Though the divide between reason-based and causal-explanatory approaches in psychiatry and psychopathology is old and deeply rooted, current trends involving multi-factorial explanatory models and evidence-based approaches to interpersonal psychotherapy, show that it has already been implicitly bridged. These trends require a philosophical reconsideration of how reasons can be causes. This paper contributes to that trajectory by arguing that Donald Davidson’s classic paradigm of 1963 is still a valid option.

Tomasi, D. 2024. Psychotherapy: Essence, Experience, and Examination. Foreword to Adler, D. 2024. What we really need – Experiences of a psychoanalyst. New York, NY: Ibidem Verlag / Columbia University Press, Original: Adler, D. 2023. Was wir wirklich brauchen: Erfahrungen eines Psychoanalytikers. Stuttgart, D: Schattauer / Klett-Cotta Verlag -/- Psychotherapy: Essence, Experience, and Examination Foreword to Dieter Adler: What we Truly Need – Experiences of a Psychoanalyst. -/- In any serious, scientific, and ethically justified healthcare profession, the focus (...) should be always on the overall health, treatment, improvement, and amelioration of the patient. What clinical and professional background should therefore a mental health professional have? In his book, Adler does not want to simply offer a quick guide to self-help. In fact, he is clear about the fact that this is not the purpose of the book: “Maybe I’ll write one sometime: How you can reliably become independent of self-help books.” In fact, this book is a reflection on a 30-year-long professional career in which the author has learned to ask questions, to listen attentively, and to help shed light on some of the most complex and hidden aspects of what makes us human. To be sure, this does not mean that this book does not present a practical approach to well-being, quite the contrary. The author lists a series of areas the patient can focus on, in order to achieve a higher state of balance, healing, and happiness. Amongst these we find socialization, upbringing, and community, making friends, understanding and working on one’s emotions and the emotions of others, staying physically and mentally active, finding a sense of security and confidence, maintaining a sense of curiosity, finding a work-life balance and rediscovering peace and calmness, having goals, purposes, and meaning in life, and of course, understanding those negative, self-sabotaging mechanisms and processes which hinder such developments. (shrink)

Thomas Szasz famously argued that mental illness is a myth. Less famously, Szasz argued that since mental illness is a myth, so too is psychotherapy. Szasz’ claim that mental illness is a myth has been much discussed, but much less attention has been paid to his claim that psychotherapy is a myth. In the first part of this essay, I critically examine Szasz’ discussion of psychotherapy in order to uncover the strongest version of his case for thinking (...) that it is a myth. As we’ll see, this involves an understanding of psychotherapeutic interventions as treatments of psychopathological problems. In the rest of this essay, I turn to this directly and argue that psychotherapy has an important non-pathocentric dimension. I argue that we fail to appreciate the nature and variety of psychotherapy if we concentrate only on its pathocentric dimensions. Though I use Szasz as a stalking horse, the substantive topic is the nature of psychotherapy. This enquiry falls into the philosophy of psychotherapy as distinct from the philosophy of psychiatry and the philosophy of psychoanalysis. (shrink)

Psychotherapy is effective. Since the 1970’s, meta-analyses, and meta-analyses of meta-analyses, have consistently shown a significant effect size for psychotherapeutic interventions when compared to no treatment or placebo treatments. This effectiveness is normally taken as a sign of the scientific legitimization of clinical psychotherapy. A significant problem, however, is that most psychotherapies appear to be equally effective. This poses a problem for specific psychotherapies: they may work, but likely not for the reasons that ground their theoretical explanations for (...) their effectiveness. A prominent explanation for the findings of common efficacy in psychotherapy is to postulate that all successful therapies work by altering maladaptive meanings and providing patients with new, more adaptive meanings. This paper argues that the ‘meaning view’ of psychological change is likely mistaken; psychological problems are not normally problems of meaning nor are they directly ameliorated by changes in meaning. This paper then outlines a skill-based explanation for the findings of the common efficacy of psychotherapy. (shrink)

This is a paper on the philosophical clinical psychology of PTSD. How best to improve our treatment plans for the disorder is the primary imperative in the clinical literature. Our failure to properly treat those suffering from PTSD up until now could be either the result of merely a problem in practice or, more seriously, a problem in principle. In this essay, I explore three possible accounts consistent with the supposition that what we have here is a problem in principle. (...) I call the first the “Somatic” hypothesis; the second, the “Memorial”; and the third, a “Rilkean” hypothesis of PTSD, which is inspired by the recent work of M. Rowlands. The first two have been more-or-less articulated previously; the third is introduced here for the first time. The primary argument of this essay is abductive: I argue in favor of a Rilkean Memory hypothesis of PTSD by comparing it to the other two accounts and showing that it possesses greater theoretical virtue than they do. I then conclude the essay by noting certain limitations with the account here sketched, nonetheless suggesting that this hypothesis can open up new avenues of clinical research and treatment options for the disorder. (shrink)

