Naturalistic accounts of mental disorder aim to identify an objective basis for attributions of mental disorder. This goal is important for demarcating genuine mental disorders from artificial or socially constructed disorders. The articulation of a demarcation criterion provides a means for assuring that attributions of 'mental disorder' are not merely pathologizing different forms of social deviance. The most influential naturalistic and hybrid definitions of mental disorder identify biological dysfunction as the objective basis of mental (...) disorders: genuine mental... (shrink)

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we (...) find that people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

Some researchers and autistic activists have recently suggested that because some ‘autism-related’ behavioural atypicalities have a function or purpose they may be desirable rather than undesirable. Examples of such behavioural atypicalities include hand-flapping, repeatedly ordering objects (e.g., toys) in rows, and profoundly restricted routines. A common view, as represented in the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-TR (APA, 2000), is that many of these behaviours lack adaptive function or purpose, interfere with learning, and constitute the non-social (...) behavioural dysfunctions of those disorders making up the Autism Spectrum. As the DSM IV-TR continues to be the reference source of choice for professionals working with individuals with psychiatric difficulties, its characterization of the Autism Spectrum holds significant sway. We will suggest Extended Mind and Enactive Cognition Theories, which theorize that mind (or cognition) is embodied and environmentally embedded, as coherent conceptual and theoretical spaces within which to investigate the possibility that certain repetitive behaviours exhibited by autistics possess functions or purposes that make them desirable. As lenses through which to re-examine ‘autism-related’ behavioral atypicalities, these theories not only open up explanatory possibilities underdeveloped in the research literature, but also cohere with how some autistics describe their own experience. Our position navigates a middle way between the view of autism as understood in terms of impairment, deficit and dysfunction and one that seeks to de-pathologize the Spectrum. In so doing we seek to contribute to a continuing dialogue between researchers, clinicians and self- or parent advocates. (shrink)

Abstract:In this paper, I distinguish four ways in which aspects or features of mental illness may be said to be functional. I contend that discussion of teleological perspectives on mental illness has unfortunately tended to conflate these senses. The latter two senses have played important practical roles both in predicting and explaining patterns of behavior, cognition, and affective response, atnd relatedly, in developing successful interventions. I further argue that functional talk in this context is neither inconsistent with viewing (...) some disorders as dysfunctional in one of several senses, nor inappropriately adaptationist, provided we keep these senses of function distinct, and are precise about which is in play in a given context. (shrink)

In this thesis I develop an account of how processes of social understanding are implicated in experiences of mental disorder, critiquing the lack of examination of this phenomena along the way. First, I demonstrate how disorder concepts, as developed and deployed by psychiatric institutions, have the effect of shaping the cognition of individuals with psychopathology through setting expectations. Such expectation-setting can be harmful in some cases, I argue, and can perpetuate epistemic injustices. Having developed this view, I criticise enactive (...) accounts of mental disorder for failing to consider how such terms like ‘dysfunction’ are open to interpretation and can come embedded with normative expectations. Enactive accounts consequently run the risk of perpetuating injustices in their account of the sociality of mental disorder. Similar concerns arise when we consider the attachment of enactivism to the medical model, I argue. But by adapting enactivism to consider other experiences of disorder, such as those described as ‘madness’, enactive psychiatry may genuinely provide ethical groundwork for a better conception of disordered experience. Then, I consider a further concern with a distinctly medicalised conception of mental disorder from the perspective of self-illness ambiguity, arguing that self-illness ambiguities appear to form a special class of ambiguities due to their proximity to disorder concepts which mark them as appropriate targets for therapeutic treatment. However, I argue further that we should be critical of the idea that self-illness ambiguities necessitate disambiguation, as, in cases where self and illness are demarcated, individuals may still experience distress because simply having a mental disorder can be socially alienating. The medicalised focus in self-illness ambiguity, and the explicit need from the medical perspective to disambiguate it, might then exacerbate the distress someone experiences in mental disorder. Moreover, drawing on Mad Studies, I suggest that one might not need a coherent self-narrative to live well. Because of this, one may not need to adopt a medicalised view of the self in the case of selfillness ambiguity. In order to support this analysis, I provide a phenomenological account of language and argue that the very thoughts implicated in mental disorder shape the individual’s perception of the world due to the way that language foregrounds particular aspects of our world. This demands a critical examination of the language adopted and used by both clinicians and disordered individuals. I thus conclude with some thoughts on how to approach research and developing understanding of mental disorder given that we, as people, are always implicated in this process and therefore socialisation of some kind will always be taking place. (shrink)

Scientists, philosophers, and even the lay public commonly accept that schizophrenia stems from a biological or internal ‘dysfunction.’ However, this assessment is typically accompanied neither by well-defined criteria for determining that something is dysfunctional nor empirical evidence that schizophrenia satisfies those criteria. In the following, a concept of biological function is developed and applied to a neurobiological model of schizophrenia. It concludes that current evidence does not warrant the claim that schizophrenia stems from a biological dysfunction, and, in fact, that (...) unusual neural structures associated with schizophrenia may have functional or adaptive significance. The fact that current evidence is ambivalent between these two possibilities (dysfunction versus adaptive function) implies that schizophrenia researchers should be much more cautious in using the ‘dysfunction’ label than they currently are. This has implications for both psychiatric treatment as well as public perception of mental disorders. (shrink)

Objective Manic and depressive phases of bipolar disorder (BD) show opposite psychomotor symptoms. Neuronally, these may depend on altered relationships between sensorimotor network (SMN) and subcortical structures. The study aimed to investigate the functional relationships of SMN with substantia nigra (SN) and raphe nuclei (RN) via subcortical-cortical loops, and their alteration in bipolar mania and depression, as characterized by psychomotor excitation and inhibition. -/- Method In this resting-state functional magnetic resonance imaging (fMRI) study on healthy (n = 67) and BD (...) patients (n = 100), (1) functional connectivity (FC) between thalamus and SMN was calculated and correlated with FC from SN or RN to basal ganglia (BG)/thalamus in healthy; (2) using an a-priori-driven approach, thalamus-SMN FC, SN-BG/thalamus FC, and RN-BG/thalamus FC were compared between healthy and BD, focusing on manic (n = 34) and inhibited depressed (n = 21) patients. -/- Results (1) In healthy, the thalamus-SMN FC showed a quadratic correlation with SN-BG/thalamus FC and a linear negative correlation with RN-BG/thalamus FC. Accordingly, the SN-related FC appears to enable the thalamus-SMN coupling, while the RN-related FC affects it favoring anti-correlation. (2) In BD, mania showed an increase in thalamus-SMN FC toward positive values (ie, thalamus-SMN abnormal coupling) paralleled by reduction of RN-BG/thalamus FC. By contrast, inhibited depression showed a decrease in thalamus-SMN FC toward around-zero values (ie, thalamus-SMN disconnection) paralleled by reduction of SN-BG/thalamus FC (and RN-BG/thalamus FC). The results were replicated in independent HC and BD datasets. -/- Conclusions These findings suggest an abnormal relationship of SMN with neurotransmitters-related areas via subcortical-cortical loops in mania and inhibited depression, finally resulting in psychomotor alterations. (shrink)

The fifth text-revised iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) defines paraphilia as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners”. Paraphilic disorders specifically denote a paraphilia that is “currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others”. A diagnosis of paraphilic disorder either demands the (...) personal distress and/or impairment of function that is caused by the atypical sexual urges and fantasies to be present, or the status of non-consent of the other person that these sexual fantasies and urges are directed towards when acted upon by the patient. This paper discusses how consent not only becomes the standard for permissible and legal sexual activity with other persons, but also, when the diagnostic criteria are taken at face-value, for sexual pathology in the DSM-5-TR when the patient acts on their sexual urges. After a close investigation of various possible interpretations of the element of non-consensuality in the diagnostic criteria for paraphilic disorders, this paper concludes that the DSM-5-TR does not offer a clarifying explanation on how mental health professionals should under-stand its approach to diagnosing paraphilic disorders, leaving us with an ambiguous, unclear and unsettled conceptualisation of what it would mean to fulfil its diagnostic criteria. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

