This book, called a companion, could be renamed a feast. People may not have the time to sit through every course, but they ought at least to sample the atmosphere. Indeed, anyone who does not wish to attend the feast should, perhaps, be regarded as having a disorder! To challenge this suggestion, to argue that a failure to wish to consume philosophy of psychiatry cannot be regarded as a ‘disorder’, is already to be supping the same fare.
I should be amazed to find a psychiatrist who could not discover something stimulating in this volume. In an authoritative way it marks out a territory that must be of concern to psychiatrists: conceptual issues concerning the mind and the brain, personal identity, dangerousness, competence, criminal responsibility, the clash between biomedical and social constructionist models of mental illness, the notion of character, the nature of thought insertion, and so on.
Nevertheless, it is possible to develop hiccups during a feast. Some parts may be too tough or a little spicy for some. This is unavoidable, because the philosophy of psychiatry is so broad. Thus, there is a variety of topics, including (for instance) descriptive psychopathology, psychotherapy, child development and nosology; and a variety of styles, from some quite difficult philosophical analysis (e.g. concerning dissociative phenomena and a nonunitary view of the self) to more accessible talk of the space of reasons and the realm of law in connection with reductionism in science.
What really makes the feast for me is when the philosophy is crucially relevant to practice. Here are three examples. First, in the next week I shall be involved in a decision to compulsorily detain someone living in residential care who is bizarre and smelly. Reading about the definition of mental disorder was exactly to the point. Second, in our discussions with families and other professionals, an appreciation of the centrality of values to psychiatric practice helps to underpin the importance of giving time to these careful negotiations. And third, as we interact with our patients - especially with the pressures of time and value for money bearing down on us - to be reminded of the tradition of Verstehen, of the need for empathic understanding, is inspiring. At its best, philosophy can provide a motivation for good practice, where the quality of our interactions should count for as much as mundane outcome measures.
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