Wednesday 31 December 2008

Christmas spirit

In the hinterland between Christmas and New Year, I went, today, for a walk in the Howgills (the Lake District itself is as busy now as it is for August bank holiday and thus best avoided). On easy ground and with no navigational issues I found myself wondering what the best way is to approach the Christmas holiday period. As a child, I recall, it had a very particular resonance, independent of either religious or secular mysticism. There was a specific and exciting ambience and, even if the prospect of being given presents was part of the cause of this mood, it certainly wasn’t its object. The odd thing is that I cannot now recall what the mood was, what it took the time to be ‘about’ (not, of course, that it was literally about anything).

(2008 having been such a lamentable year for me for reading fiction I’ve resolved – a little crassly – simply to read a Dance to the Music of Time in 2009. Surely such a simple project will work! Already one feature of the book series is striking. It is realist but it starts in 1921 and continues to the 1970s with the same degree of access to the details of the time. Aspects of the narrator’s school-life, for example, are portrayed – unbelievably – with infinite and unproblematic access to their mood. Does anyone have such memory?)

One possible clue as to how to approach the season is something I’ve been struck by increasingly this year: the false ring of being wished a good Christmas on, say, Christmas Eve by people one might well see within a few days. Such wishing seems to compress a weight of expectation onto a single day and a single perspective: such as a solitary attempt on the summit of Everest or one’s necessarily personal interview with Death (pictured). No-one would compress wishes for a summer onto the fate of Midsummer’s Eve, for example. A good summer is both temporally extended and (potentially, at least) shared.

Perhaps the best that one can hope for is a kind of collective Humean projectivist illusion. What’s right within the false sounding wishing is something like the idea of taking the season to have a kind of meaning (again, though, not really/literally). It’s that which is collectively supported by the disproportionate enjoyable round of mulled wine parties, dinners, evenings out etc. But the problem with that as an idea is that it still leaves the content of projected attitude to be explained: the ‘meaning’ or atmosphere. (In a more serious vein, that is the problem for projectivism in general, mentioned before.) That remains – to me – as opaque as Jaspers’ idea of delusional atmosphere. What could it be?

I return to delusional atmosphere and its content here.

Sunday 21 December 2008

The skull beneath the skin

The bad news is that the Christmas number one in the UK is a cover version of Leonard Cohen’s Hallelujah by the winner of the X Factor (a factory pop reality show; I can’t help feeling that that’s so much less good sounding than a Factory pop reality show might have been). In previous posts (here, here, and here), I’ve - possibly tediously - worked through my intuitions to decide that whilst there may, in extreme circumstances (and nearly everything about Rolf Harris spells danger), be some kind of risk of blasphemy (no doubt why as a typical teenager fundamentalist I had no time for them), cover versions set up a dialogue with originals which is often fascinating. And I had an excuse to mention Wittgenstein’s discussion of children playing trains, which is always useful. So why is it such bad news about Hallelujah?

One of the other things Wittgenstein says in this area is that one form of aesthetic judgement is a) a form of comparison in which one b) sees or hears something as something. Now hear this as the conclusion, one is told, for example. That prompts the kind of worry that motivates moral particularism, however. Why, if one’s focus is, or should be, on this case (moral or aesthetic), should one look away at the key moment to other examples? Why isn’t that the wrong direction of gaze? Further, if aesthetic judgements were to work by such comparisons then the comparisons would either have to be with other aesthetic or with other non-aesthetic aspects (or past judgements). This leads to two bad choices. It seems unlikely that present aesthetic judgements could merely turn on non-aesthetic features. But if they depend on past aesthetic judgements, then that threatens vicious regress. How did those judgements get off the ground? But let me put that worry aside for the moment and return to the case at hand.

Let me declare my view that the best version of the Cohen song is the one by John Cale on I’m Your Fan (a cd I insisted on playing having retired to spin the – generally mellow – discs at the end of London dinner parties in 1992). The Buckley version is horribly over the top. (The chart topping version isn’t worth comment.) But with the judgement-as-comparison thought in play, then surely having exposure to these versions will simply provide me with indirect access to the fine Cale version, in memory at least? Surely it’s no bad thing? In fact, however, I’m going to avoid music radio for a couple of weeks because of another comparison.

The Arts Centre at the University of Warwick used to serve only one real ale: Charles Wells Bombardier. It served this in such lamentably poor quality that rejecting pints became second nature. That, however, was a comparatively good result. One had at least tried to buy a decent real beer, failed, and thus bought a hugely expensive bottle of, say, Old Hooky but one could meet one’s bank manager in good faith. The problem was with the penumbra of doubtful pints that were not so screamingly awful that they violated the Sale of Goods Act but would still bring no pleasure. Repeated exposure to these taught one to taste every stage of the degradation of a beer (like the scenes of speeded-up decay in the Peter Greenaway film A Zed and Two Noughts). Thus, in a merely poor beer, one could anticipate its final vile state, two days later. And then eventually, one could taste in even a good pint of Bombardier those flavours that in its death throws would carry the final reek of oxidation.

Did that comparison reveal the essential structural weakness of Bombardier? Or was it a distortion that should have had nothing to do with its flavour for those with a luckier choice of pub? I’m not sure. And I’m not sure what the result of listening to a dreadful rendition of Hallelujah for the next two weeks. (Revellation or distortion?) But I’m not prepared to take the risk.

Monday 15 December 2008

Mere habit?

I am used to thinking about habit as the underpinnings of normatively or conceptually structured action and thought. As an ex-Wittgensteinian, I think of habit as a surrogate for a Platonic foundation for our concepts. Against the idea that habitual action might be a middle ground between conceptually structured activity and mindless doing, I see conceptual structure in the habits. And, of course, this invocation of custom and habit to underpin concepts has familiar Humean echoes. Mere habit escalates into something normatively richer.

Two things brought this to mind this weekend. The first was the need to stack the winter’s load of firewood for the stove. Delivered as a loose pile on the garage floor, I needed to stack it more tightly and higher against a wall. I thus spent an hour or so mindlessly stacking. But not in fact mindless. After only a few minutes a pattern began to appear: unconsciously I found myself slotting the differently shaped bits of wood into a more rather than a less appropriate gap, a particular way up and round, so as to keep the wood stable. Norms simply appeared, loosely fossilised in the final pattern of wood.

The second was taking part in a 10km organised run in Langdale, the first such event I’ve taken part in. I half wondered whether some further structure of thought – some sort of implicit plan – would simply appear during the course of running. I’m sure it does for fitter people in the way that in, eg., learning to ski one learns to individuate ones actions as ‘going to that tree’ rather than turning one’s skis. But I found I lacked the extra capacity necessary to do anything other than mindlessly stagger to the end. There was no further room for doing it right or wrong. Mere habit, it turned out.

Saturday 13 December 2008

Jack Bauer against the Principlists!

This week, quite uncharacteristically, I let Gloria drag me both to a trendy bar (well, as close as Preston comes) rather than my usual old man’s pub and also into a conversation about moral philosophy. (My one short article in JME is all I’ll ever write about moral philosophy.) But the issue was an curious one.

Suppose one holds both to a form of moral principlism and, more specifically, to the principle that torture is always wrong. Suppose, also, that that one’s interlocutor objects by citing what G called a ‘ticking time bomb’ case familiar to fans of Jack Bauer (pictured). The torture of a suspect is putatively justified because of the threat of a ticking time bomb that will kill averagely virtuous people. Suppose, fourthly, that it is at least open to question whether the anti-torture-principlist can contest the account of the case first advanced with further details. Perhaps, for example, torture produces unreliable results. Even in urgent cases there are more trusting alternatives. Training torturers to be able to act in such cases has too many unpleasant other consequences. And so forth.

But what, G wondered (amongst other perhaps more interesting issues we might have got to if I hadn’t been so dim about this one), have the particular details of the case even got to do with the original principle? If principles discipline moral judgement (ie. they determine their truth or correctness, whether or not we actually appeal to them for guidance) then bandying about rival accounts of the details of particular cases seems to be missing the point. A principlist should firmly stand aloof and say that, through whatever act of divination one arrives at underlying principles, once one has arrived at the principles, the particular cases can (as a maths teacher of mine often used to say) take care of themselves. They cannot conflict with the underlying principle that, eg., torture must be wrong.

Over a San Miguel (not at all appropriate brain food it seems to me), my instinct was to think this. There would be something pretty heroic about a principlist who took that – self-consistent – line. But there are two reasons for them to condescend to contest details. Firstly, cases might stand to principles as cases stand to putative empirical laws in a hypothetico deductive account of theory testing. If so, then contesting the details would be part of an alternative account of how one arrives at or justifies principles to replace one of mere divination.

Secondly, even principlists must think that their principles ‘touch the ground’ in real cases. A principlism of principles only would be a kind of abstract moral platonism, useful only in the next life, perhaps. So rival principlists, contesting the status the torture, must aim to make the interplay of favoured principles realised in every case of torture work out their way.

I suspect that, in practice, this tends to stretch cases into attenuated principles. They become the standard cases of moral education (like the ladder of mass m leaning at angle θ against a wall on a ground with a frictional coefficient of μ; or, rather, like a Jehovah’s Witness debating surgery).

