A Metaphysics of Psychopathology

From Philosophical Psychopathology

A Metaphysics of Psychopathology

By Peter Zachar

An exploration of what it means to think about psychiatric disorders as “real,” “true,” and “objective” and the implications for classification and diagnosis.





An exploration of what it means to think about psychiatric disorders as “real,” “true,” and “objective” and the implications for classification and diagnosis.

In psychiatry, few question 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). In this book, Peter Zachar considers such terms as “real” and “reality”—invoked in psychiatry but often obscure and remote from their instances—as abstract philosophical concepts. He then examines the implications of his approach for psychiatric classification and psychopathology.

Proposing what he calls a scientifically inspired pragmatism, Zachar considers such topics as the essentialist bias, diagnostic literalism, and the concepts of natural kind and social construct. Turning explicitly to psychiatric topics, he 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 attempt to eliminate narcissistic personality disorder from the DSM-5. Returning to such concepts as real, true, and objective, Zachar argues that not only should we use these metaphysical concepts to think philosophically about other concepts, we should think philosophically about them.


$45.00 X ISBN: 9780262027045 288 pp. | 6 in x 9 in 7 line drawings


  • The Metaphysics of Psychopathology is undoubtedly a rich, stimulating, and wide-ranging book that constitutes a welcome addition to the burgeoning literature on the philosophy of psychiatry.

    The Philosophical Quarterly

  • The author is equally at home with clinical practice and philosophical analysis, and the book will be of interest to clinicians; philosophers of science; science, technology, and society (STS) scholars; and historians of science and medicine. Clinicians, whether seasoned or in training, will find the coverage intellectually engaging. Those with minimal background in philosophy may find it challenging. Yet, the writing is clear and the abstractions fleshed out with familiar examples to aid accessibility.

    Lisa M. Osbeck



  • Erudite yet engaging, philosophically sophisticated yet clinically relevant, A Metaphysics of Psychopathology is an ideal guide for navigating the turbulent waters engulfing DSM-5. Peter Zachar provides a voice of sanity amidst the strident polemics marring the debate over the latest edition of psychiatry's bible and its often controversial diagnoses. He is surely one of the most thoughtful clinicians writing about the meaning of mental illness today.

    Richard J. McNally

    Professor and Director of Clinical Training, Department of Psychology, Harvard University, and author of What Is Mental Illness?

  • This is an extraordinarily rich book based on wide-ranging and detailed interdisciplinary scholarship. It brings debate over the metaphysics of mental illness several steps forward, even for those may wish to challenge it. And it will enable other scholars to build on its insights.

    George Graham

    Professor of Philosophy, Georgia State University

  • A Metaphysics of Psychopathology is a very valuable book. Zachar is a sophisticated philosophical thinker with a gift for writing clearly. His discussion of what it means to say that something is a real mental disorder supplies one of the best, and most sensible, available answers to this important question.

    Rachel Cooper

    author of Psychiatry and Philosophy of Science and Diagnosing the Diagnostic and Statistical Manual of Mental Disorders

  • By bridging across tenets of analytical philosophy, psychopathology, and the current DSM nomenclature of mental disorders, Zachar examines critically the implicit conceptual underpinnings of selected constructs such as depression and personality disorders. The clarity of argumentation and the richness of detail in this scholarly volume make a captivating reading not only for professionals but for anyone interested in the history of ideas in psychiatry and clinical psychology.

    Assen Jablensky

    Winthrop Professor of Psychiatry, The University of Western Australia


  • Honorable Mention, 2014 American Publishers Award for Professional and Scholarly Excellence (PROSE Award) in Psychology, presented by the Professional and Scholarly Publishing Division of the Association of American Publishers