Philosophy - Contribution to psychiatry

1. PHILOSOPHY – CONTRIBUTION
TO PSYCHIATRY
PRESENTER - Dr. Sriram.R, 2nd year
MD Psychiatry PG
CHAIRPERSON – Dr. Sai, AP

2. ORGANIZATION
• WHAT IS PHILOSOPHY?
• EPISTEMOLOGY
• LOGIC
• METAPHYSICS
• ETHICS AND POLITICAL PHILOSOPHY
• AESTHETICS
• SPECIALIZED BRANCHES OF PHILOSOPHY
• PHILOSOPHY OF MIND
• PHENOMENOLOGY IN PHILOSOPHY
• PHENOMENOLOGY IN PSYCHIATRY
• EXISTENTIALISM
• EXISTENTIAL THERAPY AND LOGOTHERAPY
• PSYCHIATRY AS A MEDICAL MODEL
• CONCLUSIONS

3. WHAT IS PHILOSOPHY?
• Philosophy is the study of general and fundamental problems,
such as those connected
with reality, existence, knowledge, values,reason, mind,
and language. (Grayling, 1999)
• The word "philosophy" comes from the Ancient
Greek φιλοσοφία (philosophia), which literally means "love of
wisdom".
• The introduction of the terms "philosopher" and "philosophy"
has been ascribed to the Greek thinker Pythagoras.

4. WHAT IS PHILOSOPHY?
• Philosophy is divided into many sub-fields. These include
–Epistemology
–Logic,
–Metaphysics,
–Ethics
–Aesthetics.

5. EPISTEMOLOGY
• Epistemology is concerned with the nature and scope of
knowledge, such as the relationships
between truth, belief, perception and theories of justification.
• The regress argument, a fundamental problem in epistemology,
occurs when, in order to completely prove any statement, its
justification itself needs to be supported by another justification.
• Rationalism is the emphasis on reasoning as a source of
knowledge. Empiricism is the emphasis on observational evidence
via sensory experience over other evidence as the source of
knowledge.

6. EPISTEMOLOGY
• Parmenides (fl. 500 BC) argued that it is impossible to doubt
that thinking actually occurs. But thinking must have an
object, therefore something beyond thinking really exists.
• Plato (427–347 BC) combined rationalism with a form
of realism. The philosopher's work is to consider being, and
the essence (ousia) of things.
• Modern rationalism begins with Descartes, a
French philosopher, mathematician and writer.

7. EPISTEMOLOGY
• Reflection on the nature of perceptual experience,
as well as scientific discoveries in physiology and
optics, led Descartes (and also Locke) to the view
that we are directly aware of ideas, rather than
objects :
– Is an idea a true copy of the real thing that it
represents? Sensation is not a direct interaction
between bodily objects and our sense, but is a
physiological process involving representation.
– How can physical objects such as chairs and tables, or
even physiological processes in the brain, give rise to
mental items such as ideas? This is part of what
became known as the mind-body problem.
– If all the contents of awareness are ideas, how can we
know that anything exists apart from ideas?

8. Jean Piaget (1896-1980)
• Natural scientist
• Genetic epistemology
• Philosophy:
Jürgen Habermas

9. Piaget’s contribution to psychiatry
• Swiss developmental psychologist and philosopher known for
his epistemological studies with children.
• His theory of cognitive development and epistemological view
are together called "genetic epistemology".
• According to Jean Piaget, genetic epistemology "attempts to
explain knowledge, and in particular scientific knowledge, on
the basis of its history, its sociogenesis, and especially the
psychological origins of the notions and operations upon
which it is based"

10. Piaget’s contribution to psychiatry
• A Schema is a structured cluster of concepts, it can be used to
represent objects, scenarios or sequences of events or relations.
The original idea was proposed by philosopher Immanuel Kant as
innate structures used to help us perceive the world.
• Piaget (1953) described three kinds of intellectual structures:
behavioural (or sensorimotor) schemata, symbolic schemata, and
operational schemata.
– Behavioural schemata: organized patterns of behaviour that are used to
represent and respond to objects and experiences.
– Symbolic schemata: internal mental symbols (such as images or verbal
codes) that one uses to represent aspects of experience.
– Operational schemata: internal mental activity that one performs on
objects of thought

11. Piaget’s contribution to psychiatry
• The four development stages are described in Piaget's theory
are
– 1. Sensorimotor stage: from birth to age two.
– 2. Preoperational stage: Piaget's second stage, the pre-operational
stage, starts when the child begins to learn to speak at age two and
lasts up until the age of seven.
– 3. Concrete operational stage: from ages seven to eleven.
– 4. Formal operational stage: from age eleven to sixteen and onwards
(development of abstract reasoning).

