In the 2000s, several psychiatrists cited the lack of relational disorders in the DSM-IV as one of the two most glaring gaps in psychiatric nosology, and campaigned for their inclusion in the DSM-5. This campaign failed, however, presumably in part due to serious “ontological concerns” haunting such disorders. Here, I offer a path to quell such ontological concerns, adding to previous conceptual work by Jerome Wakefield and Christian Perring. Specifically, I adduce reasons to think that collective disorders are compatible with (...) key metaphysical commitments of contemporary scientific psychiatry, and argue that if one accepts the existence of mental disorders in individuals as medical, then one has good reasons to accept the existence of collective disorders as medical. First, I outline how collective disorders are reconcilable with both the harmful dysfunction model of disorder and a denial of mind-body dualism. I then identify some potential weaknesses in the main pre-existing example of a collective disorder, offering my own examples as supplements. These examples’ medical plausibility is bolstered by: work in philosophy of biology on the generalized selected effects theory of function, and work in analytic philosophy of mind on collective mentality. Finally, after offering preliminary responses to the objection that the recognition of collective disorders may lead to an overpathologization of everyday life, I spell out ways in which this recognition may have empowering effects for some would-be patients; for example, by providing substance to the notion of a “sane response to an insane world.”. (shrink)

In the 2000s, several psychiatrists cited the lack of relational disorders (what I call “collective disorders”—disorders of groups rather than individuals) in the DSM-IV as one of the two most glaring gaps in psychiatric nosology, and campaigned for their inclusion in the DSM-5. This campaign failed, however, presumably in part due to serious “ontological concerns” haunting such disorders. Here, I offer a path to quell such ontological concerns, adding to previous conceptual work by Jerome Wakefield and Christian Perring. Specifically, I (...) adduce reasons to think that collective disorders are compatible with key metaphysical commitments of contemporary scientific psychiatry, and argue that if one accepts the existence of mental disorders in individuals as medical, then one has good reasons to accept the existence of collective disorders as medical. First, I outline how collective disorders are reconcilable with both the harmful dysfunction model of disorder and a denial of mind-body dualism. I then identify some potential weaknesses in the main pre-existing example of a collective disorder, offering my own examples as supplements. These examples’ medical plausibility is bolstered by: (1) work in philosophy of biology on the generalized selected effects theory of function (largely from Justin Garson), and (2) work in analytic philosophy of mind on collective mentality (largely from Bryce Huebner). Finally, after offering preliminary responses to the objection that the recognition of collective disorders may lead to an overpathologization of everyday life, I spell out ways in which this recognition may have empowering effects for some would-be patients; for example, by providing substance to the notion of a “sane response to an insane world.”. (shrink)

The thesis that mental states extend beyond the skull, otherwise known as the extended mind thesis, has attracted considerable philosophical attention and support. It has also been accused of lacking practical import. At the same time, the field of psychiatry has remained largely unacquainted with ExM, tending to rely instead upon what ExM proponents would consider to be outdated models of the mind. ExM and psychiatry, therefore, have much to offer one another, but the connection between the two has remained (...) largely unexplored. Here, I consider what implications ExM may have for psychiatry and, in so doing, reveal how psychiatry may lend practical import to ExM. First, I detail the possibility of the extension of one mental state relevant to psychiatry. I augment this example by surveying other possibilities for extension in the context of psychiatric diagnoses. I then consider ways in which such extensions might alter psychiatric diagnosis and treatment. Overall, I argue that recognition of the truth of ExM could alter the diagnostic status of certain individuals by correcting both false positives and false negatives, re-conceptualize certain aspects of treatment, help us re-envision psychiatric research, and potentially increase empathy towards those individuals considered to be mentally disordered or mentally different. (shrink)

In this paper, I offer one moral reason to eschew antidepressant medication in favor of cognitive therapy, all other things being equal: taking antidepressants can be a form of self-objectification. This means that, by taking antidepressants, one treats oneself, in some sense and some cases, like a mere object. I contend that, morally, this amounts to a specific form of devaluing oneself. I argue this as follows. First, I offer a detailed definition of “objectification” and argue for the possibility of (...) self-objectification on this definition. I then explain why this form of self-objectification is morally problematic. (Morally problematic does not mean morally impermissible. It means, instead, that there is a moral reason opposing the activity in question). After, I describe how taking antidepressants can count as self-objectifying. Finally, I defend my thesis against a key objection offered by Levy. Thus, assuming that antidepressants and cognitive therapy are equally efficacious, and that all other things are equal, the self-objectifying character of antidepressants is a compelling reason to regard cognitive therapy as a first-choice treatment for depression. (shrink)