In this last feature, principlists accounts of cases seem quite different from particularists for whom the ‘valence’ of any feature might be transformed by the presence of another feature. Ironically, whilst it is particularists who have the greatest reason to stress the importance of particular cases when discussing moral judgements, it is almost impossible to discuss interesting cases with them since in the real conversational situation of pub of trendy bar there is never enough shared knowledge of the details of the real cases they trade in.

PS: (a few weeks later): As reported here, sitting in the Forum, Gloria suggested that we take a 24 style scene to think about principlism. On last week’s gripping episode of 24, the man himself was challenged by a moral principlist who asserted against Bauer-ian actions: “But it’s the rules that make us better.” As a good particularist, Bauer had no intellectual cramp in replying: “Not today”.

Thursday 11 December 2008

Knowing how

Last night I read Stanley and Williamson’s (pictured) ‘Knowing how’ (Stanley, J. and Williamson, T. (2001) ‘Knowing how’ Journal of Philosophy, 98: 411-444). On the face of it, it is a troubling read for someone writing a book on tacit knowledge. On the assumption that, whatever it is exactly, there is a strong connection between tacit knowledge and know-how, it seems reasonable to hope that know-how, or knowledge-how, is importantly distinct from knowledge-that even whilst it retains the rights to the title ‘knowledge’. Stanley and Williamson argue that this is not so. Knowledge-how is not distinct from but merely a form of knowledge-that.

The paper divides into three sections with four main areas of argument.

In the first, Stanley and Williamson take issue with the modern father of the distinction between knowledge-how and knowledge-that: Gilbert Ryle. They argue both that Ryle’s regress argument for the priority of knowledge-how over knowledge-that does not work. They also argue against Ryle’s positive claim that knowledge-how is an ability (on the basis that one can retain know how even if one has, for practical reasons, lost an ability actually to perform an act).

In the second section they present a detailed summary of syntactic and semantic analyses of statements ascribing a variety of forms of knowledge including both knowledge-how and knowledge-that. Although the analysis they offer is way beyond my competence in the field, the gist of the argument seems to be that neither relevant syntactic nor semantic work draws any important distinction between these two forms of knowledge.

The third argument area grows from this. Statements ascribing knowledge-how to subjects can take the broader form of a knowledge-that ascription.

Suppose that Hannah does not know how to ride a bicycle. Susan points to John, who is riding a bicycle, and says, ‘That is a way for you to ride a bicycle’. Suppose that the way in which John is riding his bicycle is in fact a way for Hannah to ride a bicycle. So, where the demonstrative ‘that way’ denotes John’s way of riding a bicycle, (28) seems true:
(28) Hannah knows that that way is a way for her to ride a bicycle.
Relative to this context, however:
(29) Hannah, knows [how PRO, to ride a bicycle].
seems false… Where the demonstrated way is the only contextually salient way of riding a bicycle, (28) and (29) ascribe knowledge of the same proposition to Hannah. But this proposition is ascribed under different guises. In (28), knowledge of the proposition is ascribed to Hannah under a demonstrative mode of presentation. In (29), Knowledge of that proposition is ascribed to Hannah under a different mode of presentation, what we call a practical mode of presentation.
[ibid: 428-9]

This gives rise to the following account of know-how.

So, here is our complete account of knowing-how. Suppose modes of presentation are semantically relevant. Then (29) is true relative to a context if and only if there is some contextually relevant way ώ such that Hannah stands in the knowledge-that relation to the Russellian proposition that ώ is a way for Hannah to ride a bicycle, and Hannah entertains this proposition under a practical mode of presentation. [ibid: 430]

Finally, they anticipate a number of plausible objections to their proposal, closing with this comment.

All knowing-how is knowing-that. Neglect of this fact impoverishes our understanding of human action, by obscuring the way in which it is informed by intelligence. [ibid: 444]

I’m going to have to think rather more carefully about the argument against Ryle’s regress. Given that I have always thought of Ryle as expressing an argument akin to Wittgenstein’s rejection of what McDowell calls the master thesis, I’ve never thought carefully about how exactly Ryle’s version of that broad consideration works. So there are two things for me to do about this section: to rethink Ryle in the light of Stanley and Williamson and to see whether their argument counts against Wittgenstein.

The second and third points, however, do not seem to be too worrying on this first encounter, however. Firstly, there is something reassuring about the idea that know-how can be expressed given a sufficiently broad construal of language. The suggestion is like McDowell’s expansion of the space of concepts outside antecedently prepared bits of language to embrace, eg, colour patches. This in turn recalls Wittgenstein’s comment.

What about the colour samples that A shews to B: are they part of language? Well, it is as you please. They do not belong among the words; yet when I say to someone: “Pronounce the word ‘the’ “, you will count the second “the” as part of the language-game; that is, it is a sample of what the other is meant to say. It is most natural, and causes least confusion, to reckon the samples among the instruments of the language. [Wittgenstein 1953 §16]

So the idea that one can say what way things should be done demonstratively – and thus say what a subject understands – is not too unfamiliar. Better, surely, to embrace this idea than either Adrian Moore’s mysterious ineffable understanding or Harry Collins’ scepticism about such tacit knowledge. (Collins calls such knowledge capricious and says that one cannot reliably determine whether it has been passed on. This surely relies on a false contrast with knowing-that.)

But on the other hand, to encode knowledge-how as knowledge-that requires not only this use of a demonstrative to pick out the way, eg., a piece of music should be played, it also involves distinct modes of presentation for a non-violinist conductor and the leader of the orchestra. In an obvious sense, one of them does not know how to play the piece that way, even whilst she knows that that is the way to play it. But characterising this ‘practical mode of presentation’ is surely what was of interest about the putative distinction between knowledge-how and knowledge-that.

My hunch is that this might leave things like this. Broadly Rylean and Wittgensteinian arguments against a Cartesian and cognitive account of intentionality still imply that knowledge-that depends on knowledge-how. (This point, I suspect, survives in the account yet to be given of a practical mode of presentation.) But once language or intentionality is taken for granted (being lazy: once we can take for granted that we are in the space of reasons), then know-how can be expressed linguistically, providing one has a sufficiently broad conception of language in play.

PS. Having now looked at papers replying to Stanley and Williamson by Alva Noë, Ted Poston, John Bengson and Mark Moffett, and Elia Zardini, I plan to return to this issue in late January.

Thursday 4 December 2008

Tacit knowledge

In a taxi ride across Cairo in 2005 with Bill Fulford, I rashly announced that I was writing a book on tacit knowledge. The sense of ‘writing’ was that in saying one is thinking about writing, or actively pursuing the possibility of writing, not necessarily at the glad stage of typing actual chapters. Nevertheless, this idea, retrospectively and prospectively, justified my being introduced as someone working on tacit knowledge (an idea which has had a bit of a hold on some colleagues, much as one’s relatives may recall with perfect clarity a rash statement from one’s teens). Wearing my applied philosophy hat, tacit knowledge promises practical utility and that has been a helpful impression when, eg, being introduced to clinicians in a medical school.

In the meantime, however, I’ve been distracted into other projects. Fortunately, the same (introductory) purpose has been served by the central role of judgement in much of what I’ve written about and which more quickly connects Wittgenstein, and possibly Kant, with aspects of clinical judgement. (For an attempted justification see here.) But finally I’m writing (in the sense explained above!) the book on TK with my good friend Neil Gascoigne (pictured). (In my case, at least, it may be an occasional weekend project rather than blocked out time during the working week.)

Two initial problems have to be faced. One is that Neil sees all ground level philosophical issues through the lens of metaphilosophy. (By contrast, I’m merely troubled by how philosophy is possible. It’s a condition of adequacy of an account that it must be possible in its own terms and philosophical dogmatism should be avoided.) Further, his metaphilosophical stance takes the reaction to scepticism as its starting point. Especially in a book on tacit knowledge, this is bound to produce differences in how we want to frame the issues. (Is tacit knowledge really best thought of in the context of a response to Gettier problems?)

The other is that I realise that the question of what makes TK tacit is one for which none of the plausible answers completely attracts me. If ‘tacit’ equals unreflective (as, eg Erik Rietveld’s work implies), that looks to be merely a contingent phenomenological distinction. If it is taken to be darkly ineffable (as Adrian Moore’s tantalising book suggests), then it is hard to avoid a sense of implausible mystery clinging to it (one does not standardly say that the tacit knowledge of white sauce making is ineffable). If, as I’m inclined to say, one presses the idea that it is not (finally?) linguistically codifiable, then some apparently explicit judgements will count as tacit.

It seems odd to have decided on so much else about the book but not, perhaps, the central issue.

Friday 28 November 2008

Off the beat?

Whilst running yesterday I played the podcast of a recent In Our Time programme on neuroscience which included on the panel the Kings College philosopher David Papineau. Later in the evening I went to hear to Zutons play at Carlisle (living where I do, I have to seize such opportunities).

In the ordinary sense of the word, Papineau wasn’t dogmatic. Indeed, Melvyn Bragg was obviously a little frustrated for the first half of the programme because the notes he had submitted in advance were obviously much more forthright than Papineau himself initially was. He conceded, for example, the naturalness of a dualist position against his own ‘died in the wool materialism’ (though I’m not sure it is really a natural position; the assumption it is calls for questioning). But when urged, he did outline a standard physicalist account of the mind-brain relation.

