Our main objective is to locate and analyze some philosophical issues about the concept of mental illness and the manner it is used, especially in contemporary psychiatry. It is even difficult to find a standard meaning in the main psychiatric textbooks; and, when there is some exposition of the concept, it is sparse, uncritical and vague. As an immediate consequence of these issues, practical guidelines and protocols for the clinic arise, which become almost “automatic”, unreflective behaviors, (...) practices translated as health interventions and public mental health policies. An example is the problem of overdiagnosis, in which the use of medical technology (categories, drugs, clinical exams, etc.) has generated more harm and risks to the subject's health than benefits. Exposing these issues from a philosophical perspective can eventually contribute to the field of mental health. For this work, the main manuals and textbooks of psychiatry were selected to analyze how they deal with the concept of mental illness or disorder, in addition to locating the present discussion in authors from both philosophy and the psychiatric field and how they contribute to its clarification. (shrink)

Kant’s conception of mental illness is unlikely to satisfy contemporary readers. His classifications of mental illness are often fluid and ambiguous, and he seems to attribute to human beings at least some responsibility for preventing mental illness. In spite of these apparent disadvantages, I argue that Kant’s account of mental illness can be illuminating to his views about the normative dimensions of human cognition. In contrast to current understandings of mental (...) class='Hi'>illness, Kant’s account is what I refer to as “non-pathological.” That is, most mental illnesses are for Kant continuous with normally functioning cognition. Someone with a healthy reason can easily fall into mental illness and someone with mental illness can (perhaps not as easily) re-establish healthy reason. By accepting a non-pathological definition of mental illness, it follows for Kant that humans have more agency and responsibility regarding their mental health than current views allow, which explains why several of his writings aim to prescribe a “diet of the mind” (2:271). Contrary to popular readings of Kant as a champion of reason’s power, Kant’s conception of mental illness shows that he recognizes how fragile human reason can be. (shrink)

This chapter begins by sketching an account of morally responsible agency and the general conditions under which it may fail. We discuss how far individuals with psychiatric diagnoses may be exempt from morally responsible agency in the way that infants are, with examples drawn from a sample of diagnoses intended to make dierent issues salient. We further discuss a recent proposal that clinicians may hold patients responsible without blaming them for their acts. We also consider cognitively impaired subjects in the (...) light of related issues in moral and political theory, asking whether they have been unjustly excluded from liberal conceptions of political community due to their presumed lack of agency. (shrink)

As a contribution to a wider discussion on moral discernment in theological anthropology, this paper seeks to answer the question “What is the impact of mental illness on an individual’s ability to make moral decisions?” Written from a clinical psychiatric perspective, it considers recent contributions from psychology, neuropsychology and imaging technology. It notes that the popular conception that mental illness necessarily robs an individual of moral responsibility is largely unfounded. Most people who suffer from mental (...) health problems do not lose the capacity to make moral decisions, and mental illness on its own rarely explains anti-social or criminal behaviour. Moreover, the assumptions of some scientists, that recent developments in neuropsychology and brain imaging suggest biological determinism, must be treated with caution. (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 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)

This chapter has two aims. The first aim is to compare and contrast three different conceptual-explanatory models for thinking about mental illness with an eye towards identifying the assumptions upon which each model is based, and exploring the model’s advantages and limitations in clinical contexts. Major Depressive Disorder is used as an example to illustrate these points. The second aim is to address the question of what conceptual-theoretical framework for thinking about mental illness is most likely (...) to facilitate the discovery of causes and treatments of mental illness in research contexts. To this end, the National Institute of Mental Health’s Research Domain Criteria (RDoC) Project is briefly considered. (shrink)

This paper aims to show how the legacy of socialism with a human face represents a far more serious obstacle for the postsocialist transition than the heritage of rigid socialism. This is because an amalgamation of the perception of the autochthonous character of socialism accompanied by the perception of its soft, human face, creates an anti-capitalist mentality (Ludwig von Mises) that leaves an enormous impact on the long-term understandings of the concepts of individual, society, state, and reforms. This sort of (...) mentality is deeply entrenched in Serbia, where a full-scale process of “debolshevization” has never been initiated. The continuity with socialist legacy is apparent in key segments of the ill-fated transition: political, institutional, economic, symbolical, and no less moral. (shrink)