It’s a common assumption in psychiatry and psychotherapy that mental health conditions are marked out by some form of epistemic irrationality. With respect to obsessive-compulsive disorder (OCD), the mainstream view is that OCD causes irrational beliefs. Recently, however, this ‘doxastic view’ has been criticized from a theoretical and empirical perspective. Instead a more promising ‘zetetic view’ has been proposed which locates the epistemic irrationality of OCD not in irrational beliefs, but in the senseless inquiries it prompts. Yet, in (...) this paper I present a special class of cases—sexual obsessive-compulsive disorder (S-OCD)—which cannot be explained by existing doxastic and zetetic accounts of the epistemic irrationality of OCD. In addition, some people with S-OCD appear to be adhering too well to a plausible set of norms for inquiry. Their suffering seems to be partially caused by an excess of rationality, and not a lack thereof. They seem, if anything, too rational. This shows firstly that it’s unlikely that there is one form of epistemic irrationality common to all persons living with OCD. Secondly, it should lead us to rethink the epistemic categories we use in classifying mental health conditions such as OCD. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to (...) developing CAI systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

Psychedelic-Assisted Psychotherapy is being investigated as a treatment for a range of psychiatric illnesses. Current research suggests that the kinds of subjective experiences induced by psychedelic compounds play key roles in producing therapeutic outcomes. To date, most knowledge of therapeutic psychedelic experiences are derived from psychometric assessments with scales such as the Mystical Experience Questionnaire. While these approaches are insightful, more nuanced and detailed descriptions of psychedelic-induced changes to subjective experience are required. Drawing on recent advancements in qualitative methods (...) arising from the interdisciplinary field of phenomenological psychopathology, we propose a systematic and comprehensive investigation into how Psychedelic-Assisted Psychotherapy alters subjective experience. This research program aims to characterise the nature of therapeutic psychedelic experiences by drawing on concepts from philosophical phenomenology. Such characterisations should, moreover, contribute to our understanding of the mechanisms of psychedelic therapy, the role of integration therapy, and related philosophical debates. (shrink)

Background: The complexity of diagnostic presentations of an inpatient psychiatry population requires an integrative approach to health and well-being. In this sense, the primary need of this research aims at developing clinical strategies and healthier coping skills for anger, anxiety, and depression; promoting self-esteem, healthier sleep, and anxiety reduction; as well as enhancing mood and emotional–behavioral regulation via exercise and nutrition education. Objectives: The primary objective is to promote exercise, fitness, and physical health in inpatient psychiatry patients. The (...) secondary objective includes therapeutic management of depressive symptoms and patient-centered approach to mania, angry outbursts, and generalized disruptive behavior. The tertiary objective is promoting research in the psychophysiological effectors of exercise and nutrition education in combination with psychotherapy. Method: Monitoring self-reported changes in mood and general well-being via administration of surveys and questionnaires pre- and postexercise sessions. Results: The research yielded positive outcomes in all areas investigated, suggesting the positive effects of exercise and mind–body strategies in the context of psychotherapy in inpatient psychiatry. Conclusion: Physical exercise may be a helpful way to reduce mental health disorders in the context of inpatient psychiatry by targeting anxiety, depression, anger, psychomotor agitation, and muscle tension and addressing stressors and triggers and to develop a more balanced and integrated sense of self. (shrink)

This paper deals with a classical issue that remains at the core of the contemporary philosophical debate: the fact that the meaning of life is interlaced—in both negative and positive ways, with respect to morality—with happiness. On some historical conceptions, individual happiness must be sacrificed for the moral (universal, objective) good of a life, where the good fundamentally coincides with the meaning of life. On other approaches, happiness and flourishing (where flourishing is understood in terms of life’s meaningfulness) consist in (...) good action and a good life. On still other views, happiness, while equated with the meaning of life, is reduced to mere pleasure, to a sensorial state that can be influenced by outside forces. In the current literature, the prevailing interpretations of this question are largely deontological, eudaimonic or hedonic in character. Moving from the Schelerian theory of the stratification of the emotional life, and emphasizing the affective side of this broadly ethical question, this paper intends to examine this issue through the lens of phenomenology. From this perspective, the connection between happiness and the meaning not only of life but also of existence can be understood in light of what appears to underlie both phenomena: the entire existence of the individual, which is revealed most clearly in an act of personal love. Since this paper considers the condition humaine in all its complexity, that is to say, even in its fragility and vulnerability, within this framework I will also consider possible abnormal manifestations of happiness. Following Rümke’s clinical observations of pathological frameworks in which the feeling of happiness manifests itself, this paper shows how the deepest feeling of happiness, understood as a Schelerian personality feeling, can remain untouched by pathology. In his classic (but largely unappreciated) enquiry into the happiness syndrome, Rümke engages in a fruitful dialogue with Scheler, whose theory of the stratification of emotional life plays a crucial role in the former’s study of the phenomenology and the clinical aspects of happiness. Not only is Rümke’s Zur Phänomenologie und Klinik des Glücksgefühls an excellent example of applied phenomenology, but it also confirms the results of Scheler’s research on affective life. (shrink)