But whilst David Papineau wasn’t dogmatic in any pejorative sense, the account he offered was dogmatic in this sense. It comprised a set of positive but philosophical claims thus making me wonder: on what premises had it been based (if it were philosophical as opposed to empirical but likely to be true)? But that is too blunt a question to be happy with. Ultimately, no positive philosophical account would escape it and the only alternative lies in Wittgenstein’s comment: I destroy, I destroy, I destroy!

But later at the Zutons, the following association struck me. A few years ago I played their first album throughout the autumn as a gently upbeat mildly funky cd to, eg., drive to. But I hadn’t thought of them amplified to gig level volume, presenting a wall of sound. For the first few moments they sounded a bit like, and made me wish I were hearing, Seamonsters era Wedding Present. But what redeemed things was that, although they slipped weirdly into channelling first Thin Lizzy and ultimately early Pink Floyd, most of the time the Zutons’ music is syncopated (it also has two saxophones, a flute, self-conscious drum solos and other quirks). It is often nicely off the beat. As a result, although it climaxed with a standard four-four thrash, this seemed a destination justified because achieved only once they had travelled a circuitous route.

This made me realise what seems so odd about philosophy in the style of David Papineau. Recall Michael Dummett’s (pictured) remark at the start of The Logical Basis of Metaphysics. He’s had a plumbing disaster after trying to make some alterations himself with hammer and chisel (perhaps, my memory is dim). The emergency plumber comes to rescue him and when queried about whether all is lost says no, it is a straight-forward job providing that one does not go about it, as Dummett has, ‘bald-headedly’. (I really will have to check this memory!) So equally, suggests Dummett, philosophy should not be attempted head on like Papineau, but via a principled route through, for example, the philosophy of language, to set some ground rules. Philosophy should be, so to speak, off the beat. That’s what’s wrong with dogmatic philosophy. It is merely on the beat.

Thursday 27 November 2008

Do animals need a ‘theory of mind’?

At this fortnight’s Uclan Philosophy research seminar Ian Ground (pictured), from the University of Sunderland, gave a paper called ‘Do animals need a ‘theory of mind’? to be published as a book chapter. The paper seemed to me to fall into two parts. First he argued that much work in animal cognition work which is used to argue for a theory of mind presupposes a background Cartesianiam. One revealing quote was:

That a mirror-educated chimpanzee immediately rubs off a spot on his forehead when he sees it in a mirror is not… clear evidence for self-awareness, at least in its usual sense… Our conscious selves are not our bodies… we do not see our conscious selves in mirrors. Gallup’s chimpanzee has [merely] learnt a point to point relation between a mirror image and his body, wonderful as that is. [Jaynes, J. (1978) ‘In a manner of speaking’ BBS 1: 578-9]

Ian recalled the Wittgensteinian claim that such implicit Cartesianism also structured its apparent polar opposite: behaviourism. He didn’t say it quite like this but the idea was that the description of behaviour that behaviourism took as the basis of an analysis of mindedness (the mind just being the behaviour) was what was left over on the bodily side of a Cartesian distinction between mind and body. (Then again, given how clumsy that sentence was, maybe it’s a good thing he didn’t put it like that!) Against this background, theory theory looks to be a necessary route from observable behaviour to unobservable mental states.

But, there is another option. If one denies the Cartesian divide between observable behaviour to unobservable mental states one can see that in behaviour mind can be expressed. (In the human case, it is usual, following Strawson, to start talking of the central role of the person at about this point.) So, Ian suggested, there’s no need to deploy theory theory either to grant that animals might have minds or to underpin their own ability to detect other minds. We can all get by by seeing others’ minds in their behaviours, including, eg, my cat Brix.

It was a bit surprising that in this account, no mention was made of McDowell, who has famously discussed the connection between Cartesianism and an impoverished conception of behaviour, given that he was the target of the final section.

In this, Ian argued that a neo-Kantian view - championed by McDowell - of experience blocked a view of animal minds. The worry is that an agent’s expressive behaviour can only express a content that the agent can entertain, him- her- or itself. On a neo-Kantian approach, however, firstly, all such content must be conceptualised and secondly, only language can carry concepts. So given that animals lack language, they lack concepts, thus content and thus minds.

Ian’s response was to suggest that animals’ interactions with the world could deliver a sufficient degree of articulation for them to be able to experience or inhabit a world rather than a mere environment as McDowell says, following Gadamer.

I wasn’t sure, however, how this answer was supposed to deliver the right response. Firstly, whilst there might be fine grained behavioural discrimination, there’s surely no hope that this could underpin the inferential properties of linguistically structured concepts. Secondly, this distinction would surely mean that our ability to read animals’ expressive behaviour would need a translation between the normatively and inferentially structured concepts we use and animals’ proto-concepts before we could attribute mental states.

Ian agreed that there were problems with his view but suggested it was better than either denying animal minds (a non-starter for a plausible philosophy of mind) or, my other suggestion, starting with the linguistic mind as a prototype and abstracting away from it. This seemed to him to be equally unfair to animals.

(Sorry this is such an uncritical post; I will link back to it when I have something at least a little interesting to say about the matter myself.)

Wednesday 19 November 2008

McDowell on Intention in Action

In case anyone hasn’t seen this lecture, here’s a link to McDowell on Intention in Action on Youtube. The gently unforgiving style of delivery is typical. We are straight into the philosophy with little sense of where we’re going. How unlike the style I try to teach undergraduates of giving a plan and a clear structure in advance. And yet, how oddly effective it is.

Sunday 16 November 2008

Trying to understand the endogenous Given

Last week, I gave two papers at the University of Hertfordshire. The system is that one first presents a research paper during a two hour session, pauses an hour and then gives a shorter paper to the undergraduate philosophy society. The audiences seemed very friendly.

(One man, however, in my short presentation on Thomas Szasz muttered loudly that he didn’t know why he’d come. He very much reminded me of the slightly confused man in ‘Four Weddings and a Funeral’ who asks the Hugh Grant character, Charles, ‘Who are you?’ and Hugh Grant replies, ‘I’m Charles’, hugely annoyed, the older man replies, ‘Don’t be ridiculous! Charles has been dead for years’. I didn't mind that he was a bit rude.)

But I was a little fazed by one question asked of my other paper which seems to suggest a real problem for a particular kind of philosophy. My paper turned on the worry that McDowell’s rejection of an endogenous (strangely, pictured!) component to our thinking rules out a role for a non-Quinean picture of philosophy and that his own comments do not go far enough to explain how the insight in Mind and World is possible. McDowell suggests that there is no difficulty in rejecting an endogenous scheme but preserving analytic truths.

We can reject the two factors without threatening the idea that there are limits to what makes sense: that our mindedness, as [Jonathan] Lear puts it, has a necessary structure. The idea of a structure that must be found in any intelligible conceptual scheme need not involve picturing the scheme as one side of a scheme-world dualism. And analytic truths (in an interesting sense, not just definitionally guaranteed truisms such as “A vixen is a female fox”) might be just those that delineate such a necessary structure. [McDowell 1994: 158]

The rejection of the endogenous is put thus:

If we embrace the picture I recommend…, in which the conceptual realm is unbounded on the outside, we make it unintelligible that meaning’s impact on determining what we are to believe is endogenous as opposed to exogenous. (Not that it is exogenous instead; the need to make this kind of determination simply lapses.) [McDowell 1994: 157]

But this rejection might suggest a merely Quinean picture of the web of belief in which there is no special role for philosophy except as lazy empirical science which doesn’t bother with experiment.

There is one further suggestion in the text: ‘at least some of the “hinge propositions” to which Wittgenstein attributes a special significance in On Certainty’ [McDowell 1994: 158 fn 35] should count as delineating a necessary structure in our mindedness. But most hinge propositions in On Certainty seem to be contingent. In this context, they look like central beliefs in Quine’s web and charting them looks more like anthropology than philosophy or ‘transcendental anthropology’.

Anyway, my suggested resolution was to take McDowell’s rejection as of the endogenous Given not merely the endogenous given (just as perception can provide an exogenous given even if not exogenous Given), and to base this on a response to Jonathan Lear.

Lear’s transcendental anthropology might – had it been coherent – have been a picture for how Mind and World might combine both transcendental and anthropological stances. But it fails because – I suggest – it relies on a picture of the endogenous Given to constrain our concepts, to turbo-charge why, eg., 7 + 5 has to equal 12 (not just because that is the rule). I also suggested that Achilles’ outburst against the Tortoise about logic taking one by the throat was a further instance of an implicit appeal to the endogenous Given, compelling our concepts from outside the conceptual though, somehow, inside understanding.

Anyway, I was asked how the idea of the endogenous Given and endogenous given could be distinguished since, if I understood the questioners, the constraint operated on concepts and could not be from outside the conceptual order. There are two things to say, however. The exogenous Given operates on concepts but from outside the conceptual. So, insofar as we understand the latter, we should be able to understand the former.

