PREFACE This volume is a sequel to yet independent of our Paranoia: A Study in Diagnosis, Reidel, Dordrecht and Boston, 1976. Whereas our first book centered on diagnosis, this centers on treatment. In our first volume, all discussions of nosology (theory of illness) and of treatment was ancillary to our discussion of diagnosis; similarly all discussion of this volume dealing with nosology - there is very little on diagnosis here - is ancillary to our discussion of psychotherapy. It is still our profoundest conviction that to speak of treatment without diagnosis is meaningless, if not irresponsible, since otherwise one does not know what one is talking about. Hence, our present study, though it centers on theories of treatment, links psychotherapy with psychopathology. It is the rationale of psychotherapy which is of importance, and the rationale dwells in this link. We wish our present study to be self-contained and understood by readers who are not familiar with our first book - or with any specific literature. Our discussion of medicine in general, meaning the rationale of therapy in general, helps the uninitiated reader, as well as the initiated, we hope: it certainly has helped us. We did not see how else can we study a branch of medicine; we felt the need for some idea of how medicine is supposed to work.

1. GENERAL The term "diagnostics" refers to the general theory of diagnosis, not to the study of specific diagnoses but to their general framework. It borrows from different sciences and from different philosophies. Traditionally, the general framework of diagnostics was not distinguished from the framework of medicine. It was not taught in special courses in any systematic way; it was not accorded special attention: students absorbed it intuitively. There is almost no comprehensive study of diagnostics. The instruction in diagnosis provided in medical schools is exclusively specific. Clinical instruction includes (in addition to vital background information, such as anatomy and physiology) specific instruction in nosology, the theory and classification of diseases, and this includes information on diagnoses and prognoses of diverse diseases. What is the cause of the neglect of diagnostics, and of its integrated teaching? The main cause may be the prevalence of the view of diagnostics as part-and parcel of nosology. In this book nosology is taken as a given, autonomous field of study, which invites almost no comments; we shall freely borrow from it a few important general theses and a few examples. We attempt to integrate here three studies: ll of the way nosology is used in the diagnostic process; of the diagnostic process as a branch of applied ethics; ~ of the diagnostic process as a branch of social science and social technology.

In Science and Culture, Joseph Agassi addresses scientism and relativism, two false philosophies that divorce science from culture in general and from tradition in particular. According to Agassi, science is an integral part of culture, and both scientism and relativism ignore the cultural value of science. This work helps break the isolation of science from the rest of culture by promoting popular science and reasonable history of science. Agassi provides examples of the value of science to culture at large, discussions of items of the general culture and their interactions with science, and practical strategies and tools. He offers a wide variety of case studies to exemplify these. In this book Agassi puts significant topics such as autonomy, tolerance, reason, philosophy and responsibility on the agenda of democratic philosophy today.

This work addresses scientism and relativism, two false philosophies that divorce science from culture in general and from tradition in particular. It helps break the isolation of science from the rest of culture by promoting popular science and reasonable history of science. It provides examples of the value of science to culture, discussions of items of the general culture, practical strategies and tools, and case studies. It is for practising professionals, political scientists and science policy students and administrators.

1. GENERAL The term "diagnostics" refers to the general theory of diagnosis, not to the study of specific diagnoses but to their general framework. It borrows from different sciences and from different philosophies. Traditionally, the general framework of diagnostics was not distinguished from the framework of medicine. It was not taught in special courses in any systematic way; it was not accorded special attention: students absorbed it intuitively. There is almost no comprehensive study of diagnostics. The instruction in diagnosis provided in medical schools is exclusively specific. Clinical instruction includes (in addition to vital background information, such as anatomy and physiology) specific instruction in nosology, the theory and classification of diseases, and this includes information on diagnoses and prognoses of diverse diseases. What is the cause of the neglect of diagnostics, and of its integrated teaching? The main cause may be the prevalence of the view of diagnostics as part-and parcel of nosology. In this book nosology is taken as a given, autonomous field of study, which invites almost no comments; we shall freely borrow from it a few important general theses and a few examples. We attempt to integrate here three studies: ll of the way nosology is used in the diagnostic process; of the diagnostic process as a branch of applied ethics; ~ of the diagnostic process as a branch of social science and social technology.

In our papers on the rationality of magic, we distinghuished, for purposes of analysis, three levels of rationality. First and lowest (rationalitYl) the goal directed action of an agent with given aims and circumstances, where among his circumstances we included his knowledge and opinions. On this level the magician's treatment of illness by incantation is as rational as any traditional doctor's blood-letting or any modern one's use of anti-biotics. At the second level (rationalitY2) we add the element of rational thinking or thinking which obeys some set of explicit rules, a level which is not found in magic in general, though it is sometimes given to specific details of magical thinking within the magical thought-system. It was the late Sir Edward E. Evans-Pritchard who observed that when considering magic in detail the magician may be as consistent or critical as anyone else; but when considering magic in general, or any system of thought in general, the magician could not be critical or even comprehend the criticism. Evans-Pritchard went even further: he was sceptical as to whether it could be done in a truly consistent manner: one cannot be critical of one's own system, he thought. On this level (rationalitY2) of discussion we have explained (earlier) why we prefer to wed Evans Pritchard's view of the magician's capacity for piece-meal rationality to Sir James Frazer's view that magic in general is pseudo-rational because it lacks standards of rational thinking."