This paper surveys some philosophical issues with the language surrounding mental illness, but is especially focused on pejoratives relating to mental illness. I argue that though 'crazy' and similar mental illness-based epithets (MI-epithets) are not best understood as slurs, they do function to isolate, exclude, and marginalize members of the targeted group in ways similar to the harmfulness of slurs more generally. While they do not generally express the hate/contempt characteristic of weaponized uses of (...) slurs, MI-epithets perpetuate epistemic injustice by portraying sufferers of mental illness as deserving minimal credibility. After outlining the ways in which these epithets can cause harm, I examine available legal and social remedies, and suggest that the best path going forward is to pursue a reclamation project rather than aiming to censure the use of MI-epithets. (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)

In this article I aim to make progress towards the philosophical goal of ascertaining what, if anything, all mental illnesses have in common, attempting to unify a large sub-set of them that have a relational or interpersonal dimension. One major claim is that, if we want a promising theory of mental illness, we must go beyond the dominant western accounts of mental illness/health, which focus on traits intrinsic to a person such as pain/pleasure, lethargy/liveliness, fragmentation/integration, (...) and falsehood/authenticity. A second major claim is that the relational facets of mental illness are plausibly understood theoretically in terms of a person’s inability to identify with others or to exhibit solidarity with them, relational values that are salient in the African philosophical tradition. I show that these two extrinsic properties well explain several intuitive instances of mental illness, including, amongst several others, being abusive, psychopathic, narcissistic, histrionic, paranoid, and phobic. (shrink)

Psychological well-being is a major global concern receiving more scholarly attention following the 2008 Great Recession, and it becomes even more relevant in the context of COVID-19 outbreak. In this study, we investigated the impact of economic uncertainty resulting from natural disasters, epidemics, and financial crisis on individuals' mental health. As unemployment rate exponentially increases, individuals are faced with health and economic concerns. Not all society members are affected to the same extent, and marginalized groups, such as those suffering (...) from chronic mental illnesses or low-income families cannot afford the downsizing, mass lay-offs and lack of access to public health services. Psychiatric profession is familiarized with the phenomenon of intolerance of uncertainty (IU), and we examine how this concept is associated with job uncertainty and social identity disturbance. Several studies have formally investigated the effects of IU, but to our knowledge, this is the first research integrating the psychological well-being, job uncertainty and identity disturbance caused by economic breakdown. Literature points to many reported cases of PTSD, anxiety, depression and suicidal tendencies following major social disasters. Yet, we have undertaken to analyze the subjective experiences underlying the self-harming behaviors in an attempt to fill the methodological gap by drawing insights from prominent psychological, sociological and economic theories. We find economic uncertainty to have a positive relation to job uncertainty and identity disturbance, and a negative relationship with psychological well-being. Psychological well-being depends on coherency between both abstract subjective and concrete objective identity, and when these perceptions are inconsistent, cognitive dissonance arises resulting in identity disturbance. We argue that stability is not associated with monetary advantage only, but also with a wide range of other benefits that are crucial for individuals' growth, satisfaction and sense of identity. Therefore, we propose the implementation of social support and public welfare policies to mitigate health risks during the turbulent socio-economic changes. (shrink)

Let’s begin by imagining a hypothetical psychotic illness called “Schneider’s Disease”, recognized for over 100 years. Let’s assume there has been great controversy as regards the “most valid” set of diagnostic criteria for SD.

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)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health (...) are aimed just at reducing mental illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

One of the philosophical discussions stimulated by the recent scientific study of psychopathy concerns the mental illness status of this construct. This paper contributes to this debate by recommending a way of approaching the problem at issue. By relying on and integrating the seminal work of the philosopher of psychiatry Bill Fulford, I argue that a mental illness is a harmful unified construct that involves failures of ordinary doing. Central to the present proposal is the idea (...) that the notion of failure of ordinary doing, besides the first personal experience of the patient, has to be spelled out also by referring to a normative account of idealised conditions of agency. This account would have to state in particular the conditions which are required for moral responsibility. I maintain that psychopathy is a unified enough construct that involves some harms. The question whether the condition involves also a failure of ordinary doing, as this notion is understood in this paper, is not investigated here. (shrink)

