A very draft version of a paper for a conference in Italy in a couple of weeks.
In response to the concern that criteriological psychiatric diagnosis, based on the DSM and ICD classifications, pigeon-holes patients, there have been calls for it to be augmented by an idiographic formulation. I have argued elsewhere that this is a mistake [Thornton 2008a, 2008b, 2010]. If ‘idiographic’ judgement is construed as essentially individualistic then it is in tension with the aim of such judgement also being valid. Looking back to its original proponent Wilhelm Windelband yields no clear alternative account of idiographic judgement. But in this paper I will argue that Windelband just provide a helpful clue in his remark that ‘every interest and judgement, every ascription of human value is based upon the singular and the unique... Our sense of values and all of our axiological sentiments are grounded in the uniqueness and incomparability of their object’ [Windelband 1980: 182]. This suggests a role for the idiographic not as the content of a particular kind of judgement but rather as characterising its aim. I will argue that this connects to the issue of the generalisability of small scale qualitative social science research and to the critique of ‘looking away’ in moral philosophy.
Causation, explanation, idiographic, interventionism, nomothetic, understanding,
The idea that psychiatric diagnosis or, more broadly, psychiatric formulation should include an idiographic element is explicit in publications by psychiatrists working on the WPA initiative Psychiatry for the Person. It forms part of the explicitly broad conception of diagnosis called a comprehensive model or concept of diagnosis. The Idiographic (Personalised) Diagnostic Formulation closely connects a comprehensive model with an idiographic component:
This comprehensive concept of diagnosis is implemented through the articulation of two diagnostic levels. The first is a standardised multi-axial diagnostic formulation, which describes the patient’s illness and clinical condition through standardised typologies and scales... The second is an idiographic diagnostic formulation, which complements the standardised formulation with a personalised and flexible statement. [IDGA Workgroup, WPA 2003: 55]
The role of the idiographic aspect is to complement and contrast a general approach through ‘typologies and scales’ with something personal and individual. The psychiatrist James Phillips makes this individual focus explicit: ‘In the most simple terms, a[n] idiographic formulation is an individual account’ [Phillips: 2005: 182 italics added].
But this raises the following question. If an idiographic element is to be a genuine complement to general typologies and scales, what kind of understanding of an individual does it comprise? How is it different from criteriological diagnosis, for example? Although the term ‘idiographic’ has a settled use in psychological research to refer to small scale qualitative studies, that use does not explain how an idiographic element would be a genuine complement to criteriological diagnosis in psychiatry.
Windelband and individuals
The distinction between idiographic and nomothetic forms of understanding was first introduced by Wilhelm Windelband in his rectoral address of 1894. Windelband, as a post-Kantian philosopher, was familiar with the debate about the relation of the human and natural sciences called the ‘Methodenstreit’, a debate which shaped, for example, psychiatrist and philosopher Karl Jaspers’ views of the importance of empathy for understanding psychopathology [Thornton 2007: 90-2]. That distinction is usually thought of as a distinction between explanation and understanding. Jaspers contrasts explanation in terms of causal connections with understanding of meaningful connections (and further subdividing understanding into phenomenology and empathy for example) [Jaspers 1974]. This has in turn led modern philosophers, especially those in the Wittgensteinian tradition, to characterise understanding as a form of intelligibility suited for the meaning-laden actions and utterances of rational animals hence stressing its rational and normative character that ‘finds no echo in physical theory’ [Davidson 1980: 231].
In his address, however, Windelband stresses instead that the difference between nomomethetic and idiographic, whilst still a distinction in method or form of knowledge rather than subject matter, concerns the difference between general and particular.
In their quest for knowledge of reality, the empirical sciences either seek the general in the form of the law of nature or the particular in the form of the historically defined structure. On the one hand, they are concerned with the form which invariably remains constant. On the other hand, they are concerned with the unique, immanently defined content of the real event. The former disciplines are nomological sciences. The latter disciplines are sciences of process or sciences of the event. The nomological sciences are concerned with what is invariably the case. The sciences of process are concerned with what was once the case. If I may be permitted to introduce some new technical terms, scientific thought is nomothetic in the former case and idiographic in the latter case. Should we retain the customary expressions, then it can be said that the dichotomy at stake here concerns the distinction between the natural and the historical disciplines. [Windelband 1980: 175-6]
Windelband remarks that the distinction he is attempting to frame is not based on a distinction of substances: sciences of nature or natural science [Naturwissenschaften], versus the sciences of the mind [Geisteswissenschaften]. Such a distinction is hostage to the fortunes of that dualism. If the reductionist project of explaining mental properties in physical terms were successful then that contrast would be undermined.