In our papers on the rationality of magic, we distinghuished, for purposes of analysis, three levels of rationality. First and lowest (rationalitYl) the goal directed action of an agent with given aims and circumstances, where among his circumstances we included his knowledge and opinions. On this level the magician's treatment of illness by incantation is as rational as any traditional doctor's blood-letting or any modern one's use of anti-biotics. At the second level (rationalitY2) we add the element of rational thinking or thinking which obeys some set of explicit rules, a level which is not found in magic in general, though it is sometimes given to specific details of magical thinking within the magical thought-system. It was the late Sir Edward E. Evans-Pritchard who observed that when considering magic in detail the magician may be as consistent or critical as anyone else; but when considering magic in general, or any system of thought in general, the magician could not be critical or even comprehend the criticism. Evans-Pritchard went even further: he was sceptical as to whether it could be done in a truly consistent manner: one cannot be critical of one's own system, he thought. On this level (rationalitY2) of discussion we have explained (earlier) why we prefer to wed Evans Pritchard's view of the magician's capacity for piece-meal rationality to Sir James Frazer's view that magic in general is pseudo-rational because it lacks standards of rational thinking."

PREFACE This volume is a sequel to yet independent of our Paranoia: A Study in Diagnosis, Reidel, Dordrecht and Boston, 1976. Whereas our first book centered on diagnosis, this centers on treatment. In our first volume, all discussions of nosology (theory of illness) and of treatment was ancillary to our discussion of diagnosis; similarly all discussion of this volume dealing with nosology - there is very little on diagnosis here - is ancillary to our discussion of psychotherapy. It is still our profoundest conviction that to speak of treatment without diagnosis is meaningless, if not irresponsible, since otherwise one does not know what one is talking about. Hence, our present study, though it centers on theories of treatment, links psychotherapy with psychopathology. It is the rationale of psychotherapy which is of importance, and the rationale dwells in this link. We wish our present study to be self-contained and understood by readers who are not familiar with our first book - or with any specific literature. Our discussion of medicine in general, meaning the rationale of therapy in general, helps the uninitiated reader, as well as the initiated, we hope: it certainly has helped us. We did not see how else can we study a branch of medicine; we felt the need for some idea of how medicine is supposed to work.

This volume is dedicated to Mario Bunge in honor of his sixtieth birthday. Mario Bunge is a philosopher of great repute, whose enormous output includes dozens of books in several languages, which will culminate with his Treatise on Basic Philosophy projected in seven volumes, four of which have already appeared Reidel, I 974ff. ]. He is known for his works on research methods, the foundations of physics, biology, the social sciences, the diverse applications of mathematical methods and of systems analysis, and more. Bunge stands for exact philosophy, classical liberal social philosophy, rationalism and enlightenment. He is brave, even relentless, in his attacks on subjectivism, mentalism, and spiritualism, as well as on positivism, mechanism, and dialectics. He believes in logic and clarity, in science and open-mindedness - not as the philosopher's equivalent to the poli tician's rhetoric of motherhood and apple pie, but as a matter of everyday practice, as qualities to cultivate daily in our pursuit of the life worth living. Bunge's philosophy often has the quality of Columbus's egg, and he is prone to come to swift and decisive conclusions on the basis of argu ments which seem to him valid; he will not be perturbed by the fact that most of the advanced thinkers in the field hold different views."

"If a science has to be supported by fraudulent means, let it perish. " With these words of Kepler, Agassi plunges into the actual troubles and glories of science (321). The sociology of science is no foreign intruder upon scientific knowledge in these essays, for we see clearly how Agassi transforms the tired internalist/externalist debate about the causal influences in the history of science. The social character of the entire intertwined epistemological and practical natures of the sciences is intrinsic to science and itself split: the internal sociology within science, the external sOciology of the social setting without. Agassi sees these social matters in the small as well as the large: from the details of scientific communication, changing publishing as he thinks to 'on-demand' centralism with less waste (Ch. 12), to the colossal tension of romanticism and rationality in the sweep of historical cultures. Agassi is a moral and political philosopher of science, defending, dis turbing, comprehending, criticizing. For him, science in a society requires confrontation, again and again, with issues of autonomy vs. legitimation as the central problem of democracy. And furthermore, devotion to science, pace Popper, Polanyi, and Weber, carries preoccupational dangers: Popper's elitist rooting out of 'pseudo-science', Weber's hard-working obsessive com mitment to science. See Agassi's Weberian gloss on the social psychology of science in his provocative 'picture of the scientist as maniac' (437)."