The tendency to draw mind-brain dichotomies and evaluate mental disorders dualistically arises in both laypeople and mental health professionals, leads to biased judgments, and contributes to mental health stigmatization. This paper offers a theory identifying an underlying source of these evaluations in social practice. According to this theory, dualistic evaluations are rooted in two mechanisms by which we represent and evaluate the beliefs of others in folk psychology and theory of mind: the doxastic conception of mental (...) disorders and doxastic voluntarism. Tracing these origins contributes to our understanding of mental state representation in cognitive science and philosophy of psychiatry, the concept of belief in philosophy of mind, and may help improve patient experience and treatment in light of social stigmatization and bias toward mental illness. (shrink)

Personal recovery entails the idea of learning to live a good life in the face of mental illness. It takes place in a continuous dynamic between change and acceptance and involves the existential dimension in the broadest sense. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. Furthermore, there seems to be an emphasis on the component of change. Little attention is payed to the (...) role and integration of dealing with loss in personal recovery. In this paper, the role of loss in mental illness will be elaborated from an existential perspective. This will be done by relating existential changes to possibly disruptive experiences of loss in wider experience. With the help of several perspectives on dealing with loss it will be argued this can be integrated in processes of recovery. Then, it will be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery. The result consists of a refinement of the view on personal recovery. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loss and loss in wider experience in the context of psychopathology entails, and (2) to further develop perspectives on recovery in mental health care. (shrink)

Hegel reads the poet Novalis as an expression of terminal irony, a pathological case of Gemüt, where the conscious mind is alienated from reality and turns its negativity inwards on the contents of its own natural soul. The condition of self-feeling, presented in Hegel’s “Anthropology”, is a self-consumption that manifests itself somatically in the physical disease (consumption) from which Novalis dies. The poet’s literary production represents a pathological fixation that impedes the dynamic organicity of Hegelian Science. As such, Novalis’s (...) class='Hi'>mental illness and death constitute an expression of romantic irony and an ongoing threat to Hegel’s philosophy. (shrink)

Moralising accounts of depression include the idea that depression is a sin or the result of sin, and/or that it is the result of demonic possession which has occurred because of moral or spiritual failure. Increasingly some Christian communities, understandably concerned about the debilitating effects these views have on people with depression, have adopted secular folk psychiatry’s ‘medicalising’ campaign, emphasising that depression is an illness for which, like (so-called) physical illnesses, experients should not be held responsible. This paper argues (...) that both moralising and medicalising models of depression are intellectually and practically (pastorally and therapeutically) problematic, gesturing towards more promising emphases. (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)

This article argues in favor of modifying the medical model of severe psychiatric disturbances that underlies calling them "mental illness." The key reason for this proposal is that numerous specialists other than physicians as well as non-specialists contribute to the process of assisting a person recover from what the author suggests might better be called "extraordinary functional disability." There is little uniformity in existing definitions under state laws, but all involve three types of intervention: civil commitment; civil determination (...) of legal competency; and standing to be subject to criminal law. Physicians typically make relevant determinations in each of these areas; but non-physicians are the principal care-givers once a determination has been made. (shrink)

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the (...) self and that which belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (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)

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)

