This book uses rare pathologies to inform questions on topics such as consciousness and rationality. Rather than trying to answer these by inventing far-fetched scenario or 'thought experiments', it is better to utilize a rich but under-used clinical resource.

In his Contributions to Philosophy, Martin Heidegger introduces "acceleration" as one of the three symptoms--along with "calculation" and the "outbreak of massiveness"--of our technological way of "being-in-the-world." In this article, I unpack the relationship between these symptoms and draw a twofold conclusion. First, interpreting acceleration in terms of time pathologies, I suggest the self is becoming increasingly fragmented and emotionally overwhelmed from chronic sensory arousal and time pressure. This experience makes it difficult for us to qualitatively distinguish what matters to (...) us in our everyday lives, resulting in a pervasive cultural mood of indifference, what Heidegger calls "profound boredom." Second, by drawing on Heidegger's hermeneutic method, I argue that the practice of mainstream psychology, by adopting the reductive methodology of the empirical sciences, largely ignores our accelerated socio-historical situation, resulting in therapeutic models that have a tendency to construct and perpetuate the very pathologies the psychologist is seeking to treat. (shrink)

This is a penetrating reinterpretation and defense of Hegel's social theory as an alternative to reigning liberal notions of social justice. The eminent German philosopher Axel Honneth rereads Hegel's Philosophy of Right to show how it diagnoses the pathologies of the overcommitment to individual freedom that Honneth says underlies the ideas of Rawls and Habermas alike. Honneth argues that Hegel's theory contains an account of the psychological damage caused by placing too much emphasis on personal and moral freedom. Although these (...) freedoms are crucial to the achievement of justice, they are insufficient and in themselves leave people vulnerable to loneliness, emptiness, and depression. Hegel argues that people must also find their freedom or "self-realization" through shared projects. Such projects involve the three institutions of ethical life--family, civil society, and the state--and provide the arena of a crucial third kind of freedom, which Honneth calls "communicative" freedom. A society is just only if it gives all of its members sufficient and equal opportunity to realize communicative freedom as well as personal and moral freedom. (shrink)

This chapter aims to distinguish between pathologies of agency in the strict sense and mere sources of impediments or distortion. Expanding on a recent notion of necessarily less-than-successful agency, it complements a mainstream approach to mental disorders and anomalous psychological conditions in the philosophy of mind and action. According this approach, the interest of such clinical case studies is heuristic, to differentiate between facets of agency that are functionally and conceptually separate even though they typically come together. Yet, in the (...) absence of independent criterion for a pathology of as opposed to inner obstacle to agency, this heuristic is at risk of becoming circular or uninformative, falling back on a clinical diagnosis it is meant to take as a starting point only. The chapter develops such a criterion and shows how it could work tracking agential achievement across two core dimensions of agency: planning and responsiveness to reasons. The discussion concludes with some implications on assessing decisional capacity and safeguarding agent autonomy in psychiatric settings. (shrink)

Modern man's pathology of normalcy -- The concept of mental health -- Humanistic science of man -- Is man lazy by nature?.

Since psychiatry remains a descriptive discipline, it is essential for its practitioners to understand how the language of psychiatry came to be formed. This important book, written by a psychiatrist-historian, traces the genesis of the descriptive categories of psychopathology and examines their interaction with the psychological and philosophical context within which they arose. The author explores particularly the language and ideas that have characterised descriptive psychopathology from the mid-nineteenth century to the present day. He presents a masterful survey of the (...) history of the main psychiatric symptoms, from the metaphysics of classical antiquity to the operational criteria of today. Tracing the evolution of concepts such as memory, consciousness, will and personality, and of symptoms ranging from catalepsy and aboulia to anxiety and self-harm, this book provides fascinating insights into the subjective nature of mental illness, and into the ideas of British, Continental and American authorities who sought to clarify and define it. (shrink)

The quantitative experimental scientific psychology that became prominent by the turn of the twentieth century grew from three main areas of intellectual inquiry. First and most directly, it arose out of the traditional psychology of the philosophy curriculum, as expressed in theories of mind and cognition. Second, it adopted the attitudes of the new natural philosophy of the scientific revolution, attitudes of empirically driven causal analysis and exact observation and experimentation. Third, it drew upon investigations of the senses. Natural philosophical (...) disciplines such as optics and acoustics treated the functioning of the senses. Optics, in particular, had from antiquity comprised a complete theory of vision, combining the physics, physiology, psychology, metaphysics, and epistemology of vision, using mathematical techniques where feasible. Within medicine, sensory physiology examined anatomy, physiology, and pathology. Philosophical psychology had long examined the senses as mental capacities connected with cognition and knowledge, and such discussions also heeded the new attitudes of natural philosophy. This chapter first examines the early relations of psychology to biology and characterizes various eighteenth-century loci of psychological thought. It then pursues nineteenth-century developments in Germany and Britain that culminate in the “new” psychology of the 1860s and 1870s. (shrink)

This paper, "The Ecological Pathology of Man," is an expanded excerpt from the author's book, "The Pathology of Man: A Study of Human Evil." ¶¶¶¶¶¶¶¶ When taken as a serious and dispassionate object of study from the standpoint of the science of pathology, the human species is easily recognized as a global pathogen. Incontrovertible evidence on all sides tells us this, and yet we have steadfastly avoided an honest look in the mirror. We so often choose—willfully and with strong convictions (...) sustained by homocentric prejudice—to hide the facts from ourselves, and to proceed with untroubled ignorance to overlook the worldwide human and natural devastation for which our species is responsible. (shrink)

The authors consider the nature of explanatory models in the social sciences in order to suggest ways in which conceptual systems differ. They suggest that, in many cases, theorists, researchers and clinicians can utilize insights from rival models in building their own models, without sacrificing the integrity of their own work.

