Narrative rather than idiographic approaches as counterpart to the nomothetic approach to assessment

As part of its Institutional Program on Psychiatry for the Person, the World Psychiatric Association has called for an idiographic element to be added to psychiatric diagnosis to complement criteriological and dimensional elements. Such a call, however, prompts the question of what kind of additional element this is. Just what is meant by idiographic understanding and how, exactly, does it complement, by being distinct from, other elements within psychiatric diagnostic judgement? The first half of this paper continues discussion from an earlier paper [Thornton: Eur Arch Psychiatry Clin Neurosci 2008;258 (suppl 5):104-109] to consider the idea, inspired by Wilhelm Windelband's rectoral address of 1894, that idiographic judgement is distinct because it is a special kind of 'individualised' judgement about individuals. I argue, however, that the most promising interpretation of this idea falls prey to Wilfrid Sellars argument against the Myth of the Given and thus it cannot be a genuine complement to criteriological diagnosis. In addition to this idea, however, 'idiographic' has also been used to label narrative judgement. The second half of the paper highlights how narrative judgement, shorn of any connection to metaphysical theories of the self, is an essentially normative form of judgement that contrasts with, and can thus complement, criteriological diagnosis.