CIN-MPI BODY PERCEPTION SEMINAR
Summer 2012
The Centre for Integrative Neuroscience and Max Planck Institute for Biological Cybernetics are pleased to announce the following talk:
What Good are Natural Kinds for Psychiatry?
by Kathryn Tabb
History & Philosophy of Science
University of Pittsburgh
Monday April 23
4:00 - 5:30 pm
Hertie Institute, 2nd Floor Seminar Room
Otfried-Müller-Str. 27
ABSTRACT
Recently psychiatrists as well as philosophers of psychiatry have concerned themselves with the question of whether or not mental diseases are natural kinds. I argue that the adoption of this term of art ushers into the philosophy of psychiatry certain expectations traditionally applied to scientific objects, which sidelines the status of psychiatric kinds as medical objects. I introduce a rather deflated kind concept that can better facilitate the philosophical project of describing the kinds as they are actually referred to by practitioners and researchers. The shift away from a traditional natural kind concept towards a more accurate concept of psychiatric kinds in practice is essential for a philosophical analysis of nosology.
I will begin by briefly demonstrating how psychiatric kinds fall short of being traditional natural kinds, arguing that, like many kinds in the life sciences, they do not display necessary and sufficient membership conditions. More problematic for the traditional account, however, is that the decision to recognize a certain cluster of properties as pathological is fundamentally normative. Finally, there is a fuzziness of intension as well as extension in the use of psychiatric kind terms ― different psychiatric professionals, such as social workers, researchers, and clinicians, may use different descriptions to identify members of the same kind. I argue that another kind of kind, a property-cluster kind, can best capture these complexities.
Under this account psychiatric kinds are seen as clusters of symptoms that are deemed to be pathological and demanding intervention. However, I suggest that to actually capture the way psychiatric kinds are established and maintained, philosophers must view them as more than the criteria lists offered by diagnostic manuals. Using Boyd’s homeostatic property cluster (HPC) kind concept, I argue that psychiatric kinds have underlying causal pathways that can explain their co-occurrence. Insofar as the methods used in the laboratory and the clinic to investigate these pathways are often heterogeneous, contested, and complex, few psychiatric kinds have well-established etiologies. Rather, their utility is the result of negotiations that integrate those property clusters (that is, syndromes) that demand medical attention with the homeostatic mechanisms (that is, causal pathways) theorized by researchers.
I use Major Depressive Disorder (MDD) as a case study, and focus in particular on its ambiguous relationship with General Anxiety Disorder. I demonstrate how the HPC kind account can be used to describe the struggles of researchers and clinicians to establish MDD as valid and robust object of inquiry, rather than to justify claims about the naturalness or “reality” of the diagnostic category post hoc (as traditional natural kind accounts might). I conclude that there is no easy ― and certainly no categorical ― answer as to whether psychiatric kind terms pick out discrete divisions in the world. Rather, a philosophical account of psychiatric kinds should recognize that operationalized symptom clusters can be useful in practice; even as it distinguishes such kinds from those that, through scientific methods, have been demonstrated to reflect causal structures in the world.