In this paper, we draw on developmental findings to provide a nuanced understanding of background emotions, particularly those in depression. We demonstrate how they reflect our basic proximity (feeling of interpersonal connectedness) to others and defend both a phenomenological and a functional claim. First, we substantiate a conjecture by Fonagy & Target (International Journal of Psychoanalysis 88(4):917–937, 2007) that an important phenomenological aspect of depression is the experiential recreation of the infantile loss of proximity to significant others. Second, we argue (...) that proximity has a particular cognitive function that allows individuals to morph into a cohesive dyadic system able to carry out distributed emotion regulation. We show that elevated levels of psychological suffering connected to depressive background emotions may be explained not only in terms of a psychological loss, but also as the felt inability to enter into dyadic regulatory relations with others—an experiential constraint that decreases the individual’s ability to adapt to demanding situations. (shrink)

The DSM‐5 highlights two essential psychological features of anorexia nervosa (AN): recalcitrant fear of gaining weight and body image disturbance. Prominent accounts grant false beliefs about body weight and shape a central role in the explanation of AN behavior. In this article, we propose a stronger emphasis on recalcitrant fear. We show that such fear can explain AN behavior without the intermediary of a false belief, and thus without the associated explanatory burdens and conceptual difficulties. We illustrate how shifting the (...) emphasis from false belief to recalcitrant fear can supplement a number of different non‐doxastic models of AN. (shrink)

Philosophical accounts denying that temporal passage is an objective feature of reality face an explanatory challenge with respect to why it appears to us as though time passes. Recently, two solutions have surfaced. Cognitive illusionism claims that people experience the passage of time due to their belief that time passes. Cognitive error theory claims that we do not experience the passage of time, but hold the belief that we do, which we have acquired through making an inference from the prior (...) belief that time passes. These approaches suppose that belief and passage experience are explanatorily connected, and they depend on the claims that people who experience the passage of time or at least believe that they do also believe that time passes. To test these claims, we probed the beliefs of populations of individuals with depression and schizotypy, thus conditions that are strongly associated with alterations in temporal phenomenology. Depression was assessed with the Beck Depression Inventory (BDI) and schizotypy with the short Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). While cognitive illusionism and inferentialist cognitive error theory would predict a strong association between BDI and O-LIFE scores and beliefs about time passage, our study found no such association. The experience of passage does not seem to be explanatorily connected to beliefs about the passage of time. (shrink)

Body checking, characterized by the repeated visual or physical inspection of particular parts of one’s own body (e.g. thighs, waist, or upper arms) is one of the most prominent behaviors associated with eating disorders, particularly Anorexia Nervosa (AN). In this paper, we explore the explanatory potential of the Recalcitrant Fear Model of AN (RFM) in relation to body checking. We argue that RFM, when combined with certain plausible auxiliary hypotheses about the cognitive and epistemic roles of emotions, is able to (...) explain key characteristics of body checking, including how body checking behavior becomes habitual and compulsive. (shrink)

Authenticity has become a widespread ethical ideal that represents a way of dealing with normative gaps in contemporary life. This ideal suggests that one should be true to oneself and lead a life expressive of what one takes oneself to be. However, many contemporary thinkers have pointed out that the ideal of authenticity has increasingly turned into a kind of aestheticism and egoistic self-indulgence. In his book, Varga systematically constructs a critical concept of authenticity that takes into account the reciprocal (...) shaping of capitalism and the ideal of authenticity. Drawing on different traditions in critical social theory, moral philosophy and phenomenology, Varga builds a concept of authenticity that can make intelligible various problematic and potentially exhausting practices of the self. (shrink)

Respiratory rhythms sustain biological life, governing the homeostatic exchange of oxygen and carbon dioxide. Until recently, however, the influence of breathing on the brain has largely been overlooked. Yet new evidence demonstrates that the act of breathing exerts a substantive, rhythmic influence on perception, emotion, and cognition, largely through the direct modulation of neural oscillations. Here, we synthesize these findings to motivate a new predictive coding model of respiratory brain coupling, in which breathing rhythmically modulates both local and global neural (...) gain, to optimize cognitive and affective processing. Our model further explains how respiratory rhythms interact with the topology of the functional connectome, and we highlight key implications for the computational psychiatry of disordered respiratory and interoceptive inference. (shrink)

