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Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius
Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 Hardback); 0±470±84647±X Electronic)
CHAPTER
6
The Role of Phenomenology in
Psychiatric Diagnosis and
Classification
Josef Parnas 1 and Dan Zahavi 2
1 Department of Psychiatry, Hvidovre Hospital, Hvidovre, Denmark
2 Danish Institute for Advanced Studies in the Humanities, Copenhagen, Denmark
INTRODUCTION
As with most classifications, psychiatric classification has essentially a pragmatic
purpose, that is to delimit entities useful for the choice of treatment,
prevention and prediction of outcome. Moreover, classifications create important
constraints for aetiological and pathogenetic research, because they
dictate, more or less explicitly and authoritatively, the boundaries of what is
declared as relevant fields of research. According to the medical model,
psychiatric classification should be ultimately based on aetiological knowledge,
and any other approach, be it symptomatic, syndromatic or even more
complexly descriptive like the multiaxial) is considered as provisional.
Validity of psychiatric diagnosis is considered as a problem of matching
clinical entities with ``real'' processes of nature [1]. In the case of most
psychiatric disorders, however, hoping for a segmentation of ``real'' processes
of nature into neat ``real kind'' categories is perhaps overoptimistic or
even expressive of a certain epistemological naõÈveteÂ. In any case, the majority
of current diagnostic categories are based on typologies of human experience and
behavior, and in all likelihood this state of affairs will continue to prevail in a
foreseeable future. Therefore, a search for a faithful description of experience
must be considered as a necessary first step in any taxonomic effort, including
attempts of reducing abnormal experience to its potential biological
substrate. This prerequisite, articulated in psychopathology by Karl Jaspers
in 1923 [2], has been more recently expressed by Thomas Nagel [3] in the
context of consciousness research: ``a necessary requirement for any coherent
reductionism is that the entity to be reduced is properly understood''. But the
Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and
Norman Sartorius. # 2002 John Wiley & Sons, Ltd.