In A Logic in Madness, Aaron J. Hauptman presents the case of Mr. A, a college-age man suffering from the unexpected and cruel severance of a romantic relationship. This breakup caused Mr. A to become severely depressed, harboring a desire to starve himself. However, Mr. A adamantly refused any sort of pharmacotherapy for his condition. Being someone who has “a doggedness with rationality” and who cares deeply about being logical, he offered several arguments and reasons for his refusal. One of (...) these was: “I am depressed for a very good reason and if, because of that, I have these feelings then it is right for me to have these feelings”. He further regarded drug therapy as “dishonest,”... (shrink)

There is a sense in which antidepressants are feminist drugs, liberating and empowering …A lot of things have been said about Prozac.1 We have been instructed both to "listen" and to "talk back" to Prozac (Kramer 1993; Breggin 1994), Prozac has been called a wonder drug (Schumer 1989; Cowley 1990), it has been described as capable of dramatically changing selves and dramatically changing our conception of what a self is (Kramer 1993), it has been accused of dulling our artistic drive (...) (Berlin 2008), of diminishing our authenticity (Elliott 2000) and has been called a modern-day Soma, à la Brave New World (Weisberger 1995, 72; PCBE 2003, 258). It has also been called a "feminist drug." It is this last claim that we .. (shrink)

Prozac has been lauded by Peter Kramer for instilling potentially “liberating” personality traits in women such as assertiveness, resilience, and confidence. Witnessing these effects, Kramer declares that there is a sense in which antidepressants like Prozac are “feminist.” In this paper, we scrutinize Kramer’s claim from myriad angles. We evaluate putatively “feminist” uses of antidepressants in both women who are diagnosed with clinical depression and women thought to use them instead for “enhancement” purposes. We conclude that there are, indeed, some (...) ways in which Prozac is feminist, and some ways in which it is decidedly antifeminist. (shrink)

As neuroscience has gained an increased ability to enchant the general public, it has become more and more common to appeal to it as an authority on a wide variety of questions about how humans do and should act. This is especially apparent with the question of gender roles. The term ‘neurosexism’ has been coined to describe the phenomenon of using neuroscientific practices and results to promote sexist conclusions; its feminist response is called ‘neurofeminism’. Here, our aim is to survey (...) the phenomena of neurosexism and neurofeminism using a largely philosophical approach, incorporating concepts from the philosophy of mind, the philosophy of science, ethics, and feminist philosophy. First, we delineate how neuroscientific studies purporting to show sex brain differences may be prone to bias at a number of methodological levels – including the choice of categories to be studied, and the choice of tools for data gathering, analysis, and presentation. Then, we show how interpretations of such studies may wrongly assume the notion of ‘hard-wiring’. Furthermore, lack of attention to distinctions within philosophy of mind may result in a mistaken supposition that brain differences lead to mental and/or psychological and/or behavioral ones. It is not difficult to see how these forms of neurosexism, leading to claims of ‘hard-wired’ gender differences that map onto traditional and harmful gender stereotypes, raise ethical questions. We conclude by briefly considering one: are the harms caused by neurosexist studies and their interpretations outweighed by their potential benefits? (shrink)

The stories we tell of psychiatric disability1 and gender play a crucial role not only in the experience of psychiatric disorders, but in who disordered individuals are in the most literal sense. Recent theories of the self—so-called narrative self-constitution views, or “narrative theories”—contend that the self is, fundamentally, constituted by a narrative one tells about oneself. Furthermore, this narrative almost certainly absorbs elements from surrounding cultural scripts. Thus, narrative self-constitution views can shed light on some of the ways in which (...) cultural... (shrink)

A primary intention of our original manuscript was to provide examples of both harmful and helpful influences of one cultural artifact—depression memoirs—on who female readers take their selves to be, and who they may actually end up being. Bradley Lewis beautifully articulated our strategy as “chart[ing] out … conflicting vectors” : that is, delineating select examples of how certain outer narratives conveyed in depression memoirs may kindle sexist and sanist modes of being. Our hope was that making these vectors explicit (...) could ultimately be liberating for some individuals by “opening up... (shrink)