The article discusses the actual problem of social support for people with mental health problems, which has an important place in the study field of social psychology and social work.The article also deals with the definition of the concept of “mental health”, the problem of introducing the term “mental health problems” as a way to avoid stigmatization, and the spread of a humanistic attitude to persons with a psychiatric diagnosis. It also discussed modern theoretical approaches that (...) offer an understanding of the contribution of biological, social, and psychological factors into the cause of mental health problems. -/- The problem of mental illness is common to all countries of the world, as WHO data evidenced the number of people with mental disorders among the world’s population, ranging from 4–5 %. According to researchers P. Voloshin and N. Maruta, the spread of mental and behavioral disorders in Ukraine is characterized by a slow increase of about 2.9 % in every 10 years. Researchers argue that in subsequent years, according to the prognostic data, there will be an increase in these indicators. The issue of providing social support to people with PDS in Ukrainian society is very relevant, which is complicated by their social isolation in the process of recovery after the treatment. The results of scientific research in the context of different cultures and relatively diverse life events (hospitalization, mental illness, unemployment, old age) generally confirm the positive results of using social support to promote mental and physical health. Instead, there are no studies in Ukrainian science related to the phenomenon of social support of people with mental health problems. -/- It is important to define the concepts of “mental health” and “mental health problems” in the process of studying the features of social support for people with mental health problems. The term “mental health” combines the medical and psychological fields of science and practice, but modern psychology offers a comprehensive approach to assessing the psychological health of a person, the psychological norm, its limits, taking into account the criteria of mental health. The description of the mental health given by the Psychological Dictionary points out the components of awareness and the sense of continuity, continuity and identity of their physical and mental “I”; sense of continuity and identity of experiences in similar situations; critical to yourself and your mental activity and its results; the adequacy of psychic reactions of force and frequency of environmental influences; the ability to manage their behavior in accordance with social norms; planning personal activities and implementing them; changing the way of behavior depending on the changing circumstances of life. -/- The concept of “mental health problem” was taken as a term that denotes all the symptoms classified in ICD-10 and DSM-IV, which are recommended by experts to clients for appropriate treatment and care. Scientists and mental health practitioners point out that mental health problems can affect the way an individual thinks, feels, and behaves; affects self-service, fulfills professional duties, social, family roles, and household behavior, which is usually deeply affected by the quality of life of the individual. Numerous results of the research show that there are specific psychological and personality factors apart from the biological causes of mental disorders (genetic factors that contribute to the imbalance of chemicals in the brain) that make people vulnerable to occurrences of the mental health problems. -/- Several modern theoretical approaches offer an understanding of the contribution of biological, social, and psychological factors to the induction of mental health problems: the traditional medical model, the rehabilitation model, the interface model, the social model, and the biopsychosocial approach. Only biopsychosocial and social models are consistent with the definition of WHO disability and emphasize the impact social aspects of mental health and the quality of life of people with mental health problems. -/- Individuals with PPP, as a social community, have specific needs that differentiate them from other members of society, one of which is the need for constant socio-psychological support. So, the contribution of psychology and social work to the quality of life of people with mental disorder lies in the application of professional approaches and methods based on the biopsychosocial (social) model, which emphasize the need for socio-psychological support. An example of such a technique is the model of modern social work practice “people-in-environment”, which serves as a guiding principle of social work and emphasizes the importance of understanding the persons with disorder and their behavior in the light of the multiple context of the social environment in which these persons live and act. Specialists of social work and psychology make interventions at three levels: individual, at the family level, and at the community level, by means of intensifying the support of the environment within the cognitive-behavioral and other approaches, which contribute to the process of reintegrating people with mental health problems into community. (shrink)

Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of (...) themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real. (shrink)

Expression is the central concept in Wittgenstein’s philosophy of mind, and our experiences are reflected in our bodily expressions or gestures, facial expressions, behaviors and linguistic expressions. It seems true that we have no access of other people’s experiences but we can know or talk about them in so far as they are the common experiences of all. This inaccessibility of other’s experiences may create a genuine thinking that one’s experiences are private and the first person present tense psychological (...) utterances are not descriptive at all. They are understood solely as expressive and expression is the outer concept of a mental phenomenon. In this paper, an attempt will be made on the basis of Wittgenstein’s critique of the relationship between the concepts of experience and expression we shall argue that certain uses of the dichotomy between the inner and the outer are mistakes. According to Wittgenstein, the inner is not a set of experiences which are or are not expressed by our immediate (primitive) expressions or linguistic expressions rather it is the capacity of the subject to express himself genuinely. (shrink)

It has become popular of late to identify the phenomenon of thinking a singular thought with that of thinking with a mental file. Proponents of the mental files conception of singular thought claim that one thinks a singular thought about an object o iff one employs a mental file to think about o. I argue that this is false by arguing that there are what I call descriptive mental files, so some file-based thought is not singular (...) thought. Descriptive mental files are mental files for which descriptive information plays four roles: determines which object the file is about, if any, it sets limits on possible mistakes that fall within the scope of successful reference for the file, it acts as a ‘gatekeeper’ for the file, and it determines persistence conditions for the file. Contrary to popular assumption, a description playing these roles is consistent with the file-theoretic framework. Recognising this allows us to distinguish the notion of singular thought from that of file-thinking and better understand the nature and role of both. (shrink)

