Problems of living meaningfully in psychiatry and philosophy.

Abstract

Dan J. Stein’s editorial on philosophy and psychiatry notes his recent publication titled Problems of Living. This a Big Book. I do not particularly mean in terms of length, for the book runs to about 300 pages. I have three other things in mind. One is that Stein’s book addresses some of the most important and difficult questions about the nature of human life and how to live it, among which are: What can we know about human nature and our environment? What is a mind? What is suffering? What is the difference between right and wrong? What makes a life meaningful? A second is that the book answers these kinds of questions from a bird’s eye view, in the first instance considering theoretical answers to them and in the fields of both philosophy and psychiatry (while also addressing some specific, concrete matters). As Stein plausibly suggests in his editorial, combining insights from these two fields is likely not only to enrich our scholarly understanding of psychiatry, but also to help psychiatrists and their patients grapple with practical quandaries. A third is that in discussing theories of the human condition, the book invokes an amazingly wide array of literature, to the point of citing nearly 2,000 works. (Many are in footnotes, which one need not read to grasp the major points.) To obtain focus, in the rest of this critical notice I explore Stein’s discussion of life’s meaning, particularly as it pertains to philosophy, one of this reader’s areas of expertise. Stein describes his approach to meaning in life as ‘‘integrative,’’ like his approach to all the other major questions he addresses. An integrative position is one that is in between two extremes, taking kernels of truth from each and combining them in a plausible way. In the context of life’s meaning, one integrative approach is to advance a hybrid account of what confers meaning on life, in contrast to a subjective or objective account. A subjective view is that meaning consists of whatever an individual is attracted to, whereas an objective view is that there is a proper way to live, regardless of the individual’s subjective orientation. A hybrid view is that meaningfulness consists of living in the objectively proper way, while also being subjectively attracted to doing so. For another example of an integrative approach to life’s meaning, Stein advances pluralism in contrast to both monism and relativism. A monist view is that there is a single kind of life that is meaningful (or at least most meaningful, on which consider Aristotle’s prizing of philosophy), whereas relativism is the view that any kind of life is meaningful, so long as it is believed to be. A pluralist view is that there are many kinds of life that are meaningful and that cannot be reduced to a single property. Here is a third illustration of integration. On the one hand, there is the view that we can in principle quantify how much meaning would come from a given action compared to others, say, by adding up the final value of their consequences. On the other hand, there is the view that it is, if not nonsensical, then at least pointless to think of measuring how much meaning there is in an action (let alone a life), perhaps because meaning is ineffable or incommensurable. In between, there is the moderate position that, although we cannot specify with cardinal numbers how meaningful an action is, we can know that some actions are more meaningful than others, such that we can make progress. These examples should give the reader a good idea of Stein’s broader project, which this reader finds quite sensible. For all the major topics, he routinely contrasts a more hard-nosed, narrow, scientistic, or objectivist approach (often called ‘‘classical’’) with a softer, lax, interpretive, or subjective approach (‘‘critical’’), where his own view is in between. Often ‘‘realism’’ is an apt description of Stein’s middle ground. That involves presuming there are objective facts of the matter about meaning and other enquiries, but that there are a variety of ways of apprehending those facts that socially contingent beliefs and practices sometimes facilitate and sometimes frustrate. For philosophers already sympathetic to an integrative or realist approach, there are details that get glossed over in Problems of Living, but that are naturally of interest. For a first example, suppose one accepts the hybrid approach to what makes a life meaningful. Is being attracted to what one is doing a necessary condition for it to be meaningful, or is it merely a contributory condition? For instance, if a nurse is not drawn to cleaning out patients’ bedpans, but does it anyway, does no meaning accrue at all to her life