While questions about the human mind are as old as philosophy itself, a systematic approach to the dysfunctions and pathologies of it has just emerged since the last century. This editorial aims to give a short introduction into the field of philosophy of psychiatry and provide a rough map of fields and questions being investigated by philosophers of mind, psychiatry and life science theorists. It should enable the readers to engage in further reading exploring this interesting field of research.
When thinking about medicine and philosophy, a typical discipline that comes to mind is medical ethics. Should a patient be kept on life support under all circumstances? If not, why? Should there be a universal obligatory vaccination? Is it morally justified to fixate a patient? These are examples of questions we might approach by means of medical ethics.
However, there are other perspectives dealing with conceptual questions about health and disease as well. For many questions and realms within philosophy of mind, there are also corresponding research issues in philosophy of psychiatry. For instance, it is a question of debate whether and how we can offer causal explanations of the emergence of mental illness or what – from an ontological standpoint – mental illnesses even are. Every claim made in psychiatric articles, books, and also everyday clinical practice implies a range of underlying metaphysical and practical assumptions on the nature of the mental. We can talk about mental disorders as being – or exhibiting underlying – essences allowing us for offering explanations of pathological mechanisms and etiological modeling. However, the nature of mental disorders might not be equally understandable as, for instance, somatic pathologies like bone fracture or tumorous tissue change, where the pathological and therapeutical target is more or less biochemically and locally distinct. While some mental illnesses might have a clear underlying neurochemical anomaly in substrates that is causally relevant for the emergence of the mental illness, there are other cases in which neural dysfunction and psychological dysfunction may be both causally dependent on another factor or there are cases where the brain did what it was supposed to do (what this even is, again, is a question that cannot be answered by relying on neurologic evidence alone) but the external circumstances or »pathological« stimuli made an individual develop mental health issues. Also, in terms of the individual contentual aspects of mental disorders such as depression or schizophrenia, accounting for the respective phenomenologies and existentialist dimensions of these conditions certainly plays another crucial role in understanding and treating particular patients.
Hence, there are at least more than one level of explanation in psychiatry. Some mental illnesses are investigated and explained in terms of molecular mechanisms in the brain, others in terms of behavioral means, and so on. While these fields more or less deal with the question of what mental disorders are, there are also other ways of engaging with conceptual issues in psychopathology. We can philosophically analyze the way we conceive mental health and how we should do. On the other hand, we can also analyze the way we scientifically approach mental illness and try to offer good conceptual foundations for psychopathological research in philosophy of science. I shall mention that all of the above-named fields are not fully separated from each other but might rather be seen as forming a nexus. What counts as good scientific practice is at least partly related to the concepts of psychopathology underlying our research questions. On the other hand, our concepts of mental health and illness, also at least partly, rely on the evidence we have gained so far. In order to ideally grasp and further our understanding of mental processes in normal and dysfunctional conditions, it is important not to dogmatically limit ourselves to one single level of explanation but practically evolve and adjust our concepts as new empirical evidence is attained, but also to keep in mind that the methods we apply to answer certain hypotheses are already influenced by the underlying (and maybe unquestioned) concepts we adopt from folk psychological thinking or everyday experience.
A good start to get an impression of existing literature in philosophical fields (not only in the psychiatric realm) is the Stanford Encyclopedia of Philosophy (SEP), an online encyclopedia edited by Edward N. Zalta and colleagues that is frequently updated and has each article written by an expert or team of experts in the respective field.
An alternative and equally reliable tool to getting started is the peer-reviewed online journal Philosophy Compass edited by Alexander Guerrero, which also offers a wide range of sections. In this last section, I will mention some good series of publication for further reading. Besides the general philosophy pages mentioned above, there are some book series particularly dedicated to the study of philosophy of psychiatry.
One example is the MIT Press series Philosophical Psychopathology which adopts an interdisciplinary approach to the mental and its pathologies, being concerned with »conceptual, methodological, scientific, ethical, and social issues« related to mental health.
Another example of a book series that is dedicated to the interdisciplinary field of philosophy and psychiatry and entails a comprehensive range of books each dealing with different aspects of psychiatry, are the International Perspectives in Philosophy and Psychiatry, that are published at Oxford University Press.
There is also a journal uniquely dedicated to the field of philosophy of psychiatry, edited by John Z. Sadler and published by Johns Hopkins University Press in cooperation with the Association for the Advancement of Philosophy and Psychiatry (AAPP).
With this short editorial, I hope to be able to offer a rough insight into the research questions of issue in the field of philosophy of psychiatry and provide a research starting point for everyone interested.
Titel image: The Flammarion Engraving (artist unknown).