Much research in the philosophy of psychiatry has been devoted to the characterization of the normal and the pathological. In this article, we identify and deconstruct two postulates that have held sway in the philosophy of psychiatry. The first postulate concerns the belief that clinicians would benefit from conceiving of psychiatric disorders as stable entities with clear boundaries. By relying on a symptom-based approach, we support a conception of psychiatric disorders whose symptoms are the products of many activated mechanisms in (...) mutual interactions. The second postulate concerns the way in which the philosophy of psychiatry has approached the question of harm. We posit that clinicians perceive harms primarily through networks of clinical manifestations. The identification and deconstruction of these two postulates leads us to propose a practical definition of a psychiatric disorder that is useful for the clinician, while adopting a principle of prudential conservatism that does not exclude other theoretical definitions of psychiatric disorder that are useful as an epistemic hub. Thus, we propose the following definition of a psychiatric disorder that is relevant to clinical practice: “a set of clinical manifestations belonging to the prototypical central core of psychiatry, organized in a causal network, involving at least one harm, and whose set of harms exceeds the traditional threshold of significance for a given psychiatric disorder, directly related to an activated mechanism. Such a network composed of clinical manifestations is frozen in a state that is unable to allow the deactivation of these manifestations spontaneously without a therapeutic intervention”. (shrink)

Ian Hacking uses the looping effect to describe how classificatory practices in the human sciences interact with the classified people. While arguably this interaction renders the affected human kinds unstable and hence different from natural kinds, realists argue that also some prototypical natural kinds are interactive and human kinds in general are stable enough to support explanations and predictions. I defend a more fine-grained realist interpretation of interactive human kinds by arguing for an explanatory domain account of the looping effect. (...) First, I argue that knowledge of the feedback mechanisms that mediate the looping effect can supplement, and help to identify, the applicability domain over which a kind and its property variations are stably explainable. Second, by applying this account to cross-cultural case studies of psychiatric disorders, I distinguish between congruent feedback mechanisms that explain matches between classifications and kinds, and incongruent feedback mechanisms that explain mismatches. For example, congruent mechanisms maintain Western auditory experiences in schizophrenia, whereas exporting diagnostic labels inflicts incongruence by influencing local experiences. Knowledge of the mechanisms can strengthen explanatory domains, and thereby facilitate classificatory adjustments and possible interventions on psychiatric disorders. (shrink)

The distinction between institution types and institution tokens plays an important role in Francesco Guala’s philosophy of institutions. In this commentary, I argue that this distinction faces a number of difficulties that are not sufficiently addressed in Understanding Institutions. In particular, I critically discuss Guala’s comparison between the taxonomy of organisms and the taxonomy of institutions, consider the semantics of institution terms on different levels in this taxonomy, and argue for an alternative solution to the problem of how to reconcile (...) reformism and realism about institutions like marriage. (shrink)

This paper investigates interactive kinds, a class of kinds suggested by Ian Hacking for which classification generates a feedback loop between the classifiers and what is classified, and argues that human interactive kinds should be distinguished from non-human ones. First, I challenge the claim that there is nothing ontologically special about interactive kinds in virtue of their members being classified as such. To do so, I reject Cooper’s counterexample to Hacking’s thesis that kind descriptions are necessary for intentional action, arguing (...) that classification is required for intentional action. Having considered ways to characterise the metaphysics of interactive kinds and the semantics of kind terms, I argue that the fact that classification facilitates intentional action makes human interactive kinds ontologically distinctive because of the anomalous nature of the change which the kind-classification brings about. I then briefly examine further distinguishing features of human interactive kinds. (shrink)