Essential Philosophy of Psychiatry is a concise introduction to the growing field of philosophy of psychiatry. Divided into three main aspects of psychiatric clinical judgement, values, meanings and facts, it examines the key debates about mental health care, and the philosophical ideas and tools needed to assess those debates, in six chapters. In addition to outlining the state of play, Essential Philosophy of Psychiatry presents a coherent and unified approach across the different debates, characterized by a rejection of reductionism and (...) an emphasis on the ineliminability of uncodified skilled judgement. The first part, Values, outlines the debate about whether diagnosis of mental illness is essentially value-laden and argues that the prospects for reducing illness or disease to plainly factual matters are poor. It also explains the important role of skilled contextual judgement, rather than a principles-based deduction, in ethical judgement. The second part, Meanings, examines the central role of understanding and a shared first person perspective, both against attempts to reduce meaning to basic information-processing mechanisms and to explain away the difficulties of understanding psychopathology in recent models of delusion. The third part, Facts, shows the importance of uncodified clinical judgements, both in assessing the validity of psychiatric taxonomy and in the application of Evidence Based Medicine. Despite advances in the codifaction of practice and operationalism of diagnosis, an element of judgement remains in the assessment both of what, at one level, is good evidence for diagnosis and treatment and what, at a higher level, is good evidence for the validity of classification overall. (shrink)

Editorial preface to the fourth edition and modified translation -- The text of the Philosophische Untersuchungen -- Philosophische untersuchungen = Philosophical investigations -- Philosophie der psychologie, ein fragment = Philosophy of psychology, a fragment.

The imperviousness of delusions to counter-evidence makes it tempting to classify them as imaginings. Bayne and Pacherie argue that adopting a dispositional account of belief can secure the doxastic status of delusions. But dispositionalism can only secure genuinely doxastic status for mental states by giving folk-psychological norms a significant role in the individuation of attitudes. When such norms individuate belief, deluded subjects will not count as believing their delusions. In general, dispositionalism won't confer genuinely doxastic status more often than do (...) competing accounts of belief. (shrink)

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the book (...) is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

In Minimal Rationality, Christopher Cherniak boldly challenges the myth of Man the the Rational Animal and the central role that the "perfectly rational...

For this second edition, the editors have returned to Austin's original lecture notes, amending the printed text where it seemed necessary.

The author believes that large‐scale rationality on the part of the interpretant is essential to his interpretability, and therefore, in his view, to her having a mind. How, then are cases of irrationality, such as akrasia or self‐deception, judged by the interpretant's own standards, possible? He proposes that, in order to resolve the apparent paradoxes, one must distinguish between accepting a contradictory proposition and accepting separately each of two contradictory propositions, which are held apart, which in turn requires to conceive (...) of the mind as containing a number of semi‐independent structures of interlocking beliefs, desires, emotions, memories, and other mental states. (shrink)

Much as we would like to conceive empirical thought as rationally grounded in experience, pitfalls await anyone who tries to articulate this position, and ...

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)

"Our literature is replete with complaints about the chaotic state of the systematics of psychoses and every psychiatrist knows that it is impossible to come to any common understanding on the basis of the old diagnostic labels. ... Thus, not even the masters of science can make themselves understood on the basis of the old concepts and with many patients the number of diagnoses made equals the number of institutions they have been too. ... Errors are the greatest obstacles to (...) the progress of science; to correct such errors is of more practical value than to achieve new knowledge. We have here eliminated chaos of terms behind which useful concepts of disease were mistakenly sought; we have eliminated a veritable forest of boundary posts, not one of which indicated any natural line of demarcation. ... By the term „dementia praecox“ or „schizophrenia“ we designate a group of psychoses whose course is at times chronic, at times marked by intermittent attacks, and which can stop or retrograde at any stage, but does not permit a full restitutio ad integrum. The disease is characterized by a specific type of alteration of thinking, feeling, and relation to the external world which appears nowhere else in this particular fashion." Eugen Bleuler. Dementia Praecox or the Group of Schizophrenias. Translated by Joseph Zinkin. International Universities Press, New York, 1950. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

Recreative Minds develops a philosophical theory of imagination that draws upon the latest work in psychology. This theory illuminates the use of imagination in coming to terms with art, its role in enabling us to live as social beings, and the psychological consequences of disordered imagination. The authors offer a lucid exploration of a fascinating subject.

