Philosophy of Psychiatry and Psychopathology, Misc

Traditionalists affirm that in self-deception I intend to deceive myself; but, on the standard account of interpersonal deception, according to which deceiver intend to make their target believe a falsehood, traditionalism generates paradoxes, arising from the fact that I will surely know that I want to make myself believe a falsehood. In this thesis, I argue that these well-known paradoxes need not arise under my manipulativist account of deception. In particular, I defend traditionalism about self-deception by showing that what causes (...) paradoxes is not the idea that self-deception is an intrapersonal analogue of interpersonal deception but rather our incorrect conceptions of deception, interpersonal deception, and lying. I show, by way of counterexamples, that the essence of deception is not ending up epistemically worse off but rather being intentionally manipulated into forming or retaining a certain truth-evaluable mental state. Vitally, contra the standard view, the deceiver need not hold that the mental state he intends to produce in the deceived involves a falsehood; in fact, the targeted effect may involve a proposition believed by the deceiver to be true or about whose truth the deceiver suspends belief. Any phenomenon rightly called self-deception, I argue, involves an action in which the person intentionally manipulates (by way of a trick) her own way of forming or retaining some truth-evaluable mental state of her own (belief or a belief-like thought). Thus, on the manipulativist view, a self-deceiver may non-paradoxically intend to deceive himself: the relevant intention is to affect a particular truth-evaluable thought by way of non-deviantly manipulating his agential use of his own cognitive capacities. While all cases of self-deception involve intentional manipulation of the self by the self, how this manipulative trick works out varies in different kinds of cases. In some cases, the self-deceptive manipulative trick is not intentional under that description, a description that captures the so-called deflationary view. Although the manipulativist account allows for numerous different strategies of self-deception, and is consistent with both traditionalism and deflationism, it cannot, by itself, vindicate the idea of lying to oneself. On the standard conception, lying to myself is practically impossible (if the mind is not partitioned) and this is because the very forming the intention to lie to myself – as including the intention to make myself believe my own lie – seems very unlikely. Arguably, people will not φ if they think that φ-ing is impossible. I argue that some kinds of behaviour typically understood as self-deception are actually cases in which the person is lying to herself without the intention to deceive herself; rather, she avoids legitimising an unfavourable state of affairs by openly affirming its contrary. It may also be the case, however, that some lies to oneself are aimed at deceiving – this is because, as I argue, liars need not assert what they believe is false; hence, by lying to myself, I may intend to increase my confidence in the belief I already hold. Finally, the motive for self-deception is always a matter of preserving the person’s endorsed idealised picture of reality. This account allows me to explain all possible cases of self-deception. In the last chapter, I apply my theory to some paradigmatic cases first outlined in my introduction. (shrink)

Experimental and theoretical studios are reported of the current-voltage characteristics and Josephson radiations from granular Y1Ba2Cu3Oy bridges. We show that the granular structure of bridges can be understood as a series connected independent and inhomogeneous resistively shunted junction army. When we take typical values of junction critical parameters, the experimental results are well understood quantitatively.

The question that drives this paper is: How does time function in psychosis? Given the altered or inhibited relation to speech in psychosis, I think that it is worth working out a notion of temporal or, to borrow Bessel van der Kolk’s term, “rhythmical. .. .interactions” (Listening to Trauma, 2014) with the afflicted persons. Using Freud’s analysis of non-linear psychic time, I construct a theoretical model of temporal modifications in psychosis. I then use this model, along with Lacan’s writings on (...) psychosis, to show the temporality peculiar to psychotic breakdowns. Aligning the theoretical analyses with the individual testimonies, I draw on patient accounts of psychotic time-perception recited by Davoine and Gaudillière and by Minkowski. (shrink)

Madness and Modernism is undoubtedly one of the most profound and perspicacious treatments of an illness that is utterly baffling to most laypersons and academics alike. Sass artfully brings together two obscure, complex, and unnerving realms -- the schizophrenic and the modern and postmodern aesthetic -- into mutual enlightenment. The comparisons between schizophrenic symptoms such as loss of ego boundaries, perspectival switching, and world catastrophe with modern literature and art is so adroit that it is almost eerie. The reader finds (...) herself peering into a borderline incomprehensible realm with increasing levels of clarity, by which she gains insight into the utterly chaotic, confused, and bizarre. The lucidity Sass brings to the obscure and confused is a reflection of the many contradictions he introduces to his readers as being entirely paradigmatic of both madness and modernism: that of desiring human contact but also shunning it entirely, of being both afflicted by disease but also exercising a sort of agency, and indeed, an ideal intellectual freedom within the confines of such an affliction, of moving both towards an objectifying materiality of the external world and a total subjectivization of perception, of the tendency towards the hyperabstract and the utterly concrete (between being too "far away" or "too close," respectively). Sass is able to make sense of a world in which these contradictions exist side by side simultaneously, and the disconcerting confusion this causes is palpable to the reader. Sass demonstrates not only his penetrating intellect, but also his unwavering patience and empathy, both in the treatment of the subject matter and the treatment of the subjects suffering from this extraordinary illness. The book is required reading for anyone interested in phenomenological psychiatry, or even psychiatry more generally. (shrink)

