Imperfect Cognitions

Today's post is by Max F. Kramer , an  Assistant Professor of Bioethics at Geisinger College of Health Sciences, and Clinical Ethicist at Geisinger Health System. Kramer discussed the recent paper "Depressed, Not Disordered: Fittingness and Pathologies of Emotion", published in the Journal of Medicine & Philosophy .  Max F. Kramer A once-prevalent view in philosophy – and possibly still prevalent in public life – holds that reason and emotion are inherently opposed. An extension of this view would have us characterise mental illness as some imbalance between the two; typically, a pattern of excessive emotion or deficient reason. Although this perspective is misguided in certain important ways, it serves as a point of entry into the affective dimensions of psychopathology and especially the class of psychological phenomena categorised as affective disorders: mental illnesses characterised by some defect, impairment, or aberration in the functioning of one’s emotional a...

In this post, Susi Ferrarello , Francesca Brencio , Valeria Bizzari and Magnus Englander present a recent special issue of Frontiers in Psychology entitled: " Phenomenological Psychopathology: Who, What and How? An analysis of key figures, advancements and challenges ”.  Valeria Bizzari Phenomenology offers psychopathology a framework for understanding the patient’s lived experience without preconceptions, while psychopathology allows phenomenology to explore human plurality more deeply. In this special issue we aimed to gather papers focusing on the intersection of phenomenology and psychopathology, examining key concepts, contemporary challenges, and clinical applications.  Topics of interest include: the theoretical and practical advancements of phenomenological psychopathology the role of embodiment emotions like envy and melancholy in disorders  the use of phenomenological methodologies like interviews in clinical settings.  Key phenomenological concepts such ...

In this post, Amelia Gangemi and Valentina Cardella introduce their new book, Reasoning in Psychopathology  (Routledge 2024). Reasoning in Psychopathology Rationality can be broadly categorized into two types: rationality of action, which concerns behavior appropriate to achieving one’s goals, and theoretical rationality, which involves conformity to norms, such as logical or social norms. Many philosophers and psychologists argue that a key aspect of mental disorder is a deficiency in rational control over one’s behavior. This notion is consistent with the common view that mental illness involves a lack of discipline or self-control. Contrary to this view, individuals with mental disorders do not necessarily exhibit impaired rationality. In our book, we present studies of schizophrenia, depression, and anxiety disorders that suggest that individuals with these conditions can reason logically within their symptomatic domains and may even outperform unaffected individuals on certain...

Today's post is by Dan Cavedon-Taylor who is the author of a paper to appear in Synthese entitled " Must depression be irrational? " Dan Cavedon-Taylor From Capgras syndrome to schizophrenia, anorexia to obsessive-compulsive disorders, mental health conditions are thought to entail failures of epistemic rationality. This includes depression, which is often conceptualised by philosophers as necessarily involving mental states that are ‘unwarranted by’ or ‘disproportionate to’ events in one’s life ( Davies 2016; Wakefield & Demazeux 2016 ; Tully 2019 ). Call this view of depression, the ‘Irrationality View’. For some of us, the Irrationality View seems plainly incorrect. There appears to be a clear difference, in rational terms, between depression caused by change in season versus depression caused by, e.g., homelessness, refuge experience, serious assault, and perhaps even gaslighting ( Abrahams 2024 ). For that reason, I think we ought to prefer a Mixed View of depr...

This post is by Dan Degerman, Leverhulme Early Career Research Fellow at the University of Bristol, soon to join the new project EPIC (Epistemic Injustice in Healthcare), funded by a Wellcome Discovery Award. (A version of this post appeared on the EPIC blog on 15th September 2023.) Some members of team EPIC: Matthew Broome, Ian Kidd, Dan Degerman, Havi Carel, Kathleen Murphy-Hollies, and Fred Cooper. Silence is an important phenomenon in mental health. But while philosophers have had much to say about the social silencing of people with psychiatric diagnoses, other ways in which silence can feature in psychopathology have been underexplored. In a recent workshop at the University of Bristol, generously funded by the Leverhulme Trust, we sought to begin to address this neglect by exploring the different faces of silence in psychopathology. Ian Kidd opened the workshop with a talk that explored painful silences common in bereavement grief. In particular, he focused on four silences, ea...

