Association for the A A Advancement of Philosophy and Psychiatry B u l l e t i n P& P From the Editor President’s Column This issue of the AAPP Bulletin is a play in three acts. The first and main The AAPP Community – An Open and Bright Future act is a challenge put out by Scott Wa- terman regarding the status of the psy- Over the past year the AAPP Officers and the Executive Council have been chiatric profession, following by com- brainstorming ideas for making the AAPP into a more cohesive organization for mentaries and a final response by Scott. which the benefits of membership are clear. This has been challenging for a The second act is another challenge, number of reasons. First, we are geographically spread out; not only over the U.S. this one by our president, Peter Zachar, and Canada, but over the entire world. Second, we are clinicians and academics, encouraging us to work more closely M.D.s and Ph.D.s, and ethicists, phenomenologists, social-political philosophers, together in the further development of philosophers of medicine, of science, of mind, and so on, with different scholarly AAPP. Finally, John Sadler offers us a traditions and methodologies. valuable guide in citing literature for In some ways all that ties us together is the name philosophy of psychiatry, articles in PPP. and that is a flimsy basis for building a community. We are not all interested in In lieu of a formal table of con- the same kinds of journal articles or conference topics. One would think that the tents, let me indicate that my own com- philosophy of psychiatry is a narrow specialty area – but it is not. If it were nar- mentary begins on this page, while rower, a community would be easier to build. Scott’s target article begins on page 2. Despite these challenges, there are also tremendous resources for us to grow The commentaries continue with Paul as a community and make the AAPP home to all those committed to advancing Lieberman’s contribution on page 3, both the philosophical understanding of all psychiatry/clinical psychology and and Scott’s response to commentaries advancing the philosophical literature through the study of psychological health begins on page 9. Finally, John Sad- and dysfunction. ler’s guide to references appears on Philosophy, Psychiatry, and Psychology remains the leading journal dedicat- page 12. ed to the philosophy of psychiatry. Due to its popularity, there was a backlog of articles and the issues were delayed, but thanks to John Sadler and the editorial team, the journal has worked through the backlog of articles and is now being An Imperfect Psychiatry published on time. We anticipate the publication of a redesigned website some- time in the next year and are planning on distributing an AAPP Newsletter twice a I am writing this response to Scott year with information about the recent publications and relevant activities of all Waterman following several days in AAPP members. We are also rethinking the AAPP Bulletin and hope to encour- Yosemite National Park. It is spring in age more members to submit materials. the park, with snowmelt gorging the The most important resource is our members – especially those who are in- rivers as they roar and plunge down- terested in becoming committed to the organization itself. Coming to the annual ward into the valley in violent currents AAPP meeting is an important way to get involved as you start to put faces to and massive waterfalls, tearing away names and hopefully begin to make connections. This is easier to do if you at- anything in their paths. I take from my tend multiple meetings. It may take some time. When the group you are trying to hikes through the park an impression of enter is not populated with extroverts, you typically have to become familiar be- nature as both staggeringly beautiful fore you can become known. I was an associate professor before I found AAPP, and violently destructive – and indiffer- but I quickly realized that I wanted it (and not one of the APAs) to be my home ent to the concerns of that portion of organization. I would encourage you to consider choosing us as well. nature represented by our human selves. (Continued on page 2) When Scott Waterman summarizes his reasons for no longer being a psy- chiatrist, he includes his disappoint- hoopla over “interventional psychiatry,” as its proponents, perhaps excepting ments with the DSM classificatory sys- ECT, promise more than they produce. tem, his disillusionment with psychoa- Scott doesn’t quite tell us what an acceptable psychiatry would be, but what nalysis, his concerns over the corrupt- he writes suggests that it would be a biomedical psychiatry that was truly bio- ing effects of the psychopharmacologi- medical. He talks about his early interest in neurology and “biological psychia- cal industry on the field, and his more try,” and writes: “I seized opportunities to redirect my