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El. knyga: Philosophy of Psychiatry: A Contemporary Introduction

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This is the first introductory textbook of its kind devoted to philosophy of psychiatry, offering a thorough and accessible investigation of the conceptual and philosophical problems at the heart of psychiatric practice and research. While it applies some of the long-standing concerns of philosophy to the mental health professions, it also investigates philosophical problems and issues that have arisen more recently from careful examination of psychiatric phenomena. Divided into two parts, Philosophy of Psychiatric Practice and Research and Philosophy and Psychopathology, the books 12 chapters cover topics like the ontological status of mental illness, philosophical issues in diagnosis, the role of culture in psychiatry and the relationship between mental illness and personal identity, as well as explore foundational problems in studying well-known psychopathologies like schizophrenia, depression and addiction. All chapters include initial overviews and concluding summaries and a list of suggested readings.

Key Features











Two-part structure divided between (1) philosophy of psychiatric practice and research, and (2) philosophy and psychopathology presents a clear, yet distinctive picture of the field





Offers a unified style and vision throughout, with easy-to-follow segues from chapter to chapter





Pedagogical features include chapter overviews and summaries, discussion questions and sections for further reading
Preface xii
Acknowledgements xviii
1 Introduction: what is philosophy of psychiatry and why does it matter?
1(10)
1.1 Philosophy of × 1
1(2)
1.2 Psychiatry broadly construed
3(3)
1.3 Why does the philosophy of psychiatry matter?
6(5)
1.3.1 It improves understanding and treatment of mental illness
6(1)
1.3.2 It improves the way our institutions function
7(1)
1.3.3 It improves our societal responses to mental illness
8(1)
1.3.4 It gets to the heart of what makes us human
9(1)
Summary
10(1)
Note
10(1)
Further reading
10(1)
PART 1 Philosophy of Psychiatric Practice and Research
11(128)
2 What is mental illness?
13(26)
2.1 Illness, disease and neighbouring notions
14(7)
2.1.1 Illness, disease, disorder and sickness
14(4)
2.1.2 Illness versus disability
18(2)
2.1.3 Illness, difference and diversity
20(1)
2.2 Philosophical accounts of illness
21(11)
2.2.1 Mapping the terrain
21(5)
2.2.2 How viable is objectivism?
26(2)
2.2.3 Hybrid accounts
28(1)
2.2.4 Values-based accounts
29(3)
2.3 Is mental illness a myth?
32(7)
2.3.1 Szasz's argument against the existence of mental illness
33(2)
2.3.2 What does the myth achieve?
35(1)
2.3.3 Taking stock: is mental illness real?
36(1)
Summary
37(1)
Notes
38(1)
Further reading
38(1)
3 Psychiatric diagnosis and the medical model
39(29)
3.1 Diagnosis and the medical model
39(8)
3.1.1 The relationship between diagnosis and the medical model
40(1)
3.1.2 Motivations for the medical model
41(2)
3.1.3 What is diagnosis?
43(2)
3.1.4 Current practices of Western psychiatric diagnosis: the DSM and the ICD
45(1)
3.1.5 Strong versus minimal medical models
46(1)
3.2 Issues in psychiatric diagnosis
47(8)
3.2.1 Causalism versus descriptivism
48(1)
3.2.2 Essentialism versus pragmatism
49(1)
3.2.3 Objectivism versus evaluativism
50(1)
3.2.4 Internalism versus externalism
50(2)
3.2.5 Categories versus dimensions
52(3)
3.2.7 Taking stock
55(1)
3.3 Challenges and alternatives to diagnosis
55(13)
3.3.1 Concerns about the impact of psychiatric diagnosis
55(2)
3.3.2 Theoretical concerns with diagnosis
57(3)
3.3.3 Alternatives to diagnosis
60(5)
3.3.4 To diagnose or not to diagnose?
65(1)
Summary
66(1)
Further reading
67(1)
4 Mental illness, moral responsibility and the boundaries of the person
68(26)
4.1 Introducing the issue
68(8)
4.1.1 Responsibility and related notions
69(2)
4.1.2 A variety of concrete examples
71(5)
4.2 Approaches to mental illness and moral responsibility
76(3)
4.2.1 Mental illness and legal responsibility: "the insanity defence"
76(2)
4.2.2 Incidental versus intrinsic accounts