Insofar as psychiatrists and neurologists tend to the cognitive well-being of others, their work is interwoven with philosophical concerns and theoretical assumptions about the nature of the mind, its myriad functions, and the conditions governing its multiform pathologies. That the mind figures so prominently in their ordinary language attests to the wealth of insights that stands to be gained through a dialogue with philosophy. In one of the earliest efforts to taxonomize psychiatric medicine, Allgemeine Psychopathologie, Jaspers incisively remarks that "the (...) exclusion of philosophy would be disastrous for psychiatry…if any psychopathologist thinks he can disregard philosophy and leave it aside as useless he will... (shrink)

One of the more striking aspects of Maurice Merleau-Ponty's Phenomenology of Perception (1945) is his use of psychological case studies in pathology. For Merleau-Ponty, a philosophical interpretation of phenomena like aphasia and psychic blindness promises to shed light not just on the nature of pathology, but on the nature of human existence more generally. In this paper, I show that although Merleau-Ponty is surely a pioneer in this use of pathology, his work is deeply indebted to an earlier philosophical study (...) of pathology offered by the German Neo-Kantian Ernst Cassirer in the third volume of the Philosophy of Symbolic Forms (1929). More specifically, I argue that Merleau-Ponty, in fact, follows Cassirer in placing Kant's notion of the productive imagination at the centre of his account of pathology and the features of existence it illuminates. Recognizing the debt Merleau-Ponty's account of pathology has to the Kantian tradition not only acts as a corrective to more recent interpretation of Merleau-Ponty's views of pathology (Dreyfus, Romdenh-Romluc), but also recommends we resist the prevailing tendency to treat Merleau-Ponty's philosophy as anti-Kantian. Instead, my interpretation seeks to restore Merleau-Ponty's place within the Kantian tradition. (shrink)

In this article, I respond to commentaries by Eva Jablonka and Simona Ginsburg and by David Spurrett on my target article “Complexity and the Evolution of Consciousness,” in which I have offered the first extended articulation of my pathological complexity thesis as a hypothesis about the evolutionary origins and function of consciousness. My reply is structured by the arguments raised rather than by author and will offer a more detailed explication of some aspects of the pathological complexity thesis.

Cognitive therapies are often biased in their assessment of clinical problems by their emphasis on the role of verbally-mediated thought in shaping our emotions, and in stressing the influence of thought upon feeling. Alternatively, a more phenomenological appraisal of psychological dysfunction suggests that emotion and thinking are complementary processes which influence each other. Cognitive psychology developed out of information-processing models, whereas phenomenological psychology is rooted in a philosophical perspective which avoids the assumptions of positivist methodology. But, despite their different origins, (...) the two disciplines overlap and complement each other. This book, originally published in 1995, illustrates how feeling states are a crucial component of mental health problems and, if adequately differentiated, can result in a greater understanding of mental health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Vice, Mental Disorder, and the Role of Underlying Pathological ProcessesNancy Nyquist Potter (bio) and Peter Zachar (bio)Keywordsresponsibility, virtue theory, cultural norms, psychopathologyThe issues discussed by John Sadler are among the most complicated in the philosophy of psychiatry, if for no other reason than that they highlight an area where disciplinary fault lines between clinical psychiatry/ psychology and philosophy seem most evident. We spent a year writing an article (...) on the relationship between the assessment of personality disorders and moral evaluations, and these fault lines became manifest not only between ourselves, but also when discussing our ideas with members of the various disciplines.Many practicing psychiatrists acknowledge that moral attributions (such as manipulativity) might be made about people with certain disorders (such as borderline personality disorder), but also find the argument that psychiatric diagnoses are moral rather than medical conditions to be a ludicrous bit of antipsychiatry in the Szaszian tradition. Philosophers, on the other hand, are less involved with these diagnostic categories in their day-to-day work and are more willing to be skeptical. Whether they are doing philosophy of psychiatry, moral theory, or sociopolitical philosophy, they are interested in digging a little bit deeper and are not impressed by arguments to the effect that—it’s obvious that these are really disorders. Being “obvious” is not a persuasive philosophical argument.The metaphysical task of determining what belongs in the category of criminality compared with other ways of sorting behavior has parallels in moral philosophy: Why is fraud, or theft, criminalized whereas (most) lying is not? Why is one set of moral norms enforceable, whereas a second set is aspirational? Does the difference involve property, where infractions of property are thought to be more serious wrongs than lying, which is “only” psychological rather than material? Are the “most serious” wrongs the ones we mark as crimes? Why is sodomy still criminalized in some areas but betraying one’s lifelong love is viewed as morally reprehensible but not criminal? Both actions are private, and only one seems to do harm—unfaithfulness—yet that is the one that is not criminalized. The point here is that, regardless of domain, our classification systems need to be justifiable, yet justification is most often mystifying. [End Page 27]The same is true for classifying mental disorders. The class of mental disorders appears to be a somewhat inconsistent collection of heterogeneous conditions and does not form a natural kind (Zachar 2000). At the most, the class of mental disorders names a family of loosely related conditions and the reasons for inclusion can shift from disorder to disorder.If the class of mental disorders does not specify an internally coherent kind akin to gold, deciding on the scope of psychiatric practice becomes an important problem. As Sadler asks, for what reasons do we classify pedophilia with schizophrenia—both as disorders—but omit sadism? This is an important question of disciplinary scope.This question of scope is itself ethically charged because, on the one hand, bringing a condition under the purview of psychiatry offers the possibility for treatment, and at least establishes the goal of improving the lives of people with specific kinds of problems. Making lives better is one of the humanistic justifications for science itself; clearly it is a raison d’être of psychiatry. On the other hand, medicalization sets up the conditions for a certain kind of social control. Hospitalization, educational services, day treatment, and disability payments are all contingent upon psychiatric diagnostic practices. These programs and the institutions that manage them are both socially available and socially prescribed. The diagnosed behaviors can now be considered to be entities, and explanations of them can be developed. New technologies for altering them will also be introduced. Such practices have been associated with dehumanization (Phillips 2009).Two important questions also need to be distinguished. The first is a question for moral philosophy—What degree of responsibility do people with putative mental disorders have for their behaviors? For example, should people with psychotic disorders or personality disorders be held responsible for crimes they commit? If so, under what conditions? Should responsibility for certain behavior be mitigated? If so, under what conditions? Moral philosophy... (shrink)