The aim of this study is to justify the belief that there are biological normative mechanisms that fulfill non-trivial causal roles in the explanations (as formulated by researchers) of actions and behaviors present in specific systems. One example of such mechanisms is the predictive mechanisms described and explained by predictive processing (hereinafter PP), which (1) guide actions and (2) shape causal transitions between states that have specific content and fulfillment conditions (e.g. mental states). Therefore, I am guided by a (...) specific theoretical goal associated with the need to indicate those conditions that should be met by the non-trivial theory of normative mechanisms and the specific models proposed by PP supporters. In this work, I use classical philosophical methods, such as conceptual analysis and critical reflection. I also analyze selected studies in the field of cognitive science, cognitive psychology, neurology, information theory and biology in terms of the methodology, argumentation and language used, in accordance with their theoretical importance for the issues discussed in this study. In this sense, the research presented here is interdisciplinary. My research framework is informed by the mechanistic model of explanation, which defines the necessary and sufficient conditions for explaining a given phenomenon. The research methods I chose are therefore related to the problems that I intend to solve. In the introductory chapter, “The concept of predictive processing”, I discuss the nature of PP as well as its main assumptions and theses. I also highlight the key concepts and distinctions for this research framework. Many authors argue that PP is a contemporary version of Kantianism and is exposed to objections similar to those made against the approach of Immanuel Kant. I discuss this thesis and show that it is only in a very general sense that the PP framework is neo-Kantian. Here we are not dealing with transcendental deduction nor with the application of transcendental arguments. I argue that PP is based on reverse engineering and abduction inferences. In the second part of this chapter, I respond to the objection formulated by Dan Zahavi, who directly accuses this research framework of anti-realistic consequences. I demonstrate that the position of internalism, present in the so-called conservative PP, does not imply anti-realism, and that, due to the explanatory role played in it by structural representations directed at real patterns, it is justified to claim that PP is realistic. In this way, I show that PP is a non-trivial research framework, having its subject, specific methods and its own epistemic status. Finally, I discuss positions classified as the socalled radical PP. In the chapter “Predictive processing as a Bayesian explanatory model” I justify the thesis according to which PP offers Bayesian modeling. Many researchers claim that the brain is an implemented statistical probabilistic network that is an approximation of the Bayesian 7 rule. In practice, this means that all cognitive processes are to apply Bayes' rule and can be described in terms of probability distributions. Such a solution arouses objections among many researchers and is the subject of wide criticism. The purpose of this chapter is to justify the thesis that Bayesian PP is a non-trivial research framework. For this purpose, I argue that it explains certain phenomena not only at the computational level described by David Marr, but also at the level of algorithms and implementation. Later in this chapter I demonstrate that PP is normative modeling. Proponents of the use of Bayesian models in psychology or decision theory argue that they are normative because they allow the formulation of formal rules of action that show what needs to be done to make a given action optimal. Critics of this approach emphasize that such thinking about the normativity of Bayesian modeling is unjustified and that science should shift from prescriptive to descriptive positions. In a polemic with Shira Elqayam and Jonathan Evans (2011), I show that the division they propose into prescriptivism and Bayesian descriptivism is apparent, because, as I argue, there are two forms of prescriptivism, i.e. the weak and the strong. I argue that the weak version is epistemic and can lead to anti-realism, while the strong version is ontic and allows one to justify realism in relation to Bayesian models. I argue that a weak version of prescriptivism is valid for PP. It allows us to adopt anti-realism in relation to PP. In practice, this means that you can explain phenomena using Bayes' rule. This does not, however, imply that they are Bayesian in nature. However, the full justification of realism in relation to the Bayesian PP presupposes the adoption of strong prescriptivism. This position assumes that phenomena are explained by Bayesian rule because they are Bayesian as such. If they are Bayesian in nature, then they should be explained using Bayesian modeling. This thesis will be substantiated in the chapters “Normative functions and mechanisms in the context of predictive processing” and “Normative mechanisms and actions in predictive processing”. In the chapter “The Free Energy Principle in predictive processing”, I discuss the Free Energy Principle (hereinafter FEP) formulated by Karl Friston and some of its implications. According to this principle, all biological systems (defined in terms of Markov blankets) minimize the free energy of their internal states in order to maintain homeostasis. Some researchers believe that PP is a special case of applying this principle to cognition, and that predictive mechanisms are homeostatic mechanisms that minimize free energy. The discussion of FEP is important due to the fact that some authors consider it to be important for explanatory purposes and normative. If this is the case, then FEP turns out to be crucial in explaining normative predictive mechanisms and, in general, any normative biological mechanisms. To define the explanatory possibilities of this principle, I refer to the discussion of its supporters on the issue they define as the problem of continuity and discontinuity between life and mind. A critical analysis of this discussion and the additional arguments I have formulated have allowed me to revise the explanatory ambitions of FEP. I also reject the belief that this principle is necessary to explain the nature of predictive mechanisms. I argue that the principle formulated and defended by Friston is an important research heuristic for PP analysis. 8 In the chapter “Normative functions and mechanisms in predictive processing”, I start my analyzes by formulating an answer to the question about the normative nature of homeostatic mechanisms. I demonstrate that predictive mechanisms are not homeostatic. I defend the view that a full explanation of normative mechanisms presupposes an explanation of normative functions. I discuss the most important proposals for understanding the normativity of a function, both from a systemic and teleosemantic perspective. I conclude that the non-trivial concept of a function must meet two requirements which I define as explanatory and normative. I show that none of the theories I have invoked satisfactorily meets both of these requirements. Instead, I propose a model of normativity based on Bickhard's account, but supplemented by a mechanistic perspective. I argue that a function is normative when: (1) it allows one to explain the dysfunction of a given mechanism; (2) it contributes to the maintenance of the organism's stability by shaping and limiting possible relations, processes and behaviors of a given system; and when (3) (according to the representational and predictive functions) it enables explaining the attribution of logical values of certain representations / predictions. In such an approach, a mechanism is normative when it performs certain normative functions and when it is constitutive for a specific action or behavior, despite the fact that for some reason it cannot realize it either currently or in the long-term. Such an understanding of the normativity of mechanisms presupposes the acceptance of the epistemic hypothesis. I argue that this hypothesis is not cognitively satisfactory, and therefore the ontic hypothesis should be justified, which is directly related to adopting the position of ontic prescriptivism. For this reason, referring to the mechanistic theory of scientific explanations, I formulate an ontical interpretation of the concept of a normative mechanism. According to this approach, a mechanism or a function is normative when they perform such and such causal roles in explaining certain actions and behaviors. With regard to the normative properties of predictive mechanisms and functions, this means that they are the causes of specific actions an organism carries out in the environment. In this way, I justify the necessity of accepting the ontic hypothesis and rejecting the epistemic hypothesis. The fifth chapter, “Normative mechanisms and actions in predictive processing”, is devoted to the dark room problem and the related exploration-exploitation trade-off. A dark room is the state that an agent could be in if it minimized the sum of all potential prediction errors. I demonstrate that, in accordance with the basic assumption of PP about the need for continuous and long-term minimization of prediction errors, such a state should be desirable for the agent. Is it really so? Many authors believe it is not. I argue that the test of the value of PP is the possibility of a non-trivial solution of this problem, which can be reduced to the choice between active and uncertainty-increasing exploration and safe and easily predictable exploitation. I show that the solution proposed by PP supporters present in the literature does not enable a fully satisfactory explanation of this dilemma. Then I defend the position according to which the full explanation of the normative mechanisms, and, subsequently, the solution to the dilemma of exploration and exploitation, involves reference to the existence of constraints present in the environment. The constraints 9 include elements of the environment that make a given mechanism not only causal but also normative. They are therefore key to explaining the predictive mechanisms. They do not only play the role of the context in which the mechanism is implemented, but, above all, are its constitutive component. I argue that the full explanation of the role of constraints in normative predictive mechanisms presupposes the integration of individual models of specific cognitive phenomena, because only the mechanistic integration of PP with other models allows for a non-trivial explanation of the nature of normative predictive mechanisms that would have a strong explanatory value. The explanatory monism present in many approaches to PP makes it impossible to solve the problem of the dark room. Later in this chapter, I argue that the Bayesian PP is normative not because it enables the formulation of such and such rules of action, but because the predictive mechanisms themselves are normative. They are normative because they condition the choice of such and such actions by agents. In this way, I justify the hypothesis that normative mechanisms make it possible to explain the phenomenon of agent motivation, which is crucial for solving the dark room problem. In the last part of the chapter, I formulate the hypothesis of distributed normativity, which assumes that the normative nature of certain mechanisms, functions or objects is determined by the relations into which these mechanisms, functions or objects enter. This means that what is normative (in the primary sense) is the relational structure that constitutes the normativity of specific items included in it. I suggest that this hypothesis opens up many areas of research and makes it possible to rethink many problems. In the “Conclusion”, I summarize the results of my research and indicate further research perspectives. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