It is commonly accepted by those who consider macroevolution as a process decoupled from microevolution that its apparent jerkiness (and, hence, incompatibility with principles of population genetics) results from the structural complexity of epigenetic systems, since all complex cybernetic systems are expected to behave discontinuously. To analyse the validity of this assumption, the process of self-improvement has been analysed in a complex cybernetic system by means of computer simulations. It turns out that the investigated system tends to develop by accumulation (...) of as small structural changes as possible, while larger changes are likely to result in the collapse of the system rather than in its persistence or improvement. This implies that cybernetic considerations alone cannot justify the claim that the very nature of epigenetic systems induces evolution by discrete steps rather than by gradual accumulation of small changes. (shrink)

In honoring Carroll Izard’s contributions to emotion research, we discuss infant facial activity and emotion expression. We consider the debated issue of whether infants are biologically prepared to express specific emotions. We offer a perspective that potentially integrates differing viewpoints on infant facial expression of emotion. Specifically, we suggest that evolution has prepared infants with innate action readiness patterns, which are crucial for early infant–caregiver social interaction, and in the course of social interaction specific facial configurations acquire functional significance, becoming (...) associated with specific emotions. Research has not confirmed the presence of innate neurophysiological action patterns that map onto discrete emotions but evidence indicates that the possibility has not been ruled out. (shrink)

Cognitive Task Analysis (CTA) helps researchers understand how cognitive skills and strategies make it possible for people to act effectively and get things done. CTA can yield information people needemployers faced with personnel issues, market researchers who want to understand the thought processes of consumers, trainers and others who design instructional systems, health care professionals who want to apply lessons learned from errors and accidents, systems analysts developing user specifications, and many other professionals. CTA can show what makes the workplace (...) workand what keeps it from working as well as it might.Working Minds is a true handbook, offering a set of tools for doing CTA: methods for collecting data about cognitive processes and events, analyzing them, and communicating them effectively. It covers both the "why" and the "how" of CTA methods, providing examples, guidance, and stories from the authors' own experiences as CTA practitioners. Because effective use of CTA depends on some conceptual grounding in cognitive theory and researchon knowing what a cognitive perspective can offerthe book also offers an overview of current research on cognition.The book provides detailed guidance for planning and carrying out CTA, with chapters on capturing knowledge and capturing the way people reason. It discusses studying cognition in real-world settings and the challenges of rapidly changing technology. And it describes key issues in applying CTA findings in a variety of fields. Working Minds makes the methodology of CTA accessible and the skills involved attainable. (shrink)

The concept of the future is re-emerging as an urgent topic on the academic agenda. In this article, we focus on the ‘politics of the future’: the social processes and practices that allow particular imagined futures to become socially performative. Acknowledging that the performativity of such imagined futures is well-understood, we argue that how particular visions come about and why they become performative is underexplained. Drawing on constructivist sociological theory, this article aims to fill this gap by exploring the question (...) ‘how do imagined futures become socially performative’? In doing so, the article has three aims to identify the leading social–theoretical work on the future; conceptualize the relationship of the imagination of the future with social practices and the performance of reality; provide a theoretical framework explaining how images of the future become performative, using the concepts ‘techniques of futuring’ and ‘dramaturgical regime’. (shrink)

Epistemic Permissivists face a special problem about the relationship between our first- and higher-order attitudes. They claim that rationality often permits a range of doxastic responses to the evidence. Given plausible assumptions about the relationship between your first- and higher-order attitudes, it can't be rational to adopt a credence on the edge of that range. But Permissivism says that, for some such range, any credence in that range is rational. Permissivism, in its traditional form, cannot be right. I consider some (...) new ways of developing Permissivism to avoid this argument, but each has problems of its own. (shrink)

Romance novels are primarily aimed at, written about, and written for women. They have been accused of being fantasies which feature sexually objectified heroines who are passive recipients of overwhelming masculine sexual energy. After shoring up these critiques of romance novels with A.W. Eaton’s account of how art can objectify its subjects, we examine a challenge to romance novels: does the sexual content in romance novels objectify its heroines? There is strong reason to think so. However, we argue that careful (...) attention to the ways art can objectify its subject reveals that romance novels are structured to make it impossible for their heroines to be objectified. In many cases, individual signs of objectification are raised as possible outcomes and dismissed as part of the plot of a romance novel. Satisfying sex in a romance novel does not appear until it is impossible for the romantic heroine to be objectified. Understood in this way, romance novels serve as a model for one way that objectification could be avoided. The fantasy of a romance novel is not objectifying sex. It is sex free of objectification. (shrink)

