Recent empirical findings from social psychology, ecological psychology, and embodied cognitive science indicate that situational factors crucially shape the course of human behavior. For instance, it has been shown that finding a dime, being under the influence of an authority figure, or just being presented with food in easy reach often influences behavior tremendously. These findings raise important new questions for the philosophy of action: Are these findings a threat to classical conceptions of human agency? Are humans passively pushed around (...) by situational factors, or are there agential aspects in the way we spontaneously experience and react to situations? How can one conceptualize the pervasive influence of situational factors on human action? What are situations in the first place, and how should the influence of these situations on action be thought of? This paper sets out to develop a new conceptual repertoire for thinking about the influence of situations on action, drawing on research from ecological psychology as well as from embodied and enactive cognitive science. The key proposal is the development of a philosophical sensorimotor account of agency: Action, it is proposed, should be conceived of as constant dynamical interaction of agential and environmental factors – factors which should all be conceptualized in new ways. (shrink)

This paper proposes a basic revision of the understanding of teleology in biological sciences. Since Kant, it has become customary to view purposiveness in organisms as a bias added by the observer; the recent notion of teleonomy expresses well this as-if character of natural purposes. In recent developments in science, however, notions such as self-organization (or complex systems) and the autopoiesis viewpoint, have displaced emergence and circular self-production as central features of life. Contrary to an often superficial reading, Kant gives (...) a multi-faceted account of the living, and anticipates this modern reading of the organism, even introducing the term self-organization for the first time. Our re-reading of Kant in this light is strengthened by a group of philosophers of biology, with Hans Jonas as the central figure, who put back on center stage an organism-centered view of the living, an autonomous center of concern capable of providing an interior perspective. Thus, what is present in nuce in Kant, finds a convergent development from this current of philosophy of biology and the scientific ideas around autopoeisis, two independent but parallel developments culminating in the 1970s. Instead of viewing meaning or value as artifacts or illusions, both agree on a new understanding of a form of immanent teleology as truly biological features, inevitably intertwined with the self-establishment of an identity which is the living process. (shrink)

Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant of such an objectivist approach to defining metal disorder, natural function objectivism. Proponents of this approach make recourse to the notion of natural function in order to reach a value-free definition of mental disorder. The exploration of Christopher Boorse's 'biostatistical' account of natural function (1) will be followed an investigation (...) of the 'hybrid naturalism' approach to natural functions by Jerome Wakefield (2). In the third part, I will explore two proposals that call into question the whole attempt to define mental disorder (3). I will conclude that while 'natural function objectivism' accounts fail to provide the backdrop for a reliable definition of mental disorder, there is no compelling reason to conclude that a definition cannot be achieved. (shrink)

In the decade and a half since the appearance of Varela, Thompson and Rosch's workThe Embodied Mind,enactivism has helped to put experience and consciousness, conceived of in a distinctive way, at the forefront of cognitive science. There are at least two major strands within the enactive perspective: a broad view of what it is to be an agent with a mind; and a more focused account of the nature of perception and perceptual experience. The relation between these two strands is (...) discussed, with an overview of the papers presented in this volume. (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)

Among the characteristic features of depression is a diminishment in or lack of action and motivation. In this paper, I consider a dominant philosophical account which purports to explain this lack of action or motivation. This approach comes in different versions but a common theme is, I argue, an over reliance on psychologistic assumptions about action–explanation and the nature of motivation. As a corrective I consider an alternative view that gives a prominent place to the body in motivation. Central to (...) the experience of depression are changes to how a person is motivated to act and, also as central, are changes to bodily feelings and capacities. I argue that broadly characterizing motivation in terms of bodily capacities can, in particular, provide a more compelling account of depressive motivational pathology. (shrink)

Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the “atheoretical” (...) approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry’s over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry. As a result, the field has suffered a loss of knowledge that may be difficult to recover. (shrink)

