Early Career Scholars Conference in Philosophy of Psychiatry: Overcoming Mind-Brain Dualism in the 21st Century

We are delighted to announce the (first) Early Career Scholars Conference in Philosophy of Psychiatry: Overcoming Mind-Brain Dualism in the 21st Century Medicine, to take place at the Center for Philosophy of Science at the University of Pittsburgh, on November 21-22, 2014. The conference program can be found here. If you would like to register for this free event, please contact Joyce McDonald (pittcntr@pitt.edu).

If you have questions or queries please contact us, Serife Tekin and Kathryn Tabb.

In this post, we would like to provide some information about the conference. We thank our co-organizers, William Bechtel, Trey Boone, Mazviita Chirimuuta, Peter Machamer, Edouard Machery, Kenneth Schaffner, as well as our co-sponsors, the Center for Philosophy of Science, University of Pittsburgh, Pittsburgh, PA, and the Department of Philosophy and Religious Studies, Daemen College, Buffalo, NY. We also thank the Center staff, Joyce McDonald, Karen Kovalchick, and Cheryl Greer for their tremendous help with the logistics of the conference.

What is the conference about?

The conference aims to address the current state of psychiatric research and treatment by exploring the ways in which the mind-brain dualism of contemporary approaches – visible in the bifurcation of psychiatric research into investigations of the lived experience of mental illness and investigations of its underlie mechanisms – can be overcome in contemporary psychiatry. We are especially interested in integrative attempts to analyze this problem that draw on resources from contemporary philosophy of mind, philosophy of science (including philosophy of cognitive science and neuroscience) and philosophy of medicine. One goal of the conference is to progress towards a reconciliation between the claim that psychopathology needs to be scientific and the claim that it needs to keep the experience of the sufferer at its core. Another is to provide a supportive and exciting experience for early-career scholars in this burgeoning field. 

What is the significance of the theme of the conference?

Psychiatry’s aspirations as a branch of medicine are often in conflict with its aspirations as a branch of science. As a branch of medicine, it aims to clinically address the complaints of individuals with mental disorders, including the subjective, mental, and first- person aspects of psychopathology (such as feelings of worthlessness and hallucinations). As a branch of science, on the other hand, it targets the objective, embodied, and third-person correlates of mental distress (such as atypical brain mechanisms and behavioral anomalies). The Diagnostic and Statistical Manual of Mental Disorders (DSM), the psychiatric taxonomy used in the US and increasingly around the world, has traditionally been employed to identify both the scientific and medical targets of psychiatry, as well as in the service of sociological, pedagogical, and forensic projects. In attempting to be everything for psychiatry, however, the manual has succeeded in fully pleasing no one. The virtually universal dissatisfaction with contemporary nosology has led to a tension between critics who argue the way forward is focusing on the needs of patients and those who believe psychiatry should work harder to resemble the sciences. This tension became explosive following the publication of the recently revised DSM, the the DSM-5.

With respect to treatment, concerns have been raised in clinical circles that the behavior-based and symptom-oriented categories of mental disorders in the DSM-5 do not effectively discriminate appropriate human responses to stressful life events (such as grief) from complex mental disorders, because the categories fail to be responsive to the first-person experiences those suffering from these conditions. Nor do they provide an appropriate delineation of spectrum disorders such as schizophrenia, though new dimensional criteria for this disorder do appear in Section III of the DSM-5. DSM’s phenomenologist critics take these problems in psychiatric classification as obstacles for the development of effective treatment strategies.

With respect to research, the National Institutes of Mental Health (NIMH), the division of the United States government that funds most research in psychiatry, has abandoned the DSM for research purposes (Insel 2013). The argument put forward was that the DSM categories are no longer sufficient for research purposes because they lack validity. These critics have argued that a diagnostic system that aims to scrutinize mental illness should more directly reflect modern brain science, as “mental illness will be best understood as disorders of brain structure and function that implicate specific domains of cognition, emotion, and behavior” (Insel 2013). As an alternative to the DSM, the NIMH announced the Research Domain Criteria (RDoC) project, which attempts to create a new conceptual framework to describe psychiatric research that brings together the resources provided by various basic sciences, including genetics and neuroscience. Critics of the NIMH’s approach have suggested that the primacy of neuroscientific and genetic research into psychopathology continues an unfortunate trend that ignores the crucial role of the phenomenology of mental illness.

