This ground breaking work explores the genealogical analysis of the discourses of reflection. Barry Sandywell traces the differences between the traditional discourses of reflection and the experiences of reflexivity in everyday, social and philosophical thought. Brilliantly organised and abounding with astonishing insights, Reflexivity and the Crisis of Western Reason offers a fundamental challenge to our normal ways of viewing social thought.

This paper describes a community event organized in response to the appropriation and overreliance on the psychiatric patient “personal story” within mental health organizations. The sharing of experiences through stories by individuals who self-identify as having “lived experience” has been central to the history of organizing for change in and outside of the psychiatric system. However, in the last decade, personal stories have increasingly been used by the psychiatric system to bolster research, education, and fundraising interests. We explore how personal (...) stories from consumer/survivors have been harnessed by mental health organizations to further their interests and in so doing have shifted these narrations from “agents of change” towards one of “disability tourism” or “patient porn.” We mark the ethical dilemmas of narrative cooptation and consumption, and query how stories of resistance can be reclaimed not as personal recovery narratives but rather as a tool for socio-political change. (shrink)

The author analyses how debate over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has tended to privilege certain conceptions of psychiatric diagnosis over others, as well as to polarise positions regarding psychiatric diagnosis. The article aims to muddy the black and white tenor of many discussions regarding psychiatric diagnosis by moving away from the preoccupation with diagnosis as classification and refocusing attention on diagnosis as a temporally and spatially complex, as well as highly mediated process. (...) The article draws on historical, sociological and first-person perspectives regarding psychiatric diagnosis in order to emphasise the conceptual—and potentially ethical—benefits of ambivalence vis-à-vis the achievements and problems of psychiatric diagnosis. (shrink)

This paper offers a critical analysis of the strategic use of biomedical models of mental illness as a means of challenging stigma. Likening mental illnesses to physical illnesses reinforces notions that persons with mental illnesses are of a fundamentally “different kind,” entrenches misperceptions that they are inherently more violent, and promotes overreliance on diagnostic labeling and pharmaceutical treatments. I conclude that too much has been invested in the claim that the body is somehow morally neutral, and that advocates of this (...) approach oversimplify, misrepresent, and underestimate the personal and social costs of physical illness. (shrink)

The word stigma comes from ancient Greece, and was initially used in reference to signs or symbols physically cut into or burned onto the bodies of those deemed to be of an inferior status. It was a marking of one's tarnished and flawed character. Today, stigma is more often attached to one's social standing, personality traits, or psychological makeup. "People are no longer physically branded; instead they are societally labeled—as poor, as criminal, homosexual, mentally ill, and so on. These labels (...) influence public perceptions and behavior and lead to devaluation and denigration of those who are so labeled" (Wahl 1999, 11–12).The modern usage of the term stigma and contemporary focus on the concept as a topic of .. (shrink)

In this paper we set out the context in which experiences of mental distress occur with an emphasis on the contributions of social and structural factors and then make a case for the use of intersectionality as an analytic and methodological framework for understanding these factors. We then turn to the political urgency for taking up the concept of recovery and argue for the importance of research and practice that addresses professional domination of the field, and that promotes ongoing engagement (...) and dialogue about recovery as both a personal and social experience. To this end, we describe a unique project that sought to deepen our understanding of how recovery is being thought about and applied in the current context of mental health care in Vancouver, BC, with a specific focus on how, and whether, people are taking up and addressing dimensions of power that we see as critical to the operationalization of recovery within a social justice framework. Emerging from our research and discussion is a set of critical questions about whether or not the political moment in Canada with respect to re-invigorating recovery should be embraced, versus a rejection of the concept of recovery as too limiting in its scope and too vulnerable to professional co-optation. (shrink)

In this paper we argue that ill persons are particularly vulnerable to epistemic injustice in the sense articulated by Fricker. Ill persons are vulnerable to testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons are also vulnerable to hermeneutical injustice because many aspects of the experience of illness are difficult to understand and communicate and this often owes to gaps in collective hermeneutical resources. We then argue (...) that epistemic injustice arises in part owing to the epistemic privilege enjoyed by the practitioners and institutions of contemporary healthcare services—the former owing to their training, expertise, and third-person psychology, and the latter owing to their implicit privileging of certain styles of articulating and evidencing testimonies in ways that marginalise ill persons. We suggest that a phenomenological toolkit may be part of an effort to ameliorate epistemic injustice. (shrink)

