Greetings to all SOPH members and welcome all to our April newsletter.

In this newsletter we have highlighted the activities of our Section at the upcoming RANZCP Congress. We also invite you to our Section Congress dinner with an excellent speaker. Then read on for a most insightful book review. And if you reach the end, you will find our reflection on a piece of art.

We would also like acknowledge the recent resignation of our Chair, Associate Professor Robert Kaplan and thank him for his significant contributions and guiding of the Section to its current achievements which has been enormous. Rob has also been an active writer and contributor to the historical background and history of the College. We truly thank him.

With regards,

Dr Susan Lutton, Member, WA Representative
Editor

RANZCP CONGRESS 2025

We are delighted to announce that our Section is featuring strongly in the 2025 RANZCP Congress on Tuesday 6 May 2025.

We are offering the following symposium with three outstanding speakers:

Consciousness, ethics and creativity - Expanding the boundaries of modern psychiatry
Chair Dr Andrew Howie

This symposium addresses critical themes at the intersection of psychiatry, philosophy, ethics, and the arts, including the emergence of consciousness in infancy, the challenges in protecting trans and gender-diverse individuals from conversion practices, and the integration of arts into mental health care. Each topic reflects growing frontiers in the psychiatric field, demanding a reconsideration of current practices and ethical frameworks.

When does consciousness start?
Professor Timothy Bayne: Professor of Philosophy at Monash University

Consciousness remains a deeply debated subject, particularly in infants. Some theories propose a "late onset," requiring cognitive capacities that develop well after birth. Other theories suggest that consciousness arises much earlier, possibly before birth. The difficulty lies in the challenges of studying infant consciousness without verbal communication or intentional behaviour.

This presentation will examine philosophical and empirical approaches to determining when consciousness begins in human development.

Protecting Trans and Gender Diverse People from Conversion Practices
Dr Nicole Vincent: Senior Lecturer in the Transdisciplinary School, and Deputy Chair of the Health and Medical Research Ethics Committee, University of Technology Sydney (UTS).

In March 2025, Australia's "Conversion Practices Ban Bill" will come into effect. While aimed at protecting trans and gender-diverse (TGD) individuals, the bill paradoxically leaves them more vulnerable, as it exempts registered health practitioners from legal repercussions. This presentation is a discussion of these controversies and its implication for psychiatrists.

 The Relationship Between Art, Psychiatry, and Health: What the Evidence Tells Us
Dr Jennifer Harrison: a contemporary Australian poet and child psychiatrist. She is The Dax Poetry Collection Manager for the Dax Centre at the University of Melbourne and is the Chair of the WPA Section for Art and Psychiatry

The World Health Organisation’s 2019 report revealed substantial evidence that the arts have positive effects on mental health. Dr Harrison integrates this evidence with her own work in art and psychiatry, emphasising the role of creative expression in healing. She will discuss how arts-based interventions improve various mental health outcomes, offering valuable tools for psychiatric practice.

This symposium urges the psychiatric community to engage with innovative interdisciplinary approaches that expand the understanding of consciousness, improve protections for marginalized groups, and embrace creative therapies for holistic mental health care.

SOPH CONGRESS SECTION DINNER
Tuesday 6 May

You are warmly invited to the Section of Philosophy & Humanities in Psychiatry Networking Dinner during Congress week—a special evening of conversation, connection, and creativity.

Section, non-section members and partners all welcome.

📅 Date and Time: Tuesday 6 May 2025 at 7.30 pm
📍 Venue: Sofia’s Restaurant & Bar
The Oasis, Shop G0.53, Victoria Avenue, Broadbeach QLD 4218
💵 Price: $140 (includes two-course set menu and two-hour drinks package)
🔔 RSVP: Payment required by COB 1 May 2025. Please book early as places are limited.

Dr Jennifer Harrison, Psychiatrist and award-winning international poet, will share her personal insights as our dinner speaker.

               On Being a Psychiatrist and Poet: The Creative Process.