The psychedelic renaissance did not emerge from a void. While a tremendous upswell of interest in psychedelics can be observed today, there is scant acknowledgment of the current spiritual crisis that has led to this burgeoning enthusiasm. Having lost our sense of the sacred, we have—with disastrous consequences—become alienated from ourselves, others, and the natural environment. Secular psychotherapy and psychiatry have failed to address the myriad mental health problems that are prevalent right now, which has compelled people to (...) desperately look for alternatives to fill the void in their lives. Sacred medicines have been used for millennia in humanity’s traditional cultures as part of their spiritual practices. Now that psychedelic-assisted psychotherapy (PAT) is being developed, we must avoid repeating the mistakes of modern psychology, which misguidedly seeks to situate entheogenic therapy on a desacralized foundation of materialism, reductionism, and scientism. Nevertheless, although the full benefit of entheogens can likely be gained only in the context of a sacred tradition, they may still have some measure of therapeutic value even when used in conjunction with secular psychotherapy. This article examines the metaphysical foundations of sacred psychology and argues that entheogenic therapy needs to be grounded on the same basis. The framework employed here is a “transpersonal” perspective that applies the insights found in the world’s great wisdom traditions. It will be argued that the adoption of psychedelics in mental health treatment presupposes a fully integrated psychotherapy that is possible only when it is rooted in a spiritually informed ontology. (shrink)

Martin Heidegger (1889–1976) is one of the most influential philosophers of the twentieth century. His influence, however, extends beyond philosophy. His account of Dasein, or human existence, permeates the human and social sciences, including nursing, psychiatry, psychology, sociology, anthropology, and artificial intelligence. In this chapter, I outline Heidegger’s influence on psychiatry and psychology, focusing especially on his relationships with the Swiss psychiatrists Ludwig Binswanger and Medard Boss. The first section outlines Heidegger’s early life and work, up to and (...) including the publication of Being and Time, in which he develops his famous concept of being-in-the-world. The second section focuses on Heidegger’s initial influence on psychiatry via Binswanger’s founding of Daseinsanalysis, a Heideggerian approach to psychopathology and psychotherapy. The third section turns to Heidegger’s relationship with Boss, including Heidegger’s rejection of Binswanger’s Daseinsanalysis and his lectures at Boss’s home in Zollikon, Switzerland. (shrink)

This brief essay examines the basic parameters of the neuroscientific and philosophical understanding at the basis of emotional and cognitive processes in the broader context of Embodied cognition. More in detail, the discussion follows a series of areas of investigation, structured via responses to basic questions, namely: A) Impact of mind-body dualism in everyday life, B) Possible Preferred Perspective (PPP) under the lenses of Emotional Intelligence, C) Simulation-Theory vs. Theory-Theory D) Neuropsychological paired-deficits vs. Physiological Investigations E) Influence of social distancing (...) on the ability to recognize and understand emotions F) Conclusion. (shrink)

Different cultures show different understandings of consciousness, soul, and spirit. Native indigenous traditions have recently seen a resurgence of interest and are being used in psychotherapy, mental health counselling, and psychiatry. The main aim of this review is to explore and summarize the native indigenous concepts of consciousness, soul, and spirit. Following a systematic review search, the peer-reviewed literature presenting research from 55 different cultural groups across regions of the world was retrieved. Information relating to native concepts of (...) consciousness, soul, and spirit were excerpted from the sources and contrasted. Contrasting these indigenous concepts revealed important implications for understanding consciousness within a cross-cultural perspective and has practical implications for applied approaches utilizing native indigenous traditions. (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)

Empirical assessments of Cognitive Behavioral Theory and theoretical considerations raise questions about the fundamental theoretical tenet that psychological disturbances are mediated by consciously accessible cognitive structures. This paper considers this situation in light of emotion theory in philosophy. We argue that the “perceptual theory” of emotions, which underlines the parallels between emotions and sensory perceptions, suggests a conception of cognitive mediation that can accommodate the observed empirical anomalies and one that is consistent with the dual-processing models dominant in cognitive psychology.