In the course of the discussion, Professor Quine pinpoints the difficulties involved in translation, brings to light the anomalies and conflicts implicit in our ...

Thomas S. Kuhn's classic book is now available with a new index.

These works, as the sub-title makes clear, are unfinished sketches for Philosophical Investigations, possibly the most important and influential philosophical work of modern times. The 'Blue Book' is a set of notes dictated to Witgenstein's Cambridge students in 1933-1934: the 'Brown Book' was a draft for what eventually became the growth of the first part of Philosophical Investigations. This book reveals the germination and growth of the ideas which found their final expression in Witgenstein's later work. It is indispensable therefore (...) to students of Witgenstein's thought and to all those who wish to study at first-hand the mental processes of a thinker who fundamentally changed the course of modern philosophy. (shrink)

Bortolotti argues that the irrationality of many delusions is no different in kind from the irrationality that marks many non-pathological states typically treated as beliefs. She takes this to secure the doxastic status of those delusions. Bortolotti’s approach has many benefits. For example, it accounts for the fact that we can often make some sense of what deluded subjects are up to, and helps explain why some deluded subjects are helped by cognitive behavioral therapy. But there is an alternative approach (...) that secures the same benefits as Bortolotti’s account while bringing additional benefits. The alternative approach treats both many delusions and many of the non-pathological states to which Bortolotti compares them as in-between states. Subjects in in-between states don’t fully believe the beliefs which it is sometimes convenient to ascribe to them. This alternative approach to belief and belief-ascription fits well with an independently attractive account of the varied purposes of our ordinary attitude ascriptions. It also makes it easier to make fine-grained distinctions between intentional attitudes of different kinds. (shrink)

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent (...) epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions. (shrink)

In Paradoxes of Delusion, Sass aims to use passages from Wittgenstein to characterize the feeling of “mute particularity” that forms a part of delusional atmosphere. I argue that Wittgenstein’s discussion provides no helpful positive account. But his remarks on more everyday cases of the uncanny and the feeling of unreality might seem to promise a better approach via the expressive use of words in secondary sense. I argue that this also is a false hope but that, interestingly, there can be (...) no interesting or substantial explanation of this failure. (shrink)

Circumscribed delusional beliefs can follow brain injury. We suggest that these involve anomalous perceptual experiences created by a deficit to the person's perceptual system, and misinterpretation of these experiences due to biased reasoning. We use the Capgras delusion (the claim that one or more of one's close relatives has been replaced by an exact replica or impostor) to illustrate this argument. Our account maintains that people voicing this delusion suffer an impairment that leads to faces being perceived as drained of (...) their normal affective significance, and an additional reasoning bias that leads them to put greater weight on forming beliefs that are observationally adequate rather than beliefs that are a conservative extension of their existing stock. We show how this position can integrate issues involved in the philosophy and psychology of belief, and examine the scope for mutually beneficial interaction. (shrink)

