Imperfect Cognitions

This week's post is by Alexander Edlich, and Alfred Archer and is based on their paper Rejecting Identities: Stigma and Hermeneutical Injustice . Alexander Edlich's work focuses on ethics, social philosophy, and moral responsibility. He is the author of The Scope of Moral Protest: Beyond Blame and Responsibility (Springer, 2025) and research papers in different areas of ethics and social philosophy. Alfred Archer is an Associate Professor of philosophy at Tilburg University. He is the co-author of Extravagance and Misery: The Emotional Regime of Market Societies (Oxford University Press 2024); Why It’s Ok to be a Sports fan (Routledge 2024) and Honouring and Admiring the Immoral: An Ethical Guide (Routledge 2021). He is currently writing a book on ethics and sportswashing for Routledge’s Ethics and Sport series.      Alexander Edlich                                     Alf...

Today's post is by Jodie Russell (University of Birmingham) who is addressing self-illness ambiguity. Jodie Russell In a recent paper titled “ Prescriptive ‘selves’ and self-illness ambiguity ” ( Synthese 2025), I explain the phenomenon of self-illness ambiguity and argue that individuals who experience these ambiguities might feel a particular form of social isolation. Self-illness ambiguities occur when people struggle to determine whether a thought, feeling, or behaviour is due to their illness (specifically, a mental disorder) or due to who they are as a person (i.e. stemming from their self). For example, someone with depression might find it difficult to tell whether their sadness after being let down by a friend is a symptom of their depression or a response rooted in their personal history of being let down by others. As Sadler (2004) describes, mental disorder can saturate or transform a person’s relationship to the world, and this transformation can be valuable in itsel...

Here  Martino Belvederi Murri (University of Ferrara) discusses research on epistemic justice and dignity for people with psychosis. A version of this post appeared on the EPIC blog in July 2024. Martino Belvederi Murri Individuals experiencing acute psychosis in inpatient psychiatric settings face unique challenges. Consider the case of Jake, a student who is struggling between familial conflicts and economic difficulties, as well as choices related to his life career. Auditory hallucinations may take the form of “voices” that comment on his everyday actions, and may lead Jake to think that people spy on him with malevolent intent. These symptoms can lead to angst and withdrawal from social activities, possibly culminating into severe anxiety and agitation. The grave societal stigma that is attached to mental illness exacerbates feelings of isolation and diminishes help-seeking. The promotion of patient empowerment is a key component of recovery, and is increasingly seen as a du...

Today's post is by Nimra Ahsan. Nimra is a fifth year medical student at the University of Birmingham, where she is currently completing a Masters in Mental Health. She is interested in how the study of mental health can help inform and improve future clinical practice, including her own. This is the last post in a series of perspectives from students taking the Philosophy and Ethics of Mental Health and Wellbeing module. Nimra Ahsan The interaction between psychiatry and psychopathology is one that is blending (Stanghellini and Broome, 2014). With a contemporary focus on patient experience, human subjectivity (or phenomenology) is creating a holistic perspective concerning mental health conditions, such as schizophrenia. Described as a ‘disturbance of minimal self’, our understanding of schizophrenia has deepened and the ipseity-disturbance model developed by Sass and Parnas has contributed to this substantially ( Nelson, Parnas and Sass, 2014 ). This model led to the formation o...

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 recent months, conspiracy beliefs such as COVID-19 denialism have often been described as delusional. Psychologists have suggested a correlation between the acceptance of conspiracy theories and schizotypal traits, that is, traits characterized by psychotic symptoms ( Douglas et al. 2017 ).  Anna Ichino In this post, I ( Lisa Bortolotti ) discuss some of the similarities and differences between conspiracy beliefs and delusions—this is the topic of a paper co-authored with  Anna Ichino  and  Matteo Mameli  for  Reti, Saperi, Linguaggi . Surface features   Both conspiracy beliefs and delusions of persecution involve attributing evil intentions or responsibility for adverse events to an individual or a group that the person does not trust. Conspiracy beliefs, but not delusions, are typically developed as an alternative to an official, authoritative version of the events ( Ichino and Räikkä 2020 ). Both types of belief are regarded as implausible by tho...

This week on Imperfect Cognitions, we showcase a couple of posts by authors with papers published in a special issue from the European Journal of Analytic Philosophy ( EuJAP ). The special issue is on the Philosophy of Medicine  with guest editors Saana Jukola and Anke Bueter.  In today's post, Anne-Marie Gagné-Julien discusses her paper in the special issue, which you can read here . Anne-Marie is a postdoctoral fellow at the Biomedical Ethics Unit at McGill University and also affiliated with the École normale supérieure (ENS). She works on philosophy of psychiatry and medicine, social epistemology, and epistemic innocence.  Anne-Marie Gagné-Julien Medicalization is the process through which nonmedical problems are conceptualized and treated as medical problems ( Conrad and Slodden 2013 ). It has become a controversial topic both within and outside psychiatry, especially since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disord...