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in (...) mental health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy. (shrink)

Hundreds of evaluative studies of psychotherapy still leave the issue of its effectiveness unsettled. The author argues that such studies have ignored the major determinant of therapeutic effectiveness, the role of a patient’s belief in the successful outcome in therapy. Psychiatrist Thomas Szasz, one of the foremost critics of psychiatry, wrote of this paper: "It is one of the best, if not the best, that I have read on this subject.” It makes little sense to claim that a (...) certain therapy is effective or ineffective in itself; rather, there is a relation of mutual interaction among three terms: a patient’s ability to learn in a psychological context, a therapist’s ability to teach, and the capacity of an approach to therapy to engender in the patient the necessary belief in its effectiveness. -/- The paper is followed by a 4-page 2014 Afterword. (shrink)

This paper argues that psychoanalysis enables us to see mental disorder as rooted in emotional conflicts, particularly concerning aggression, to which our species has a natural liability. These can be traced in development, and seem rooted in both parent-offspring conflict and in-group cooperation for out-group conflict. In light of this we may hope that work in psychoanalysis and neuroscience will converge in indicating the most likely paths to a better neurobiological understanding of mental disorder.

A brief critical notice of Dan J Stein's new book _Problems of Living: Perspectives from Philosophy, Psychiatry, and Cognitive-Affective Science_.

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of (...) psychotherapy have a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

Das sinnvolle Leben ist nicht nur in der gegenwärtigen Philosophie wieder verstärkt ein Thema, sondern auch in Psychiatrie und Psychotherapie. Bereits seit langer Zeit jedoch spielt es eine zentrale Rolle in der Existenzanalyse und Logotherapie, die der Psychiater Viktor E. Frankl entwickelt hat. Frankls eigenständige Sinntheorie wird in der gegenwärtigen philosophischen Sinndebatte allerdings weitestgehend ignoriert. Das Ziel dieses Artikels ist es, diesen Zustand zu beenden und die heutige philosophische Sinndebatte mit Frankl ins Gespräch zu bringen. Einerseits geht es darum, Frankls (...) Sinntheorie im Lichte der philosophischen Sinndebatte zu verstehen und zu bewerten: Was für eine Art von Sinntheorie vertritt er? Wie ist sie einzuordnen? Wie steht es um ihre innere Kohärenz, die Plausibilität seiner sinntheoretischen Überzeugungen und die Qualität ihrer Begründung? Andererseits soll geprüft werden, inwiefern Frankls Ansatz die gegenwärtige philosophische Sinndiskussion voranbringen kann: Gibt es bei ihm theoretische Elemente, die in der Philosophie zu wenig Beachtung finden? Kann er der philosophischen Sinntheorie wichtige Impulse geben? Die Analyse folgt in ihrer Struktur wesentlichen Elementen der Frankl’schen Sinntheorie, von den grundlegenden formalen und metaethischen Aspekten hin zu inhaltlichen Bestimmungen des Sinns und dem individuellen Umgang mit ihm: Zunächst wird die zentrale Bedeutung des Sinns für das menschliche Leben thematisiert, dann Fragen nach der metaethischen Einordnung, nämlich nach der subjektivistischen oder objektivistischen Ausrichtung sowie der Rolle des Supernaturalismus. Dann stehen mit der Selbsttranszendenz und dem Wertebezug sowie den drei Wertkategorien wesentliche Elemente der Sinnkonstituierung im Fokus der Betrachtung. Die Ergebnisse werden im Schlusskapitel zusammengefasst. Es zeigt sich, dass der theoretische Austausch in beide Richtungen fruchtbar sein kann, Frankls Denken allerdings auch einige Hindernisse bereithält. Sein Ansatz entpuppt sich mit seinem objektivistischen Charakter und der zentralen Rolle von Selbsttranszendenz und Wertbezug als an die heutige Sinndiskussion gut anschlussfähig, seine oftmals fehlenden Begründungen hingegen als gravierender methodischer Makel, bei dem eine Orientierung an modernen philosophischen Standards wünschenswert wäre. Wiederholt entsteht der Eindruck, dass seine Sinntheorie maßgeblich durch sein praktisches, therapeutisches Interesse geprägt ist. Einigen seiner Theoreme wird das Potential zugesprochen, die philosophische Sinntheorie bereichern zu können: Das sind die Situativität und Individualität des Sinns sowie die Gegebenheit der Sinnmöglichkeiten und die Verantwortung für ihre Verwirklichung. (shrink)

Common mental health disorders are rising globally, creating a strain on public healthcare systems. This has led to a renewed interest in the role that digital technologies may have for improving mental health outcomes. One result of this interest is the development and use of artificial intelligence for assessing, diagnosing, and treating mental health issues, which we refer to as ‘digital psychiatry’. This article focuses on the increasing use of digital psychiatry outside of clinical settings, in the following (...) sectors: education, employment, financial services, social media, and the digital well-being industry. We analyse the ethical risks of deploying digital psychiatry in these sectors, emphasising key problems and opportunities for public health, and offer recommendations for protecting and promoting public health and well-being in information societies. (shrink)