Contemporary psychiatry faces serious challenges because it has failed to incorporate accumulated knowledge from basic neuroscience, neurophilosophy, and brain–mind relation studies. As a consequence, it has limited explanatory power, and effective treatment options are hard to come by. A new conceptual framework for understanding mental health based on underlying neurobiological spatial-temporal mechanisms of mental disorders (already gained by the experimental studies) is beginning to emerge.

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study of schizophrenia (...) and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

Psychologists and neuroscientists often struggle to integrate findings in their respective domains, a problem due partly to implicitly and explicitly held philosophical positions on issues of reduction and autonomy across these domains. The present article reviews how reduction and autonomy have been used in philosophical arguments regarding how macro-scale findings relate to micro-scale findings across various scientific disciplines. The present article demonstrates how macro findings are indispensable to explanations of phenomena of interest by (a) providing information regarding higher levels of (...) organization in mechanisms, (b) including information not contained within certain micro explanations that (c) provides more general and stable causal explanations relative to micro explanations in certain situations. The purpose of presenting these analyses and recommendations is to disabuse psychologists and neuroscientists of pervasive assumptions that psychology is reducible to biology and that lower level phenomena (molecular) should be prioritized as somehow more explanatory than higher level phenomena (behavioral). The article concludes with 3 hypothetical scenarios from clinical psychology and psychiatry illustrating this critique and providing a pragmatic approach to clarify the relative roles, and importance, of biological and psychological data in service of general and stable explanations that are tailored to the kind of intervention desired. (shrink)

Review of the collection "Responsibility and Psychopathy: Interfacing Law, Psychiatry and Philosophy", edited by Luca Malatesti and John McMillan.

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by delusional (...) episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

Fredrik Svenaeus has applied Heidegger’s concept of ‘being-in-the-world’ to health and illness. Health, Svenaeus contends, is a state of ‘homelike being-in-the-world’ characterised by being ‘balanced’ and ‘in-tune’ with the world. Illness, on the other hand, is a state of ‘unhomelike being-in-the-world’ characterised by being ‘off-balance’ and alienated from our own bodies. This paper applies the phenomenological concepts presented by Svenaeus to cases from a study of depression. In doing so, we show that while they can certainly enrich our understanding of (...) depression, they can also reveal a clash between some societal definitions of illness and the individual’s definition. Phenomenological analysis may thus cause us to question what we mean, or think should be meant, by the terms ‘health’ and ‘illness’. (shrink)

The main objective in this chapter is to examine the role of judgments of rationality in the current understanding of psychiatric disorders. To what extent are the criteria for classification and diagnosis independent of judgments of rationality? The typical symptoms of many psychiatric disorders are described as instances of epistemic, procedural, or emotional irrationality, and references to such forms of irrationality are frequently made in the current classificatory and diagnostic criteria for schizophrenia, dementia, depression, and personality disorders. That said, the (...) chapter defend the view that irrationality is neither necessary nor sufficient for a behavior to be characterized as symptomatic of a psychiatric disorder. (shrink)

New class of therapies, including bipolar therapies (BPT) and paradoxical unipolar therapies (PUT) were firstly proposed in relation to a clinical insight and to some results of biological investigations, then they gave rise to mathematical modeling which brought a justification of these therapies, at least from a theoretical point of view. After recalling the mathematical model for the regulation of agonistic antagonistic couples, and reporting the fundamental types of control simulation by means of it, we point out the validity of (...) therapeutical applications inferred from this model. These therapy modalities, including BPT and PUT, now concern the following diseases: astrocytomas, epilepsia and trials on multiple sclerosis. Even if such attempts are in their early stage, noticeably for the last case where biological changes have mainly been studied, it seems that a large span of treatments is open to BPT and PUT. Improvement of these techniques in the future depends, in our opinion, on a parallel working on the dynamics of the mathematical model and the dynamics, perceived by clinical insight and confirmed by biological investigations, of the body reactions to such strategies. Justification of BPT and PUT was given, by resorting to the notion of pathological homeostasis which, too often, intervenes in order to nullify the effects of unilateral (not paradoxical) therapies. This research has elicited some therapies which use two agents with antagonistic effects or only an agent with effects similar to the agent already in excess in the body - in both cases at nearly physiological doses. (shrink)