78(1)
4.3 Requirements for responsibility
79(7)
4.3.1 A simple view: information and control
80(1)
4.3.2 The Deep Self View
80(3)
4.3.3 The Sane Deep Self View
83(2)
4.3.4 Taking stock
85(1)
4.4 Mental illness revisited
86(8)
4.4.1 Objectivism and the incidental view
86(1)
4.4.2 Values-based accounts and the intrinsic view
87(1)
4.4.3 Fictionalism about mental illness and morality
88(1)
4.4.4 Narratives of illness, responsibility and personhood
89(3)
Summary
92(1)
Notes
92(1)
Further reading
93(1)
5 Religion, culture and pathology
94(19)
5.1 The controversial exemption of religious belief
95(1)
5.2 Safety in numbers
96(5)
5.2.1 Epistemic considerations for widely held belief
97(2)
5.2.2 Practical considerations for widely held belief
99(1)
5.2.3 Biomedical considerations for widely held belief
99(1)
5.2.4 Taking stock: the intelligence of the masses?
100(1)
5.3 Is religion special?
101(4)
5.3.1 A values-based approach: religion as life-enhancing
102(1)
5.3.2 An objectivist approach: the cognitive science of religion
103(2)
5.4 The challenge of cultural sensitivity
105(8)
5.4.1 An objectivist approach
106(1)
5.4.2 A values-based approach
107(1)
5.4.3 The social kindling hypothesis
108(1)
5.4.4 Context of formation versus context of evaluation
109(2)
Summary
111(1)
Further reading
112(1)
6 Scientific explanation in psychiatry
113(26)
6.1 The challenge of scientific psychiatry
114(1)
6.2 The nature of explanation
115(9)
6.2.1 The formal-logical view
116(2)
6.2.2 The ontological view
118(1)
6.2.3 The pragmatic view
119(4)
6.2.4 Taking stock
123(1)
6.3 Levels and kinds of explanation
124(9)
6.3.1 Levels of explanation: an ambiguity
125(2)
6.3.2 Levels and kinds of explanation: two separate constraints
127(2)
6.3.3 A comment on personal explanation
129(2)
6.3.4 Some examples
131(2)
6.4 Related issues
133(6)
6.4.1 Accuracy and explanatory power
133(2)
6.4.2 Two kinds of reductionism
135(2)
Summary
137(1)
Notes
137(1)
Further reading
138(1)
PART 2 Philosophy and Psychopathology
139(186)
7 Schizophrenia
141(34)
7.1 The concept of schizophrenia
142(3)
7.1.1 A brief history of "schizophrenia"
142(1)
7.1.2 "Psychosis"
143(1)
7.1.3 The relationship between schizophrenia and psychosis
144(1)
7.2 The phenomenon itself
145(3)
7.2.1 Diagnosing schizophrenia
146(1)
7.2.2 Epidemiology of schizophrenia
147(1)
7.3 Mechanistic accounts
148(14)
7.3.1 Source-monitoring accounts
149(2)
7.3.2 Self-monitoring accounts
151(3)
7.3.3 The dopamine hypothesis
154(1)
7.3.4 Introducing the predictive processing framework
155(4)
7.3.5 Predictive processing accounts of psychosis
159(3)
7.4 Phenomenological approaches
162(4)
7.4.1 Big P versus Little p phenomenology
162(1)
7.4.2 Ipseity accounts of schizophrenia
163(1)
7.4.3 Psychosis as disruption to the anticipatory structure of experience
164(1)
7.4.4 The explanatory contribution of phenomenological approaches
165(1)
7.5 The case against schizophrenia
166(9)
7.5.1 Socio-political critiques
167(1)
7.5.2 Scientific critiques
168(1)
7.5.3 Pragmatic critiques
169(1)
7.5.4 Where does this leave us?
170(2)
Summary
172(1)
Notes
173(1)
Further reading
173(2)
8 Hearing voices
175(27)
8.1 The varieties of voice hearing
176(4)
8.1.1 Varieties in context
176(1)
8.1.2 Varieties in phenomenology
177(3)
8.1.3 Varieties of underlying mechanism
180(1)
8.2 The self-monitoring account
180(10)
8.2.1 Introducing self-monitoring
181(1)
8.2.2 Inner speech-based self-monitoring accounts
181(2)
8.2.3 Arguments in favour of inner speech-based self-monitoring accounts
183(2)
8.2.4 Problems and further developments
185(5)
8.2.5 Self-monitoring without inner speech?
190(1)
8.3 Alternative accounts
190(5)
8.3.1 Spontaneous activation accounts
191(1)
8.3.2 Memory-based accounts
192(2)
8.3.3 Social deafferentation accounts
194(1)
8.3.4 Taking stock
195(1)
8.4 From self-monitoring to predictive processing
195(7)
8.4.1 The problem of hypervigilance hallucinations
195(1)
8.4.2 Prediction is pervasive in all cognition, not just action monitoring
196(1)
8.4.3 A predictive processing account of AVH
197(3)
8.4.4 Remaining challenges and future directions
200(1)
Summary
200(1)
Notes
201(1)
Further reading
201(1)
9 Delusion
