Wednesday, 22 March 2017

Delusion post in Imperfect Cognitions

Lisa Bortolotti's Imperfect Cognitions blog has recently published a short summary that Bill Fulford and I wrote, advertising the view of delusions we took in our chapter in Schramme, T. & Edwards, S. (eds) Handbook of the Philosophy of Medicine.

I try to resist being drawn into substantial theorising but in this case I think a kind of non-theory theory might be called for. It also serves as a reason to connect delusion to tacit knowledge.

We think that there is a clinically recognizable local breakdown in that those relations which is not sufficient to take someone outside the space of reasons (a mere machine) but which resists specific understanding because, as Jaspers emphasised, the reasons cannot be shared. Further, just as rationality as a whole resists codification so breakdowns in the space of reasons do too. Recognising delusion is thus a matter for tacit rather than explicit knowledge.

Wednesday, 15 March 2017

Big or small p philosophy and/of psychiatry?

I gave a talk (briefly described here) at the Northern Ireland division of the Royal College of Psychiatrists the other day and so decided to pitch it at the idea that philosophy is a more or less obligatory part of self-conscious mental healthcare. The contrasting foils I considered were that it was either a debunking account of psychiatry in other terms such as an exercise of social control or, as Jennifer Hansen suggested to the AAPP a few years ago, a desperately needed defense of psychiatry against criticism essentially from outside it. I suggested instead that philosophical reflection grows organically out of internal debates in thoughtful psychiatry.

Afterwards, and after some interesting questions and debate, one person expressed surprise that the talk had been more about the philosophy of psychiatry than he had expected. I think he said that he had expected more philosophy with a small ‘p’. But I think he meant what I would express by saying philosophy with a large ‘P’: general, unapplied philosophy. So I have volunteered to go back and do that, if they wish, in the future. Mainstream philosophy for psychiatrists, as it were.

The irony is that when I was first invited to give philosophy of psychiatry sessions at large international psychiatry conferences by Bill Fulford, he always stressed that psychiatrists would be most interested in the standard philosophical debate about the mind-body problem. At the time, this was fortunate because there wasn’t a wealth of bespoke philosophy of psychiatry (not that I could bring myself to do quite or only that). Now with somewhere between 50-100 books published in the last 20 years by philosophers and by psychiatrists on what we thus call philosophy and psychiatry (and 30 years of PPP) it seems curious if actually Bill’s suggestion for what is really wanted remains true.

Tuesday, 21 February 2017

The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health

I see that the Palgrave Handbook of Sociocultural Perspectives on Global Mental Health edited by Ross White, Sumeet Jain, David Orr and Ursula Read has now been published (see here).

The publishers' blurb runs:

This handbook incisively explores challenges and opportunities that exist in efforts aimed at addressing inequities in mental health provision across the globe. Drawing on various disciplines across the humanities, psychology, and social sciences it charts the emergence of Global Mental Health as a field of study. It critically reflects on efforts and interventions being made to globalize mental health policies, and discusses key themes relevant for understanding and supporting the mental health needs of people living in diverse socio-economical and cultural environments. Over three rich sections, the handbook critically engages with Global Mental Health discourses. To help guide future efforts to support mental health and wellbeing in different parts of the world, the third section of the handbook consists of case studies of innovative mental health policy and practice, which are presented from a variety of different perspectives.

My self-centred interest is that I have chapter in it on 'Cross-cultural psychiatry and validity in DSM-5'

Abstract
The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual, DSM-5, puts greater emphasis than previous editions on cross-cultural factors affecting mental illness [APA 2013]. Diagnostic criteria have been revised to take account of cross-cultural variation, there is a more specific cultural formulation and a glossary lists nine ‘Cultural Concepts of Distress’. But the DSM does not present a clear view of the universal or local constitution of mental illness. Nor does it give an account of the relation of the cultural concepts to the rest of the taxonomy of disorders nor the extent to which they are put forward as valid diagnoses. The first section of this chapter outlines three possible views of the nature of cultural concepts of distress. On one view, which dates back to the German psychiatrist Karl Birnbaum, an underlying universal ‘pathogenic’ component is overlain by a variable ‘pathoplastic’ cultural shape [Birnbaum 1923]. This combination suggests the possibility of two single factor models: pathogenic-only and pathoplastic-only. But, as the second section argues, establishing the correctness of any one of these is difficult. Two influential approaches to the nature of the concept of disorder – Wakefield’s harmful dysfunction analysis and Fulford’s failure of ordinary doing – can be pressed with only minor adjustment to support any of the a priori models of cultural concepts. The final section examines one of the nine cultural concepts: khyal cap or wind attacks, a syndrome found among Cambodians. On inspection none of the three models helps accommodate its own incompatible aetiological theory with the biomedical view of the rest of the DSM. This suggests that the very idea of cultural concepts of distress fits uneasily with the aspirations to validity of the rest of DSM-5.