The following questions emerge out of the tension between these two lines of criticism: Can mental disorders be investigated and treated by the tools of the sciences alone, should phenomenological approaches dominate, or is this a false distinction, and an integrated approach is possible? Shall the scientific research on mental disorders be limited to basic sciences such as neuroscience and genetics, or is there a role that must be played by cognitive, developmental, and social psychology, and for scientific analyses of the economic and social dimensions of mental suffering? What is the relationship between psychiatric research and psychiatric treatment? Is the NIMH encouraging the autonomy of clinicians or is it leaving them behind by replacing the DSM with the prima facie “reductionistic” RDoC framework? Does its vision for psychiatric research exclude evaluations of psychotherapeutic and behavioural approaches or is it the best way forward for the discovery of new treatment options? Or both?

We believe that progress on these questions is hindered by a contemporary form of dualism, in which psychiatric disorders are seen as either disembodied problems in living or as subtypes of somatic disease. There is a tendency to perceive the etiology of psychiatric disorders as either brain based (organic or biological), to be investigated by schemas such as the RDoC, or mind based (functional or psychological), to be investigated by behavior-based schemas such as the DSM or patient-centered approaches that take a more holistic approach to disorder. There is also a tendency to divide psychiatric treatment into those that directly target the brain, e.g., antidepressants, and those that purportedly target the mind, e.g., cognitive behavior therapy, often to the detriment of the latter. While significant work has been done to overcome the dualistic conception of persons in the contemporary philosophy of cognitive science and in the philosophy of neuroscience, the results of these debates have not been fully transferred to the domain of psychiatry.

What is the conference format?

Philosophy of Psychiatry is a burgeoning area of research for philosophers of mind and science who are interested in exploring the nature of typical and atypical cognition. As such, there are an increasing number of early career scholars (graduate students, postdocs, untenured faculty) who conduct research in the area. The conference will bring these early career scholars in contact with senior philosophers who have expertise in philosophy of science, philosophy of neuroscience, and philosophy of medicine. Each paper by a junior scholar will be commented on by a senior scholar, which will strengthen these papers. In addition, there will be two poster sessions, giving the junior scholars the opportunity to develop their papers and facilitate lively discussions. Further, this format will initiate junior-mentor relationships that will help strengthen the philosophy of psychiatry community.

Why is the conference held at the Center for Philosophy of Science, at the University of Pittsburgh?

There are both historical and contemporary reasons for this. Historically speaking, both the Center for Philosophy of Science, and the Department of History and Philosophy of Science have played an essential role in the development of philosophy of psychiatry. Adolf Grünbaum, a philosopher of science well-known for his criticism of Sigmund Freud and psychoanalysis, founded the Center for Philosophy of Science in 1960, with the mandate he was given by the university administration to establish a first-class Center for Philosophy of Science. In its 54 year long history, the Center has been an international leader in the development and dissemination of original work in the philosophy of science, including the philosophy of psychiatry.

The History and Philosophy of Science Department is also the home to leading scholars in philosophy of psychiatry, medicine, cognitive science, and neuroscience. Some have worked closely with members of the working groups and committees of the DSM-5 revision project, for instance, and some work on various philosophical and scientific issues in medicine, cognitive science, and neuroscience.

In addition, the University of Pittsburgh hosts a large psychiatry and neuroscience research and clinical community, including, the Department of Psychiatry, the Department of Neuroscience, the Center for the Neural Basis of Cognition, UPMC’s re:solve Crisis Network, etc., which makes the place the perfect hub for a conference in philosophy of psychiatry.

Every year the Center for Philosophy of Science hosts a few conferences, selected from proposals submitted by the affiliated philosophy of science community. We presented the idea to organize a conference in philosophy of psychiatry to Ken Schaffner and Peter Machamer during a dinner conversation. Our idea was later supported and developed with the help of our co-organizers, and our proposal was accepted by the Center’s Advisory Board.

Why is the conference co-sponsored by Daemen College?

Daemen College is a private, nonsectarian, co-educational, comprehensive liberal arts college in Buffalo, New York, chartered to award both undergraduate and graduate level degrees. A national leader in both the humanities and science departments (e.g., English, History and Government, Philosophy and Religious Studies, Natural Science) and health related professional programs (e.g., Health Care Studies, Nursing, Physical Therapy, Physician Assistant, Social Work) Daemen has excellent resources for supporting areas of inquiry such as the philosophy of psychiatry, which relies on core skills such like critical thinking, creative problem solving, moral and ethical discernment, in addressing the theoretical, practical, and ethical concerns within research and clinical issues in mental health and its care.

Regularly teaching medical ethics and philosophy of science classes to a wide range of students from different health and humanities departments, Serife Tekin feels that she is rewarded every semester by the genuine interest in mental health research and care related topics that she sees in students. In fact, a number of her students will be attending the conference. Students will later share what they have learned at the conference with their peers and the larger academic community at Daemen during the College’s 2015 Academic Festival where students showcase their academic achievements.

 

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