Data indicate the ubiquity and rapid increase of depression wherever war, want and social upheaval are found. The goal of this paper is to clarify such claims and draw conceptual distinctions separating the depressive states that are pathological from those that are normal and normative responses to misfortune. I do so by appeal to early modern writing on melancholy by Robert Burton, where the inchoate and boundless nature of melancholy symptoms are emphasized; universal suffering is separated from the disease states (...) known as melancholy or melancholia, and normal temperamental variation is placed in contrast to such disease states. In Burton's time these distinctions and characterizations could be secured by the anchoring tenets of humoral theory. Without such anchoring, and in light of the findings and assumptions of today's biological diagnostic psychiatry, we must re-visit each of them. My goals here are to show the need for analytic foundations when claims are made about depression such as those cited above, and to draw attention to some contemporary attempts that may help provide those foundations, particularly, attempts to define disorder or disease. With adjustments, one of these (Cooper 2002) is shown to take us some way toward that goal. (shrink)

Donald Gustafson has argued that grief centres on a combination of belief and desire:The belief that the subject has suffered an irreparable loss.The desire that this should not be the case.And yet, as Gustafson points out, if the belief is true, the desire cannot be satisfied. Gustafson takes this to show that grief inevitably implies an irrational conflict between belief and desire.I offer a partial defence of grief against Gustafson's charge of irrationality. My defence rests on two elements. First, I (...) offer an alternative model of emotion, which presents emotions as complex episodes, initiated by emotional appraisals. Secondly, I appeal to John Bowlby's account of grief to argue that grief involves two forms of sadness (anguish and desolation) which Gustafson's analysis runs together. I concede that anguish does characteristically involve an element of irrationality. But the irrationality of anguish does not arise from an apparently gratuitous clash between belief and desire, but from a conflict between emotion and belief—a form of irrationality that is both familiar and easily explained. Moreover, desolation need not involve any irrationality. (shrink)

This paper constitutes a defence of an affective account of emotion. I begin by outlining the case for thinking that emotions are just feelings. I also suggest that emotional feelings are not reducible to other kinds of feelings, but rather form a distinct class of feeling state. I then consider a number of common objections that have been raised against affective accounts of emotion, including: (1) the objection that emotion cannot always consist only of feeling because some emotions - for (...) example, indignation and regret - necessarily have a cognitive component (say, the perception of a lost opportunity in the case of regret); (2) the objection that emotion cannot consist only of feeling because in order to explain how emotions have intentional objects we will have to recognise that emotion consists of cognition; and (3) the objection that emotion cannot consist only of feeling because emotion, but not feeling, can be variously assessed or evaluated. However, I demonstrate how an affective account of emotion might be successfully defended against all of the objections that are cited. (shrink)

In this paper I aim to provide a characterisation of emotional disorder. I begin by criticising the thought that an agent can be judged to be experiencing an emotional disorder if his emotion causes him some type of harm. This then leads me to develop the claim that emotional disorder relates to sufficiently inappropriate emotion, where (sufficiently) inappropriate emotion relates to emotion that fails to be (sufficiently) responsive to the agent's beliefs and/or desires. Finally, I conclude the paper by suggesting (...) that if an essentially non‐cognitivist conception of emotion is accepted then – on the characterisation of emotional disorder that I defend – there may exist strong grounds for thinking that cognitive therapy will be an inappropriate form of treatment in cases of emotional disorder.1. (shrink)

Definition of the problem The eleventh version of the International Classification of Diseases (ICD-11), which became effective in 2022, has raised a number of issues associated with medical ethics. Arguments In this context the paper explores the normative view of grief as a disease. ICD-11 contains the new diagnosis of “prolonged grief disorder” with a definition that fails to aid its clear distinction from the normal course of grief. The article discusses the philosophical and ethical implications of this diagnosis and (...) explores the risks of medicalizing and pathologizing grief which may lead to an undermining of its value. Conclusions and further perspectives The paper’s specific focus is the particular case of parental grief. We show that pediatric palliative care counteracts many risk factors for difficult grief reactions and may therefore serve as a valuable instrument for their prevention. We propose in this context the concept of “advance bereavement planning” as a potentially beneficial extension of advance care planning and palliative care in general. (shrink)

People who experience love often experience break-ups as well. However, philosophers of love have paid little attention to the phenomenon. Here, I address that gap by looking at the grieving process which follows unchosen relationship terminations. I ask which one is the loss that, if it were to be recovered, would stop grief or make it unwarranted. Is it the beloved, the reciprocation of love, the relationship, or all of it? By answering this question I not only provide with an (...) insight on the nature of break-ups, but also make a specific claim about the nature of love. I argue that the object that is universally lost in all break-ups is a person with certain intrinsic qualities, who is in a relationship characterised by certain shared activities and recognized as romantic. That means that, at least in romantic terminations, the beloved and the relationship are not independent objects of grief. So, plausibly, they may not independent objects of value in love. Hence, those who state otherwise should face up to this objection coming from the study of break-ups. (shrink)