In this chapter, I articulate the structure of a general concept of autonomy and then reply to possible objections with reference to Ulysses arrangements in psychiatry. The line of argument is as follows. Firstly, I examine three alternative conceptions of autonomy: value-neutral, value-laden, and relational. Secondly, I identify two paradigm cases of autonomy and offer a sketch of its concept as opposed to the closely related freedom of action and intentional agency. Finally, I explain away the autonomy paradox, to which (...) the previously identified pair of paradigm cases seems to give rise in the context of mental disorder. By addressing this paradox, we learn two valuable lessons. The first is about the relationships between the three conceptions of autonomy above. The second is about the relationship between autonomy and mental disorder. (shrink)

Objective: Alterations in psychomotor dimension cut across different psychiatric disorders, such as schizophrenia (SCZ) and bipolar disorder (BD). This preliminary study aimed to investigate the organization of intrinsic brain activity in the subcortical-cortical sensorimotor system in SCZ (and BD) as characterized according to psychomotor dimension. -/- Method: In this resting-state functional magnetic resonance imaging (fMRI) study, functional connectivity (FC) between thalamus and sensorimotor network (SMN), along with FC from substantia nigra (SN) and raphe nuclei (RN) to basal ganglia (BG) and (...) thalamic regions, were investigated by using an a-priori-driven and dimensional approach. This was done in two datasets: SCZ patients showing inhibited psychomotricity (n = 18) vs. controls (n = 19); SCZ patients showing excited psychomotricity (n = 20) vs. controls (n = 108). Data from a third dataset of BD in inhibited depressive or manic phases (reflecting inhibited or excited psychomotricity) were used as control. -/- Results: SCZ patients suffering from psychomotor inhibition showed decreased thalamus-SMN FC toward around-zero values paralleled by a concomitant reduction of SN-BG/thalamus FC and RN-BG/thalamus FC (as BD patients in inhibited depression). By contrast, SCZ patients suffering from psychomotor excitation exhibited increased thalamus-SMN FC toward positive values paralleled by a concomitant reduction of RN-BG/thalamus FC (as BD patients in mania). -/- Conclusions: These findings suggest that patients exhibiting low or high levels of psychomotor activity show distinct patterns of thalamus-SMN coupling, which could be traced to specific deficit in SN- or RN-related connectivity. Notably, this was independent from the diagnosis of SCZ or BD, supporting an RDoC-like dimensional approach to psychomotricity. (shrink)