Even with these characterisations in play, however, the distinction as so far introduced is not clear. Consider the contrast between ‘what is invariably the case’ and ‘what was once the case’. There are three problems with using this contrast to characterise a notion of ‘idiographic’. First, it threatens to slip back from a methodological distinction of how a subject matter is approached to the underlying nature of the events in question (whether, as a matter of fact, they are invariant or unique). Second, a substantive distinction does not explain in what way an idiographic understanding differs from any other sort. Third, the uniqueness of its subject matter cannot separate the idiographic and nomothetic. The gravitational forces on a mass, for example, depend in principle on a vector sum of its relation with every other object in the universe and thus some of the events described by physics are likely to be unique.
One of the clues Windelband himself offers is to suggest that history is a paradigm of idiographic sciences which ‘provide a complete and exhaustive description of a single, more or less extensive process which is located within a unique, temporally defined domain of reality’ [Windelband 1980: 174] However, this does not explain how historical explanation differs from physics, say. Windelband’s further comments about historical judgement are unhelpful. He says:
[H]istory seeks structural forms… [Windelband 1980: 178]
[I]n the historical sciences,… [thought] is devoted to the faithful delineation of the particulars… [ibid: 178]
The historian’s task… is to breathe new life into some structure of the past in such a way that all of its concrete and distinctive features acquire an ideal actuality or contemporaneity. His task, in relation to what really happened, is similar to the task of the artist, in relation to what exists in his imagination. [ibid: 178]
But the task of ‘describing structure’ is shared by some nomothetic sciences like chemistry. ‘Delineation of particulars’ is also the common aim of both idiographic and nomothetic sciences. The physics of a particular mass concerns that individual. Talk of ‘ideal actuality’ may be uniquely appropriate for the idiographic sciences but hardly sheds light on what this amounts to.
It might be assumed that using history as a paradigm suggests a connection to the other broad way of construing the Methodenestreit mentioned above as marking a distinction between explaining natural events and understanding meaning-laden events or rational subjects. But Windelband offers an example of historical understanding that is of a merely biological process, which show that this is not what he has in mind.
Consider… the subject matter of the biological sciences as evolutionary history in which the entire sequence of terrestrial organisms is represented as a gradually formative process of descent or transformation which develops in the course of time. There is neither evidence nor even a likelihood that this same organic process has been repeated on some other planet. In this case, the science of organic nature is an idiographic or historical discipline. [Windelband 1980: 176]
In summary, although Windelband coins a distinction between idiographic and nomothetic, stresses that it is a distinction of a form of understanding rather than of types of subject matter and offers history as an example of idiographic understanding, it remains unclear what the distinction amounts to.
Elsewhere I have suggested that the appeal of idiographic judgement stems from a recoil from subsuming human individuals under conceptual categories – from pigeon-holing people – and hence instead attempting to understand them in other ways or other terms, a kind of ‘individualising intuition’ [Thornton 2008a, 2008b, 2010]. The problem is then to explain what novel form of judgement would address this task. If judgement in general takes a subject predicate form – s is P – then there are two elements to consider: the referential element and the predicational element.
The referential element does not seem to be a hopeful place to look to draw a distinction between nomothetic and idiographic. Consider the traditional deductive-nomological model of explanation as an example. This contains general laws (hence the name). But it also refers to the particular circumstances of the explanans. Whether an adequate formal model of explanation or not, since the DN model of explanation is designed to fit paradigmatically nomothetic sciences, mere singular reference to particular circumstances is not sufficient to distinguish a different form of intelligibility.
But ‘individualising’ the predicational element seems equally unpromising albeit in a different way. Such a predicate would have to be designed for a particular single element carrying with it no possible application to, and hence comparison with, other individuals. What could such a predicate be? What property would be picked out such that it could not possible apply to other cases? The closest idea seems to be a kind of name designed for specific individual (person or event). But that collapses this proposal back into the referential element of the judgement. In neither way can the ‘individualising intuition’ be satisfied through a novel form of judgement.