The past decade has witnessed a growing awareness of conceptual and methodological hurdles within psychology and neuroscience that must be addressed for taxonomic and explanatory progress in understanding psychological functions to be possible. In this paper, I evaluate several recent knowledge-building initiatives aimed at overcoming these obstacles. I argue that while each initiative offers important insights about how to facilitate taxonomic and explanatory progress in psychology and neuroscience, only a “coordinated pluralism” that incorporates positive aspects of each initiative will have (...) the potential for success. (shrink)

It often seems incorrect to say that psychiatric conditions are diseases, and equally incorrect to say that they are not. This results in what would seem to be an unsatisfactory stalemate. The present essay examines the considerations that have brought us to such a stalemate in our discussions of autism. It argues that the stalemate in this particular case is a reflection of the fact that we need to find the logical space for a position that rejects both positive and (...) negative answers. It then suggests one way in which we might find such space, by applying Michael Dummett’s notion of semantic disharmony. (shrink)

If we already had a periodic table of mental illness in hand, there would be less need for a book of this type. Although some psychiatrists do think of themselves as chemists, the analogy is without warrant. Not only does psychiatry lack an analogue of the periodic table, its principal tool -- the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- is a contentious document. Even subsequent to the publication of DSM-III in 1980, which was intended to serve as (...) an operational guideline for clinical practice, it and its heirs (DSM-V was published in 2013) have often fueled rather than quelled controversy. Although beginning with that third major revision of DSM a concerted effort has been made to ensure greater consistency in diagnoses, psychiatry remains beset by concerns that it is insufficiently scientific, unduly influenced by the pharmaceutical industry, indecisive as to whether it should focus on the mind or the brain, incapable of distinguishing among types of diseases, inclined to expand illness criteria without adequate justification, overly reliant on subjective judgments, wont to conflate clinical and ethical judgments, and engaged in indiscriminate use of psychoactive drugs. These worries concerning its scientific and ethical status are among the reasons that psychiatry attracts the attention of philosophers. (shrink)

Human behavior is frequently described both in abstract, general terms and in concrete, specific terms. We asked whether these two ways of framing equivalent behaviors shift the inferences people make about the biological and psychological bases of those behaviors. In five experiments, we manipulated whether behaviors are presented concretely (i.e. with reference to a specific person, instantiated in the particular context of that person’s life) or abstractly (i.e. with reference to a category of people or behaviors across generalized contexts). People (...) judged concretely framed behaviors to be less biologically based and, on some dimensions, more psychologically based than the same behaviors framed in the abstract. These findings held true for both mental disorders (Experiments 1 and 2) and everyday behaviors (Experiments 4 and 5) and yielded downstream consequences for the perceived efficacy of disorder treatments (Experiment 3). Implications for science educators, students of science, and members of the lay public are discussed. (shrink)

Many philosophers and psychologists have sought to explain experiences of auditory verbal hallucinations and “inserted thoughts” in schizophrenia in terms of a failure on the part of patients to appropriately monitor their own inner speech. These self-monitoring accounts have recently been challenged by some who argue that AVHs are better explained in terms of the spontaneous activation of auditory-verbal representations. This paper defends two kinds of self-monitoring approach against the spontaneous activation account. The defense requires first making some important clarifications (...) concerning what is at issue in the dispute between the two forms of theory. A popular but problematic self-monitoring theory is then contrasted with two more plausible conceptions of what the relevant self-monitoring deficits involve. The first appeals to deficits in the neural mechanisms that normally filter or attenuate sensory signals that are the result of one’s own actions. The second, less familiar, form of self-monitoring approach draws an important analogy between Wernicke’s aphasia and AVHs in schizophrenia. This style of self-monitoring theory pursues possible connections among AVHs, inserted thoughts, and the disorganized speech characteristic formal thought disorder. (shrink)

Psychiatry or psychopathology finds itself in a state of imbalance. The reason: the impossibility to unite biological and psychological factors. Effectively, this leads to the psychic reality being largely ignored. And yet psychiatry as a human science will have to acknowledge the psychic reality: the human capacity to symbolise reality. This book demonstrates that phenomenology, hermeneutics and Lacanian psychoanalysis support this view, whilst also drawing on Cassirer’s theory of symbolization. In the domain of psychopathology, this convergence and the conceptual space (...) it brings offer an opportunity to create cross-fertilisation, enlarging the Lacanian clinical perspective. It will result in a philosophical conception of man as animal symbolicum , an animal fallen prey to language. In sum, the book renders a contribution to Lacanian psychopathology, to the philosophy of psychiatry and to philosophical anthropology. It is of interest to psychiatrists, psychologists, psychoanalysts and philosophers alike. (shrink)