During the last dozen years, Daniel Dennett has been elaborating an interconnected – and increasingly influential – set of views in the philosophy of mind, the philosophy of psychology, and those parts of moral philosophy that deal with the notions of freedom, responsibility, and personhood. The central unifying theme running through Dennett's writings on each of these topics is his concept of an intentional system. He invokes the concept to “legitimize” mentalistic predicates ("Brainstorms", p. xvii), to explain the theoretical strategy (...) of cognitive psychology and artificial intelligence, and, ultimately, to attempt a reconciliation between “our vision of ourselves as responsible, free, rational agents, and our vision of ourselves as complex parts of the physical world of science” (BS, p. x). My goal in this paper is to raise some doubts about the “intentional coin” (BS, p. xviii) with which Dennett proposes to purchase his moral and “mental treasures.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 267-271 [Access article in PDF] Likening Strikes Twice:Psychiatry, Osteopathy, and the Likeness Argument Stephen Tyreman PRIMA FACIE PSYCHIATRY and osteopathy do not appear to share much common ground; however, in at least one important respect they pursue similar goals. By seeking to consolidate their independent identities, each is challenging the dominance of the medical model. This involves justifying what they do and why (...) they should exist as independent professions. With osteopathy the situations are different in the United Kingdom and the United States, but in both countries the same challenge exists (Howell 1999; Tyreman 1998). Broadly, it boils down to how osteopathy is positioned in relation to conventional (orthodox or allopathic) medicine and, particularly, to how its practice and theory is validated by scientific methodology. Howell, an allopathic practitioner, sums up the situation as he sees it in the United States by concluding in his New England Journal of Medicine editorial, "many people—even osteopaths—question what it is that osteopathy has to offer that is distinctive.... The paradox is this: if osteopathy has become the functional equivalent of allopathy, what is the justification for its continued existence? And if there is value in therapy that is uniquely osteopathic—that is, based on osteopathic manipulation or other techniques—why should its use be limited to osteopaths?" (1999, 1468). In the United Kingdom, with the passing of the Osteopaths Act in 1993 and the establishment of statutory self-regulation, the profession has been trying to define itself by identifying its raison d'être and the extent to which it aligns itself with medical assumptions.Fueling this dilemma, which in different ways affects psychiatry and osteopathy (and other professions supplementary to, allied with, or complementary to medicine), is the same question: does the paradigm of physical illness, explained and validated by the biological sciences, provide the basic model for understanding and treating all forms of illness—physical, mental, and functional? How are the concepts of illness and disease to be defined and how do such definitions relate to the justification for treatment and other health interventions?Neil Pickering has produced an interesting contribution to the mental illness side of this debate by analyzing the likeness argument, wherein mental illness is said to be a real illness and therefore a legitimate reason for providing treatment, because, in significant respects, it has the same features as other forms of illness acknowledged as being real illnesses. In criticizing the argument he identifies two key assumptions: "that there are features of human conditions... that decide what category or kind, these conditions are a member of" and "that, with respect to the [End Page 267] presence or absence of these features, a condition... is describable independent of the category it is assigned to" (2003, p. 245). He rightly points out that these assumptions do not stand up to analysis and therefore, if indeed they are fundamental assumptions for the argument, the likeness argument must fail. His reason for requiring the argument to fail is that it is not possible to describe (illness) features independently of the category to which they are assigned, which undermines both key assumptions. Therefore all such attempts must fail. He is not clear about what replaces it other than implying that it entails value judgments and human selection.My comments are not so much criticisms of Pickering's conclusion, which I think is correct, but of his reasons for coming to that conclusion, which I think are based on false assumptions; with a different emphasis his argument could be made much stronger.Pickering's argument appears to rest on (at least) three assumptions: he explicitly states that (for the purposes of his argument) illness and disease can be used interchangeably; second, that physical illness is a natural kind; third, that for conventional/allopathic medicine, illness is best understood and explained in physical terms. In addition, and partly as a consequence of the above, there is an implicit assumption that physical illness is the standard against which all other claims to be illnesses should be tested; that is, that... (shrink)

This paper describes and defends in detail a novel account of belief, an account inspired by Ryle's dispositional characterization of belief, but emphasizing irreducibly phenomenal and cognitive dispositions as well as behavioral dispositions. Potential externalist and functionalist objections are considered, as well as concerns motivated by the inevitably ceteris paribus nature of the relevant dispositional attributions. It is argued that a dispositional account of belief is particularly well-suited to handle what might be called "in-between" cases of believing - cases in (...) which it is neither quite right to describe a person as having a particular belief nor quite right to describe her as lacking it. (shrink)

