYCHOLOGY.

    Of course, what is meant by a lot or a little depends upon the comparison class. Compared with, say, the philosophy of neuroscience, there is more in or on the philosophy of psychiatry, but compared with the philosophy of cognitive science, there is much more in the philosophy of cognitive science. All sorts of hypotheses may be offered to explain these differences, and the differences themselves are changing. As more and more philosophers learn neuroscience, the quantity of work in neurophilosophy is ascending. Likewise, as more and
    more philosophers are becoming acquainted with psychiatry and clinical
    psychology, the quantity of work in the philosophy of psychiatry is rising.

    As a philosopher, I am more concerned, as I am sure you are, too, more
    with issues of quality than of quantity in a field, and with questions about how to estimate or judge philosophical quality in an area or field. I am also more concerned with the publicity or
    visibility of work than with its sheer quantity. Personally, I believe that a good portion of work in the philosophy of psychiatry is of very high quality, but perhaps is not as visible (to
    other philosophers and others) as in related areas of philosophy.

  8. Further to George’s very useful comments, I think that it is true to say that Anglo-American philosophy has only recently rediscovered an interest in psychiatry (by contrast with phenomenology on mainland Europe) and this was initially sparked by a response to 1960’s anti-psychiatry. Thus the field, right now, is in a very interesting state of flux.

    It is also not a ‘natural kind’ (by contrast with, say, more uniform areas like philosophy of language). In my own view it splits into at least three areas: concern with the presence or not of values in diagnosis; an attempt at understanding meanings in psychopathological experiences (in contrast to Jasper’s suggestion of un-understandability) which drives many interpretative philosophical models; and a more or less naturalistic concern with the philosophy of science of psychiatry and thus the validity of psychiatric classification. So, in a slogan: values, meanings and facts.

    The Oxford Textbook of Philosophy and Psychiatry of which George Graham and I are co-authors with Bill Fulford (and which is out) and also Jennifer Radden’s Companion are in the OUP series International Perspectives in Philosophy and Psychiatry which has already published in the diverse areas I’ve mentioned. See:
    http://www.oup.co.uk/academic/medicine/psychiatry/ippp/

  9. Lindsay J Webb

    Hi Rob- I am so glad that you have show in interest in the Philosophy of Psychiatry. How was your course, “What Sorts of People Should There Be?”

    First, it seems to me that there might be more work by philosophers on psychiatry, then vice versa. However, to address your concern about why there is little work (which is debated of course) by philosophers on psychiatry, I will day the following:

    Modern academic departments in philosophy have shifted from a continental focus to more analytical applications. For some reason or another, the philosophy of psychiatry (the philosophy of mental health, the philosophy of mental illness) is viewed by some as a field studied more by continental traditions than analytic philosophy. So, with this shift in practice, the philosophy of psychiatry sort of fell by the wayside. I have no idea why some assume that mental disabilities are not problems for philosophers. Perhaps we are viewed as a bunch of hippie-philosophers who seek to bring back the traditions and arguments associated with the French and American anti-psychiatry movements. But, we trudge on, in an effort to take ourselves seriously, and while we do move forward in this discipline, we can only hope that the philosophy departments of today understand that mental disorder is a problem for: philosophers of mind, law, ethics, politics, and science.

    Please do visit the following sites for links:
    http://www2.warwick.ac.uk/fac/med/study/cpd/subject_index/pemh/
    http://www.kcl.ac.uk/gsp08/programme/126
    http://www.uclan.ac.uk/facs/health/ethnicity/institute/philosophy_introduction.html
    http://www3.utsouthwestern.edu/aapp/
    http://www.angelfire.com/ms/perring/
    http://www.peh-med.com/content/2/1/22

    Thanks and good luck Rob,

    Lindsay J Webb