Meaning, understanding and explanation

A century ago, Karl Jaspers responded to recent developments in neuroscience by stressing the equal importance of understanding and meaning in psychiatry alongside scientific explanation. Today, psychiatric care benefits from growing knowledge of the workings of the brain and the connections between mental illness and biology. Like the rest of medicine, it is subject to a growing self-conscious awareness of the importance of evidence based medicine. But, at the same time, it is a particular focus of medicine for the person, exemplified, for example, by the WPA’s institutional program for psychiatry for the person and by an increasingly influential service user movement which calls for psychiatry to understand the whole person not just the disease or illness.

This raises a series of related questions. Is understanding a person the same sort of venture as explaining the functioning, or malfunctioning, of their brain? Is charting the meaning and significance of someone’s experiences a proper part of a natural scientific discipline or is it distinct? If the natural sciences describe nature, the real and external world, are meanings part of that world or something we impose on it?

These four sessions explore some of these questions, starting with Jaspers’ distinction between understanding and explanation (and his appeal to empathy) and then thinking about whether understanding really is distinct from explanation and if so why? That is contested and so the third session looks at one recent attempt to bring the two back together under a synoptic view. The fourth session explores a recent claim that explanation in psychiatry even of mental (rather than physical) states or experiences may make no rational sense: the assumption that there are mechanisms in physical causation and rational links for psychological causation may be merely sometimes useful prejudices.

This short pre-conference course before the 2011 INPP conference in Sweden examines the relation of understanding and explanation starting with Jaspers views, then more modern accounts of the distinction, Bolton and Hill’s attempt to draw them together and finally John Campbell’s very recent criticism of the assumption that causation in psychiatry is rationally structured.

The - very brief - pre-course reading is:

Fulford, K.W.M. (Bill) and Thornton, T. (2009) ‘The role of meanings and values in the history and philosophy of the science of psychiatry’ in Basant Puri, B. and Treasaden, I. Psychiatry – an evidence-based text for the MRCPsych, London: Hodder Arnold, Health Sciences

Thornton, T. and Schaffner, K. (2011) ‘Philosophy of science for psychiatry for the person’ International Journal of Person Centered Medicine 1: 128-30

Sessions

1: Jaspers on understanding and explanation

2: The modern Methodenstreit?

3: Is meaning part of the natural world?

4: The multi-level model of explanation and psychiatry

There are suggestions for further reading for each of the sessions.