In this paper I respond to three commentaries on Epistemic Injustice: Power and the Ethics of Knowing. In response to Alcoff, I primarily defend my conception of how an individual hearer might develop virtues of epistemic justice. I do this partly by drawing on empirical social psychological evidence supporting the possibility of reflective self-regulation for prejudice in our judgements. I also emphasize the fact that individual virtue is only part of the solution – structural mechanisms also have an essential role (...) in combating epistemic injustice. My response to Goldberg principally concerns my perceptual account of the epistemology of testimony, which I defend as being both well-motivated and best categorized as a species of non-inferentialism. I also explain its relation to the reductionism/non-reductionism contrast, and defend my resistance to casting it as any kind of default view. In response to Hookway, I contrast discriminatory with distributive forms of epistemic injustice, and defend the basic taxonomy I present in the book, which casts testimonial and hermeneutical injustice as the two fundamental discriminatory forms of epistemic injustice. (shrink)

Sandra Harding here develops further the themes first addressed in her widely influential book, The Science Question in Feminism, and conducts a compelling analysis of feminist theories on the philosophical problem of how we know what we ...

Miranda Fricker's book Epistemic Injustice is an original and stimulating contribution to contemporary epistemology. Fricker's main aim is to illustrate the ethical aspects of two of our basic epistemic practices, namely conveying knowledge to others and making sense of our own social experiences. In particular, she wishes to investigate the idea that there are prevalent and distinctively epistemic forms of injustice related to these aspects of our epistemic lives, injustices which reflect the fact that our actual epistemic practices are socially (...) situated. Most of the book focuses on two such forms – Testimonial Injustice and Hermeneutical Injustice – and on the epistemic virtues required to counteract them.Testimonial Injustice occurs when a hearer fails, because of prejudice, to give due credit to the word of a speaker. For instance, in the novel To Kill a Mockingbird, the jury in the trial of Tom Robinson fail to regard his testimony as credible because he …. (shrink)

This book explores the epistemic side of racial and sexual oppression. It elucidates how social insensitivities and imposed silences prevent members of different groups from listening to each other.

Antipsychotic medications are sometimes imposed on psychiatric patients deemed dangerous to themselves and others. This is based on the assumption that treatment is safe and effective, and that recovery depends on biological adjustment. Under new laws, patients can be required to remain on these medications after leaving hospitals. However, survivors attest that forced treatment used as a restraint can feel like torture, while the consequences of withdrawal can also be severe.

In this paper I explore the tacit underlying sense of bodily certainty that characterizes normal everyday embodied experience. I then propose illness as one instance in which this certainty breaks down and is replaced by bodily doubt. I characterize bodily doubt as radically modifying our experience in three ways: loss of continuity, loss of transparency, and loss of faith in one's body. I then discuss the philosophical insights that arise from the experience of bodily doubt. The paper uses a Humean (...) framework with regards to bodily certainty, treating it as a taken for granted tacit aspect of normal experience. I argue that although bodily certainty is not rationally justifiable, we are nonetheless unable to reject it. Bodily certainty is thus revealed to be part of our brute animal nature. I conclude by suggesting that the study of pathology is a philosophical method useful for illuminating tacit aspects of experience. (shrink)

The mental patients' liberation movement, which started in the early 1970s, is a political movement comprised of people who have experienced psychiatric treatment and hospitalization. Its two main goals are developing self-help alternatives to medically-based psychiatric treatment and securing full citizenship rights for people labeled "mentally ill." The movement questions the medical model of "mental illness," and insists that people who have been labeled as "mentally ill" speak on their own behalf and not be represented by others who claim to (...) speak "for" them. The movement has developed its own philosophy, and operates a variety of self-help and mutual support programs in which ex-patients themselves control the services that are offered. Despite obstacles, the movement continues to grow and develop. (shrink)