Monday, 20 February 2017

Philosophy as a research method in health research

Here is another video of me. Sorry. But it was made a year ago to promote health research methods at UCLan. Such videos persuade me of the real skills of those who make presentation both seamless and natural. I manage neither here.


Tuesday, 14 February 2017

Kant's schematism, Wittgenstein and David Bell on the art of judgement

Some years ago I suffered prolonged writer's block and lost the ability to write or think about philosophy. I was teaching a module on Wittgenstein at Anglia Poly whilst employed by Warwick University and I drove across the A14 every week, drinking a couple of pints and eating corn beef hash at the Tram Depot with my friend Neil Gascoigne and moaning about my inability to think.

Anglia was organising a conference on the analytic -continental divide in philosophy and he suggested, more or less arbitrarily, that I could write something about the problem raised in Kant’s schematism. Starting from David Bell’s paper on the art of judgement which connects that issue to Wittgenstein served as a prompt. Bell suggests, among other things, that the kind of understanding one has of a Jackson Pollock could serve as the right kind of middle ground between full blown conceptual understanding and something which isn't understanding at all. (So my worries about this are akin to my objections to Hannah Ginsborg's 'primitive normativity'.)

The paper wasn’t great but released the block and got me to a few conferences including in Canada. But I was never able to place it. (Mind, for example, said it was too aesthetic; the British Journal of Aesthetics said it wasn’t aesthetic enough.) So some years later I published it in a Polish theology journal. I doubt it has ever been read.

Anyway: here’s a video I have found last week on my university server of an attempt I made a couple of years ago to explain it – not very successfully - to an audience of social scientists.

Friday, 10 February 2017

Emergence, meaning and rationality

Although the word 'emergence' has never featured in any paper I have written - it is not 'in my index' as Rorty delightfully says somewhere - I was an 'emergence fellow' at Durham's Institute of Advanced Study the year my parents died. Hence as a form of singing for my supper I wrote a paper on emergence for their in-house journal before I left. It is now here.

Possibly not my best work, on rereading it, but I was distracted.

Wednesday, 8 February 2017

Dialogues in Philosophy, Mental and Neuro Sciences

"Dear Colleague,
I'm pleased to inform you that the new issue of the international online journal Dialogues in Philosophy, Mental and Neuro Sciences has been published, it is freely readable at:

The issue contains:
Volume 9, Issue 2, December 2016

ORIGINAL ARTICLES
M. Aragona
The roots of psychopathological understanding: Karl Jaspers' Verstehen and the influence of Moritz Geiger's empathy

R. Gatta & M. C. Segneri
Biographies of Asylum in Italy: Body, Illness and Rights

A. M. Petta, M. Aragona, P. Zingaretti, C. Ottaviani, G. Antonucci, A. Sarnicola, G. F. Spitoni
Psychopathology, body uneasiness and self-identity in patients with non-BED obesity compared to healthy controls

HISTORY OF MENTAL CONCEPTS
E. C. Laségue & J. Falret
La folie à deux (ou folie communiquée)

DIALOGUES
J. Korf
A short comment on the "Defence of Chalmers" by Hane Htut Maung

H. H. Maung
Two Concepts of the Mental: A Comment on Korf's Reply


Dialogues in Philosophy, Mental and Neuro Sciences proposes and includes Original Papers, Negative Experimental Results, History of Mental Concepts, New Ideas and Dialogues, as described in the guidelines for the authors.

Would you like to write a Dialogue? It is a short article (up to 600 words) freely published and without any deadline commenting another article already published on the previous issues of our Journal.
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Editorial Office