efforts toward medical recent awareness of the limited efficac- student education, eager to exorcise what I had long identified as rampant mind- ity of pharmacological agents. He body dualistic fallacies embedded in medical discourse, training, and practice. could well have included the current Implementation of major curricular reform in the early 2000s allowed me to par- (Continued on page 6) Volume 26, Number 1 2019 (Continued from page 1, President) tinent then. While many in the West switch to psychiatry. The timing of my We invite AAPP members and perceived godless Communism to be change of specialty choice landed me, student members to make suggestions the paramount threat to freedom in quite by accident, in one of the nation’s about how to encourage more member 1950s America and Great Britain, most psychoanalytically oriented resi- involvement. Because the organization others were concerned that elements dency training programs. My quickly is structured with a leadership team of the anti-Communist program were formed suspicion that psychoanalytic (called the Executive Council), oppor- at least as dangerous. In that context, doctrine was fundamentally flawed was tunities to serve on committees has Edwards found in Russell’s free- reinforced by the defensive (and frank- been limited, but we want to open that thinking secularism an antidote to ly anti-intellectual) responses of my up a bit more as well. If you are inter- what he saw as the dangers of the teachers and by the publication of ested in becoming an ad hoc member ideological – including religious – Adolf Grünbaum’s 1984 treatise, The of one of our committees, please con- conformity that was increasingly Foundations of Psychoanalysis: A Phil- tact the committee chair. expected, if not imposed, as part of osophical Critique (and later by the the Western defense against recovered false memory debacle). Scott Waterman (Jaspers award com- (ironically) tyranny. Those experiences, among others, mittee): [email protected] So why should anyone care prompted my decision to pursue train- whether I am or am not a psychia- ing in research in “biological” psychia- James Phillips (AAPP Bulletin com- trist? (I am putting aside the question try. I was particularly animated by the mittee): [email protected] of whether someone who has decided notion that early-onset psychopatholo- to leave the profession is still a psy- gy, not yet contaminated by what we Christian Perring (Media/website com- chiatrist. As I am also not a Christian, considered the artifactual overlay of the mittee): [email protected] I won’t suggest that the principle of varied consequences of chronic dys- redemption should constitute the ba- function and marginalization, would be We are not an assembly line or- sis of an answer to that question!) where causes and mechanisms could ganization whose workings are auto- Perhaps the most straightforward ultimately be elucidated. That optimism mated – all the work is done on a vol- reason why anyone should care about was eventually dispelled by the reality unteer basis. We cobble it together my professional status is the purport- of an investigatory program that de- year after year – but that gives us a ed shortage of psychiatrists. As re- pended on definitions of phenotypes feeling of shared ownership that some ported in a very recent Association of specified in the DSM. My main conso- other organizations lack. It takes ef- American Medical Colleges press lation about that blind alley was that I fort to get involved, but contributing to release, 111 million Americans live recognized it for what it was and a small scholarly organization like in “mental health professional short- moved on before many of my col- AAPP can be a very satisfying part of age areas” and over half of U.S. leagues did. a career. counties have no psychiatrists. This, My subsequent focus on clinical in the context of the canonical asser- child and adult psychopharmacology *** tion that about 20% of us are mental- teaching and practice rewarded the ly ill (or, in the Orwellian parlance of abilities that had made me a very suc- the day, suffer with “a mental health cessful medical student – an excellent condition”), is said to constitute a memory for scientific findings and a Why I Am Not a Psychiatrist crisis. As Russell would surely rec- capacity to invoke them in appropriate G. Scott Waterman, M.D., M.A. ognize, implicit in the syllogism contexts. Initially, I tried to assure my- University of Vermont whose conclusion is that we need self that the generally modest benefits [email protected] more psychiatrists is the proposition our clinic patients seemed to derive that their presence in greater numbers from our efforts reflected the nature of On March 6, 1927, Bertrand Rus- would mitigate the problem of human a university-based tertiary referral ser- sell explained to those in attendance suffering.