The Shadow of God in the Philosopher’s Garden. The Parc de La Villette in Paris in the context of the philosophy of chôra I Bernard Tschumi’s project of the Parc de La Villette could have won the competition and was implemented thanks to the political atmosphere that accompanied the victory of the left-wing candidate in the French presidential elections in 1981. François Mitterand’s revision of the political programme and the replacement of radical reforms with the construction of prestigious architectural objects (...) and urban assumptions in the French capital gave Tschumi a unique opportunity to realise ideas that polemicised with traditional forms of social life, questioned the basic principles of architecture and included architectural work in the philosophical disputes over the issues of metaphysics. Tschumi’s theoretical assumptions put forward during the design of the Parc de La Villette highlighted the questions of conflict between the main components of the project and suggested that the intensification of differences was analogous to Jacques Derrida’s creation of the concept of différance. It was this philosopher who in a special commentary to Derrida’s project also introduced the concept of maintenant, which aimed at demonstrating that the architect’s polemical inclinations remain in a hidden balance with his inclinations to affirmation of architectural principles. During the discussion between Derrida and Peter Eisenman, who was to take part in the design of the Parisian park, the concept of the chôra was also put forward, which in the course of the debate led to an additional confusion of architectural and philosophical problems. II In the period from the Antiquity to the Renaissance, the dialogue Timaeus was the most frequently commented work of Plato. At present, the most frequently discussed is the issue of the chôra included in it, which aroused fascination among philosophers, researchers of rhetoric, religion, feminism, but also architecture. The work on the chôra also influenced the development of the interpretation of the Parc de La Villette, among which the topics related to the beginning and the change were highlighted. In early uses of the word chôra in Greek, as in Homer’s 18th Book of Iliad, it meant both dancing and a place to dance. On this occasion, it can be seen that it is not possible to determine which phenomenon took precedence in the creation of the name. It cannot be denied, however, that the word concerned a specific movement, as if circular and returning to an indefinable beginning. Despite gaining more and more general meanings, the word chôra has retained its connection with the dance of people on the threshing floor, the dance of bees (choros meliton) or the dance of stars (choros astron). In Timaeus, the chôra is a space filled with movement with an effect similar to shaking the sieve to husk the grain: it separates similar elements from the dissimilar ones. The juxtaposition of the Parc de La Villette and the chôra already at this stage leads to the suggestion that the park was treated by the architect as a place of dynamic changes leading to the establishment of new social solutions. In his statements, the architect confirmed that the park was to be a space of new politics and ethics. The book by Julia Kristeva La Révolution du langage poétique contributed to the spread of the belief that works of art can play a role as factors of political revolution. In this work, the author put forward the thesis that the chôra is a kind of space, the character of which has a destructive influence on attempts to conclude language games. The chôra gives beginning to words, but at the same time, by leaving a trace of this beginning it forces us to renew their meanings. The chôra understood in this way, turns out to be an irremovable beginning, to which one has to return all the time. Kristeva found manifestations of the chôra’s activity in avant-garde French poetry, to which she attributed the role of a mediator between criticism of metaphysics and aspirations for social change. The chôra, violating the language, introduces some voids into it, as if traces of the abyss, which direct the consciousness towards understanding the necessity of political changes. The Parc de La Villette was to pursue similar objectives in the city space. In his essays, Tschumi considered the problems of creating spaces that would give rise to a radical democracy. The proposed rebellious spaces should have the characteristics of a void, in which contradictory forces would occur as forms of pure activity. The means of achieving this goal was to concentrate contradictions and make them visible. The Parc de La Villette was supposed to collect differences as indelible and at the same time by showing them it was supposed to raise awareness of the social world as a conglomerate of differences. Saturation of the space of the park with subversive values results from the character of this space suppressed in the consciousness, as well as from the social diversity which has not been taken into account so far. The main contradictions contained in space relate to the division that exists between its presentation as a mental problem and a sensual one. The park was the deliberate creation of a place that transcends such a division and creates a separate space for negotiation between architectural theories and its practical applications. The purpose of the park was to become a place of future events, which would not hide their conflicting character coming from diversity of both space and society. The method of composition usually aimed at achieving a harmonious whole has been replaced by Tschumi with a system of juxtaposition of non-coherent elements or those resulting from variations and transformations. Tschumi did not seek direct influence on politics in the Parc de La Villette, but made room for thinking about the possibilities of the future. He introduced problems rather than showed solutions to them. The task of the park was to put the principles of architecture into a kind of vibration that would inspire users to participate in the new community. III Tschumi believes that the quality of architecture depends on the theoretical factor it contains. Such a view led to the creation of architecture that would achieve visibility and comprehensibility only after its interpretation. On his way to creating such an architecture he took on a purely philosophical reflection on the basic building block of architecture, which is space. In 1975, he wrote an essay entitled Questions of Space, in which he included several dozen questions about the nature of space. The questions he formulated could be regarded as analogous to the situation in the philosophy of the time, in which the interest in questioning the most obvious forms of understanding the world and intellectual categories increased. The research on space is an area common to many fields of natural sciences, humanities and artistic creation, but it also deals with other problems, such as issues of experience. The concept of space-time continuum proposed by Hermann Minkowski drew attention to the identity of time and space with the events taking place. Probably regardless of the postulates of physicists commenting on Albert Einstein’s discoveries, also in philosophy it increased the importance of the concept of the event which became dominant in Martin Heidegger’s latest work Contributions of Philosophy: Of the event. Furthermore, Tschumi’s reflections on space entered into relation with the problem of experience, which aroused the interest of a group of French philosophers trying to assimilate Georges Bataille’s concept of “inner experience”. Both Tschumi and Derrida referred to Bataille because his views could be used not only to modify the concept of the subject, but also to change the understanding of what constitutes the area of architecture. The discussion on experience has led to the recognition that the subject is not sovereign, but actually a form of what is on their outside. Such insights make it possible to treat the area of the Parc de La Villette as existing mainly when it is organised by its users. The decisive features of the park are its assumptions, according to which it is a variety of active void that leads to agreeing new social relations with it. The park does not force to participate in already existing moral or political communities, but tries to move into an unknown future in which the scope of free functioning of individuals will be increased. Doubts about the principles of functioning of the individual self and its discovery as a whole composed of non-coherent parts, as well as its dependence on its own depth full of disordered forces, influenced the understanding of architecture as a set of contradictions whose source is a fundamental void anticipating the empty phenomenal space. The use of this phenomenal void in architecture, as well as the rejection of the whole and unity, had a specific political purpose and drew its inspiration from political analyses. In the Parc de La Villette, metaphysics and politics were brought closer together because the philosophy of void was used to create new conditions for community action. It can be argued that the source of this philosophy was the perception of errors in existing societies dependent on the shortcomings of traditional metaphysics. Spacing (espacement) was one of the key terms in Derrida’s philosophy, which was also combined with the concepts of différance and chôra. The study of the nature of space, especially its transition from the level of pure possibility to the level of sensual phenomenon, also contributes to understanding how well designed space can have an impact on its audience. This explanation is based on Tschumi’s assumption that the space of the Parc de La Villette contradicts the integrating approaches and instead exposes contradictions, but it does so in a way that combines incompatible properties into a single piece of architecture. The specificity of such integration is similar to the invention of a musical phrase, which is an ideological message: moral and political. Such a thesis may raise doubts, however, if both the clearly adopted assumptions and those deduced from the work allow for their logically ordered presentation then to a limited extent it may be assumed that the work has achieved a connection between a specific philosophy of space and its practical application. Derrida combined the problem of spatiality with the problem of transcendental imagination in the philosophy of Immanuel Kant, who in the first version of Critique of Pure Reason assumed that pure imagination precedes the appearance of time and space, even in their transcendental forms. The imagination in such a situation can be described as a factor activating time and space, which indicates what function is played by movement in this activity. This leads us to recognize that the ultra originary source of pure forms of sensual intuition is movement, which in early Greek philosophy was identified with void and its lack of resistance to phenomena occurring in it. Derrida’s philosophy in search of a certain super-transcendental source of time and space pointed to différance which, like void or the chôra, does not have material features or even any other form of being. Différance is the primary cause of the disruption of motionlessness and the introduction of activity into motionless time and space, thus its activity can be described as spacing (espacement). Derrida’s discoveries in this respect are not entirely original, because Georg Wilhelm Friedrich Hegel already pointed out when examining the present that it is primarily a differential relation (differente Beziehung), which, being seemingly neutral, influences the present with supernatural force and makes it unidentifiable with itself. Differente Beziehung must similarly influence the originary space, negating its initial character by multiplying its divisions and expanding its boundaries. Différance acts by revealing contradictions wherever there is apparent undifferentiation. Tschumi, composing the Parc de La Villette as a variety of void and a set of incompatible layers, followed the rules of différance or the chôra: he made void visible together with its saturation with contradictions. If space can be considered to be the result of the activity of difference, such activity has a certain regularity, which influences the behaviour of its observers. Differences or contradictions fall into a certain rhythm, which can be considered a manifestation of transcendent order. The problem is that what can be considered the source of such order, namely the logos or God, is partly disorder and error. According to descriptions contained in Timaeus, the world is a combination of forces that drive to order with forces of erroneous necessity that resounds in every order and forces it to return to disorder. Derrida denied the possibility of understanding différance as a theological value, even if it were a negative or apophatic theology, but no categorical denial could be perfect. The assumption that différance or the chôra are not endowed with any substance properties cannot deny their activity, and thus a certain force. Already since Democritus, philosophy has multiplied the names of such a force and the contradictory variety of its manifestations, never forgetting also the necessity for reason to withdraw from the possibility of giving its correct characteristics. Such a withdrawal may be interpreted as an expression of respect and, in certain situations, as a cult of the force that precedes reasonableness. The Parc de La Villette, which is an artistic divagation about the contradictions and forces behind them, can be considered as a place of their sublimation, and therefore as a variation of the temple of what differs from order and disorder. IV In the texts that presented the theoretical assumptions of the Parc de La Villette, Tschumi used a large number of terms that contradicted not only the traditional principles of composing architecture, but also negated the rules of social order and the foundations of Western metaphysics. Tschumi’s statements, which are a continuation of his leftist political fascinations from the May 1968 revolution, as well as his interest in the philosophy of French poststructuralism and his collaboration with Derrida, prove that terms such as “disruption”, “dissociation”, “disfunction”, “disjunction” and “dispersion” not only referred to architectural problems but also applied to political criticism and the deepest foundations of thinking itself. His collaboration with Derrida manifested itself primarily in the publication La Case Vide: La Villette 1985, in which the architect’s design drawings and texts explaining his concepts related to the Parc de La Villette were accompanied by an extensive essay by Derrida, which included theoretical problems taken up by Tschumi in a philosophical context. Architectural and philosophical issues were also combined during seven discussion meetings organised by Eisenman, invited by Tschumi to collaborate on the design of the Parc de La Villette. Eisenman, who, like Tschumi, invited Derrida to participate in the design of the park and also led to the publication of Chora L Works: Jacques Derrida and Peter Eisenman, in which his ideas were confronted with Derrida’s philosophical text. In this case, Derrida’s essay was not a direct commentary on the architect’s concepts, but rather a reflection on the question of the chôra presented by Plato in Timaeus. During the discussion and in his essay, Derrida pointed out that the chôra is a component of the created world, yet it does not belong to it, but precedes it. The originality of the chôra is so radical that she also precedes all the factors of creating the world, including ideas and the Demiurge. Thus athesis appeared in the metaphysics of the West that the chôra is a form of active abyss, in relation to which all beings are secondary, both those perfect (as ideas or God) and those created, such as the world, things, people or language. This leads to the conclusion that the chôra does not exist, because all existence is a derivative of the chôra. Nor could the chôra be described, since it is a form of developing a space that is preceded by a lack of space characteristic of the chôra. Derrida intended the chôra to be an instance with an exceptional degree of transcendentalism, an anti-metaphysical instance, but also an a-theological one. However, this attempt failed, both in the field of secular philosophy and in the field of theology. Derrida’s characteristics of the chôra to strengthen its transcendentalism and negation of metaphysics had to be expressed in a language that immediately produces new concepts and a new metaphysics that reproduces the categories of the beginning, the origin or the foundation known from earlier philosophical traditions. All forms of criticism of metaphysics are also inspired by negative, apophatic and mystical theology. The undermining of many concepts of permanent meaning and the introduction of new concepts of unstable meaning, characteristic of the philosophy of deconstruction, had many features of originality, but it was directed towards problems whose solutions repeat, with the use of new vocabulary, the findings known in culture since Democritus. Thus, if apophatic philosophy can be regarded as deconstruction avant la lettre, then deconstruction itself in its late versions began to take on the features of a new religion. The exchange of inspiration between theology and deconstruction was manifested in a series of scientific conferences and publications in which Derrida’s philosophical concepts were interpreted within the scope of religious thought. Theological threads began to be found in such concepts of deconstruction as différance or the chôra, while at the same time Derrida himself undertook in his philosophy to study problems such as the Other (L’Autre) or the Impossible (Impossible), which belonged to newer theological traditions. As a consequence of the new problems, the deconstruction became closer to the features of a new religion. Philosophy, at least from Kant’s time, has tried to create a system that would take over from religion the tasks of setting moral and political goals. Similarly, Derrida has directed his interest towards the problems of democracy and ethics, which would enable their renewal. Attempts to create a new religion (cleared of old metaphors), a new community or a new democracy bring problems and threats which may be no less troublesome than the previous systems. All promises of freedom carry with them threats, the greater the more they strive for perfection. The renewal of existential orders, sometimes carried out by means of violent changes, is a certain repetitive feature of human cultures. Deep changes, however, do not protect against the return of both old gods and old demons. Tschumi and Derrida were shaped in their youth by the atmosphere of leftist rebellion against the moral and political limitations of ossified communities and the imperfections of democracy. The ethical theme distinguishes many of their works, including the Parc de La Villette. The opposition to the metaphysical traditions of philosophy and architecture contained in this park was prompted by specific political situations and resulted from bringing political issues to the level of philosophical considerations. Achievements made at the level of pure concepts were then subject to elevation, to a kind of sacralization, which made them religious concepts. The deconstruction reached for the status of the new religion especially when it found its followers and began to generate moral obligations. In the new situation, terms such as the chôra, l’Autre or the Impossible were absolutized and in relation to them a cult and attitude of adoration emerged. The Parc de La Villtette then gained new post-secular meanings, which allow it to be assigned the function of a Temple of Otherness (L’Autre) and Impossible. V In the traditional sense, a work of art creates an illustration of the outside world, or of a certain text or doctrine. Sometimes it is considered that such an illustration is not literal, but is an interpretation of what is visible, or an interpretation of a certain literary or ideological message. It can also be assumed that a work of art creates its own visual world, a separate story or a separate philosophical statement. Parc de La Villette represents the last of these possibilities: it is a philosophical statement that develops the premises derived from poststructuralist philosophies and the philosophy of deconstruction. The uniqueness of its being status, however, is that it does so not only at the level of the theoretical assumptions, but also through its functioning as an active philosophical work. This means that a park is a happening philosophy. Its activity, however, does not refer only to the present tense, but is also an attempt to penetrate the future, all otherness and impossibility. This kind of activity assumes that the work, in a sense, does not yet fully exist, but is also still produced in the processes of its interpretation. The theoretical foundations of the park included texts by Tschumi, in which he questioned traditional ways of creating a work of architecture, postulating in return the use of a long series of negations, which were comparable to the crisis of metaphysics characteristic of contemporary philosophy. It is therefore no coincidence that the publication containing Tschumi’s theoretical text on Parc de La Villette was accompanied by an essay by Derrida developing some of the architect’s concepts. The next step in integrating philosophy into the process of park design was a series of discussions between Eisenman and Derrida, who completely moved the creation of the park into the world of thoughts, without accentuating the need for their realization in the material reality. The main topic of these discussions was the problem of the chôra, which was taken up by later commentators and used to interpret the park as a work in which the philosophy of the beginning is manifested relating to issues of politics, morality and religion. The park was therefore interpreted as a space of invention within the scope of creating new rules of functioning of the community and democracy. Thinking about the political future may, however, exceed the horizon of ordinary expectations. Although philosophical thought is always connected with contemporary problems and metaphysics sometimes intertwines with current politics, yet at the same time the customs of philosophy also include crossing horizons and thinking about absolute otherness and impossibility. Initially, the chôra, différance, absolute otherness (tout autre) and the Impossible were concepts of pure philosophy of atheistic character, but with the further development of the discussion, more and more theological motifs began to emerge. One of the reasons for this phenomenon was the fact that radical negations of all being, which were contemplated in contemporary philosophy (by Heidegger and Derrida, among others), had previously been manifested in negative and apophatic theologies (by Master Eckhart, among others).Also the category of the “Other”, taken from Emmanuel Levinas, was clearly connected with the thought about God. A further reason for connecting the chôra with the theological thought was the interest in the philosophy of deconstruction expressed by some theologians. John Caputo in particular managed to persuade Derrida to participate in discussions on the current status of religion. In the late period of Derrida’s writing, further statements on religious topics appeared. All these reasons led to posing a question about the identity of the chôra and God. Although there were no satisfactory conclusions on this issue, the discussion was also important to create an interpretation of the park as a place of worship. The chôra, representing, according to Plato, the preoriginal emptiness is the place of every beginning, but it turns out that it is not neutral to the being created in it. The chôra deposits itself in every being as an irremovable beginning that interferes with its stability. The chôra, therefore, forces us into a palintropical movement, but it also turns out to be a pure compulsion, an erring necessity and a fundamental force from which, in the human perception, motifs useful to the individual and to the community are extracted. All definitions of this force, including its anthropomorphisation, are formulated in such a way that they allow for building private and collective morality upon them. Such definitions are changed depending on variable political situations. It is difficult to determine whether in the processes of changes in the formulation of “God’s names” any essential value is retained, which is not subject to change. The current definitions of the chôra (God?), which can be found, for example, in the philosophy of Caputo, stress that she is a combination of various and contradictory forces. This characteristic inherits much of Plato’s concept, reminds us of Master Eckhart’s views on Gottheit and, at the same time, is not unfamiliar to Tschumi, whose essays were an apologia of contradictions. The current concept of chôra, transferred into the sphere of politics, is the praise of social diversity and the protection of the difference from the forces of order. In the Parc de La Villette, the future community and democracy were elevated as a system of safe existence of individuals in all their singularity. The park is a temple of a future community in which individual beings have nothing in common. (shrink)