This paper offers a critique of a central psychopathological concept, the notion of "poor reality-testing. "Using ideas from the philosopher Ludwig Wittgenstein, I consider the nature of delusions in schizophrenia, largely through examining Daniel Paul Schreber's famous Memoirs of My Nervous Illness. Many schizophrenic individuals do not in fact mistake their fantasies for reality, as is traditionally assumed. Rather, I argue, they engage in a solipsistic mode of experience, a felt subjectivization of the lived world that is associated with a (...) stance of passivity and hyperconsciousness. I discuss the existential conditions and consequences of this stance and show that certain anomalous or paradoxical features of schizophrenic delusion are explicable on this phenomenological account. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 135-141 [Access article in PDF] On Delusions of Sense:A Response to Coetzee and Sass Rupert Read Keywords schizophrenia, Wittgenstein, Schreber, Faulkner, Benjy, grammar, madness, Cogito The great writings on and of severe mental affliction—those for instance of Schreber, 'Renee', Donna Williams, Artaud, Faulkner's The Sound and the Fury, Coetzee's In the Heart of the Country, Kafka's "Description of a struggle," and even (I (...) would add) key parts of The Lord of the Rings—present us with something deeply enigmatic. They have, we might say, a strong grammar, a grammar—a mode of hanging together, and (in this case) of linguistically seeming to make a sense that is not our sense and that we cannot make sense of—... they have a grammar all of their own, and all of its own, a grammar that resists and rejects interpretation even as it sometimes seems to offer interpretations. 1It was Wittgenstein's view that to make mental illness unpuzzling was a mistake, or (better, perhaps) a mythologically problematic move. Wittgenstein's aim in his philosophizing was to understand what was enigmatic when it could be understood without unwisely turning it into something altogether unpuzzling... and then to acknowledge that there are some things that may remain forever puzzling, without committing oneself to the metaphysically disastrous claim that the reason they are endlessly puzzling is that they lie outside the boundaries of human life, language, or reason, as though we could peek outside those alleged boundaries to see what was there, but never truly say anything about it.There simply may be places where our understanding—phenomenological understanding, understanding of what it is like—gives out, and not because it is (or we are) merely human. For instance, perhaps one cannot capture some mental illness by intellection alone, or even perhaps at all. Perhaps the best understanding one can have of mental illness is purely negative (in a sense at least as strong as that involved in negative theology, wherein God is only defined by what it is not).Louis Sass (2003) writes I am not sure whether or not Read would accept that a philosophical position can be understandable despite its containing deep, internal logical tensions (perhaps he would not). If such understanding is possible, however, it does seem to open the way for a similar understanding of conditions like that of Schreber. (p. 127) Unfortunately, however, it is indeed not possible—that is, this notion is merely a fantasy—by my lights. Philosophical positions, all of which turn out to contain such inexorable tensions, cannot be understood: they are mirages. Solipsism, as a position, is not any better (or worse) off [End Page 135] than (say) (Metaphysical) Realism. They are both mirages, just different aspects of the same nothing. 2 Considered as positions, they are in the end literally—when one understands their logic—one and the same nothing. Wittgenstein already made this quite clear in his Tractatus. Perhaps in contrast to Sass, there is then nothing special about solipsism: it is just one mode of presentation rather than another of the illusion that there can be philosophical positions.Sass claims that in saying this kind of thing I am committed to ruling out that some mental illness can be understood or can even exist, on abstract intellectual grounds. I am not. I am simply wishing to leave open the possibility that there may be things that some people utter or seem to experience which intellection gives us little or no assistance with. If Sass wishes to deny this, then I suggest that it is he and not I who is the absolutist intellectualist here, in insisting that rewriting something deeply strange in a weaker grammar is furthering our grasp of it.My suggestion concerning Faulkner's presentation of Benjy, in my original paper, was that it is a mythological mistake to think that Faulkner provides us with the tools for giving an unpuzzling rendition of what had perhaps appeared to be "another country," inaccessible to us. Rather, Faulkner's representation... (shrink)

