Ongaro, Giulio (2024) Outline for an Externalist Psychiatry (3): Social Etiology and the Tension Between Constraints and the Possibilities of Construction. Philosophy, Psychiatry, & Psychology, 31 (3). pp. 301-314.

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Abstract

Any progress in shaping up an externalist psychiatry, so previous discussion suggested, must begin from questions about the ontology of social causation. So far, research and theory have adhered to a naturalistic approach to the social causes of illness, concentrating mostly on the ‘social determinants of mental health’ (inequality, discrimination, housing insecurity, etc.). The paper starts with an assessment of ‘social determinants’ through the lens of epidemiology and critical psychiatry. It illustrates existing practical and political approaches that fight these constraints and it highlights their therapeutic value. It argues, though, that a focus on social determinants is not sufficient for fully realizing externalism because a great portion of sociogenic illness remains causally indeterminate. Alongside political action, externalism requires a social etiology that is established by virtue of the meaning that it holds for patients, rather than by virtue of its capacity to identify objective social causes of illness. This entails abandoning naturalism about social causation and embracing constructivism. The paper shows that this methodological shift is less contradictory and more effective than it is commonly imagined. Drawing from further anthropological evidence, it concludes that only by lending support to projects that balance a focus on constraints with social construction will psychiatry be truly externalist. At stake is a prospect of effective treatment for sociogenic illness for the countless in struggle.

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Item Type:	Published Article or Volume
Creators:	Creators Email ORCID Ongaro, Giulio hmongaro@ust.hk 0000-0003-2782-0642
Keywords:	Social ontology; social determinants of mental health; naturalism; social construction; social aetiology; externalist psychiatry
Subjects:	Specific Sciences > Anthropology General Issues > Causation Specific Sciences > Medicine > Psychiatry
Depositing User:	Dr. Giulio Ongaro
Date Deposited:	27 Sep 2024 11:54
Last Modified:	27 Sep 2024 11:54
Item ID:	23960
Journal or Publication Title:	Philosophy, Psychiatry, & Psychology
Official URL:	https://muse.jhu.edu/pub/1/article/937774
DOI or Unique Handle:	https://doi.org/10.1353/ppp.2024.a937774
Subjects:	Specific Sciences > Anthropology General Issues > Causation Specific Sciences > Medicine > Psychiatry
Date:	25 January 2024
Page Range:	pp. 301-314
Volume:	31
Number:	3
URI:	https://philsci-archive.pitt.edu/id/eprint/23960

Available Versions of this Item

• Outline for an externalist psychiatry (3): social aetiology and the tension between constraints and the possibilities of construction. (deposited 28 Jan 2024 11:17)
  • Outline for an Externalist Psychiatry (3): Social Etiology and the Tension Between Constraints and the Possibilities of Construction. (deposited 25 Sep 2024 11:48)
    • Outline for an Externalist Psychiatry (3): Social Etiology and the Tension Between Constraints and the Possibilities of Construction. (deposited 27 Sep 2024 11:54) [Currently Displayed]

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