Tuesday 29 October 2019

Goodbye PERFECT (Michael and Valeria)

A month from the end of project PERFECT, Michael Larkin (Co-Investigator) and Valeria Motta (Doctoral Research Fellow) reflect on what the project meant for them.

One helpful way to think about being involved in a project as expansive as PERFECT is to reflect on where it is sending you next. In this post, we discuss some of the things they have learned from our interdisciplinary work together.

Michael Larkin

Michael: One of the most interesting aspects of PERFECT for me has arisen from the opportunity to work with you on your PhD. It’s going to be a really innovative combination of philosophical argument and phenomenological-psychological investigation. I’m aware that – coming into it – you were already very well-read on the phenomenological philosophy. I’m curious to know what has struck you most about getting to grips with qualitative methods in psychology?

Valeria Motta

Valeria: Thank you Michael. It was very interesting for me working with you too. I was surprised to find a variety of approaches within qualitative methods. And it was interesting to think about the epistemological implications of these different approaches. I am specifically referring to the difference between discursive and experiential qualitative methods. The discursive method focuses on the linguistic resources and conversational features that participants use to give accounts of their experience. The experiential method (such as IPA) aims to understand the connection between embodied experience, talk about the experience and a participant’s making sense and emotional reaction to that experience. 

From a philosophical perspective this is interesting. It talks about the relationship between language and experience. As I read it, an important difference between these methods is the role of language. For the experiential method, language is more than what we employ to describe an experience. It is a constitutive part of it. In other words, the experiential method is making ontological claims about the very nature of our experience: that it is embodied, that it involves emotions and the use of language. This is not so clearly the case for a discursive method. And here I wonder whether, in the discursive method, the linguistic resources are regarded solely as ways of expressing an experience or as constitutive parts of the experience.

M: Right – these are the two most well-established epistemological positions in qualitative psychology, so it helps to orient yourself if you can get a feel for them. I’m not sure the distinctions play out quite the same in other disciplinary domains. I think a discourse analyst would want to pick up on your last point too. They might be interested in ‘experience,’ but I think they’d say that they were interested in how ‘experience’ is constructed – through talk and action – and how it might act as a socially-meaningful form of knowledge. So there is a relationship to ‘experience-as-topic’ there, but it’s quite distinct from the phenomenological one. And they might add that a particular kind of authority or expertise is invoked when people talk about ‘their experience’ of something – which is where Lisa’s work on narrative seems to be headed as well. I think both the experiential and discursive approaches are interested in sense-making though – it’s just that they focus on different contexts and dimensions of this.

V: I guess what I was thinking is that when a methodology proposes to study talk and action (all external manifestations), one could say that the implications of this are that the psyche can be perceived directly via its external expressions (language, culture, history). This is liberating as well as problematic. We rid ourselves from having to presuppose the existence of mental representations. But, at the same time, we could argue that what this method investigates is what is historically built. In other words, narratives may tell us more about a group than about individual experiences. Perhaps this serves as a good ‘way into’ individual experiences.

But you mentioned that both approaches are interested in sense-making. What qualitative methods refer to when they talk about sense making was another crucial thing for me understand and I thought it is used quite distinctively in methods such as IPA. We read that IPA researchers analyze what participants say in order to learn about how they make sense of their experience. I remember asking you to clarify sense making for me in this context.

M: Yes, that phrase is doing quite a lot of work. It’s also used interchangeably with meaning-making, and we’ll have to defer for another time a discussion about whether sense and meaning are the same thing! A lot of what’s implied by the phrase is related to its historical role in clearing a space for a different kind of psychology. Jerome Bruner’s work – particularly Acts of Meaning - was very important for qualitative psychology. It set out the possibility of a variant of psychology which was less interested in the causes of behaviour, or the intrinsic qualities shared by ‘types’ of people, and more interested in the meaning of behaviour, or how we make sense of our relationships to self and others.

Effectively, this kind of work is asking, ‘How do people make sense of the world?’ A lot of the initial progress was made on the discursive front, and so there the focus was on linguistic, social and cultural aspects of meaning. It employed the idea that meaning is a resource (in the form of say a discourse, or narrative) that is ‘out there’ in the world, available to us, but also working upon us. That in turn opens out a relationship between meaning and power (how do power relationships affect the meanings that we can claim for ourselves in different contexts?), and another between meaning and embodiment (how do we make sense of how we feel?), and another between meaning and experience (how do we make sense of what has happened to us?).

