Philosophy of Mind
Philosophy of psychopathology today.
Messerschmidts heads at Belvedere in Vienna.
X-mental state or behaviour. What makes x a symptom of a disorder y?
What y a mental disorder?
These are two different qustions.
The first question has to do with what makes a particular condition a disorder, so how do we go from health to disorder? How do we determine the difference.
The second question handles mental disorder versus brain disorders, that is fully physical disorders qua disorder in the brain.
Paul Schreber, a political figure that was committed to a mental institution because of his serious delusions. He decided to write a book about his beliefs. Mainly to explain to people why he doesn’t belong in the mental institution.
Schreber considered himself to be the mother of a new race of people. And obviously since he was a man, he had to transform into a woman, from which he could give birth a new perfect race of humans.
There is a bit of knowledge about brain dysfunctions and differences involved in certain mental disorder. Why do we say that depression is a mental disorder, whilst epilepsy is a brain disorder. It doesn’t help to talk to a psychotherapist if you have epilepsy.
Did Nietzsche have a mental or a brain disorder? Probably both. The last 10 years of Nietzsche’s life was spent in sitting in an armchair.
If Nietzsche was suffering from psychosis with general paralysis, this means that there would have been an intercranial bacterial infection in the DSM-2.
Psychiatry is quite recent. But in these twohoundred years quite a lot has happened. Idk why we care.
Roy Porter Madness: a brief history. Porter initiated a bit of a paradigm shift in the historiography of psychiatry. Before psychiatry was quite whiggish. The history of psychiatry was seen as a march towards progress, evernew sophisticated theories about mental illness and how to treat it, it was mainly hagiographic. It was very top-down, seen from the eyes of the psychiatrist.
Porter tried to rewrite the history by making it from the eyes of a patient.
Edward Shorter, A History of Psychiatry. A lot more partisan in the debates within psychiatry. He is very much in favour of biological psychiatry. We should do away with the diagnosis creep, the increasing tendency to pathologise. He is very anti-psychoanalysis as well.
The mind game, witchdoctors and psychiatrists, by F. Fuller Torrey. He concludes that there is no substantial difference between witch-doctors and psychiatrists when it comes to describing and treating mental illness.
Rachel Aviv, Strangers to ourselves. Contains a bunch of case studies of people mentally suffering.
Psychiatry originated in the 18th century. It originated in western Europe, and its first embodiment was the doll-huys in Amsterdam. These were small-scale proto-psychiatric institutions. With very heterogenous people ran by religious orders. These were people who were so seriously ill that their families could no longer take care of them.
At the end of the 18th century, lunatic asylums had been developed however. Proper state-institutions were you place away sick people.
Charles Darwin and Cartin Brown speak about how big they’ve suddenly become. How has it become such that this huge population has suddenly required this kind of care?
Well one answer will be capitalism, if people aren’t productive they’ll be cast aside, and a lot of people ended up destitute because of it so they were sent away to institutions.
The first psychiatrists definitely wanted to cure these people. But most of the case they didn’t really need this kind of therapy, so none of them were cured. Therapeutic pessimism was then developed. Psychiatrists began by promising governments heaven, and after 1 century everyone basically gave up. Henry Maudeley talks about the prospects of curing people as basically none. At the end of the 19th century there is a definite pessimism. Institutions started being some of the most depressing people ever.
Psychiatrists reverted to a new tactic, which involved a huge wave of experimentation, and basically experimenting on the people they were supposed to help. Like malaria therapy, electroshock therapy, lobotomy, injecting random stuff, inducing meningitis, chilling people down and heating them up, having them breath pure carbon dioxide.
In the leadup to the second world war, the nazis experimented with ways to get rid of the jews by killing people with mental disorders. Aktion T4.
Psychiatrists started trying new tech and doing physical experiments on their patients with zero result. Oddly enough, in this time, two psychiatrists got the noble prize for medicine for giving their patients malaria. The point was that the malaria was supposed to kill the mental disorder (if it was caused by bacteria). Ice picks and so on. Great.
David Rosenhan’s anti-psychiatry experiment. Rosenhan was an american psychologist who wanted to test these institutional psychiatrist’s ability to distinguish sane and insane people. He and 7 other people each went to a different north american psychiatric institution and presented themselves with 1 symptom that they all agreed on – hearing a certain sound, an auditory hallucination that repeated three words. They were all admitted. On average they were admitted for 19 days and left having received over 2100 pills. Apparently they had no ability to distinguish between real insane people.
Psychiatry lost all credibility after ww2. Psychoanalysis instead gained a lot of traction after this time. From the 50s until the 80s.
Institutional psychiatry is just one part of the history of psychology but quite important.
You could see these old institutions crumbling down, which later led to the de-institutionalisation, people just left or where expelled.
Cahalan suggests that Rosenhan’s experiments were actually fraudulent.
The growth of biological psychiatry: give prozac to people. Robert Spitzer was the editor of DSM-3 from 1980. It suggested a new kind of wind blowing. Psychiatry was to focus on biological aspects of mental illness and data rather than consensus. One important element was the development of anti-depressents.
What makes a condition a disorder?
In this class we think of mental disorder.
Naturalism, Noramtivism, Hybridism, Pluralism, Eliminativism.
I should read up on the perspectives on disorders.
Having a disorder provides us with a sort of excuse. It excuses us of certain duties. People don’t expect ill people to work. Being ill comes with certain privileges. There are some illnesses that are out of our control. They don’t allow for free will, so we avoid responsibility.
The severity argument can be used to distinguish between a disease and normality. Pluralism kind of allows for that.
Eliminativism is the idea that given the fact that the concept of disorder is som any different integrations and definitions, it’s perhaps wise to eliminate the concept of disorder. They don’t need this concept.
There is a distinction between disorder and impairment, which has to do with the consequences of being ill.