Philosophy & Psychiatry: Reflections of Mind - AMPQ - 11 June 2009

Des neurosciences à l’inconscient

• 43e Congrès annuel de l’AMPQ

• Jeudi le 11 juin 2009

• 16h00 à 17h30

Philosophy and Psychiatry:

Reflections of Mind

Geopoliticus child watching the birth of the new man

- Dali

Philosophy & Psychiatry

Vincenzo Di Nicola

• Psychologist and Child Psychiatrist

Université de Montréal

• Doctoral candidate European Graduate School

Key words

• Philosophy and psychiatry

• Phenomenology and existential psychiatry

• Ethics and biopolitics

Pedagogical objectives

1. To identify the history of the relationship between psychiatry and philosophy.


2. To offer an overview of areas of mutual interest to both psychiatry and philosophy, including philosophy of mind, philosophy of science and definitions of the person, identity and what we consider as essentially human qualities.


3. To review two areas in more detail: (a) phenomenology and existential psychiatry, and (b) ethics and biopolitics.

Areas of mutual interest

• Philosophy of mind• Philosophy of science • Philosophy of technology• Phenomenology (as a science of the

person and hence a foundation study for psychiatry)

• Philosophy as a tool for social exploration (identity, the definition of the person)

• Ethics and biopolitics

Uses of philosophy by psychiatry

• Inspiration

• Validation

• Justification

Other uses of philosophy

• Edification

• Consolation

Other uses of philosophy

• Clinical philosophy … Consolation as intervention

• Applied philosophy … Bio-ethics Research ethics Professional ethics

What is philosophy?

• Everything is like something, what is this like?

--Bryan Magee, Men of Ideas (1982) quoting English novelist E.M. Forster

What is philosophy?

• The purpose of philosophy is to show the fly the way out of the fly-bottle.

--Ludwig Wittgenstein, Philosophical

Investigations (1953)

Ludwig Wittgenstein (1889-1951)

(1889-1951)

What is philosophy?

• The owl of Minerva spreads its wings only with the falling of the dusk.

--G.W.F. Hegel, Philosophy of Right (1820)

G.W.F. Hegel (1770-1831)

(1770-1831)

What is philosophy?

• One more word about giving instruction as to what the world ought to be. Philosophy in any case always comes on the scene too late to give it...

• When philosophy paints its gray in gray, then has a shape of life grown old.

• By philosophy’s gray in gray it cannot be rejuvenated but only understood.

• The owl of Minerva spreads its wings only with the falling of the dusk.

—G.W.F. Hegel, “Preface,” Philosophy of

Right (1820)

What is philosophy?

• Understanding, clarification, edification, reflection, groundwork, foundations …

• Critical theory, deconstruction

What is philosophy?

Two kinds of philosophers …

• Those who build up theories and explanations, carefully, brick by brick --Aristotle, Aquinas, William James, Freud

• Those who tear them down, critically … brick by brick or with a wrecker’s ball--Luther, Nietzsche, Karl Marx, Michel Foucault

What is psychiatry?

• This can be imagined as a philosophical question

• People often invoke philosophical considerations in their definition of psychiatry …

What is psychiatry?

• Karl Jaspers … phenomenological psychiatry

• R.D. Laing … existential psychiatry

• Salvador Minuchin … structural family therapy

• Mara Selvini Palazzoli … systemic family therapy

• Samuel Guze … Why Psychiatry is a Branch of Medicine

• Robert Spitzer … architect of DSM … descriptive nosography, atheoretical

What are they?

• Sigmund Freud

• Karl Jaspers

• Jean Piaget

• Michel Foucault

What are they?

• Sigmund Freud (1856-1939)

• Neurologist & neuropathologist

• Founder of psychoanalysis

• Philosopher

What are they?

• Karl Jaspers (1883-1959)

• PhenomenologicalPsychiatrist

• Professor of Philosophy

What are they?

• Jean Piaget (1896-1980)

• Natural scientist• Genetic epistemology• Philosophy: Jürgen Habermas

What are they?

• Michel Foucault(1926-1984)

• Psychologist• Philosopher:

Structuralism & post-structuralism

• Historian • Critic

Philosophical deconstruction

• What do family therapists still refer to psychodynamics ?


Alternatives for describing families and family phenomena …

• Relationships, attachment• Interpersonal patterns• Myths, rules, rituals• Family as a structure, system• Family life as a text (to be edited)• The family as a storying culture


Why do so many terms for negative psychosocial factors come from hydraulics and materials sciences ?

• Stress• (Mental) fatigue• Tension• Resistance


And of course, so do the positive factors …

• Resilience• Bouyancy• Rebound


What do we mean by development ?

• Growth (Classical models, Dante)• Evolution

--Convergence, teleology (Teilhard de Chardin)

• Ages & stages (Paediatrics)• IQ as a model (Binet, Dalton)• Unfolding

--Genetic epistemology (Piaget, Kohlberg)


Explanatory models are usually based on metaphors

• Aleksandr Solzhenitsyn (1918-2008) Cancer Ward (1968)

• Susan Sontag (1933-2004) Illness as Metaphor (1978) Aids and Its Metaphors (1988)

Phenomenology and existential psychiatry


• Ludwig Binswanger (1881-1966)

• R.D. Laing (1927-1989)


• PhenomenologicalPsychiatrist

• General Psychopathology



• Ludwig Binswanger (1881-1966)

• Existential analysis• The Case of Ellen West• with many rereadings

(R.D. Laing, Sal Minuchin)


• R.D. Laing (1927-1989)

• Scottish psychiatrist and psychoanalyst

• Existential philosophy and psychiatry

• Pioneer in family studies• Critical psychiatry

Ethics and biopolitics

• Giorgio Agamben (b. Rome, 1942)


• Giorgio Agamben (b. Rome, 1942)

• Key notions:

• Homo sacer/Sacred Man (1998)• Stato di eccezione, État

d’exception, State of Exception (2005)


• Key notions: • Biopolitics • Adopted from Foucault (a

technology of power, biopower)

• Biós (a form of life) vs Zōē (mere life)

• Biopolitics is the reduction of others to bare life

Conclusion

• The history of psychiatry, psychology and psychoanalysis are intimately intertwined with philosophical questions

Conclusion

• Understanding this history will help us avoid reductive modes of thought

• Contemporary psychiatry accepts the notion of paradigms as evolution and progress

Conclusion

• A full account of mind cannot be provided by an understanding of brain

• No matter how sophisticated the argument for biological psychiatry becomes (cf. Eric Kandel), it will not speak to mind, fully understood.

Conclusion

• Leon Eisenberg put the question as brainlessness vs mindlessness

• or psychoanalysis without brain vs biological psychiatry without mind

Conclusion

• I expand the question to include:

• Mind (the science of mental life)• Body (biological psychiatry)• Heart (phenomenology, empathy)• Soul (meaning, transcendence)

Conclusion

• Our culture is at war with subjectivity

• Technopoly is the surrender of culture to technology

Conclusion

• We have not exhausted what phenomenological psychiatry can teach us by elucidating human experience and expanding our empathy

Health & Medicine

Philosophy & Psychiatry: Reflections of Mind - AMPQ - 11 June 2009