Each of these loosely reflects a different subset of epistemological and methodological interests, but a couple of concerns are cross-cutting – one is context and the other is the idea that meaning or sense-making is an active, effortful human endeavour. In IPA, we’re asking, ‘How does this person in this context, make sense of this experience?’ – and then across cases, we’re doing analysis to identify patterns of meaning in those accounts. That’s what a theme is: a pattern of meaning, a way of capturing people’s relationship to something of significance in their world. The focus of those patterns can vary, though, in terms of the degree of abstraction that analysts might aim for.

Tuesday 22 October 2019

Goodbye PERFECT (Sophie)

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 you’ve had, or something you did, and looked back to realise that you might have said something as part of the account that wasn’t strictly true. Perhaps, wrapped up in entertaining your audience, you added some details to embellish the story, and only later realised that something you said didn’t really happen. We don’t always recognise when we’ve done this (in fact, frequently we don’t!), and whilst there’s a sense in which it’s obviously bad to tell each other things which are false, we don’t think that assessment is the whole story.

As part of the project’s focus on confabulation, Lisa and I guest-edited a special issue of Topoi dedicated to new philosophical perspectives on confabulation (you can read blog posts on the papers in the issue here). Whilst recognising confabulation’s drawbacks, I think it has some important benefits because it allows us to imbue our explanations with the themes that resonate with our picture of ourselves (and that we want our friends have of us) which leads to important social and psychological advantages.

I’ve also continued my work on implicit bias, in which we can judge and act disfavourably toward members of marginalised groups even though we consider ourselves to be egalitarians. I have written about the metaphysics of the underlying cognitions, the issues surrounding their erasure through future technological means, and their epistemic benefits (better understanding of social injustice). I got to talk about some of this research on a BBC Radio 4 Analysis special and in a related BBC news article.

What has felt like some of the most important work I’ve done whilst here is my Philosophy of Mind workshop series, which incorporates research by all PERFECT team members, and was developed in partnership with Mind in Camden. The workshop series introduces participants to the philosophical tools which enable us to challenge mental health stigma. It gives participants an opportunity to reconstruct models of mental health that better support and include both insights from lived experience, and research findings showing how all brains use various tricks and shortcuts (some of which play a key role in supporting agency), regardless of whether we routinely experience mental distress.

I’m really proud of this work, and I talk in more depth about it in this summary on the blog, this interview on the Daily Nous, and on its relevance to meeting the challenge from epistemic injustice in this post with Lisa for Mental Elf.

I’ve felt honoured to have been able to learn from the participant perspective; firstly through co-production of a research paper written with a participant and expert-by-experience (under review); and through this wonderful podcast created by Bonny Astor from Mind in Camden (herself a workshop participant turned facilitator, who ran an adapted series of philosophy workshops for Pentonville Prison!) which features three other participants who discuss the merits of doing philosophy together.

I’ve run the workshop series in various formats with people with lived experience of mental distress and who have unusual experiences and beliefs; mental health professionals; and mental health advocates and campaigners; and have used materials developed there to run one off workshops and CPD training days with at medical institutions and NHS trusts. I’m still running iterations of the workshop series and training days, so get in touch if you’d like to know more.

On behalf of the rest of the PERFECT team it is my very great pleasure to thank everyone who’s been involved in the project in some way: our advisory board, our network members, our collaborators within academia and beyond, and you, of course, our dear readers! And whilst we’re turning the office lights off for now, the Imperfect Cognitions blog lives on - we just made too many interesting connections to stop sharing summaries of new research, books and conferences, so see you back here on Tuesdays!

Tuesday 15 October 2019

Phenomenology of Health and Relationships

Today's post is by Michael Larkin and William Day (both at the University of Aston). They are reporting on the Phenomenology of Health and Relationships conference, which was sponsored by project PERFECT and held at the University of Aston on 22-23 May 2019.

We're both participants in the Phenomenology of Health and Relationships group at Aston University. In planning our inaugural conference, the group initially considered a narrower focus on Interpretative Phenomenological Analysis (IPA). There is a regular (more-or-less annual) IPA Conference, and we had agreed to host it. Eventually we settled on a broader theme (Creativity and Affect). IPA is one approach which many of us use in our work, but it is not the only one, and methods are not the sole focus of our meetings. When we meet as a group, we do discuss creative innovations in methodology, but we also read phenomenology, and explore studies which offer experiential insights on health and relationships. We hoped that a broader theme would open up dialogue around these cross-cutting issues and provide a space for thinking about the development of IPA, but also its relationship to philosophy and to other approaches. 

In our Call for Papers, we encouraged presenters to think about these cross-cutting issues, and also to feel free to suggest creative ways of engaging the attendees with their work. We were delighted to see, when the responses to our Call For Papers began to arrive, that there was a considerable appetite for an event like this. 