This book chapter is a short response to a paper by the psychiatrist Nicholas Kontos, on the phenomenon of psychological symptom amplification (PSA). PSA takes place when patients present symptoms to clinicians that they do not actually have, or, perhaps more commonly, they exaggerate symptoms they do have. Kontos argues that, because of modern medical training, it is very difficult for clinicians to recognize that the patient's presented symptoms are exaggerated or nonexistent. I argue that the hiddenness of PSA is (...) a result of far-reaching instutitional changes that took place in American psychiatry in the 1970s. In short, many psychiatrists went from seeing mental disorders as (unconscious) strategies to seeing them as dysfunctions, nothing more. Recognizing PSA involves adopting a perspective that has been effectively abolished in contemporary American psychiatry. (shrink)

Meaning-making plays a central role in how we deal with experiences of suffering, including those due to mental disorder. And for many, religious beliefs, experiences, and practices (hereafter, religious engagement) play a central role in informing this meaning-making. However, a crucial facet of the relationship between experiences of mental disorder and religious engagement remains underexplored—namely the potentially positive effects of mental disorder on religious engagement (e.g. experiences of bipolar disorder increasing sense of God’s presence). In what follows, (...) I will present empirical findings from two recent studies of mine which shed light on the extent to which participants experienced these positive effects, specific components of these effects, and how they fit into their understanding of their mental disorder and its relationship to their religious identity. In doing so, I will draw on and expand Tasia Scrutton’s Potentially Transformative view (2015a, 2015b, 2020) according to which mental disorders may provide opportunities for spiritual growth. My empirical results align with and help deepen an account according to which mental disorders are potentially spiritually transformative by providing further insight into such instances: specifically, which symptoms and internal and external factors are often involved, as well as which religious beliefs, experiences, and/or practices are often affected. After presenting these results and articulating their relevance for a potentially transformative view of mental disorder, I will then address some potential objections to the theoretical account as well as some limitations of the empirical work, before sketching possible promising directions for future research. (shrink)

Recently there has been a trend of moving towards biological and neurocognitive based classifications of mental disorders that is motivated by a dissatisfaction with the syndrome-based classifications of mental disorders. The Research Domain Criteria (indicated with the acronym RDoC) represents a bold and systematic attempt to foster this advancement. However, RDoC faces theoretical and conceptual issues that need to be addressed. Some of these difficulties emerge when we reflect on the plausible reading of the slogan “mental disorders (...) are brain disorders”, that according to proponents of RDoC constitutes one of its main presuppositions. Some authors think that endorsing this idea commits RDoC to a form of biological reductionism. We offer empirical and theoretical considerations for concluding that the slogan above should not be read as a reductionist thesis. We argue, instead, that the slogan has a pragmatic function whose aim is to direct research in psychopathology. We show how this function might be captured in the framework of a Carnapian explication as a methodological tool for conceptual engineering. Thus, we argue that a charitable interpretation of the aims of the proponents of RDoC should be understood as an attempt at providing an explication of the concept of mental disorder in terms of brain disorder whose main goal is to provide a more precise and fruitful notion that is expected to have a beneficial impact on classification, research, and treatment of psychiatric conditions. (shrink)

The antipsychiatrists in the 1960's, specifically Thomas Szasz, have claimed that mental illness does not exist. This argument was based on a specific definition of physical disease that, Szasz argued, could not be applied to mental illness. Thus, by problematizing mental illness, the spotlight had turned to physical disease. Since then, philosophers of medicine have proposed definitions applying both to pathophysiological and psychopathological conditions. This paper analyzes prominent naturalist definitions which aim to provide value-free accounts of pathological (...) conditions, as well as normative accounts that propose value-laden accounts. The approaches surveyed differ not only in terms of value, but also in terms of their perspective. This perspective concerns whether the concept of health, illness or disease/disorder is emphasized. The emphasis on health or illness is holistic as it looks at the human being as a whole, while focus on disease or disorder is analytic as it considers part functions. I will here argue in favor of holism and will propose a definition of mental health based on Sartre's existential psychoanalysis of Gustave Flaubert. (shrink)

