Anorexia Nervosa as Irreducibly Normative: A Dilemma Posed for Dominic Murphy’s Two- Stage Picture of Psychiatry

In Psychiatry in the Scientific Image, philosopher Dominic Murphy proposes a two-stage picture of psychiatry with mental disorders conceptualized as an underlying malfunction of a cognitive mechanism, followed by a judgement of the harmful effects this malfunction can have. Murphy himself raises a dilemma to this mechanistic reductionism, in that there are several mental disorders which seem to be irreducibly normative, and that the disorders must make normative assumptions of rationality in order to be fully understood. In this paper, I take up this obstacle to the two-stage picture by arguing that the three key aspects of anorexia nervosa — its triggers, aims, and the sustaining behaviors — render it irreducibly normative under Murphy’s model. I contend that the first two components of triggers and aims cannot be reduced down to a psychological malfunction of rationality in light of evidence that their causal phenomenology is largely culturally-based and deemed rationally oriented towards human flourishing. I then analyze potential underlying biological and physiological factors of the disorder’s self-starvation behaviors to assess whether this is enough to reduce anorexia down to a mechanistic explanation. I conclude that normativity needs to be assessed for a complete conception of the disorder, such that it cannot be reduced down to a non-normative malfunctioning mechanism of rationality.