I suggested earlier that Windelband’s distinction between idiographic and nomothetic is a distinct variant of a broader discussion of the difference between human and natural sciences that in more familiar forms concerns understanding and explanation. Such a distinction plays a key role in the thinking of Karl Jaspers. Christophe Hoerl suggests that Jaspers contrast has both an epistemic and ontological dimension [Hoerl 2013]. Epistemically, the distinction runs as follows:
Explaining, Jaspers thinks, requires repeated experience – it is achieved by “observation of events, by experiment and the collection of numerous examples” (GP, 3 p. 302), which allow us to formulate general rules and theories. Understanding, by contrast, is achieved (if it is achieved) directly upon confrontation with a particular case. As Jaspers also puts it, “[p]sychological understanding cannot be used mechanically as a sort of generalized knowledge but a fresh, personal intuition is needed on every occasion” (GP, p. 313). We might thus say that Jaspers subscribes to a form of epistemic particularism regarding understanding. Understanding is not achieved by bringing certain facts under general laws established through repeated observation. Rather, the grasp it delivers of how one psychic event emerges from another in a particular case strikes us “as something self-evident which cannot be broken down any further” (GP, p. 303). [Hoerl 2013: 108]
Ontologically, understanding and explanation chart different aspects of reality: meaningful psychic connections and rules of causality, respectively. Hoerl points out that Jaspers suggests that the former are not causal. (In this, he resembles 1970s Wittgensteinian philosophers.) But Hoerl objects both that this makes it ‘quite obscure what genuine epistemic gain understanding could deliver’ [ibid: 109] and also that Jasper’s talk of events ‘emerging’ from others seems to be a causal notion [ibid: 110]. The difficulty here is a dilemma. If understanding is construed as non-causal then it risks epistemic obscurity. But if it is causal, it risks collapsing into explanation.
Hoerl suggests a reconciliation via the distinction between singular and general causation.
When he talks about (mere) causal explanation, what he has in mind are general causal claims linking types of events. Understanding, by contrast, is concerned with singular causation in the psychological domain – i.e. with the particular way in which one psychic event emerges from or arises out of another on a particular occasion. [ibid: 111]
This suggestion raises a question, however. Given that since Hume, a dominant approach to causation has stressed a connection between causal relations and constant conjunctions, what account of singular causal relations can be given?
Following John Campbell, Hoerl suggests that an interventionist approach fits the bill. Campbell’s discussion of interventionism within psychology and psychiatry starts by rejecting two connections which philosophers find natural: between non-mental causal connections and mechanisms and between mental causal connections and rational relations.
Campbell suggests that:
there is an analogy between:
1 the idea that propositional attitude ascriptions depend on the ascription of rationality to the subject, and
2 the idea that all causal interactions between pieces of matter must be comprehensible in mechanistic terms.
Both ideas express an insight – that we find it extremely puzzling when we encounter causal relations among propositional attitudes that are not broadly rational, just as we find it extremely puzzling when we encounter causal interactions between physical objects that are not mechanistic, and that involve spooky ‘action-at-a-distance’. Both ideas express a natural impulse of philosophers – to elevate this kind of point into a kind of synthetic a priori demand that reason makes on the world. This impulse has to be resisted. [Campbell 2009: 142]
Campbell suggests that, in both cases, there is a genuine insight. As a matter of custom and habit, we find an absence of material mechanisms and an absence of rational connections between mental states puzzling. But in both cases it is a characteristic philosophical error to promote this natural expectation into a justified a priori claim that the world must respect. Mere custom and habit cannot rationally sustain any such demand on how the world must be.
Campbell rejects the necessity of both physical mechanisms and rational connections in favour of an interventionist approach to causation. With respect to the latter, he argues:
Suppose you believe:
1 that this man is stroking his chin, and
2 that this man believes you need to shave.
