Appeals to practices are common the humanities and social sciences. They hold the potential to explain interesting or compelling similarities, insofar as similarities are distributed within a community or group. Why is it that people who fall under the same category, whether men, women, Americans, baseball players, Buddhists, feminists, white people, or others, have interesting similarities, such as similar beliefs, actions, thoughts, foibles, and failings? One attractive answer is that they engage in the same practices. They do the same things, (...) perhaps as a result of doing things at the same site or setting, or perhaps as a result of being raised in a similar way among members of the same group. In the humanities, appeals to practices often serve as a move to point out diversity among different communities or diversity within the same community. Communities are distinct from one another in part because their members do different things or do things in different ways. The distinct and varied ways in which different communities enact social norms or formulate law, state institutions, and public policy might be explicable in part by the different practices their members are socialized into. Appeals to practices hold the promise of explaining these differences in terms of the different background practices of the groups, cultivated through a kind of cultural isolation or sense of collective identity. In the social sciences, appeals to practices have played a central role in fundamental theorizing and theory building. Appeals to practices in the social sciences are often much more systematic and theoretical, forming the core of the systematic theories of Pierre Bourdieu and Anthony Giddens in Anthropology and Sociology. Practice theory has thus become a growth industry in social scientific investigation, offering the promise of a central object of investigation that explains both unity and difference within and across communities and groups. But it is unclear just what practices are and what role, both ontological and explanatory, that practices are supposed to play. The term `practices' is used to pick out a wide range of things, and its relation to other terms, from `tradition' or `paradigm' to `framework' or `presupposition', is unclear. Practices are posited as ubiquitous, yet they are difficult to isolate and pin down. We are all said to participate in them, but they remain hidden. Their role, whether causal, logical, or hermeneutical, remains mysterious. After locating the historical origins of appeals to practices in the work of Ludwig Wittgenstein and Martin Heidegger, my dissertation uses Stephen Turner's broad and systematic critique of appeals to practices to develop a new type of account. My account is a phenomenological account that treats practices as human doings that show up to people in material and social environments and make themselves available for specific responses in those environments. I argue that a phenomenological account is an effective alternative to accounts that treat practices as either shared objects with properties or shared and implicit presuppositions. I use a phenomenological account of practices to treat important debates in feminist philosophy and the philosophy of the social sciences, particularly debates over pornography's subordination of women and the classification of mental disorders in psychiatry. (shrink)

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made about (...) individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. (shrink)

This paper examines the ways in which social scientific discourse and classification interact with the objects of social scientific investigation. I examine this interaction in the context of the traditional philosophical project of demarcating the social sciences from the natural sciences. I begin by reviewing Ian Hacking’s work on interactive classification and argue that there are additional forms of interaction that must be treated.

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of mental disorders. I (...) articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry. (shrink)

Abstract Recently, some philosophers of psychiatry (viz., Rachel Cooper and Dominic Murphy) have analyzed the issue of psychiatric classification. This paper expands upon these analyses and seeks to demonstrate that a consideration of the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM) can provide a rich and informative philosophical perspective for critically examining the issue of psychiatric classification. This case is intended to demonstrate the importance of history for philosophy of psychiatry, and more generally, the potential benefits (...) of historically-informed approaches to philosophy of science. (shrink)

Mental disorder (earlier entitled “illness” or “disease”) is ascribed to deviations from normal thoughts, reasoning, feelings, attitudes, and actions that are considered socially or personally dysfunctional and apt for treatment. Schizophrenia, depression, and bipolar disorder are core examples. The concept of mental disorder plays a role in many domains, including medicine, social sciences such as psychology and anthropology, and the humanities, including literature and philosophy. Philosophical discussions are the primary focus of the present entry, which differs from the entry on (...) Philosophy of Psychiatry in noting several different approaches—not only those of the philosophy of science and mind, but also those arising from phenomenology and social theory. -/- Mental disorder is a widely contested concept and there are longstanding debates on whether disorders are biological or social in nature. Even uncontroversial disorders, such as those listed above, were not always regarded as disorders in the past (Porter 2002). Moreover, the status of mental disorder has frequently indicated ethical, as much as other deficiency (Irwin 2013). Such reminders direct our attention to contemporary medical psychiatry’s sometimes uncompromisingly neurobiological, and avowedly value-free “medical model”, with its incumbent analogies and assumptions, and to the general question of how the taxa of psychiatric classifications are to be viewed as objects of natural science. This model has received intensive philosophical scrutiny, including arguments that deny these conditions are deficiencies at all. Along with issues arising from cognitive psychology and the neurosciences, such foundational matters make up much of the following entry. Because of their focus on issues central to the philosophy of mind and ethics (e.g., the mind-body problem, moral responsibility, agency and identity), analyses of mental disorder have extensive implications for those fields. As clinical phenomena, they also reflect an inescapable, everyday, social reality, giving theoretical inquiries additionally urgent practical, moral, and legal implications. (shrink)