Context — Children and adults with psychopathic traits and conduct or oppositional defiant disorder demonstrate poor decision making and are impaired in reversal learning. However, the neural basis of this impairment has not previously been investigated. Furthermore, despite high comorbidity of psychopathic traits and attention deficit/hyperactivity disorder, to our knowledge, no research has attempted to distinguish neural correlates of childhood psychopathic traits and attention-deficit/hyperactivity disorder. Objective—To determine the neural regions that underlie the reversal learning impairments in children with psychopathic traits (...) plus conduct or oppositional defiant disorder. Design — Case-control study. Setting — Government clinical research institute. Participants — Forty-two adolescents aged 10 to 17 years: 14 with psychopathic traits and oppositional defiant disorder or conduct disorder, 14 with attention-deficit/hyperactivity disorder only, and 14 healthy controls. Main Outcome Measure — Blood oxygenation level–dependent signal as measured via functional magnetic resonance imaging during a probabilistic reversal task. Results — Children with psychopathic traits showed abnormal responses within the ventromedial prefrontal cortex (Brodmann area 10) during punished reversal errors compared with children wit hattention deficit/hyperactivity disorder and healthy children (P < .05 corrected for multiple comparisons). Conclusions — To our knowledge, this study provides the first evidence of abnormal ventromedial prefrontal cortex responsiveness in children with psychopathic traits and demonstrates this dysfunction was not attributable to comorbid attention-deficit/hyperactivity disorder. These findings suggest that reversal learning impairments in patients with developmental psychopathic traits relate to abnormal processing of reinforcement information. (shrink)

Obsessive-compulsive disorder is a commonly occurring neuropsychiatric condition characterized by bothersome intrusive thoughts and urges that frequently lead to repetitive dysfunctional behaviours such as excessive handwashing. There are well-documented alterations in cerebral function which appear to be closely related to the manifestation of these symptoms. Controlled studies of cognitive-behavioural therapy techniques utilizing the active refocusing of attention away from the intrusive phenomena of OCD and onto adaptive alternative activities have demonstrated both significant improvements in clinical symptoms and systematic changes in (...) the pathological brain circuitry associated with them. Careful investigation of the relationships between the experiential and putative neurophysiological processes involved in these changes can offer useful insights into volitional aspects of cerebral function. (shrink)

At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a certain extent, for diagnosis, is the DSM, now at its fifth edition. The main reasons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative failure of the project of finding biomarkers for most mental disorders. Descriptivism has also the advantage (...) of capturing the phenomenology of mental disorders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descriptive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

Our philosophical understanding of mental illness is being shaped by neuroscience. However, it has the paradoxical effect of igniting two radically opposed groups of philosophical views. On one side, skepticism and denialism assume that, lacking clear biological mechanisms and etiologies for most mental illnesses, we should infer they are constructions best explained by means of social factors. This is strongly associated with medical nihilism: it considers psychiatry more harmful than benign. On the other side of the divide, naturalism (...) and reductionism are on the look for failures in the biological functioning of the organism whenever a genuine mental illness occurs. Psychiatry as currently practiced, accordingly, exhibits the gaps of an ongoing research programme; a yet to be completed neuroscience would link mental illnesses with identifiable biological mechanisms. Both sides of this divide claim to be fostered by scientific discoveries and advances in neuroscience, when taken at face value. Against this background, we argue instead for a modest view. To that end, we draw attention to some nuances in the scientific realism debate. While contending that neuroscientific theories and models aim to provide true representations of their target systems, and can justifiably claim to have attained some, we argue that our confidence should not be placed beforehand in specific features of these scientific representations. Hence, it would be unwarranted to extract morals for psychiatry from posits (or their absence) in neuroscientific explanations of mental illnesses. To illustrate our position, we examine some recent discoveries in neuroscience concerning bipolar disorder. We conclude by linking our topic to a broader issue in the philosophy of medicine: insofar as psychiatry is a biomedical specialty, its classifications of health and disease are guided by pragmatic concerns, as well as by scientific discoveries. (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)

The aim of the Validation Theory (VT) as a meta-empirical construct is to introduce a new vista in the reorganization of the neuroscience, in its role of a science of the Mind-and-Brain unification. The present study focuses on existing discrepancies and contradictions between the methods of basic neurosciences and those prescribed by the psychological science. Our view is that these discrepancies are based on a high penetration of traditional neuroscience methods into the biological processes, coupled with low extrapolation (experimenting with (...) animal models) and vice versa for the psychological and psychopathological methods. A novel epistemological model for integrating psychological and neuroscientific knowledge is proposed. It is represented as a simultaneous investigation of the brain activity with penetrating high resolution functional Magnetic Resonance Imaging and in extenso application of set of psychological tests for exploring correspondence (cross-validation) between their compounds. The proposed approach leads to a revision of the neuroscientific and psychological terms, methods and data, followed by a revision of their relative interplay. This would make possible a practical exchange of expensive but objective fMRI with the lower costing psychological instruments (effect of "minimization"). The approaches proceeding from VT will infiltrate diagnostics and prevention in psychiatry. On a further stage the pharmaco-psychological monitoring will uncover new opportunities. This proofs' based research and practice represents an integral counterpart of the values-based mental health care. In conclusion VT is an evolutionary corner stone in order to traverse the stage of a Brain-Brain paradigm and to reach the point of development of the Mind-Brain paradigm. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs (...) written by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

Abstract: At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a cer- tain extent, for diagnosis, is the DSM, now at its fifth edition. The main rea- sons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative fail- ure of the project of finding biomarkers for most mental disorders. Descrip- (...) tivism has also the advantage of capturing the phenomenology of mental dis- orders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descrip- tive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, in the context (...) of decisional capacity assessments, the difficulties to reconcile 1) and 2) with 3) which they at the same time seem to imply. Having clarified the centrality of a cogent notion of mental disorder for addressing these difficulties, I comment on three promising lines of inquiry about the nature and scope of autonomy that emerge from the following chapters. (shrink)

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of (...) class='Hi'>mental disorders. I articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry. (shrink)

What we call today negative symptoms are thought to descend from the very deficits that the earliest scholars of schizophrenia (such as Kraepelin and Bleuler) considered to be the key, fundamental symptoms of the disorder. In the latter half of the 20th century, delusions and hallucinations received greater prominence, which eventually changed both the concept of schizophrenia and its diagnostic criteria by placing positive symptoms at the forefront. The first decade of the 21st century witnessed a resurgence of interest in (...) negative symptoms of schizophrenia. Persistent and clinically significant negative symptoms were declared an unmet therapeutic need in a large proportion of cases by several schizophrenia experts, who, with the support of the NIMH, held a consensus development conference in 2005 to discuss negative symptoms and how to proceed in this area. The Consensus Statement read that improved recognition and awareness of negative symptoms are the fi rst step to improving function in patients with negative symptoms of schizophrenia. According to the principles of Values-Based Practice that also means improving recognition and awareness of the diverse values involved in the conceptualization and practical assessment of negative symptoms. By analyzing selected conceptual papers on negative symptoms, instruments developed for the assessment of this area of psychopathology, and clinical vignettes, we intend to point out some values-related issues in the diagnosis of negative symptoms as well as to make the case that these symptoms may be a particularly complex aspect of schizophrenia, vis-à- vis understanding the role played by values. (shrink)

This paper explores the enduring impact of Cartesian dualism on the formulation of autism diagnosis and its subsequent implications for our contemporary understanding of the condition. It presents a concise historical overview tracing the evolution of autism diagnosis through the lenses of two traditional reductionist paradigms: a psychological framework (emphasizing it as a mental disorder) and a biological framework (viewing it as a neurological dysfunction). However, the paper argues for a revised perspective that transcends the limitations inherent in both (...) conventional viewpoints and challenges the Cartesian dichotomy between the physical and the mental realms. Instead, it proposes an instrumentalist conception of mental phenomena. This conceptual shift is motivated by the ethical imperative of affording autistic individuals a more dignified and inclusive standing within society, one that acknowledges their moral value. (shrink)