Perhaps the philosophical thesis most commonly associated with Brentano is that intentionality is the mark of the mental. But in fact Brentano often and centrally uses also what he calls ‘inner perception’ to demarcate the mental. In this paper, I offer a new interpretation of Brentano’s conception of the interrelations between mentality, intentionality, and inner perception. According to this interpretation, Brentano took the concept of mind to be a natural-kind concept, with intentionality constituting the underlying nature (...) of the mental and inner-perceivability serving as the concept’s reference-fixer. (shrink)

This chapter argues that mental fictionalism can only be a successful account of our ordinary folk-psychological practices if it can in some way preserve its original function, namely its explanatory aspect. A too strong commitment to the explanatory role moves fictionalism unacceptably close to the realist or eliminativist interpretation of folk psychology. To avoid this, fictionalists must degrade or dispense with this explanatory role. This motivation behind the fictionalist movement seems to be rather similar to that of Sellars when (...) he came up with the Myth of Jones, his proto-theory of mental concepts. He was faced with the problem of preserving the explanatory status of mental concepts without turning them into proper theoretical entities. By introducing the Sellarsian proto-theory of concepts related to the mental and outlining its main points, this chapter aims to provide a critique of the two versions of mental fictionalism that are arguably the strongest: Adam Toon’s prop-oriented pretence theory and Tamás Demeter’s expressive storyism. (shrink)

Does having a mental disorder, in general, affect whether someone is morally responsible for an action? Many people seem to think so, holding that mental disorders nearly always mitigate responsibility. Against this Naïve view, we argue for a Nuanced account. The problem is not just that different theories of responsibility yield different verdicts about particular cases. Even when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied (...) that a more nuanced approach is needed. (shrink)

Prof. Cohen and I answer six questions: (1) Why do we lock people up? (2) How can involuntary civil commitment be reconciled with people's constitutional right to liberty? (3) Why don't we treat homicide as a public health threat? (4) What is the difference between legal and medical approaches to mental illness? (5) Why is mental illness required for involuntary commitment? (6) Where are we in our efforts to understand the causes of mental illness?

Plato’s partition argument infers that the soul has parts from the fact that the soul experiences mental conflict. We consider an ambiguity in the concept of mental conflict. According to the first sense of conflict, a soul is in conflict when it has desires whose satisfaction is logically incompatible. According to the second sense of conflict, a soul is in conflict when it has desires which are logically incompatible even when they are unsatisfied. This raises a dilemma: (...) if the mental conflict is supposed to be the latter kind of conflict, then the partition argument is valid but is likely unsound; if it’s supposed to be the former kind, then the partition argument has true premises but is invalid. We explain this dilemma in detail and defend a dispositionalist solution to it. (shrink)

Police killings of individuals with mental illness have prompted calls for greater funding of mental health services to shift responsibilities away from the police. Such investments can reduce police interactions with vulnerable populations but are unlikely to eliminate them entirely, particularly in cases where individuals with mental illness have a weapon or are otherwise dangerous. It remains a pressing question, then, how police should respond to these and other vulnerable aggressors with diminished culpability (VADCs). This (...) article considers and ultimately rejects three potential approaches from the ethics of defensive force literature. It looks to improve on them by developing what I call the fusion account, which explains how vulnerability and diminished culpability fit together to provide moral grounds for extra protections from deadly force. The article’s final sections explore the policy implications of the fusion account for police administrators, officers, and the law. (shrink)

Two experiments with undergraduates as subjects were carried out with the aim of replicating and extending previous results showing that the implication of the behavioral life-cycle hypothesis (H. M. Shefrin & R. H. Thaler, 1988) that people classify assets in different mental accounts (current income, current assets, and future income) may explain how consumption choices are influenced by temporary income changes. In both experiments subjects made fictitious choices between paying for a good in cash or according to a more (...) expensive installment plan after they had received an income which was either less, the same, or larger than usual. In Experiment 1 subjects were supposed to have savings so that the total assets were equal, whereas in Experiment 2 the total assets varied. The results of both experiments supported the role of mental accounts in demonstrating that subjects were unwilling to pay in cash after an income decrease even though they had access to saved money. Thus, in effect they chose to pay more for the good than they had to. Indicating a need for further refinement of the concept of mental account, choices to pay in cash after an income decrease tended to be more frequent when the consumption and savings motives were compatible than when they were incompatible. Furthermore, increasing the total assets made subjects more willing to pay in cash after an income decrease. (shrink)