As a result of being measured, individuals sometimes alter their behavior and attitudes to such extent that subsequent measurement results are affected. This ‘reactivity’ to measurement problematizes prediction and explanation, but some reactivity is nevertheless legitimate. Using the example of the measurement of race in the US Census, this article demonstrates that some forms of reactivity do not affect the accuracy of research. The article argues that legitimacy of reactivity depends on the metaphysical status of the phenomenon being measured. It (...) is argued that reactivity’s legitimacy is affected by the arbitrariness of a measure and the voluntariness of measurement results. (shrink)

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)

Human behavior and thought often exhibit a familiar pattern of within group similarity and between group difference. Many of these patterns are attributed to cultural differences. For much of the history of its investigation into behavior and thought, however, cognitive science has been disproportionately focused on uncovering and explaining the more universal features of human minds—or the universal features of minds in general. -/- This entry charts out the ways in which this has changed over recent decades. It sketches the (...) motivation behind the cultural turn in cognitive science, and situates some of its central findings with respect to the questions that animate it and the debates that it has inspired. Woven throughout the entry are examples of how the cognitive science of culture, and especially its elevated concern with different forms of diversity and variation, continues to influence and be influenced by philosophers. -/- One cluster of philosophical work falls within the traditional subject matter of philosophy of science, in this case of the cognitive and social sciences. Philosophers have analyzed and assessed the methods and evidence central to the scientific study of cognition and culture, and have offered conceptual scrutiny, clarification, and synthesis. Research in a second vein sees philosophers themselves contributing more directly to cognitive scientific projects, (co)constructing theories, helping build computational models, even gathering empirical data. A third kind of work is naturalistic philosophy or philosophy of nature, wherein philosophers seek to use results from the cognitive science of culture to inform or transform debates over long-standing philosophical questions, including questions about the nature of philosophy and philosophical methodology itself. (shrink)

This paper asks when a natural disease kind is truly 'reactive' and when it is merely associated with a corresponding social kind. I begin with a permissive account of real kinds and their structure, distinguishing natural kinds, indifferent kinds and reactive kinds as varieties of real kind characterised by super-explanatory properties. I then situate disease kinds within this framework, arguing that many disease kinds prima facie are both natural and reactive. I proceed to distinguish ‘simple dependence’, ‘secondary dependence’ and ‘essential (...) dependence’ between a natural kind and its classification, and argue that a natural kind is only really reactive, in an important sense, under conditions of essential dependence. On this basis, I offer a principled hypothesis for why psychiatric kinds tend to be more metaphysically unstable than paradigm somatic disease kinds. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the DSM's (...) diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

This paper addresses the question of how human science categories yield projectable inferences by critically examining Ron Mallon’s ‘social role’ account of human kinds. Mallon contends that human categories are projectable when a social role produces a homeostatic property cluster (HPC) kind. On this account, human categories are projectable when various social mechanisms stabilize and entrench those categories. Mallon’s analysis obscures a distinction between transitory and robust projectable inferences. I argue that the social kinds discussed by Mallon yield the former, (...) while classifications of biological kinds yield the latter. Classifications from psychiatry (‘schizophrenia,’ ‘hysteria’) are discussed as examples. (shrink)

This chapter examines philosophical issues surrounding the classification of mental disorders by the Diagnostic and Statistical Manual of Mental Disorders (DSM). In particular, the chapter focuses on issues concerning the relative merits of descriptive versus theoretical approaches to psychiatric classification and whether the DSM should classify natural kinds. These issues are presented with reference to the history of the DSM, which has been published regularly by the American Psychiatric Association since 1952 and is currently in its fifth edition. While the (...) first two editions of the DSM adopted a theoretical (psychoanalytic) and etiological approach to classification, subsequent editions of the DSM have adopted an atheoretical and purely descriptive (“neo-Kraepelinian”) approach. It is argued that largest problem with the DSM at present—viz., its failure to provide valid diagnostic categories—is directly related to the purely descriptive methodology championed by the DSM since the third edition of the DSM. In light of this problem, the chapter discusses the prospects of a theoretical and causal approach to psychiatric classification and critically examines the assumption that the DSM should classify natural kinds. (shrink)

