Yes, my definition would be reducing the complexity of a person's mental disorder to their brain. I think most psychiatrists/psychologists would accept this definition of biological reductionism. And for some disorders with a more psychological/social cause (like PTSD or borderline personality disorder) reduction to the brain probably isn't the right level of understanding.
For major mental illnesses (like schizophrenia or bipolar disorder) it seems that reducing to the level of the brain is important for discovering new treatments, although each individual needs to be understood within their own psychological/social/cultural background.
I completely agree about the problems of surrogate markers. This is less of an issue in psychiatry because at the moment we don't yet have any biomarkers in clinical practice (arguably the closest might be Alzheimer's disease).
Most psychiatric services I've worked in (all NHS) do not treat patients as numbers or ICD/DSM diagnoses. It is standard for an initial assessment to last more than an hour and follow-up assessments to be 30 minutes. I can't imagine trying to see a patient in a 15 minute window - perhaps this is one of the reasons I ended up in psychiatry!
Reductionism is a great protection against going down rabbit holes of woo, and certainly better and safer than making up arbitrary models and presenting them as reality.
You almost concede too much! Studying the brain is important, indeed. Even the most "social" of factors can only influence mental illness by interacting with...the brain. Don't give any ground to those rank dualists! :-)
If this is your way to see reductionism how would you differentiate it to interactionism in your own words when you seem to accord and consider reasonably other factors like psychological social and cultural factors in your clinical and academic practice ?
I’m not familiar with that term so afraid I don’t have a good answer.
While in clinical practice, it’s almost always important to have psychological, social and cultural factors in mind, in other settings (e.g. drug discovery, research into pathophysiology) a more biological view may serve better.
Oh okay, I found strange to define yourself as reductionist while not knowing the other philosophical perspectives related to it like interactionism, holism, emergence etc.
But it’s interesting because somewhat you seem to have an interactionist perspective which consider mental illnesses explainable and treatable by both biological and psychosocial factors in your clinical practice as you mentioned.
However you seem to be reductionist in research settings for neurodevelopmental disorders but in a soft way if you also consider that some illnesses like ptsd shouldn’t be reduced to biomedical perspective but should include psychosocial factors in their research field.
So in my opinion, I think that technically it’s not a true literal reductionist perspective in general which is a position that definitely lack of nuance (it’s like saying that everything in mental disorders and their treatments should be reduced to biomedical research and clinical practice letting no space for including a minimum of psychosocial perspectives) when you seem to still value psychosocial factors in specific circumstances and fields of research and for clinical practice as well.
As a result it could be defined as a sort of partial interactionism with a strong preference for biomedical paradigm ? Or weak/flexible reductionism if you prefer
Thanks for the thoughtful comment and a good summary. It sounds like you know more about these concepts than I do! In my defence, reductionism is frequently used in the wider psychiatry discourse, whereas concepts like interactionism are not
Oh I understand better ! You meant this term in its common use that conceives reductionism with a slightly different meaning than the original and epistemological definition of it which is less strict with a broader use and meaning.
While in its rigorous definition, reductionism is something very strict by reducing absolutely everything to biology which is not really the case in its common sense that is more translated into a preference or trend to emphasize biomedical explanation and treatment while still valuing psychosocial factors to some extent.
That’s why people on this post seemed to not understand your vision of reductionism depending on their conception of reductionism by the previous two definitions of reductionism.
What’s reductionistic about your definition? That the brain is the primary site of study for mental illness, and the individual the primary site of intervention? What are you “reducing to?”
The 15 minute “med check” lends itself to biological reductionism, and not the kind you’ve laid out here. There’s little latitude for acknowledging the host of interactions between the individual and the systems in which they live. There’s little opportunity to consider issues beyond criteria to reach a DSM diagnosis. What seems to happen is what C. Thi Nguyen describes as “value capture” - surrogate markers, in this case diagnostic criteria (but sometimes also scales and tests) stand in for richer, more nuanced realities. This happens because (1) surrogate markers are commensurate with one another, (2) surrogate markers are clearer than narrative, and (3) bureaucracies struggle to handle large amounts of idiosyncratic narrative content. If you dwell in value capture long enough, you wind up with “value collapse,” where all effort is geared toward to the surrogate marker and the thing it’s meant to represent disappears. The person becomes the number; the biological reductionism is complete. A more concrete way this happens elsewhere in medicine, for example, is when clinicians chase after creatinine as a marker of renal function without discerning how creatinine fits into a broader understanding of this person’s overall health.
Is value capture and collapse a danger in the way you understand reductionism?