Habits are the topic of a venerable history of research that extends back to antiquity, yet they were originally disregarded by the cognitive sciences. They started to become the focus of interdisciplinary research in the 1990s, but since then there has been a stalemate between those who approach habits as a kind of bodily automatism or as a kind of mindful action. This implicit mind-body dualism is ready to be overcome with the rise of interest in embodied, embedded, extended, and (...) enactive (4E) cognition. We review the enactive approach and highlight how it moves beyond the traditional stalemate by integrating both autonomy and sense-making into its theory of agency. It defines a habit as an adaptive, precarious, and self-sustaining network of neural, bodily, and interactive processes that generate dynamical sensorimotor patterns. Habits constitute a central source of normativity for the agent. We identify a potential shortcoming of this enactive account with respect to bad habits, since self-maintenance of a habit would always be intrinsically good. Nevertheless, this is only a problem if, following the mainstream perspective on habits, we treat habits as isolated modules. The enactive approach replaces this atomism with a view of habits as constituting an interdependent whole on whose overall viability the individual habits depend. Accordingly, we propose to define a bad habit as one whose expression, while positive for itself, significantly impairs a person’s well-being by overruling the expression of other situationally relevant habits. We end by considering implications of this concept of bad habit for psychological and psychiatric research, in particular with respect to addiction research. (shrink)

In a series of recent works, Ian Hacking has produced a model of social causation in mental illness and begun to sketch in outline how this might be integrated with the medical model of psychiatry. This article elaborates and revises Hacking 's model of social forces, criticizes him for attempting a merely semantic resolution of the tension between the social and the biological, and sketches an alternative approach that builds upon his substantial insights.

The DSM characterizes major depressive disorder partly in temporal terms: the depressive mood must last for at least two weeks, and also must impact the subject "most of the day, nearly every day." However, from the standpoint of phenomenological psychopathology, the long-lasting quality of the condition hardly captures the distinctiveness of depression. While the DSM refers to objective time as measured by clocks and calendars, what is especially striking about depression is the distortions to lived time that it involves. But (...) is there any relation between a) these disruptions to temporal experience and b) the tendency for depressive symptoms to persist and endure? To explore the connection between lived time and objective time, I investigate the embodied and enactive nature of intentionality among subjects suffering from depression. What I call 'affective framing' is a spontaneous, pre-reflective way of filtering information that involves bodily attunement and allows subjects to focus their attention on what they feel is important. I will argue that affective framing ordinarily has a forward-looking temporal structure and a "teleological direction" that is rooted in our embodiment. However, depression involves a distortion in future-directed intentionality, so that a subject becomes temporally desituated and cut off from the future. This contributes to many of the characteristic features of depression, including apparent lack of motivation, inability to imagine future possibilities, alterations in lived time, and a sense that one is "stuck." To gain a better understanding of this disruption to the futuredirected structure of affective framing in cases of depression, I look to concepts from complex dynamic systems theory and the notion of 'habit.' My proposed account aims to shed light on how a disruption to future-directedness impacts bodily attunement and reinforces depression as a long-term condition. (shrink)

What Kyselo calls the “body-social problem” concerns whether to individuate the human self in terms of its bodily aspects or social aspects. In her view, either approach risks privileging one dimension while reducing the other to a mere contextual element. However, she proposes that principles from enactivism can help us to find a middle ground and solve the body-social problem. Here Kyselo looks to the notions of “needful freedom” and "individuation through and from a world" and extends them from the (...) realm of biological individuation to an individuation in terms of social interactions. However, I will argue that because Kyselo’s solution to the body-social problem downplays the role of the living body, it actually is in tension with the enactivist framework. First, while enactivism places the living body at the center of selfhood and subjectivity, Kyselo’s account treats the living body as mere means and mediator. Second, her claim that the self is socially enacted and individuated is in tension with the enactivist conception of autonomous agency, which centers on the autonomous organization of the living body. However, suppose we grant Kyselo’s claim that we are necessarily social beings, but claim that the mind of a minded human animal constitutively extends to the limits of its living organismic body, but no further. My proposed “life shaping” thesis says that the self is not just essentially embodied, but also partially causally determined or shaped by social interactions, and thoroughly influenced by social norms and values. The life shaping thesis can explain how the self is individuated biologically, in terms of the autonomous organization of the living body, but nonetheless deeply embedded in the social world. (shrink)