Face perception, perhaps the most highly developed visual skill in humans, is mediated by a distributed neural system in humans that is comprised of multiple, bilateral regions. We propose a model for the organization of this system that emphasizes a distinction between the representation of invariant and changeable aspects of faces. The representation of invariant aspects of faces underlies the recognition of individuals, whereas the representation of changeable aspects of faces, such as eye gaze, expression, and lip movement, underlies the (...) perception of information that facilitates social communication. The model is also hierarchical insofar as it is divided into a core system and an extended system. The core system is comprised of occipitotemporal regions in extrastriate visual cortex that mediate the visual analysis of faces. In the core system, the representation of invariant aspects is mediated more by the face-responsive region in the fusiform gyrus, whereas the representation of changeable aspects is mediated more by the face-responsive region in the superior temporal sulcus. The extended system is comprised of regions from neural systems for other cognitive functions that can be recruited to act in concert with the regions in the core system to extract meaning from faces. (shrink)

Stalnaker's Thesis about indicative conditionals is, roughly, that the probability one ought to assign to an indicative conditional equals the probability that one ought to assign to its consequent conditional on its antecedent. The thesis seems right. If you draw a card from a standard 52-card deck, how confident are you that the card is a diamond if it's a red card? To answer this, you calculate the proportion of red cards that are diamonds -- that is, you calculate the (...) probability of drawing a diamond conditional on drawing a red card. Skyrms' Thesis about counterfactual conditionals is, roughly, that the probability that one ought to assign to a counterfactual equals one's rational expectation of the chance, at a relevant past time, of its consequent conditional on its antecedent. This thesis also seems right. If you decide not to enter a 100-ticket lottery, how confident are you that you would have won had you bought a ticket? To answer this, you calculate the prior chance--that is, the chance just before your decision not to buy a ticket---of winning conditional on entering the lottery. The central project of this article is to develop a new uniform theory of conditionals that allows us to derive a version of Skyrms' Thesis from a version of Stalnaker's Thesis, together with a chance-deference norm relating rational credence to beliefs about objective chance. (shrink)

_Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach_ offers a new, short term psychotherapeutic approach to working dynamically with children who suffer from irritability, oppositional defiance and disruptiveness. _RFP-C_ enables clinicians to help by addressing and detailing how the child’s externalizing behaviors have meaning which they can convey to the child. Using clinical examples throughout, Hoffman, Rice and Prout demonstrate that in many dysregulated children, _RFP-C_ can: Achieve symptomatic improvement and developmental maturation as a result (...) of gains in the ability to tolerate and metabolize painful emotions, by addressing the crucial underlying emotional component. Diminish the child’s use of aggression as the main coping device by allowing painful emotions to be mastered more effectively. Help to systematically address avoidance mechanisms, talking to the child about how their disruptive behavior helps them avoid painful emotions. Facilitate development of an awareness that painful emotions do not have to be so vigorously warded off, allowing the child to reach this implicit awareness within the relationship with the clinician, which can then be expanded to life situations at home and at school. This handbook is the first to provide a manualized, short-term dynamic approach to the externalizing behaviors of childhood, offering organizing framework and detailed descriptions of the processes involved in _RFP-C_. Supplying clinicians with a systematic individual psychotherapy as an alternative or complement to PMT, CBT and psychotropic medication, it also shifts focus away from simply helping parents manage their children’s misbehaviors. Significantly, the approach shows that clinical work with these children is compatible with understanding the children’s brain functioning, and posits that contemporary affect-oriented conceptualizations of defense mechanisms are theoretically similar to the neuroscience construct of implicit emotion regulation, promoting an interface between psychodynamics and contemporary academic psychiatry and psychology. Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach is a comprehensive tool capable of application at all levels of professional training, offering a new approach for psychoanalysts, child and adolescent counselors, psychotherapists and mental health clinicians in fields including social work, psychology and psychiatry. (shrink)

Antimicrobial resistance (AMR) is one of the defining global health threats of our time, but no international legal instrument currently offers the framework and mechanisms needed to address it. Fortunately, the actions needed to address AMR have considerable overlap with the actions needed to confront other pandemic threats.

