This is the eighth part of a series in which I respond to the themes developed by Thomas Kuhn in his work ‘The Structure of Scientific Revolutions’. This eighth part is a response to Chapter 7. My review of Chapter 7 can be seen in the Appendix which should clarify some of the subsequent discussion. I have interpreted the essence of this chapter as the need for crises in science. These crises occur when scientists are repeatedly faced with anomalies which cannot be explained by the central paradigm.
At the time of writing, the discover of a Higgs boson-like particle at CERN’s Large Hadron Collider has dominated the news. In a previous post I have argued that this may in fact represent part of normal science since the experimental findings have confirmed the standard model. In other words the findings fit with the guiding paradigm. However there remains the possibility that this could herald a period of revolutionary science. When the LHC is in full operation, it may generate findings which do not fit with the Standard Model and which would represent anomalies. Kuhn predicts that repeated anomalies lead to crises. These crises necessitate an alternative model or theory to explain the occurrence of these repeated anomalies. Thus if the Standard Model generates many findings which are dissonant with the Standard Model these anomalies would lead to an alternative model with a debate between proponents of the two models and perhaps a transition between these models.
Whilst the above is supposition, the revolution in science isn’t an overnight phenomenon but one which takes place over lengthy periods. The culture changes, there are debates and in the twilight years of the passing paradigm the loyal proponents fight a rearguard action. Finally the transition is complete. From this perspective we can see that exciting scientific events widely disseminated in the media and discussed at significant length might not necessarily be the revolutionary science that Kuhn talks about. Instead the dust must settle and we must look not just at the science but at the players – the scientists themselves. We must wait to see the anomalies, the generation of a competing theory, the ensuing theoretical debate between the camps. Then it becomes clear that we are seeing a revolution. Even then though we must wait to see if the new paradigm succeeds.
Kuhn suggests that historical revisionism occurs at a frenetic pace and this is nowhere better exemplified than in the textbook which has a specialised goal of educating the student of science. Historical nuances and the struggle of the moment are transformed into the clear march of progress. The old redundant theory is simply brushed aside as the bold and better new all encompassing theory is pushed to the foreground. Kuhn notes instead that science is not necessarily progressive but that the proponents of science give the illusion of progress. I am inclined to disagree with him on this point although I will discuss this at length in another post. Perhaps the proponents of science are not too dissimilar to the proponents of any other discipline. People naturally form a group identity and perhaps it is the characteristics of this group identity which drive the historic revisionism that may be seen in the textbook. Maybe this approach is even the right one for the goals of education.
With regards to Kuhn’s work I am particularly interested in how it might apply to Psychiatry. There have been several movements that have fallen under the rubric of antipsychiatry or critical psychiatry. Could it be that the antipsychiatrists or critical psychiatrists have found the anomalies which are needed for revolutionary science in Psychiatry? Here is a brief consideration of a few
1. Dr Niall McLaren in his work ‘Humanising Madness’ (see review here) suggests that there is no coherent biopsychosocial model. Whilst this is a very interesting point for debate does it relate to the anomaly that has been discussed above? I would argue that it doesn’t. McLaren’s point is about something more fundamental – the very existence of the model itself. The model is the core of the paradigm and if it is argued that there is no coherent model then there can be no anomaly. However there are models but these occur within single domains (rather than spanning the biopsychosocial domain) and it is here that we can better talk of anomalies.
2. The effectiveness of medication. From time-to-time there are published meta-analyses which purport to show that medications don’t work. There are often ripostes which criticise the methodology of these studies or other meta-analyses which show that they do work. In terms of revolutionary science there is something very distinctive about these debates because there are other areas of consideration. Kuhn does in his work briefly suggest that in terms of science there is something distinctive about Medicine. Finding that a drug might not work is not just interesting from a scientific perspective but also has clinical implications that resonate far beyond the laboratory and must be treated with sensitivity.
From the perspective of revolutionary science does an anomalous finding about the efficacy of a medication herald the beginning of a revolutionary science? There are unlikely to be repeated crises because medications are rigorously tested and it would be unusual for a whole series of trials after some time to start showing the medication doesn’t work. When this does happen for instance in the case of antibiotic resistance there is another explanation altogether. However when meta-analyses are published they can highlight possible difficulties with efficacy although a single publication isn’t the repeated crises that Kuhn talks about.
In the hypothetical example of a medication which goes from being efficacious for a condition to ineffective through empirical trials the end-results don’t necessarily tell us too much about the paradigm. If a drug works or doesn’t work there could be any number of underlying reasons which range from how the medication is metabolised through to the types of receptors that it is acting on or the regulation of those same receptors or interactions with other aspects of treatment. The anomaly in this case is not specific enough to tell us about the underlying model. Perhaps the anomaly can only arise when we investigate specific components of the model – up or down-regulation of receptors types for example. Perhaps our models of treatment have to be multifaceted and the anomalies will occur in a very small component of this model.
3. Social Constructivism. There is the argument that diagnoses are social constructs that are distinct from illness conditions but in many cases overlap. If this were correct would it be an anomaly? Again this is unlikely because elsewhere I have argued that diagnoses categories represent the application of a body of scientific knowledge. There is an involved process which leads to the construction of the diagnostic category. If an illness condition were to go from existence to non-existence I would argue that this would not be an anomaly. The transition does not necessarily lead us into a better understanding of an underlying scientific model. There may for instance be difficulties with one of the stages in the process leading to the construction of the diagnostic entity.
Maybe the dissonant finding here tells us more about process than about science. Perhaps in order to be able to find anomalies we need to ensure that there is a consistency between the epidemiological findings for an illness and the various models of pathogenesis. When such a consistency is ensured then it may be possible to start to identify anomalous findings.
The multiple layers of consideration in the biological, psychological and social domains make the task a complex one but not insurmountable. First of all there must be a revolution in the way these problems are conceptualised.
Review of Chapter 7 of ‘The Structure of Scientific Revolutions’
The 7th Chapter In Kuhn’s ‘The Structure of Scientific Revolutions’ is titled ‘Crisis and the Emergence of Scientific Theories’, in which Kuhn elaborates on the conditions which he suggests lead to scientific revolutions. He identifies several historically important scientific theories and examines the circumstances surrounding their acceptance in detail. Kuhn’s poses the question of how new theories are accepted in the place of older more well established theories. He gives the example of Newtonian mechanics and the occurrence of early advocates against an absolute model of space in favour of a relativistic model. However what is interesting is that these criticisms were apparent only for a short while before disappearing from the scientific debate. Kuhn argues that this occurred because there was no ‘crisis’ in science. In other words, the ‘normal science’ which he discussed previously was not producing consistent anomalies which would cause the scientists to question the validity of the underlying theory. As a result, there was no impetus to take this debate further until the late nineteenth century when this became relevant to the contemporary debate in physics. Kuhn uses physics to generalise to science whilst making no mention in this chapter of those branches directly relevant to the neurosciences. Nevertheless it’s interesting to note that in the neurosciences several theories do coexist which are currently relevant and which offer different perspectives on the same set of phenomenon. Kuhn’s arguments hold relevance to a winner-takes-all approach to theory building or else the neurosciences have been in a persistent state of ‘crisis’ according to his arguments. This though doesn’t seem consistent with the many practical benefits that these different theories have produced and so maybe the neurosciences represent a branch of science which merit their own philosophy of science.
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