In medicine, some personality traits, involving specific patterns of thought, feeling, and behavior, are considered to be pathological. Personality types, characteristic of such pervasive and maladaptive traits, are known under the term “personality disorders.” However, some of these pathological traits, diagnostic of so-called Cluster B personality disorders, largely describe immoral behavior. Hence, the question arises as to how such immoral behavior could be framed also as a medical problem. Moreover, it is not immediately clear whether persons with these disorders could (...) be held responsible for their immoral actions. By drawing on virtue ethics and the concept of responsibility without blame, the article demonstrates how the problem of compatibility between medicalization, cultivation of moral character, and responsibility could be resolved. Thereby, it is suggested that Cluster B personality disorders are best understood as both a moral and medical problem. (shrink)

Summary The article substantiates the possibility and meaningfulness of a coherent theoretical system for psychotherapy, as it is strived for in Gestalt Theoretical Psychotherapy and presented in several articles in this issue of the journal "Gestalt Theory". The necessity of consistency in the theoretical assumptions and concepts of a psychotherapy method is not derived from scientific considerations alone, but already arises from the elementary role of consistency in human life. This also results in the requirements for the (...) consistency of theoretical foundations of psychotherapy. It is not fulfilled in a mere internal, logical consistency of its models, but only in the actual fitting together with the critical-phenomenal and naive-phenomenal worlds of the therapists and their clients in the reality test of life. (shrink)

Review of the collection "Responsibility and Psychopathy: Interfacing Law, Psychiatry and Philosophy", edited by Luca Malatesti and John McMillan.

Most psychotherapeutic approaches are, to a greater or lesser extent, rooted in the theories and principles of scientific psychology. Nevertheless, in-session psychotherapeutic interaction between a therapist and a client is, at its core, a folk-psychological practice. As such, it is based on folk-psychological skills and competencies. But which ones exactly? This chapter argues that, while we may initially be inclined to perceive the practice of psychotherapy as primarily involving sophisticated mindreading on the part of both the therapist and the (...) client/patient, a complete characterization of psychotherapy must give at least the same amount of attention to different forms of therapeutic mindshaping. Using examples drawn from multiple therapeutic traditions, I illustrate how therapeutic mindreading and mindshaping interact. I conclude by highlighting some of the consequences of this perspective for the ethics and politics of psychotherapy. (shrink)

Mental health challenges can be described via the application of multiple lenses, from clinical-medical perspectives, to social and community-based, to further understandings in the context of public health. While these challenges can represent multiple issues to the scientific community at-large, especially because of the translational issues attached to the application of research and practice to the sphere of community services, it is useful to understand that the triad ethics, evidence, and experience can be instrumental in navigating the complexity of the (...) issue-at-hand. Furthermore, the work of researchers and practitioners is rooted in a solid understanding of the specific needs of psychiatric patients, particularly from the perspective of possible misunderstandings, ostracization, and stigmatization of psychiatric issues and related presentation, affect, and behaviours. Years of research have indicated how a proper interaction between resources at the level of scientific research and the community is a fundamental cornerstone for a practice rooted in both science and true care for individuals affected by mental health disorders. In this presentation we will discuss the case of the Centro Salute Mentale (Mental Health Centre, CSM) of Verona. (shrink)

DOI:10.20850/9781716645440 -/- An amazing exploration of the mind is now possible for everyone. With the Colors of The Sunrise, the first volume of the series The Psychotherapy of Whole: Aesthetics, Philosophy, Humanism, and Cognitive Science the reader has the opportunity to engage with a book that utilizes the methods and structure of self-help, popular science, and expressive therapies books. -/- Science, psychotherapy, philosophy, music, art and digital reality for the first time come together in a book phenomenon and (...) a series designed during 16 years to provide the first A.I Psychotherapy model internationally, focused on a profound study that has been evaluated by leading names from many of the areas analyzed around the world. -/- The book has been based on the background of advanced academic research, lending from the recent and updated investigations in an extraordinary number of areas. These include but are not limited to the disciplines of social sciences, psychiatry, philosophy, expressive art therapies, exact sciences, history, politics, artificial intelligence, and humanities that are presented from a global perspective. -/- Linguistics, neuroscience, anthropology, robotics, physics, and mathematics reconsidered as positive parts of the universal structures. It is explained the manner of uniting the cognition staying in perfect harmony with the today’s knowledge acquired by cognitive science, and the knowledge that traditionally contributes to the flourishing of the human mind through the philosophical approaches. -/- This manner discovered through the cutting-edge clinical and scientific study of the author. As a Licensed Social Worker and Cognitive Scientist, Anthony N. Skarvelakis devoted many years of professional investigation to reach a cognitive metaprogram as a model that expands human thought, giving the solution searched for years regarding the design of the first complete model of A.I Psychotherapy. (shrink)

