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The missing self in scientific psychiatry

  • Şerife TekinEmail author
S.I.: Psych&Phil

Abstract

Various traditions in mental health care, such as phenomenological, and existential and cognitive-behavioral psychotherapy, implicitly or explicitly acknowledge that a disruption of the self, or the person, or the agent (often using these three concepts synonymously) is among the common denominators of different mental disorders. They often emphasize the importance of understanding patients as reasonsresponsive, in their full mental health relevant complexity, if their mental disorder is to be treated successfully. The centrality of the concept of the self is not mirrored in the mainstream scientific approaches in psychiatry however; the self has rarely been considered as the object of scientific research, the empirical investigation of which might yield successful explanations of and interventions in mental disorders. Thus, even though self-related phenomena are clinically relevant in so far as they give important information about a mental disorder to the clinician and help the development of effective interventions, they are not considered among the scientifically relevant properties of mental disorders. Leaving the self-related phenomena out of the scientific research on mental disorders can be attributed to the presupposition that the self is not empirically tractable and its use will hinder psychiatry’s goal to be scientific. In this paper, taking issue with this, I argue the self is empirically tractable, and its use as a target of research will not hinder psychiatry’s scientific commitments.

Keywords

Self Person Mental disorder Psychiatry Science 

Notes

Acknowledgements

I thank Owen Flanagan, George Graham, William Bechtel, Adele Abrahamsen, the audiences present at the University of Pittsburgh (2014), the Southern Society for Philosophy of Psychiatry (2016), and the two anonymous reviewers for their feedback.