12. LOGIC
• Logic is the study of the principles of correct reasoning.
• Arguments use either deductive reasoning or inductive
reasoning.
• Deductive reasoning is when, given certain statements
(called premises), other statements (called conclusions)
are unavoidably implied.
• Rules of inference from premises include the most popular
method, modus ponens, where given “A” and “If A then B”,
then “B” must be concluded

13. LOGIC
• Propositional logic uses premises that are propositions, which
are declarations that are either true or false.
• Predicate logic uses more complex premises
called formulae that contain variables.
• Inductive reasoning makes conclusions or generalizations
based on probabilistic reasoning. For example, if “90% of
humans are right-handed” and “Joe is human” then “Joe is
probably right-handed”.

14. METAPHYSICS
• Metaphysics is the study of the most general features of reality,
such as existence, time, the relationship
between mind and body, objects and their properties, wholes and
their parts, events, processes, and causation.
• Traditional branches of metaphysics include cosmology, the study of
the world in its entirety, and ontology, the study of being.
• Idealism, for example, is the belief that reality is mentally
constructed or otherwise immaterial while realism holds that
reality, or at least some part of it, exists independently of the mind.

15. ETHICS AND POLITICAL PHILOSOPHY
• Ethics, or "moral philosophy," is concerned primarily with the
question of the best way to live, and secondarily, concerning the
question of whether this question can be answered.
• The main branches of ethics are meta-ethics, normative ethics,
and applied ethics.
• Meta-ethics concerns the nature of ethical thought, such as the
origins of the words good and bad, and origins of other
comparative words of various ethical systems, whether there are
absolute ethical truths, and how such truths could be known.
• Normative ethics are more concerned with the questions of how
one ought to act, and what the right course of action is.

16. ETHICS AND POLITICAL PHILOSOPHY
• Jeremy Bentham and John Stuart Mill are famous for
propagating utilitarianism, which is the idea that the fundamental
moral rule is to strive toward the "greatest happiness for the
greatest number".
• Political philosophy is the study of government and the relationship
of individuals (or families and clans) to communities including
the state. It includes questions about justice, law, property, and the
rights and obligations of the citizen.
• In The Republic, Plato presented the argument that the ideal society
would be run by a council of philosopher-kings, since those best at
philosophy are best able to realize the good.

17. AESTHETICS
• Aesthetics deals with beauty, art, enjoyment, sensory-
emotional values, perception, and matters of taste and
sentiment.

18. SPECIALIZED BRANCHES OF PHILOSOPHY
• Philosophy of language explores the nature, the origins, and the use of
language.
• Philosophy of law (often called jurisprudence) explores the varying
theories explaining the nature and the interpretations of law.
• Philosophy of mind explores the nature of the mind, and its relationship
to the body, and is typified by disputes between dualism and materialism.
In recent years there has been increasing similarity between this branch of
philosophy and cognitive science.
• Philosophy of religion explores the questions regarding religion, including
the nature and existence of God, the examination of religious experiences,
analysis of religious vocabulary and texts, and the relationship
of religion and science.
• Philosophy of science explores the foundations, methods, implications,
and purpose of science.
• Metaphilosophy explores the aims of philosophy, its boundaries, and its
methods.

19. PHILOSOPHY OF MIND
• Branch of philosophy that studies the nature of
the mind, mental events, mental functions, mental
properties,consciousness, and their relationship to the
physical body, particularly the brain.
• The mind–body problem, i.e. the relationship of the mind to
the body, is commonly seen as one key issue in philosophy of
mind, although there are other issues concerning the nature
of the mind that do not involve its relation to the physical
body, such as how consciousness is possible and the nature of
particular mental states.

20. PHILOSOPHY OF MIND
• Dualism and monism are the two major schools of
thought that attempt to resolve the mind–body problem.
• Dualism can be traced back to Plato and
the Sankhya and Yoga schools of Hindu philosophy, but it was
most precisely formulated by René Descartes in the 17th
century.
• Substance dualists argue that the mind is an independently
existing substance, whereas Property dualists maintain that
the mind is a group of independent properties
that emerge from and cannot be reduced to the brain, but
that it is not a distinct substance.

