It is common to defend the Homeostatic Property Cluster ( HPC ) view as a third way between conventionalism and essentialism about natural kinds ( Boyd , 1989, 1991, 1997, 1999; Griffiths , 1997, 1999; Keil , 2003; Kornblith , 1993; Wilson , 1999, 2005; Wilson , Barker , & Brigandt , forthcoming ). According to the HPC view, property clusters are not merely conventionally clustered together; the co-occurrence of properties in the cluster is sustained by a similarity generating ( (...) or homeostatic ) mechanism . I argue that conventional elements are involved partly but ineliminably in deciding which mechanisms define kinds , for deciding when two mechanisms are mechanisms of the same type, and for deciding where one particular mechanism ends and another begins. This intrusion of conventional perspective into the idea of a mechanism raises doubts as to whether the HPC view is sufficiently free of conventional elements to serve as an objective arbiter in scientific disputes about what the kinds of the special sciences should be. (shrink)

As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like (...) shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts. This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD diagnosis: boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia. (shrink)

The effects of mental disorder are apparent and pervasive, in suffering, loss of freedom and life opportunities, negative impacts on education, work satisfaction and productivity, complications in law, institutions of healthcare, and more. With a new edition of the 'bible' of psychiatric diagnosis - the DSM - under developmental, it is timely to take a step back and re-evalutate exactly how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in the definition and (...) boundaries of mental disorder. It addresses two main questions regarding mental illness. Firstly, what is the basis of the standards or norms by which we judge that a person has a mental disorder - that the person's mind is not working as it should, that their mental functioning is abnormal? Controversies about these questions have been dominated by the contrast between norms that are medical, scientific or natural, on the one hand, and social norms on the other. The norms that define mental disorder seem to belong to psychiatry, to be medical and scientific, but are they really social norms, hijacked and disguised by the medical profession? Secondly, what is the validity of the distinction between mental disorder and order, between abnormal and normal mental functioning? To what extent, notwithstanding appearances, does mental disorder involve meaningful reactions and problem-solving? These responses may be to normal problems of living, or to not so normal problems - to severe psycho-social challenges. Is there after all order in mental disorder? With the closing of asylums and the appearance of care in the community, mental disorder is now in our midst. While attempts have been made to define clearly a concept of mental disorder that is truly medical as opposed to social, there is increasing evidence that such a distinction is unviable - there is no clear line between what is normal in the population and what is abnormal. 'What is Mental Disorder?' reviews these various crucial developments and their profound impact for the concept and its boundaries in a provocative and timely book. (shrink)