This chapter identifies and explores a series of challenges raised by the clinical concept of delusion for theories which conceive autonomy as an agency rather than a status concept. The first challenge is to address the autonomy-impairing nature of delusions consistently with their role as grounds for full legal and ethical excuse, on the one hand, and psychopathological significance as key symptoms of psychoses, on the other. The second challenge is to take into account the full logical range of delusions, (...) which may take the form of true or false factual beliefs, positive or negative evaluations, as well as the paradoxical delusion of mental illness. The third and final challenge is to make room for non-pathological or, autonomy-preserving delusions and to offer a credible way of distinguishing between these and pathological or, autonomy-impairing delusions. By setting out these challenges, we are able to, firstly, distinguish between two separate conceptions of objectivity that may be at work in existing accounts of delusions and, secondly, to put a spotlight on an elusive yet inescapable notion of agential success that underlies our thinking about autonomy as well as mental disorder. (shrink)

● Any given placement (e.g. Sun in Taurus; Mars in Capricorn; Mercury in the third house) is necessarily common to tens of thousands of people. Saturn in the ninth house, for example, will not behave the same or produce the same effects in the twenty or one hundred charts in which we find it there. In each case Saturn will behave in accordance with the rest of the astrographic/chart composition (as if we stayed in the same hotel in different epochs (...) or different people contracted the same disease; our stay will be different each time, according to the epoch, and each person’s symptoms will too, be different, according to their individual biochemistry; not to mention that each chart or astrography, like each genetic code or sequence, is unrepeatable). Certainly, “no planet can produce, on its own, what only the combined or concerted action of all can” (BUSTAMANTE, 2023, SPICA magazine, pp. 93-111). Hence the synergistic nature of the interpretative exercise (i.e., the whole is greater than all its parts). The fundamental component of the mathematical expression of the interpretive exercise is: astrological triangulation, the functional denomination for what we know as synthesis (WEISS, 1946; LEO, 1983, HAND, 1981). In order to demonstrate its usefulness, as well as the convenience of its mathematical expression, we have chosen two individuals (JEFFREY DAHMER, STEVEN SPIELBERG) whose astrographies do not—according to the community—explain their lives. The rest of the astrographies correspond to those of serial killers JOHN WAYNE GACY, DAVID CARPENTER, and TED BUNDY. ● We explain, by means of algebraic notations, the synthesis and the functional values that make up the synthesis. ● We take the Moon and Neptune as relevant bodies for the purpose of diagnosing or studying endocrine or neurohormonal issues, and Mars, Pluto, and Saturn as relevant planets for the purpose of inferring violence or sinister behaviour, upon the case, and quadratures or oppositions—and conjunctions—between Venus and the Moon, the Moon and Neptune, and the Sun or Venus and Neptune or Uranus as indicators of neurohormonal disorders and/or sexual deviance (APA definition) . ● We consider quadratures (90º) or oppositions (180º)—and conjunctions—between Mercury or the Moon and Saturn, or between Mars or the Moon and Saturn, Uranus, Neptune, and/or Pluto as powerful indications of violence or mental disorders, upon the case. ● We have also regarded Sagittarius as a sign as expansive and abundant as its ruler, Jupiter, according to the best of its characterisations (or as an exceptionally swift and wild sign, according to other characterisations), and the fifth region of a natal chart as one closely related to fortune in a broad sense (material and immaterial). ● Because we advocate the idea that orbs should be predicated of the planet (size, speed), not the aspect itself, the gas giants (Jupiter, Saturn, Uranus, and Neptune) and the Sun have been granted up to 10º of orb (or 12º, in the case of broad influence ). We understand aspectual relationships as angular relationships held between two or more celestial bodies placed in signs with at least one property in common (according to our molecular theory of the ecliptic, compatible with the optical theory of the aspects from the Hellenistic tradition). (shrink)

John Searle has argued that functions owe their existence to the value that we put into life and survival. In this paper, I will provide a critique of Searle’s argument concerning the ontology of functions. I rely on a standard analysis of functional predicates as relating not only a biological entity, an activity that constitutes the function of this entity and a type of system but also a goal state. A functional attribution without specification of such a goal state has (...) no truth-value. But if completed with a goal state, functional attributions understood as four-place relations attain a truth-value. The truth conditions of all attributions of function involve a dependence claim of the goal state on the function bearer’s activity. The nature of this dependence may differ; I consider five different possibilities: causality, mechanistic constitution, mereology, supervenience and metaphysical grounding. If these dependency relations are objective, Searle’s central ontological thesis fails. What he ought to have said is that our valuing survival or other goal states may be the reason why biology seeks functional knowledge, but this has nothing to do with ontology. I will show further that Searle also raised an interesting challenge concerning the relationship of functional and causal truths, but it does not threaten the objectivity of functions either. At best, it could show that functional vocabulary is eliminable. However, I will show that functional vocabulary is not so eliminable. (shrink)

Approaching mental health on a global scale with particular reference to low- and mid-income countries raises issues concerning the disregard of the local context and values and the imposition of values characteristic of the Global North. Seeking a philosophical viewpoint to surmount these problems, the present paper argues for a value-laden framework for psychiatry with the specific incorporation of value pluralism, particularly in relation to the Global South context, while also emphasizing personal values such as the choice of treatment. (...) In sketching out this framework, the paper aims to overcome the clash between universalism and relativism about psychiatric categories by focusing on how overlaps between cultures can contribute to ontology-building. A case study analyzing ethnopsychiatric research in the context of South India will illustrate the proposed view, while also pointing out avenues for further research on the causal efficacy of local shared beliefs about mental disorder. If approaches across different traditions and theoretical frames are shown to work in treating similar ailments, causal connections appear to cut across the different ontologies. Ethnopsychiatry would play a central role in such research, namely in disclosing the variables and mechanisms at work within the local approaches. (shrink)

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in (...) such a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

I clarify some of the details of the modal theory of function I outlined in Nanay (2010): (a) I explicate what it means that the function of a token biological trait is fixed by modal facts; (b) I address an objection to my trait type individuation argument against etiological function and (c) I examine the consequences of replacing the etiological theory of function with a modal theory for the prospects of using the concept of biological function to explain mental (...) content. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

No two individuals with the autism diagnosis are ever the same—yet many practitioners and parents can recognize signs of ASD very rapidly with the naked eye. What, then, is this phenotype of autism that shows itself across such distinct clinical presentations and heterogeneous developments? The “signs” seem notoriously slippery and resistant to the behavioral threshold categories that make up current assessment tools. Part of the problem is that cognitive and behavioral “abilities” typically are theorized as high-level disembodied and modular functions—that (...) are assessed discretely (impaired, normal, enhanced) to define a spectral syndrome. Even as biology reminds us that organic developing bodies are not made up of independent switches, we remain often seduced by the simplicity of mechanistic and cognitive models. Developmental disorders such as autism have accordingly been theorized as due to different modular dysfunctions—typically of cortical origin, i.e., failures of “theory of mind” (Baron-Cohen et al., 1985), of the “mirror neuron system” (Ramachandran and Oberman, 2006), of “weak central coherence” (Happe and Frith, 2006) or of the balance of “empathizing” and “systemizing” (Baron-Cohen, 2009), just to list a few. -/- The broad array of autonomic (Ming et al., 2005; Cheshire, 2012) and sensorimotor (Damasio and Maurer, 1978; Maurer and Damasio, 1982; Donnellan and Leary, 1995; Leary and Hill, 1996; Donnellan and Leary, 2012; Donnellan et al., 2012) differences experienced and reported by people with autism have by such theories typically been sidelined as “co-morbidities,” possibly sharing genetic causes, but rendered as incidental and decisively behaviorally irrelevant symptoms—surely disconnected from cognition. But what if the development of cortically based mental processes and autonomous control relies on the complexities and proper function of the peripheral nervous systems? Through such an “embodied” lens the heterogeneous symptoms of autism invites new interpretations. We propose here that many behavioral-level findings can be re-defined as downstream effects of how developing nervous systems attempt to cope and adapt to the challenges of having various noisy, unpredictable, and unreliable peripheral inputs. (shrink)