Kirk and Kutchins begin with the fact that the primary justification for the development and adoption of DSM-III was that it would increase diagnostic reliability. In various contexts, they discuss the sources of diagnostic "error." One is information variance, the consequence of different clinicians asking different questions, receiving slightly different responses to the same questions, interpreting responses differently, and eliciting different behavior from the client. Another is criterion variance, the consequence of different opinions among clinicians about what information is relevant, (...) how information should be interpreted, and what diagnostic category, if any, is appropriate. Other sources of "error" are differences in clinicians' past personal experiences, expectations, emotions, and illogical thinking, unfounded inferences, selective attention, and stereotypes. (shrink)

Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. The series will aim to build links between the sciences and humanities in psychiatry. Our ability to decipher mental disorders depends to a unique extent on both the sciences and the humanities. Science provides insight into the 'causes' of a problem, enabling us to formulate an 'explanation', and the humanities provide insight into its 'meanings' and helps with our 'understanding'. Psychiatry, (...) if it is to develop as a balanced discipline, must draw on input from both of these spheres. Nature (for causes) and Narrative (for meanings) will help define the series as a whole by touching on a range of issues relevant to this 'border country'. With contributions from an international star-studded cast, representing the field of psychiatry, psychology and philosophy, this volume will set the scene for this new interdisciplinary field. This will be of interest to all those with practical experience of mental health issues, whether as providers or as users/consumers of services, as well as to philosophers, social scientists, and bioethicists. (shrink)

_The first part called the Preamble tackles: (a) the issues of silence and speech, and life and disease; (b) whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c) the phenomenon of Why, How, and What; (d) how are mind and brain related; (e) what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f) bioethics and the four principles of beneficence, non-malfeasance, (...) autonomy, and justice; (g) the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a) the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b) biology, Freud and the reinvention of psychiatry; (c) critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d) the biological, the psychoanalytic, the psychosocial and the cognitive; (e) the issues of clarity, reductionism, and integration; (f) what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a) psychiatric disorder, mental health, and mental phenomena; (b) issues in psychiatric ethics; (c) social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a) antipsychiatry revisited; (b) basic arguments of antipsychiatry, Szasz, etc.; (c) psychiatric classification and value judgment; (d) conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy, Religion, and Spirituality in Psychiatry. It includes topics like (a) relevance of philosophy to psychiatry; (b) psychiatry, religion, spirituality, and culture; (c) ancient Indian concepts and contemporary psychiatry; (d) Indian holism and Western reductionism; (e) science, humanism, and the nomothetic-idiographic orientation. The last part, called Final Goal, talks of the need for a grand unified theory. The whole discussion is put in the form of refutable points._. (shrink)

Freud, working from a background in clinical neurology and against a backdrop of burgeoning theory development in biology and neurophysiology, thought that the layers of the mind mirrored the layers of the brain although he was well aware of the conceptual problems involved in trying to identify the two. His associationist view, based on a neurobiological and evolutionary approach to the mind tends to underestimate the role of consciousness in a holistic conception of the psyche. The role of language and (...) the disciplines and practices which structure the psyche make it a domain in which negotiated solutions to life challenges are produced from the socio-cultural resources of discourse applied to the biological propensities resulting from innate dispositions and learning history. Although the biological and social realms obey fundamentally different rules, their psychological effects are realised in a common medium — the brain — a fact that can be detached from reductive approaches to psychology or psychiatry and can give substance to the idea of the body being inscribed like a surface on which events have left their trace. (shrink)

In spite of a considerable progress in comorbidity research and huge literature on it, this phenomenon is one of the greatest epistemological, research and clinical challenges to contemporary psychiatry and medicine. Mental disorders are very often comorbidly expressed, both among themselves and with various sorts of somatic diseases and illnesses. Therefore, comorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and effi cient treatment within (...) the frame of person centered transdisciplinary psychiatry and integrative medicine. This review focuses fi rst on conceptual chaos and different connotations, then on transdisciplinary perspectives of comorbidity and multimorbidity. The authors compiled an extensive set of various views and perspectives, dilemmas and controversies, in order to evaluate what we know and what we don’t about comorbidity, what comorbidity is and what comorbidity is not, what are facts and what are non-facts on comorbidity and multimorbidity. (shrink)

Deviance is esteemed in the art world, and all great artists have broken with the traditions that preceded them and rebelled against their contemporaries. Yet in society deviance is more often than not condemned. Our apparently contradictory attitudes toward artistic and social deviance are explicable in light of the conservative nature of institutions and the nature of comprehensibility and psychiatry.