Forthcoming, Journal of Philosophy [pdf manuscript].

I introduce and argue for the importance of a cognitive state that I call alief. An alief is, to a reasonable approximation, an innate or habitual propensity to respond to an apparent stimulus in a particular way. Recognizing the role that alief plays in our cognitive repertoire provides a framework for understanding reactions that are governed by nonconscious or automatic mechanisms, which in turn brings into proper relief the role played by reactions that are subject to conscious regulation and deliberate (...) control. (shrink)

Epistemic injustice is a harm done to a person in their capacity as an epistemic subject by undermining her capacity to engage in epistemic practices such as giving knowledge to others or making sense of one’s experiences. It has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice than the healthy. This paper claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory (...) factors for epistemic injustice in psychiatric patients are outlined: global and specific. Some suggestions are made to counteract the effects of these contributory factors, for instance we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients. (shrink)

Brains, it has recently been argued, are essentially prediction machines. They are bundles of cells that support perception and action by constantly attempting to match incoming sensory inputs with top-down expectations or predictions. This is achieved using a hierarchical generative model that aims to minimize prediction error within a bidirectional cascade of cortical processing. Such accounts offer a unifying model of perception and action, illuminate the functional role of attention, and may neatly capture the special contribution of cortical processing to (...) adaptive success. This target article critically examines this approach, concluding that it offers the best clue yet to the shape of a unified science of mind and action. Sections 1 and 2 lay out the key elements and implications of the approach. Section 3 explores a variety of pitfalls and challenges, spanning the evidential, the methodological, and the more properly conceptual. The paper ends (sections 4 and 5) by asking how such approaches might impact our more general vision of mind, experience, and agency. (shrink)

I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; mitigating the injustice will require open and meaningful dialogue between clinicians and service user organisations, as well as individuals. I suggest that clinicians must become familiar with and take seriously concepts and frameworks for (...) understanding mental distress developed in service user communities, such as Hearing Voices Network, and by individual service users. This is especially necessary when these concepts and frameworks explicitly conflict with medical or technical understandings of users’ experiences. I defend this proposal against three objections. (shrink)

Many critics of medicalization express concern that the process privileges individualised, biologically grounded interpretations of medicalized phenomena, inhibiting understanding and communication of aspects of those phenomena that are less relevant to their biomedical modelling. I suggest that this line of critique views medicalization as a hermeneutical injustice—a form of epistemic injustice that prevents people having the hermeneutical resources available to interpret and communicate significant areas of their experience. Interpreting the critiques in this fashion shows they frequently fail because they: neglect (...) the ways in which medicalization may not obscure, but rather illuminate, individuals’ experiences; and neglect the testimony of those experiencing first-hand medicalized problems, thus may be guilty of perpetrating testimonial injustice. However, I suggest that such arguments are valuable insofar as they highlight the unwarranted epistemic privilege frequently afforded to medical institutions and medicalized models of phenomena, and a consequent need for greater epistemic humility on the part of health workers and researchers. (shrink)

PEOPLE WITH MENTAL HEALTH conditions are often required to address the question of whether they should disclose information about their mental health. Should they inform their employers, colleagues, friends, family, neighbors, and so on, that they have a mental health condition? Should they be encouraged by others to do so? There has been a recent move to promote disclosure as a way to increase the empowerment and decrease the self-stigma of people with mental health conditions. For instance, a three-week intervention, (...) Coming Out Proud, has been devised to inform people about the costs and benefits of disclosure, forms of disclosure, and helpful ways to tell... (shrink)

Many individuals who have mental disorders often report negative experiences of a distinctively epistemic sort, such as not being listened to, not being taken seriously, or not being considered credible because of their psychiatric conditions. In an attempt to articulate and interpret these reports we present Fricker’s concepts of epistemic injustice (Fricker, 2007, p. 1) and then focus on testimonial injustice and hermeneutic injustice as it applies to individuals with mental disorders. The clinical impact of these concepts on quality of (...) care is discussed. Within the clinical domain, we contrast epistemic injustice with epistemic privilege and authority. We then argue that testimonial and hermeneutic injustices also affect individuals with mental disorders not only when communicating with their caregivers but also in the social context as they attempt to reintegrate into the general society and assume responsibilities as productive citizens. Following the trend of the movement of mental health care to the community, the testimonies of people with mental disorders should not be restricted to issues involving their own personal mental states. (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)

I introduce and argue for the importance of a cognitive state that I call alief. An alief is, to a reasonable approximation, an innate or habitual propensity to respond to an apparent stimulus in a particular way. Recognizing the role that alief plays in our cognitive repertoire provides a framework for understanding reactions that are governed by non‐conscious or automatic mechanisms, which in turn brings into proper relief the role played by reactions that are subject to conscious regulation and deliberate (...) control. (shrink)

The Arabic philosophical fable _Hayy Ibn Yaqzan _is a classic of medieval Islamic philosophy. Ibn Tufayl, the Andalusian philosopher, tells of a child raised by a doe on an equatorial island who grows up to discover the truth about the world and his own place in it, unaided—but also unimpeded—by society, language, or tradition. Hayy’s discoveries about God, nature, and man challenge the values of the culture in which the tale was written as well as those of every contemporary society. (...) Goodman’s commentary places _Hayy Ibn Yaqzan _in its historical and philosophical context. The volume features a new preface and index, and an updated bibliography. “One of the most remarkable books of the Middle Ages.”—_Times Literary Supplement_ “An enchanting and puzzling story.... The book transcends all historical and cultural environments to settle upon the questions of human life that perpetually intrigue men.”—_Middle East__ Journal_ “Goodman has done a service to the modern English reader by providing a readable translation of a philosophically significant allegory.”—_Philosophy East and West_ “Add[s] bright new pieces to an Islamic mosaic whose general shape is already known.”—_American Historical Review_. (shrink)

Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and (...) ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. (shrink)