Mental disorder (earlier entitled “illness” or “disease”) is ascribed to deviations from normal thoughts, reasoning, feelings, attitudes, and actions that are considered socially or personally dysfunctional and apt for treatment. Schizophrenia, depression, and bipolar disorder are core examples. The concept of mental disorder plays a role in many domains, including medicine, social sciences such as psychology and anthropology, and the humanities, including literature and philosophy. Philosophical discussions are the primary focus of the present entry, which differs from the entry on (...) Philosophy of Psychiatry in noting several different approaches—not only those of the philosophy of science and mind, but also those arising from phenomenology and social theory. -/- Mental disorder is a widely contested concept and there are longstanding debates on whether disorders are biological or social in nature. Even uncontroversial disorders, such as those listed above, were not always regarded as disorders in the past (Porter 2002). Moreover, the status of mental disorder has frequently indicated ethical, as much as other deficiency (Irwin 2013). Such reminders direct our attention to contemporary medical psychiatry’s sometimes uncompromisingly neurobiological, and avowedly value-free “medical model”, with its incumbent analogies and assumptions, and to the general question of how the taxa of psychiatric classifications are to be viewed as objects of natural science. This model has received intensive philosophical scrutiny, including arguments that deny these conditions are deficiencies at all. Along with issues arising from cognitive psychology and the neurosciences, such foundational matters make up much of the following entry. Because of their focus on issues central to the philosophy of mind and ethics (e.g., the mind-body problem, moral responsibility, agency and identity), analyses of mental disorder have extensive implications for those fields. As clinical phenomena, they also reflect an inescapable, everyday, social reality, giving theoretical inquiries additionally urgent practical, moral, and legal implications. (shrink)

Justin Garson introduces the distinction between two views on Madness we encounter again and again throughout history: Madness as dysfunction, and Madness as strategy. On the latter view, Madness serves some purpose for the person experiencing it, even if it’s simultaneously harmful. The strategy view makes intelligible why Madness often holds a certain allure – even when it’s prima facie terrifying. Moreover, if Madness is a strategy in Garson’s metaphorical sense – if it serves a purpose – it makes sense (...) to use consciously chosen strategies for living with Madness that doesn’t necessarily aim to annihilate or repress it as far as possible. In this paper, we use our own respective stories as case studies. We have both struggled to resist the allure of Madness, and both ended up embracing a kind of Pyrrhonian scepticism about reality instead of clinging to sane reality. (shrink)

Can nonhuman animals and artificial intelligence (AI) entities be attributed moral agency? The general assumption in the philosophical literature is that moral agency applies exclusively to humans since they alone possess free will or capacities required for deliberate reflection. Consequently, only humans have been taken to be eligible for ascriptions of moral responsibility in terms of, for instance, blame or praise, moral criticism, or attributions of vice and virtue. Animals and machines may cause harm, but they cannot be appropriately ascribed (...) moral responsibility for their behavior. This thesis challenges the conventional paradigm by proposing an alternative approach where moral agency is conceived as the competence to participate in moral responsibility practices. By shifting focus from intra-individual to contextual and socially situated features, this practice-focused approach appears to make the attribution of moral agency to nonhuman animals and AI entities more plausible than commonly assumed. Moreover, considering the current and potential future prevalence of nonhuman animals and AI entities in everyday settings and social contexts, a potential extension of moral agency to such entities could very well transform our social, moral, and legal practices. Hence, this thesis proposes that the attribution or withholding of moral agency to different entities should be carefully evaluated, considering the potential normative implications. (shrink)

In this paper, I will argue for two interrelated theses. First, if we take phenomenological psychopathology seriously, and want to understand what it is like to undergo various psychopathological experiences, we cannot treat madpeople’s testimony as mere data for sane clinicians, philosophers, and other scholars to analyze and interpret. Madpeople must be involved with analysis an interpretation too. Second, sane clinicians and scholars must open their minds to the possibility that there may be experiences that other people have, which they (...) nevertheless cannot conceive of. I look at influential texts in which philosophers attempt to analyze and understand depersonalization and thought insertion. They go astray because they keep using their own powers of conceivability as a guide to what is or is not humanly possible to experience. Several experiences labeled inconceivable and therefore impossible by these philosophers, are experiences I have had myself. Philosophers and others would be less likely to make this mistake if they would converse and collaborate more with the madpeople concerned. When this is not feasible, they should nevertheless strive to keep an open mind. Fantastical fiction may have a role to play here, by showing how bizarre experiences may nevertheless be prima facie conceivable. (shrink)