Cognitive therapies are often biased in their assessment of clinical problems by their emphasis on the role of verbally-mediated thought in shaping our emotions, and in stressing the influence of thought upon feeling. Alternatively, a more phenomenological appraisal of psychological dysfunction suggests that emotion and thinking are complementary processes which influence each other. Cognitive psychology developed out of information-processing models, whereas phenomenological psychology is rooted in a philosophical perspective which avoids the assumptions of positivist methodology. But, despite their different origins, (...) the two disciplines overlap and complement each other. This book, originally published in 1995, illustrates how feeling states are a crucial component of mental health problems and, if adequately differentiated, can result in a greater understanding of mental health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Vice, Mental Disorder, and the Role of Underlying Pathological ProcessesNancy Nyquist Potter (bio) and Peter Zachar (bio)Keywordsresponsibility, virtue theory, cultural norms, psychopathologyThe issues discussed by John Sadler are among the most complicated in the philosophy of psychiatry, if for no other reason than that they highlight an area where disciplinary fault lines between clinical psychiatry/ psychology and philosophy seem most evident. We spent a year writing an article (...) on the relationship between the assessment of personality disorders and moral evaluations, and these fault lines became manifest not only between ourselves, but also when discussing our ideas with members of the various disciplines.Many practicing psychiatrists acknowledge that moral attributions (such as manipulativity) might be made about people with certain disorders (such as borderline personality disorder), but also find the argument that psychiatric diagnoses are moral rather than medical conditions to be a ludicrous bit of antipsychiatry in the Szaszian tradition. Philosophers, on the other hand, are less involved with these diagnostic categories in their day-to-day work and are more willing to be skeptical. Whether they are doing philosophy of psychiatry, moral theory, or sociopolitical philosophy, they are interested in digging a little bit deeper and are not impressed by arguments to the effect that—it’s obvious that these are really disorders. Being “obvious” is not a persuasive philosophical argument.The metaphysical task of determining what belongs in the category of criminality compared with other ways of sorting behavior has parallels in moral philosophy: Why is fraud, or theft, criminalized whereas (most) lying is not? Why is one set of moral norms enforceable, whereas a second set is aspirational? Does the difference involve property, where infractions of property are thought to be more serious wrongs than lying, which is “only” psychological rather than material? Are the “most serious” wrongs the ones we mark as crimes? Why is sodomy still criminalized in some areas but betraying one’s lifelong love is viewed as morally reprehensible but not criminal? Both actions are private, and only one seems to do harm—unfaithfulness—yet that is the one that is not criminalized. The point here is that, regardless of domain, our classification systems need to be justifiable, yet justification is most often mystifying. [End Page 27]The same is true for classifying mental disorders. The class of mental disorders appears to be a somewhat inconsistent collection of heterogeneous conditions and does not form a natural kind (Zachar 2000). At the most, the class of mental disorders names a family of loosely related conditions and the reasons for inclusion can shift from disorder to disorder.If the class of mental disorders does not specify an internally coherent kind akin to gold, deciding on the scope of psychiatric practice becomes an important problem. As Sadler asks, for what reasons do we classify pedophilia with schizophrenia—both as disorders—but omit sadism? This is an important question of disciplinary scope.This question of scope is itself ethically charged because, on the one hand, bringing a condition under the purview of psychiatry offers the possibility for treatment, and at least establishes the goal of improving the lives of people with specific kinds of problems. Making lives better is one of the humanistic justifications for science itself; clearly it is a raison d’être of psychiatry. On the other hand, medicalization sets up the conditions for a certain kind of social control. Hospitalization, educational services, day treatment, and disability payments are all contingent upon psychiatric diagnostic practices. These programs and the institutions that manage them are both socially available and socially prescribed. The diagnosed behaviors can now be considered to be entities, and explanations of them can be developed. New technologies for altering them will also be introduced. Such practices have been associated with dehumanization (Phillips 2009).Two important questions also need to be distinguished. The first is a question for moral philosophy—What degree of responsibility do people with putative mental disorders have for their behaviors? For example, should people with psychotic disorders or personality disorders be held responsible for crimes they commit? If so, under what conditions? Should responsibility for certain behavior be mitigated? If so, under what conditions? Moral philosophy... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pathology of the Mind: Disorder Versus DisabilityRichard G. T. Gipps (bio)Keywordsorder, disorder, ability, disability, mental illnessAlfredo Gaete (2008) describes mental disorders as impairments in intentionality, phenomenal consciousness, and intelligence that cause harm to the affected person. I found persuasive Gaete’s claim that the concept of ‘mental disorder’ is best understood as nontheoretical and nontechnical. I also find compelling his argument that a previous contribution of my own—which relied in (...) part on specifying different senses of ‘disorder’ in psychological, physiological, and social cases—was misguided. Further, his suggestion that we ought at least to attempt analysis in terms of necessary and sufficient conditions before we seek out less definitive characterizations (in terms of family resemblances) also persuades me, although I find myself less sanguine than he about the general possibility of achieving such analyses.One of Gaete’s principal claims is that mental disorder is helpfully understood in terms of an absence of a capacity—that is, as a disability. There are two related objections—or two aspects of the same objection—that I would like to offer the author with respect to this claim. These may well not be conclusive, but will I hope at least function as foils against which the author can usefully sharpen his argument. One objection suggests that there is a viable distinction between the concepts of mental disorder and mental disability, as commonly used in clinical contexts, which the account offered seems unable to respect. The second suggests that the account may not be able to theorize what is argued to be the essential contribution of the concepts of order and disorder (as opposed to ability and disability) to the everyday concept of mental disorder. Accordingly, it questions the power of a disability approach such as Gaete’s to capture the essential nature of mental disorder.In his paper, Gaete classifies mental retardation and developmental, or (what in the United Kingdom are known as) learning, disabilities (autism, etc.) as cases of mental disorder. I found this surprising because it is not common linguistic practice in the psychological circles in which I operate. It would also seem to make a nonsense of commonly accepted ideas like: “Mental disorders are more likely to occur in patients with developmental disabilities (e.g., in autism, Asperger, or Down syndrome) than in the general population.” (For an example, see Campbell and Malone [1991]). On Gaete’s classification, it would appear that people with autism eo ipso have a mental disorder, and [End Page 341] hence the commonly accepted idea would need to be interpreted as merely a statement about comorbidities of different disorders of the same general (i.e., mental) type. But that is not, I believe, how the term is commonly used, and Gaete’s suggestion must therefore be treated as revisionary rather than descriptively analytical.One way of reconstructing a rationale underlying the distinction between mental disabilities and mental disorders is as follows. A developmental disability involves a failure of (certain aspects of) the mind to grow and reach an expected level or type of organization. A mental disorder by contrast involves a disturbance or disorganization (not simply an impoverishment) within the mind at whichever level of organization it has reached. As the mind develops, and reaches new levels or types of organization, the forms which mental disorders may take accordingly change.Autism and schizophrenia provide helpful illustrations of this distinction. Autism represents a failure of (among other things) the social mind to develop in childhood. The person with moderate to severe autism may attain at best a very shaky grasp on the realities of other minds and social conventions. That is, the degree of mental structure they obtain—their social competencies or capacities—will likely remain limited. It is this fundamental deficit that marks out the disability, and not the social anxieties or other such disturbances that can beset the autistic person.Schizophrenia, by contrast, tends to occur at late adolescence, when the individual has developed higher levels of—albeit often fragile—mental structure. Yet it is not the fragility of such mental structure, but rather the disruptions that can occur within such structures as have developed, that mark them out... