Tuesday 31 March 2020

Into the Abyss

This post is by Anthony S. David, Director of the Institute of Mental Health at University College London. Here he talks about his new book, Into the Abyss: a neuropsychiatrist’s notes on troubled minds (Oneworld Publications, 2020).

When I submitted a title for my first non-academic book I did so with some trepidation. Apart from sounding somewhat negative, wouldn’t people think it was something about mountaineering, a cautionary tale perhaps? As I explained to my concerned editor, the intended readership like those of this blog would be, “interested in themes at the intersection of philosophy, psychology, and psychiatry” and would instantly pick up the reference to Jaspers, the early 20th Century philosopher-psychiatrist. Somehow he wasn’t reassured. 

But the abyss metaphor is a powerful descriptor of the challenge of understanding the experience of the person who is mentally ill – to reach out across the abyss into what Jaspers called ‘an impenetrable country’, the mind of the disordered – especially where the disorder is in some sense extreme or severe, as in psychosis. Anyone of those interested in the 3 Ps mentioned above, and especially if they have a therapeutic role, will see this as the essence of our job description.

That job description, to put it grandly, to understand the human condition especially in extremis is always of course a challenge and perhaps an impossible one, yet one many of us find hard to resist. So whether it is a person suffering from nihilistic delusions following a brain injury, or someone with an unusual eating disorder, or, a functional neurological disorder so extreme that it renders the person comatose, there has to be, or so we believe, a way of comprehending and even explaining. And maybe, every so often, we may find jointly, a pathway, a bridge, reconnecting their world with ours. 

In writing these extended case histories it is clear that finding a narrative is not just novelist’s work as German psychiatrist Kurt Schneider once put it, but something mental health professionals and indeed every one of us tries to do to make sense of our lives – particularly when faced with adversity or loss. It cannot be a mere fiction, a gloss or a re-writing of history but there is a creative element which fills in gaps and which provides at least a framework for understanding what would otherwise be, in Jaspers words, un-understandable.

Anthony David

One of the most notorious counteractions to Jaspers’ un-understandability of psychosis claim came from R.D. Laing who in The Divided Self (1960/2010; Modern Classics. Penguin Books, London) sought to make psychosis ‘more socially intelligible’ than had hitherto be thought possible by delving into individuals’ ‘existential phenomenology’ and their family interactions. He did so with great sensitivity and skill but not always in ways which were transparent and replicable. It is the bio-psycho-social approach which is now our all-purpose methodology and explanatory model.

The model proposed in the 1970s by George Engel, a psychologically minded US physician, has come under fire from all sides as being, both too obvious (like motherhood and apple pie), and too vague and indefinable. Thankfully, we now have Derek Bolton and Grant Gillett’s exposition (The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments. Palgrave, 2019) and intellectual underpinning of the model to help us bolster our adherence to it. 

In some ways what I was trying to achieve in Into the Abyss was an illustration of the subtle power of the biopsychosocial approach. How all the constitutive elements must be considered in any presentation but each has to be weighted differently as appropriate. We can only do this by attempting an empathic understanding, by working collaboratively with the person in distress in front of us; by examining our own assumptions and being receptive to what’s going on in our brains, our minds and our society. When we do this we find that the abyss closes before our very eyes and that we are all part of the same world after all.

Tuesday 24 March 2020

The Power of Stories

Today's post is by Lisa Bortolotti (Birmingham) who is summarising the main argument in a recent paper co-authored with Anneli Jefferson (Cardiff) on the power of stories in debates about mental health, published in Diametros open access.

Autobiographical stories do not merely offer insights into a person's experience but can be used as evidence for a controversial claim within a public debate. Although the function of stories is not typically to persuade your audience that something is the case, some engaging stories are likely to exercise a powerful influence on readers' thought and behaviour. One reason for their influence is that stories are vivid and concrete, more accessible than other forms of evidence which might require expertise or training to be fully understood or evaluated.

Our main message in the paper is that, if stories are used as evidence and are influential in changing hearts and minds, then we should treat stories as we treat other forms of evidence, acknowledging that stories can be good or bad evidence for the claim they allegedly support. Moreover, there will be epistemic and moral duties that will apply to the use of those stories in public debates. In our view, this is particularly important when stories are told to reaffirm or reconstruct people's identities, as in some mental health debates. 

In the paper we refer to examples from two very lively debates, one on the nature of distress ("Should it be medicalised or should we see it as an effect of trauma?") and one on the nature of autism ("Is it an instance of neurodiversity or a disability?"). Referring to recent stories (brief articles in newspapers, blog posts, or book-length memoirs) where authors reported their own experiences and reflected on them, we showed how stories were then presented as reasons to reject a certain model of distress or a certain conception of autism. They became part of an argument.

