关键词: Philosophy of psychiatry embodied cognition enactivism mind‐body problem naturalism normativism pluralism reductionism scientism values‐based care

来  源:   DOI:10.1002/wps.21194   PDF(Pubmed)

Abstract:
Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important - psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence-based and values-based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi-level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of \"difference-makers\", as well as a consideration of \"lived experience\" in both research and practice. Third, in considering a range of questions about the brain-mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain-mind as embodied, embedded and enactive offers a conceptual approach to the mind-body problem that facilitates the clinical integration of advances in both cognitive-affective neuroscience and phenomenological psychopathology.
摘要:
哲学和精神病学交叉领域的工作有着广泛而有影响力的历史,最近受到了越来越多的关注,随着专业协会的出现和文学的发展。在本文中,我们回顾了哲学和精神病学工作的关键进展,及其相关的临床意义。首先,在理解和分类精神障碍方面,现在,自然主义者和规范主义者的考虑都被视为重要的-精神病学结构需要考虑事实和价值。在概念层面,这种综合观点鼓励从严格的科学主义转向软自然主义,而在临床实践中,这有助于基于证据和基于价值的精神卫生保健。第二,考虑到精神病学的本质,现在越来越强调多元化的方法,包括本体论,解释性和价值多元化。概念上,多元主义方法承认引起精神病理学的多层次因果相互作用,在临床上,它强调了广泛的“差异制造者”的重要性,以及在研究和实践中对“生活经验”的考虑。第三,在考虑一系列关于大脑思维的问题时,以及躯体和心理因素如何促进精神障碍的发展和维持,关于具体认知的概念和实证工作提供了一种越来越有价值的方法。将大脑思维视为具体体现,嵌入式和主动为身心问题提供了一种概念性方法,可促进认知情感神经科学和现象学精神病理学的临床整合。
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