Gerrit Glas

This book focuses on two important, interlinked themes in psychiatry, i.e., the relation between self (or: person), context and psychopathology; and the intrinsic value-ladenness of psychiatry as a practice. Written against the background of scientistic tendencies in today’s psychiatry, it is argued in Part I that psychiatry needs a clinical conception of psychopathology alongside more traditional scientific conceptions; that this clinical conception of psychopathology must be based on a fundamental rethinking of the interaction between illness manifestations, contextual influences and the patient as person, such that psychopathology is conceived as the product of this interaction rather than as the outward manifestation of a broken mechanism within the patient. In Part II, it is shown that self- and context-related factors have a large impact on who one is as a professional. I argue that an analysis is needed of the normative aspects of the relations that sustain and frame professional role-fulfilment. This analysis culminates into a so-called normative practice model (NPM) which distinguishes between qualifying, conditioning and foundational principles (or: rules, norms). The normative practice model helps to locate and resist scientistic defenses of the legitimacy of psychiatry and to replace them by a positive account that provides clinicians (and scientists) the conceptual tools they need to justify what they do in broader contexts. The main thrust of the argument is to show that psychiatry needs a value-sensitive account of its legitimacy, in which other normative dimensions are recognized than those that sustain the expert role. Psychiatrists should in other words not defend the legitimacy of their profession by referring to the expert role solely but provide a broader account in which justice is done to the broader social, legal, and economic contexts of professional activity. The analysis of this inherent normativity begins within clinical practice, it extends to the concept of disease as well as to wider domains of psychiatric care and the sociology of professions, and, finally, amounts into an analysis of the value-ladenness of interactions between healthcare institutions, the government, professional organizations and patient groups.

This article is devoted to the conceptual analysis of two texts of leading scholars in cognitive neuroscience and its philosophy, Patricia Churchland and Eric Kandel. After a short introduction about the notion of reduction, I give a detailed account of the way both scientists view the relationship between theories about brain functioning on the one hand and consciousness and psychopathology, respectively, on the other hand. The analysis not only reveals underlying philosophical mind/brain conceptions and their inner tensions, but also the conceptual relevance of distinctions that are fundamental in the work of Dooyeweerd, such as the distinction between modes and entities, between law and subject and between subject function and object function. After a brief clarification of the way these distinctions function in Dooyeweerd’s theory of the body as an ‘enkaptic structural whole’, I try to explain how the conceptual framework, developed here, could be applied to brain functioning and leads to greater clarity in neuroscientific theorizing