This chapter introduces the rationalist model of delusions. It begins by presenting John Campbell’s seminal proposal that delusions are caused top-down by pathological Wittgensteinian framework or hinge beliefs. After presenting Campbell’s rationalist account of delusions, the chapter raises and examines prominent objections by Tim Bayne & Elisabeth Pacherie as well as by Tim Thornton. The former make an important distinction between the aetiological top-down cognitive part and the epistemological rationalist framework part of Campbell’s account. The thesis that delusions are caused (...) top-down by pathological beliefs is not equivalent to the thesis that delusions are Wittgensteinian framework certainties. This chapter endorses this distinction. While the arguments against the top-down aspect are found to be more convincing – which motivates popular two-factor theories – the rationalist framework model of delusions is defended as an epistemologically promising account of delusion. Finally, this chapter examines a range of developments that have been made taking Campbell’s rationalism as a starting point. Most prominently the section examines Eilan’s early development of rationalism and Rhodes and Gipps’ proposal that delusions are not framework propositions but a product of their absence. (shrink)

The medical and social model of disability is discussed and debated among researchers, scholars, activists, and people in general. It is common to hold a mixed view and believe that some disabled people suffer more from social obstacles and others more from medical problems inherent in their bodies or minds. Rachel Cooper discusses possible ‘test environments’, making explicit an idea which likely plays an implicit part in many disability discussions. We place or imagine placing the disabled person in a range (...) of different environments. If there is a relevant test environment in which they do fine, their problem was societal/external; if there is not, it was medical/internal. Cooper admits that deciding on the appropriate range of test environments is an ethical and political question. In this chapter, I argue that we often ought to widen our scope when discussing psychiatric disabilities. (shrink)

This paper first outlines a new taxonomy of different views concerning the relationship between normative judgments and motivation. In this taxonomy, according to the Type A views, a positive normative judgment concerning an action consists at least in part of motivation to do that action. According to the Type B views, motivation is never a constituent of a positive normative judgment even if such judgments have, due to the kind of states they are, a causal power to produce motivation in (...) an agent. Finally, according to the Type C views, a normative judgment can produce motivation only with the help of a third mental state or a distinct substantial local disposition. This paper then outlines a novel evolutionary argument for the Type B views. If we assume that normative judgments' ability to shape our motivations enabled efficient planning and cooperation , the psychological mechanism responsible for this adaptation should be understood as a proximal mechanism. This paper argues that it is then more likely that we evolved to make normative judgments that have direct causal powers to influence our motivations because such Type B mechanisms are more reliable than the Type C mechanisms. It also suggests that the Type A views are either empirically false or collapse into the Type B views. (shrink)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

Wouter Kusters argues that madness has much to offer philosophy, as does philosophy to madness. In this paper, i support both claims by drawing on a mad phenomenon which I label Radical Psychotic Doubt, or RPD. First, although skepticism is a minority position in epistemology, it has been claimed that anti-skeptical arguments remain unsatisfying. I argue that this complaint can be clarified and strengthened by showing that anti-skeptical arguments are irrelevant to RPD sufferers. Second, there's a debate about whether so-called (...) hinge commitments are beliefs or not. I argue that RPD can be used to strengthen the case that they are. Moreover, if hinges are beliefs, some madpeople are more epistemically rational than some sane philosophers. Third, drawing on my own mad experiences, I challenge evidentialism by presenting a better candidate for a truly forced cchoice about what to believe than William James' traditional religious example. I further show that in certain psychiatric contexts, evidentialism has more radical implications than Jamesian pragmatism, which comes out as more conservative. Finally, I discuss how philosophical theories like pragmatism and Pyrrhonism can provide inspiration for new and much-needed coping strategies for RPD sufferers. (shrink)

Delusions are often thought of as the hallmark of irrationality. Accepted definitions of delusion are cast in terms of epistemic features that reflect irrationality: impossibility or falsity of con...

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the self and that which (...) belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (shrink)

The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, I argue that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, I argue that issues of unintelligibility can be (...) addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. I conclude by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person’s subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility. (shrink)