A dominant view of guilt and shame is that they have opposing action tendencies: guilt- prone people are more likely to avoid or overcome dysfunctional patterns of behaviour, making amends for past misdoings, whereas shame-prone people are more likely to persist in dysfunctional patterns of behaviour, avoiding responsibility for past misdoings and/or lashing out in defensive aggression. Some have suggested that addiction treatment should make use of these insights, tailoring therapy according to people’s degree of guilt-proneness versus shame-proneness. In this (...) paper, we challenge this dominant view, reviewing empirical findings from others as well as our own to question (1) whether shame and guilt can be so easily disentangled in the experience of people with addiction, and (2) whether shame and guilt have the opposing action tendencies standardly attributed to them. We recommend a shift in theoretical perspective that explains our main finding that both emotions can be either destructive or constructive for recovery, depending on how these emotions are managed. We argue such management depends in turn on a person’s quality of self-blame (retributive or ‘scaffolding’), impacting upon their attitude towards their own agency as someone with fixed and unchanging dispositions (shame and guilt destructive for recovery) or as someone capable of changing themselves (shame and guilt productive for recovery). With an eye to therapeutic intervention, we then explore how this shift in attitude towards the self can be accomplished. Specifically, we discuss empathy-driven affective and narratively-driven cognitive components of a process that allow individuals to move away from the register of retributive self-blame into a register of scaffolding ‘reproach’, thereby enabling them to manage their experiences of both shame and guilt in a more generative way. (shrink)

Self-narrative is often, perhaps primarily, a tool of self- constitution, not of truth representation. We explore this theme with reference to our own recent qualitative interviews of substance-dependent agents. Narrative self- constitution, the process of realizing a valued narrative projection of oneself, depends on one’s narrative tracking truth to a certain extent. Therefore, insofar as narratives are successfully realized, they have a claim to being true, although a certain amount of self-deception typically comes along for the ride. We suggest that, (...) because agents typically value certain outcomes more highly than truth for truth’s sake, it makes sense to narrate in ways that aren’t strictly true if that helps ensure highly valued outcomes do come true. Walker (2012) outlines three ways of defending the truth of past-directed narratives, but the role of future-directed narratives in realizing highly valued truths provides her a fourth way. (shrink)

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...) effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. (shrink)

In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less blameworthy but also as less (...) fit for ordinary interpersonal relationships. We examine how these responses, in turn, shape the addicted person’s view of themselves, their character and their capacities, and provide a negative narrative trajectory that impedes recovery. We close with a consideration of how these effects might be mitigated by adopting less demanding variations of the participant stance. (shrink)

Mit Herbert Schnädelbach bestimmen die Autoren dieses Bandes Philosophie als 'Versuch gedanklicher Orientierung im Bereich der Grundsätze unseres Denkens, Erkennens und Handelns'. Ihre Texte sind Beiträge zur inhaltlichen Ausführung dieser programmatischen Begriffsbestimmung.

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)

Der akademischen Philosophie wird manchmal nachgesagt, sie suche Antworten auf Fragen, die außer Philosophen niemanden umtreiben. In diesem Band sind »zwölf philosophische Antworten« auf Fragen versammelt, die sich jeder irgendwann einmal stellt und über die professionelle Philosophen lediglich etwas schärfer und gründlicher nachdenken. Die Autoren dieses Bandes greifen pointiert, allgemeinverständlich und mit philosophischem Vertiefungsanspruch aktuelle Kontroversen auf. Sie erheben dabei den Anspruch, philosophisch argumentativ sowohl dem Zeitgeistrelativismus als auch der Dominanz empirischer Wissenschaften entgegenzutreten. Es ist keineswegs „alles bloß Ansichtssache“; denn (...) Toleranz ist nicht einfach nur achselzuckendes Wegschauen. Um zu einer klugen und begründeten Orientierung zu kommen, bedarf es auch nicht der einseitigen Zuflucht zu heute populären Antwortinstanzen wie der Religion, der Neurobiologie oder der Ökonomie. In der Tradition der philosophischen Aufklärung ist weiterhin auf den nachdenkenden Menschen zu setzen, der in der Philosophie vertiefende Anregungen erhält, um sich zu aktuellen Kontroversen ein begründetetes Urteil zu bilden. Über das Handwerk des Philosophen – Meinen, Glauben und Wissen – Rechte und Pflichten, Werte und Normen – Fairness als Prinzip – Zur Verteidigung der Freiheit als Dilemma – Zum Streit über das Lebewesen Mensch – Das Geist-Körper-Problem und die Hirnforschung – Das Schuldprinzip und die Willensfreiheit – Die Wissenschaft zwischen Natur und Kultur – Grenzen des wirtschaftlichen Denkens – Das Wahrheitsproblem in der Mediengesellschaft – Religion im Streit der Meinungen Mit Beiträgen von Simone Dietz, Heiner Hastedt, Detlef Horster, Peter Janich, Geert Keil, Corinna Mieth, Herbert Schnädelbach und Anke Thyen. (shrink)