For further information or to advise of dietary requirements, please contact:
Dr Trevor Ma – 📧 drtrevorma@gmail.com

We look forward to an inspiring evening with colleagues and friends!

RELATED TOPICS OF INTEREST AT CONGRESS    

We would also draw your attention to other stimulating presentations in Congress related to the values of our Section.

Sunday 4 May: Workshop: The challenge of human rights on the profession of psychiatry by Neeraj Gill.

Monday 5 May: Current controversies in human rights and psychiatry by Neeraj Gill, Michael Evans, Calina Ouliaris, Melissa Castan, Suresh Sundram.

Tuesday 6 May:

Identifying reasons behind the increase in Involuntary psychiatric treatment in Queensland by Neeraj Gill, Andrew Wilson, Irene Clelland, Daniel Houghton, Jappan Sawhney.

Ethics in action: Launching the 2025 Code of Ethics and exploring opportunities in practice by Richard Harvey, Izaak Lim.

Wednesday 7 May:

Lights, cameras, page and stage: Representation of mental illness in the arts by Lieu-Chi Nguyen.

Stoicism in the 21^st century by Stephen Duffy.

College Citation recipient – Reflections from Ms De Backman-Hoyle De Backman-Hoyle

Can relational ethics help to reverse the erosion of our professional behaviours towards each other? by Sue Mackersey

Wherefore art thou? Art and design in psychiatry by Yoshi Bandara, Thomas Sellitto, Anusha Jayasekera, Eishitha Bandara.

Thursday 8 May: Moral distress in psychiatry by Trevor Ma

BOOK REVIEW

Towards a Humane Psychiatry? A Review of Niall McLaren’s Theories in Psychiatry: Towards a Post-Positivist Psychiatry
 Reviewed by Andrew Howie

Introduction

For readers of Niall McLaren's Substack (McLaren, 2025) or his burgeoning bibliography, this is a much-anticipated book. For those unfamiliar with his work, it is my pleasure to introduce him as a member of a vanishingly small group: a practising psychiatrist and recognised philosopher, who is also an accomplished and prolific essayist and blogger. McLaren is smart, eclectic, distinctive, and incisive. He is also funny. I often found myself laughing out loud at his caustic insights, thereby testing my long-suffering family’s patience. There are many epiphanies to be had in reading his work. Famous and notorious in Queensland psychiatry, McLaren deserves to be much better known across Australia, New Zealand, and beyond.

His training as a psychiatrist, further refined with decades of clinical experience—including 25 years working in the remote Northern regions of Australia — clearly serves his writing well. Immersed as he has been in the practicalities of a diverse and challenging psychiatric practice, he would daily have been reminded of the sometimes questionable relevance of the psychiatric academy. More recently, and no doubt considerably intellectually enriched by his clinical experience, he has returned to the academic fold as an honorary research fellow in the Department of Philosophy, University of Queensland.

His work covers philosophy, pedagogy, politics, history, international relations, diversity and tolerance, extremism, and beyond. His philosophical work focusses on what he sees as fundamental flaws in psychiatric theory and practice. His critical approach is driven by “a passionate desire to see psychiatry evolve into a philosophically and scientifically mature discipline” (Aftab, 2020). And he has an abundance of insights to offer.

1. Theoretical Exposition: From Critique to Construction

McLaren’s latest book consolidates and expands upon his previous philosophical works, including Humanizing Madness (2007), Humanizing Psychiatry (2010), Humanizing Psychiatrists (2011), and Natural Dualism and Mental Disorder (2022). He contends that psychiatry lacks a coherent theory of mental disorder, resulting in a discipline that is both conceptually impoverished and ethically compromised. The absence of a model of mind undermines both diagnosis and treatment.

At the heart of McLaren’s argument is a critique of biological psychiatry, which he views as ideologically driven. He dismisses the chemical imbalance hypothesis and asserts that initiatives like DSM-5 and ICD-10 impose arbitrary classifications without explanatory value. Diagnostic systems, he claims, are "unrelated islands of description floating in a sea of ignorance."