In today's post, Lucienne Spencer (University of Bristol) discusses the wrongful depathologization of serious mental conditions. The post is based on a paper co-authored with Havi Carel and published open access in Philosophy of Medicine. Lucienne Spencer The Mental Health Foundation states that ‘people with mental health problems are amongst the least likely of any group with a long-term health condition or disability to find work, be in a steady, long-term relationship, live in decent housing [or] be socially included in mainstream society’. Given the global decline in mental health following the coronavirus pandemic, addressing the marginalisation of people with psychiatric illness has never been more urgent. According to the literature, this marginalisation is grounded in sanist attitudes that portray people with psychiatric illness as ‘dangerous and frightening’, ‘incompetent to participate in “normal” activities’ and ‘morally repugnant’.  Comic by Michael Seymour Blake (Inst...

This post is the third in a series of posts on a project on  agency and youth mental health  funded by a MRC/AHRC/ESRC Adolescence, Mental Health and the Developing Mind: Engagement Award and led by Rose McCabe at City University. The research team members were asked the same four questions and today it is Rose McCabe's turn to answer. Rose McCabe Rose is a psychologist specialising in professional-patient communication in mental health care. She records professional-patient encounters and micro-analyses verbal and nonverbal communication. She also works on translating these findings into novel interventions to improve communication and patient outcomes in mental healthcare.  What interests you about clinical encounters with young people in the mental health context? I am fascinated by communication between people and how it has the potential to impact us in a good or bad way. In a mental health context, when someone is distressed and vulnerable, this becomes even m...

Here is the second post in our series reflecting on the end of project PERFECT , this week from postdoc Sophie Stammers . Whilst we’ve all focused on something slightly different, PERFECT researchers were united in using philosophical and psychological tools to dismantle the assumptions that give rise to mental health stigma, and to change the narrative on what counts as ‘good’ and ‘bad’ cognition. A big focus of my work on the project has been the issue of confabulation. We confabulate when we give an account of an event or an action that is not grounded in evidence, but which is given sincerely. Originally, researchers were interested in confabulation as it arose in cases of mental distress or cognitive disfunction, but it turns out that confabulation arises commonly and frequently in all of us, from explanations of mundane consumer choices, to accounting for our moral and political beliefs. Maybe you’ll have been engaged in an explanation of an event, or an experience...

Hello! This is a post in a series where we are reflecting on the end of project PERFECT , offer an overview of our activities, and look at the future! So it's me first. Research Yesterday the project officially ended, after five intense and wonderful years. We did achieve the goals that we set for ourselves, investigating what we call the epistemic innocence of beliefs that are irrational and often false. Epistemic innocence is the capacity some beliefs have to support epistemic agency despite their obvious epistemic costs. In other words, it is good for us to have those beliefs in some respects, even if the beliefs themselves are not well-supported by, or responsive to, evidence. Our main focus was on those belief-like states that can be at the same time common in the non-clinical population and symptomatic of mental health issues: delusional beliefs, distorted memory beliefs, and confabulatory explanations. Indeed, we investigated these three cases in some d...

In this post, I summarise a paper I recently wrote with Kathy Puddifoot (University of Durham), which appears open access in an excellent new book, entitled 'Why Philosophy?' and edited by Diego Bubbio and Jeff Malpas. Kathy Puddifoot Philosophical research impacts on our understanding of the world. We argue that empirically informed philosophy can help us both reduce and control the effects of implicit bias on our behaviour, and challenge the stigma associated with the diagnosis of psychiatric disorders. In both cases, knowledge of philosophy and practice of philosophy make a significant contribution to the development of a fairer society. Implicit bias Implicit biases are responses to members of social groups (e.g., races, religions, gender, ability groups), associating members with traits in virtue of their social group membership. Biases may occur unintentionally, seemingly without the believer being aware of their occurrence, and are difficult to control. Th...

A nna Lavis is a Lecturer in Medical Sociology and Qualitative Methods in the Social Studies in Medicine (SSiM) Team in the Institute of Applied Health Research at the University of Birmingham. She also holds an honorary research position in the Institute of Social and Cultural Anthropology, University of Oxford. Her work explores individuals’ and informal caregivers’ experiences and subjectivities of mental illness and distress across a range of social and cultural contexts, both offline and on social media, with a particular focus on eating disorders and self-harm.  In this post Eugenia Lancellotta interviews Anna on her latest project, Virtual Scars: Exploring the Ethics of Care on Social Media through Interactions Around Self-Injury , funded by the Wellcome Trust, Seed Award in Humanities and Social Science. EL: How did you become interested in the ethics of care in self-harming online communities? AL: I started work on relationships between social media an...

On 9th January at the Royal Society of Medicine an event took place, Global Mental Health: Children in Crisis . The first speaker, Vikram Patel  (Harvard Medical School), presented a lecture on how to prevent mental health problems in children. He highlighted the importance of linking epidemiological and neuroscientific data. From en epidemiological perspective, deprivation is a very significant risk factor for mental health problems, comparable to what smoking is for lung cancer. And most mental health probelms begin before the age of 24. From a neuroscientific perspective, the brain is very plastic in young adulthood. The prefrontal region of the brain (linked to executive decision making) matures 5-8 years later than the limbic region (linked to basic emotional reactions). Adversities associated with poor developmental outcomes include: Malnutrition Stressors Infections War and displacement Parental ill-health Abuse The need for responsive parents ...