In the end, we argue that when we participate in a debate, in the pub, in the classroom, or on social media, we have a responsibility to assess a story as evidence when the story is used to support a given viewpoint. That does not entail silencing courageous people who offer valuable first-person accounts, but requires that we as 'consumers' of the story develop our own critical distance from it. We also make some preliminary suggestions about what can be done to ensure that the use of stories contributes to the variety of the resources available in a debate without compromising the quality of the argumentation or increasing polarisation.

Saturday 21 March 2020

Great Minds Don't Think Alike

This post is the second in a series of posts featuring presentations that could not be delivered at Philosophy conferences due to the coronavirus outbreak.

Today Nick Byrd, PhD Candidate at Florida State University, summarises his paper, "Great Minds Do Not Think Alike: Individual Differences In Philosophers’ Trait Reflection, Education, & Philosophical Beliefs".

Many philosophers accept that relying on unreflective intuition is standard fare in philosophy (e.g., Chalmers, 2014; De Cruz, 2014; Kornblith, 1998; Mallon, 2016). Many philosophers also consider reflection to be crucial for philosophical inquiry (e.g., Goodman, 1983; Hursthouse, 1999; Korsgaard, 1996; Rawls, 1971; Sosa 1991). Fortunately, cognitive scientists have developed measures of peoples’ reliable on unreflective and reflective reasoning (e.g., Evans, Barston, and Pollard, 1983; Frederick, 2005; Sirota, et al., 2018).

In fact, among laypeople, individual differences in reflection often predicts differences in their philosophical judgment. For instance, more reflective people are often more likely to be atheists (Pennycook et al., 2016) and social conservatives (Deppe et al., 2015). However, some of those correlations could be explained by other factors such as numeracy (Byrd & Conway, 2019), training in philosophy (Livengood et al., 2010), culture (e.g., Gervais et al., 2018), and personality (e.g., Alper & Yilmaz, 2019). As I learned about this literature, I began asking some empirical questions.

  1. Will individual differences in philosophers’ reliance on reflection predict their beliefs about classic philosophical questions (i.e., the PhilPapers survey)? 
  2. If so, will the direction of these correlations match what we find among laypeople? 
  3. Will the correlations be detected when controlling for culture, numeracy, personality, etc.?
  4. Will the findings replicate in a larger, pre-registered study?

Two large studies (N > 1000), one pre-registered, investigate these questions. The result? Many correlations between reflection and philosophical beliefs among non-philosophers replicated among philosophers (Table 8). For example, less reflective philosophers preferred theism to atheism and the so-called deontological responses to the so-called utilitarian response on the trolley problem (Pennycook et al., 2016; Reynolds, Byrd, & Conway, under review).

Nonetheless, philosophical judgments were sometimes better predicted by factors like education, gender, and personality than by reflection. Also, the remaining relationships between reflection and philosophical views were partially mediated by having a Ph.D. in philosophy or by preferences for actively open-minded thinking (Baron, 2018). So although some relationships between reflection and philosophy remain robust among philosophers, there is more to the link between reflection and philosophical belief.

Consider a normative question about these data. Are the philosophical views that correlate with reflection betterviews (ceteris paribus)? Some dual process theorists employ this inference (e.g., Baron, 1994; Greene, 2013). However, I argue that the inference faces empirical and philosophical obstacles that have yet to be surmounted.

Now consider two reasons why a few of the present findings deviated from past findings. First, the PhilPapers survey is mostly a measure of agreement with general philosophical views or principles. It is not a measure of intuitions about particular thought experiments. Those familiar with conversational implicature research will be unsurprised that psychological factors can predict different responses to each measure (Cullen, 2010).

Second, academic philosophers are different than laypeople (Livengood et al., 2010). Whether this caused by philosophical education, academia’s selection mechanisms, or some combination of factors is not yet understood. Nonetheless, it is unsurprising that the present findings could vary by population.

Tuesday 17 March 2020

A Manifesto for Mental Health

Today's post is by Peter Kinderman, Professor of Clinical Psychology at the University of Liverpool, who presents his recent book, A Manifesto for Mental Health  (Palgrave 2019).

Nobody really believes that our mental health system is fit for purpose, but too many people persist in reinforcing that failed system. It is no longer good enough to call for better funding; we need genuinely radical change.

My new book presents a new and distinctive perspective. One that challenges traditional approaches and vested interests of professionals, but one with surprisingly well-placed support.

I argue that we need to change our ideas about what mental health actually is.

Before setting out practically how our mental health system should change, A Manifesto for Mental Health critically examines the dominant ‘disease-model’ of mental health care. Using research into both biological neuroscience and the social determinants of psychological problems, the book offers a contemporary, genuinely biopsychosocial, alternative to the idea that our psychological distress is best thought of as symptoms of illnesses, and treated as such. The way we care for people with mental health problems at present is not only unscientific and ineffective, it is creating a hidden human rights emergency. We need a new approach.