I argue that the language of some schizophrenic persons is akin to the language of Benjy in Williams Faulkner's novel The Sound and the Fury, in one crucial respect: Faulkner displays to us language that, ironically, cannot be translated or interpreted into sense... without irreducible 'loss' or 'garbling.' The same is true of famous schizophrenic writers, such as Renee and Schreber. Such 'garbling' is of an odd kind, admittedly: it is a garbling that inadvisably turns nonsense into sense.... Faulkner's language (...) is a language of paradox, of nonsense masquerading beautifully as sense. When this language works, it generates the powerful illusion that we can make sense of the 'life-world' of a young child or an 'idiot'—or a sufferer from chronic schizophrenia. But this remains, contrary to Louis Sass's claims, an illusion. Thus, drawing on the thinking of Wittgenstein (his On Certainty, especially, with its incisive critique of the very idea of being able to make claims or statements from within a sufficiently altered [non]state of mind) and of the Wittgensteinian literary critic James Guetti (who critiques the very idea of 'deranged language' being paraphrased into sense), I argue that the most impenetrable cases of schizophrenia may be cases not of a sense being made that we cannot grasp, nor of a different form of life, but, despite appearances, of no sense, no form of life, at all. This is an option that has not really been considered in the literature of/on psychopathology to date. And it can be tentatively established, not through a dubious scientism, but through a careful attention to the literature of the insane and the literature of Modernism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 265-266 [Access article in PDF] Definition Is Limited and Values Inescapable Richard Mullen THIS IS A welcome paper that lays bare some of the presumptions of those who seek to determine the status of psychiatric disorder. At different times debate on the subject reflects stigma, prejudice, needs for coherent categorization, and occasionally just antipsychiatric resentment. As Pickering hints, much philosophical argument may be (...) selected to support a position already chosen.The article illustrates that the likeness argument is insufficient to demonstrate that mental disorders are or are not disorders in any other more profound sense. Similarly perhaps, if a debate were conducted about whether or not a bony fracture, hypertension, obesity, or bacterial infection were real illnesses, the likeness argument might be unfruitful. This is perhaps unsurprising; notions of health and illness, mental or physical, are largely abstractions. In psychiatry, so-called symptoms are themselves abstract classifications of incompletely articulated mental phenomena far more diverse than the definitions and criteria to be found in a diagnostic manual.Argument by analogy is always limited. If my car has a flat tire, the car will be dysfunctional or disordered. Its loss of performance will be the symptoms of the flat tire, which is the lesion. It is a problem quickly diagnosed and treated. If convenient, I suppose my car could have been said to be ill, but this would not lead to any particular insights into the nature of cars, mechanics, health, or anything else.A variety of concepts can be contained within terms such as illness,disease, and disorder. They include the clinicopathological approach (the disease is the organic lesion), the disease is deviance approach, disease as distress, and approaches that consider disease—particularly mental disorder—as largely socially constructed. None may resolve the questions that Pickering raises, but recognizing that our terms are not always precise or used consistently is part of formulating the problem more clearly. For the most part clinical psychiatry (and the rest of medicine) has no difficulty in properly identifying most of our patients as disordered or ill. The fact that there are some borderline instances, difficult to classify either way, does not invalidate the classification.Consideration of whether or not the features of a disorder can in themselves determine whether or not a person is disordered is timely for two reasons. As stigma about (some) psychiatric disorder lessens, and opportunities for complaint and compensation expand, an era of self-definition as mentally disordered has arrived. How are mental health practitioners to respond to someone whose mental distress appears not to be clinically significant, but who demands access to the sick role? Also of current concern for clinical psychiatry is widespread pressure to define as disordered those persons whose antisocial behavior brings them into conflict with society. Professional recognition that definitions of mental disorder are inadequate, or rather incomplete, [End Page 265] may be valid. Worryingly, there are others who are willing to define it for us.Both major international systems of classification of mental disorder offer definitions of mental disorder that turn on what is to be meant by clinical significance or clinically recognizable. In the current Diagnostic and Statistical Manual, mental disorder implies "clinically significant impairment or distress," and criteria for specific disorders mostly including a comment about "clinically significant distress or impairment in social, occupational, or other important areas of functioning" (APA 2000, 8). In the International Classification of Disease, disorder is used to imply "existence of a clinically recognizable set of symptoms or behavior associated in most cases with distress and with interference with personal function" (WHO 1992, 5). It seems that no definition of mental disorder is adequate for all purposes. Seeking to improve existing definitions by further defining the terms used quickly becomes an exercise in pedantry, far removed from practical utility.Pickering mentions as an example the "symptom" of delusions. Available definitions are widely recognized as incomplete or otherwise unsatisfactory (David 1999). This leads to debate about what the individual elements within the definition precisely mean. However in practice delusions are identified with remarkably high reliability (WHO 1973... (shrink)

