Reasons vs causes
As the first session has explored, within natural science, causes are, arguably, best understood in the context of a system of natural laws which also connect to causal explanation. But the idea of a social aetiology might suggest a role for factors an appreciation of which would take account of their meanings and significance and of the rules and proprieties that govern them. That suggests that understanding is also in play.
The father of modern psychiatry, Karl Jaspers worked at a time in the development of psychiatry very similar to our own in that there were dramatic advances in the neurosciences of the day: the period became known as psychiatry’s first biological phase. Despite this, Jaspers warned of an over emphasis within psychiatry of a natural scientific model of explanation.
Jaspers’ reservations about an emphasis on a natural-scientific approach to psychiatry were driven by his understanding of the philosophical debates about psychology in the late nineteenth century, the so-calledMethodenstreit. This concerned whether the human sciences (the Geisteswissenschaften) should try to emulate their far more successful cousins the natural sciences (Naturwissenschaften), or whether they should go their own methodological way.
Jaspers regarded psychopathology as a hybrid. It lay both within the natural sciences, pursuing abnormalities of brain functioning, but also within the human sciences, pursuing the experiences, aims, intentions and subjective meanings of its patients.
Jaspers thus emphasised the importance of understanding, by contrast with explanation, in two important papers. He distinguished between subjective and objective symptoms and between understanding via meaningful connections and explanation via causal connections. Despite this, it is far from clear what the difference between understanding and explanation amounts to in his account.
To get a better understanding of whether understanding really does chart a distinct form of intelligibility it is necessary to come up to date and to draw on the work recent philosophers working in the tradition of the philosophers Ludwig Wittgenstein. This session thus combines an examination of Jaspers with more recent work: a kind of modern methodenstreit.
Essential reading
Fulford, K.W.M., Thornton, T. and Graham, G. The Oxford Textbook of Philosophy and Psychiatry Oxford: Oxford University Press chapter 10 sessions 1 and 2.
Fulford, K.W.M., Thornton, T. and Graham, G. The Oxford Textbook of Philosophy and Psychiatry Oxford: Oxford University Press chapter 15 session 3 up to the end of p427
Further reading
Jaspers, K. ([1912] 1968) ‘The phenomenological approach in psychopathology’ British Journal of Psychiatry 114: 1313-1323
Jaspers, K. ([1913] 1974) ‘Causal and “Meaningful” Connections between Life History and Psychosis’, trans. by J.Hoenig, in S.R.Hirsch and M.Shepherd. in Hirsch, S.R., and M. Shepherd, Themes and Variations in European Psychiatry, Bristol: Wright: 80-93
McDowell, J. (1994) Mind and World, Harvard: Harvard University Press pp66-72.
Thornton, T. (2007) Essential Philosophy of Psychiatry. Oxford: Oxford University Press chapter 4
Winch, P. (1988) The Idea of a Social Science and its Relation to Philosophy, London: Routledge chapters 3, 4
The slides for this session are here and here.
Reflections on this session are here.