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Biopsychosocial vs Biological Reductionism

Posted by Estella on August 28, 2006, at 2:04:03

I'm not sure whether the meds board is the most appropriate place for this... But it might be. I've been reading about some of the controversy between the biological reductionists and the social constructionists (with respect to mental illness) and I thought it might be interesting to discuss some of this if people are interested.

One obstacle to biological reduction would be if dualism turns out to be true. Within science there is an assumption of materialism, however. The weakest version of the claim is a global supervenience claim where the mental facts supervene on the global physical facts. Supervenience is a one way (a-symmetric) dependency relation so that baldness supervenes on hair distribution means that if two people are alike in hair distribution then they are alike in baldness whereas the converse is not the case. Similarly the facts about the physical world fix the facts about our mental world but not vice versa. In order for there to be a change in mental state there must be a change in brain state (or the physical state of the environment) but a change in brain state (or the physical state of the environment) does not entail a change in mental state.

This means that in order for mental states to change there must be a change to the brain and / or to the environment.


The biopsychosocial model claims that there are three aspects to mental disorder:
- Biological
- Psychological (Mental)
- Social
The medical model typically takes the biological level of explanation to be fundamental. It is thus REDUCTIONIST in spirit.

Some people hold on to a reductionist model of science more generally. The facts about psychology are thought to reduce to the facts about biology and the facts about biology are thought to reduce to the facts about chemistry and the facts about chemistry are thought to reduce to the facts about physics

(And the facts about physics require an observer which brings us back to mind... But at any rate...)

It is true that the sciences stand in a supervenience relation. God (so to speak) didn't have to fix the physical facts and then fix the chemical facts and then fix the biological facts and then fix the psychological facts. He just had to fix the physical facts and then that settled all the facts. The other facts ride along for free. But supervenience doen't entail REDUCTION is possible, however. One way in which reduction could fail to hold would be if the kinds at one level of explanation are massively multiply realised on a lower level of explanation.

For example, economics is the science of buying and selling and supply and demand etc etc. Money is a natural kind according to economics. When we consider whether money is a natural kind it seems that it is indeed a natural kind from within the special science of economics. If we consider money from lower levels of explanation then it seems that money doesn't map onto a lower level natural kind, however. Money can be made of paper or metal or shells and the physical instantiation is irrelevant.

Similarly to mental illness... When you don't find markers within the individual, instead you find averages are different when you compare populations. An average difference in a population doesn't constitute a causal mechanism within the individual, however.

It used to be thought that reductionism (and the unity of science) was the aim. Now people are happy to go with a picture where no level is fundamental except insofar as our interests determine the level at which there are the most robust generalisations.

For example... If you want to know about buying and selling then the appropriate level of explanation (the fundamental level of explanation) is the level of money and economics. If you try and explain buying and selling at the level of quantum indeterminacies you are missing the point and you won't find robust generalisations at the level of subatomic particles.

Similarly... If you want to explain mental illness it is wrong headed to appeal to quantum indeterminacies because physics isn't the fundamental level of explanation. For most mental illnesses even the neurological / biological level of explanation is wrong headed because there aren't robust generalisations to be found at the neurological level.

Of course this might be a problem with the state of our knowledge and just because we haven't found robust generalisations at the biological level doesn't mean that there aren't any to be found. Our inability to find them might show us that this is the wrong way to go, however. For some illnesses there are quite good explanations at the psychological and social levels. Also... Unless you are a dualist and think that the mind can vary independently of its neural basis alterations to psychology entail that there are alterations to neurology. It might be that for a long time yet... Maybe even forever as a matter of principle (ie not just due to the current state of our knowledge) the best way to treat mental illness is to...

Talk to people.

Though... What is 'mental' about mental illness at any rate? Vision is taken to be a paradigmatic mental process if anything is but if this is the case then how come cortical blindness isn't a mental disorder? How about the agnosias? Psychiatry doesn't deal in natural kinds so much as kinds that have been historically considered to be the subject matter of psychiatry. And the sexual disorders... How are they anything other than disorders that are socially disaproved of? How on earth did they get to stay in the DSM when homosexuality got bunted out (as it should have).





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