We ran our event at Fazeley Studios in Digbeth. The venue was lovely - spacious and light - and we had the good fortune to be running over two warm and bright spring days.

Zoë Boden’s invited workshop opened the event, with a morning focused on analysing image-making data in phenomological research. Zoë kicked things off by asking delegates to introduce themselves through drawings representing how they were feeling. Here's the image that Will made, as he brightened the corners of the unfolding morning of May 22nd -

During the workshop, Zoë drew upon her work exploring young peoples’ experience of psychosis, and her analytic framework (Boden, 2013; Boden & Eatough, 2014) for multi-modal analysis. Her workshop made a compelling argument for considering images as distinct residuals of subjectivity in their own right, not just as a way to elicit narrative data. After the session, the coffee break was buzzing with people enthusing about how they were going to incorporate these ideas into their next research project.

The conference’s first keynote came from Virginia Eatough whose talk developed a phenomenological perspective on affect. Virginia began with the premise that people are “existential world disclosers.” She positioned affect as a distinct layer of experience which orients ourselves towards others; a concern-ful, relational mode of involvement in the world. Virginia focused then on the power of language to make this manifest. Language is “in the world”, a practical engagement that helps us get to understanding. She develop this point through reference to an insightful analysis: ‘“It’s like having an evil twin”: the lifeworld of a person with Parkinson’s disease’ (Eatough & Shaw, 2019). In this case study, ‘Barbara’ - 61 years old and living with a diagnosis of Parkinson’s disease for four years – reflects on ‘losing her grip.’ The multiple meanings of ‘grip’ employed by Barbara, and expanded through Virginia’s analysis, illuminated the complex relationship between the loss of physical grip and encroaching psychological uncertainty.

Virginia Eatough

In the afternoon that followed, we had parallel sessions with fascinating papers on aspects of spiritual experience (David Wilde), parenting and health (Kristina Newman, Kat Slade, Lydia Aston) and coping with ongoing ill-being (Joanna Farr, Collette Beecher). Refreshed insights into the connections between method (from the morning), concepts (from the keynote) and research practice (in the afternoon papers) were already coming to the surface of our conversations in between the sessions.

In the call for papers, we had strongly encouraged submissions from presenters who wished to do something a little unusual with the format. We were fortunate enough to be able to end the first day with two really exciting and innovative examples of what conferences can do. In one session, William presented his multi-media reflections on the film “I, Daniel Blake”. He was too modest to mention it in his draft notes for this piece, of course, but this is a piece of work which foregrounds the way that the auditory and visual dimension of cultural narratives create experiential meaning for audiences. In the other session, Asztrik Kovacs and Daniel Kiss used music, song, narration and photographs to reflect on the experience of psychiatric hospitalisation in Hungary. The piece drew on family experience, archival images, and reflections on field research, and it was woven together into a single, unbroken flow of performance. This was a highlight of the conference for many of us, who loved the way that it evoked the intensity of connections that can still persist between people even when they are separated by time, place and experience.

Tuesday 8 October 2019

Glenside: Mental Health Museum

There’s a lovely little church in Blackberry Hill, Bristol, nestled in the grounds of what was once the old psychiatric hospital. Step inside, and you’ll find a curious assemblage of artefacts, writings, recordings, drawings, and sculptures, telling the stories of the many mental health patients and practitioners of Bristol’s past. Welcome to Glenside Hospital Museum, which I’ll tell you a bit about now, before encouraging you to take a look for yourself if you’re ever over that way. (In terms of the content, I do discuss patient accounts of treatments, some that are quite upsetting.)

At the start of the exhibition, we see the shift from dominant attitudes in 1600s Britain of seeing mental illness and distress as a punishment from the Christian god, or a mark of demonic possession, to the idea that the afflicted are sufferers for whom there might be a cure, and the birth of modern psychiatry as a medical field in the 1800s. You can peruse a detailed timeline developed by the museum’s volunteer researchers, chronicling treatments, philosophical theories of mental health, significant public events, and the attitudes of those in power across the ages.

The museum has quite an array of historical artefacts: anatomical models for teaching, such as the brain of wound cotton; old medicine bottles and records of treatment advice (for instance, for preventing a faint, you would once have been advised to imbibe a ‘tot’ of brandy – this author does not endorse this advice, not least because I am rather uncertain as to how many millimetres are in a ‘tot’… is it at the patient’s discretion?); early ECC scanners and ECT machines, as well as something called a ‘violet ray’, a device used to administer high frequency, low current blasts of electricity to the body, which was used in effort to relieve various symptoms of mental disquiet as well as physical ailments such as asthma…though it’s not clear that it was very successful…

I was particularly moved by the emphasis on the experiences of the individuals involved in the hospital over the years. I listened to a clip from a sound archive in which Mary Cox, a medical secretary in the 1970s, had no choice but to take her sick dog to work one day – the patients so enjoyed petting and spending time with the dog (which he enjoyed as well!) that he became a regular visitor. 

