Philosophical Psychology, Volume 0, Issue 0, Page 1-5, Ahead of Print.

The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired from Plato’s Symposium, where the physician Eryximachus presents a purely neurophysiological discourse on love. James Giordano’s and Gerrit Glas’s commentaries on my paper have the timbre of a contemporary symposium, in this instance to discern the nature of suffering. Thus, I take Giordano’s and Glas’s commentaries to be generally sympathetic to my offering, although providing further critical insights that deepen the multidimensional understanding of suffering and (...) the correct ethical and medical response. From different perspectives both commentators zone in on one central aspect of my analysis, that is .. (shrink)

Dr. Lacewing’s paper is a very interesting one. We agree in part, but only in part. Lacewing (2012) rejects the general thesis that “causal inferences must always be justified on the basis of Mill’s canons” (p. 199). I agree, but so does his target, Adolf Grünbaum, as we shall see in a moment. But first there is a question about Grünbaum’s alleged reliance on Mill’s Methods of Agreement and Difference. This interpretation may not make a difference to Lacewing’s arguments, but (...) it is worth correcting, given that some philosophers criticize both methods and yet their criticisms have no direct bearing on any of Grünbaum’s arguments. When Grünbaum speaks of “Millian methods,” he is not necessarily talking .. (shrink)

The word "ontology" presently encompasses two different meanings. In the philosophical sense, ontology has been defined since the days of Aristotle as the "science of being," also called "metaphysics." In this sense, ontology is concerned with categorizing discrete entities in reality and the relationships that hold between those entities (Aristotle 1952). Ontology, in the tradition of philosophical realism, aims to describe every day, mesoscopic entities and relations as they are in themselves, and not from the specific viewpoint of some particular (...) domain or conceptual schema. The type of entities realist ontology concerns are those that exist "out there" in the world (such as tables, chairs, mountains, streams .. (shrink)

Evidence-based medicine (EBM) made its first appearance in the medical lexicon in 1990 and since then has enjoyed widespread support from within the medical profession, including among psychiatrists. Proponents of evidence-based psychiatry (EBP) point to its ability to demonstrate the efficacy of various psychiatric treatments, promising improved mental health outcomes and more efficient use of healthcare resources as a result. Policymakers and insurers have embraced EBP in hopes that these goals will be realized. However, the question of whether EBM is (...) even applicable to psychiatry remains largely unaddressed, even though it is an urgent one, given the various corporate, professional, and governmental pressures .. (shrink)

This chapter offers an interpretation of Jaspers’ distinction between explaining and understanding, which relates this distinction to that between general and singular causal claims. Put briefly, I suggest that when Jaspers talks about (mere) explanation, what he has in mind are general causal claims linking types of events. Understanding, by contrast, is concerned with singular causation in the psychological domain. Furthermore, I also suggest that Jaspers thinks that only understanding makes manifest what causation between one element of a person’s mental (...) life and another ultimately consists in – that is, the particular way in which one psychic event can emerge from or arise out of another. I contrast the resulting view both with a view on causation in psychiatry recently put forward by John Campbell, and also with another view that is the target of Campbell’s attack, which is due to Donald Davidson and Daniel Dennett. (shrink)

A brief poll of my scientific colleagues confirmed that, to a person, they regard addiction as a disease, whereas most non-science acquaintances consider it to be a failure of willpower. Reconciliation of these polarized views seems difficult and rather than finding a middle path, such as suggested by Foddy and Savulescu. I am an entrenched supporter of the view that addiction can be a disease. I first should declare my position as a card-carrying biologist, holding the view that behavior emanates (...) from the brain and, accordingly, that behavior and emotions result from brain function. This brain function also produces addiction and related behaviors, whereas Foddy and Savulescu seem to credit humans with a greater capacity to choose than biological evidence suggests. The second problem relates to definitions of disease: I argue that there are at least three ways addiction might be considered a disease. 1.? ? ? Addiction is a disease because it results in pathology. For example, hypertension is a disease. Hypertension per se does not cause dysfunction, but leads to pathologically definable conditions such as stroke and myocardial infarction. Smoking, like hypertension, can result in pathologies such as emphysema and cancer. The problem is not smoking per se, or even addiction to nicotine, rather it is the consequent diseases caused by tobacco. Nevertheless, if hypertension is a disease, so is smoking. The question of “choosing‘ to persist with smoking has no bearing on whether it is disease. Whether a person chooses to care for their hypertension or ignore it does not alter the fact that they have hypertension; it is still a disease and it will still harm them. Whether addiction affects the capacity to choose is not relevant because it does not alter the fact that smoking causes pathology and hence is a disease. 2.? ? ? Foddy and Savulescu argue that addiction leaves no tell-tale pathology to set it aside from. (shrink)

Many psychopathological disorders – clinical depression, borderline personality disorder, schizophrenia and autistic spectrum disorder (ASD) – are commonly classified as disorders of the self. In an intuitive sense this sort of classification is unproblematic. There can be no doubt that such disorders make a difference to one’s ability to form and maintain a coherent sense of oneself in various ways. However, any theoretically rigourous attempt to show that they relate to underlying problems with say, such things as minimal selves or, (...) even, so-called narrative selves – where these latter constructs are invoked to do genuine explanatory work – would require, inter alia, philosophical clarification of what it is that one is precisely committed to in talking of such things (if things they be). It would also require justification for believing in selves of these various kinds. I have elsewhere put on record some of my worries about proposed justifications for believing in minimal selves (Hutto 2008b). But – lest I be accused of favouritism – it should be noted that I also have concerns about the very idea of narrative selves. Several authors have made strong claims about the role of narratives in self constitution (e.g. Dennett 1991, Flanagan 1996, Schechtman 1996). Under standard interpretations these proposals are ambiguous, underdeveloped in key respects, embed obvious tensions or generate puzzles. For these reasons I think we should be cautious of lax talk of selves that are woven from narrative cloth. This is not to say that I agree with Strawson (2004) that adopting a narrative perspective might not be essential for being a self (or at least being a self of a certain sort – even an ethically interesting sort).1 It is rather that I think that before we get around to assessing such claims we need a better understanding of just what we are committed to in talking of selves in general. This is a major philosophical programme, and not one with which I will attempt to engage in this paper – not even in passing.. (shrink)