Recently, there’s been a lot of interest in a research program that tries to understand propositional representation in terms of the subject’s performance of sub-propositional mental acts like reference and predication (e. g. Burge 2010, Hanks 2015, Soames 2010, 2015). For example, on one version of the view, for a subject to predicate the property of being a composer of Arvo just is what it is to perform the to the basic propositional act of judging that Arvo is a (...) composer (e. g. Hanks 2015). In this paper I first present my own version of this view and contrast it with alternatives. I then argue that we must clearly separate the thin predication-resultant notion of judging (S(emantic)-judgment) from a much richer notion used in epistemology (E(pistemic)-judgment). The former is just the act of thinking a forceful thought. The latter is the act of making up one’s mind about how things are, a way of concluding theoretical or doxastic deliberation. I argue that these two acts differ in three ways: levels of propositional attitude, objective vs. subjective norms, and the possibility of sub-personal occurrence. (shrink)

I argue that rather than dismiss Foucault’s first book, Mental Illness and Personality, as an “apologetic exposition of Pavlov’s reflexology,” we ought see it as a valuable source documenting Foucault’s change of attitude towards psychology and the history of science in the early 1950s. I argue that there are two distinguishable strands that make up the text. The ‘frame’ of the book—the introduction, first chapter of the second part and conclusion of the book—is expressive of a critical attitude (...) towards psychology, and indicative of rather sophisticated conception of the history of science as a critical history aimed at bringing into view the unscientific forces that shape scientific labor. The ‘main body’ of the text—the first part and the second chapter of the second part—by contrast, reads as the history of the steady dialectical progress of the psychological sciences towards an ever more accurate understanding of mental illness. It is thus indicative to a naïve approach to psychology and to its history. The tension between the two strands of the book thus documents the starting point of Foucault’s then shifting attitudes toward the psychological sciences and the history of science, and the set of questions and sources that lead him to problematize his understanding of and approach to the latter. (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)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, (...) we ask: “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

The notion of harm is frequently used in the discussion of the nature of mental disorder. Harm also plays important roles in the prominent diagnostic manuals such as DSM and ICD. Recently, however, Cristina Amoretti and Elisabetta Lalumera have questioned the idea that harm should be a necessary constituent of mental disorders. They argue that the notion of harm is underspecified and potentially leads to false negatives in diagnosing mental disorders. Given that harm plays significant roles in (...) medical diagnosis and treatment indicates that we should be reluctant to remove it as a criterion for deciding whether some condition is a mental disorder. Instead, we argue that harm should be understood in the prudential sense and harm in this sense provides a way of responding to worries raised by Amoretti and Lalumera, while staying true to the conception of harm that is relevant for psychiatric practice. (shrink)

The main aim of this article is to present and defend a thesis according to which conceptual representations of some types of mental states are encoded in the same neural structures that underlie the first-personal experience of those states. To support this proposal here, I will put forth a novel account of the cognitive function played by ‘shared representations’ of emotions and bodily sensations, i.e. neural structures that are active when one experiences a mental state of a certain (...) type as well as when one observes someone else experiencing a state of the same type. I will argue that shared representations in fact constitute vehicles of certain mental state concepts (more precisely, concepts of specific types of emotions and somatosensory states). The main line of arguing for this will consist in showing that shared representations exhibit specific, ‘conceptual’ functional properties:(1) causal effect on forming metacognitive judgments, (2) cognitive penetrability, (3) diversity of input types. (shrink)

Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease and for who may be accorded the social privileges and personal responsibilities associated with being sick. In this article, we consider an ideal diagnostic test for coronavirus disease 2019 infection with respect to four groups of people—positive and asymptomatic; positive and symptomatic; (...) negative; and untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency. (shrink)