21. PHILOSOPHY OF MIND
• Monism is the position that mind and body are
not ontologically distinct kinds of entities (independent
substances).
• This view was first advocated in Western
philosophy by Parmenides in the 5th century BC and was later
by the 17th century rationalist Baruch Spinoza.
• Idealists maintain that the mind is all that exists and that the
external world is either mental itself, or an illusion created by
the mind.

22. PHENOMENOLOGY IN PHILOSOPHY
• Founded in the early years of the 20th century by Edmund Husserl.
• Edmund Husserl's phenomenology was an ambitious attempt to lay
the foundations for an account of the structure of conscious
experience in general.
• Phenomenology, in Husserl's conception, is primarily concerned
with the systematic reflection on and study of the structures
of consciousness and the phenomena that appear in acts of
consciousness.
• This ontology (study of reality) can be clearly differentiated from
the Cartesian method of analysis which sees the world as objects,
sets of objects, and objects acting and reacting upon one another.

23. PHENOMENOLOGY IN PSYCHIATRY
• Phenomenology is the study of subjective experience, in
PSYCHIATRIC terms, and is a component of “descriptive
psychopathology”
• It is an approach to psychological subject matter that has its roots in
the philosophical work of Edmund Husserl.
• For example, we might ask, "Is my experience of redness the same
as yours?"
• While it is difficult to answer such a question in any concrete way,
the concept of intersubjectivity is often used as a mechanism for
understanding how it is that humans are able to empathise with
one another's experiences.

24. PHENOMENOLOGY IN PSYCHIATRY
• Carl Rogers' person-centered psychotherapy theory is based directly
on the "phenomenal field" personality theory of Combs and Snygg.
• That theory in turn was grounded in phenomenological thinking.
• Rogers attempts to put a therapist in closer contact with a person
by listening to the person's report of their recent subjective
experiences, especially emotions of which the person is not fully
aware.
• For example, in relationships the problem at hand is often not
based around what actually happened but, instead, based around
the perceptions and feelings of each individual in the relationship.
The phenomenal field focuses on "how one feels right now".

25. Karl Jaspers (1883-1959)
• Phenomenological/Existential
Psychiatrist
• Professor of
Philosophy

26. Karl Jaspers contribution to psychiatry
• He published a paper in 1910 in which he addressed the
problem of whether paranoia was an aspect of personality or
the result of biological changes.
• Jaspers set about writing his views on mental illness in a book
which he published in 1913 as General Psychopathology. This
work has become a classic in the psychiatric literature and
many modern diagnostic criteria stem from ideas contained
within them.
• Jaspers believed that psychiatrists should diagnose symptoms
(particularly of psychosis) by their form rather than by their
content.

27. Karl Jaspers contribution to psychiatry
• For example, in diagnosing a hallucination, the fact that a
person experiences visual phenomena when no sensory
stimuli account for it (form) assumes more importance than
what the patient sees (content).
• He argued that clinicians should not consider a belief
delusional based on the content of the belief, but only based
on the way in which a patient holds such a belief.
• Jaspers also distinguished between primary and secondary
delusions. He defined primary delusions as autochthonous
meaning arising without apparent cause.

28. EXISTENTIALISM
• Existentialism is a term applied to the work of a number of
late 19th- and 20th-century philosophers who shared the
belief that philosophical thinking begins with the human
subject—not merely the thinking subject, but the acting,
feeling, living human individual.
• The individual's starting point is characterized by what has
been called "the existential attitude", or a sense of
disorientation and confusion in the face of an apparently
meaningless or absurd world.
• The 19th-century philosophers Søren
Kierkegaard and Friedrich Nietzsche are widely regarded as
the fathers of existentialism.

29. EXISTENTIAL THERAPY
• Existential psychotherapy is a philosophical method of
therapy that operates on the belief that inner conflict within a
person is due to that individual's confrontation with the
givens of existence.
• These givens, as noted by Irvin D. Yalom, are: the inevitability
of death, freedom and its attendant responsibility,
existential isolation (referring to phenomenology), and
finally meaninglessness.

