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Evolutionary Psychiatry and Nosology: Prospects and Limitations Baltic International Yearbook of Cognition, Logic and Communication Volume 7 MORALITY AND THE COGNITIVE SCIENCES Article 5 2012 Evolutionary Psychiatry and Nosology: Prospects and Limitations Luc Faucher Université du Québec à Montréal Follow this and additional works at: https://newprairiepress.org/biyclc This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. Recommended Citation Faucher, Luc (2012) "Evolutionary Psychiatry and Nosology: Prospects and Limitations," Baltic International Yearbook of Cognition, Logic and Communication: Vol. 7. https://doi.org/10.4148/ biyclc.v7i0.1776 This Proceeding of the Symposium for Cognition, Logic and Communication is brought to you for free and open access by the Conferences at New Prairie Press. It has been accepted for inclusion in Baltic International Yearbook of Cognition, Logic and Communication by an authorized administrator of New Prairie Press. For more information, please contact [email protected]. Evolutionary Psychiatry and Nosology 2 The Baltic International Yearbook of about some disorders. Using the case of depression, I will then Cognition, Logic and Communication show what kind of problems evolutionary explanations of partic- ular psychopathologies encounter. In conclusion, I will evaluate October 2012 Volume 7: Morality and the Cognitive Sciences where evolutionary thinking leaves us in regard to what I identify pages 1-64 DOI: 10.4148/biyclc.v7i0.1776 as the main problems of our current nosologies. I’ll then argue that the prospects of evolutionary psychiatry are not good. LUC FAUCHER 1. INTRODUCTION Université du Québec à Montréal This paper was originally a chapter prepared for a volume which unfor- tunately never got to be published. When I began writing this paper, I was a post-doctoral student working under Stephen Stich, and was EVOLUTIONARY PSYCHIATRY AND NOSOLOGY: attending one of his seminars about the philosophy of psychopatholo- PROSPECTS AND LIMITATIONS gies. Given that I had just finished a thesis about the philosophical implications of evolutionary psychology, I was naturally drawn to evo- lutionary psychiatry.1 This rather new discipline (which has old roots, for instance in the likes of Maudsley, James, and Freud2) proposed to ABSTRACT: In this paper, I explain why evolutionary psychia- add to the focus on proximal (psychological) mechanisms of current try is not where the next revolution in psychiatry will come from. psychiatry, the consideration of evolutionary origins of those mecha- I will proceed as follows. Firstly, I will review some of the prob- nisms. I was interested in evolutionary psychiatry not only because lems commonly attributed to current nosologies, more specifically I saw it as a natural extension of evolutionary psychology, but also to the DSM. One of these problems is the lack of a clear and con- because it solved a problem which was dear to me at the time: the sensual definition of mental disorder; I will then examine specific problem of the unification of disciplines, especially the problem of the attempts to spell out such a definition that use the evolutionary unification of psychology. While teaching a philosophy of psychology framework. One definition that deserves particular attention (for a number of reasons that I will mention later), is one put forward class, I became acquainted with the debate between partisans of unifi- by Jerome Wakefield. Despite my sympathy for his position, I cation of psychology (Staats 1987a,b, 1989, 1991) and partisans of the must indicate a few reasons why I think his attempt might not disunification of psychology (Ermer et al. 2007b; Koch 1981; Kendler be able to resolve the problems related to current nosologies. I 1987). The debate never echoed much in philosophy of psychology, suggest that it might be wiser for an evolutionary psychiatrist to but I thought the question of the importance of unification for psy- adopt the more integrative framework of “treatable conditions” chology was interesting and worth pondering. One incarnation of this (Cosmides & Tooby 1999). As it is thought that an evolution- problem that seemed to me of crucial importance—because, among ary approach can contribute to transforming the way we look at other things, of its practical consequences—was that which was en- mental disorders, I will provide the reader with a brief sketch countered in psychiatry. Psychiatry, as many experts saw it, was badly of the basic tenets of evolutionary psychology. The picture of in need of unification. Solutions to the unification problem had been the architecture of the human mind that emerges from evolu- tried before, but according to many the answer that had been adopted tionary psychology is thought by some to be the crucial back- drop to identifying specific mental disorders and distinguishing had failed. Indeed, tired of internal wars between various theoreti- them from normal conditions. I will also provide two examples cal factions (psychoanalysis, behaviorism, humanism, phenomenology, of how evolutionary thinking is supposed to