Recent criticisms of medicine converge on fundamental questions about the aim of medicine. The main task of this paper is to propose an account of the aim of medicine. Discussing and rejecting the initially plausible proposal according to which medicine is pathocentric, the paper presents and defends the Autonomy Thesis, which holds that medicine is not pathocentric, but sanocentric, aiming to promote health with the final aim to enhance autonomy. The paper closes by considering the objection that the Autonomy Thesis (...) is overly permissive and allows many highly controversial procedures as legitimate parts of medicine. (shrink)

Scaffolded Minds offers a novel account of cognitive scaffolding and its significance for understanding mental disorders. The book is part of the growing philosophical engagement with empirically informed philosophy of mind, which studies the interfaces between philosophy and cognitive science. It draws on two recent shifts within empirically informed philosophy of mind: the first, toward an intensified study of the embodied mind; and the second, toward a study of the disordered mind that acknowledges the convergence of the explanatory concerns of (...) psychiatry and interdisciplinary inquiries into the mind. The book sets out to accomplish a dual task: theoretical mapping of cognitive scaffolding; and the application/calibration of fine-grained philosophical distinctions to empirical research. It introduces the notion of actively scaffolded cognition (ASC) and offers a taxonomy that distinguishes between intrasomatic and extrasomatic scaffolding. It then shows that ASC offers a productive framework for considering certain characteristic features of mental disorders, focusing on altered bodily experience and social cognition deficits. (shrink)

Grief is often described as characterized by a particular emotional response to another person’s death. While this is true of paradigm cases, we argue that a broader notion of grief allows accommodating forms of this emotional experience that deviate from the paradigmatic case. The bulk of the paper explores such a nonparadigmatic form of grief, anticipatory-vicarious grief, which is typically triggered by pondering the inevitability of our own death. We argue that AV-grief is a particular moral emotion that serves a (...) unique function and is indissolubly linked to the practical identities of human agents. An agent’s AV-grief is about the harm that occurs to individuals whose practical identities depend on the agent. (shrink)

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further (...) work making medicine’s internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino’s account of the aim of medicine as well as the Hastings Center’s consensus report. (shrink)

It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

A large part of the contemporary literature on dehumanization is committed to three ideas: (a) dehumanization involves some degree of denial of humanness, (b) such denial is to be comprehended in mental terms, and (c) whatever exact mechanisms underlie the denial of humanness, they belong in the realm of post-perceptual processing. This chapter examines (c) and argues that the awareness of minds might belong to perceptual processing. This paves the way for the possibility that dehumanization might, at least in part, (...) be a perceptual phenomenon, such that dehumanizers visually perceive the dehumanized as exhibiting lesser-than-human minds. It is perhaps unsurprising that the first systematic investigations of dehumanization approached the phenomenon as linked to contexts of war, genocide, extreme hatred, and violence. One guiding hypothesis was that dehumanizers exclude the dehumanized from a moral community of human beings, implicitly conceptualized as displaying distinct individualities and being embedded in caring interpersonal relations. By comprehending the dehumanized as deindividuated entities to which moral norms and considerations of fairness do not apply (Opotow 1990), dehumanizers are able to disengage from moral restrictions and self-sanctions (Bandura 1999). (shrink)

There is growing attention towards atypical brain-body interactions and interoceptive processes and their potential role in psychiatric conditions, including affective and anxiety disorders. This paper aims to synthesize recent developments in this field. We present emerging explanatory models and focus on brain-body coupling and modulations of the underlying neurocircuitry that support the concept of a continuum of affective disorders. Grounded in theoretical frameworks like peripheral theories of emotion and predictive processing, we propose that altered interoceptive processes might represent transdiagnostic mechanisms (...) that confer common vulnerability traits across multiple disorders. A deeper understanding of the interplay between bodily states and neural processing is essential for a holistic conceptualization of mental disorders. (shrink)

The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book (...) demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy. (shrink)

This paper starts by distinguishing three views about the phenomenal character of perceptual experience. ‘Low-level theorists’ argue that perceptual experience is reducible to the experience of low-level properties, ‘high-level theorists’ argue that we have perceptual experiences of high-level properties, while ‘disunified view theorists’ argue that perceptual seemings can present high-level properties. The paper explores how cognitive states can penetrate perceptual experience and provides an interpretation of cognitive penetration that offers some support for the high-level view.