A pluralistic view of psychiatric classification is defended, according to which psychiatric categories take a variety of structural forms. An ordered taxonomy of these forms—non-kinds, practical kinds, fuzzy kinds, discrete kinds, and natural kinds—is presented and exemplified. It is argued that psychiatric categories cannot all be understood as pragmatically grounded, and at least some reflect naturally occurring discontinuities without thereby representing natural kinds. Even if essentialist accounts of mental disorders are generally mistaken, they are not implied whenever a psychiatric category (...) that is not pragmatically grounded is posited. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 219-227 [Access article in PDF] The Practical Kinds Model as a Pragmatist Theory of Classification Peter Zachar Pragmatist theories of scientific classification are intended to be pluralistic models that recognize different ways of cutting up the world as valuable, but do not require us to adopt whatever-goes relativism or metaphysical antirealism. How ironic that my application of pragmatism to psychopathology has been charged (...) with not being sufficiently pluralistic because it tries to fit all psychiatric disorders into the Procrustean bed of practical kinds. The Practical Kinds Model in General As a point of clarification, the practical kinds model is not a description of a type of category combined with an argument that all psychiatric disorders should be seen as belonging to that type. If it were that kind of model, I would fully agree with Haslam that practical kinds, fuzzy kinds, and discrete kinds are all potential types of psychiatric disorders. Like Nick Haslam, I believe that there are many different things in the DSM-IV and the ICD-10, and they cannot neatly be classified as the same type of thing.Rather than identifying a type of category, the practical kinds model is a general theory of scientific classification. It is a nonessentialistic theory. Essentialism is the view that things have real essences. In the Aristotelian version of essentialism, an essence is an internal structure, and it is the internal structure that makes anything be the kind of thing it really is. In this classical category model, category members either have the essence or they do not, and everything that has the appropriate essence is a member of that category. The world is supposed to therefore have a well-defined structure, and the job of the scientist is to discover that structure. Ian Hacking (1999) has termed this view of categorization inherent structurism.The practical kinds model does not deny that things have internal structures; it only denies that internal structure by itself determines category membership. Internal structure is an important consideration in identifying categories, but external criteria can always play a role. External or relational criteria play more important roles in some cases than they do in others, but they cannot be eliminated once and for all. Essentialistic theories, which favor an almost exclusive focus on inherent structures, have the advantage of being more parsimonious, but they do so by ignoring real complexity.The best way to illustrate this point is to examine a category whose identification is heavily weighted in terms of internal criteria, or an inherent structure, such as a chemical element. [End Page 219] For example, hydrogen is defined as the element that has an atomic number of 1. This means that it has one proton in its nucleus and normally one electron orbiting its nucleus. The atomic number reflects an internal property, and anything that has an atomic number of 1 is hydrogen. The same is true for the other elements. Anything that has an atomic number of 79 is gold; anything that has an atomic number of 19 is potassium, and so on. Also part of the essentialistic view is the notion that all the important properties of an element are systematically (or lawfully) related to its internal structure.It would be foolish to deny the practical utility of the atomic theory of chemistry. But even in this strongest of cases, external criteria can potentially play a role in how we decide to carve up the world and what we identify as the relevant categories. The point can be clearly illustrated with a Gedanken experiment based on the ideas of Donnellan (1983). Assume that we were to make contact with extraterrestrial life, and the result of that contact was our initiation into a larger galactic community like those portrayed on Star Trek or Babylon 5. Fortunately for us, it turns out that all planets in the community use a gold-based currency, just like we do on Earth. What we call gold, however, is too common to be the galactic basis of a currency, but a particular isotope... (shrink)

The DSM is the main classification of mental disorders used by psychiatrists in the United States and, increasingly, around the world. Although widely used, the DSM has come in for fierce criticism, with many commentators believing it to be conceptually flawed in a variety of ways. This paper assesses some of these philosophical worries. The first half of the paper asks whether the project of constructing a classification of mental disorders that ‘cuts nature at the joints’ makes sense. What is (...) mental disorder? Are types of mental disorder natural kinds (that is, are the distinctions between them objective and of fundamental theoretical importance, as are, say, the distinctions between the chemical elements)? The second half of the paper addresses epistemic worries. Even if types of mental disorder are natural kinds there may be reason to doubt that the DSM will come to reflect their natural structure. In particular, I examine the extent to which the DSM is theory-laden, and look at how it has been shaped by social and financial factors. Ultimately, I conclude that although the DSM is of immense practical importance it is not likely to become the best possible classification of mental disorders. (shrink)

This paper asks what it means to say that a disorder is a “real” disorder and then considers whether culture-bound syndromes are real disorders. Following J.L. Austin I note that when we ask whether some supposed culture-bound syndrome is a real disorder we should start by specifying what possible alternatives we have in mind. We might be asking whether the reported behaviours genuinely occur, that is, whether the culture-bound syndrome is a genuine phenomenon as opposed to a myth. We might (...) be wondering whether the condition should rightly be considered a disorder, as opposed to some sort of non-disorder condition. We might want to know whether the culture-bound syndrome is really a distinct disorder, in the sense that scientific classification systems should include it as a separate category, or whether it is just a variant of a universally occurring disorder. I argue that some specific difficulties can arise with determining whether a culture-bound syndrome is a real disorder in each of these three senses. However, the frequent assumption that real disorders will necessarily occur universally, and that those that occur only in certain environments are suspicious is not generally justified. (shrink)

Commentary on the editorial by D Stein et al.'s "What is a Mental/Psychiatric Disorder? From DSM-IV to DSM-V".

A common theme in the contemporary medical model of psychiatry is that pathophysiological processes are centrally involved in the explanation, evaluation, and treatment of mental illnesses. Implied in this perspective is that clinical descriptors of these pathophysiological processes are sufficient to distinguish underlying etiologies. Psychiatric classification requires differentiation between what counts as normality (i.e.- order), and what counts as abnormality (i.e.- disorder). The distinction(s) between normality and pathology entail assumptions that are often deeply presupposed, manifesting themselves in statements about what (...) mental disorders are. (shrink)