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 313-316 [Access article in PDF] Normativity and Pathology Mike Gane Keywords: positivism, sociology, pathology, normativity. THE STRENGTH OF VICTORIA MARGREE'S contribution to the examination of the thematic of pathology and its Nietzschean/Canguilhemian variation is that it reveals the challenging complexity of this theme. My comments on this contribution are developed from an interest in the ways that the concern with pathology was part (...) of the initial program of the social sciences, particularly sociology, as it was inaugurated by Auguste Comte and Emile Durkheim in its formative period. Margree touches on the importance of social analysis at the end of her paper; my comments work to some extent in the opposite direction—from the social to the psychological. My concerns lead me to contest a number of her epistemological positions, particularly those concerning the notion of positivism and "objective" analysis.For the first positivist philosophers, positivism was primarily a method; in fact it embraced the set of methods developed by the sciences to obtain the highest degree of objectivity. It was explicitly opposed to methodological reductionism, arguing that each science had specific methods applicable to its own domain. Canguilhem was certainly against methodological reductionism (Renard 1996, 127), but Margree's conception of positivism in psychology as biological reductionism is quite a different and is a later-derived variation of positivism. As such perhaps it should not be conflated with early notions of pathology. Sociological positivism as developed in Durkheim's methodology, although different in many aspects from that of Comte, retained the idea that scientific objectivity was to be the result of epistemological procedures, not what might be called ontological reduction to a physical level of the object. Durkheim tries to clarify the rules governing the analysis of abnormal forms and to define social dysfunction and teratology. The general field of abnormal forms or pathology in the analysis of social life fell into decline after Durkheim and was abandoned in favor of the study of social deviance. The very idea of a study of social pathology itself was critiqued by Szasz and Foucault in particular as a new form of power, which came into existence at the end of the eighteenth century as an essential component of the disciplinary society. Foucault was himself clearly indebted to Canguilhem, and he made this evident on several occasions, such as his lectures at the Collège de France Les Anormaux given in 1974 and 1975 (Foucault 1999). Thus, although the field of pathology and abnormal forms continues in psychology it has been abandoned in sociology, leaving only traces (such as the concept of anomie) in the works of some thinkers such as Baudrillard, whose usage may be ironic more than an attempt to revive the terrain. Could it be that Canguilhem and Foucault [End Page 313] have then more or less swept the field clear of such scientism, even though the reconceptualization in terms of normativity suggested by Canguilhem has not been widely taken on? Indeed there may be important differences between the conceptualization of Canguilhem and Foucault (after all, as Margree points out, Canguilhem can be read as attempting to invert the relation between normativity and normative, not to withdraw from the terrain altogether). Foucault seems to approach a position elaborated in sociology earlier by Max Weber in his rejection of the attempt to use the field of pathology as a way of evading moral choices. Canguilhem discusses responsibility in "Thérapeutique, expérimentation, responsibilité" (1983, 391), noting the importance of professionalization and legal controls on professional practice.The fundamental issues posed by the project of social science continue to be haunted by the same set of problems as established in analysis of pathological phenomena, whether it be conceived in terms of order and disorder (chaos), social breakdown, radical evil, "failed states," even deviation or noncompliance with "correct" forms of language or behavior (harassment, racism, child abuse) and so on, or pathology (perversion, dysfunction, disease, illness, abnormalities). The question in part is: is there anything lost by replacing pathology with more political, religious, moral, and legal terminologies? From Foucault's point... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 317-319 [Access article in PDF] Canguilhem and Social Pathology Victoria Margree Keywords: Canguilhem, organism, society, pathology. MIKE GANE'S COMMENTARY on my paper "Normal and Abnormal" engages with the important question of the possibility of a concept of social pathology. However, I would like to begin my response by conceding a couple of his points around my definitions of epistemological positions. First, I agree (...) that the critique of my original piece was indeed directed most specifically toward biological reductionism, and that this should not perhaps be conflated with all positions that might be grouped under positivism. Indeed, I found Gane's description of scientific objectivity as conceived by sociological positivism ("[as] the result of epistemological procedures, not what might be called ontological reduction to a physical level of the object") tantalizingly reminiscent of Bachelard's own conception of objectivity in the physical sciences, a conception that Canguilhem must have been in sympathy with, and that Bachelard himself explicitly opposes to the epistemology of the "positivists" in his own arena (Bachelard 1984). Second, Professor Gane is quite correct to foreground the changes that take place in Canguilhem's thinking around the pathological once his attention turns to the new discoveries of the genetic sciences. For the purposes of the original piece, my focus was on the work conducted in the thesis on the Normal and the Pathological of 1943, and the version of normativity/health elaborated there shall continue to provide the main frame of reference for my reply.However, it is the attention to the problem of social pathology that forms the major ground of Gane's response, and it is toward this issue that I will direct my remaining comments. Without reaching any final conclusions, I would like to outline what I believe would be at least one major tendency in Canguilhem's thinking on the possibility of such a concept, and then to explore some of the productive aporias or difficulties in this.Canguilhem's early theorization of health as normativity would seem to explicitly prohibit its extension to an idea of social pathology. For Canguilhem health, as Greco (1998) explains, is a meaningful concept because it is indexed to the inherent teleology of the living organism. Because a society is not alive, does not possess the intrinsic teleology of the organic body, terms such as health or disease cannot be attributed to society in anything other than an explicitly metaphorical way.In my original paper, I argued that for Canguilhem environmental features can be characterized as possessing pathological value for organisms—indeed, health for Canguilhem is always a matter of relations and not a quality inherent in isolated features. I then suggested that because the human environment is an irreducibly social one, social norms, such as impose a fixed regularity [End Page 317] upon what sorts of mental phenomena count as normal, could possess pathological value for the individual. As the previous paragraph ought to suggest, this was perhaps already to strain against the limits of Canguilhemian thinking by veering close to an idea of social pathology. Institutionalized racism and intolerance of aberrant mental experiences may not be diseases for the social body in quite the same way that cancer may be for the organic body, but because these could be argued to be detrimental to the health and normativity of those who live within that society, I argued that they could be said to have a pathological value in relation to the individual.This is a formulation that I suspect Canguilhem could not accept. As Greco again explains, for Canguilhem society is not an environment. Social norms do not possess vital value for the human organism (Greco 1998, or Canguilhem 1991 in the "New Reflections"). Social norms in fact present constraints with respect to which the individual has a choice, whereas environmental norms are determining for the health of the individual.Now, it seems to me that there are at least a couple of problems with this. First, what about societies that use violence to back up their social injunctions? Is it not the case that... (shrink)