I am very grateful to both Edward Erwin and Peter Fonagy for their thoughtful and engaging comments. I do not have space to deal fully with all the issues they raise, but I will try to clarify some key points at which perhaps I implied more than I intended, or failed to be clear. Erwin states that I claim the following principle is a method for inferring causes: “if X is causally relevant to the occurrence of Y, then the incidence (...) of Ys in the class of Xs and Ys will be different compared with the incidence of Ys in the class of non-Xs and Ys” (Erwin 2012, 217). This is not so. The method I attribute to Grünbaum is given in what follows the principle in the quotation given on p. 199, namely, “To validate a .. (shrink)

According to Bowden (20121), anorectics’2 bodily experiences are characterized by a “corporealization,” which has notably been described as follows: “The exchange with the environment is inhibited, excretions cease; processes of . . . shrinking, and drying up prevail” (Fuchs 2005, 99). What is described here is melancholia, but a similar characterization would be applicable to anorexia. I think, however, that the notion of ‘corporealization’ is not fine-grained enough to capture the specificity of anorexic/pathological bodily experiences. To develop this point, I (...) here propose to apply some of Heidegger’s key notions to the conceptualization of bodily experience (Caron 2008). As currently defined, the .. (shrink)

According to Aristotle, "to be learning something is the greatest of pleasures not only to the philosopher but also to the rest of mankind," (Poetics 1448b). But even as he affirms the unbounded human capacity for integrating new experience with existing knowledge, he alludes to a significant exception: "The sight of certain things gives us pain, but we enjoy looking at the most exact images of them, whether the forms of animals which we greatly despise or of corpses." Our capacity (...) for learning is happily engaged in viewing representations of painful objects, but not, it seems, in viewing the objects themselves. When an experience is intensely painful, what then is a rational animal to do? We can neither disable our learning process, nor erase its traces. In the face of intense pain, horror, or terror, learning and remembrance cause no pleasure but rather persistent psychological pain and disruption. The memorious mind reverberates with trauma. (shrink)

Principle 2 of the 2005 Mental Capacity Act (MCA) requires that decision-making capacity should be assumed, unless there is conclusive evidence, on a balance of probabilities, to the contrary (Department of Constitutional Affairs 2005). In his article “The Paradox of the Assessment of Capacity Under the Mental Capacity Act 2005,” Ajit Shah (2011) raises the concern that the new Deprivation of Liberty Safeguards (DOLS), introduced through the Mental Health Act (Department of Health 2007), conflict with this principle (henceforth, the principle (...) of presumed capacity) because, in practice, they will encourage the routine assessment of capacity even in the absence of any positive evidence of diminished capacity .. (shrink)

“A Liberal Account of Addiction‘ is a major contribution to the discussion of addiction, its treatment, and the social and policy issues which arise from it. Questioning as it does many generally accepted assumptions about addictive behavior, particularly the use of hard drugs, it will provoke even those who do not agree with it to rethink their positions. Many of its suggestions are relevant also, in my opinion, to thinking about other areas of psychiatric interest. Nevertheless, I want to argue (...) that its authors have perhaps not freed themselves sufficiently from some common assumptions, in particular about the nature of mental disorder, and that their argument might benefit from such liberation. The central assumption that I have in mind is that understanding human actions is nothing but understanding the brain activity that accompanies them. If so, then a pattern of behavior can count as a ’mental disorder’ in any clinically or legally relevant sense only if it is the result of a brain disease, causing a breakdown in normal brain functioning. Starting from this assumption, the authors seek to show, by means of evidence from neuroscience, that addiction to drugs does not have a unique ’neural substrate,’ distinct from that of any other kind of pleasure-seeking behavior. When we have a pleasurable experience of any kind, as they point out, dopamine is normally released within the brain. This, they say, activates the ’reward’ pathways, making the person more likely to repeat the behavior that gives rise to the pleasurable experience in questionÑwhether it is eating, sex, or injecting heroin. Addiction, they argue, is therefore just a tendency to repeat an intensely pleasurable experience, whatever the nature of that experience might be. The particular chemistry of the substance involved in this particular form of pleasure is, they argue, irrelevantÑall that matters is that the experience it gives someone is pleasant. Addiction, they. (shrink)

Pathological Altruism presents a number of new, thought-provoking theses that explore a range of hurtful effects of altruism and empathy.

All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood. (Article 1, Universal Declaration of Human Rights 1948) This resounding statement encapsulates a number of problematic themes for lawyers with respect to personality disorder, and acutely so for the extremes of personality disorder embraced by designations such as psychopathy or dangerous and severe personality disorder (DSPD). These designations are in themselves (...) contentious; they do not have commonly agreed definitions either across disciplines or across jurisdictions. Morse (2008), for example, argues in a fascinating account that .. (shrink)