This essay was originally published as Lou Marinoff, “Thus Spake Settembrini,” in Philosophy and Psychiatry, edited by Thomas Schramme & Johannes Thome, De Gruyter, Berlin, 2004, 27–49.

It is republished here by permission of Walter de Gruyter and Company.

What Unites Philosophy and Psychiatry?

Before discussing what unites philosophy and psychiatry, I will attempt to define my terms. This is for the sake of avoiding unnecessary debates that emanate from what philosophers call “equivocations”—ambiguities of language or usage that give rise to disagreements that are semantic but not substantive. As we may find enough substantive matters to dispute, let us at least seek a degree of semantic accord at the outset.

By psychiatry, I understand a branch of medicine concerned with the diagnosis and treatment of so-called “mental” disorders. I say “so-called” because the use of the term “mental” in this context is fraught with philosophical difficulties from the outset, stemming from the unresolved “mind-brain” problem. If mental activity is considered a mere epiphenomenon (i.e., an insubtantive reflection, or ontological chimera) of brain activity, then mental illness is presumably reducible to brain dysfunction. Then again, in so far as thoughts, memories, volitions, intentions, aspirations, dreams, hallucinations and other ostensibly mental phenomena remain unreduced or incompletely reduced to neural, neurochemical, synaptic, engramic, or other biological substrates, the dualistic distinction between states of mind and states of brain is bound to bear some weight. By my lights, progress in medical science (including psychiatry) is synonymous with advances in reliable knowledge of the body (including the brain); whereas progress in medical arts is synonymous with advances in reliable knowledge of the integral person, which includes approaches to understanding consciousness and its manifestations for what they are, and not merely for what they are assumed to be.