In an excerpt from the museum’s oral archive, Clive tells his story about undergoing a leucotomy (also known as a lobotomy, a barbaric procedure in which parts of the brain are physically destroyed) in the 1960s: “It was a horrible time for me because I couldn’t do anything after that operation. I had to learn how to do things all over again and I was ill for a long time.” Clive discussed how he didn’t blame his parents, who signed off on the procedure, as well as how he wished to meet others who had had the same operation to try to reach a better understanding of his experiences. We don’t know if that wish was ever granted.

I particularly enjoyed the exhibition of drawings by Denis Reed, former artist, lecturer, and patient of Bristol Mental Hospital in the 1950s. His sketches show a series of lively interactions, the savouring of cigarettes – an important currency for patients, as well as the listlessness of other aspects of life on the men’s ward.

Currently, you can also see “We Had Names: patients of The Bristol Lunatic Asylum” an exhibition by contemporary artist Anwyl Cooper-Willis. Among my favourite pieces was the wall of sketches of individuals, based on 1890s admission photographs, and drawn on ECG paper.

Glenside Hospital Museum is free to visit (a £2 donation is suggested), has full disabled access, and is open at 10am – 12:30pm on Wednesdays and Saturdays. You can find more access info here.

Tuesday 1 October 2019

Goodbye PERFECT (Lisa)


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.


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 depth, Ema Sullivan-Bissett and Andrea Polonioli focusing on delusion and belief, Kathy Puddifoot on memory, and Sophie Stammers on confabulation. However, we significantly extended the number of cases to investigate, covering also those beliefs that seem to be due to implicit bias (thanks to Kathy's and Sophie's interest and strong background in the topic) and those that are produced as a result of optimism bias (Anneli Jefferson was instrumental here). We also connected epistemic innocence to the literature on the ethics of belief and epistemic normativity (thanks to Ema) and to traditional issues concerning rationality and good reasoning (thanks to Andrea).

The project developed in other, unexpected, ways with a thread of research on complex emotions that can be to some extent epistemically innocent (such as loneliness and boredom). We also reflected on the role of personal relationships and social context in the formation of those beliefs and the manifestation of those emotions that have been the object of our study. In this aspect of the project, Michael Larkin was a pivotal influence, conceptually and methodologically, and made a substantial contribution to the training of our shining PhD students, Magdalena Antrobus and Valeria Motta.

We hosted three academic workshops, in 2016, 2017, and 2018 and published extensively, within the core team and in collaboration with network members too. We guest-edited two special issues of well-established philosophy journals (an issue of Philosophical Explorations on False but Useful Beliefs and an issue of Topoi on Philosophical Perspectives on Confabulation), and secured open access for all the original contributions gathered in those issues. We also published an open access book, Delusions in Context, and prepared a monograph, aptly called Epistemic Innocence, which is in press.

Outreach and impact activities

Investigating all the interesting issues above, we wanted to be able to disseminate our results as widely as possible, which was consistent with our aim of undermining mental health stigma by promoting an understanding of the human mind according to which mental health and mental illness are continuous.

We used this blog as a platform and we organised six events as part of the Arts and Science Festival, with topics ranging from domestic violence to hallucinations, from the role of imagination in recovery to self-management of mood changes in bipolar experiences. We stepped out of our comfort zone very frequently, organising art exhibitions, hosting film screenings, and getting children to play with emotions lego... It was all great fun!

Sophie will talk about her experience with creating a pop-up philosophy group and engaging mental health service users, service providers, carers, and campaigners in project PERFECT's work. Here I will just take the opportunity to thank Akiko Hart and Bonny Astor at Mind in Camden, Antonis Kousoulis and Jolie Goodman at the Mental Health Foundation, and our friends at SureSearch for invaluable support throughout the project. We know it is not easy to work with academics...

So did we make an impact? Probably too early to say! We did spread the word, on radio, TV, newspapers, magazines, blogs, posters, and in schools, theatres, festivals, museums. The result is a long list of accessible resources you can browse on the PERFECT website.

The Future

Well, PERFECT people will keep in touch and keep collaborating! Our blog will continue with one new post a week and will bring you updates on project developments. And we will all start new projects. Mine is on stories.

Don't forget us!