Essays in the philosophy of psychiatry

Abstract

This dissertation consists of three chapters in which I address metaphysical and epistemological issues that arise in psychiatry, with particular attention paid to anti-psychiatric concerns. In Chapter 1, I consider three versions of anti-realism about psychiatric illness. I argue that Szasz's version of anti-realism should be rejected because it rests on a misunderstanding of illnesses more generally. Although I do not offer any clear refutations of labeling theory or cultural relativism, I point out the serious disadvantages of holding either view. I argue that in the absence of compelling reasons to endorse either labeling theory or cultural relativism, we are within our rights to remain realists about psychiatric illness. In Chapter 2, I address an epistemological concern that the scientific legitimacy of psychiatric taxonomy is compromised by the role that value judgments play in the study of mental disorders. I claim that this worry presupposes a view of science according to which objective observation and theory construction would not even be possible. I argue that, on a revised understanding of science proposed by Helen Longino, a scientifically legitimate psychiatric taxonomy is within our reach. Finally, in Chapter 3, I turn to the metaphysical problem of providing an account of disorders. An important part of a realist view of mental disorders includes an account of disorders. I claim that in light of available evidence of the heterogeneity of disorders, it is unlikely that disorders share an essence, and I argue that previous attempts to provide a Lockean account of disorders fail for this reason. I propose instead that disorders are homeostatic property cluster kinds of the sort first described by Richard Boyd.