This paper utilizes the enactivist notion of ‘sense-making’ to discuss the nature of depression and examine some implications for treatment. As I understand it, sensemaking is fully embodied, fundamentally affective, and thoroughly embedded in a social environment. I begin by presenting an enactivist conceptualization of affective intentionality and describing how this general mode of intentional directedness to the world is disrupted in cases of major depressive disorder. Next, I utilize this enactivist framework to unpack the notion of ‘temporal desituatedness,’ and (...) maintain that the characteristic symptoms of depression result from a disruption to the future-directed structure of affective intentionality. This can be conceptualized as a loss of “online intelligence” and a shrinking of the field of affordances. Then, I argue that two of the standard modes of treatments for depression, medication and cognitive behavioral therapy, are not fully sufficient means of restoring online intelligence, and that these limitations stem partly from the approaches’ implicit commitment to a brain-bound, overly cognitivist view of the mind. I recommend expressive arts interventions such as dance-movement therapy and music therapy as important supplementary treatment methods that deserve further consideration. Insofar as they revitalize subjects’ bodies and emotions, cultivate an openness to the future, and promote self-insight and social synchrony, these treatment modes not only reflect key insights of enactivism, but also offer great potential for lasting healing. (shrink)

This chapter examines naturalistic accounts of mental disorder: accounts that define disorder as biological dysfunction. There are three such accounts: an eliminativist account ; a forward-looking or goal-contribution account and a backward-looking or evolutionary account. I argue first, and contra Szasz, that biological functions can be attributed at a mental level. But our mental architecture might simultaneously support many different ways of attributing function claims, which might undermine a strong naturalism about mental disorder. Second, I argue that Boorse's forward-looking account (...) of disorder as dysfunction is not value-free. Third, I argue that Wakefield's backward-looking account does not accurately map onto our disorder judgments or medical purposes. I conclude that whilst Boorse's forward-looking account of disorder as dysfunction tracks medical usage better than Wakefield's evolutionary account, a truly value-free account of mental disorder cannot be sustained. (shrink)

The thesis that mental states extend beyond the skull, otherwise known as the extended mind thesis, has attracted considerable philosophical attention and support. It has also been accused of lacking practical import. At the same time, the field of psychiatry has remained largely unacquainted with ExM, tending to rely instead upon what ExM proponents would consider to be outdated models of the mind. ExM and psychiatry, therefore, have much to offer one another, but the connection between the two has remained (...) largely unexplored. Here, I consider what implications ExM may have for psychiatry and, in so doing, reveal how psychiatry may lend practical import to ExM. First, I detail the possibility of the extension of one mental state relevant to psychiatry. I augment this example by surveying other possibilities for extension in the context of psychiatric diagnoses. I then consider ways in which such extensions might alter psychiatric diagnosis and treatment. Overall, I argue that recognition of the truth of ExM could alter the diagnostic status of certain individuals by correcting both false positives and false negatives, re-conceptualize certain aspects of treatment, help us re-envision psychiatric research, and potentially increase empathy towards those individuals considered to be mentally disordered or mentally different. (shrink)

In the recent history of psychology and cognitive neuroscience, the notion of habit has been reduced to a stimulus-triggered response probability correlation. In this paper we use a computational model to present an alternative theoretical view (with some philosophical implications), where habits are seen as self-maintaining patterns of behavior that share properties in common with self-maintaining biological processes, and that inhabit a complex ecological context, including the presence and influence of other habits. Far from mechanical automatisms, this organismic and self-organizing (...) concept of habit can overcome the dominating atomistic and statistical conceptions, and the high temporal resolution effects of situatedness, embodiment and sensorimotor loops emerge as playing a more central, subtle and complex role in the organization of behavior. The model is based on a novel “iterant deformable sensorimotor medium” (IDSM), designed such that trajectories taken through sensorimotor-space increase the likelihood that in the future, similar trajectories will be taken. We couple the IDSM to sensors and motors of a simulated body and environment and show that under certain conditions, the IDSM forms self-maintaining patterns of activity that operate across the IDSM, the body, and the environment. We present various environments and the resulting habits that form in them. The model acts as an abstraction of habits at a much needed sensorimotor “meso-scale” between microscopic neuron-based models and macroscopic descriptions of behavior. Finally, we discuss how this model and extensions of it can help us understand aspects of behavioral self-organization, historicity and autonomy that remain out of the scope of contemporary representationalist frameworks. (shrink)