This book explores the central questions and themes lying at the heart of a vibrant area of philosophical inquiry. Aligning core issues in psychiatry with traditional philosophical areas, it presents a focused overview of the historical and contemporary problems dominating the philosophy of psychiatry. -/- Beginning with an introduction to research issues, it addresses what psychiatry is and distinguishes it from other areas of medical practice, other health care professions and psychology. With each section of the companion corresponding to a (...) philosophical subject, contributors systematically relate themes in philosophy of psychiatry to topics in philosophy of mind, phenomenology, philosophy of science, ethics, social and political philosophy, metaphysics, epistemology, and philosophy of medicine. Looking ahead to new research directions, chapters address recent issues including the metaphysics of mental disorders, gender and race in psychiatry and psychiatric ethics. -/- Featuring discussion questions, suggestions for further reading and an annotated bibliography, The Bloomsbury Companion to Philosophy of Psychiatry is an accessible survey of the debates and developments in the field suitable for undergraduates in philosophy and professional philosophers new to philosophy of psychiatry. (shrink)

This paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g., schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a superior method for classifying natural kinds than the purely descriptive approach adopted by the DSM since DSM-III. My argument (...) suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e., projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories. (shrink)

This book makes trouble: it explores the reality that digital culture is largely an extension of an older coloniality of power of the global north. It suggests a line of inquiry for the social sciences to reflect on their own imperial role and develop a contemporary critical and pragmatic scope, shifting their gaze from problems to opportunities.

The question of how psychiatric classifications are made up and to what they refer has attracted the attention of philosophers in recent years. In this paper, I review the claims of authors who discuss psychiatric classification in terms referring both to the philosophical tradition of natural kinds and to the sociological tradition of social constructionism — especially those of Ian Hacking and his critics. I examine both the ontological and the social aspects of what it means for something to be (...) a mental disorder, and how the ontological status of these disorders hinges on social causation. Finally, I conclude by suggesting a way in which the biological and the social may be reconciled in an integrative model of variation in psychiatric disorder. (shrink)

The reactions that science triggers on the people it studies, describes, or theorises about, can affect the science itself and its claims to knowledge. This phenomenon, which we call reactivity, has been discussed in many different areas of the social sciences and the philosophy of science, falling under different rubrics such as the Hawthorne effect, self-fulfilling prophecies, the looping effects of human kinds, the performativity of models, observer effects, experimenter effects and experimenter demand effects. In this paper we review state-of-the-art (...) research that falls under the remit of the philosophy of reactivity by considering ontological, epistemic and moral issues that reactivity raises. Along the way, we devote special attention to articles belonging to this journal's Topical Collection entitled “Reactivity in the Human Sciences”. (shrink)

Classify and Label is a philosophical treatment of classification in the social sciences and everyday life, focusing on its moral, social, and political implications. This book stands at the intersection of philosophy of the social sciences, feminist philosophy, philosophy of sex, and social and political philosophy.

In recent years both philosophers and scientists have asked whether or not our current kinds of mental disorder—e.g., schizophrenia, depression, bipolar disorder—are natural kinds; and, moreover, whether or not the search for natural kinds of mental disorder is a realistic desideratum for psychiatry. In this dissertation I clarify the sense in which a kind can be said to be “natural” or “real” and argue that, despite a few notable exceptions, kinds of mental disorder cannot be considered natural kinds. Furthermore, I (...) contend that psychopathological phenomena do not cluster together into kinds in the way that paradigmatic natural kinds (e.g., chemical kinds and species) do; and, in light of this fact, I conclude that the normative ideal of natural classification—i.e. classifying real or natural kinds—is not appropriate as a general strategy for psychiatry. In the conclusion to this dissertation I propose an alternative way forward. Rather than assuming a priori that psychopathological phenomena cluster together into kinds, a more tractable and theoretically promising approach would be to first explain how particular kinds of experiences and behaviours—e.g, hallucinations, delusions, disorganized thinking, mania, low mood, etc.—are produced. (shrink)