But of course, my problem is that I do not think we can understand either sort of Given really. That there is no endogenous Given is not a contingent fact. It makes no sense. So, when asked to fill out how there could be such a Given, I was a bit stumped. Only if one already were tempted by the idea (as I think Lear has been), can the therapeutic move directed against seem to have any point.

Tuesday 11 November 2008

Postscript to: Cover versions and Wittgenstein on playing trains

Further to my previous thought about cover versions of popular songs Wittgenstein’s discussion of children playing trains, in Saturday’s Guardian, in an article about Barack Obama, Marina Hyde commented thus:

Have you ever heard Rolf Harris’s version of Led Zeppelin’s Stairway to Heaven? It has a didgeridoo solo, and is not widely acknowledged to be a masterpiece. Bless Rolf, though, because years after its release, he revealed he’d never actually heard the original when he came to record it. “And when I did,” he confessed in horror, “I thought: ‘Oh my God, what have I done?’”

Of course, this story seems highly unlikely. But imagine if it were true. That would completely alter the status of Rolf’s version’s relation to the original. Arch pastiche would become an accidental stumble into the territory of blasphemy. The whole feel of the game would be changed.

(A correspondent from East Molesey adds:
Tim,
I believe that the story about dear old Rolf is completely true. As I heard it at the time of the single's release, Rolf had guested on a TV show (Australian?), on which the convention was that all interviewed musicians had to play a version of Stairway to Heaven. Having never heard it, Rolf simply got hold of a copy of the sheet music and, being the pro he is, performed from that.

I wonder what he meant when he asked himself what he had done upon hearing the original? My guess is that his thought might translate as "I've covered a bloody awful song by perhaps the most over-rated band in history (though their first album was OK, along with a couple of tracks from their fourth)".
Best,
Peter
)

Faith and Aristotle

I popped along to a seminar on conceptions of mental wellbeing and eudaimonia, this morning, put together by Karen Newbiggin (Institute for Philosophy, Diversity and Mental Health), Dave Littlewood (Philosophy) and Mahmood Chandia (Islamic Studies), all now part of ISCRI (the International School for Communities, Rights and Inclusion) at Uclan.

Karen Newbiggin presented an overview of her scoping exercise on empirical findings concerning conceptions of mental health in Scotland amongst Chinese and Pakistani ethnic populations. These included the use of ‘happiness’ by the Chinese, informed by either Confucianism or Taosim, and the notion of a ‘peaceful mind’ informed by Islam.

Dave Littlewood presented an overview of Aristotle (pictured, apparently) on eudaimonia, suggesting that one aspect of his discussion that hadn’t been sufficiently developed in recent commentary and which might be most useful for contemporary work on mental wellbeing was the social dimension of flourishing.

Mahmood Chandia discussed the differing views of physical and mental health deriving from Islam and the connection between mental wellbeing and a self-conception framed in faith-related terms.

Whilst Mahmood’s presentation had the authority of personal commitment and Dave’s had the characteristic doubt of a professional philosopher, I had assumed that I would ‘read’ the former as an account of actors’ categories and the latter as a potential, at least, discussion of analysts’ categories. That is, following Karen’s overview, I assumed that Mahmood would provide a further description of a conception of wellbeing framed within a particular (religious faith based) community whilst an Aristotelian account might enable us more broadly to think what wellbeing might be or mean.

Perhaps the actual result is obvious. Although Aristotle says some entirely reasonable things – still!, after two millennia – that simple reasonableness now seems entirely suspicious. On whose authority is that kind of plain speaking philosophy put forward (by contrast with the philosophy which- in the title of Kuusela’s recent book – rejects dogmatism)? I realise that, these days, I simply do not believe in Aristotle.

Tuesday 4 November 2008

Philosophy, social science and reasons

Yesterday I went to a paper given by my colleague Phil Thomas at an inter departmental group for Mental Health and Society. Taking as his point of departure Peter Sedgwick’s Marxist book Psychopolitics which argued, among other things, that the arguments for anti-psychiatry might be used by the right wing to reduce resources for mental healthcare, Phil wanted briskly to outline (rather than argue in full at much greater length than time allowed) that there was a difficulty even in Marxist writing in escaping an Enlightenment individualism and that this had consequences for a proper understanding of multiculturalism.

A post-Enlightenment conception of the self based on ‘interiority and self reflexivity’ led, at a distance, to a failure to escape a ‘normative, reified and fixed’ view of culture. Thus, escaping an individualist account of the self was the cost of being able to adopt a properly sensitive approach to multiculturalism.

Two things struck me about the seminar. Firstly, there was something utterly appropriate about being at a seminar at an ex-polytechnic at which the participants debated with themselves about whether they should call themselves, or think of themselves as, Marxists or not. The issue was both an academic one (befitting university debate) but also politically and practically significant (befitting a polytechnic).

Secondly, I was left a little uneasy about how the connections which Phil – for the sake of speed – merely gestured at might be filled out if time had allowed. Just how does one get from a view of the self has having particular ‘inner’ characteristics to a view of culture as both fixed, substantive and to be judged judgementally? For one thing, how does one get from what seem to be non-evaluative premises concerning the nature of selves to evaluative conclusions about culture?

Two options strike me. One is that there might be a conceptual argument that connects the two with suitably specified additional premises. Phil himself suggested that an individualistic model of the self is often combined with adoption of autonomy as a moral principle. Nevertheless, I doubt that that would really work.

So I suspect that what sustains the longer argument is a piece of qualitative social science. The Enlightenment model of the self is taken by many to be a reason for the moral importance of individual autonomy. That’s what it is to be a reason in this field. And given that, if you want a better view of multiculturalism, you need to argue against the ‘premiss’.

Interestingly, if so, whilst that may seem very close to philosophical analysis (and thus to the philosophy of psychiatry as I see it) it is actually diametrically opposed to it in spirit. Philosophical analysis often focuses on an association that is plausible and taken for granted and then points out that the one thing doesn’t actually follow from the other, despite the common view. That something is taken to be a reason isn’t enough for it to be a reason.

(Of course, one problem for reason-particularism is that it is quite hard to fill out why that is true. It is not that real reasons can in general be codified in deductive structures, for example. That is not the test of a genuine reason.)

Saturday 1 November 2008

Putnam on magical theories of reference

Last week, I was invited by my colleague Peter Lucas to reply to a paper he was giving defending phenomenology from the charge, made against it by Hilary Putnam in Reason, Truth and History, that it subscribes to a merely magical theory of intentionality.

I last looked at Reason, Truth and History twenty years ago with quite different eyes. Then, I took its attack on reference to be an attack on a correspondence theory of truth and an inflated metaphsyical realism (as Putnam seems to want us to take it). But now it seems to be more like a defence of a Davidsonian prioritising of truth over reference as an approach to semantics. If so, whilst the Skolem-Lowenheim thesis, to which he appeals, seems to deliver a familiar result, it seems to presuppose a too intellectual picture of how reference might get off the ground to promise a helpful account of language.

Deriving reference from truth in the absence of a contextualising account of a language game (for want of a better phrase) seems a no hoper. Davidson tempers his truth-based approach to formal semantics with the more general philosophy of language of the field linguist employing the principle of charity, for example. Putnam merely darkly talks of reference within a conceptual scheme:

In an internalist view also, signs do not intrinsically correspond to objects… But a sign that is actually employed in a particular way by a particular community of users can correspond to particular objects within the conceptual scheme of those users. ‘Objects’ do not exist independently of conceptual schemes. We cut the world into objects when we introduce one or another scheme of description. Since the objects and the signs are alike internal to the scheme of description, it is possible to say what matches what. [Putnam 1981: 52]

This might be intended to make a merely negative point. One cannot place words in a relation with extra conceptual reality. Or, taking account of Travis’ writing in this area – he argues that objects such as pieces of meat are themselves extra conceptual – things impact on thought only through our conceptual abilities. They never brutely impact. But Putnam’s language implies that there is a substantial insight into the nature of the world summarised in the label ‘internal realism’. We can only refer within our scheme as though extra-scheme reference is denied to us. We’d aim at that more penetrating gaze but are blocked by the limits of our grasp.

What was equally disappointing was the way in which Putnam recruited Wittgenstein to his initial argument against a magical theory of reference. The set-up is something like this. According to Putnam, ‘mental presentations’ (a technical term), had they existed, would have been essentially representational. They would have had essential intentionality. Mental images and concepts are not mental presentations, so defined. They are like physical images and signs whose intentionality is contingent.

Concepts are not mental presentations that intrinsically refer to external objects for the very decisive reason that they are not mental presentations at all. Concepts are signs used in a certain way… And signs do not themselves intrinsically refer. [Putnam 1981: 18]
The doctrine that there are mental presentations which necessarily refer to external things is not only bad natural science; it is also bad phenomenology and conceptual confusion. [Putnam 1981: 21]
[M]ental representations no more have a necessary connection with what they represent than physical representations do. The contrary supposition is a survival of magical thinking. [Putnam 1981: 3]

He then deploys an argument inspired by Wittgenstein which illustrates the contingent intentionality of pictues and hence, apparently, mental images.