Today's post is by  Juliette Vazard on her recent paper " Losing the light at the end of the tunnel: Depression, future thinking, and hope " ( Mind & Language 2023). Juliette Vazard is a postdoctoral researcher at the University of Toronto and she works at the intersection of philosophy of mind (particularly emotion), epistemology, and cognitive science. Juliette Vazard Patients with clinical depression show a significant decrease in their ability to entertain thoughts of future positive events that could happen as part of their lives (MacLeod et al., 1996; Bjärehed et al., 2010; Thimm et al., 2013; Anderson & Evans, 2015; Szőllősi et al., 2015). Understanding the mechanisms which sustain this change in prospective cognition is of major clinical import, since developing a perspective on the future is key in the recovery of these patients (Cooper, Darmody, & Dolan, 2003).  Although the connection between lack of hope and depression is well established in the l...

A group of researchers from the University of Ferrara, Bologna, New York, and Stockholm have developed a tool to predict the risk of developing depression in people over 55. Anyone can calculate their risk through a website . Here  Martino Belvederi Murri  (Ferrara) reports on the study that could mark a turning point in terms of early identification and prevention of this condition. The prophetess Manto According to the World Health Organization, depression is the leading cause of disability in the world. About 15% of people suffer from depression at least once in their life: the consequences can range from temporary suffering to the loss of work and social relationships, to suicide. The impact of the pandemic, isolation, the economic crisis and the population aging make depression a widespread economic and social problem, especially in late life. Unfortunately, depression often goes unrecognized or does not receive prompt treatment. This is due to several factors, such as sc...

In this post Linda Gask presents Finding True North: The healing power of place, a book published in April 2021 by Sandstone Press.  What does it mean to ‘recover’ from depression? The answer you receive to this question will vary by the profession, training, experience, and ideological stance of the person you ask. Some will speak in terms of a reduction in the number of symptoms of depression you have ticked ‘yes’ to. Others will focus on regaining ability to function in the world, particularly in your relationships and ability to work. How do you ‘recover’? Is it simply about taking the tablets, going to therapy- or both? Or is there more to it?  What about mindfulness, and exercise, and all the other suggestions people helpfully provide? There will also be a few who will admonish you for your choice of words to describe a shade of normal human unhappiness and add to the guilt you were feeling for being depressed in the first place. Personally, I’ve found the writing of D...

In today's post Paul Noordhof discusses the possibility of imagining pain, summarising a paper, Explaining impossible and possible imaginings of pain , that appears open access in a forum dedicated to responses to Jennifer Radden's article, Imagined and Delusional Pain , in Rivista internazionale di Filosofia e Psicologia. Noordhof's paper is an output of the AHRC Project  Deluded by Experience , led by  Ema Sullivan-Bissett  at the University of Birmingham.  Paul Noordhof One form of imagining has a content that is like our sensory experiences and bodily sensations. For example, if I’m asked how many windows the front of my mother’s house has, I might answer by imagining the house as if I am looking at it. Equally, we can imagine our hand being warmed by a close-by fire. In a recent paper, inspired and responding to a paper by Jennifer Radden entitled ‘Imagined and Delusional Pain’, I considered the question of whether it is possible to imagine a pain in the same wa...

Today's post is by  Robert N. McCauley , William Rand Kenan Jr. University Professor at the Center for Mind, Brain, and Culture at Emory University and George Graham, Professor of Philosophy at Georgia State University. Robert N. McCauley Our book, Hearing Voices and Other Matters of the Mind , promotes a naturalistic approach, which we call Ecumenical Naturalism, to accounting for the long recognized and striking cognitive continuities that underlie familiar features of religiosity, of mental disorders, and of everyday thinking and action. The case for those continuities rests on two considerations. The first is empirical findings that mental phenomena (e.g., hearing voices) associated with mental disorders are more widespread than typically assumed. The second consideration concerns those continuities’ grounding in one sort of intuitive, unconscious, automatic, instantaneous (System 1) cognition, viz., maturationally natural cognition (MATNAT). MATNAT systems address...

Today's post is by Derek Bolton . He is Professor of Philosophy and Psychopathology at King’s College London. His latest book co-authored with Grant Gillett  is The Biopsychosocial Model of Health and Disease: Philosophical and Scientific Developments  (Springer Palgrave, 2019, Open Access). Imagine how odd this would be: You or the family were attending clinic (say neurology, orthopedic, pediatric or psychiatric), enquired about causes and cures, and the reply referred to complexity and the Biopsychosocial Model. You go home and look this up, and happen upon criticism by many authoritative commentators to the effect that the Biopsychosocial Model, popular though it is, is scientifically, clinically, and philosophically useless. This is actually where we are and this is the problem we diagnose and address in our book. We propose a formulation of the problem along the following lines: The 1960s and ‘70s saw the beginnings of systems theory approaches in biology, ...