As is well known, Wittgenstein pointed out an asymmetry between first- and third-person psychological statements: the first, unlike the latter, involve observation or a claim to knowledge and are constitutionally open to uncertainty. In this paper, I challenge this asymmetry and Wittgenstein's own affirmation of the constitutional uncertainty of third-person psychological statements, and argue that Wittgenstein ultimately did too. I first show that, on his view, most of our third-person psychological statements are noncognitive; they stem from a subjective certainty: a (...) certainty which, though not the result of an epistemic process, is not invulnerable to error in that it is a kind of assumption. I then trace Wittgenstein's realization that some third-person psychological certainties are not merely subjective but 'objective' (which means, as he uses the word, that they are logically indubitable): in some cases, we can be as logically certain that someone else is in pain than we are about ourselves being in pain. This positively reinforces Wittgenstein's rebuttal of other mind scepticism. I conclude with a response to objections about the legitimacy of calling an assurance that is logical (i.e., that does not have uncertainty or doubt on its flipside) a 'certainty', by suggesting that the flipside is to be found in pathological cases, and most pertinently here, in cases of dyssemia: a rare disorder affecting the ability to properly express or recognize basic physical expressions of feeling. (shrink)

Abstract:We examine the moral and managerial significance of some empirical studies in cognitive psychology. We suggest that these results may plausibly be interpreted as expressing deontological commitments of experimental subjects, even though psychologists who discuss the results seem to suppose that they show that people are irrational consequentialists. We argue that the plausibility of our interpretation suggests how managers who wish to take seriously entrenched social views on morality might best craft corporate policy on corporate responsibility, and we suggest that (...) the form of argument we employ may be regarded as a kind of appeal to reflective equilibrium. (shrink)

Within the context of psychological measurement, realist commitments pervade methodology. Further, there are instances where particular scientific practices and decisions are explicable most plausibly against a background assumption of epistemic realism. That psychometrics is a realist enterprise provides a possible toehold for Stephen Jay Gould’s objections to psychometrics in The Mismeasure of Man and Joel Michell’s charges that psychometrics is a “pathological science.” These objections do not withstand scrutiny. There are no fewer than three activities in ongoing psychometric research (...) which presuppose a commitment to a minimal epistemic realism. Those activities include selecting between different models for representing data, estimating ability in the context of item response theory, and the move to make the individual the fundamental unit of analysis in psychometrics thereby calling for a shift in what sorts of data are evidentially relevant. In none of these activities are the commitments and disregard for evidence that Gould and Michell find objectionable or “pathological.”. (shrink)

Of the topics found in psychoanalytic theory it is Freud's philosophy of mind that is at once the most contentious and enduring. Psychoanalytic theory makes bold claims about the significance of unconscious mental processes and the wish-fulfilling activity of the mind, citing their importance for understanding the nature of dreams and explaining both normal and pathological behaviour. However, since Freud's initial work, both modern psychology and philosophy have had much to say about the merits of Freudian thinking. Developments in (...) psychology, philosophy, and psychoanalysis raise new challenges and questions concerning Freud's theory of mind. This book addresses the psychoanalytic concept of mind in the 21st century via a joint scientific and philosophical appraisal of psychoanalytic theory. It provides a fresh critical appraisal and reflection on Freudian concepts, as well as addressing how current evidence and scientific thinking bear upon Freudian theory. The book centres upon the major concepts in psychoanalysis, including the notion of unconscious mental processes and wish-fulfilment and their relationship to dreams, fantasy, attachment processes, and neuroscience. (shrink)