Suppose there is a planet somewhere on which human beings have evolved… Suppose these humans, although otherwise like us, have never seen trees. Suppose they have never imagined trees... Suppose one day a picture of a tree is accidentally dropped on their planet by a spaceship ... Imagine them puzzling over the picture. What in the world is this? All sorts of speculations occur to them: a building, a canopy, even an animal of some kind. But suppose they never come close to the truth.
For us the picture is a representation of a tree. For these humans the picture only represents a strange object, nature and function unknown. Suppose one of them has a mental image which is exactly like one of my mental images of a tree as a result of having seen the picture. His mental image is not a representation of a tree. It is only a representation of the strange object (whatever it is) that the mysterious picture represents…
We can even imagine that the spaceship which dropped the ‘picture’ came from a planet which knew nothing of trees. Then the humans would still have mental images qualitatively identical with my image of a tree, but they would not be images which represented a tree any more than anything else.
[Putnam 1981: 3-4]

Putnam thus drives a wedge between pictures (of a tree) and trees. Pictures are not essentially representational. They need not be individuated by what they represent. And they have other non-intentional intrinsic (eg spatial) properties.

But to count against a magical theory of reference or intentionality (of mental images), the argument needs to sever the connection between the aliens’ mental images and the picture. It does not. Why generalise from the contingent intentionality of pictures to that of mental images?

Note also the point about concepts. Putnam says ‘Concepts are signs used in a certain way… And signs do not themselves intrinsically refer.’ But what of signs used in a certain way? I agree that one might pick out the way in a manner that has no essential connection to the meaning of the sign. But if so, that way will not explain concepts in the way that Putnam has just claimed is possible (when he says that concepts are just signs used in a certain way). Picked out in the way that is needed for that identity claim, then the way signs are used seems, contra Putnam, to have an essential connection to the concept.

I think that the overall problem is this. Wittgenstein criticises the appeal to images (which resemble what they are about) and other free-standing mental items (such as inner signs, like signposts, that just stand there) as an explanation of intentionality. Thus the contingent intentionality of pictures counts against the use of images in explanations of intentionality. Putnam, by contrast, argues that what we would pre-philosophically call ‘mental images’ (rather than explanations of mental images) are not mental presentations as he defines them and have merely contingent intentionality. And this move seems simply wrong.

What seems a little ironic is that Wittgenstein himself sometimes seems to say quite spooky things about intentionality:

“You said, ‘It’ll stop soon’. Were you thinking of the noise or of your pain?” If he answers “I was thinking of the piano-tuning - is he observing that the connexion existed, or is he making it by means of these words? - Can’t I say both? If what he said was true, didn’t the connexion exist - and is he not for all that making one which did not exist? [§682]

I draw a head. You ask “Whom is that supposed to represent?” - I: “It’s supposed to be N.” - You: “But it doesn’t look like him; if anything, it’s rather like M.” - When I said it represented N. - was I establishing a connexion or reporting one? And what connexion did exist? [§683]

I do not mean that Wittgenstein subscribes to a magical theory of intentionality. He subscribes to no theory in this area. But his rejection of subvenient mechanisms of thought verges on the spooky.

Friday 31 October 2008

For him, painting should be abandoned

In Paris last weekend I wondered round both the Pompidou and the City of Paris Modern Art Museum which had a fine Dufy exhibition. Later I squeezed into the Frieze Art Fair: a commercial exhibition by a number of galleries. Two things struck me:

The proportion of works that appealed to me at Frieze was tiny: perhaps one in twenty. By contrast, in a typical municipal contemporary gallery I might like half of what is displayed and covet one quarter. Now one thought is that the latter has much greater quality control. To be on display a work’s artist must meet some sort of accepted standard. He or she must have a reputation in the art world generally or some such. And this serves as a kind of justification for inclusion even if particular works are under par.

But my worry is that even in expectation-challenging conceptual art, there is a kind of cosy familiarity. On a trip down the east of the United States a few years ago I lost count of the Donald Judd ‘draws’. What had seemed only so interesting seen once became more and more appealing seen – over time – en masse. Contra Hume’s remark that:

What we learn not from one object, we can never learn from a hundred. [Hume Treatise 1.3.6]

... another Judd is quite different from one’s first Judd.

The other thing that struck me is how similar in tone are the blurbs written by municipal curators by such works (commercial galleries don’t seem to bother with conveying the truth in art.). Take the line I noticed in the Pompidou:

For him, painting should be abandoned, expressive of a lost social totality.

It doesn’t say: he thought that he should abandon painting. It is more general and normatively compelling than that. But it is not: he thought that painting should be abandoned. That recognises the manifesto in the content but also seems to invite us, the reader, to disregard it. It is merely something he thought. Rather it combines the manifesto: painting should be abandoned, with the weakening device ‘for him’ to produce the characteristic partial endorsement by the curator. The artist must have seen some truth. He or she is an artist after all. But it is a truth that hasn’t been shared by all such artists, many of whom have carried on painting.

Wednesday 15 October 2008

Too many (foot)notes!

Catching up with Laurie Taylor’s sociology programme on BBC Radio 4, I was struck by a very uncharacteristic interview. In the main, Taylor interviews academics who describe their research in fairly accessible everyday terms. But in a discussion of how consumerism itself motivates and causes crime, Dr Steve Hall from Northumbria University peppered his (otherwise actually quite interesting) account with a ludicrously large series of names –

Disreali, Dick Hobbs, Weber, Bourdieu, Veblen, Thomas Frank, Joseph Heath and Andrew Potter, Zygman Bauman, Nikolas Rose, René Gerard, Steven Cohen, Adorno, Horkheimer, Žižek

– as though footnoting a paper. In the (surprisingly) informal context of a conversation with Laurie Taylor, however, rather than substantiating his claims, it had the strange effect of making them sound very much less plausible.

This reminds me of a strange feature of giving excuses, for example, for not attending a dinner party. If there are a number of reasons one might offer for not attending a dinner, reasons that all individually pull in the same direction or have the same ‘valence’ (in Jonathan Dancy’s helpful word), then it might seem that putting them all together in the same note might produce a better, more plausible excuse. But strangely if I am told by someone that they have a family visit, a work deadline and that they are not feeling well, that seems much less plausible than any one of them would have been in isolation.

By the way, I hear that (my friend) Dr Havi Carel (pictured), Senior Lecturer in Philosophy at the University of the West of England has been successful in an AHRC network bid on ‘The Concepts of Health, Illness and Disease’. Well done her!

Friday 10 October 2008

Psychiatry and Freedom, INPP conference

I’ve just been to the International Network for Philosophy of Psychiatry conference organised this year by John Sadler (pictured) in Dallas, Texas. Given my slightly misanthropic tendencies, I often wonder what the purpose of going to conferences is (I wonder this particularly as I get up at 6am to catch a plane, for example). Clearly, one reason is networking for one’s next job. But as I’m quite happy where I am at the moment, that isn’t it. So I think there are two good reasons to go to the INPP conference (and thus why I will go to Lisbon 2009):

Firstly, the morale raising idea of belonging to a particular academic community. A goodly number of the ‘aristocracy’ of philosophy of psychiatry were in Dallas including: Gerrit Glas, Julian Hughes, Jim Philips, Nancy Potter, Jennifer Radden, Giovanni Stanghellini, John Sadler, Werdie van Staden (though Derek Bolton, Bill Fulford, Grant Gillett were missing this year). It was good to meet (or meet again) Claudio Banzato, Jennifer Hansen, Christian Perring, Neil Pickering and Jessica Wahman (“the most attractive woman in philosophy of psychiatry”, apparently). The field is sufficiently small that one can have a sense of belonging to a group bound together by overlapping shared interests.

Secondly, it is a way of learning what subjects currently constitute the discipline. Because it is not a natural kind, philosophy of psychiatry seems to me to be more open to ongoing revision than more central areas of analytic philosophy. But of course, one has to factor out the effect of the title of the conference. In this case, at least half the participants had gamely followed the connection to freedom. But I think that that is more John Sadler’s vision than an agreed conception of its future.

I used the conference as a chance to begin to think, after 4 years of saying that I’ve been doing this, about the role that tacit knowledge (or skilled coping) might have in shedding light on clinical judgement. Like other aspects of clinical judgement it seems to share the need for a balance between a focus on individual cases and on the essential generality of conceptual judgement. This is nicely exemplified in the recent debate between Dreyfus and McDowell where Dreyfus assumes that McDowell’s commitment to conceptuality must preclude the individual focus of skilled coping and McDowell counters, in effect, that generality is not the same as codification.