What is it for the first belief to be a cause of the second? On the interventionist analysis, it is for the intervention on the first belief to be a way of changing whether you have the second belief. So if some external force changed your belief that this man is stroking his chin, you would no longer believe that he believes you need to shave. There is no appeal to rationality here, no appeals to mechanism. [Campbell 2009: 143]
The causal connection between one state and another is underpinned in interventionist terms based on the idea that if intervening on the first belief is a stable way of bringing about a change in the second then this is sufficient for there to be a causal connection between them.
For propositional attitudes to count as causes of other propositional attitudes such as delusions, Campbell suggests two conditions have to be met. There should be ‘systematic relations between cause variables and the subsequent delusion’ and there should be a correlation between a change of the cause and a change of the effect [Campbell 2009: 146]. More generally for the causal explanation of mental states, the causal variables, which he calls ‘control variables’, should have large, specific and systematic correlations with their effects akin to the way the controls of a car systematically control its behaviour. These conditions do not require a rational connection, however.
The classical philosophical approach has been to regard propositional attitudes as part of a ‘conceptual scheme’ that we bring to bear in describing the ordinary world. This conceptual scheme is taken to have strong a priori constraints on its applicability. In particular, as we have seen, rationality is taken to be a norm with which the scheme has to comply... The appeal I have just been making to the notion of a control variable is intended to replace this invocation of rationality... [I]t is the fact that we have control variables, not the fact that we have rationality, which means that we are ‘at the right level’ to talk of beliefs and desires. [Campbell 2009: 147]
Taken together, Hoerl’s and Campbell’s accounts suggest a recipe for idiographic judgement. Hoerl suggests that understanding charts singular psychological causal relations and that singular causal relations can be construed on interventionist terms. Campbell argues, also on interventionist grounds, that the assumption that causal connections between psychological states must presuppose rational relations between them is mistaken. The combination suggests an austere view which is not tied to the psychological realm. Hence the possibility that this might offer substance to Windelband’s emphasis on the particular rather than the meaningful. Perhaps idiographic judgement trades in singular causal relations shorn of rational relations?
I do not think that this will work, however. Consider Campbell’s example of the deluded man who thinks that someone else believes he needs to shave in virtue of the fact that that other person is stroking their chin. Campbell suggests that this can be given an interventionist account without presupposing rationality. But in doing this, Campbell simply assumes the correct interpretation of the two beliefs of the deluded person. Whence this interpretation? It does not seem to be a matter of brute causation. If it is not, then Campbell’s claim that articulating the causal connections does not require rationality is misleading. Identifying the causal connections may not but identifying the mental states themselves may do.
What of non-mental cases such as Windelband’s example of merely biological evolutionary event where there is ‘neither evidence nor even a likelihood that this same organic process has been repeated’? The problem in such cases is that mere non-repeatability of subject matter is not sufficient to ensure its study is not nomothetic. It seems for example an empirical question whether the Big Bang was a one off event or whether a collapsing universe will, in the future, lead to a repetition of an event of that general kind. Hence whether the physics and cosmology of the early universe – which is continuous with physics in general – counts as nomothetic or idiographic in this sense is an open empirical question. But such a view of idiographic will not serve the purpose set for it by the felt need not to pigeon hole individuals.
In summary, the idea in this section was the following. It might be possible to spell out a notion of idiographic judgement by looking at one version of the related distinction within the Methodenstreit between understanding and explanation. According to Hoerl’s interpretation of Jaspers, understanding concerns singular causation in the psychological domain. Such causation is, on one model at least, underpinned by the idea of intervention rather than nomological generality. Further, according to Campbell, even in the psychological domain, such singular causation need not trade in rational relations. At this point in the combination of ideas, the analysis offered may no longer be an account of Jasperian understanding but seems, partly for that very reason, to be a promising match for Windelband’s emphasis on particularity within and without the mental realm. (That is why idiographic judgement is not simply the same as understanding.) However, moving away from the connection between understanding and rationalisation also undermines the substance of the potential account of idiographic judgement that remains. Had an antecedent variable been changed then a consequent effect would also have changed. But such reasoning cannot be based on laws of nature at risk of collapsing back onto the nomological and cannot be based on rational relations without collapsing back into a narrower version of understanding.
Values and the singular aims of idiographic inquiry
So far I have suggested that two broad approaches to filling out Windelband’s account of idiographic understanding have failed. Attempting to articulate a form of judgement that eschews implicit comparison between individuals undermines the content of the putative judgements. Stressing singular rather than general causation either assimilates the idiographic to rational understanding – with its own distinctive form of generality – or does not sufficiently distance it from nomothetic judgement.
