A much needed contribution to the expanding literature on the philosophical issues raised by clinical psychiatry, this book provides a clarification and thorough discussion of the philosophical assumptions that already permeate many aspects of psychiatry, for instance the scope of the principles of professional ethics, the rationale for the classification of mental disorders and the divergent approaches to reductionism.
The volume is very clearly structured and easy to use and has well-defined sections, a glossary of philosophical terms and suggestions for further reading. It is divided in three parts: values, meanings and facts, each of which can be read independently, thereby allowing both professionals and students to select an area of interest when the need for clarification arises. The obvious connections between these parts are also explored by Thornton, not just in the introduction and the conclusion, but in the course of his historically informed and engaging discussion.
It would be a mistake, though, to conceive of Essential Philosophy of Psychiatry as a textbook which presents a neutral stance to the methodological approaches one can adopt. The work is truly original and controversial. It offers a fairly complete account of the current trends in the subject, but then argues convincingly for the importance of preserving essential judgements in psychiatry as sensitive to complex factors that characterise the context of the clinical setting. I share Thornton’s concerns with the attempts to reduce psychiatry to something else. Psychiatrists are not mere brain mechanics, intent on addressing a dysfunction by restoring chemical balance. Neither can they be seen as mathematicians applying algorithms to guarantee minimum levels of care to users and stay clear of legal action.
But the fact that psychiatrists deal with persons who are capable of beliefs, desires, intentions and emotions, and who can suffer as a consequence of having such intentional states, does not speak against the contributions that disciplines such as cognitive neuropsychology can make to the understanding of the mind. The study of the cognitive mechanisms by which, say, beliefs are formed and revised is not in competition with, but is necessary for, an understanding of the experience and the behaviour of the person who forms and revises those beliefs.
- © 2008 Royal College of Psychiatrists