The thesis of the present volume is critical and dual. (1) Present day philosophy of man and sciences of man suffer from the Greek mis taken polarization of everything human into nature and convention which is (allegedly) good and evil, which is (allegedly) truth and fal sity, which is (allegedly) rationality and irrationality, to wit, the polar ization of all fields of inquiry, the natural and social sciences, as well as ethics and all technology, whether natural or social, into the totally positive and the totally negative. (2) Almost all philosophy and sci ences of man share the erroneous work ethic which is the myth of man's evil nature - the myth of the beast in man, the doctrine of original sin. To mediate or to compromise between the first view of human nature as good with the second view of it as evil, sociologists have devised a modified utilitarianism with deferred gratification so called, and the theory of the evil of artificial competition (capitalist and socialist alike) and of keeping up with the Joneses. Now, the mediation is not necessary. For, the polarization makes for abstract errors which are simplistic views of rationality, such as reductionism and positivism of all sorts, as well as for concrete errors, such as the disposition to condemn repeatedly those human weaknesses which are inevitable, namely man's inability to be perfectly rational, avoid all error, etc., thus setting man against himself as all too wicked."

There is a curious parallel between the philosophy of science and psychiatric theory. The so-called demarcation question, which has exercised philosophers of science over the last decades, posed the problem of distinguishing science proper from non-science - in par ticular, from metaphysics, from pseudo-science, from the non rational or irrational, or from the untestable or the empirically meaningless. In psychiatric theory, the demarcation question appears as a problem of distinguishing the sane from the insane, the well from the mentally ill. The parallelism is interesting when the criteria for what fails to be scientific are seen to be congruent with the criteria which define those psychoses which are marked by cognitive failure. In this book Dr Yehuda Fried and Professor Joseph Agassi - a practicing psychiatrist and a philosopher of science, respectivel- focus on an extreme case of psychosis - paranoia - as an essentially intellectual disorder: that is, as one in which there is a systematic and chronic delusion which is sustained by logical means. They write: "Paranoia is an extreme case by the very fact that paranoia is by definition a quirk of the intellectual apparatus, a logical delusion. " (p. 2."

There is a curious parallel between the philosophy of science and psychiatric theory. The so-called demarcation question, which has exercised philosophers of science over the last decades, posed the problem of distinguishing science proper from non-science - in par ticular, from metaphysics, from pseudo-science, from the non rational or irrational, or from the untestable or the empirically meaningless. In psychiatric theory, the demarcation question appears as a problem of distinguishing the sane from the insane, the well from the mentally ill. The parallelism is interesting when the criteria for what fails to be scientific are seen to be congruent with the criteria which define those psychoses which are marked by cognitive failure. In this book Dr Yehuda Fried and Professor Joseph Agassi - a practicing psychiatrist and a philosopher of science, respectivel- focus on an extreme case of psychosis - paranoia - as an essentially intellectual disorder: that is, as one in which there is a systematic and chronic delusion which is sustained by logical means. They write: "Paranoia is an extreme case by the very fact that paranoia is by definition a quirk of the intellectual apparatus, a logical delusion. " (p. 2."

Joseph Agassi is a critic, a gadfly, a debunker and deflater; he is also a constructor, a speculator and an imaginative scholaro In the history and philosophy of science, he has been Peck's bad boy, delighting in sharp and pungent criticism, relishing directness and simplicity, and enjoying it all enormously. As one of that small group of Popper's students (ineluding Bartley, Feyerabend and Lakatos) who took Popper seriously enough to criticize him, Agassi remained his own man, holding Popper's work itself to the criteria of critical refutation. Agassi's range is wide and his publications proliik. He has published serious studies in the historiography of science, applied sociology (on Hong Kong with LC. Jarvie), foundations of anthropology, interpretive scientific biography (Faraday), Judaic studies, philosophy of technology (which Agassi pioneered, particulady in distinguishing it from the philosophy of science), as weIl as the many works on the Iogic, methodoI ogy, and history of science. Even as we go to press, Agassi's works are appearing; we append an imperfect and selected bibliography. For Agassi, the test of relevance is whether something is interesting."

Joseph Agassi is a critic, a gadfly, a debunker and deflater; he is also a constructor, a speculator and an imaginative scholaro In the history and philosophy of science, he has been Peck's bad boy, delighting in sharp and pungent criticism, relishing directness and simplicity, and enjoying it all enormously. As one of that small group of Popper's students (ineluding Bartley, Feyerabend and Lakatos) who took Popper seriously enough to criticize him, Agassi remained his own man, holding Popper's work itself to the criteria of critical refutation. Agassi's range is wide and his publications proliik. He has published serious studies in the historiography of science, applied sociology (on Hong Kong with LC. Jarvie), foundations of anthropology, interpretive scientific biography (Faraday), Judaic studies, philosophy of technology (which Agassi pioneered, particulady in distinguishing it from the philosophy of science), as weIl as the many works on the Iogic, methodoI ogy, and history of science. Even as we go to press, Agassi's works are appearing; we append an imperfect and selected bibliography. For Agassi, the test of relevance is whether something is interesting."