Yes, my definition would be reducing the complexity of a person's mental disorder to their brain. I think most psychiatrists/psychologists would accept this definition of biological reductionism. And for some disorders with a more psychological/social cause (like PTSD or borderline personality disorder) reduction to the brain probably isn't the right level of understanding.
For major mental illnesses (like schizophrenia or bipolar disorder) it seems that reducing to the level of the brain is important for discovering new treatments, although each individual needs to be understood within their own psychological/social/cultural background.
I completely agree about the problems of surrogate markers. This is less of an issue in psychiatry because at the moment we don't yet have any biomarkers in clinical practice (arguably the closest might be Alzheimer's disease).
Most psychiatric services I've worked in (all NHS) do not treat patients as numbers or ICD/DSM diagnoses. It is standard for an initial assessment to last more than an hour and follow-up assessments to be 30 minutes. I can't imagine trying to see a patient in a 15 minute window - perhaps this is one of the reasons I ended up in psychiatry!
Reductionism is a great protection against going down rabbit holes of woo, and certainly better and safer than making up arbitrary models and presenting them as reality.
You almost concede too much! Studying the brain is important, indeed. Even the most "social" of factors can only influence mental illness by interacting with...the brain. Don't give any ground to those rank dualists! :-)
True - but is the brain the right level to examine such social factors? 🤔
If, by the end of our lifetimes ,"strong emergence" (aka magic) is no longer a credible concept, I'll die a happy man.
Good piece. Succinct and to the point.
If this is your way to see reductionism how would you differentiate it to interactionism in your own words when you seem to accord and consider reasonably other factors like psychological social and cultural factors in your clinical and academic practice ?
I’m not familiar with that term so afraid I don’t have a good answer.
While in clinical practice, it’s almost always important to have psychological, social and cultural factors in mind, in other settings (e.g. drug discovery, research into pathophysiology) a more biological view may serve better.
Oh okay, I found strange to define yourself as reductionist while not knowing the other philosophical perspectives related to it like interactionism, holism, emergence etc.
But it’s interesting because somewhat you seem to have an interactionist perspective which consider mental illnesses explainable and treatable by both biological and psychosocial factors in your clinical practice as you mentioned.
However you seem to be reductionist in research settings for neurodevelopmental disorders but in a soft way if you also consider that some illnesses like ptsd shouldn’t be reduced to biomedical perspective but should include psychosocial factors in their research field.
So in my opinion, I think that technically it’s not a true literal reductionist perspective in general which is a position that definitely lack of nuance (it’s like saying that everything in mental disorders and their treatments should be reduced to biomedical research and clinical practice letting no space for including a minimum of psychosocial perspectives) when you seem to still value psychosocial factors in specific circumstances and fields of research and for clinical practice as well.
As a result it could be defined as a sort of partial interactionism with a strong preference for biomedical paradigm ? Or weak/flexible reductionism if you prefer
Thanks for the thoughtful comment and a good summary. It sounds like you know more about these concepts than I do! In my defence, reductionism is frequently used in the wider psychiatry discourse, whereas concepts like interactionism are not
Oh I understand better ! You meant this term in its common use that conceives reductionism with a slightly different meaning than the original and epistemological definition of it which is less strict with a broader use and meaning.
While in its rigorous definition, reductionism is something very strict by reducing absolutely everything to biology which is not really the case in its common sense that is more translated into a preference or trend to emphasize biomedical explanation and treatment while still valuing psychosocial factors to some extent.
That’s why people on this post seemed to not understand your vision of reductionism depending on their conception of reductionism by the previous two definitions of reductionism.
What’s reductionistic about your definition? That the brain is the primary site of study for mental illness, and the individual the primary site of intervention? What are you “reducing to?”
The 15 minute “med check” lends itself to biological reductionism, and not the kind you’ve laid out here. There’s little latitude for acknowledging the host of interactions between the individual and the systems in which they live. There’s little opportunity to consider issues beyond criteria to reach a DSM diagnosis. What seems to happen is what C. Thi Nguyen describes as “value capture” - surrogate markers, in this case diagnostic criteria (but sometimes also scales and tests) stand in for richer, more nuanced realities. This happens because (1) surrogate markers are commensurate with one another, (2) surrogate markers are clearer than narrative, and (3) bureaucracies struggle to handle large amounts of idiosyncratic narrative content. If you dwell in value capture long enough, you wind up with “value collapse,” where all effort is geared toward to the surrogate marker and the thing it’s meant to represent disappears. The person becomes the number; the biological reductionism is complete. A more concrete way this happens elsewhere in medicine, for example, is when clinicians chase after creatinine as a marker of renal function without discerning how creatinine fits into a broader understanding of this person’s overall health.
Is value capture and collapse a danger in the way you understand reductionism?