References

  1. American Psychiatric Association. (1952). Diagnostic and statistical manual: Mental disorders (1st ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association. (1980). Diagnostic and statistical manual: Mental disorders (3rd ed.). Washington, DC: American Psychiatric Association.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual: Mental disorders (5th ed.). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  5. Azrin, N. H., Donohue, B., Besalel, V. A., Kogan, E. S., & Acierno, R. (1994a). Youth drug abuse treatment: A controlled outcome study. Journal of Child and Adolescent Substance Abuse, 3(3), 1–16.CrossRefGoogle Scholar
  6. Azrin, N. H., McMahon, P. T., Donahue, B., Besalel, V., Lapinski, K. J., Kogan, E., et al. (1994b). Behavioral therapy for drug abuse: A controlled treatment outcome study. Behavioral Research and Therapy, 32(8), 857–866.CrossRefGoogle Scholar
  7. Bailer-Jones, D. M. (1999). Tracing the development of models in the philosophy of science. In L. Magnani, N. J. Nersessian & P. Thagard (Eds.), Model-based reasoning in scientific discovery (pp. 23–40). New York: Kluwer Academic/Plenum Publishers.Google Scholar
  8. Bechtel, W. (2008). Mental mechanisms: Philosophical perspectives on cognitive neuroscience. London: Routledge.Google Scholar
  9. Beck, A. T. (1962). Reliability of psychiatric diagnoses: A critique of systematic studies. American Journal of Psychiatry, 119, 210–6.CrossRefGoogle Scholar
  10. Bridgman, P. W. (1938). Operational analysis. Philosophy of Science, 5, 114–131. (Reprinted in Bridgman 1955, 1–26).CrossRefGoogle Scholar
  11. Carroll, K. M., & Onken, L. S. (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry, 162(8), 1452–1460.CrossRefGoogle Scholar
  12. Cartwright, N. (1983). How the laws of physics lie. Oxford: Oxford University Press.CrossRefGoogle Scholar
  13. Chang, H. (2009). Operationalism. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy. http://plato.stanford.edu/archives/fall2009/entries/operationalism/.
  14. Cooper, J. E., Kendell, R. E., Gurland, B. J., Sartorius, N., & Farkas, T. (1969). Cross-national study of diagnosis of the mental disorders: Some results from the first comparative investigation. The American Journal of Psychiatry, 10(Suppl), 21–29.CrossRefGoogle Scholar
  15. Dennett, D. C. (1971). Intentional systems. The Journal of Philosophy, 68(4), 87–106.CrossRefGoogle Scholar
  16. Fidler, T. L., Clews, T. W., & Cunningham, C. L. (2006). Reestablishing an intragastric ethanol self-infusion model in rats. Alcoholism: Clinical and Experimental Research, 30, 414–428.CrossRefGoogle Scholar
  17. First, M. B., Pincus, H. A., Levine, J. B., Williams, J. B. W., Ustun, B., & Peele, R. (2004). Clinical utility as a criterion for revising psychiatric diagnoses. American Journal of Psychiatry, 161, 946–954.CrossRefGoogle Scholar
  18. Flanagan, O. (2013a). The shame of addiction. Frontiers in Psychiatry, 120(4), 1–11.Google Scholar
  19. Flanagan, O. (2013b). Identity and addiction: What alcoholic memoirs teach. In K. W. M. Fulford, M. Davies, R. Gipps, Graham, J. Sadler, G. Stanghellini & T. Thornton (Eds.), The Oxford handbook of philosophy and psychiatry (pp. 865–888). Oxford: Oxford University Press.Google Scholar
  20. Frigg, R., & Hartmann, S. (2016). “Models in Science”, The Stanford encyclopedia of philosophy (Winter 2016 Edition). E. N. Zalta (Ed.), forthcoming. https://plato.stanford.edu/archives/win2016/entries/models-science/.
  21. Fulford, K. W. M., & Sartorius, N. (2009). The secret history of ICD and the hidden future of DSM. In M. Broome & L. Bortolotti (Eds.), Psychiatry as cognitive neuroscience: Philosophical perspectives (pp. 29–47). Oxford: Oxford University Press.CrossRefGoogle Scholar
  22. Godfrey-Smith, P. (2006). The strategy of model-based science. Biology and Philosophy, 21, 725–740.CrossRefGoogle Scholar
  23. Godfrey-Smith, P. (2009). Models and fictions in science. Philosophical Studies, 143, 101–116.CrossRefGoogle Scholar
  24. Graham, G. (2013). The disordered mind: Philosophy of mind and mental illness (2nd ed.). London: Routledge.Google Scholar
  25. Hacking, I. (1983). Representing and intervening. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  26. Hempel, C. (1994/1961). Introduction to problems of taxonomy. In Zubin, J. (Ed.), Field studies in the mental disorders. New York: Grune and Stratton, pp. 3–22. (Reproduced in Sadler, J. Z., O. P. Wiggins, & M. A. Schwartz (Eds.), Philosophical perspectives on psychiatric classification (pp. 315–331) Baltimore: Johns Hopkins University Press.)Google Scholar
  27. James, W. (1890). The principles of psychology. New York: H. Holt.CrossRefGoogle Scholar
  28. Jopling, D. (2000). Self-knowledge and the self. New York: Routledge University Press.Google Scholar
  29. Langeland, W., Draijer, N., & van den Brink, W. (2002). Trauma and dissociation in treatment-seeking alcoholics: Towards a resolution of inconsistent findings. Comprehensive Psychiatry, 43, 195–203.CrossRefGoogle Scholar
  30. Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low-income mothers. American Journal of Orthopsychiatry, 70, 316–326.CrossRefGoogle Scholar
  31. Neisser, U. (1988). Five kinds of self-knowledge. Philosophical Psychology, 1, 35–59.CrossRefGoogle Scholar
  32. Nestler, E. (2013). Cellular basis of memory for addiction. Dialogues Clinical Neuroscience, 15(4), 431–443.Google Scholar
  33. Novalis, P., Rojcewicz, S., & Peele, R. (1993). Clinical manual of supportive therapy. Washington, DC: American Psychiatric Association Press.Google Scholar
  34. Parnas, J., & Bovet, P. (2014). Psychiatry made easy: Operationalism and some of its consequences. In Philosophical issues in psychiatry III, Chapter 11. Oxford: Oxford University Press.Google Scholar
  35. Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126(7), 983–987.CrossRefGoogle Scholar
  36. Sadler, J. Z. (2005). Values and psychiatric diagnosis. Oxford: Oxford University Press.Google Scholar
  37. Schaffner, K., & Tabb, K. (2014). Hempel as a critic of Bridgman’s operationalism: Lessons for psychiatry from the history of science (a response to Bovet and Parnas). In K. Kendler & J. Parnas (Eds.), Philosophical issues in psychiatry III, Chapter 24. Oxford: Oxford University Press.Google Scholar
  38. Schwartz, M. A., & Wiggins, O. P. (1987a). Typifications: the first step for diagnosis in psychiatry. The Journal of Nervous and Mental Disease, 175, 65–77.Google Scholar
  39. Schwartz, M. A., & Wiggins, O. P. (1987b). Diagnosis and ideal type: A contribution to psychiatric classification. Comprehensive Psychiatry, 28(4), 227–91.Google Scholar
  40. Tekin, Ş. (2014). The missing self in Hacking’s looping effects. In H. Kincaid & J. A. Sullivan (Eds.), Classifying psychopathology: Mental kinds and natural kinds (pp. 227–256). MIT Press.Google Scholar
  41. Tekin, Ş. (2015). Against hyponarrating grief: Incompatible research and treatment interests in the DSM-5. The DSM-5 in perspective: Philosophical reflections on the psychiatric babel. In P. Singy & S. Demazeux (Eds.), History, philosophy and the theory of the life sciences Series (Vol. 10), Springer Press, pp. 179–197.Google Scholar
  42. Tekin, Ş. (2011). Self-concept through the diagnostic looking glass: Narratives and mental disorder. Philosophical Psychology, 24(3), 357–380.CrossRefGoogle Scholar
  43. Tekin, Ş. (2016). Are Mental Disorders Natural Kinds? A Plea for a New Approach to Intervention in Psychiatry. Philosophy, Psychiatry, and Psychology, 23(2), 147–163.CrossRefGoogle Scholar
  44. Thagard, P. (2014). The self as a system of multilevel interacting mechanisms. Philosophical Psychology, 27, 145–163.CrossRefGoogle Scholar
  45. Trevarthen, C. (1980). The foundations of intersubjectivity: Development of interpersonal and cooperative understanding in infants. In D. Olson (Ed.), The social foundations of language and thought: Essays in Honor of J.S. Bruner (pp. 316–342). New York: W.W. Norton.Google Scholar
  46. Tsou, J. (2015). DSM-5 and psychiatry’s second revolution: Descriptive vs. theoretical approaches to psychiatric classification. In S. Demazeux & P. Singy (Eds.), The DSM-5 in perspective: Philosophical reflections on the psychiatric babel. Dordrecht: Springer.Google Scholar
  47. Wakefield, J. C. (2015). The loss of grief: Science and pseudoscience in the debate over DSM-5’s elimination of the bereavement exclusion. In S. Demazeux & P. Singy (Eds.), The DSM-5 in perspective: Philosophical reflections on the psychiatric babel. History, philosophy and the theory of the life sciences series. Dordrecht: Springer.Google Scholar
  48. West, R., & Brown, J. (2013). Theory of addiction (2nd ed.). Chichester: Wiley.CrossRefGoogle Scholar
  49. Wilkes, K. (1988). Real people. Oxford: Oxford University Press.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Daemen CollegeAmherstUSA

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