Over the past decade the welfare state has come under sustained attack not only from quarters which never approved of its policies, but also from political theorists who used to support it. With the collapse of communism, the policy of comprehensive welfare provision came under renewed scrutiny. It was argued that its impact on work incentives is most detrimental. Examining in detail current unemployment debates within Western welfare states, this book seeks to verify or refute the view that non-work is (...) increasingly chosen by work shy individuals - the 'pathological' theory of unemployment. Drawing from a range of disciplinary perspectives - from social philosophy and the history of philosophy, to occupational psychology and feminist economics - this interdisciplinary analysis reveals that the "pathological" theory of unemployment, with its reliance on a deficient depiction of human nature and its disregard of non-pecuniary work incentives and empirical evidence on benefit fraud, cannot be upheld. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 387-394 [Access article in PDF] Psychosis Good and Bad:Values-Based Practice and the Distinction Between Pathological and Nonpathological Forms of Psychotic Experience Mike C. Jackson and K. W. M. Fulford IN TWO PAPERS in this issue of Philosophy, Psychiatry, and Psychology, Marek Marzanski and Mark Bratton (2002) and Caroline Brett (2002) develop important critiques, from the perspectives respectively of Christian theology and Eastern (...) philosophy, of our 1997 analysis of the distinction between pathological and nonpathological forms of psychotic experience (Jackson and Fulford 1997).In this response, we briefly summarize the main points from our 1997 analysis; we consider, separately, the important although very different challenges to that analysis from the perspectives of our two critics; and we briefly indicate the main lines of recent developments in policy, practice, and research in mental health as they relate to this important area of human experience. The Jackson and Fulford (1997) Analysis In our 1997 paper, we presented three case studies from a larger series (Jackson 1991, 1997, 2001) selected with the express aim of bringing into focus the conceptual difficulties that arise at the borderline between psychotic illness and what we called benign spiritual experience. On the basis of these case studies we argued thatspiritual experiences, which are essentially benign, can involve explicitly psychotic phenomenology; traditional psychiatric diagnostic methods, which focus on the form and content of beliefs and experiences, are not capable of distinguishing between pathological and nonpathological forms of such psychotic experiences; [End Page 387]evaluation of such experiences (and claims about "illness" and health more generally) necessarily involves value judgments as well as judgments about matters of fact (specifically, the "facts" of traditional descriptive psychopathology); and more specifically, the distinction between pathological and nonpathological phenomena concerns the way in which they are embedded in the structure of the values and beliefs by which the actions of the subjects concerned are defined: "In the case of pathological psychotic phenomena," we argued, "there is a radical failure of action.... In the case of spiritual psychotic phenomena, action is radically enhanced" (Jackson and Fulford 1997, 55).We then proposed a cognitive problem-solving model of psychotic experiences. This model suggests that such experiences can be a normal and adaptive psychological response to existential crises, such as loss of meaning or purpose in life, coming to terms with death or bereavement, and so on (Batson and Ventis 1982; Jackson, 1991, 1997, 2001). The model is consistent with a subsequent position paper published by the British Psychological Society arguing the case for a psychological formulation of psychotic experiences and cognitive-behavioural methods in their management (2000).In the case of nonpathological psychotic experience, the psychotic elements of the experience promote a paradigm shift in the individual's underlying assumptions, which effectively resolves their impasse and allows them to move forward. This is normally a self-limiting process, in that when the individual is able to utilize their insight, it acts to resolve the stress which triggered it. In pathological psychosis, this process fails for various possible reasons, which were not explored in any depth in that paper (but see Jackson 2001 for a more detailed discussion). The Challenge From Marzanski and Bratton Marek Marzanski and Mark Bratton reexamine the questions raised by our cases from a Christian theological perspective (Marzanski and Bratton 2002). They suggest a theologically based definition of spiritual experience according to which the criteria for "genuine" experience concerns its context within the development of the individual's religious faith. In Bratton and Marzanski's account, these criteria are based on a Christian value system.They present three cases of their own, which, in contrast to the three cases in our 1997 paper, vividly illustrate how phenomena that may be valued negatively from a medical perspective (i.e., as defined by us in terms of their consequences for action), may, at one and the same time, be valued positively from a religious perspective (i.e., in terms of their consequences for the... (shrink)

Traditionally, debates between psychiatrists and anti-psychiatrists have centered around the appropriateness of positivist models of psychological disorder. According to positivism, the cause of unusual or distressing mental states is to be found in biological abnormalities. This paper suggests that anti-psychiatry often challenges positivism by opposing accounts of social causation to those of physical, biological disease without first questioning the adequacy of positivist accounts of physical illness itself. Using the work of philosopher of medicine, Georges Canguilhem, I wish to elaborate a (...) non-positivist account of physical disease, which can then be applied to debates in mental health to redefine the terms within which the role of biological abnormalities can be thought. Applying Canguilhem's definition of pathology, the paper argues for a conception of mental illness in which the scientific identification of biological abnormalities is useful, but not in itself sufficient. Finally, these arguments are related to recent work involving cognitive therapy approaches to voice hearing and schizophrenia. (shrink)

Why do people persist in commitments that threaten their happiness, security, and comfort? Why do some of our most central, identity-defining commitments resist the effects of reasoning and critical reflection? Drawing on real-life examples, empirical psychology, and philosophical reflection, this book argues that these commitments involve an ethical stance called devotion, which plays a pervasive—but often hidden—role in human life. Devotion typically involves sacralizing certain values, goals, or relationships. To sacralize a value is to treat it as inviolable (trade-offs with (...) ordinary values are forbidden), incontestable (even contemplating such trade-offs is prohibited), and dialectically invulnerable (no rational considerations can disrupt the agent’s commitment to the value). Philosophy of Devotion offers a detailed philosophical account and defense of these features. Devotion and the sacralization of values can be reasonable; indeed, a life involving meaningful, sustained commitment depends on these stances. Without devotion, we risk an existential condition called normative dissipation, in which all of our commitments become etiolated. Yet devotion can easily go wrong, deforming into the individual and group fanaticism that have become pervasive features of modern social life. The book provides an alternative to fanaticism, investigating the way in which we can express non-pathological forms of devotion. We can be devoted through affirmation and through what is termed the deepening move, which treats the agent’s central commitments as systematically inchoate. Each stance enables a wholehearted form of devotion that nevertheless preserves flexibility and openness, avoiding the dangers of fanaticism on the one hand and normative dissipation on the other. -/- (The attached file contains the introductory chapter.). (shrink)

