DSM and the problem of the physical substrate

I have been doing discursive reading of the DSM and one curious thing is the mimicking of Linnaeus and medical models.  For this reason it has to assume a “physical substrate” for mental illnesses and Emil Kraeplin of course chose the brain, although the DSM is curiously silent on this question now… otherwise it slips into mentalisms and things… But the brain is certainly fashionable again…

With a contextual view at the bottom in Figure 1 below, we can see that the clusters are made around idiosyncratic contexts of a person with behavioral ‘symptoms’, not generalizable diagnoses, and therefore the so-called physical substrate of ‘mental health issues’ IS THE ENVIRONMENT! The environmental contexts ARE the physical basis (social, cultural, historical, opportunity and economic), not the brain.  The equivalent of the DSM clustering into axes, etc., is the contingency structure of each person’s world.

Figure 1


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