change our thinking etc.), the architects of the DSM had been looking for ways to increase Vol. 7: Morality and the Cognitive Sciences 3 Luc Faucher Evolutionary Psychiatry and Nosology 4 unity within their field. The solution they hit upon was to attempt to I will proceed as follows. Firstly, I will review some of the prob- produce a nosology independent of particular etiological theories that lems commonly attributed to current nosologies, more specifically to divided the field. As Wiggins and Schwartz put it, the problem was the the DSM. One of these problems is the lack of a clear and consensual following: definition of mental disorder; I will then examine attempts to spell out such a definition. One definition that deserves particular attention Because no particular orientation or limited subgroup of (for a number of reasons that I will mention later), is one put forward schools has established its credentials as the sole scientific by Jerome Wakefield. Despite my sympathy for his position, I must approach, there remains no scientific criterion for officially indicate a few reasons why I think his attempt might not be enough adopting one orientation over the others (Schwartz and to resolve the problems related to current nosologies. I suggest that Wiggins, 1988). Thus the field of psychiatry must some- it might be better to place accounts like Wakefield’s into the larger how accommodate all of the divergent schools and yet ar- framework of “treatable conditions” (Cosmides & Tooby 1999). As it is rive at a single classification scheme that all agree to use. thought that an evolutionary approach can contribute to transforming How then to reach agreement amid such unyielding dis- the way we look at mental disorders, I will provide the reader with a agreement? (1994, p. 91) brief sketch of the basic tenets of evolutionary psychology. The picture In brief (and to be elaborated on later in this article), the archi- of the architecture of the human mind that emerges from evolutionary tects of the DSM adopted what can be called the “vacuum strategy psychology is thought by some to be the crucial backdrop to identifying of unification”, trying to separate psychiatric observation from psychi- specific mental disorders and distinguishing them from normal condi- atric theories: “The common classification scheme would consist of tions. I will also provide two examples of how evolutionary thinking is categories whose meaning could be defined as far as possible through supposed to change our thinking about some disorders. In conclusion, direct observation” (idem, 91). The use of observation was thought to I will evaluate where evolutionary thinking leaves us in regard to what protect categories from “infection” from theories and from its effects on I identify as the main problems of our current nosologies. unification of the discipline. But, as many observed at the time, such classification is in essence shallow, it evacuates “theoretical entities” as 2. THE DSM AND ITS DISCONTENTS well as etiological explanations by relying only on clinical phenomenol- ogy. I thought that the solution to the problem of unification was The Diagnostic and Statistical Manual of Mental Disorders, better know elsewhere—namely in the adoption of an evolutionary point of view. as the DSM, is one of the main classification manuals for mental disor- 3 At the time, I thought that the adoption of an evolutionary psychology ders used by clinicians around the world. Having achieved an iconic point of view would provide the much-needed meta-theoretical frame- status, it is often referred to as the “bible of psychiatry”. The third work to achieve the unification of psychiatry. edition of the DSM (DSM-III, 1974) is considered as something of a Ten years later, my views of evolutionary psychology and its po- paradigm shift in psychiatric classification with its emphasis on descrip- tential for the unification of psychiatry have changed. I now see a tive diagnosis and provision of explicit criteria sets (Jensen et al. 1997, number of problems with this view (some of which I detail in recent p. 236). Further editions have stayed within the limits of the paradigm and forthcoming publications, for instance Faucher & Blanchette 2011; set by the editors of the third edition. Many researchers, some of whom Faucher in preparation a,i) and my hope in its potential for unification are even members of the task force responsible for the new edition of has waned. In this paper, I will explain why evolutionary psychiatry the DSM (for instance, Hyman 2011), think that DSM-V will not be is no longer where I think the next revolution in psychiatry will come a significant departure from the vision embodied by the previous edi- from. tions. www.thebalticyearbook.org Vol. 7: Morality and the Cognitive Sciences 5 Luc Faucher Evolutionary Psychiatry and Nosology 6 Despite its practical success, the DSM has come under the fire nu- provides the example of hypomania which she thinks has been merous times for what are thought to be its conceptual flaws (see wrongly listed as a condition by DSM’s own standards.
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