In his classic essay “The phenomenological approach to psychopathology”, Karl Jaspers defended the irreducible reality of the “subjective” mental symptoms and stressed the pivotal role of empathy in their diagnostic assessment. However, Jaspers’ account of the epistemological role of empathy in psychopathological diagnosis was far from clear: whereas at several places Jaspers claimed that empathy provides a direct access to patients’ abnormal mental experiences, at other places he stressed that it did so only indirectly, through a whole battery of their (...) observable clinical indicators. The aim of this paper is to reassess Jaspers’ account of the epistemological role of empathy in psychopathological diagnosis. (shrink)

According to the predominant view within contemporary philosophy of psychiatry, mental disorders involve essentially personal and societal values, and thus, the concept of mental disorder cannot, even in principle, be elucidated in a thoroughly objective manner. Several arguments have been adduced in support of this impossibility thesis. My critical examination of two master arguments advanced to this effect by Derek Bolton and Jerome Wakefield, respectively, raises serious doubts about their soundness. Furthermore, I articulate an alternative, thoroughly objective, though in part (...) normative, framework for the elucidation of the concept of mental disorder. The concepts of mental dysfunction and impairment of basic psychological capacities to satisfy one’s basic needs are the building blocks of this framework. I provide an argument for the objective harmfulness of genuine mental disorders as patterns of mental dysfunctions with objectively negative biotic values, as well as a formally correct definition of the concept of mental disorder. Contrary to the received view, this objective framework allows for the possibility of genuine mental disorders due to adverse social conditions, as well as for quasi-universal mental disorders. I conclude that overall, the project of providing an objective account of the concept of mental disorder is far from impossible, and moreover, that it is, at least in principle, feasible. (shrink)

Gloria Ayob Begins her commentary with the main metaphysical and ethical motivations for including the personal perspective in psychopathological assessments. The metaphysical motivation: human actions are performed for a reason. Thus, from the personal perspective, explaining human actions amounts to justifying them by appeal to individual’s reasons. However, does it follow from this peculiarity that “explanations of human behavior that appeal to empirical generalizations and those that consist in justifying an action by appeal to reasons are of entirely different logical (...) orders” (Ayob 2013, 127) as she contends? I do not think so for two main reasons. First, in both cases, genuine explanations involve factual .. (shrink)

Clinicians in their everyday practice of psychiatry face permanently the following epistemological and methodological problem: currently available psychiatric knowledge, like all types of scientific and technological knowledge, is general—at least in certain respects—in sharp contrast with the obvious particularities and even idiosyncrasies of each real individual mental patient they meet in the clinical encounter. This problem is admittedly the source of a permanent tension in the practice and above all in the philosophy of psychiatry. In the practice of psychiatry, conscientious (...) clinicians always try to find a necessarily pragmatic solution to this problem, mainly with the means of their psychiatric knowledge .. (shrink)