Whether your scepticism is as absolute and sincere as you claim is something we shall learn later on, when we end this little meeting: we’ll then see whether you leave the room through the door or the window; and whether you really doubt that your body has gravity and can be injured by its fall—which is what people in general think on the basis of their fallacious senses and more fallacious experience. What Could Be more dissimilar than a well-argued philosophical (...) thesis and a psychiatric delusion? Compare, for instance, Hume’s (1739) view that the self is nothing more than a “bundle” of perceptions with the psychiatric patient’s view that the thoughts in his head belong to someone else. Or, compare the .. (shrink)

take leave of one’s senses English, Verb. 1. (idiomatic) To go crazy; to stop behaving rationally A Chief concern in “Only a Philosopher or a Madman” was to draw attention to a number of striking yet underappreciated similarities between paradigm psychiatric delusions and standard philosophical doctrines, “nihilistic” as well as “common sense.” The similarities were presented as illuminating given their potential to inform the debate over whether psychiatric delusions are properly (or usefully) conceptualized as beliefs. The paper’s central argument might (...) be summarized as follows: Paradigm psychiatric delusions appear to differ, in particular ways, from ordinary beliefs. In essence, the .. (shrink)

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate (...) the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience. (shrink)

This paper seeks to illuminate the nature of empathy by reflecting upon the phenomenology of depression. I propose that depression involves alteration of an aspect of experience that is seldom reflected upon or discussed, thus making it hard to understand. This alteration involves impairment or loss of a capacity for interpersonal relatedness that mutual empathy depends upon. The sufferer thus feels cut off from other people, and may remark on their indifference, hostility or inability to understand. Drawing upon the example (...) of depression, I argue that empathy is not principally a matter of ‘simulating’ another person’s experience. It is better conceived of as a perception-like exploration of others’ experiences that develops progressively through certain styles of interpersonal interaction. (shrink)

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global (...) reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. (shrink)

Excerpts from Robert Nozick's "Invariances" Necessary truths are invariant across all possible worlds, contingent ones across only some.

Reviews evidence which suggests that there may be little or no direct introspective access to higher order cognitive processes. Ss are sometimes unaware of the existence of a stimulus that importantly influenced a response, unaware of the existence of the response, and unaware that the stimulus has affected the response. It is proposed that when people attempt to report on their cognitive processes, that is, on the processes mediating the effects of a stimulus on a response, they do not do (...) so on the basis of any true introspection. Instead, their reports are based on a priori, implicit causal theories, or judgments about the extent to which a particular stimulus is a plausible cause of a given response. This suggests that though people may not be able to observe directly their cognitive processes, they will sometimes be able to report accurately about them. Accurate reports will occur when influential stimuli are salient and are plausible causes of the responses they produce, and will not occur when stimuli are not salient or are not plausible causes. (shrink)

A fundamental issue in the philosophy of psychiatry is that of the reality of mental illness: is there any such thing as mental illness? The dominant means of resolving this issue—either for or against—is the likeness argument. This states that mental illness exists, or does not, depending on the extent to which putative mental illnesses (such as alcoholism or schizophrenia) are like universally accepted illnesses (such as pneumonia). To succeed, this argument has to assume (1) that the features of conditions (...) such as schizophrenia will decide whether they are illnesses or not and (2) that the existence of these features can be determined independently of the question whether they are illnesses or not. Both assumptions can be questioned. A weaker objection to the likeness argument questions the first, but it is possible to overcome it. A stronger objection questions the second assumption, and is successful in undermining it. This also undermines the first assumption. As a result, the likeness argument will fail. Two major objections to the stronger objection are considered and accommodated. (shrink)

