Those of us interested in the relationship between psychiatry and philosophy have been blessed in recent years by an out-pouring of relevant articles and books. This work, by the British philosopher Rachel Cooper, is a noteworthy and high-quality contribution to this literature. As indicated by the title, this book has an agenda. For the philosopher-author, it is to use psychiatry as a field to illustrate and explore key issues in the philosophy of science. Cooper focused on four major themes, which are best summarized in her own words from her conclusion:

After an introduction, Cooper spends two chapters exploring the nature of mental illness. In a cogent writing style, she reviews the main positions swirling around this issue (e.g. Szasz, Laing, Foucault, Boorse, Wakefield, etc.). Her generally sensible conclusion is that mental illness is not a myth and while no ‘air-tight’ single definition of mental illness is yet available, or even on the horizon, some consensus on key points is emerging. While values are likely to be a part of any such definition, that does not, she suggests, mean that science cannot progress or make important contributions.

Her next two chapters, which are somewhat more novel in context, examine the nature of explanation in psychiatry. Cooper contrasts what she terms a ‘natural history’ style of explanation with a ‘case history’ approach. (She views a natural history approach in science to be that taken by descriptive rather than experimental disciplines such as field biology or geology.) There are shades here of Jaspers' famous distinction between ‘explanation’ and ‘understanding’ but her approach is not entirely equivalent. In Cooper's discussion of the natural history approach, she raises at some length, again in an even-handed way, the question of whether psychiatric disorders are close enough to ‘natural kinds’ for the natural history approach to work. She concludes that at least some disorders are close enough to her definition of natural kinds (a rather broad one, I might note) for the natural history approach to work.

In the next section of the book, also two chapters, she examines the ‘relations between theories’ in psychiatry. Again, this is rather novel material and ought to be of wide interest. She makes the cogent point that as practiced in the clinic, psychiatry (and more broadly the field of mental health) has a wide number of schools and theories which compete for influence. Cooper concludes that psychiatry is perhaps the best available example of a ‘multi-paradigm science’. In a particularly interesting section, she convincingly shows that Kuhn's idea that different scientific paradigms cannot effectively communicate with each other is probably false for psychiatry.

The final section of the book, a bit more conventional in content, examines how values and interests impact on our field. This section contains a pointed discussion about the possible implications of the systematic biases in the RCT literature induced by pharmaceutical companies trying to spin the data to put their produce in a maximally beneficial light.

The only appreciable systemic weakness of this work is that the author – an academic philosopher – is not always optimally conversant with psychiatric concepts and terms. Cooper's lack of clinical experience shows through now and again as a naïveté about psychiatric problems. But generally these are minor concerns as she certainly has done hard work to read a wide range of psychiatrically relevant literature.

This is quite a good book and should be widely read. It is brief and clearly written with a low level of technical philosophical jargon. More to the point, it is generally quite sensible – not a characteristic of all philosophical writings. This book shows the relevance of ‘good sense’ analytic philosophy to psychiatric research and practice. It would make an excellent and thought-provoking introduction to those interested in exploring the fruitful interface between psychiatry and the philosophy of science.