Abstract
Biological psychiatry is now the dominant paradigm in psychiatry, so much so that to use the term “psychiatry” at the beginning of the twenty-first century is often to mean “biological psychiatry.” With the abandonment of mind-based therapies and explanations to psychotherapists, who increasingly are clinical psychologists and social workers, psychiatry—the discipline historically straddling the mind-brain split in medicine—has come down firmly on the side of brain, with strict biological reductivism as its explanatory model. Axiomatically, mind events are reducible to, or at least entirely mappable onto, brain events with nothing left over to explain. This does not mean that mental phenomena are “caused” by prior biological events (a Cartesian dualist position), but rather that there is no difference between the two. There are not two events—a body event followed by a mind event or vice versa—just one, though it is capable of many kinds of description.
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Notes and References
Penfield, Wilder. The Mystery of the Mind. Princeton, NJ: Princeton University Press, 1975.
Eccles, John C. The Human Psyche. Berlin: Springer International, 1980.
And so does the distinguished American philosopher John Searle. See his The Construction of Social Reality (New York: The Free Press, 1995). Most of the ideas I present in this chapter are completely congruent with Searles’s, though they were developed quite independently. Searles uses a different vocabulary and set of concepts than I (though I have adapted several for use here), but the basic conceptual structure is highly similar.
See, for example, Methods of Logic, 3rd rev. ed. (New York: Holt Rinehart and Winston, 1972); Ontological Relativity (New York: Columbia University Press, 1969); The Roots of Reference (La Salle, IL: Open Court, 1973).
Op. cit., pp. 27–29 and 43–50.
Which, of course, is just what psychiatry is now doing as it nestles under the umbrella of neuroscience.
Sacks, Oliver. A Leg to Stand On. New York: Summit Books, 1984. It is not well known that the final chapter for the American edition is completely different from the one in the English edition. Sacks told me that his American publisher forced him to write a different ending because American readers would find the original last chapter too depressing.
“Entwurf einer Psychologie,” pp. 371–466 in Sigmund Freud, Aus den Anfängen der Psychoanalyse: Briefe an Wilhelm Fliess, Abhandlungen und Notizen aus den Jahren 1887–1902 (London: Imago Publishing Co., 1950). Edited by Marie Bonaparte, Anna Freud, and Ernst Kris (with Kris actually doing almost all the work). Translated in 1954 by Eric Mosbacher and James Strachey as The Origins of Psychoanalysis: Letters to Wilhelm Fliess, Drafts and Notes: 1887–1902 (London: Imago Publishing Company, 1954). The “Entwurf ” is translated as “Project for a Scientific Psychology,” pp. 347–445.
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This is no longer true. Many object relations theories, now the dominant models in Anglophone psychoanalysis, deemphasize or even abandon drive theory.
American Psychiatric Association. Diagnostic and Statistical Manual: Mental Disorders (Washington, DC: American Psychiatric Association Mental Hospital Service, 1952). DSM-I and II were largely the idea of the APA’s first director of public relations, Robert L. Robinson (1915–1980), with important input coming from the physician and APA staff member Paul Wilson. Second, revised edition 1968 as DSM-II: Diagnostic and Statistical Manual of Mental Disorders. Third, much enlarged and revised edition 1980 as Diagnostic and Statistical Manual of Mental Disorders, itself revised in 1987 with DSM-III-R appended to the title (which is what everyone called it). Fourth revised and enlarged edition 1994 as Diagnostic and Statistical Manual of Mental Disorders Fourth Edition: DSM-IV.
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See Sander Gilman’s chapter on the history of the concept of schizohrenia in the Handbook.
See, for example, his The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century (Cambridge University Press, 1996) and German Berrios & Roy Porter, eds. A History of Clinical Psychiatry: The Origins and History of Psychiatric Disorders (New York University Press, 1995).
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See Searle’s Construction of Social Reality for an outstanding discussion of exactly how this works in practice.
See David Healy’s commentary on the subject in his chapter in the Handbook.
Frank, Jerome. Persuasion and Healing: A Comparative Study of Psychotherapy, 3rd rev. ed. (Baltimore: Johns Hopkins University Press, 1991) [1st ed. 1961].
See also Wallace’s “Psychiatry’s Sickness and Its Biological Cure,” Psychiatry 60(1997): 89–99.
Masson, Jeffrey Moussaieff. Final Analysis: The Making and Unmaking of a Psychoanalyst (Reading, MA: Addison-Wesley, 1990). The best-written such account I have read, by a former insider in the American psychoanalytic establishment. For a very readable and fairly objective account of Masson’s break with Kurt Eissler and departure from psychoanalysis see Janet Malcolm’s In the Freud Archives (New York: Alfred A. Knopf, 1984), originally published as a New Yorker article.
Sacks, Oliver. Awakenings (London: Duckworth, 1973).
Coriat, Isador “The Treatment of Dementia Praecox by Psychoanalysis,” Journal of Abnormal Psychology 1917, 12: 326.
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Gach, J. (2008). Thoughts Toward a Critique of Biological Psychiatry. In: Wallace, E.R., Gach, J. (eds) History of Psychiatry and Medical Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-34708-0_23
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