Psychiatric language and concepts, and the norms they embed, have come to influence more and more areas of our daily lives. This has recently been described as a feature of the ‘psychiatrization of society.’ This paper looks at one aspect of psychiatrization that is still little studied in the literature: the psychiatrization of our emotional lives. The paper develops an extended account of emotion pathologizing as a form of affective injustice that is related to psychiatrization and that specifically harms psychopathologized (...) people, i.e., people who are socially perceived to be mentally ill. After introducing an initial account of emotion pathologizing as articulated in Pismenny et al. (2024), we extend the account by demonstrating how processes and practices of emotion pathologizing are informed by (1) the dominant biomedical approach to psychiatry and (2) sanism, a system of discrimination and oppression that disadvantages people who have received a psychiatric diagnosis, or are perceived as in need of psychiatric treatment. We then argue that emotion pathologizing can manifest as an affect-related hermeneutical injustice that disadvantages psychopathologized individuals by unfairly constraining how they make sense of and understand their own emotional experiences. (shrink)

In the monograph Philosophy and Psychedelics: Frameworks for Exceptional Experience, Hauskeller raises the important subject of individualization and alienation in psychedelic psychotherapy. Under the prevailing conditions of neoliberalism, Hauskeller contends that psychedelic-assisted psychotherapy appropriates Indigenous knowledges in an oppressive fashion, may be instrumentalised to the ends of productivity gain and symptom suppression, and may be utilised to mask societal systems of alienation. Whilst offering a valuable socio-political critique of psychedelics' clinical uptake, we suggest that Hauskeller's view does not (...) adequately acknowledge the ways in which psychedelics offer a challenge to the Western reductive bio-medical understanding of healing and wellbeing. It is contended herein that Indigenous knowledges, in alliance with a range of emerging sciences, offer both an engagement with ethnomedicines in a less harmfully appropriative fashion, and a renewed understanding of the means by which psychedelics achieve therapeutic change. With this understanding, what becomes apparent are the potential ways in which psychedelic medical usage may produce positive feedback upon the oppressive systems in which we are embedded. That is, transpersonal experience through encounters with the ineffable may offer a revisioning of Western psychology and cognitive science. Indeed, if psychedelics are approached with an understanding of the actual means by which they produce therapeutic outcomes—changing mental representations of the self, or self-insight derived through non-ordinary states of consciousness—then psychedelic psychotherapy offers a reimagining of psychiatric nosology, challenging conventional understandings of both pathology and wellbeing through an overturning of specified and discrete deficit models of psychopathology. This may provide both a critique of the prevailing categories used to describe madness and an expansion of our understanding of the mind-body relation, as well as an increased recognition of positive psychology grounded in cross-cultural contemplative traditions. This provides an implicit challenge to the pharmaceutical industrial-complex and its profit motives; and the corresponding neoliberalist, globalising tendencies which Hauskeller seeks to address. -/- . (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)

In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological process, but with a (...) range of different causal pathways, each involving complex interactions of various biological, psychological, and social factors. This paper explores the implications of causal heterogeneity for whether psychiatric diagnoses can be said to serve causal explanatory roles in clinical practice. I argue that while they may fall short of picking out a specific cause of the patient's symptoms, they can nonetheless supply different sorts of clinically relevant causal information. In particular, I suggest that some psychiatric diagnoses provide negative information that rules out certain causes, some provide approximate or disjunctive information about the range of possible causal processes, and some provide causal information about the relations between the symptoms themselves. (shrink)

It is often claimed in parts of the psychiatric literature that neuroscientific research into the biological basis of mental disorder undermines dualism in the philosophy of mind. This paper shows that such a claim does not apply to all forms of dualism. Focusing on Kenneth Kendler’s discussion of the mind–body problem in biological psychiatry, I argue that such criticism of dualism often conflates the psychological and phenomenal concepts of the mental. Moreover, it fails to acknowledge that there are different (...) varieties of dualism, and so overlooks the important metaphysical insights of contemporary dualist philosophers. I argue that while the neuroscientific research underpinning biological psychiatry challenges the traditional dualism of René Descartes, it does not pose any problem for the more modern dualism of David Chalmers. It is possible to take seriously the scientific claims of biological psychiatry while holding that this latter form of dualism is true. This has implications for the positioning of the mind–body problem in psychiatry. While the “easy” problem of explaining psychological processes is relevant to the aims of biological psychiatry, psychiatrists need not worry about the “hard” problem of consciousness. (shrink)