No doubt the very idea of a habit implies a generality of content. But conceiving phronesis as a habit, or a set of habits, is consistent with holding that the only way one can register the generality of phronesis is by a description on these lines: ‘‘the habit of responding to situations as phronesis requires’’. And that leaves what response a particular situation calls for from the phronimos still needing to be determined by situation-specific discernment. [McDowell 2007 341]

Being quite sad to leave (well organised, John!) I was reminded of what may have been my first proper hint of a sense of mortality. Permitted to go on one of their trips, before I was strictly old enough to join the Cub Scouts, I came home upset that whilst it would be possible to go on subsequent trips, and they might even repeat the same plan, I would never have that experience again. This was an inchoate hint of Windelband’s thought which underpins his emphasis on the individual case:

[E]very interest and judgment, every ascription of human value is based upon the singular and the unique. Simply consider how swiftly our emotions abate whenever their object is multiplied or becomes nothing more than one case among thousands of others of the same sort. “She is not the first,” we read in one of the most terrifying texts of Faust. Our sense of values and all of our axiological sentiments are grounded in the uniqueness and incomparability of their object... Every dynamic and authentic human value judgment is dependent upon the uniqueness of its object. [Windelband 1980: 182]

Thursday 18 September 2008

800 words on Thomas Szasz

Brendan Kelly is putting together a short composite article on Thomas Szasz from 5 or so short separate pieces. I know that I ought to be able to say something about someone so important to the philosophy of psychiatry at whatever length is required but this seems to me to be tricky. 800 words is almost enough to say something but I fear it would take more skill than I have to say something interesting in that limited space. Given that I think of myself primarily as a kind of philosophical journalist, this does seem disappointing.

Here is my first stab, though likely to change.

The Myth of Mental Illness fifty years after publication: What does it mean today?

In the Myth of Mental Illness, Thomas Szasz offered, or at least appeared to offer, a number of arguments against the reality of mental illness. The most important is expressed in this passage:
The concept of illness, whether bodily or mental, implies deviation from some clearly defined norm. In the case of physical illness, the norm is the structural and functional integrity of the human body. Thus, although the desirability of physical health, as such, is an ethical value, what health is can be stated in anatomical and physiological terms. What is the norm, deviation from which is regarded as mental illness? This question cannot be easily answered. But whatever this norm may be, we can be certain of only one thing: namely, that it must be stated in terms of psychological, ethical, and legal concepts… [W]hen one speaks of mental illness, the norm from which deviation is measured is a psychosocial and ethical standard. Yet the remedy is sought in terms of medical measures that – it is hoped and assumed – are free from wide differences of ethical value. The definition of the disorder and the terms in which its remedy are sought are therefore at serious odds with one another.[Szasz 1972: 15]

The argument here starts from the assumption that mental illness and physical illness involve deviation from different norms. Medical intervention, however, is capable of addressing only one sort of deviation – that of physical illness – and thus it cannot address the kind of deviation from a norm implicit in mental illness. Since the conception of mental illness involves the idea that it can be so treated, there is something incoherent about the very idea.

Since medical interventions are designed to remedy only medical problems, it is logically absurd to expect that they will help solve problems whose very existence have been defined and established on non-medical grounds. [ibid: 17]

Szasz also develops a shorter version of this argument. If mental illness is a deviation from a psychosocial norm then this leads by itself to an objection from circularity:

Clearly, this is faulty reasoning, for it makes the abstraction ‘mental illness’ into a cause of, even though this abstraction was originally created to serve only as a shorthand expression for, certain types of human behaviour. [ibid: 15]

Whilst neither of these arguments is compelling, they do suggest an important result that has shaped the philosophy of psychiatry since. They are not compelling because, even if mental illness is defined by, or identified through, psycho-social norms, this need not imply that it is identical to or constituted by such deviation. It may be that the illness is the cause of the deviation such that, even though it is picked out by its characteristic effects, it is not identical to them. (Firing the gun may be picked out as the cause of the death of the president; but it is not identical to the death: it slightly predates it.) If so, Szasz’ argument fails. To establish his conclusion he would need to establish the truth of a kind of mental illness behaviourism which goes beyond highlighting the role of societal norms in picking out illness.

Although the argument for the stronger conclusion fails, it is enough to block a common assumption that shapes biologically minded psychiatry. The assumption is that a successful biological account of a psychiatric syndrome places the condition on the same footing as a physical illness or disease. It would remove it from the debates around anti-psychiatry about deviation from societal norms. But that does not follow. If Szasz is right that conditions are only picked out as illnesses through deviations from societal norms, an aetiological account of the causes of such deviations does not remove the conceptual connection between mental illness and societal norms.

Thus what seems most important to the debate within philosophy of psychiatry about the nature of mental illness is Szasz’ premiss: that mental illness is picked out or identified in psychological, ethical, or legal terms. (In fact, Szasz himself recently suggested that the proposition that mental illness is a myth was not the conclusion of an argument he offered but something he accepted as a premise [Szasz 2004: 321]. This perhaps suggests that he did not aim to move much beyond the claim that mental illness is an essentially evaluative notion. That is why I said he may merely have appeared to offer an argument for the myth of mental illness.)

Szasz’ premiss also highlights a genuine complexity at the heart of current debate about psychiatric taxonomy. Assuming that deviation from a societal norm plays a key role in picking out mental illness, how is it to be specified? It might be specified either in terms which presuppose the concept of illness – hence a pathological deviation from a societal norm – or they might be specified in some other illness-independent terms. One, albeit implausible, example of the latter would be simply to say that any deviation from the – still to be defined – central norms is indicative of illness. Less implausibly, one might suggest mental illness is identified via specific politically defined deviations. This would be a Foucaultian reading of a broadly Szaszian approach to mental illness. It would also be a form of reductionism. The concept of illness would be reduced to other independent concepts. The alternative, by contrast, has to take illness or pathology to be a primitive, that is irreducible, term.

Take the case of those people who claim that the inner voices that they hear are indicative not of a pathology but of their membership of a different community. Their experiences are a deviation from a societal norm but does the deviation also amount to a pathology? The underlying problem now takes the form of a dilemma. If one can specify in illness-independent terms the kind of deviation that amounts to a pathology, then one has a neutral ground to assess the status of hearing voices. But, given the general failure of reductionist programmes within philosophy, that seems a difficult task. On the other hand, if the deviation in question has always to be understood in illness-involving terms, that will provide no help where the pathological status of an experience is precisely what is in question.
(PS: An update and Szasz’ reply is here.)

Szasz, T. (1972) The Myth of Mental Illness, London: Paladin
Szasz, T. (2004) ‘Reply to Bentall’ in Schaler, J.A. (ed) Szasz Under Fire, Chicago: Open Court: 321-6

Wednesday 17 September 2008

Projectivism and causation

In trying to fill out the apparently Wittgensteinian idea that the conceptual order depends on some underlying contingencies – the ‘whirl of organism’ in Stanley Cavell’s phrase – and the contrast between such a thought and the idea of absolute representations, Gloria and I have been looking at Helen Beebee’s paper on a projectivist account of causation [Beebee, H. (2007) ‘Hume on Causation: A Projectivist Interpretation’, in R. Corry and H. Price, (eds.) Causation, Physics and the Constitution of Reality: Russell’s Republic Revisited Oxford: Oxford University Press: 224-49]. I must say, I’m quite confused at the moment both by the paper and by what I can recall of projectivism in Blackburn’s quasi-realism. I need to do some urgent revision.

The part of Beebee’s paper that is darkest to me is her response to an objection to Hume from Stroud. (The following section of the paper, by contrast, is striking.) Beebee summarises Stroud’s objection thus:

Stroud wants to think of Hume as ‘holding that we do really think of objects as causally or necessarily connected…’. In other words, he wants to think of Hume as holding that we are capable of believing – and hence of thinking – that c caused e… But to be capable of having such thoughts, Stroud thinks, the relevant idea – of necessary connection… – must be capable of representing the world as being a certain way: the idea of necessary connection must be capable of representing c and e as bearing that relation to each other… But, given that the content of those ideas is given by something internal – an impression of reflection or a sentiment – it seems that they cannot be capable of representing the world as being a certain way at all. [226]

Thus Stroud objects that Hume lacks the resources to explain how we can have even the idea of objective or worldly causal connections when their source is merely our own tendency to infer e from c. Beebee’s solution seems to be to accept the negative aspect of Stroud (and Hume) but to suggest that there is a positive account that Stroud has not spotted.

What is it to ‘speak and think as though’ causation were a mind-independent relation? It is important to realise that, on a projectivist view, this does not involve our mistakenly assuming that there are mind-independent causal relations. The non-descriptive semantics of our causal talk would rule out the possibility of our even being capable of making this assumption: to think that there are mind-independent causal relations. in the representational sense, requires that the meaning of ‘causal relations’ is descriptive, which of course is what is being denied. [228]

So whatever phenomena projectivism aims to save, they do not include our thinking that causation is a mind-independent relation. We cannot think that. (This contrasts with the idea that we do think that, though falsely. But also, since – I assume - projectivism is supposed to contrast with an error theory, it suggests some potential tension with a pre-philosophical description of what we do think. Projectivism will have to sell us a suitable account of that.)

