The Philosophy and Therapy Podcast · John T Maier

Episode #27: David Brendel

·44 min·3 clips

Brendel describes co-constructing care with a patient who thinks the FBI is monitoring her and another who believes she is demonically possessed.

John T. Meyer introduces the podcast as a place where philosophy and therapy meet. He identifies himself as a psychotherapist in private practice in Cambridge, Massachusetts, and also as a philosopher with a background in fundamental questions in agency, value, and language. The guest is Dr. David Brandel, a psychiatrist, author, and executive coach in Belmont, Massachusetts. Brandel is described as a board-certified psychiatrist with an MD from Harvard Medical School and a PhD in philosophy from the University of Chicago, and as someone who directs Leading Minds Executive Coaching. He is the author of Healing Psychiatry and has written articles on the role of philosophical pragmatism in psychiatry, which becomes a focus of the interview. The conversation begins with a remark Brandel made in 2003 about psychiatric explanations and beneficial real-world results. Meyer asks him to unpack that Jamesian idea. Brandel says pragmatism in psychiatry has many dimensions. He treats psychiatry as a field where explanations are judged by what they help people do in practice. He gives Huntington's disease as an example of how medicine has moved from older religious or spiritual explanations to a genetic one that can be identified and predicted. Even so, Brandel argues that psychiatry does not end where neuroscience advances. People still change in relation to values, purpose, and what they experience as problematic or empowering. He notes that stress and anxiety can feel useful to some patients, functioning as a signal to try harder or do something differently. He then turns to a patient who believes in demonic possession and wants to remain Catholic. She wants the demons gone, but not the belief structure that gives the experience meaning. Brandel says that no blood test, genetic test, or brain MRI can decide that question for her. The judgment depends on her own experience and choice. The discussion closes by returning to William James as a figure who still matters in psychology, philosophy, and everyday life.

As heard by us

A careful psychiatry conversation where value, diagnosis, and belief keep pressing against each other.

John T. Meyer uses this conversation with Dr. David Brandel to probe what pragmatism can do inside psychiatry, and the episode keeps circling a stubborn question: when does a psychiatric explanation count as true if its value shows up in the real-world result it helps produce?

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Why you'd press play

You get a grounded case for pragmatism in psychiatry, with values doing real work.

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