This article has three interrelated aims. The first is to analyze the concept of grief; the second is to argue for the putative rationality of grief (against Donald Gustafson’s contention to the contrary); and the third is to offer a moral justification of grief along broadly Aristotelian lines as an intrinsically valuable trait of character—a virtue. With regard to this third and ultimate aim, I argue not only that grief plays an unappreciated positive role in our moral experiences but flesh (...) out a case for what exactly that positive moral role is. More precisely, I argue that grief is best justified as an Aristotelian desert-based emotional trait, incorporating two distinct desert-motivated desires, one specifically directed at the memory of the dead person as deserving of homage, the other more cosmically focusing on the general undeservingness of good people passing away. The argument goes against the grain of most previous instrumental justifications of grief and palpably violates David Konstan’s contention that grief involves “no reference to desert.”. (shrink)

There are many more philosophical discussions of emotions than of moods. One key reason for this is that emotions are said to have a robust connection to beliefs while moods are said to lack that connection. I argue that this view, though prevalent, is incorrect. It is motivated by examples that are not representative of how moods typically change. Indeed, once we examine the notion of belief-responsiveness and look at a wider range of examples, we can see that moods are (...) belief-responsive and can be evaluated for appropriateness along a number of dimensions. Moreover, for all cases in which moods seem to be disconnected from beliefs, I argue that there are analogous cases for emotions. In other words, the connection between moods and beliefs on the one hand and the connection between emotions and beliefs on the other are, in fact, very similar. This means that not only should we take belief-responsiveness to be a core feature of moods but also potentially pursue a unified theory for why moods and emotions would have this connection to belief. (shrink)

Disease prioritarianism is a principle that is often implicitly or explicitly employed in the realm of healthcare prioritization. This principle states that the healthcare system ought to prioritize the treatment of disease before any other problem. This article argues that disease prioritarianism ought to be rejected. Instead, we should adopt ‘the problem-oriented heuristic’ when making prioritizations in the healthcare system. According to this idea, we ought to focus on specific problems and whether or not it is possible and efficient to (...) address them with medical means. This has radical implications for the extension of the healthcare system. First, getting rid of the binary disease/no-disease dichotomy implicit in disease prioritarianism would improve the ability of the healthcare system to address chronic conditions and disabilities that often defy easy classification. Second, the problem-oriented heuristic could empower medical practitioners to address social problems without the need to pathologize these conditions. Third, the problem-oriented heuristic clearly states that what we choose to treat is a normative consideration. Under this assumption, we can engage in a discussion on de-medicalization without distorting preconceptions. Fourth, this pragmatic and de-compartmentalizing approach should allow us to reconsider the term ‘efficiency’. (shrink)

The introduction of the Diagnostic and statistical manual of mental disorders in May 2013 is being hailed as the biggest event in psychiatry in the last 10 years. In this paper I examine three important issues that arise from the new manual: Expanding nosology: Psychiatry has again broadened its nosology to include human experiences not previously under its purview . Consequence-based ethical concerns about this expansion are addressed, along with conceptual concerns about a confusion of “construct validity” and “conceptual validity” (...) and a failure to distinguish between “disorder” and “non disordered conditions for which we help people.” The role of claims about societal impact in changes in nosology: Several changes in the DSM-5 involved claims about societal impact in their rationales. This is due in part to a new online open comment period during DSM development. Examples include advancement of science, greater access to treatment, greater public awareness of condition, loss of identify or harm to those with removed disorders, stigmatization, offensiveness, etc. I identify and evaluate four importantly distinct ways in which claims about societal impact might operate in DSM development. Categorisation nosology to spectrum nosology: The move to “degrees of severity” of mental disorders, a major change for DSM-5, raises concerns about conceptual clarity and uniformity concerning what it means to have a severe form of a disorder, and ethical concerns about communication. (shrink)

Philosophical discussion tends to converge on the view that narratives are at the center of the emotion of grief. In this article, I expand on this kind of view. On the one hand, I argue that key strands of phenomenological and neuroscientific studies suggest that grief consists in a complex emotional process of disconfirmation-and-updating of the narrative self-model. By heuristically drawing on an analogy between binocular rivalry and grief, I show that certain salient aspects of the phenomenology of grief, such (...) as self-alienation and ambiguity, are straightforwardly reflected by this account. On the other hand, I argue that this hierarchical approach has the resources to: (i) show that both narratable and unnarratable experiences of personal loss are both instances of grief; and (ii) differentiate between narratable and unnarratable experiences of grief, without compromising the view that self-constituting narratives are at the center of the phenomenon. (shrink)