The moment when a person’s actual relationships fall short of desired relationships is commonly identified as the etiological moment of chronic loneliness, which can lead to physical and psychological effects like depression, worse recovery from illness and increased mortality. But, this etiology fails to explain the nature and severe impact of loneliness. Here, we use philosophical analysis and neuroscience to show that human beings develop and maintain our world-picture (our sense of what is true, important, and good) through joint attention (...) and action, motivated by friendship, in the Aristotelian sense of “other selves” who share a sense of the true and the good, and desire the good for each other as much as for themselves. The true etiological event of loneliness is the moment one’s world-picture becomes unshared. The pathogenesis is a resultant decay of our world-picture, with brain and behavior changes following as sequelae. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Vulnerabilization and De-pathologizationTwo Philosophical SuggestionsHavi Carel, PhD (bio)Alastair Morgan raises useful and interesting philosophical critiques of the 'power-threat-meaning' framework proposed by Johnstone et al. (2018). In what follows I make two suggestions that may clarify some aspects of the debate. First, to broaden the notion of threat: we can think more broadly about adverse life events as the source of mental suffering by broadening the notion of threat to (...) what I term (in joint work with Ian James Kidd) Vulnerabilization. Second, I offer a distinction between de-pathologizing psychiatric disorders (i.e., removing stigma and negative stereotypes) and de-medicalizing such disorders (i.e., rescinding them from a diagnostic manual), in order to suggest that de-medicalizing on its own does not solve the problem of stigma, but de-pathologizing is a better candidate for achieving that.Threat and VulnerabilizationMorgan argues that the notion of threat is too limited to cover the breadth of psychiatric conditions and presentations. Threat and power may often be present, but how they lead to the appearance of behaviors that meet certain diagnostic criteria, is, as Morgan states, unclear at best and only a partial explanation for psychiatric disorders (it explains some behaviors, not all). I suggest we view threat as one type of a broader category, which I propose to term 'Vulnerabilization' (Carel & Kidd, 2021).Vulnerabilization refers to the effects of interactions and actions that impact on people by harming them and making them more vulnerable to future adversity. For example, removing a struggling child from a classroom causes them to miss the lesson, and if done repeatedly, harms their capacity to continue studying. Leaving a weak patient unsupervised in the wrong kind of bed may cause them to fall and become more vulnerable to disease and infection. Failing to organize accommodation for an inmate about to be released from prison forces them onto the streets and makes them more vulnerable to reoffending. The point of the term is to draw attention to the fact that one is not born vulnerable, to paraphrase de Beauvoir, [End Page 73] but becomes vulnerabilized through acts and omissions of others. Such acts and omissions often take place under the auspices of an institution—health care, social care, education, criminal justice, and so on—and are therefore intimately tied to ethoi and conduct of institutions (for a full analysis see Carel & Kidd, 2021).Vulnerabilization is a common theme in the testimonies of people who have negative experiences of social institutions, including, of course, health care institutions. Ideally, health care systems, schools, courts, and other major institutions scaffold and protect our agency, efficiently support our endeavors, and fairly and reliably disperse social and epistemic resources. But while some people have reliably satisfying experiences of social institutions, others find that many, if not all, of the institutions they encounter abandon, ignore, silence, harm, or even kill them and people like them (this is not an exaggeration: inquiries such as the Francis Report (2013) on the Mid Staffordshire patient neglect case and the Sheldon Review (n.d.) provide plentiful examples of that).1 When vulnerable people encounter institutions, they are often at an epistemic and communicative disadvantage that makes their interactions with institutions a source of suffering and injustice and indeed makes such people even more vulnerabilized. They may be affected by poverty, disability (especially mental ill health and learning disabilities), trauma, domestic violence, ill health, racism, sexism, ageism, or other sources of disadvantage, prejudice and discrimination; and, of course, they can be disadvantaged by a combination of such factors. Seeing power as the source of much suffering, social injustice and poor mental health is, of course, entirely in line with this view and I agree with Morgan that Johnstone et al. (2018) identified an important source of suffering.De-Medicalizing Versus De-PathologizingAnother important issue about psychiatric diagnoses is the stigma and negative stereotypes surrounding mental illness. Calls to de-medicalize a specific or all mental disorders is, in part, a call to remove stigma and negative stereotype from the behaviors and mental states that characterize a mental disorder. However, to de-medicalize... (shrink)

This is a unique study, contuining the work of Merleau-Ponty and Heidegger, and using the techniques of phenomenology against the prevailing nihilism of our culture. It expands our understanding of the human potential for spiritual self-realization by interpreting it as the developing of a bodily-felt awareness informing our gestures and movements. The author argues that a psychological focus on our experience of well-being and pathology as embodied beings contributes significantly to a historically relevant critique of ideology. It also provides an (...) essential touchstone in experience for a fruitful individual and collective response to the danger of nihilism. Dr Levin draws on Merleau-Ponty's phenomenology to clarify Heidegger's analytic of human beings through an interpretation that focuses on our experience of being embodied. He reconstructs in modern terms the wisdom implicit in western and semitic forms of religion and philosophy, considering the work of Freud, Jung, Focault and Neitzsche, as well as that of American educational philosophers, including Dewey. In particular, he draws on the psychology of Freud and Jung to clarify our historical experience of gesture and movement and to bring to light its potential in the fulfilment of Selfhood. Throughout the book, the pathologies of the ego and its journey into Selfhood are considered in relation to the conditons of technology and the powers of nihilism. (shrink)

Exploring phenomenological philosophy as it relates to psychiatry and the social world, this book establishes a common language between psychiatrists, anti-psychiatrists, psychologists and social workers. It is an inter-disciplinary work by phenomenological philosophers, psychiatrists, and psychologists to discover the essence and foundations of social psychiatry. Using the phenomenology of Husserl as a point of departure, the meanings of empathy, interpersonal understanding, we-intentionality, ethics, citizenship and social inclusion are investigated in relation to psychopathology, nosology, and clinical research. This work, drawing upon (...) the rich classical and contemporary phenomenological tradition, touching on a broad range of thinkers such as Deleuze, Levinas, and R.D. Laing, also explicates how phenomenology is a method capable of capturing the human condition and its intricate relation to the social world and mental illness. (shrink)

This second volume in the serial Reviews in Fluorescence is a collection of up to 10 invited reviews on current trends and emerging hot topics in fluorescence. This new annual series compliments the other fluorescence titles published by Springer, while feeding the requirement from the fluorescence community for annual informative updates and developments.