The Royal College of Psychiatrists hosted its  Faculty of Neuropsychiatry Annual Conference on 13-14 September 2018 in London. I was fortunate to attend the first day and I am going to report on some of the interesting talks I listened to. In the first session speakers focused on neuroscience for psychiatrists, and Paul Johns, author of Clinical Neuroscience , addressed the functional anatomy of the human amygdala. The amygdala is constantly looking out for dangers and helps us evaluate the emotional significance of events. It facilitates social interactions as it enables us to read other people's minds. Further, the amygdala is involved in learning and episodic memory for important events. It is responsible for an implicit emotional memory of negative events to help us avoid adverse stimuli. The amygdala is for assessing environmental cues to determine the adequate response to threats. So patients without the amygdala are fearless but it is possible to experimentall...

This post is by Tulio Giraldi . Tulio Giraldi is a researcher and teacher of pharmacology and clinical psychology at the University of Trieste, currently Visiting Professor at the Department of Global Health & Social Science at the King’s College London.  The topics of his basic and clinical research have been cancer chemotherapy, together with the pharmacology of the central nervous system and the responses to stress. More recently, he has been researching the role of genetic polymorphisms in mental health, and the pharmacogenetics of the response of psychiatric drugs. In this post he talks about his book Unhappiness, Sadness and Depression . According to the World Health Organization (WHO), an epidemic of depression is spreading around the world, expected to become by 2020 the second leading cause of world disability and by 2030 to be the largest contributor to disease burden. The serious concern for depression and antidepressant drugs led me to analyze all the a...

My name is Magdalena Antrobus, I am a PhD student working on Project PERFECT, researching psychological and epistemic benefits of depression. Together with Lisa Bortolotti I wrote a paper entitled Depressive Delusions , exploring the nature of delusions in severe forms of depression as well as the process of their formation. Here we present a summary of the article, which was published in 2016 in the Filosofia Unisinos journal. It is common to define delusions as implausible beliefs that are held with conviction but for which there is little empirical support. The vast majority of delusions appearing in severe depression are mood-congruent, which means that their content matches the mood experienced by the person ( Hales and Yudofsky, 2003 ). Common themes of depressive delusions are persecution, guilt, punishment, personal inadequacy, or disease, with half of the affected people experiencing delusions with more than one theme. Stanghellini and Raballo (2015) point to several d...

In this post I am interested in the depiction of mental health issues in books aimed at young children. There are two interesting books addressing the issue of what the depression of a loved one means for the children involved. The first is The Colour Thief , by Andrew Fusek Peters and Polly Peters, illustrated by Karin Littlewood (Wayland 2014). The second is Virginia Wolf , by Kyo Maclear and Isabelle Arsenault (Kids Can Press 2016).   There are some interesting similarities in how depression is described in the two books. In both books, the point of view is that of a child. In The Colour Thief , a boy observes his father as he gradually falls prey to depression. The father soon gets to the point where he does not go out anymore and stays in bed all day. In Virginia Wolf , a book inspired by the relationship between the author Virginia Woolf and her sister Vanessa, a child called Vanessa witnesses a curious transformation in her beloved sister Virgina. Virginia becomes, qu...

In this post, Jennifer Radden , Professor in the Philosophy Department at the University of Massachusetts, introduces her new book: Melancholic Habits: Burton's Anatomy & the Mind Sciences . When the process of writing a book is long and slow, as this was, one enters not entirely sure where one will end – or at least, expecting mind-change as the result of the process. For me, for this book, that change was considerable, and so incremental that it is hard to identify the moments it occurred or the sequences engendering it. Some of the befores and afters stand out, though. I’d read Burton for years, and alluded to aspects of his Anatomy of Melancholy in earlier writing. But the recognition that it was possible to find a coherent model of mind and disorder (“disease,” in his pre-modern sense) implicatively related not to the actual detail of his remedies but to his remedial principles, emerged slowly as I worked through the first and second Partitions. ...

In this post, I report from the 20th Annual Meeting of the AEP and WPA Psychopathology Sessions. The symposioum took place at the Hospital Corentin Celton in Paris on the 9th and 10th of December 2016. Researchers in psychopathology and philosophers gathered to present their findings and reflections on the psychopathology of the lived body and its exposure. On the first day, Luis Madeira talked about abnormal bodily phenomena (ABP) and how these symptoms are experienced in patients with affective disorders, psychosis, and particularly schizophrenia. These features are subjective and at the same time experienced as out of control. In patients diagnosed with manic depression, the body is represented as a nebulous existence, a quasi-inefable constellation of feelings, feelings of inner burden and paralysis which is caused by a lack of motivation, with patients often wondering: “It is in me but, what should I do?” When the diagnosis is schizophrenia, reports show an increa...