A proposal for the biological grounding of intrinsic teleology and sense-making through the theory of autopoiesis is critically evaluated. Autopoiesis provides a systemic language for speaking about intrinsic teleology but its original formulation needs to be elaborated further in order to explain sense-making. This is done by introducing adaptivity, a many-layered property that allows organisms to regulate themselves with respect to their conditions of viability. Adaptivity leads to more articulated concepts of behaviour, agency, sense-construction, health, and temporality than those given (...) so far by autopoiesis and enaction. These and other implications for understanding the organismic generation of values are explored. (shrink)

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. (...) It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. (shrink)

A number of prominent writers on the concept of mental illness/disease are committed to accounts which involve rejecting certain plausible widely held beliefs, namely: that it is part of the meaning of illness that it is bad for its possessor, so the concept of illness is essentially evaluative; that if a person has a mental illness, that is a fact about him; and that the same concept of illness is applicable in the case of mental illness as in that of (...) physical illness. Methodologically this is unattractive. We should seek accounts of concepts which preserve our pre-theoretical beliefs so far as is possible. In this paper I argue that these writers are driven to this pass because they accept certain underlying metaphysical commitments including, in particular, the fact-value distinction. I then claim that there is an alternative account of mental illness (defended more fully elsewhere) which preserves our pre-theoretical beliefs, and that this account can be further buttressed because it coheres with a metaphysical picture which does not involve the metaphysical assumptions which led to the unattractive results noted above. The metaphysical picture and the account of mental illness are thus mutually supportive and suggest that there is good reason to reject the supposed fact-value distinction. (shrink)

The sensorimotor approach to perception addresses various aspects of perceptual experience, but not the subjectivity of intentional action. Conversely, the problem that current accounts of the sense of agency deal with is primarily one of subjectivity. But the proposed models, based on internal signal comparisons, arguably fail to make the transition from subpersonal computations to personal experience. In this paper we suggest an alternative direction towards explaining the sense of agency by braiding three theoretical strands: a world-involving, dynamical interpretation of (...) the sensorimotor approach, an enactive description of sensorimotor agency as contrasted with organic agency in general, and a dynamical theory of equilibration within and between sensorimotor schemes. On this new account, the sense of oneself as the author of one’s own actions corresponds to what we experience during the ongoing adventure of establishing, losing, and re-establishing meaningful interactions with the world. The meaningful relation between agent and world is given by the precarious constitution of sensorimotor agency as a self-asserting network of schemes and dispositions. Acts are owned as they adaptively assert the constitution of the agent. Thus, awareness for different aspects of agency experience, such as the initiation of action, the effort exerted in controlling it, or the achievement of the desired effect, can be accounted for by processes involved in maintaining the sensorimotor organization that enables these interactions with the world. We discuss these processes in detail from a non-representational, dynamical perspective and show how they cohere with the personal experience of agency. (shrink)

The recent discussion of the concept of mental disorder has focused on what makes a mental disorder a disorder. A question that has received less attention is what makes a mental disorder mental rather than somatic. We examine three views on this issue -- namely, the internal cause view, the symptom view, and the pluralist view -- and assess to what extent these accounts are plausible. Three strategies used to pinpoint the mental in psychiatry are identified, namely negative characterizations, exemplification (...) of paradigmatic mental features, and an appeal to intentional content. We also examine different versions of nihilism. Finally, it is observed that the discussion of what makes a mental disorder mental has largely been unaffected by conceptions of the mental in the philosophy of mind. (shrink)

This paper details the ways that gender structures our senses of agency on an enactive framework. While it is common to discuss how gender influences higher, narrative levels of cognition, as with the formulation of goals and in considerations about our identities, it is less clear how gender structures our more immediate, embodied processes, such as the minimal sense of agency. While enactivists often acknowledge that gender and other aspects of our socio-cultural situatedness shape our cognitive processes, there is little (...) work on how this shaping takes place. In order to provide such an account, I will first look at the minimal and narrative senses of agency (Gallagher 2012), a distinction that draws from work on minimal and narrative selves (Zahavi 2010). Next I will explain the influence of the narrative sense of agency on the minimal sense of agency through work on intention-formation (Pacherie 2007). After a discussion of the role of gender in the narrative sense of agency, I’ll expand on work by Haslanger (2012) and Young (1980) to offer three ways in which gender influences the minimal sense of agency, showing the effect that gender has on how we perceive our possibilities for interaction in a phenomenologically immediate, pre-reflective manner. (shrink)