What of the positive account? Beebee suggests that projectivism can give an account of how, despite their basis in our (non-descriptive) attitudes, our sayings can take on ‘propositional behaviour’. This brings ‘the resources for thinking of those habits as susceptible to critical scrutiny’ [229]. I’ll return to this a little later. Still sticking with the mainly negative aspect, Beebee continues:

Care is needed here, for it might seem as though to say that we cannot so much as think that there are mind-independent causal relations, as I did above, is tantamount to giving up on the thesis that we ‘do really think of objects as causally or necessarily connected’ , when part of the point of a projectivist interpretation of Hume is precisely that it allows him to uphold that thesis. The two claims are not really incompatible, however. To say that we cannot so much as think that there are mind-independent causal relations means, in this context, to say that we cannot genuinely think of or say two events that they stand in a mind-independent relation of causation to one another. [230]

Given what we have had already read, I take it that ‘genuine’ does not here mean correctly or truthfully thinking about mind-independent causal relations. It means it is genuinely the case that one is thinking the thought, true or false. She continues:

As Hume says, we are ‘led astray… when we transfer the determination of the thought to external objects, and suppose any real intelligible connexion betwixt them; that being a quality, which can only belong to the mind that considers them’. By contrast, to say that we do really think of objects as causally or necessarily connected is to say that we are not led astray – we are not making any kind of mistake – when we ‘speak and think as though’ causation were a mind-independent relation, in the sense just described. [230]

Whilst the phrase ‘think that there are mind-independent causal relations’ is simply to be rejected as a philosopher’s error, the contrasting phrase ‘think of objects as causally or necessarily connected’ is what is to be saved via a projectivist account. (There is something a bit odd about the fact that Beebee quotes Hume saying that we are ever led astray. According to her account, we are not led astray in our everyday causal talk because that cannot be about mind independent causal features. So she must have to think of the ‘we’ as we-philosophers reflecting on everyday linguistic practice, not we-ordinary people engaged in it.)

For to speak and think so [ie ‘of objects as causally or necessarily connected’] is merely for the expressed commitment to take on ‘propositional behaviour’. On the projectivist view, the propositional behaviour of our causal talk and thought does not amount to our genuinely representing the world as being a world of mind-independent causal relations, but it does amount to our really thinking of events as causally related. [230]

So as long we are happy that this phrase is all that does need saving and as long as the saving account is plausible, this seems to provide a way to sidestep Stroud’s worry.

Stroud presupposes that our ‘thinking of objects as causally or necessarily connected’ is a matter of our representing the world as being a certain way; and the problem is that of saying how it is possible for an idea whose origin lies in an impression of reflection to represent the world in any way at all. The projectivist interpretation resolves the problem by denying that Hume takes our thinking of objects as causally or necessarily connected to be a matter of representation in the first place. [230]

So if representing were the only form of words in play, Stroud would be right. Short of there actually existing causally necessitating features of the world to which we could stand in some sort of cognitive relation, there would be no way of even thinking about such features. Thus false thought about such connections would be impossible; falsity would rule such thought out completely. But there is another way of construing such talk (which might look to be as of such features) and that is all we ever took ourselves to be saying. Thus there is no ground level error.

My qualm is this. Because Beebee draws a sharp distinction between what is to be saved and thinking ‘that there are mind-independent causal relations’, the former cannot be interpreted as saying the latter. Given that, then it is not clear on the surface what it does mean. Outside this paper it would be reasonable simply to equate: thinking ‘of objects as causally or necessarily connected’ and ‘that there are mind-independent causal relations’. But the only other way of filling out what it does mean is via the projectivist account. That is, however, very sketchy. We are told what the purpose of such talk is - that by adopting a quasi fact stating form, our attitudes can be indirectly discussed and assessed [229] – but not what we are saying in it.

The move is further likened to teaching a novice speaker to adopt such quasi-realist utterances when expressing their colour experiences. The obvious interpretation of the colour case, however, is that the discipline a speaker learns to impose on his or her utterances is the discipline of aiming at descriptive truth about worldly colours. That may be false if an error theory of secondary qualities is correct but the case does not seem to help with the middle ground (between vindicating realism and an error theory of everyday talk) Beebee wants.

In fact, Beebee seems to say something more obviously implausible, at least in one sentence. By rejecting a representational interpretation of quasi-realist judgements of causation she says she is also rejecting an ‘intentional’ reading, in Stroud’s sense, of it. But Stroud seems merely to mean as if world involving. And rejecting that seems far too radical. Crucially, if the meaning of the utterance is not intentional in that sense, she has not so much sidestepped Stroud’s objection as conceded it whilst offering a kind of Kripkensteinian replacement (itself, of course, based on Hume). But a non-intentional meaning is surely not what we normally think we are saying in our causal talk. And thus we must be being led astray in the mismatch between what we think we are saying and what we are actually saying if quasi-realism is in fact correct.

Anyway, that is how it strikes me on an initial reading.

PS: a day later.

I’m not sure, today, about my summary. The passage that causes me most doubt, now, that I am at all following her line of thought is:

As Hume says, we are ‘led astray… when we transfer the determination of the thought to external objects, and suppose any real intelligible connexion betwixt them; that being a quality, which can only belong to the mind that considers them’. By contrast, to say that we do really think of objects as causally or necessarily connected is to say that we are not led astray – we are not making any kind of mistake – when we ‘speak and think as though’ causation were a mind-independent relation, in the sense just described. [230]

It’s the final words which seem to unpack the projectivism:

“when we ‘speak and think as though’ causation were a mind-independent relation, in the sense just described”

What I don’t get is how and whether we do speak as though causation were mind-independent. So is it that, although the semantics of our thoughts could never be of a mind-independent relation, slightly different words with totally different meanings (explained non-intentionally via their propositional behaviour) are still as though speaking of mind-independence? If so what gives them this appearance? Crucially, how can we say what the appearance is an appearance of, given our semantic predicament?

Sunday 7 September 2008

Clinical judgement and individual cases

Advances in Psychiatric Treatment sent me a manuscript by Robin Downie (pictured) and Jane Macnaughton to review a few weeks ago. Although very much in agreement with the overall aim of the paper, I didn’t really get on with the way it worked. I suspect that, precisely because I agreed with its conclusions, I wished that it had set about arguing for them in a slightly different way.

Perhaps in response to my slight qualms, the editor who had accepted the paper asked me, this week, to write a commentary on it. Thus I’m presented with the problem of critically engaging with the paper whilst still making it plain that I think that its authors are very much on the side of the angels. I'm not sure, therefore, that this draft (knocked up as the rain rained down yesterday) has the right tone, yet. (PS: a year later the commentary came out thus.)

Clinical judgement and individual cases

Like Robin Downie and Jane Macnaughton, I think that judgement lies at the heart of good clinical practice in psychiatry [Downie and Macnaughton 2009]. I fully agree with the central thrust of their paper. But in this commentary, I wish to sound a note of caution about their likely success in defending judgement against those who criticise or neglect it without some further augmentation of their strategy. My assumption is that their paper is intended to be programmatic. Thus I do not wish to criticise it as incomplete (they have written much more elsewhere, eg.). Rather, my concern is that the route to a defence of judgement that it suggests is not the best route. Of course, my own brisk criticism and positive outline is even more programmatic.

In their paper, Downie and Macnaughton suggest that two factors disguise the central role of judgement in good clinical practice. One is the misapplication of numerical codification to judgement based on qualitative research (‘qualitative judgement’ in what follows) and the other is the rise of a consumer model of healthcare. In this short note, I can consider only the former.

Downie and Macnaughton on qualitative judgement

Downie and Macnaughton argue that the important connection between numerically codified analysis, generalisation and objectivity in quantitative research is mistakenly carried over into the domain of qualitative research and hence into qualitative judgement. They blame reductionism: ‘the process of seeing human beings and their interactions in terms of a number of discrete features’. And they object:

But to try to understand patients in this way, in terms of a finite number of discrete features, is to abstract from the complexity and totality of a human interaction. Blood pressure can helpfully be abstracted in this way and measured, but not a human response in its complex totality. There is something not only patronising but clinically misleading in the suggestion that the complexity of human relationships can be reduced to a few factors and ‘measured’ with an ‘assessment tool’. [Downie and Macnaughton 2009: **]

The problem with this as a defence of the role of clinical judgement, however, is that without some argument as to why reductionism is false, it remains merely a dismissal of the reductionist dismissal of judgement. Furthermore, whilst, like Downie and Macnaughton, I believe reductionism is false, those who oppose clinical judgement are likely to be those who believe it to be true – who believe that there is no limit to the application of the method of breaking down complex interrelations into discrete features - and thus simply asserting its falsity is unlikely to achieve the end of defending judgement against such critics.

In their corresponding positive characterisation of qualitative judgement, Downie and Macnaughton make a number of claims about it. They say that:

[It] is more akin to the understanding gained from literature and art than that gained from a numerical science…
It requires the active participation of the reader to identify with the situation and relate the findings to his/her own situation…
The route to understanding is through our identification with the situation. Through that identification we reach general features of human emotions…
Through identification with the particular situation the researcher or clinician can recognise the general elements in human emotion...
[E]ven if there is no universality in human emotions and reactions there is a broad similarity, and that may be all that is needed as a basis for individualised judgement.
[Downie and Macnaughton 2009: **]

These comments suggest that the sort of judgement Downie and Macnaughton have in mind is akin to narrative understanding (this is, however, merely my gloss on their phrase ‘literature and art’; I will return to it at the end); that it turns on general features of human emotion; that it requires that the clinician achieves understanding by identification with a subject; and that it is a particular kind of individualised judgement.

Especially within mental health care, narrative understanding looks to be a genuinely useful addition to criteriological understanding and I agree with the broad thrust of this account [IDGA Workgroup 2003; Phillips 2005; Thornton 2008, forthcoming b]. But I have some specific qualms about the proposed defence of clinical judgement generally based upon it.