This dissertation is a contribution to the contemporary field of phenomenological psychopathology, or the phenomenological study of psychiatric disorders. The work proceeds with two major aims. The first is to show how a phenomenological approach can clarify and illuminate the nature of psychopathology—specifically those conditions typically labeled as major depressive disorder and bipolar disorder. The second is to show how engaging with psychopathological conditions can challenge and undermine many phenomenological presuppositions, especially phenomenology’s status as a transcendental philosophy and its corresponding (...) anti-naturalistic outlook. In the opening chapter, I articulate the three layers of the subject matter of phenomenological research—what I refer to as “existentials,” “modes,” and “prejudices.” As I argue, while each layer contributes to what we might call the “structure” of human existence, they do not do so in the same way, or to the same degree. Because phenomenological psychopathology—and applied phenomenology in general—aims to characterize how the structure of human existence can change and alter, it is paramount that these layers be adequately delineated and defined before investigating these changes. In chapters two through five, I conduct hermeneutic and phenomenological investigations of psychopathological phenomena typically labeled as major depressive disorder or bipolar disorder. These investigations address the affective aspects of depression and mania, and the embodied aspects of depression. In addition to clearly articulating the nature of these phenomena, I show how certain psychopathological conditions involve changes in the deepest or most fundamental layer of human existence—what I refer to as existentials. As I argue, many of the classical phenomenologists (including Husserl and Heidegger) believed that these structural features were necessary, unchanging, and universal. However, this presupposition is challenged through the examination of psychopathological and neuropathological conditions, undermining the status of phenomenology as a transcendental philosophy. While this challenge to classical phenomenology is only sketched in the early chapters, in chapters six and seven I develop it in more detail in order to achieve two distinct ends. In chapter six I argue that psychopathology and neuropathology not only challenge phenomenology’s status as a transcendental philosophy, but also supply a key to developing a phenomenological naturalism (which I contrast with a naturalized phenomenology). Phenomenological naturalism, as I articulate it, is a position in which phenomenology is not subsumed by the metaphysical and methodological framework of the natural sciences, but nonetheless maintains the capacity to investigate how the natural world stands independent of human subjectivity (and how events in the natural world can bring about changes in the most fundamental structures of human existence). In the seventh chapter I argue that a phenomenology in which existentials are contingent and variable rather than necessary and unchanging allows phenomenologists to contribute to new dimensional approaches to psychiatric classification. Rather than begin from distinct categories of disorder, these approaches begin from distinct core features of human existence. These features, referred to as either dimensions or constructs, can vary in degree and are studied in both normal and pathological forms. (shrink)

In this chapter, we explore how themes of existential philosophy have been used to develop a formal orientation of psychotherapy, and we discuss the main principles of existential psychotherapy and their application in practice. We also draw upon case examples to specifically illustrate how the approach of existential psychotherapy is utilized in clinical practice. In the case examples, each patient's identify has been disguised to maintain confidentiality. The new science of meaning, represented by the chapters in this (...) volume, not only offers therapists a deep conceptual framework within which to practice older, more established techniques but should also suggest new approaches. By recognizing the centrality of meaning as sense making and acknowledging the distinction between the what and the why of sense making, therapists should be armed with a variety of epistemic and teleological tools with which to fashion therapy strategies that are unique for each individual. (shrink)

Invited commentary on Nicole A. Vincent and Emma A. Jane, “Interrogating Incongruence: Conceptual and Normative Problems with ICD-11’s and DSM-5’s Diagnostic Categories for Transgender People” Australasian Philosophical Review, in press. -/- The core of Vincent and Jane’s Interrogating Incongruence is critical of the appeal to the concept of incongruence in DSM-5 and ICD-11 characterisations of trans people, a critique taken to be ground-clearing for more trans-positive, psychiatrically-infused medical interventions. I concur with Vincent and Jane’s ultimate goals but depart from the (...) view developed in the paper on two fronts. The first is that I remain sceptical about the overall prospects for truly trans-positive psychiatry. Trans should follow homosexuality and other categories of sexual orientation that have been abandoned rather than reformed as constituents of psychiatric diagnosis and categorisation. The second is that I think that the authors’ central criticisms of the appeal to incongruence are misplaced. (shrink)

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a (...) strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

This chapter examines the history of philosophy of psychology and philosophy of psychiatry as subfields of philosophy of science that emerged in the late twentieth and early twenty-first century. The chapter also surveys related literatures that developed in psychology and psychiatry. Philosophy of psychology (or philosophy of cognitive science) has been a well-established subfield of philosophy of mind since the 1990s and 2000s. This field of philosophy of psychology is narrowly focused on issues in cognitive psychology and cognitive (...) science. Compared to the thriving subfield of philosophy of cognitive science, there has been a lack of corresponding interest among philosophers of science in broader methodological questions about different paradigms and fields of study in psychology. These broader methodological questions about psychology have been addressed in the field of theoretical psychology, which is a subfield of psychology that materialized in the 1980s and 1990s. Philosophy of psychiatry emerged as a subfield of philosophy of science in the mid-2000s. Compared to philosophy of psychology, the philosophy of psychiatry literature in philosophy of science engaged with issues examined in an older and more interdisciplinary tradition of philosophy of psychiatry that developed after the 1960s. The participation of philosophers of science in the literature on theoretical psychology, by contrast, has been limited. (shrink)

A large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive diagnostic (...) categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual. (shrink)

