Psychosomatic medicine, with its prevailing biopsychosocial model, aims to integrate human and exact sciences with their divergent conceptual models. Therefore, its own conceptual foundations, which often remain implicit and unknown, may be critically relevant. We defend the thesis that choosing between different metaphysical views on the ‘mind–body problem’ may have important implications for the conceptual foundations of psychosomatic medicine, and therefore potentially also for its methods, scientific status and relationship with the scientific disciplines it aims to integrate: biomedical sciences, psychology (...) and social sciences. To make this point, we introduce three key positions in the philosophical ‘mind–body’ debate and investigate their consequences for the conceptual basis of the biopsychosocial model in general and its ‘psycho-biological’ part in particular. Despite the clinical merits of the biopsychosocial model, we submit that it is conceptually underdeveloped or even flawed, which may hamper its use as a proper scientific model. (shrink)

ABSTRACT The need to cooperate in countless ways in a democracy raises the fundamental question posed by the prisoner's dilemma: How can self‐interested individuals cooperate? Tocqueville recognized this problem and anticipated the most convincing solution to date: Robert Frank's conception of emotions as “commitment devices.” Tocqueville's analysis of the miscalculations of modern “individualism,” which lead people first into isolation and then into servitude, mirrors the failure of conscious rationality in the prisoner's dilemma. Conversely, Tocqueville emphasizes emotional “habits of the heart” (...) as the key to resisting the blandishments of individualism. (shrink)

Mealey proposes two categorical classes of sociopath, primary and secondary. I criticize this distinction on the basis that constructs of this kind have proved unrealistic in personality taxonomy and that dimensional systems capture reality much more successfully. I suggest how such a system could work in this particular context.

We consider four mechanisms by which apparent discontinuities in the distribution of antisociality could arise: (1) executive genes or hormonal systems, (2) multiplicative interactions of predisposing factors, (3) environmental tracking into a limited number of social roles, and (4) cross-generational gene—environment interactions. A more explicit consideration of complex self-organizing dynamic systems may help us understand the maintenance of antisocial subpopulations.

Progress in Neuroscience advances rapidly and promises to change some of the basic concepts we have about ourselves. The field of Neuroethics is concerned with the resulting ethical implications. In this paper, we propose a framework to systematize the questions and positions in this context. We start with the discussion of three concrete cases around the topics of treatment/enhancement, personhood and privacy. For each case, we get a set of axes along which standpoints may vary. Finally, we generalize the particular (...) axes of each case and arrive at a three-dimensional coordinate system spanned by the axes of “Liberty of Denial”, “Liberty of Use” and “Scepticism”. With this, we hope to provide a common language simplifying interdisciplinary dialogue and communication with the public. (shrink)

We consider the various criticisms and requests for clarification made by the commentators of our framework for understanding intentional relations. Our response is organized according to the main themes in the target article: general theory, phylogeny, development, and autism. We also add some discussion of further issues, such as simulation and moral theory, that were not addressed in the target article.

Strengths of Mealey's target article are its implementation of results from game-theoretic analyses and its potential links with other formal developments. In recent dynamic decision/choice models, reduced salience of avoidance tendencies, said to typify primary sociopaths, has quantifiable consequences for response latencies and choices. Also, formal models of stress effects on information processing predict selected effects of hypoarousability.

In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired underlying attitude of physicians. In this article, one of them—empathy—is presented in an interpretation that is meant to depicture (together with the two additional concepts compassion and care) this attitude. Therefore empathy in the clinical context is defined as the adequate understanding of the inner processes (...) of the patient concerning his health-related problems. Adequacy is scrutinized on behalf of the emotional and subjective involvement of he physician, and on the necessary dependence on medical—moral—goals. In the present interpretation, empathy alone is no guarantee of the right moral attitude, but a necessary instrumental skill in order to perceive and treat a patient as an individual person. The concepts of compassion and care that will be discussed in two forthcoming articles are necessary parts to describe the desired moral attitude of the physician more completely. (shrink)

In this article I briefly assesses Philip Hefner's concept of the created co-creator by considering both what it does and does not claim. Looking at issues of reductionism, biological selfishness, biology and freedom, and environmental ethics, I point out strengths and weaknesses in Hefner's conception of the created co-creator.

