Abstract

In this thesis I examine the question of whether there is a particular or special problem with the attempt to understand mental disorder on a medical model of disease. I suggest that there is, seek the root of the problem, and examine its consequences for psychiatric understanding. The adoption of the medical model in its most popular biophysical instantiation, the biomedical model, has been highly productive and successful for most of medicine. However, the adoption of the biomedical model of disease---as well as various methods of investigation and intervention the model has justified and generated---has had only mixed success in psychiatry. This raises four main questions that I will explore in this thesis: what is the biomedical model of disease? what is the evidence for its mixed success in psychiatry? what do its failures and successes suggest about the nature of mental disorder? and ultimately why does it matter? ;I consider the history of the biomedical model and the biophysically-reductive account of disease it supports before turning to an examination of three developments in psychiatric practice that appear to support psychiatry's adoption of this model: the Diagnostic and Statistical Manual of Mental Disorders , psychopharmaceutical effectiveness, and advances in investigating brains and genes. I evaluate the evidence each development provides for accepting a biophysically-reductive account of psychopathology and conclude that all three strategies face methodological and programmatic problems that suggest the biomedical model is not the most appropriate for the understanding of mental disorder. ;One consequence of this conclusion is that categories of mental disorder may not be unified by unique identifying essences in quite the way a biophysically-reductive account would expect; in other words, mental disorders do not appear to be natural kinds. I explore alternative notions of kindhood, and introduce the possibility that mental disorders constitute a new kind of kind, what I call interlevel kinds. I discuss the practical and theoretical advantages of adopting an interlevel approach to mental disorder, consider the significance such an approach could have for psychiatric research and practice, and situate these observations within a larger psychiatric and scientific framework