The question "What is mental illness?" raises many issues in many contexts, personal, social, legal, and scientific. This chapter reviews mental health problems as they appear to the person with the problems, and to family and friends-before the person attends the clinic and is given a diagnosis-a time in which whether there really is a problem, as opposed to life's normal troubles and variations, is undecided, as also the nature of the problem, if such it be, and the related matter (...) what kind of expert advice should be sought. Once at the clinic, a diagnosis may be given-using criteria well-worked-out in the diagnostic manuals. The chapter discusses the conceptualizations of mental disorder in the diagnostic manuals, their rationale, and what can and cannot be reasonably expected of them. There are more position statements than definitions, and while they signal many dilemmas, they do not resolve them. Attempts to do so in the surrounding literature on the concept of mental illness are reviewed in the chapter, with conclusions favoring the features emphasized in the diagnostic manuals: distress and impairment. Finally the chapter considers how far the science may help draw boundaries around mental illness. (shrink)

The concept of “autonomy”, once at the core of the original enactivist proposal in The Embodied Mind, is nowadays ignored or neglected by some of the most prominent contemporary enactivists approaches. Theories of autonomy, however, come to fill a theoretical gap that sensorimotor accounts of cognition cannot ignore: they provide a naturalized account of normativity and the resources to ground the identity of a cognitive subject in its specific mode of organization. There are, however, good reasons for the contemporary neglect (...) of autonomy as a relevant concept for enactivism. On the one hand, the concept of autonomy has too often been assimilated into autopoiesis and the implications are not always clear for a dynamical sensorimotor approach to cognitive science. On the other hand, the foundational enactivist proposal displays a metaphysical tension between the concept of operational closure, deployed as constitutive, and that of structural coupling ; making it hard to reconcile with the claim that experience is sensorimotorly constituted. This tension is particularly apparent when Varela et al. propose Bittorio as a model of the operational closure of the nervous system as it fails to satisfy the required conditions for a sensorimotor constitution of experience. It is, however, possible to solve these problems by re-considering autonomy at the level of sensorimotor neurodynamics. Two recent robotic simulation models are used for this task, illustrating the notion of strong sensorimotor dependency of neurodynamic patterns, and their networked intertwinement. The concept of habit is proposed as an enactivist building block for cognitive theorizing, re-conceptualizing mental life as a habit ecology, tied within an agent’s behaviour generating mechanism in coordination with its environment. Norms can be naturalized in terms of dynamic, interactively self-sustaining, coherentism. This conception of autonomous sensorimotor agency is put in contrast with those enactive approaches that reject autonomy or neglect the theoretical resources it has to offer for the project of naturalizing minds. (shrink)

Self-disorders in depression and schizophrenia have been the focus of much recent work in phenomenological psychopathology. But little has been said about the role the material environment plays in shaping the affective character of these disorders. In this paper, we argue that enjoying reliable (i.e., trustworthy) access to the things and spaces around us — the constituents of our material environment — is crucial for our ability to stabilize and regulate our affective life on a day-today basis. These things and (...) spaces often play an ineliminable role in shaping what we feel and how we feel it; when we interact with them, they contribute ongoing feedback that " scaffolds " the character and temporal development of our affective experiences. However, in some psychopathological conditions, the ability to access to these things and spaces becomes disturbed. Individuals not only lose certain forms of access to the practical significance of the built environment but also to its ​ regulative​ significance, too — and the stability and organization of their affective life is compromised. In developing this view, we discuss core concepts like " affordance spaces " , " scaffolding " , and " incorporation ". We apply these concepts to two case studies, severe depression and schizophrenia, and we show why these cases support our main claim. We conclude by briefly considering implications of this view for developing intervention and treatment strategies. (shrink)

This paper argues for psychological realism in the conception of psychiatric disorders. We review the following contemporary ways of understanding the future of psychiatry: (1) psychiatric classification cannot be successfully reduced to neurobiology, and thus psychiatric disorders should not be conceived of as biological kinds; (2) psychiatric classification can be successfully reduced to neurobiology, and thus psychiatric disorders should be conceived of as biological kinds. Position (1) can lead either to instrumentalism or to eliminativism about psychiatry, depending on whether psychiatric (...) classification is regarded as useful. Position (2), which is inspired by the growing interest in neuroscience within scientific psychiatry, leads to biological realism or essentialism. In this paper we endorse a different realist position, which we label psychological realism. Psychiatric disorders are identified and addressed on the basis of their psychological manifestations which are often described as violations of epistemic, moral or social norms. A couple of examples are proposed by reference to the pathological aspects of delusions, and the factors contributing to their formation. (shrink)