Abstract. The dangerous level of individuality in contemporary Western culture is informed by a conception of mind, self, and soul as internal to the central nervous system. The historical development of this view has produced a bounded and self-contained individual at odds with communal life. Happily, scientific and philosophical studies of mind are coming to view the human mind as embodied, enactive, encultured, and embedded in social and technical networks, and as a construction not limited to the boundaries of the (...) individual organism. Mental phenomena are hybrids of events in the head and events in the world to which they are often coupled, not least of which are with other people. There are mutual and reciprocal implications of this externalism for a number of religious themes. Our understanding of redemption might better be bound to our relationships with others, including our bodies and our sexuality, rather than to a private, individual relationship with the sacred. (shrink)

In a commentary on Mangan's article about fringe feelings in consciousness, we argue that labeling these experiences as "non-sensory" leads to a problematic conception of consciousness as divorceable from sensation. We then compare and contrast Mangan's development of William James' ideas about fringe experiences with Damasio's development of James' ideas about the body-relatedness of emotion and feeling. We propose that fringe feelings have essential motivational properties that stem from their evolutionary origins in various problems of survival. Finally, we contrast Mangan's (...) notion of the feeling of rightness with our own conception of yedasentience, and we discuss how experiment and clinical investigation of psychopathology can inform our understanding of fringe feelings. (shrink)

We doubt that primary sociopathy is adaptive, for three reasons: First, its prevalence is too low to require an adaptive explanation. Second, a common sequela of damage to the orbito-frontal lobes is Any pattern of behavior that can be produced by brain damage is unlikely to be adaptive. Third, we argue that most human social behavior is not under tight genetic control, but is produced by open-ended calculation of fitness-contingencies.

O'Brien & Opie do not address the question of the psychotherapeutic role of unconscious representational states such as beliefs. A dilemma is proposed: if they accept the legitimacy of such states then they should modify what they say about dissociation, and if they do not, they owe us an account of why.

In the Frank (1988) model, a small increase in the number of cheaters will soon be reversed. It is not clear that this prediction holds for sociopathy. There are also many attractive evolutionary models that do not admit a small, stable proportion of cheaters. Hence, without definitive evidence about the character of early human society, we cannot conclude that sociopathy has an evolutionary origin.

Interest in the neural processes underlying decision making has led to a flurry of recent research in the fields of both moral psychology and neuroeconomics. In this paper, we first review some important findings from both disciplines, and then argue that the two fields can mutually benefit each other. A more explicit recognition of the role of values and norms will likely lead to more accurate models of decision making for neuroeconomists, whereas the tasks, insights into neural mechanisms, and mathematical (...) modeling common in neuroeconomic research offer moral psychologists the opportunity to expand their field and move beyond methodological limitations that may have hindered the field’s progress to this point. We conclude by highlighting an exciting group of recent studies that illustrate the potential of research that embraces the integrated moral/neuroeconomic approach that we suggest here. (shrink)

Self-control is in the eye of the beholder. However, we speak of if a person has come to think conscious thoughts that change the motivational value of stimuli in the outside world. It is claimed that conscious thinking, and not habits bordering on compulsion, is behind self-control.

This paper argues that ignorance, rather than being a result or representation of false beliefs or misinformation, is a compensatory epistemic adaptation of complex rhetoric systems. A rhetoric system is here defined as a set of interconnected rhetorical elements that cohere into a self-organized system that is thoroughly “about” its contexts—meaning that its own boundaries and relations are both constrained and enabled by the contexts in which it exists. Ignorance, as described here, is epistemic management that preserves the boundaries and (...) relations of a rhetoric system, and is a way of dealing with information that runs counter to one’s beliefs. Ignorance is also productive, in that it produces new knowledge that works to make rhetoric systems more resistant to potential destabilization. To elaborate these points, the paper examines discourse about the phenomenon of global climate change, which illustrates how individuals productively counter information as a way of preserving beliefs. As the paper argues, ignorance is neither a cognitive nor epistemological failure, but rather is a result of the dynamic and continuous process of enforcing epistemic and rhetorical boundaries. (shrink)

Toward a neurobiologically grounded approach to explaining self-control we discuss the case of a patient with a bilateral lesion in frontal ventromedial cortex. Patients with such lesions display a marked deficit in social decision making. Compared with an account that examines the causal antecedents of self-control, Rachlin's behaviorist approach seems lacking in explanatory strength.