It is clear that our mental health and wellbeing depend largely on the society in which we live, on the things happen to us, and on how we learn to make sense of and respond to those events. To move forwards, we need to recognise that distress is usually an understandable human response to life's challenges, especially experiences of abuse, neglect and inequity, and offer practical help rather than medication. We could start by rejecting invalid diagnostic labels, and instead pay attention to the circumstances of our lives (something understood by public health physicians) and record the emotional consequences in simple, straightforward, non-medical language.

Our mental health cannot simply be reduced to genetic vulnerability, and distress merely passed off as the symptom of an illness – it depends heavily on the society in which we live, on the major life events we face, and the ways in which we interpret and face them. It’s about collectively creating a more humane society and establishing healthier communities. It’s about recognising the human and psychological cost of failed societies, ensuring that people get the practical and emotional support they need... and it’s about reminding ourselves that social problems ultimately require social solutions.

Offering a serious critique of establishment thinking, A Manifesto for Mental Health explains how, with scientific rigour and empathy, a revolution in mental health care is not only highly desirable, it is also entirely achievable.

Saturday 14 March 2020

Listening in Public: the Discourse Ecology Model

This post is the first in a series of posts featuring presentations that could not be delivered at Philosophy conferences due to the coronavirus outbreak.

Today Susan Notess, PhD Candidate at Durham University, tells us about the Discourse Ecology Model.

Susan Notess

In a healthy democracy all voices should have participation in public discourse. This does not happen if one part of the population does not listen to another part—for example, if white people do not listen to people of colour in a given democratic society. We can try to address this kind of problem with political solutions, such as targeted town hall meetings and encouraging voter turnout. We can also approach it as a problem of epistemic injustice, highlighting the need to resist prejudices and avoid silencing of vulnerable voices. I argue that while both these approaches are needed, we still have a problem if the listening habits of the society as a whole do not change.

What we need is a clear understanding of the interplay between individual habits and the habits of society, both of which contribute to and constrain each other. I propose a Discourse Ecology Model as a way to understand this dynamic and to explore how it might be possible for social habits of listening to change. For this model to work, it needs to be able to show us two things: how ‘private’ attitudes which structure individual listening behaviour can come to differ from the balance of public attitudes, and how those individual differences can put pressure on the public balance.

The controlling concept here is that of an ecosystem, the constituents of which both create and are constrained by the balance of the whole. The link to discursive systems is drawn from empirical work in historical linguistics which examines when, why, and how new usages become institutionalised across social networks and alter the norms of the system: new words get invented, old words change meaning. Dewey’s philosophy of habit change provides the substantive philosophical basis for joining these two notions—ecology and language change—as a coherent model for how individual and public discourse habits can change, and change each other.

What the Discourse Ecology Model offers us is a way to think critically about the individual’s pursuit of virtue in the face of civic vice. Can the individual become a more just listener if society is unjust, or does the stability of public listening habits constrain the individual’s development of virtues? If the latter, then how can anything change?

On my view, citizens’ pursuits of virtue in the face of civic vice are not meaningless. This claim is based in part on a wilful assumption, and in greater part on the Model of both social and individual habits as dynamic and mutually stabilizing. As with ecosystems, changes in individual habits can spread and, at least in principle, lead to changes in the habits of society. The spread of such habits is not predictable nor can it be engineered, for reasons that the historical linguistics literature makes clear. Nevertheless, the individual pursuit of virtuous social listening habits remains worthwhile, both for its own sake and for the sake of its potential to contribute to the institutionalisation of new listening habits across society.

Tuesday 10 March 2020

Problems of Religious Luck

Today's post is by Guy Axtell, professor of philosophy at Radford University, who writes about his new book on religious luck. If, after reading the post, you want to know more, you can listen to the author’s recent podcast interview with Robert Talisse for the New Books in Philosophy.

Problems of Religious Luck: Assessing the Limits of Reasonable Religious Disagreement (Lexington Books, 2019) applies philosophy of luck and risk in critiquing religious fundamentalism, and in particular, the tendency towards ‘normalizing’ polarized and polemical religious apologetics. It may seem like quite a departure from the usual association of inductive risk with policy decisions regarding science and technology, but Axtell finds the concept of inductive risk portable, and indeed useful for discussion of ‘risky’ belief or acceptance more generally. Epistemic luck and risk are developed as closely connected concepts. 

The book sketches an account of well and ill-founded nurtured belief based upon doxastic strategies involve low to high degrees of inductive risk: the moral and epistemic risk of ‘getting it wrong’ in an inductive context of inquiry. Philosophy of luck and risk are presented in this book as aiding our understanding of what is going on, at least logically and psychologically, when persons, theologies, or purported revelations ascribe various kinds of religiously relevant traits to insiders and outsiders of a faith tradition in sharply asymmetric fashion. 

