2024-01-15 Reading Log

A Note

I am deep in the rabbit hole of the Stanford Encyclopedia of Philosophy. It is such a rich resource, especially as I investigate the philosophical assumptions bolstering psychotherapy as a profession. Usually, practitioners are directed toward reading theory from a particular school of thought. Which is fine, but why not ask the questions that prompted those theorists' theorizing in the first place? Questions like: "How do we measure psychotherapeutic change?", or "What skills should we cultivate as therapists?", or "What type of thing is a mental disorder?" That is the thrust of this week's readings.

A follow-up to my reading of the SEoP's entry on philosophy of psychiatry. I must say, I'm slightly disappointed with the entry. It was incredibly heavy on jargon, and I believe the author assumes the reader is already quite familiar with the conceptual territory. You are thrown into the middle of debates without introduction, names and references are cited, and little is done to situate the reader regarding the context of the debates. Especially in contrast to the philosophy of psychiatry, this was somewhat of a letdown. Still, the author provides some excellent citations that I will be diving into.

If I took anything away the article, it is that defining mental illness/disorder/pathology is contentious and value-laden. Duh. But there is a trend to provide definitions which are "value neutral." This is perhaps the best paragraph in the entry:

Critique of value neutrality in defining mental disorders

"Following early work by Carl Hempel (1961) that depicted psychiatry’s claim to scientific status as depending on the value neutrality of its classifications, much philosophical discussion of classification has been entirely critical, conceding little usefulness to the approach, skeptical of the promise of validity, doubtful of its methodology and claims to scientific authority, un-persuaded by the categorical system employed, as well as its individualistic and idiopathic emphasis, and dubious over its claim to being, or being able to be, value-free."

Curious, our deep desire to be seen as scientific and "value neutral" in a profession defined by understanding subjectivity, experience, meaningfulness. In fact, as in the entry for philosophy of psychiatry, the author reveals the roots of this desire, which are the medical model roots―especially surrounding conceptions of disease and pathology―of our diagnostic systems.

Concepts of cell pathology morph into "mental pathology"

"On traditional, two-part models from cell pathology, dysfunctional organic processes internal to the individual are manifested in, and causally responsible for, more readily observable signs and symptoms; collectively, these two parts make up the disease. Applied to mental disorder, certain of those underlying processes have been delimited as mental by appeal to the traditional categories of faculty psychology (perception, affection, cognition, memory, and so on). For example, hallucinations represent dysfunctional perceptual capabilities, mania and depression disturbed affect regulation, and delusions defective cognitive processing."

We continue to use the conceptual materials of medical science to categorize, study, and intervene in mental disorder.

From the same author for the Philosophy of Psychiatry entry. This is a short supplement, focusing on one approach to thinking about mental illness which utilizes the "philosophical resources to make the [pathological] experience somewhat less unfathomable, and perhaps clear some ground for an explanation by pointing the way towards the sort of mental processes that would need to be involved."

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