Am J Psychiatry. 2005 Mar;162(3):433-40.

Toward a philosophical structure for psychiatry.

Kendler KS.

Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth
University, Richmond, VA, USA. kendler@hsc.vcu.edu

This article, which seeks to sketch a coherent conceptual and philosophical
framework for psychiatry, confronts two major questions: how do mind and brain
interrelate, and how can we integrate the multiple explanatory perspectives of
psychiatric illness? Eight propositions are proposed and defended: 1) psychiatry
is irrevocably grounded in mental, first-person experiences; 2) Cartesian
substance dualism is false; 3) epiphenomenalism is false; 4) both brain-->mind
and mind-->brain causality are real; 5) psychiatric disorders are etiologically
complex, and no more "spirochete-like" discoveries will be made that explain
their origins in simple terms; 6) explanatory pluralism is preferable to
monistic explanatory approaches, especially biological reductionism; 7)
psychiatry must move beyond a prescientific "battle of paradigms" to embrace
complexity and support empirically rigorous and pluralistic explanatory models;
8) psychiatry should strive for "patchy reductionism" with the goal of
"piecemeal integration" in trying to explain complex etiological pathways to
illness bit by bit.

PMID: 15741457 [PubMed - indexed for MEDLINE]