His alternative is an "interactive dualism," or biocognitive model, which conceives of the mind as a closed informational system that is rule-governed and meaning-dependent. Mental disorders, on this model, are disruptions in information processing — not merely biological dysfunctions. He draws on cognitive science, semiotics, and systems theory to ground this view.

2. Philosophical and Scientific Engagements

McLaren does not merely critique psychiatry; in Theories in Psychiatry he scrutinizes philosophy as well. It is beyond the scope of this review to survey all of the detailed critique he offers of philosophy through the ages, though these details are among the most rewarding parts of the book. However, I can indicate the flavour by pointing out that in surveying 20th-century thinkers, he dismisses Searle’s biological naturalism for failing to explain meaning; Chalmers for lacking a viable integrative model; Wittgenstein and Davidson for quietism and anti-realism; Dennett’s functionalism as eliminative; but praises Thomas Nagel for resisting reductionism, despite his model’s incompleteness.

Philosophy, McLaren argues, has failed to provide psychiatry with a defensible ontology. His solution is to reintroduce Descartes, proposing a "natural dualism" that treats mental states as informational, not merely material. Psychiatry, he contends, must develop a theory of mind rooted in a rigorous science of information.

The concluding section of the book draws heavily on philosophical critiques of positivism and reductionism. McLaren contends that positivism’s commitment to observable, quantifiable phenomena excludes the subjective and normative dimensions that are intrinsic to mental life. In McLaren's account, positivism commits a categorical error by treating mind-like entities as reducible to physical or behavioural correlates. He draws attention to how this epistemological stance fosters epistemic blind spots: emotions, beliefs, intentions, and meaning are rendered unintelligible within a strictly physicalist vocabulary.

Likewise, McLaren critiques the legacy of logical positivism for shaping psychiatry's empirical ambitions. The exclusion of metaphysical concepts led to a narrow conception of scientific legitimacy, reinforcing the dominance of biomedical paradigms. He insists that information and meaning are real, causal features of the universe, and that a comprehensive science must account for these. In doing so, McLaren effectively calls for a metaphysical rehabilitation of psychiatry—one that recognizes information not as an abstraction, but as a fundamental constituent of psychological reality.

In proposing an alternative, McLaren's "natural dualism" builds on Cartesian dualism but avoids its substance metaphysics. Instead, he emphasizes ontological complementarity: the mind is both dependent on the brain and causally efficacious in its own right. He likens informational processes to software running on the hardware of the brain, with emergent properties irreducible to their physical substrate. This allows him to affirm both scientific realism and psychological autonomy, offering a coherent alternative to reductive materialism.

3. Ethics, Human Rights, and Institutional Critique

Beyond theory, McLaren elsewhere raises serious ethical concerns. In submissions to the Australian Human Rights Commission, he argues that standard psychiatric practices often violate international prohibitions against cruel and degrading treatment. He is especially critical of coercion in institutional settings and sees the psychiatric hospital as a site of systemic rights violations.

McLaren characterizes psychiatrists as "moral entrepreneurs," using diagnostic authority to enforce social norms. Psychiatry, he contends, often operates as a form of social control.

Crucially, McLaren does not view these concerns as peripheral to the theoretical project. Rather, the ethical problems he identifies—coercion, forced treatment, diagnostic vagueness, and epistemic injustice—stem from a failure to define what mental disorder is. Without a defensible account of the mind, psychiatry lacks the normative foundation required to justify interventions. McLaren thus links ethical legitimacy to ontological coherence.

His ethical framework aligns with a liberal human rights tradition that prioritizes consent, autonomy, and dignity. But he goes further by suggesting that real ethical reform in psychiatry cannot proceed without structural change in how the mind is understood. This insistence distinguishes McLaren’s critique from others: it is not just that psychiatry does bad things; it is that it cannot consistently do good things without epistemological reform.