While philosophical questions about health and disease have attracted much attention in recent decades, and while opinions are divided on most issues, influential accounts seem to embrace negativism about health, according to which health is the absence of disease. Some subscribe to unrestricted negativism, which claims that negativism applies not only to the concepts of health and disease as used by healthcare professionals but also to the lay concept that underpins everyday thinking. Whether people conceptualize health in this manner has (...) implications for medical care and public health, and so we set out to examine this claim in two studies. Participants were asked to assess and compare the health states of two people presented in two vignettes. We found that both lay people and medical students conceptualize health as something more than the absence of disease. We argue that our findings highlight a need to rethink unrestricted negativism and indicate a need to rethink the way the debate has traditionally focused on disease. (shrink)

Motivated by a recent trend that advocates a reassessment of the aim of medical science and clinical practice, this paper investigates the epistemic aims of biomedical research. Drawing on contemporary discussions in epistemology and the philosophy of science, along with a recent study on scurvy, this paper (1) explores the concept of understanding as the aim of scientific inquiry and (2) establishes a framework that will guide the examination of its forms in biomedical research. Using the case of Tuberculosis (TB), (...) (3) it is argued that grasping a mechanistic explanation is crucial for reaching a threshold of understanding at which we may speak of an objectual, biomedical understanding of TB. (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)

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate whether health and (...) disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions. (shrink)

While research on Attention Deficit Hyperactivity Disorder (ADHD) has traditionally focused on cognitive and behavioral deficits, there is increasing interest in exploring possible resources associated with the disorder. In this paper, we argue that the attention-patterns associated with ADHD can be understood as expressing an alternative style of inquiry, or “zetetic” style, characterized mainly by a lower barrier for becoming curious and engaging in inquiry, and a weaker disposition to regulate curiosity in response to the cognitive and practical costs associated (...) with inquiry. Exploring this zetetic style from an epistemological perspective, we show that it is often epistemically rational and can be advantageous in important respects. We close by suggesting that the very aspects of the zetetic style that might at times render it disadvantageous from the point of view of individual subjects with ADHD, will often confer epistemic benefits to the social group that the subjects are part of. (shrink)

Proponents of manipulation arguments against compatibilism hold that manipulation scope (how many agents are manipulated) and manipulation type (whether the manipulator intends that an agent perform a particular action) do not impact judgments about free will and moral responsibility. Many opponents of manipulation arguments agree that manipulation scope has no impact but hold that manipulation type does. Recent work by Latham and Tierney (2022, 2023) found that people's judgments were sensitive to manipulation scope: people judged that an agent was less (...) free and responsible when a manipulation was existential (impacting at least one but not all agents) than when the manipulation was universal (impacting every agent). This study examines people's judgements about existential and universal manipulation cases that involve both intentional and non‐intentional outcomes. We found that manipulation scope also affects people's free will and responsibility judgments in manipulation cases involving both intentional and non‐intentional outcomes. Interestingly, we also found that manipulation type influences the effect that manipulation scope has on people's free will judgments but not their moral responsibility judgments, which indicates that people's free will and responsibility judgments can come apart. This puts pressure on the prevalent assumption that judgments about free will and moral responsibility are conceptually bound together. (shrink)

This paper aims to contribute to debates about the nature of philosophical inquiry and its relation to science. The starting point is the Discontinuity View (DV), which holds that philosophy is discontinuous with science. Upon critically engaging two lines of argument in favor of DV, the paper presents and defends the Continuity View (CV), according to which philosophy and science are continuous forms of inquiry. The critical engagement sheds light on continuities between philosophical and scientific inquiry while underlining special normative (...) competences of philosophical work. The final part of the paper uses these insights to offer a brief outline of a normative approach to philosophy of science. (shrink)

Amid criticism of medicine's scientific rigor and patient care, this book offers a philosophical examination of the nature and aims of medicine, and new perspectives on how these challenges can be addressed. It offers input for rethinking the agenda of medical research, healthcare delivery, and the education of healthcare personnel.