202(36)
9.1 The concept of delusion
203(9)
9.1.1 Delusion as a diagnostically important psychiatric concept
203(3)
9.1.2 Delusions as epistemically defective mental states
206(4)
9.1.3 A change of approach
210(2)
9.2 Examples of clinical delusions
212(6)
9.2.1 Schizophrenia spectrum and other psychotic disorders
212(1)
9.2.2 Delusions and mood disorders
213(1)
9.2.3 Delusion and brain injury
214(3)
9.2.4 Taking stock: taxonomies of delusion
217(1)
9.3 Explanatory accounts of delusion
218(10)
9.3.1 Delusions in psychotic disorders
218(1)
9.3.2 The classic bottom-up account of Capgras delusion (Ellis and Young 1990)
219(2)
9.3.3 Explanationist versus endorsement models
221(2)
9.3.4 One-factor versus two-factor accounts
223(2)
9.3.5 An alternative approach: top-down accounts
225(1)
9.3.6 Tracking accounts
226(2)
9.4 Delusion and belief
228(10)
9.4.1 Why might (some) delusions not be beliefs?
228(2)
9.4.2 What is belief?
230(2)
9.4.3 So do delusional patients fail to be believers?
232(2)
Summary
234(1)
Notes
235(1)
Further reading
236(2)
10 Depression
238(24)
10.1 Introducing depression
239(4)
10.1.1 Depression in the DSM
239(2)
10.1.2 The phenomenology of depression
241(1)
10.1.3 Who gets depressed?
242(1)
10.2 Delineating depression
243(9)
10.2.1 Is depression an extreme version of something familiar?
244(2)
10.2.2 How do we distinguish pathological depression from "healthy" sadness?
246(1)
10.2.3 Depression and dysthymia
247(3)
10.2.4 Depression, melancholia and cross-cultural variation
250(2)
10.3 Explaining depression
252(10)
10.3.1 Phenomenological explanations
252(1)
10.3.2 Neuroscientific and cognitive approaches
253(2)
10.3.3 Predictive processing accounts
255(1)
10.3.4 Depression and motivation
256(4)
Summary
260(1)
Note
261(1)
Further reading
261(1)
11 Addiction
262(27)
11.1 Introducing addiction
262(2)
11.2 What is addiction?
264(13)
11.2.1 The Lay View of addiction
265(3)
11.2.2 Addiction as a brain disease
268(3)
11.2.3 Addiction as a mental illness
271(1)
11.2.4 Addiction and self-control
272(4)
11.2.5 A socio-pragmatic account
276(1)
11.3 The science of addiction
277(5)
11.3.1 Addiction as evolutionary mismatch
277(1)
11.3.2 Addiction as dysfunctional reward learning
278(1)
11.3.3 Addiction as incentive salience
279(1)
11.3.3 Predictive processing accounts
280(2)
11.4 Remaining philosophical issues
282(7)
11.4.1 Addiction and rationality
282(1)
11.4.2 Addiction, responsibility and blame
283(2)
11.4.3 Addiction and pathology
285(2)
Summary
287(1)
Notes
287(1)
Further reading
288(1)
12 The future of philosophy of psychiatry
289(36)
12.1 Overlooked phenomena
290(5)
12.1.1 Post-traumatic stress disorder
290(1)
12.1.2 Anorexia nervosa
291(1)
12.1.3 Personality disorders
292(3)
12.2 Mental well-being in a digital world
295(2)
12.2.1 The self and self-esteem online
295(1)
12.2.2 Loneliness and togetherness online
295(1)
12.2.3 Internet addiction
296(1)
12.3 The rise of computational psychiatry
297(2)
12.3.1 Clinical computational neuroscience
297(1)
12.3.2 Computational psychiatric epidemiology
298(1)
12.3.3 Deep learning in diagnostics and early intervention
298(1)
12.4 Externalistic psychiatry
299(2)
12.4.1 Embodied psychiatry
300(1)
12.4.2 Embedded psychiatry
300(1)
12.4.3 Extended psychiatry
301(1)
12.4.4 Enactive psychiatry
301(1)
12.4.5 Clinical consequences of externalistic psychiatry
301(1)
12.5 Understanding psychiatric discourse
301(24)
12.5.1 Beyond realism and anti-realism: expressivism, fictionalism, constructivism
302(1)
12.5.2 The ameliorativist agenda: optimising discourse for scientific progress and social justice
303(1)
Summary
304(1)
Further reading
304(1)
References
305(20)
Index 325
Sam Wilkinson is Senior Lecturer in Philosophy in the Department of Sociology, Philosophy and Anthropology at the University of Exeter, whose research focuses on hallucinations, delusions, psychological trauma, brain injury and the nature of health and well-being. He has published articles in leading journals, including Mind and Language, Consciousness and Cognition, Review of Philosophy and Psychology and Philosophy, Psychiatry and Psychology.
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