4. The Limits of Theory: A Pragmatic Rejoinder

While McLaren’s critique is compelling, it risks overstating the necessity of foundational coherence. Medicine and psychiatry are also practices grounded in phronesis or practical wisdom. Healing often precedes explanation. The parable of Androcles and the lion reminds us: sometimes, removing the thorn is more important than understanding its ontology.  If an ancient Dr Androcles McLaren balked at removing a thorn from a lion’s paw on the basis that there was no consistent model of pain, dysfunction, and healing which could ground his intervention, the sum total of suffering in the world would have increased and an excellent story would have been lost.

Psychiatry’s evolution reflects this pragmatic heritage. Initial efforts to alleviate suffering gave rise to techniques, some effective, others not. Over time, theory followed practice. McLaren’s insistence on discarding psychiatry due to theoretical deficits risks severing the field from its compassionate roots.

5. Future Directions

Dominic Murphy’s distinction between minimal and strong models of mental disorder is instructive here: the minimal model treats disorders as descriptive symptom clusters—pragmatic but not explanatory. The strong model aspires to biological realism, aiming to identify causal mechanisms. McLaren targets the strong model but undervalues the utility of the minimal approach in clinical contexts.

Other philosophers, such as Radden and Tsou, advocate pluralism, suggesting that a "family resemblance" view of mental disorder better captures its complexity. They accept biological, psychological, and social dimensions, promoting hybrid models over McLaren’s univocal framework.  Their approach emphasizes conceptual flexibility, rejecting the binary between positivism and dualism. They argue that psychiatry’s task is not to discard existing models, but to refine them ethically and empirically.

Conclusion

Theories in Psychiatry is a rigorous, provocative, and deeply humane work. McLaren challenges psychiatry to confront its philosophical deficits and reorient itself toward a more coherent and ethically defensible foundation. His model of "natural dualism" grounded in information theory is ambitious and original.

Yet the work also reveals the limitations of theoretical purity. McLaren risks dismissing the practical, improvisational, and compassionate dimensions that have historically guided psychiatric care. His call to reject the field’s current foundation may alienate those working effectively within it, however imperfect.

Still, the book is essential reading. For clinicians, philosophers, and students alike, McLaren’s work is a welcome stimulus to critical reflection. Whether one agrees or disagrees, it deepens the discourse and demands a thoughtful response.

References

Aftab, A. (2020). Chaos theory with a human face: Niall McLaren MBBS FRANZCP. Psychiatric Times, 37(2). https://www.psychiatrictimes.com/view/chaos-theory-human-face-niall-mclaren-mbbs-franzcp

Fulford, K. W. M. (2004). Ten principles of values-based medicine. In R. M. Kraus, G. L. Mazur & J. F. Rey (Eds.), Ethical Practice in Psychiatry and the Law (pp. 205–234). New

McLaren, N. (2007). Humanizing Madness: Psychiatry and the Cognitive Neurosciences. Ann Arbor, MI: Future Psychiatry Press.

McLaren, N. (2010). Humanizing Psychiatry: The Biocognitive Model. Ann Arbor, MI: Future Psychiatry Press.

McLaren, N. (2011). Humanizing Psychiatrists: Toward a Humane Psychiatry. Ann Arbor, MI: Future Psychiatry Press.

McLaren, N. (2022). Natural Dualism and Mental Disorder: The Biocognitive Model for Psychiatry. Abingdon: Routledge.

McLaren, N. (2024). Theories in Psychiatry: Towards a Post-Positivist Psychiatry. Ann Arbor, MI: Future Psychiatry Press.

McLaren, N. (2025). Niall McLaren on Critical Psychiatry. Retrieved from https://www.niallmclaren.com/

Murphy, D. (2006). Philosophy of Psychiatry. London: Cambridge University Press.

Radden, J., & Tsou, J. Y. (2020). Philosophy of Psychiatry. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Fall 2020 Edition). https://plato.stanford.edu/archives/fall2020/entries/psychiatry/

Sadler, J. Z. (2005). Values and Psychiatric Diagnosis. Oxford: Oxford University Press.

Szasz, T. (1961). The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. New York: Harper & Row.

