Edmund O’Toole - Phenomenology and Psychiatry

This is one of the papers from our 2017 Annual Conference, the Future of Phenomenology. Information and the full conference booklet can be found at www.britishphenomenology.org.uk

Abstract

By the 1990’s biological psychiatry became the dominant approach in dealing with mental disorders. This resurgence began decades earlier in America, where the ‘biological turn’ was an attempt to reform psychiatry along empirical lines and reaffirm the authority and status of psychiatry. Bolstered by developments in pharmacology, the belief was that a revolutionary reorganization of the classification of mental disorders would lead to greater research and validity for the bio-categorical approach. This approach was generally regarded as providing a basis for greater reliability and validity in diagnosing disorders.

Subsequently much of the philosophical considerations in dealing with psychiatry were aimed at providing a scientific description of mental disorder and attempts to define scientific legitimacy. These relied on giving biologically based descriptions and explanations using evolutionary theory and the notion of biological dysfunction. However, critics pointed to the neglect of the phenomenological and intentional experience in psychopathology, many believed that the phenomenological experience should be the first and the most important point of reference, as meaningful expression, in the diagnosis of a condition or disorder. Mental states are phenomenological and intentional in nature but the casual explanation offered by the biological approach leads to the view of the subjective experience of mental disorder as symptomatic rather than meaningful. Biological accounts of functionality did not give the phenomenological experience as meaningful but rather a superficial byproduct of causal relations or underlying dysfunction.

This paper addresses this neglect of phenomenology in psychiatry and how it has impinged on the psychiatric process, from classification of mental disorders to diagnosis and treatment. I will reflect upon the importance of phenomenology for psychiatry socio-historically and why it is hermeneutically significant for multiple levels of consideration. As such, by focusing on phenomenology, this paper highlights the need to reconsider psychiatry as an interpretive science.