Reductionism by default: how implicit metaphysical assumptions influence psychiatric practice
Konsulʹtativnaâ Psihologiâ i Psihoterapiâ December 22, 2025 DOI: 10.17759/cpp.2025330408 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 120 |
| Population | Practicing psychiatrists, including residents and early-career specialists |
| Key findings | Biological reductionist positions dominated among surveyed psychiatrists (69.1%), yet 40% of the sample held views incompatible with physicalism, and many showed contradictory or eclectic attitudes. The authors report only a weak link between philosophical views and clinical attitudes, arguing that clinical decisions are driven by systemic constraints, educational standards, and pragmatic choices rather than philosophical reflection. |
Abstract
Context and relevance. Modern psychiatry exists in permanent conceptual crisis rooted in the "hard problem of consciousness". This crisis manifests clinically through a progressive decline in phenomenological analysis and the dominance of unreflected reductionism, often masked by pragmatism and clinical consensus.
Purpose: To conduct preliminary mapping of worldview positions among practicing psychiatrists regarding key philosophical issues in psychiatry and to develop a methodological framework for their further study.
Methods: A cross-sectional anonymous online survey of 120 practicing psychiatrists (including residents and early-career specialists) was conducted using an original questionnaire designed to identify both explicit and implicit attitudes. Analysis included descriptive statistics, hierarchical cluster analysis (Ward's method), and link analysis using Pearson's χ² with Bonferroni correction.
Results: The study revealed internal contradictions and eclecticism in worldview positions. While biological reductionist positions dominated (69.1%), a significant proportion of respondents demonstrated contradictory attitudes, particularly widespread implicit functionalism and views incompatible with physicalism (40% of total sample. The research also shows a weak link between philosophical views and clinical attitudes, indicating that clinical decisions are determined not by philosophical reflection but rather by systemic constraints, educational standards, and pragmatic simplified choices.
Conclusions: The documented dominance of unreflected reductionism reflects psychiatry's systemic crisis and necessitates intentional integration of philosophical reflection into psychiatric education and clinical practice.