30. LOGOTHERAPY
• Viktor Emil Frankl, M.D., Ph.D. (26 March 1905 – 2 September 1997)was
an Austrian neurologist and psychiatrist as well as a Holocaust survivor.
• Frankl was the founder of logotherapy, which is a form of existential
analysis, the "Third Viennese School of Psychotherapy“
• Frankl became one of the key figures in existential therapy and a
prominent source of inspiration for humanistic psychologists.
• Logotherapy is based on an existential analysis focusing
on Kierkegaard's will to meaning as opposed to
Adler's Nietzschean doctrine of will to power or Freud's will to pleasure.

31. R.D. Laing (1927-1989)
• Scottish psychiatrist
and psychoanalyst
• Existential philosophy
and psychiatry
• Pioneer in family studies
• Critical psychiatry

32. • Laing's views on the causes and treatment of serious mental
dysfunction, greatly influenced by existential philosophy, ran
counter to the psychiatric orthodoxy of the day by taking the
expressed feelings of the individual patient or client as valid
descriptions of lived experience rather than simply as
symptoms of some separate or underlying disorder.
• Laing was associated with the anti-psychiatry movement,
although he rejected the label.
• He also challenged psychiatric diagnosis itself, arguing that
diagnosis of a mental disorder contradicted accepted medical
procedure.

33. PSYCHIATRY AS A MEDICAL MODEL
• Psychiatry now adheres to the “medical model”, which
advocates “the consistent application, in psychiatry, of
modern medical thinking and methods”
• The medical model merely commits us to a brain-based view
of mental illness with few implications for science.
• It is true that clinical or scientific differences across
practitioners seldom seem to have much to do with divergent
interpretations of the medical model.

34. PSYCHIATRY AS A MEDICAL MODEL
• It may be helpful to
distinguish minimal andstrong interpretations.
• A minimal interpretation makes no commitments about the
underlying physical structure that causes mental illness.
• The strong interpretation of the medical model, in contrast,
dissents on just this issue. It says that the proper medical
understanding of disease is in terms of morbid anatomy.

35. PSYCHIATRY AS A MEDICAL MODEL
• Guze (1992), for example, is a minimalist. When he advocates
seeing psychiatry as a part of medicine what he means is that
we can classify disorders in terms of their characteristic
symptoms and courses.
• Thomas Sydenham, was a 17th century English physician who
distinguished varieties of pox based on their characteristic
courses and outcomes.
• Andreasen (2001) embraces the strong interpretation. She
argues that psychiatry now emerging as a form of cognitive
neuroscience, is for the first time able to identify the specific
pathophysiologies that underpin the symptoms of mental
illness.

36. CONCLUSION
• A full account of mind cannot be provided by an
understanding of brain.
• The history of psychiatry, psychology and psychoanalysis are
intimately intertwined with philosophical questions.
• Understanding this history will help us avoid reductive modes
of thought.
• Phenomenological psychiatry can teach us by elucidating
human experience and expanding our empathy.

37. REFERENCES
• A.C. Grayling (1999). "Editor's Introduction". In A.C. Grayling, ed. Philosophy 1: A Guide through the
Subject. vol. 1. Oxford University Press. p. 1. ISBN 978-0-19-875243-1
• G & C. Merriam Co. (1913). Noah Porter, ed. Webster's Revised Unabridged Dictionary (1913 ed.). G & C.
Merriam Co. p. 501. Retrieved 2012-05-13.
• Descartes, René (1998). Discourse on Method and Meditations on First Philosophy. Hacket Publishing
Company. ISBN 0-87220-421-9.
• Hart, W.D. (1996) "Dualism", in Samuel Guttenplan (org) A Companion to the Philosophy of Mind,
Blackwell, Oxford, 265-7.
• Hardy Leahy, Thomas (2001). A History of Modern Psychology. New Jersey: Prentice Hall. p. 381. ISBN 0-13-
017573-0.
• Yalom, I (1980). Existential psychotherapy. New York: Basic Books. p. 9.
• http://plato.stanford.edu/entries/psychiatry/#MedModImp
• Guze, S. B., 1992. Why Psychiatry Is a Branch of Medicine, New York: Oxford University Press.
• Andreasen, N.C., 1997. “Linking Mind and Brain in the Study of Mental Illnesses: A Project for a Scientific
Psychopathology,” Science, 275: 1586–93.–––, 2001. Brave New Brain, New York: Oxford University Press.

38. THANK YOU