Recently, mental strength education requires to change in a way that establishes a military value system suitable for a liberal democracy while facing the need to strengthen mental strength in response to unpredictable security situations. The key to fulfilling these twofold objectives lies in the fact that there is a positive correlation between the enhancement of a soldier’s democratic awareness and intangible force. Therefore, it is of great importance to emphasize the concept of ‘citizen in uniform’ as (...) one of the central military values. However, this concept has one problem before its use in military mental strength in which the orders of the military status and the orders of the civic seem heterogeneous and even conflicting. This study aims to dissolve the internal tension of this concept through a new philosophical interpretation of citizens in uniform, freedom, people and state, thereby providing the foundation for establishing for establishing new military values and enhancement of mental force. To this end, it examines the explanation of the current curriculum regarding these concepts first and diagnoses its several problems (II). The current curriculum presents a brief explanation of the compatibility of civil rights and military obligations but does not resolve the conflict between the two. A new understanding of them is possible by introducing Hegelian insights in Philosophy of Rights (III). From Hegel's point of view, freedom is not the mere absence of coercion but a capacity for self-determination. Freedom is difficult to realize wholly at the level of an isolated individual, and it calls for an ethical community to give it a specific form. A state that is the best entity in humanity is the supreme unit that defines individual freedom and identity. Then it naturally derives that national defense is one of the supreme missions directly related to the freedom and identity of its people. A re-description of the contents of the curriculum based on these insights can conceptually resolve the aforementioned problem and even strengthen its arguments (IV). The state and the people are in a more essential correlation than previously depicted, and liberal democratic values such as freedom, human rights and welfare are proved as constitutive of a state itself. The superiority of liberal democracy, which the current textbook attempts to prove, also becomes transparent. Finally, military duties do not conceptually conflict with civil freedom but are considered as a form of it. (shrink)

In mental action there is no motor output to be controlled and no sensory input vector that could be manipulated by bodily movement. It is therefore unclear whether this specific target phenomenon can be accommodated under the predictive processing framework at all, or if the concept of “active inference” can be adapted to this highly relevant explanatory domain. This contribution puts the phenomenon of mental action into explicit focus by introducing a set of novel conceptual instruments and (...) developing a first positive model, concentrating on epistemic mental actions and epistemic self-control. Action initiation is a functionally adequate form of self-deception; mental actions are a specific form of predictive control of effective connectivity, accompanied and possibly even functionally mediated by a conscious “epistemic agent model”. The overall process is aimed at increasing the epistemic value of pre-existing states in the conscious self-model, without causally looping through sensory sheets or using the non-neural body as an instrument for active inference. (shrink)

There is much to be said for a diachronic or interpersonal individuation of singular modes of presentation (MOPs) in terms of a criterion of epistemic transparency between thought tokens. This way of individuating MOPs has been discussed recently within the mental files framework, though the issues discussed here arise for all theories that individuate MOPs in terms of relations among tokens. All such theories face objections concerning apparent failures of the transitivity of the ‘same MOP’ relation. For mental (...) files, these transitivity failures most obviously occur because mental files can merge or undergo fission. In this paper I argue that this problem is easily resolved once mental files are properly construed as continuants, whose metaphysics is analogous to that of persons or physical objects. All continuants can undergo fission or fusion, leading to similar transitivity problems, but there are well-established theories of persistence that accommodate this. I suggest that, in particular, the stage theory best suits the purposes of a continuant theory of MOPs. (shrink)

This paper is a defense of the so-called phenomenal-concept strategy, based on a new view of phenomenal concepts as special de re modes of presentation of the phenomenal character of experience. Phenomenal concepts can be explained in physical terms as mental particulars (as phenomenal files) created in the individual’s mind to pick out the phenomenal character of experience by representing certain physical properties as those represented by the experiences themselves (metarepresentation). They are individuated by two fundamental relations: the (...) perceptual (acquaintance) relation the creature bears to the physical properties represented by its own experience and the relation the creature bears to itself (self-acquaintance) as the subject undergoing those experiences. Mary’s newly acquired phenomenal file presents the phenomenal character of her new experience of red by means of the new relation she bears to herself as the creature standing in the experiential relation to the color red. (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)