Firstly, it would be a mistake to base a defence of the general role of clinical judgement on the need to understand individuals’ mental states in the same meaning-laden terms as are found in literary or narrative forms. Secondly and relatedly, a restriction of judgement to an understanding of human emotion (however relevant generalities are to be construed) seems misplaced. Both of these leave open the response by a reductionist critic that judgement may have a role in the broader surroundings or context of clinical care – in mere bedside manner, perhaps - but not in the core application of medical science itself. In other words, Downie and Macnaughton do not go far enough in their defence.

Thirdly, the claim that even within the context of a narratively structured understanding of another subject’s emotional states, judgement depends on an identification by a clinician with a subject is contentious. Of course, Jaspers held that such identification was a central aspect of empathy which was itself at the heart of psychiatric understanding [Jaspers [1913] 1974]. But, again, as a defence of clinical judgement against a reductionist critic, it ignores the widely influential approach to interpersonal understanding that claims that it is mediated by implicit knowledge of a ‘theory of mind’: the ‘theory theory’ approach. This approach likens an understanding of another person’s mental states to inference to the best explanation and thus, if it were true, would undermine the contrast Downie and Macnaughton rely on to distinguish qualitative clinical judgement from scientific research.

Perhaps the most telling argument against theory theory turns on the normativity of mental content and the impossibility, in general, of codifying those norms. Refuting theory theory in such a way would not, however, justify Downie and Macnaughton’s position without some further argument as to why direct awareness of another’s mental state was also rejected in favour of the indirect route they outline via identification. (Why would one need to identify with how things are for another person to understand how they are for them? Why would one need to imagine, for example, being in pain oneself to grasp that another is in pain? Might one not simply see in what they say and do, in what they express, that they are in pain) Thus characterising qualitative judgement in these terms seems needlessly contentious as a defence of clinical judgement in general.

Fourthly, as I have argued elsewhere, it is a grave mistake to think that judgement of individual cases requires a form of ‘individualised judgement’ [Thornton 2008; Thornton forthcoming a]. Such judgement, at best, falls prey to Sellars’ criticism of the Myth of the Given [Sellars 1997]. Downie and Macnaughton may merely mean a potentially general judgement about a particular situation but, as a defence of clinical judgement, the phrase is best avoided.

Thus whilst I agree with Downie and Macnaughton’s aims, I suspect a successful defence of judgement in clinical practice needs to be both broader and deeper than the approach outlined in this paper.

Towards a defence of clinical judgement

Clinical judgement lies at the heart of good clinical practice: in the core application of medical science as well as in the broader context of understanding service users and patients. That, at least, is the claim that needs defence. Here is one way to start to defend it.

Consider the way criteriological diagnosis is codified in DSM and ICD manuals. Syndromes are described and characterised in terms of disjunctions and conjunctions of symptoms. The symptoms, in recent years, have tended to be described in ways influenced by operationalism and with as little aetiological theory as possible. (That they are neither strictly operationally defined nor strictly aetiologically theory free is not relevant here.) Thus one can think of such a manual as providing guidance for or a justification of a diagnosis offered by saying that a subject is suffering from a specific syndrome. Thus, presented with an individual, the diagnosis of a specific syndrome is justified because he or she has enough of the relevant symptoms.

The following further thought is tempting. Whilst the overall syndrome is quite general and is characterised in a way that abstracts it away from individuals, the specification of why it applies to someone is more specific in two respects. Firstly, because of the way both ICD and DSM base syndromes on a combination of conjunction and disjunction of symptoms, it is possible that a syndrome so defined may apply to two individuals with little, or even no, overlap of symptoms. The specification of symptoms is thus more tailored to individuals than the overall syndrome. Secondly, and independently of that, the heritage of operationalism suggests that individual symptoms are more closely tied, than syndromes, through a kind of measuring operation to individuals. Symptoms seem to tie more abstract syndromes to particular individuals.

There remains, however, a gap between the description or articulation of a symptom and an individual. The concepts of specific symptoms are, despite their specificity, general concepts that can be instantiated in an unlimited number of actual or potential cases. So how can one judge that a general concept applies to a specific individual case or individual person? One can attempt to bridge this gap. Textbooks of psychiatry can describe, rather than merely list, symptoms. But whatever descriptive account they give of symptoms, there will always be a gap between their general descriptions and concepts (which potentially apply to any number of individuals) and any particular individual. Bridging this gap calls for expertise. It calls for a skilled recognitional clinical judgement. In a nutshell, clinical judgement involves skilled coping with individual cases, both people and their situations, and this requires a kind of non-deductive expertise.

Immanuel Kant was aware of this gap. In his third major work, the Critique of Judgement, he draws an important distinction between what he calls ‘determinate’ and ‘reflective’ judgement. He describes these in this way:

If the universal (the rule, principle, law) is given, then judgment, which subsumes the particular under it, is determinate... But if only the particular is given and judgment has to find the universal for it, then this power is merely reflective. [Kant 1987: 18]

The model at work here is of judgement as having two elements: a general concept and a particular subject. Judgement subsumes a particular under a general concept. The contrast between determinate and reflective judgement is then between an essentially general judgement, when the concept is already given, and a particular or singular judgement, which starts only with a particular. The former, determinate judgement, appears to be relatively mechanical and thus unproblematic. The idea that if a general principle is already given then judgements which deploy it are relatively unproblematic can be illustrated through the related case of logical deduction where a general principle is already given. If, for example, one believes that
1: All men are mortal; and
2: Socrates is a man.
Then it is rational to infer that:
3: Socrates is mortal.

One reason this can seem unproblematic is the following thought. If one has accepted premises 1 and 2 then one has, ipso facto, already accepted premiss 3. To accept that all men are mortal is to accept that Tom, Dick, Harry and Socrates are mortal. So given 1 and 2, then 3 is no step at all [though see Carroll 1895 and Fulford, Thornton and Graham 2006: 98-105]. Furthermore, some central forms of deductive judgement, at least, can be codified using Frege’s logical notation. Given the codification, one can inspect the form of a deductive inference to determine whether true premises could ever lead to a false conclusion. (In fact, neither of these reasons for taking deduction, and thus determinate judgement, is quite so straight forward. Here, however, the perceived relative straight forward nature of determinate judgement is what matters.)

By contrast, for reflective judgement, there is a principled problem in how to get from the level of individuals to the level of generalities, or how to get from people and things to the general concepts that apply to them. That is not a matter of deduction because the choice of a general concept is precisely what is in question. To move from the particular to the general that applies to it is somehow to gain information not to deploy it. Reflective judgement thus cannot be a matter of mechanical derivation. Kant himself suggests that there is a connection between reflective judgement and aesthetic understanding. It may be this connection to which Downie and Macnaughton are referring when they talk of qualitative judgement as being connected to judgements of literature and art (to which I promised to return) However, there is reason to think that art cannot provide a substantial clue to further unpack the nature of the expertise involved in judgement [Thornton 2007].

But what is important about Kant’s account and the illustration of it in the case of psychiatric syndromes and symptoms is that it demonstrates how such judgement is always involved in the application of general knowledge to individuals. Whatever general claims can be gained from quantitative research – which lies at the heart of Evidence Based Medicine – their application to individuals necessarily depends on a kind of skilled expertise in judgement. This does not merely apply to understanding the psychological aspects of service users or patients (hugely important though that is). Even in judgements that are seen as paradigmatically empirical and scientific, skilled and uncodified expertise, or clinical judgement, lies at the heart of seeing that a general concept applies in an individual case or to an individual person.

Bibliography

Carroll, L. (1895) ‘What The Tortoise Said To Achilles’ Mind 4: 278-280
Downie, R. and Macnaughton, J (2009) **
Fulford, K.W.M, Thornton, T and Graham, G. (2006) The Oxford Textbook of Philosophy and Psychiatry Oxford: Oxford University Press
IDGA Workgroup, WPA (2003) ‘IGDA 8: Idiographic (personalised) diagnostic formulation’ British Journal of Psychiatry, 18 (suppl 45): 55-7
Jaspers, K. ([1913] 1974) ‘Causal and “Meaningful” Connections between Life History and Psychosis’, (trans. J.Hoenig) in Hirsch, S.R., and Shepherd, M. (eds.) Themes and Variations in European Psychiatry, Bristol: Wright: 80-93
Kant, I. (1987) Critique of judgment Indianapolis: Hackett
Phillips, J. (2005)
‘Idiographic Formulations, Symbols, Narratives, Context and Meaning’ Psychopathology 38: 180-184
Sellars, W. (1997) Empiricism and the Philosophy of Mind, Cambridge, Mass.: Harvard University Press
Thornton, T. (2007) ‘An aesthetic grounding for the role of concepts in experience in Kant, Wittgenstein and McDowell?’ Forum Philosophicum 12: 227-45
Thornton, T. (2008) ‘Should comprehensive diagnosis include idiographic understanding?’ ’ Medicine, Healthcare and Philosophy 11: 293-302
Thornton, T. (forthcoming a) ‘Does understanding individuals require idiographic judgement?’ European Archives of Psychiatry and Clinical Neuroscience
Thornton, T. (forthcoming b) ‘Idiographic versus narrative approaches to assessment’ Psychopathology