Summary of accounts of the mind and implications for psychiatry

We have looked at fi ve diff erent accounts of the mind. Th e diff erent accounts are summarized in Table 7.1. It is worth noting that in addition to the pure accounts of mind discussed here, “hybrid” accounts are also possible. One might, for example, be a functionalist about beliefs and desires, an identity theorist about emotions, and an eliminativist about intuitions and acts of will.

Furthermore, accounts of mind diff erent from those discussed here are also available. However, the accounts of mind surveyed here are suffi cient to illus-trate the range of accounts that are available, and to enable us to discuss some of the implications for psychiatry that will follow from adopting one account of the mind rather than another.

Of the fi ve accounts we have considered, in my opinion dualism, identity theory, functionalism and anomalous monism are viable theories. Although, as we have seen, these accounts face diffi culties, there are philosophers of mind who are currently working on and refi ning these views. Eliminative materialism has a far smaller following.

Th e most important implication that I wish to draw from this survey of accounts of the mind is that one does not have to be a dualist in order to think that the mind is real. Identity theorists, functionalists and anomalous monists also believe that the mind is real. Identity theorists think that the mind is real and is identical with the brain. Functionalists think that the mind is real and is functionally defi ned. Anomalous monists think that each particular mental state is identical with a brain state, but that there are no strict laws governing the mental. Only eliminative materialists deny the existence of the mind. Th is point has been missed in several recent papers in psychiatric journals. For example,

Table 7.1 Summary of accounts of mind AccountClaimsCan psychology be reduced to neuroscience?AdvantagesProblems DualismMind is a diff erent stuffNo – psychological properties cannot be captured by physical theories

Explains why minds are diff erent from other thingsDoes not fi t well with a physical worldview Identity theoryMental states are identical with brain statesYes – psychological properties just are neurological properties

Fits neatly with physical sciencesRuns into problems with the possibility of multiple realization FunctionalismMental states are functionally defi nedMultiple realization means that a reduction of “general psychology” cannot be achieved, but species-specifi c reductions are not ruled out

Can accommodate multiple realizationDepending on how inputs and outputs are defi ned, risks falling into chauvinism (e.g. denying that paralysed people have minds) or liberalism (claiming that China has a mind) Eliminative materialismMental states do not existPsychology is nonsense and should be eliminatedClaimed to fi t with expected future scientifi c fi ndingsAn unattractively radical view Anomalous monismMental states are brain states, but psychology cannot be reduced to neuroscience

Talk of rational mental states cannot be reduced, but Davidson has nothing to say about non-rational psychological states A non-dualist account that goes some way to explaining what is special about the mental Not discussed here (see Heil & Mele 1993: pt 1).

psychiatry and philosophy of science

Miresco and Kirmayer (2006) found that clinicians tended to use psychological explanations when they reasoned about disorders such as drug addiction or per-sonality disorders. Th ey worry that clinicians continue to think of some forms of mental illness as being especially “psychological”, in defi ance of research that, they claim, has shown that dualism is false. Here Miresco and Kirmayer are doubly confused. First, as argued earlier, psychiatric research has not shown, and cannot show, that dualism is false. Secondly, all materialist accounts of the mind – with the exception of eliminative materialism – provide room for the legitimacy of psychological talk. As long as one steers clear of eliminative materialism, talk of mental states is safe.

Depending on the account of mind one adopts, one will expect there to be diff erent varieties of mental illness. Most notably, functionalists think of the mind as being analogous to the soft ware that runs on a computer. Th ey will expect that there will be two possible types of mental illness. While some disorders may result from “hardware” problems with the brain, others may be caused by problems with the “soft ware” of the mind.

With the exception of eliminative materialism, all the theorists we have exam-ined accept that the mind is real and has causal powers. All can thus expect there to be mental disorders that have psychological causes. Even mind–brain identity theorists allow this. Suppose I see terrible things and suff er from post traumatic stress disorder. Th e identity theorists can accept that the images processed by my brain have led to nightmares and so on. On their account, my perceptions and nightmares just are types of brain state, so it is not surprising that they have causal eff ects. All theorists also accept that the physical is real and can aff ect the mental. If I poison my brain with drugs all theorists will expect this to aff ect my mind. Even dualists can allow for this, as they accept that physical events can bring about mental changes.

Th e diff erent theorists have diff erent views about the prospects of reduc-ing psychological theories to neuroscientifi c theories, and before we go on it is worth reminding ourselves of the arguments here. As we have seen, Fodor argues that theories about multiply realized entities resist reduction. If mental states are functionally defi ned then this would imply that a universal psychology (i.e. one that applied to all kinds of minds) could not be reduced. Nevertheless, it may still be possible to reduce psychological theories of more restricted scope.

Even if Martians and robots have mental states that are realized in physically diverse ways, it may still be the case that normal human mental states are physi-cally alike and thus reducible. In so far as psychiatry seeks only to account for the mental states of human beings, the implications of Fodor’s argument for psychiatry will thus be limited.

Davidson also argues that psychology cannot be reduced. Again, I think the implications of his argument for psychiatry are restricted. Davidson’s argument only applies to propositional mental states that are rationally related. Much of

psychiatry deals with mental states that are either non-propositional (feelings of panic, anxiety) or are not rationally linked with other mental states (delusions).

Th us, even if Davidson’s argument is accepted, theories about such psychologi-cal states might be reducible to theories at a lower level.

So as long as one rejects dualism, projects within psychiatry that aim at reducing theories at the psychological level to theories at lower levels may yet prove successful.²