In psychiatry, almost no one questions the legitimacy of asking whether a given psychiatric disorder is real. Similarly, in psychology, scholars debate the reality of such theoretical entities as general intelligence, superegos, and personality traits. And yet in both disciplines, little thought is given to what is meant by the rather abstract philosophical concept of “real.” Indeed, certain psychiatric disorders have passed from real to imaginary (as in the case of multiple personality disorder) and from imaginary to real (as in the case of post-traumatic stress disorder). Although metaphysic ... More

In psychiatry, almost no one questions the legitimacy of asking whether a given psychiatric disorder is real. Similarly, in psychology, scholars debate the reality of such theoretical entities as general intelligence, superegos, and personality traits. And yet in both disciplines, little thought is given to what is meant by the rather abstract philosophical concept of “real.” Indeed, certain psychiatric disorders have passed from real to imaginary (as in the case of multiple personality disorder) and from imaginary to real (as in the case of post-traumatic stress disorder). Although metaphysical terms such as “real “ and “objective” are readily invoked in psychiatry and psychology, they are often obscure, lofty abstractions. In this book, Peter Zachar argues that metaphysical concepts are important and useful conceptual tools, but should not be treated as all-purpose blunt instruments.From the perspective of a scientifically inspired pragmatism, Zachar explores the essentialist bias, diagnostic literalism, and the concepts of natural kind and social construct. He also proposes a new model for the domain of psychiatric disorders, the imperfect community model, which avoids both relativism and essentialism. He uses this model to understand such recent controversies as the elimination of the bereavement exclusion for depression and the attempt to eliminate narcissistic personality disorder from the DSM-5.