In a recent study, we found a negative association between psychopathy and violence against genetic relatives. We interpreted this result as a form of nepotism and argued that it failed to support the hypothesis that psychopathy is a mental disorder, suggesting instead that it supports the hypothesis that psychopathy is an evolved life history strategy. This interpretation and subsequent arguments have been challenged in a number of ways. Here, we identify several misunderstandings regarding the harmful dysfunction definition of (...) class='Hi'>mental disorder as it applies to psychopathy and regarding the meaning of nepotism. Furthermore, we examine the evidence provided by our critics that psychopathy is associated with other disorders, and we offer a comment on their alternative model of psychopathy. We conclude that there remains little evidence that psychopathy is the product of dysfunctional mechanisms. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

Mind, according to cognitive neuroscience, is a set of brain functions. But, unlike sets, our minds are cohesive. Moreover, unlike the structureless elements of sets, the contents of our minds are structured. Mutual relations between the mental contents endow the mind its structure. Here we characterize the structural essence and the logical form of the mind by focusing on thinking. Examination of the relations between concepts, propositions, and syllogisms involved in thinking revealed the reflexive graph structure of the conceptual (...) mind. Objective logic of the conceptual mind is calculated from its structure. Noteworthy features of the logic of conceptual mind are: degrees of truth, varieties of negation, admission of contradiction, and the failure of a de Morgan's law. Furthermore, cohesion of the conceptual mind follows from its reflexive graph structure. Our characterization of the structure and logic of mind constitutes a substantial refinement of the contemporary cognitive neuroscientific conceptualization of the mind as a set. (shrink)

Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. This is (...) illustrated by showing how life-history theory clarifies the status of so-called diseases of old age. The selected effect account of function deserves a more prominent place in the philosophy of medicine than it currently occupies. _1_ Introduction _2_ Biostatistical and Selected Effect Accounts of Function _3_ Objections to the Selected Effect Account _3.1_ Boorse _3.2_ Kingma _3.3_ Hausman _3.4_ Murphy and Woolfolk _4_ Problems for the Biostatistical Account _4.1_ Schwartz _5_ Analysis versus Explication _6_ Explicating Dysfunction: Life History Theory and Senescence _7_ Conclusion. (shrink)

One way in which bioethicists can benefit the medical community is by clarifying the concept of disorder. Since insurance companies refer to the DSM for whether a patient should receive assistance, one must consider the consequences of one’s concept of disorder for who should be provided with care. I offer a refinement of Jerome Wakefield’s hybrid concept of disorder, the harmful dysfunction analysis. I criticize both the factual component and the value component of Wakefield’s account and suggest how they might (...) be improved. I propose that the factual component should be statistical variation analyzed in multilevel and chronological compilations of physiological data. I propose that the value component should prioritize the individual’s authority regarding the experience of suffering from a physiological condition. My account preserves the insight of using a factual and a value component while avoiding the problems that Wakefield’s original account faces. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

In this paper, I discuss the question whether objective criteria could be provided for judging something to be a mental illness. I consider the two most prominent objectivist or naturalistic accounts of mental illness, evolutionary and bio-statistical account, which offer such a criterion by relying on the notion of biological function. According to such suggestions, illness is a condition in which there is dysfunciton in some feature of an organism. In this context, I consider different accounts for ascribing (...) functions in biologyand their relationship with the suggested accounts of illnesses. Special focus is placed on the objections according to which the ascription of functions, as envisaged in naturalistic accounts of illness, is incompatible with actual medical and psychiatric practice. I conclude that these objections are legitimate insofar we want to an account of illness that preserves the current practice of ascribing illness. However, the question remains, could a theory that tries to capture the actual medical practice be value-neutral, since our ordinary conception of illness is permeated with value judgments that indirectly enter into medical practice. In that respect, it seems that the requirement for pure objectivity is too strong and thus, it is not reasonable to expect that naturalistic accounts can satisfy it. (shrink)

Does a diagnosis of brain dysfunction matter for ascriptions of moral responsibility? This chapter argues that, while knowledge of brain pathology can inform judgments of moral responsibility, its evidential value is currently limited for a number of practical and theoretical reasons. These include the problem of establishing causation from correlational data, drawing inferences about individuals from group data, and the reliance of the interpretation of brain findings on well-established psychological findings. Brain disorders sometimes matter for moral responsibility, however, because they (...) change an individual’s moral psychology in a way that is beyond their control. While control over psychological changes is not an excusing factor, brain disorders can mitigate moral responsibility because they confront individuals with new psychological deficits or urges for which their previous moral education and existing external and internal moral resources have not prepared them. (shrink)

Background. The literature on Theory of Mind (ToM) in antisocial samples is limited despite evidence that the neural substrates of theory of mind task involve the same circuits implicated in the pathogenesis of antisocial behaviour. Method. Eighty-nine male DSM-IV Antisocial Personality Disordered subjects (ASPDs) and 20 controls (matched for age and IQ) completed a battery of ToM tasks. The ASPD group was categorized into psychopathic and non-psychopathic groups based on a cut-off score of 18 on the Psychopathy Checklist: Screening Version. (...) Results. There were no significant group (control v. psychopath v. non-psychopathic ASPD) dif- ferences on basic tests of ToM but both psychopathic and non-psychopathic ASPDs performed worse on subtle tests of mentalizing ability (faux pas tasks). ASPDs can detect and understand faux pas, but show an indifference to the impact of faux pas. On the face/eye task non-psychopathic ASPDs showed impairments in the recognition of basic emotions compared with controls and psychopathic ASPDs. For complex emotions, no significant group differences were detected largely due to task difficulty. Conclusions. The deficits in mentalizing ability in ASPD are subtle. For the majority of criminals with ASPD and psychopathy ToM abilities are relatively intact and may have an adaptive function in maintaining a criminal lifestyle. Our findings suggest the key deficits appear to relate more to their lack of concern about the impact on potential victims than the inability to take a victim perspective. The findings tentatively also suggest that ASPDs with neurotic features may be more impaired in mentalizing ability than their low anxious psychopathic counterparts. (shrink)

Counterfactual thinking—the capacity to reflect on what would, could, or should have been if events had transpired differently—is a pervasive, yet seemingly paradoxical human tendency. On the one hand, counterfactual thoughts can be comforting and inspiring (Carroll & Shepperd, Chapter 28), but on the other they can be anxiety provoking and depressing (Zeelenberg & Pieters, Chapter 27). Likewise, such thoughts can illuminate pathways toward better future outcomes (Wong, Galinsky, & Kray, Chapter 11), yet they can also promote confusion and lead (...) us astray (Sanna, Schwarz, & Kennedy, Chapter 13). The first part of this chapter focuses on work that supports the prevailing Zeitgeist in the counterfactual thinking literature: Counterfactual thinking is beneficial. The second part of the chapter, however, strikes a more cautionary tone by reviewing work that describes some deleterious consequences of counterfactual thinking. We conclude by offering a tentative reconciliation of these conflicting perspectives and suggesting directions for future research. (shrink)

So far, the value dimension underlying affectivity disorders has remained out of focus in phenomenological psychopathology. As early as at the beginning of the 20th century, however, German phenomenologist Max Scheler examined in depth the relationship between affectivity and value dimension through the concept of valueception (Wertnehmung). In this sense, a recent noteworthy contribution has been provided by John Cutting, who has drawn attention to the importance of Scheler’s analyses for psychiatry. In this work I take into consideration only two (...) aspects of Cutting’s proposal: 1) the relationship between the impairments of valueception and the perception of certain value classes; and 2) the interpretation of Scheler’s phenomenological reduction and its juxtaposition with the modus vivendi of schizophrenia. According to Cutting, in the modus vivendi of schizophrenia the valueception impairment entails putting vital values in brackets and focusing on personal values, with a process that recalls Scheler’s phenomenological reduction. Regarding the first aspect, I share Cutting’s starting point, but then shift the focus on how important the valueception is for the intersubjective dimension. In particular, I maintain that rather than compromising the perception of vital values, valueception impairments in the modus vivendi of schizophrenia interfere with the intersubjective dimension and are interwoven with a process of disembodiment. My thesis is that the modus vivendi of schizophrenia involves a disturbance of the intersubjective dimension that arises from the level of valueception and that determines the person’s self-referential closure. With regard to the second point, by analyzing Scheler’s phenomenological reduction, I sustain that its main objective is to increase both the interaction with otherness and the openness to the world (Weltoffenheit). As a consequence, the modus vivendi of schizophrenia, in my opinion, is not comparable, as Cutting claims, with Scheler’s phenomenological reduction, but goes in a different direction. (shrink)