SOPH ART SELECTION

In these difficult world times, it is of interest to look once again at the famous engraving by Albrecht Dürer – Melencolia 1 (1514).

At the centre of Melencolia is a winged personification of Melancholy. She is seated with her head resting on her hand rather dejectedly. Objects and symbols surround her including a caliper she has in her hand and objects associated with geometry, the one of the seven liberal arts that underlies artistic creation, if you look on the wall behind her there is a numbered magic square which adds up to thirty-four. As Grovier states:

The work functions as a fidget spinner for psyches overwhelmed by life.

Next to her is a putto sitting on a millstone and writing on a tablet. Dominating the background sky is the comet of Saturn. Symbols of mortality exist in the bell and hour glass.

Dürer never gave any explanation of his engraving and after 500 years of study, research and interpretation the mystery remains and the engraving as fascinating as ever.

Perhaps as Grovier further states “Rather than offering an emotionally direct depiction of melancholic despair, the engraving appears to provide instead a kind of cunning coping mechanism in the shape of an intractable puzzle – a kind of cognitive Rubikʼs cube that takes our minds off our melancholy by utterly indulging it.”

This is a concept developed by art historian Mitchell Merback in his book: Perfection’s Therapy: An Essay on Albrecht Dürer’s Melencolia 1.  Merback suggests the engraving incites a therapeutic or healing process in the observer. It is a remedy for perfection: the misery born by the pursuit for perfection. ‘The temptation to go beyond one’s limits leads to falling under the hand of melancholy,’ warns Dürer in his unfinished Nourishment for young Painters of 1512-13. 

Merback draws on humanism’s founder Francesco Petrarch and the concept of strengthening of the soul through reason. Merback’s book is well worth the journey for a new understanding of Dürer.

Other theories also consider that “Dürer powerfully translates Ficino's idea of the sad intellectual into a heroic portrait of a great mind surrounded by unused tools of discovery and creation. “ (Grovier). Dürer also knew it was the curse of one of the greatest artists of his time: his contemporary Leonardo da Vinci, whose art he had studied. Da Vinci notoriously suffered from a strange affliction that stopped him finishing his paintings.

A question asked is whether  Melencolia I is an allegorical portrait of the creative paralysis of da Vinci.

Sebald Beham, a German printmaker, active in the time of Dürer created a compact version of Melencolia  focused on the allegorical figure, whom he depicts asleep. He eliminated some of the more mysterious details like the magic square and the polyhedron; what remains is the basic association of melancholy with ennui and aspiration.

Lucas Cranach the Elder another contemporary of Dürer also depicted Melancholy (1532) with many of the same elements; the starving dog, the putto and also a distracting riddle as to whether the ball can pass through the ring held by one of the putti.

Dürer's print attracts artists to this day. Kiki Smith's (1999) etching belongs to a series of fifteen images of mostly young girls taken from literature, film, and art. The self-portrait shows a young artist embarking on her career. She appears melancholy and apprehensive for her future. Smith pared down Dürer's image to a minimum and replaced the caliper held by the main figure in the original with a printmaking tool.

Everything invites speculation rather than resolution.

References

Grovier, K. (7 November 2019) What is melancholy in the 21 st Century? BBC Culture

Jones, J. (18 March 2011) On Art.  The Guardian 

Orenstein,N. Drue Hein Curator in Charge (June 2014).  A Happy Occasion for Melencolia 1. Exhibition The Metropolitan Museum of Art. New York.

Marshall,R. (April 5 2018) Perfection’s Therapy: An Essay on Albrecht Durer’s Melencolia 1, Mitchell B. Merback  3-16am.co.uk

Merback, M. (2017) Perfection’s Therapy: An Essay on Albrecht Durer’s Melencolia 1. Princeton: Princeton University Press

Smith, K (1999) Melancholia 13 Moons America: Harlan & Weaver

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Keep in touch and any contributions to the newsletter (articles, news, reading, films or photographs) much appreciated and wanted!

Contact: Dr Sue Lutton
suelutton@iinet.net.au