The social sciences are often thought to be inferior to the natural sciences because they do not have laws. Bohman writes that “the social sciences have never achieved much in the way of predictive general laws—the hallmark of naturalistic knowledge—and so have often been denied the honorific status of ‘sciences’” (1994, pg. vii). Philosophers have suggested a number of reasons for the dearth of laws in the social sciences, including the frequent use of ceteris paribus conditions in the social sciences, (...) reflexivity, and the use of ‘odd’ concepts. This thesis argues that the scarcity of laws in the social sciences is primarily due to the concepts that social scientists often work with. These concepts are described as Nomadic and are characterised by disagreement about what can reasonably be included within the scope of a concept. The second half of the thesis explores the implications of this analysis. It argues firstly, that counterfactual analysis is problematic when using Nomadic concepts. Secondly, it argues that taking an intentional perspective on behaviour often involves the use of Nomadic concepts so, if social scientists do hope to formulate laws, then they are more likely to succeed if they focus on behaviour that is not intentional. (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)

If a human subject knows they are being measured, this knowledge may affect their attitudes and behaviour to such an extent that it affects the measurement results as well. This broad range of effects is shared under the term ‘reactivity’. Although reactivity is often seen by methodologists as a problem to overcome, in this paper I argue that some quite extreme reactive changes may be legitimate, as long as we are measuring phenomena that are not simple biological regularities. Legitimate reactivity (...) is reactivity which does not undermine the accuracy of a measure; I show that if such reactivity were corrected for, this would unjustifiably ignore the authority of the research subject. Applying this argument to the measurement of depression, I show that under the most commonly accepted models of depression there is room for legitimate reactivity. In the first part of the paper, I provide an inventory of the different types of reactivity that exist in the literature, as well as the different types of phenomena that one could measure. In the second part, I apply my argument to the measurement of depression with the PHQ-9 survey. I argue that depending on what kind of phenomenon we consider depression to be, we will accept different kinds of reactivity. I show that both under the harmful dysfunction model and the practical kinds model, certain reactive changes in measuring depression are best seen as legitimate recharacterizations of the underlying phenomenon, and define what legitimate means in this context. I conclude that in both models, biological aspects constrain characterization, but the models are not so strict that only one concept is acceptable, leaving room for reactivity. (shrink)

Are mental disorders natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of (...) kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases. (shrink)

This dissertation examines psychiatry from a philosophy of science perspective, focusing on issues of realism and classification. Questions addressed in the dissertation include: What evidence is there for the reality of mental disorders? Are any mental disorders natural kinds? When are disease explanations of abnormality warranted? How should mental disorders be classified? -/- In addressing issues concerning the reality of mental disorders, I draw on the accounts of realism defended by Ian Hacking and William Wimsatt, arguing that biological research on (...) mental disorders supports the inference that some mental disorders (e.g., schizophrenia, mood disorders, and anxiety disorders) are real theoretical entities, and that the evidence supporting this inference is causal and abductive. In explicating the nature of such entities, I argue that real mental disorders are natural kinds insofar as they are natural classes of abnormal behavior whose members share the same causal structure. I present this position in terms of Richard Boyd’s homeostatic cluster property theory of natural kinds, and argue that this perspective reveals limitations of Hacking’s account on the looping effects of human kinds, which suggests that the objects classified by psychiatrists are unstable entities. I subsequently argue that a subset of mental disorders (e.g., schizophrenia and Down syndrome) are mental illnesses insofar as they are disorders caused by a dysfunctional biological process that leads to harmful consequences for individuals. I present this analysis against Thomas Szasz’s argument that mental illness is a myth. -/- In addressing issues of psychiatric classification, my analysis focuses on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which has been published regularly by the American Psychiatric Association since 1952, and is currently in its fourth edition. After examining the history of DSM in the twentieth century, and in particular, DSM’s shift to an atheoretical and purely descriptive system in the 1980s, I consider the relative merits of descriptive versus causal systems of classification. Drawing on Carl Hempel’s analysis of taxonomic systems in psychiatry, I argue that a causal classification system would provide a superior approach to psychiatric classification than the descriptive system currently favored by DSM. (shrink)

RésuméLes concepts de Ian Hacking ont apporté une contribution importante aux débats dans le domaine de la philosophie de la psychiatrie, qui est aussi au coeur de son Cours au Collège de France. Titulaire de la « Chaire de philosophie et d’histoire des concepts scientifiques » après Michel Foucault, il est l’auteur d’une réflexion sur la classification des troubles mentaux à partir de la problématique des natural kinds. Pour expliquer les cas d’études développés dans son enseignement parisien, nous revenons d’abord (...) sur une série de concepts, pour ensuite poser la question du statut des métaphores scientifiques, et enfin discuter les rapports entre les notions de « maladie mentale transitoire » et de culture-bound syndrome – cette dernière étant issue de la psychiatrie transculturelle canadienne. (shrink)