Philosophy of mind and psychiatry

Meet the patient — and the family's question

A 28-year-old man with new passivity experiences sits with his father, who has read a magazine article, and asks: "The scan will find the chemical, won't it? And then this isn't really him, so he isn't responsible?" Two philosophical claims, one bedside, and both are wrong in ways that matter.[8][11]

The philosophy station is not a seminar. It is the discipline that stops registrars talking nonsense about cause, self and responsibility at the moments it costs most — first-episode formulation, capacity, forensic reports, and the teaching that shapes the next cohort's MSE skills.[9][10][11]

Etymology for viva gold: ipseity, from the Latin ipse, "self" — the bare sense of being a continuous first-person subject. Sass and Parnas argue schizophrenia-spectrum experience disturbs exactly this minimal self, long before any scanner could "see" it.[8]

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1. [1]Engel GL The need for a new medical model: a challenge for biomedicine Science, 1977.PMID 847460
2. [2]Engel GL The clinical application of the biopsychosocial model Am J Psychiatry, 1980.PMID 7369396
3. [3]Ghaemi SN The rise and fall of the biopsychosocial model Br J Psychiatry, 2009.PMID 19567886
4. [4]Kendler KS Toward a philosophical structure for psychiatry Am J Psychiatry, 2005.PMID 15741457
5. [5]Kendler KS Explanatory models for psychiatric illness Am J Psychiatry, 2008.PMID 18483135
6. [6]Kendler KS The dappled nature of causes of psychiatric illness: replacing the organic-functional/hardware-software dichotomy Mol Psychiatry, 2012.PMID 22230881
7. [7]Kendler KS Levels of explanation in psychiatric and substance use disorders: implications for the development of an etiologically based nosology Mol Psychiatry, 2012.PMID 21670729
8. [8]Sass LA, Parnas J Schizophrenia, consciousness, and the self Schizophr Bull, 2003.PMID 14609238
9. [9]Andreasen NC DSM and the death of phenomenology in america: an example of unintended consequences Schizophr Bull, 2007.PMID 17158191
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11. [11]Pierre JM The neuroscience of free will: implications for psychiatry J Psychiatr Pract, 2014.PMID 24330830
12. [12]Fulford KWM, Handa A New resources for understanding patients' values in the context of shared clinical decision-making World Psychiatry, 2021.PMID 34505360