We argue that the notion of "mental institutions"-discussed in recent debates about extended cognition-can help better understand the origin and character of social impairments in autism, and also help illuminate the extent to which some mechanisms of autistic dysfunction extend across both internal and external factors (i.e., they do not just reside within an individual's head). After providing some conceptual background, we discuss the connection between mental institutions and embodied habits of mind. We then discuss the significance of our view (...) for understanding autistic habits of mind and consider why these embodied habits are sometimes a poor fit with neurotypical mental institutions. We conclude by considering how these insights highlight the two-way, extended nature of social impairments in autism, and how this extended picture might assist in constructing more inclusive mental institutions and intervention strategies. (shrink)

In view of the publication of the DSM-V researchers were asked to discuss the theoretical implications of the definition of mental disorders. The reasons for the use, in the DSM-III, of the term disorder instead of disease are considered. The analysis of these reasons clarifies the distinction between the general definition of disorder and its implicit, technical meaning which arises from concrete use in DSM disorders. The characteristics and limits of this technical meaning are discussed and contrasted to alternative definitions, (...) like Wakefield’s harmful/dysfunction analysis. It is shown that Wakefield’s analysis faces internal theoretical problems in addition to practical limits for its acceptance in the DSM-V. In particular, it is shown that: a) the term dysfunction is not purely factual but intrinsically normative/evaluative; b) it is difficult to clarify what dysfunctions are in the psychiatric context (the dysfunctional mechanism involved being unknown in most cases and the use of evolutionary theory being even more problematic); c) the use of conceptual analysis and commonsense intuition to define dysfunctions leaves unsatisfied empiricists; d) it is unlikely that the authors of the DSM-V will accept Wakefield’s suggestion to revise the diagnostic criteria of any single DSM disorder in accordance with his analysis, because this is an excessively extensive change and also because this would probably reduce DSM reliability. In conclusion, it is pointed up in which sense DSM mental disorders have to be conceived as constructs, and that this undermines the realistic search for a clear-cut demarcation criterion between what is disorder and what is not. (shrink)

Conceptions of autonomy in western philosophy and ethics have often centred on self-governance and self-determination. However, a growing bulk of literature also questions such conceptions, including the understanding of the autonomous self as a self-governing independent individual that chooses, acts, and lives in accordance with her or his own values, norms, or sense of self. This article contributes to the critical interrogation of selfhood, autonomy, and autonomous decision making by combining a feminist focus on relational dimensions of selfhood and autonomy (...) with phenomenological philosophy of the embodied self as being-in-the-world. It offers a philosophical investigation of different dimensions of bodily relational autonomy by turning to phenomenological accounts of the lived body as self-reflexive. When so doing, we hope to contribute to bridging the gap that sometimes exists between discussions of autonomy in analytic moral philosophy and of freedom and facticity in phenomenological philosophy. We see this gap as unfortunate, and hold that a nuanced understanding of autonomy and autonomous decision making can be reached if these strands of philosophy are brought into dialogue. (shrink)

Schizophrenia involves profound but enigmatic disturbances of affective or emotional life. The affective responses as well as expression of many patients in the schizophrenia spectrum can seem odd, incongruent, inadequate, or otherwise off-the-mark. Such patients are, in fact, often described in rather contradictory terms: as being prone both to exaggerated and to diminished levels of emotional or affective response. According to Ernst Kretschmer, they actually tend to have both kinds of experience at the same time. This paper attempts to explain (...) what might be termed this 'Kretschmerian paradox'. Some relevant concepts and vocabulary for affect and emotion are discussed . The need for a phenomenological approach focusing on subjective experience is suggested. Three modes of abnormal experience in schizophrenia are investigated in light of their implications for affect or emotion: alienation of the lived body ; fragmented perception and loss of affordances ; and preoccupation with a quasi-delusional world created by the self. (shrink)