Further information: Jerry Kroll & Perry Mason, Conceptual and Ethical Issues Involved in Psychiatry
There are four main questions that will underlie the eight sessions of this course.
A. Mental Illnesses: Are they diseases vs social constructions?
- What are the requirements for illnesses to be diseases?
- What are the requirements for illnesses/troubles to be unusual human behaviors or ways of being that become defined as disorders
- Examination of all points between diseases and socially-constructed disorders – where are the joints or critical cutting scores?
B. Confounding Conditions: Are they important considerations?
- Scientific: issues of methodology, bias, scientific limitations
- Political: power; prejudices; social conformity; religious beliefs and values
- Economic: special interests driving the definitions, research, and reimbursements
- Professional Organizations: protecting one’s turf
C. Who speaks for the patient, family, community?
- Who selects the values that guide decisions?
- Who has the right to object to being diagnosed, being treated, being confined?
- What are the credentials for being the ‘Decider’?
- What credibility and epistemic privilege are given to Lived Experience?
D. What are philosophy’s contributions to these deliberations and actions?
- Analyze and weigh the basic concepts involved
- Assess the coherence of arguments
- Parse out the role of moral/ethics in the theory and practice of psychiatry
- Look at the role of existential, transcendental, and social theories of the meaning of life/worldviews in deciding health and illness.
Readings will be mainly from Jennifer Radden (ed.), The Philosophy of Psychiatry: A Companion, used paperback copies of which are listed online (bookfinder.com, alibris.com, amazon.com, etc.) for under $20.
Additional readings will be provided by email.
- What is mental disorder? I: Basic general concepts of health and illness
Radden, “Introduction,” pp. 3-18
Gert & Culver, “Defining Mental Disorder,” pp. 415-25
Church, “Social Constructionist Models”, pp. 393-406
emailed pdf hand-outs
- What is mental disorder? II: Illness as dysfunction; Example of Depression
Gillet, “Cognition: Brain Pain: Psychotic Cognition, Hallucination, and Delusions,” pp. 21-35
Hansen, “Affectivity: Depression and Mania,” pp. 36-53
Ericksson, Are SSRIs effective only for severe depression? – email PDF
McHugh (book review), “The loss of sadness; How psychiatry transformed normal sorrow into depressive disorder” – email PDF
- What is mental disorder III: Neurological reductionism
Phillips, “Understanding/Explanation,” pp. 180-90
Thornton, “Reductionism/Antireductionism,” pp. 191-204
Gamar & Hardcastle, “Phenomenological and Hermeneutic Models: Understanding and Interpretation in Psychiatry,” pp. 364-80
Szasz, “The Myth of Mental Illness” email PDF
- Diagnosis of mental disorder I: disorders as natural kinds? Compare DSM-1, 2, and 3
Sadler, “Diagnosis/Antidiagnosis,” pp. 164-79
Fulford, “Facts/Values: Ten Principles of Values-Based Medicine,” pp. 205-34
Harré, “Setting Benchmarks for Psychiatric Concepts,” pp. 409-14
Sections on Depression and Schizophrenia: DSM-I (1952); II (1968); III (1980) -email PDF
- Diagnosis of mental disorder II: Antipsychiatry, arbitrariness of criteria, religiosity
Berlim et al: Notes on Antipsychiatry. Email PDF
Cross-cultural constructs of norms of family interdependence
Cross-cultural constructs re religious beliefs (mainstream; cults; demons)
Jackson & Fulford, “Spiritual experience and psychopathology,” Email PDF
- Mental Illness and Diagnostic Category “Creep”
Are socially “undesirable” behaviors diagnostic of mental illness?
Examples from DSM: Tobacco Use Disorder; Gambling Disorder
History of changing diagnosis of Homosexuality across successive DSMs
Criminal Behavior as evidence of mental illness: Mad vs Bad
Wilson & Adshead, “Criminal Responsibility,” pp. 296 – 311
Readings: selected email PDFs
- A case in point: personality disorders–are they illnesses?
Categories vs. Dimensional Models for conceptualizing Personality Disorders
Borderline Personality Disorder; selected email PDFs (Kroll)
Narcissistic Personality Disorder and Politics: Should psychiatry jump in?
Kroll & Pouncy: “The ethics of APAs Goldwater Rule”, Email PDF
- Moral virtue and mental disorder—client and psychiatrist
Does the psychiatrist treat the person’s illness or the ‘whole’ person?
What does the psychiatrist owe the patient, and vice-versa?
Selected Email PDFs