Traditionally, the key features of the family system of Eating Disorders (EDs) have been considered those originally outlined by Minuchin in his description of the "psychosomatic" family patterns of interaction. This controlled study tests two of the principal characteristics of Minuchin's model, namely enmeshment and rigidity, operationalised as extreme cohesion and low adaptability. Perceived and desired cohesion and adaptability, measured with the FACES III, were compared between 30 clinical families (mothers, fathers and daughters with an ED) and 30 non-clinical families. (...) Differences across ED family members were also considered, as well as differences between ED symptomatological subgroups (restricting anorectics vs EDs with bulimic symptoms). High cohesion scores were found in ED families, but similar findings were also reported in control families. Cohesion scores were significantly higher in restricting anorectics than in patients with bulimic symptoms. Adaptability was normal in both ED and control families. This study does not support Minuchin's observations on family enmeshment and rigidity. Although high levels of cohesion were found in ED families, the same relational pattern was found in the control families, suggesting that a tendency to a hyper-involvement of family members might be "normal" in some sociocultural contexts. (shrink)

Responding to the work of previous critics of psychiatry, who have associated its undue dominance with both a modern scientific paradigm and political factors, I put forward a theoretical challenge based on MacIntyre`s work on Aquinas and Aristotle, but adding the museum and assembly as conceptual thinking tools. -/- MacIntyre`s work on practices, tradition-constituted enquiry, Marxist ideology and Kuhn are all used in putting forward a pre-modern view of knowledge. The feminist philosophy of Luce Irigaray widens the project to include (...) psychotherapy. I put forward a workable and kind version of psychiatric medicine which sets the work of the mental health service user movement in context. (shrink)

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in such (...) a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

Ontologies are being developed throughout the biomedical sciences to address standardization, integration, classification and reasoning needs against the background of an increasingly data-driven research paradigm. In particular, ontologies facilitate the translation of basic research into benefits for the patient by making research results more discoverable and by facilitating knowledge transfer across disciplinary boundaries. Addressing and adequately treating mental illness is one of our most pressing public health challenges. Primary research across multiple disciplines such as psychology, psychiatry, biology, neuroscience and pharmacology (...) needs to be integrated in order to promote a more comprehensive understanding of underlying processes and mechanisms, and this need for integration only becomes more pressing with our increase in understanding of differences among individuals and populations at the molecular level concerning susceptibility to specific illnesses. Substance addiction is a particularly relevant public health challenge in the developed world, affecting a substantial percentage of the population, often co-morbid with other illnesses such as mood disorders. Currently, however, there is no straightforward automated method to combine data of relevance to the study of substance addiction across multiple disciplines and populations. In this contribution, we describe a framework of interlinked, interoperable bio-ontologies for the annotation of primary research data relating to substance addiction, and discuss how this framework enables easy integration of results across disciplinary boundaries. We describe entities and relationships relevant for the description of addiction within the Mental Functioning Ontology, Chemical Entities of Biological Interest Ontology, Protein Ontology, Gene Ontology and the Neuroscience Information Framework ontologies. (shrink)

In order to understand both consciousness and the Freudian unconscious we need to understand the notion of innerness that we apply to the mind. We can partly do so via the use of the theory of conceptual metaphor, and this casts light on a number of related topics.

Wittgenstein’s analogy between psychoanalysis and his later philosophical methods is explored and developed. Historical evidence supports the claim that Wittgenstein characterized an early version of his general remarks on philosophy (§§89-133 in the Philosophical Investigations) as a sustained comparison with psychoanalysis. A non-adversarial, therapeutic interpretation is adopted towards Wittgenstein which emphasizes his focus on dissolving the metaphysical puzzlement of particular troubled individuals. A “picture” of Freudian psychoanalysis is sketched which highlights several features of Freud’s therapeutic techniques and his conception of (...) a neurosis. This portrait of Freud’s methods is used as an “object of comparison” for drawing attention to important aspects of Wittgenstein’s later practice of philosophy. Wittgenstein’s therapeutic conception of philosophy, though concerned with ordinary linguistic practices, is held to focus primarily on rooting out the prejudices and dogmas which lie at the heart of the puzzled philosopher’s inclinations to make metaphysical assertions. (shrink)

The paper involves an attempt to draw out the implications of a ‘moderate materialism’ for the understanding of mental illness. The argument of the paper is that once a moderate materialism which navigates carefully between the poles of (materialist) reductionism and dualism has been unpacked, the relations between the manifestations, bases, aetiologies and treatments of mental illnesses emerge as being considerably more complex than is often allowed for. Specifically, the conceptual tools required within a moderate materialist position about the mind (...) allow us to expose potential fallacies in thinking about the nature of mental illnesses, in inferences drawn from these ‘natures’ to ideal modes of treatment, and in inferences drawn from treatment response. It is concluded that moderate materialism undermines the oversimplifications which tend to cloud ‘biophysical versus psychosocial’ debates in the field of psychopathology, in part because psychological change is physiological change, and because physiological change and/or intervention need not ‘cure’ by removing a physiological cause. (shrink)

This paper argues that Hitchcock's so-called 'Freudian' films (esp. Spellbound, Psycho, and Marnie) pay tribute to the cultural magnetism of Freud's ideas whist being critical of the tehories themselves.

Robert Nozick famously asks us whether we would plug in to an experience machine, or whether we would insist upon ‘living in contact with reality’. Felipe De Brigard, after conducting a series of empirical ‘inverted’ experience machine studies, suggests that this is a false dilemma. Rather, he says, '…the fact is that people tend to prefer the state of affairs they are in currently,' or the status quo. In this paper, I argue that these studies are a test case for (...) ‘experimental philosophy’ as such. Specifically, I argue that De Brigard offers a series of faulty studies, and so, reaches unfounded conclusions. More generally, I argue that certain philosophical thought experiments cannot be tested empirically at all, and this limits what experimental philosophy can do. (shrink)

This paper explores the factors that contribute to the degree of a mood disorder patient’s self- insight, defined here as her understanding of the particular contingencies of her life that are responsive to her personal identity, interpersonal relationships, illness symptoms, and the relationship between these three necessary components of her lived experience. I consider three factors: (i) the Diagnostic Statistical Manual of Mental Disorders (DSM), (ii) the DSM culture, and (iii) the cognitive architecture of the self. I argue that the (...) symptom-based descriptions of mood disorders which eliminate the subjective features of the patient’s illness experience, in conjunction with the features of the DSM-culture and the cognitive biases that guide the patient, contribute to the impoverishment of her self-insight. The resulting impoverished self-insight would prevent her from developing resourceful responses to her interpersonal problems. In analyzing how these factors combine to influence the patient’s self-insight, I distinguish the therapeutic impact of receiving a psychiatric diagnosis, which facilitates patient’s clinical treatment, from its reflective impact, how the diagnosis informs the patient’s reflection on who she is, how her mental disorder is expressed, and how her interpersonal relationships proceed. I substantiate my argument by considering a patient’s memoir of psychopathology. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written by (...) people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)