Reading between Philosophy and Clinical Social Work

 I have recently been working my way through Peter Kramer’s 1993 classic, Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self . It has turned out to be quite different than I expected. I had run into the title in several histories of psychiatry (e.g., Anne Harrington’s Mind Fixers [2020]) and was generally under the—mistaken, I now realize—impression that the book fit squarely into the biologically-reductionist hype machine that surrounded the introduction of drugs like Prozac in the late 1980s and early 1990s. These days, it is quite common to look back on the early 1990s as a time of irrationally exuberant optimism about psychiatric medications, a kind of period of neo-Hippocratic humoral theory about serotonin (Kramer himself, somewhat ironically, I think, refers to serotonin and norepinephrine as “neurohumors”), a return of the repressed biological dimension to psychiatry and society writ large—when the Human Genome Project seemed to h...

This post is a continuation of the questions raised in this blog previously . I read clinical psychologist Peter Zachar’s book A Metaphysics of Psychopathology (2014), a dense and ambitious work that elaborates upon on the “instrumental nominalist” position about psychiatric categories that Zachar and Kendler signaled in their earlier article, while grounding in the radical empiricism of William James. Zachar seeks to bring the question of what kind of kinds psychiatric diagnostic categories are together with discussions in contemporary philosophy of science about realism and anti-realism of scientific entities, debates in analytic philosophy about natural kinds, the American pragmatists philosophical uptake of Darwin, and careful case analyses of debates about the status of such diagnoses as narcissistic personality disorder (NPD), the bereavement exception for major depressive disorder in the original DSM-5, or hysteria.   I want to state very briefly what I take to be Zachar’...

Recently, the morning newsletter of the New York Times suggested that the teen mental health crisis stems from “talking” too much about mental health. In this blog post, I will not evaluate that claim. What I want to do instead is evaluate the series of slippages whereby the nation’s paper of record produced such clickbait.   Academic articles that pass peer review have to keep a moderate tone. In the empirical disciplines, they are expected to include a Discussion section in which the authors discuss all the limitations of their results and hedge their conclusions. It’s well known, though, among students of science journalism that this moderation sometimes goes out the window in the press release. For example, when critical psychiatrist Joanna Moncrieff and colleagues published a review article in 2022 attempting to debunk “the serotonin theory of depression,” they were careful not to say much about selective serotonin reuptake inhibitors (SSRIs), one of the classes of psych...

In previous posts on personality disorders and autism, I have been dancing around a question that is central to philosophy of psychiatry: what kind of kinds are the categories found in diagnostic manuals, such as DSM-5 or ICD-11? I have touched on the debate, for example, between categorical and dimensional approaches to personality disorder classification, and, in the previous post, I mentioned Sam Fellowes’ musings about what might have happened if what Leo Kanner called “infantile autism” had not been separated out from “childhood schizophrenia” in the 1 9 40s. These sorts of issues inevitably lead to deeper questions about the very status of psychiatric diagnostic categories.   To tackle this problem-cluster head on, I thought I would look at what seems (based on my subjective impressions of citation) to be a classic article in philosophy of psychiatry, Zachar and Kendler’s “Psychiatric disorders: A conceptual taxonomy” (2007) . The authors propose six questions about diagn...