In this final section I will sketch a different approach. The clue comes from another passage in Windelband’s rectoral address in which he again stresses the importance of the contrast between the general and specific to his distinction of nomothetic and idiographic.
[T]his distinction connects with the most important and crucial relationship in the human understanding, the relationship which Socrates recognized as the fundamental nexus of all scientific thought: the relationship of the general to the particular. [Windelband 1980: 175]
The commitment to the generic is a bias of Greek thought, perpetuated from the Eleatics to Plato, who found not only real being but also real knowledge only in the general. From Plato this view passed to our day. Schopenhauer makes himself a spokesman for this prejudice when he denies history the value of a genuine science because its exclusive concern is always with grasping the specific, never with comprehending the general... But the more we strive for knowledge of the concept and the law, the more we are obliged to pass over, forget, and abandon the singular fact as such… [ibid: 181]
So far these passages repeat the importance of the singular over the general that has already been discussed. But in explaining why this is important, Windelband introduces a further element:
In opposition to this standpoint, it is necessary to insist upon the following: every interest and judgment, every ascription of human value is based upon the singular and the unique... Our sense of values and all of our axiological sentiments are grounded in the uniqueness and incomparability of their object. [Windelband 1980: 182]
Now in one respect this does not help since it merely stresses the the uniqueness and incomparability of the objects of idiographic judgement and, as the discussion above has suggested, this does not help single out a form of judgement or intelligibility to stand in opposition to the nomothetic. But there is a further idea: that what we as subjects value in judgement and sentiment is tied to uniqueness and incomparability.
This is a contentious claim and it is far from obvious that it is true. The Categorical Imperative implies, to the contrary, that love of the good has an essential generality. More mundanely, one might value a piece of industrial design – a car, bicycle or cutlery – despite its mass production. But there are some cases where value seems to be tied to uniqueness: feelings of love and friendship directed to particular individuals – by contrast with a generalized love of humanity – being paradigmatic.
This suggests a different way of thinking about idiographic not as a novel form of judgement or intelligibility but rather as pertaining to the nature of interest taken in its subject matter. In some cases, one is interested in individuals because they are instances of generalities. In others, the interest is in them as individuals.
Here is a mundane example of the contrast. In 2009, UK members of parliament (MPs) were found to have taken part in widespread abuse of their expenses system to augment their incomes. UK newspapers investigated many such cases and every day printed new instances of the absurd financial claims made. But the focus seemed to be to use each new instance to justify the general claim that MPs as a whole were a corrupt group rather than having an interest in any previously obscure MP. The reputation of politicians as a class of people was the target. By contrast, in 1997 Diana, Princess of Wales, died in a car crash provoking much newspaper coverage. One particular newspaper – the Daily Express – continued, for a decade afterwards (!), to favour for its front cover any story about the late princess. But the claims advanced were not intended to shed light on royalty, or even princesses, in general. Rather the focus was relentlessly on Diana herself. The interest was, in the sense I have suggested, idiographic.
One consequence of moving the conception of idiographic from a form of intelligibility to the nature of the interest taken in individuals is that it places no constraints on the kind of intelligibility in play. Materials from either side of the traditional explanation versus understanding distinction, for example, could be deployed for idiographic purposes. No attempt need be made to frame descriptions that could only fit one individual.
Given this, however, it may seem that the contrast between idiographic and nomothetic as proposed does not amount to very much. What does it matter with what interest or value the subject matter of idiographic inquiry is approached if the actual judgements offered are as they would be in nomothetic inquiry?
In response to this question I will finish with two general consequences. The first is that idiographic inquiry – so understood – can simply escape one of the conceptual challenges of small scale qualitative social science research. This is the question of whether and how the results can be generalised. By contrast with large scale often quantitative research, a narrow deep focus may not be based on a statistically significant sample and hence may not reliably generalise to other individuals or populations. But if not, what is the point of the inquiry? Idiographic inquiry, however, can bit on this bullet because has no interest in other individuals or populations. Like the Daily Express’s interest in Diana, its focus is on the particular for the sake of the particular.
