Reductionism, eclecticism, and pragmatism in psychiatry: The dialectic of clinical explanation

Journal of Medicine and Philosophy 28 (5 & 6):563 – 580 (2003)
  Copy   BIBTEX


Explanatory models in psychiatry reflect what clinicians deem valuable in rendering people's behavior intelligible and thus help guide treatment choices for mental illnesses. This article outlines some key scientific and ethical principles of clinical explanation in twenty-first century psychiatry. Recent work in philosophy of science, clinical psychiatry, and psychiatric ethics are critically reviewed in order to elucidate conceptual underpinnings of contemporary explanatory models. Many explanatory models in psychiatry are reductionistic or eclectic. The former restrict options for diagnostic and therapeutic paradigm choice, while the latter lack a well-defined theoretical basis. These two methodological approaches stand in a dialectical relation to one another insofar as clinicians often move from one approach to its antithesis, ultimately seeking a synthesis of the two approaches that satisfies clinical needs. Pragmatic considerations can help to transcend the reductionism/eclecticism dialectic. In the absence of a completed science of mental disorders, psychiatrists must tolerate ambiguity and uncertainty as they strive to integrate diverse explanatory concepts in a rigorous and evidence-based fashion. A pragmatic explanatory model in clinical psychiatry must focus on favorable treatment outcomes for patients by respecting the pluralistic, participatory, and provisional nature of psychiatric explanation



    Upload a copy of this work     Papers currently archived: 77,916

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Does evidence-based medicine apply to psychiatry?Mona Gupta - 2007 - Theoretical Medicine and Bioethics 28 (2):103.
Explanation in psychiatry.Dominic Murphy - 2010 - Philosophy Compass 5 (7):602-610.
The Perspectives of Psychiatry.Paul R. McHugh - 1998 - Johns Hopkins University Press.
Essential Philosophy of Psychiatry.Tim Thornton - 2007 - Oxford University Press.
Beyond Engel: Clinical pragmatism as the foundation of psychiatric practice.David H. Brendel - 2007 - Philosophy, Psychiatry, and Psychology 14 (4):pp. 311-313.


Added to PP

58 (#210,182)

6 months
1 (#485,121)

Historical graph of downloads
How can I increase my downloads?