The concept 'health' is ambiguous [18,9, 11]. The concept 'mental health' is even more so. 'Health' compasses senses of well-being, wholeness, and sound ness that mean more than the simple freedom from illness - a fact appreci ated in the World Health Organization's definition of health as more than the absence of disease or infirmity [7]. The wide range of viewpoints of the con tributors to this volume attests to the scope of issues placed under the rubric 'mental health. ' (...) These papers, presented at the Fourth Symposium on Philos ophy and Medicine, were written and discussed within a broad context of interests concerning mental health. Moreover, in their diversity these papers point to the many descriptive, evaluative, and, in fact, performative functions of statements concerning mental health. Before introducing the substance of these papers in any detail, I want to indicate the profound commerce between philosophical and psychological ideas in theories of mental health and disease. This will be done in part by a consideration of some conceptual developments in the history of psychiatry, as well as through an analysis of some of the functions of the notions of mental illness and health. 'Mental health' lays a special stress on the wholeness of human intuition, emotion, thought, and action. (shrink)

Substantially revised to include a wealth of new material, the second edition of this highly acclaimed work provides a concise, coherent introduction that brings structure to an increasingly fragmented and amorphous discipline. Paul R. McHugh and Phillip R. Slavney offer an approach that emphasizes psychiatry's unifying concepts while accommodating its diversity. Recognizing that there may never be a single, all-encompassing theory, the book distills psychiatric practice into four explanatory methods: diseases, dimensions of personality, goal-directed behaviors, and life stories. These perspectives, (...) argue the authors, underlie the principles and practice of all psychiatry. With an understanding of these fundamental methods, readers will be equipped to organize and evaluate psychiatric information and to develop a confident approach to practice and research. Praise for the original edition: "This brilliant book illuminates psychiatry more clearly than any other work I know.... This is the best (and the shortest) single volume on psychiatry that anyone could read."-- New England Journal of Medicine "Every psychiatry department, regardless of ideology, should build a course around this... work. Open-mindedness might become fashionable."-- Journal of Clinical Psychiatry "An elegantly reasoned and eloquently written book that enriches our understanding of clinical events.... [It provides] an opportunity to open our eyes to new possibilities."-- Hospital and Community Psychiatry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 265-269 [Access article in PDF] The Psychology and Physiology of Depression Walter Glannon Trauma and stressful events can disrupt the physiologic homeostasis of our bodies and brains. The physiologic stress response consists of neural and endocrine mechanisms whose function is to reestablish homeostasis. These mechanisms include the secretion of glucocorticoids (cortisol) and catecholemines (epinephrine and norepinephrine). Once an external event has ceased to (...) be a stressor or threat to a human organism, an integrated system of negative feedback loops inhibits the continued production of these hormones and effectively shuts down the stress response. These mechanisms are adaptive in the sense that they ensure the survival of the organism by reestablishing homeostasis. But prolonged exposure to real or perceived stressors can trigger prolonged secretion of stress hormones, thereby disrupting the feedback systems and causing a cascade of pathogenic events. The stress response is a double-edged sword. An acute stress response can protect an organism from external threats and reestablish homeostasis. But a chronic stress response can cause the body's defenses to become damaging rather than protective and to result in various disorders. Acute stress responses are adaptive. Chronic stress responses are often maladaptive and pathogenic.In "Depression as a Mind-Body Problem," I characterized major clinical depression as a disorder resulting from a maladaptive chronic stress response (Glannon 2003). Specifically, I argued that depression often results when our beliefs and emotions are out of proportion to the true nature of external events. The mind prolongs rather than constrains the physiologic stress response. Depression is not a disorder of the brain alone or the mind alone, however. Endocrine and immune dysfunction can contribute to the dysfunction in the brain and central nervous system that are involved in depression. Moreover, the contents of the mental states that initiate the sequence of events leading to depression are reflections of the person's natural and social environment. Thus, a satisfactory account of depression requires an analysis of the interconnections among the central nervous, endocrine, and immune systems, as well as the mind and the environment. All of these factors support the description of depression as a psychoneuroimmunologic disorder.Mike Martin (Martin 2003) and Thomas Fuchs (Fuchs 2003) discuss important aspects of depression that I did not elaborate in my paper. Martin argues that I fail to distinguish between depression as a mood and depression as a disorder. This is pertinent to the distinction evolutionary psychiatrists draw between moods that are adaptive and moods that are maladaptive. In contrast to my negative characterization of depression, Martin also makes a case for the positive [End Page 265] contributions of depression to meaningful life. Fuchs explores the notion of the brain as an organ of translation enabling patients to have meaningful subjective experience. The emphasis on subjectivity has important implications for potential preventive and therapeutic interventions for depression. For whether a person perceives an external event as a stressor may play a crucial role in the physiologic stress response. I will address the main points of these two authors in turn.Contrary to what Martin claims, I explicitly defined chronic depression as an affective (mood) disorder. My focus was on the clinical definition of major depression as a moderately severe to severe chronic disorder. It consists of affective, cognitive, and even physical dysfunction that interferes with a person's ability to carry out the normal tasks of daily life. This characterization of major chronic depression distinguishes it from milder forms of depression, such as dysthymia. Because these milder forms do not involve the same type or degree of dysfunction as more severe forms, they are not appropriately characterized as pathologies. For this reason, I focused on Nesse's (2000) discussion of depression rather than on his discussion of low mood. In fairness to Nesse and Stevens and Price (2000), not all forms of depression are pathologic according to the evolutionary view they defend. Some passive aspects of mild depression may be useful in alerting us to dangerous or wasteful behavior. It does seem plausible to describe depressed moods as falling along a continuum from those that... (shrink)

Gesellschaftskritik, or social philosophy that aims to provide firm criticism of pathological social practices, requires normatively grounded evaluative principles. In this article, we assess different possibilities for such principles with focus on a model that takes specific patterns of intersubjective interaction as its point of reference. We argue that in order to understand the full significance of this ‘intersubjective turn’ for social philosophy, and to strengthen the normative foundation of social philosophy, we need to distinguish several levels of intersubjectivity (...) and, in particular, focus on the somewhat neglected level of primary intersubjectivity. The article will discuss the account of primary intersubjectivity in Honneth’s work. We show that Honneth’s account runs into difficulties, and drawing on recent findings in developmental psychology, we suggest a rethinking of elementary recognition in terms of ‘affective proximity’. This both renders the account less susceptible to criticism and provides a normative perspective that can effortlessly enter into interdisciplinary collaboration. (shrink)