The second is that idiographic inquiry is naturally resistant to a source of error that Jonathan Dancy calls ‘looking away’ [Dancy 1993]. This is a virtue he claims for particularism over generalism in moral philosophy. Generalism claims that moral judgements can be codified in context-independent principles. Particularism opposes this and insists that small differences in a particular situation can reverse their moral valence. Hence Dancy argues from his particularist commitments for the importance of scrutinising particular situations with great care rather than being distracted by a premature comparison of that situation with others.
Particularism claims that generalism is the cause of many bad moral decisions, made in the ill-judged and unnecessary attempt to fit what we are to say here to what we have said on another occasion. We all know the sort of person who refuses to make the decision here that the facts are obviously calling for, because he cannot see how to make that decision consistent with one he made on a quite different occasion. We also know the person (often the same person) who insists on a patently unjust decision here because of having made a similar decision in a different case. It is this sort of looking away that the particularists see as the danger in generalism. Reasons function in new ways on new occasions, and if we don’t recognize this fact and adapt our practice to it, we will make bad decisions. Generalism encourages a tendency not to look hard enough at the details of the case before one. [Dancy 1993: 64]
Although the motivation differs, idiographic inquiry ‘sees’ its subject matter not primarily as interesting because it instances generalities but interesting for being the particular individual it is. And hence, whilst any subject matter will instance generalities – and such is the content of the any judgement made about it – the focus is bottom up: from individual to general characteristics rather than top-down from generalities to instances.
Recent calls for psychiatry to augment criteriological diagnosis with a more individualistic element have glossed this as an idiographic element. But this prompts the question of what the idiographic could amount to. Windelband’s various characterisations do not yield a distinct account of a form of judgement to contrast with nomothetic judgement. Nor is the use of singular causation an appropriate fit for this purpose.
Instead, Windelband’s suggestion that there is a connection between a focus on individuals rather than generalities and what is of value suggests a distinct response. On this suggestion, idiographic inquiry does not have a different form of intelligibility of its subject matter but rather has a particular kind of interest in it. It is an interest in the individual as such. This helps sidestep a worry about how to generalise small scale qualitative research and to avoid an epistemic bias of ‘looking away’: prematurely looking away from the individual to generalities. It is in such differences rather than the form of judgement taken that the difference between idiographic and nomothetic lies.
Campbell, J. (2009) ‘What does rationality have to do with psychological causation? Propositional attitudes as mechanisms and as control variables’ in Bortolotti, L. and Broome, M. (eds) Psychiatry as Cognitive Neuroscience, Oxford: Oxford University Press, 137-150
Dancy, J. (1993) Moral reasons, Oxford: Blackwell
Davidson, D. (1980) Essays on Actions and Events, Oxford: Oxford University Press
Hoerl, C. (2013) ‘Jaspers on explaining and understanding in psychiatry’ in Fuchs, T. and Stanghellini, G. (eds.) One Century of Karl Jaspers’ General Psychopathology, Oxford: Oxford University Press
IDGA Workgroup, WPA (2003) ‘IGDA 8: Idiographic (personalised) diagnostic formulation’ British Journal of Psychiatry, 18 (suppl 45): 55-7
Jaspers, K. ( 1974) ‘Causal and “Meaningful” Connections between Life History and Psychosis’, trans. by J.Hoenig, in S.R.Hirsch and M.Shepherd. in Hirsch, S.R., and M. Shepherd, Themes and Variations in European Psychiatry, Bristol: Wright: 80-93
Phillips, J. (2005) ‘Idiographic Formulations, Symbols, Narratives, Context and Meaning’ Psychopathology 38: 180-184
Thornton, T. (2007) Essential Philosophy of Psychiatry Oxford: Oxford University Press
Thornton, T. (2008a) ‘Does understanding individuals require idiographic judgement?’ European Archives of Psychiatry and Clinical Neuroscience 258 Suppl 5:104–109
Thornton, T. (2008b) ‘Should comprehensive diagnosis include idiographic understanding?’ Medicine, Healthcare and Philosophy 11: 293-302
Thornton, T. (2010) ‘Narrative rather than idiographic approaches as counterpart to the nomothetic approach to assessment’ Psychopathology 16: 284-291