Any progress in shaping up an externalist psychiatry, so previous discussion suggested, must begin from questions about the ontology of social causation. So far, research and theory have adhered to a naturalistic approach to the social causes of illness, concentrating mostly on the ‘social determinants of mental health’ (inequality, discrimination, housing insecurity, etc.). The paper starts with an assessment of ‘social determinants’ through the lens of epidemiology and critical psychiatry. It illustrates existing practical and political approaches that fight (...) these constraints and it highlights their therapeutic value. It argues, though, that a focus on social determinants is not sufficient for fully realizing externalism because a great portion of sociogenic illness remains causally indeterminate. Alongside political action, externalism requires a social etiology that is established by virtue of the meaning that it holds for patients, rather than by virtue of its capacity to identify objective social causes of illness. This entails abandoning naturalism about social causation and embracing constructivism. The paper shows that this methodological shift is less contradictory and more effective than it is commonly imagined. Drawing from further anthropological evidence, it concludes that only by lending support to projects that balance a focus on constraints with social construction will psychiatry be truly externalist. At stake is a prospect of effective treatment for sociogenic illness for the countless in struggle. (shrink)

Can psychiatry be read from an anthropological point of view? What is normal? What is pathological? Social order and pathos in question on this essay.

This chapter offers an interpretation of Jaspers’ distinction between explaining and understanding, which relates this distinction to that between general and singular causal claims. Put briefly, I suggest that when Jaspers talks about (mere) explanation, what he has in mind are general causal claims linking types of events. Understanding, by contrast, is concerned with singular causation in the psychological domain. Furthermore, I also suggest that Jaspers thinks that only understanding makes manifest what causation between one element of a person’s mental (...) life and another ultimately consists in – that is, the particular way in which one psychic event can emerge from or arise out of another. I contrast the resulting view both with a view on causation in psychiatry recently put forward by John Campbell, and also with another view that is the target of Campbell’s attack, which is due to Donald Davidson and Daniel Dennett. (shrink)

Abstract Recently, some philosophers of psychiatry (viz., Rachel Cooper and Dominic Murphy) have analyzed the issue of psychiatric classification. This paper expands upon these analyses and seeks to demonstrate that a consideration of the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM) can provide a rich and informative philosophical perspective for critically examining the issue of psychiatric classification. This case is intended to demonstrate the importance of history for philosophy of psychiatry, and more generally, the (...) potential benefits of historically-informed approaches to philosophy of science. (shrink)

Current health care standards, in many countries, Australia included, are regrettably poor. Surprisingly, practitioners and treating teams alike in mental health and disability sectors, in particular, make far too many basic care-related mistakes, in addition to the already abundant diagnostic mistakes that cause and amplify great harm. In part, too many practitioners also fail to distinguish adverse effects for what they are and all too often treat adverse effects, instead, as comorbidities. Diagnostic failures are dangerous, the result of which generates (...) and perpetuates harms that are extremely costly in terms of patient welfare, in addition to the financial burden placed on everyone. In this essay, I contend that the authority bestowed upon psychiatry is misplaced. Subsequently, this misplaced authority affects the governing and investigatory institutions reliant and informed by psychiatry. The examination process undertaken in this investigation traces the metaphysics of psychiatric disorders relative to the Diagnostic-Statistical-Manual (DSM) in all its iterations and to the epistemological construction process that serves to underpin the fundamentals of psychiatric practice. There exists a crisis of confidence in psychiatric practice and I urge drastic reform be undertaken to arrest the damage. (shrink)

The science of psychology is believed to consist of objective and meaningful knowledge about a realm of our own direct experiencing with which we are all intimate and familiar, yet about which we also feel we have very little understanding, and no real insight, and so feel inclined to submit to psychology as if it were revelatory and definitive. Society’s default attitude to psychology is one of deferential, if occasionally grudging, respect. The quasi-medical arm of psychology – psychotherapy - (...) is accorded a similar authority even when it appears to employ questionable methods and dubious reasoning. Yet our submissive, compliant attitude to these disciplines is deeply counterproductive to any serious quest for authentic metaphysical knowledge and self-fulfilment, because it effectively neutralises sceptical enquiry and intellectual self-reliance, both of which are essential precursors to, and indispensable features of, any meaningful commitment to metaphysical gnosis. And if one is to achieve clarity of thought and observational accuracy, it is especially important to approach one’s psychological capacities directly – without intermediary - in an independent and self-reliant spirit, free of the misguided and inappropriate interventions of psychology and psychotherapy, however well intended they might be. One should never allow one’s judgement to be distorted by specious theories formulated by people who can never know more about you than you can know about yourself. (shrink)

[This download contains the introductory chapter.] People confabulate when they make an ill-grounded claim that they honestly believe is true, for example in claiming to recall an event from their childhood that never actually happened. This interdisciplinary book brings together some of the leading thinkers on confabulation in neuroscience, psychiatry, psychology, and philosophy.