Dominic Murphy

DARWIN IN THE MADHOUSE: EVOLUTIONARY PSYCHOLOGY AND THE CLASSIFICATION OF MENTAL DISORDERS

Recent years have witnessed a ground swell of interest in the application of evolutionary theory to issues in psychopathology (Nesse & Williams 1995, Stevens & Price 1996, McGuire & Troisi 1998). Much of this work has been aimed at finding adaptationist explanations for a variety of mental disorders ranging from phobias to depression to schizophrenia. There has, however, been relatively little discussion of the implications that the theories proposed by evolutionary psychologists might have for the classification of mental disorders. This is the theme we propose to explore. We’ll begin, in Section 1, by providing a brief overview of the account of the mind advanced by evolutionary psychologists. In Section 2 we’ll explain why issues of taxonomy are important and why the dominant approach to the classification of mental disorders is radically and alarmingly unsatisfactory. We will also indicate why we think an alternative approach, based on theories in evolutionary psychology, is particularly promising. In Section 3 we’ll try to illustrate some of the virtues of the evolutionary psychological approach to classification. The discussion in Section 3 will highlight a quite fundamental distinction between those disorders that arise from the malfunction of a component of the mind and those that can be traced to the fact that our minds must now function in environments that are very different from the environments in which they evolved. This mis-match between the current and ancestral environments can, we maintain, give rise to serious mental disorders despite the fact that, in one important sense, there is nothing at all wrong with the people suffering the disorder. Their minds are functioning exactly as Mother Nature intended them to. In Section 4, we’ll give a brief overview of some of the ways in which the sorts of malfunctions catalogued in Section 3 might arise, and sketch two rather different strategies for incorporating this etiologically information in a system for classifying mental disorders. Finally, in Section 5, we will explain why an evolutionary approach may lead to a quite radical revision in the classification of certain

Can psychiatry refurnish the mind

In this paper, I will argue that the NIMH’s new Research Domain of Criteria (RDoC) is a useful test of the philosophical hypothesis of eliminative materialism and demonstrates the superiority of a moderate eliminativism over integrationism, which is a rival philosophical framework for the cognitive sciences. I begin by going over the motivation for RDOC, which rests on the problems with the existing Diagnostic and Statistical Manual of Mental Disorders framework in psychiatry. Then, I introduce the main tenets of RDoC before discussing eliminativism and trying to show what a moderate eliminativism looks like through the example of addiction. I then contrast that approach with intregrationism to the latter’s detriment. I end by wondering whether the broadly political consequences of eliminativism give us non-scientific reasons for resisting it, as it threatens to rob ordinary people of important means of self-description

Autonomy, Experience, and Therapy

THE CONTEMPORARY PHILOSOPHICAL idea of autonomy has a psychological implication, to wit, that there exists a comprehensive set of ideal competences, realized in our mind/brain, that enable a person to be self-governing. Autonomy is normally accorded individuals who enjoy a certain kind of psychological functioning and, perhaps, a certain sort of psychological history (Christman 1991). We think that autonomous individuals critically evaluate their life and actions, endorse them as self-determined rather than imposed from without, and guide their own lives in accordance with the plans and values they have worked out for themselves. Such self-government has to depend on some psychological structures, but philosophers have tended to theorize about what these structures might be at a considerable distance from what the behavioral sciences can tell us. Anderson and Lux’s paper is a welcome contribution to the growing literature that tries to connect issues in ethics with empirical considerations. This sort of methodological, as opposed to merely metaphysical, naturalism, is only just coming into vogue in ethics, even in moral psychology.1 Anderson and Lux are, as far as I am aware, the first people to reflect seriously on what we can learn about autonomy from clinical experience. Theirs is a very suggestive and fruitful paper that looks at real-life cases of loss of autonomy and tries to reach conclusions about what the deficits in performance tell us about the psychological preconditions of autonomy. Their paper also opens the way for an investigation into the precise neurologic and computational underpinnings of these capacities, which is essential if we are to get a serious moral psychology underway. I find little to quarrel with in the story that Anderson and Lux tell, but I will try to modify it slightly to bring out what I think is the important psychological point they make and explore some ramifications. I begin by claiming that they have scored a decisive point in favor of an external conception of autonomy. Second, I suggest that what Anderson and Lux have really put their finger on is less a requirement of accurate selfassessment than a requirement of sensitivity to feedback from the environment. I conclude by raising some of these issues about the relations between autonomy and assessments of psychological function when the deficit responsible is less amenable to clear cut neurologic identification.

Adaptationism and Psychological Explanation

The research program of narrow evolutionary psychology1 is most closely associated with the work of Cosmides, Tooby and Pinker (Barkow, Cosmides, and Tooby, 1992; Cosmides and Tooby, 1992, 1994, 1997; Baron-Cohen, 1995; Pinker, 1994, 1997; Tooby and Cosmides, 1992, 1995; Wright, 1994). Evolutionary psychology in this sense combines a highly modular view of the mind with the claim that natural selection designed human psychology to solve adaptive problems. It is the meeting of sociobiology and traditional cognitive science: of E. O. Wilson and Noam Chomsky (although Wilson does not seem quite as fond of ‘selfish genes’ as some of the people who have sought to apply his ideas). Of course, many people working in psychology who do not share the assumptions of the Cosmides-Tooby program nonetheless take evolution seriously. They write books or papers such that if you didn’t know what evolutionary psychology was supposed to be, you’d think they were doing it (e.g., Allman, 1999; Atran, 1990; Frank, 1988; Griffiths, 1997; Griffiths & Stotz, 2000; Godfrey-Smith, 1996; Hauser and Carey, 1998; Kitcher, 1990; Sober and Wilson, 1998).

“Deviant Deviance”: Cultural Diversity in DSM-5

The DSM-IV-TR dealt with cultural diversity in mental illness by adopting the category of culture-bound syndromes (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 4th edn, text revision [DSM-IV-TR]. American Psychiatric Association, Washington, DC, 2000). DSM-5 makes some reforms including a structured program for assessing cultural influence on mental illness (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th edn [DSM-5]. American Psychiatric Association, Washington, DC, 2013). It also drops the category of culture-bound syndrome. These are improvements, but much of the underlying logic of DSM-IV-TR remains. In particular, the DSM-5 is still prone to see Western psychology as the human norm. These changes are discussed and situated in a wider intellectual context. Recent work in the cognitive sciences and cognitive anthropology has drawn attention to the dangers inherent in taking Western psychology as the norm. However, strong claims of cultural difference may rest on questionable philosophical assumptions about the semantics of kind terms. The relevant literature is surveyed and suggestions are made for developing psychiatry along lines that take its lessons into account.

What Will Psychiatry Become

Modern psychiatry aims at uncovering the causal structure of mental illness. I discuss two issues relating to this. First, the allure of reductionism, which goes along with a metaphysical commitment to levels of explanation that gets in the way of more promising approaches to psychiatric explanation. Second, I discuss the place of psychology within psychiatry, suggesting that we may need to develop new psychological concepts to do justice to neuroscientific developments, but that this might rob psychiatry of the ability to help patients understand themselves.

Cognitive Science Without Cognitive Psychology

The claim that cognitive psychological explanations are indispensable to cognitive science may reflect an a priori constraint that we need not accept. I show why, and then go on to envisage one possible future for cognitive science, exemplified by neuroeconomics, in which explanation is physiological, and the psychology merely heuristic.