Psychiatry, Causation, and Ideology

Causation has a central position in the self-understanding of medicine. Establishing a cause is significant in showing a collection of symptoms is a disease. Understanding the cause of illness offers tremendous advantages in finding treatments.

Causation is typically understood in a materialist sense. Murphy in Psychiatry in the Scientific Image says “”For social explanations to play a genuine explanatory role they must work via a material mechanism.” It is not clear why only physical causes are accepted. I argue in restricting ourselves to physical causes we are overly restrictive.

After listening to this talk, if you remember it, the memories will be encoded in the brain in a process Kandel investigated in simpler forms. To understand learning we need to pay attention to a different level of phenomena. If you learn anything new today, it makes sense to understand that by your choice to come to these talks. We might seek the cause of your decision to attend in your neurochemistry, but if you have learned something new, it is likely to be fruitless to search for the "cause" of this new knowledge in your established neural makeup.

The cause of the changes that encode this knowledge may be sensory inputs you receive as you listen to the talk. But is the best explanation for what has been learned found at this level? If I study for a test, is it more illuminating to think about the optical inputs I receive or my decision to study? When things go wrong, as in Alzheimer's disease, we look for what goes wrong that prevents us from learning. When the brain is functioning normally, however, it is not clear talking about neurons and proteins tells us more than talking about studying does.

Is what is important in PTSD the molecular changes or the trauma? What are the reasons for preferring one account over the other? Can this be answered a priori? In the same way for every psychiatric illness? I think there is a place for psychopathology, not merely brain disease