This paper is about four inferences patterns governing conditionals: Transitivity, Simplification, Contraposition, and Antecedent Strengthening. Transitivity, Simplification, and Contraposition are intuitively compelling. Although Antecedent Strengthening may seem less attractive at first, close attention to the full range of data reveals that it too has considerable appeal. An adequate theory of conditionals should account for these facts. The strict theory does so by validating them. But the variably strict theory invalidates them. So the variably strict theorist faces a question: why do (...) we find these inferences so compelling? In this paper, I suggest an answer on her behalf: that they are reasonable inferences in the sense introduced by Stalnaker (1975). -/- . (shrink)

The epistemic thesis is the thesis that a 'might' counterfactual like 'If Matt had gone to the parade, David might have gone to the parade' has the same meaning as 'Maybe, if Matt had gone to the parade, David would have gone to the parade.' I offer a new theory of the counterfactual interpretation of the modal 'might' on which 'might' has the same meaning as 'maybe would'. And I show that, when coupled with a plausible semantics for 'if' clauses, (...) my theory validates the epistemic thesis. (shrink)

In this opening essay, Ginger Danto remembers her father's early life and time travelling in France and Italy, as well as his art‐making—in particular his woodcuts.

This lavishly illustrated book highlights the conservation importance of congregatory animals species--those which gather in vast groups. It also focuses on the irreplaceability of the congregation sites which are able to support such large gatherings of animals, fish, or birds.

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Objective: To identify the frequency and nature of care conflict dilemmas that United States long-term care providers encounter, response strategies, and use of ethics resources to assist with dispute resolution. Design: An online cross-sectional survey was distributed to the Society for Post-Acute and Long-Term Care Medicine (AMDA). Results: Two-thirds of participants, primarily medical directors, have rejected surrogate instructions and 71% have managed family conflict. Conflict over treatment decisions and issues interpreting advance directives were frequently reported. Half of facilities lack a (...) formal dispute mediation policy. Only five respondents have called an ethics consult for assistance. Conclusion: Ethically tense care conflicts commonly arise in long-term and post-acute care facilities. Few facility procedures incorporate ethics resources into actual practice. Recommendations are made to create actionable policy, increase access to ethics services, and support staff skill development in order to improve the end-of-life care experiences for patients, families, and care facility staff. (shrink)

The literature on counterfactuals is dominated by strict accounts and variably strict accounts. Counterexamples to the principle of Antecedent Strengthening were thought to be fatal to SA; but it has been shown that by adding dynamic resources to the view, such examples can be accounted for. We broaden the debate between VSA and SA by focusing on a new strengthening principle, Strengthening with a Possibility. We show dynamic SA classically validates this principle. We give a counterexample to it and show (...) that extra dynamic resources cannot help SA. We then show VSA accounts for the counterexample if it allows for orderings on worlds that are not almost-connected, and that such an ordering naturally falls out of a Kratzerian ordering source semantics. We conclude that the failure of Strengthening with a Possibility tells strongly against Dynamic SA and in favor of an ordering source-based version of VSA. (shrink)

According to quality theories of love, love is fitting by virtue of properties of the loved person. Despite their immediate plausibility, quality theories have met with many objections. Here I focus on two that strike at the heart of what makes the quality theory an appealing account of love, specifically, the theory’s ability to accommodate the fact that loving someone is a way of valuing them for who they are. The fungibility objection and the problem of love’s object maintain that (...) if a person is loved on the basis of their qualities, they are not valued in the right kind of way. I propose a new kind of quality theory which both answers these objections and is independently well-motivated. Specifically, I argue that to love a person as a whole, one must value them as an organic unity. (shrink)

We defend a new constraint on the progressive that says that what you are doing is always specific in an important sense. This principle is Progressive Specificity: if you are Ving and to V is to X or to Y, then you are Xing or you are Ying. We offer three arguments for Progressive Specificity. We then extend those arguments to an analogous principle governing the futurative progressive. Finally, we explore the relationship between Progressive Specificity and the well-known principle of (...) Conditional Excluded Middle. -/- . (shrink)

The works of many early critics of the Christian church were burned by ruling emperors or otherwise destroyed in the second and third centuries, but the writings of the Greek pagan philosopher, Celsus, have survived indirectly through his eloquent opponent Origen of Alexandria. In his apologetical treatise, Contra Celsum, Origen argues against the ideas set forth by Celsus and quotes from Celsus' The True Doctrine at length. Through this treatise, Celsus has come to represent the detached pagan voice of the (...) ages. In this translation, Professor Hoffmann has, for the first time, painstakingly reconstructed the main order of the philosopher's argument. Celsus' discourse shows him to be an eclectic philosopher--a dabbler in various schools of thought, including Platonism and Stoicism, and a student of the history and religious customs of many nations. Hoffman supplements this definitive translation with an informative introduction, summarizing Celsus' premises and placing the identity of Celsus in its historical context. (shrink)