I WOULD LIKE TO respond to the four commentaries in turn. In each case I have started by setting out what I think the commentaries are claiming; in doing so, I may reveal that I have misunderstood or misconstrued, and I apologize where this is the case. My responses in many cases are provisional: the commentaries have given me much to think about. Also, my responses are selective—there are many points not touched upon here that deserve consideration. Finally, the order (...) of my responses is arbitrary. (shrink)

Lisa Bortolotti argues convincingly that opponents of the doxastic view of delusion are committed to unnecessarily stringent standards for belief attribution. Folk psychology recognises many non-rational ways in which beliefs can be caused, and our attributions of delusions may be guided by a sense that delusions are beliefs that we cannot explain in any folk psychological terms.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 261-264 [Access article in PDF] Contingency, Arbitrariness, and Failure Michael Loughlin PICKERING AIMS TO affect the form of the debate about the reality of mental illness. He notices that many influential arguments both for and against the existence of mental illnesses are in an important sense circular. It is observed that a given condition is relevantly similar to conditions we all agree are (...) genuine illnesses and on the basis of this observation it is concluded that it too can be classified as a type of illness—from which it can be inferred that mental illnesses do indeed exist. But Pickering contends that the initial observation can only be made if we already construe the condition in question as a type of illness. Otherwise we may interpret the data differently.So unless we help ourselves to the categorization whose legitimacy it is supposed to establish, the likeness argument cannot get going. He illustrates his point effectively. Most of his examples are taken from authors defending the existence of mental illness and it would have been interesting to see a more detailed account of the argument working in the other direction. Even so, his references to Szasz (Pickering 2003) are sufficient to convince readers familiar with Szasz's work that a version of the likeness argument (the paradigm approach) is as much at work in his refutation of the existence of mental illnesses as is it in Boorse's proof of their reality.This is an incisive analysis, which should be taken very seriously indeed by contributors to the debate. Its most immediate implication is a negative one. We should not rely upon any version of the likeness argument to establish the existence (or nonexistence) of mental illnesses: "the likeness argument must fail" (Pickering 2003, p. 253). One important question left unanswered by the paper concerns what form the debate should take, if its criticisms are accepted. Assuming we agree that the likeness argument is methodologically flawed, what should the methodology be for debating the substantive issues at stake? Put another way, how can we break the circle? How is it possible to construct arguments that do not presuppose their main conclusions, and so to make real intellectual progress in addressing this issue? Is this in fact possible? What would a valid argument in this area look like, and what sort of observational premises (if any) would be acceptable as evidence?On the most skeptical reading of his thesis, Pickering's arguments render the ideal of intellectual progress toward a resolution of this debate strictly unattainable. The circle cannot be broken, because the theory dependence of our categorizations makes the truth about the reality of mental illness either unknowable or irredeemably relative to one's intellectual starting point. Having argued that the likeness argument fails in the case of alcoholism, Pickering states one possible response to this failure on the part of psychiatry as the concession that the classification [End Page 261] of alcoholism as an illness is "very much a matter of opinion (2003, p. 250). Because he then argues that the argument fails for logically analogous reasons in the case of schizophrenia, we may feel invited to draw the same conclusion about that condition. He later admits there is "some truth in the charge" that "the rejection of the likeness argument seems to introduce an unacceptable element of contingency into the way important questions about the categorization of schizophrenia and alcoholism are answered" (p. 253). His response to this is that it is not his arguments that lead to this element of contingency, and he reiterates that the likeness argument cannot get beyond such contingencies (p. 253).Certainly he seems committed to the view that no observational premises can "decide, or help decide, the issue" because the "detectable and observable features" of a purported mental illness "do not determine what description should be given of them" (p. 250). Even the fact that a particular description seems intuitively irresistible or "natural" cannot decide this. His argument on this point concerns the fact that what appears natural or intuitively obvious to us is... (shrink)