The question of certainty and the issue of epistemology in psychiatry as a scientific discipline

Abstract

The purpose of this essay is to make a case for the adoption of reasonable ideas and conclusions arrived at through reasoning; in addition to those arrived at through the popular empirical methods in psychiatry. There are a lot in psychology and psychiatry that cannot be objectively demonstrated or explained on the basis of experimentation. It is a known fact that some patients achieve spontaneous symptom remission; others improve with placebo. If for instance a wrong diagnosis is made to the effect that a patient is suffering from a malignant condition when she is not, the chances are that such a patient may die much earlier than she would otherwise have done if the diagnosis had never been made. It is not the actual existence of an object or event that elicits the emotions and effects associated with that object or event. Irrespective of the method through which knowledge is acquired, for most conclusions or estimates that we arrive at, there is a probability that we are wrong. We therefore do not need an over- reliance on empirical methods (though they have their benefits). Our literature in the Medical Sciences is replete with studies that follow a rigid, formalized and structured pattern of objectives, methods, results, discussion and conclusion. This method of contributing to knowledge often makes people blind to the fact that we can contribute to knowledge through individual reasoning. In epistemological considerations in psychiatry as in many other disciplines, reasoning is a very important tool. We must work from first principle.

Keywords: Epistemology; psychiatry; research; reasoning; science; first principle