Our inductive risk account shows as epistemically significant not just the diversity of beliefs in a domain, but contrariety of those beliefs. inductive risk account argues for the claim that the epistemic status of belief is challenged not just by symmetrical contrariety, but more especially by polarized and polemical contrariety. The connections between “religious luck” and “inductive epistemic risk,” this book argues, allow researchers to cross disciplinary boundaries in new ways.

The book applies anti-risk epistemology by trying to show how the ascending degrees of inductive risk in an agent’s doxastic strategy contribute to a philosophical account of how to distinguish between benign luck and the malign modal luck. It develops an inductive risk-based account of what it means to motivate serious etiological challenges, and to support them empirically through markers of bias. The ethics of belief is also addressed in the book from a focus on responsible risk management.

Doxastic responsibility is understood in terms of the degree of riskiness of agents’ doxastic strategies, which is in turn most objectively measured through accordance or violation of inductive norms. Doxastic responsibility is attributable to agents on the basis of how epistemically risky was the process or strategies of inquiry salient in the etiology of their belief or in their maintenance of a belief already held. Highly fideistic conceptions of faith are some of the most problematic, and markers of inductive risk are developed to help provide a scale for distinguishing strong from moderate religious fideism. Some of the key concepts discussed include:

  • Inductive risk: the risk of ‘getting it wrong’ in an inductive context of inquiry.
  • Inductive context of inquiry: Any context of inquiry dependent upon reasoning by analogy, generalization or applied generalization, or cause-and-effect.
  • Counter-inductive thinking: Counter-induction is a strategy that whether self-consciously or not reverses the normal logic of induction. As such it should be distinguished from merely weak inductive reasoning and seen instead as thinking or belief uptake that carry especially high inductive risk.

Tuesday 3 March 2020

Do Non-human Animals Have Episodic Memory?

Today's post is by Ali Boyle. Ali is a research associate in Kinds of Intelligence at the Leverhulme Centre for the Future of Intelligence in Cambridge and the Center for Science and Thought in Bonn. Her research focusses on non-human minds and the methods used to study them. In this post, she is going to summarise her recent paper, The impure phenomenology of episodic memory, appeared in Mind & Language.

One question under investigation in comparative psychology is whether nonhuman animals have episodic memory – the kind of memory involved in recollecting past experiences. A problem for this research is that on many accounts, the defining feature of episodic memory is that it involves an experience of ‘mentally reliving’ past events. But if that’s right, then asking whether animals have episodic memory amounts to asking whether they have this distinctive experience. Many researchers think this renders the question unanswerable, since we have no experimental way of getting at animals’ experiences.

This puzzle motivates my paper. In it, I argue that even if we characterise episodic memory in terms of a distinctive experience of ‘mentally reliving’, or recollection, it remains an answerable empirical question whether animals have it. That’s because although episodic recollection is phenomenological, it’s not purely phenomenological. Although it is an experience, its experiential features are tied up with other functional and representational features – and those features are experimentally tractable.

For instance, recollection involves an experience of mental imagery. But mental imagery is not just experiential; it’s representational. When we have (visual) mental imagery, we have a representation with a certain content – some perceptible features, spatially arranged. Recollection is also often said to have a felt quality of ‘pastness’. But this feeling of pastness is not idle: it’s said to ground, or perhaps bottom out in, a judgment that what’s being represented is a past event. And so on.

These representational and functional features give us an empirical foothold for detecting episodic memory. We’d have grounds for thinking that ‘mental reliving’ was going on if we could detect its characteristic functional & representational footprint in nonhuman memory. In the paper, I sketch the kind of behavioural test one might use to detect this footprint. 

Of course, someone might object that a positive result in this kind of test wouldn’t guarantee that the subject was episodically remembering. That’s true! But, I argue, it’s not concerning. The most concerning alternative explanation of such results would be one that appealed to extant forms of memory – like ‘semantic memory’, the store of general knowledge. But other extant forms of memory don’t share episodic memory’s functional footprint, so they’d fit poorly with this sort of evidence. 

A better fitting alternative explanation would be that animals have ‘zombie memory’ – a form of memory with episodic memory’s functional footprint, but without its experiential qualities. This possibility is less troubling, though – because whilst zombie memory might be metaphysically possible, we have no reason to think that it actually exists. It is not the job of a scientific experiment to rule out merely metaphysical possibilities, but to discriminate between plausible, empirically motivated theories.

The paper is about episodic memory, but has a broader message. The puzzle about episodic memory rests on the thought that behavioural tests can’t tell us about nonhuman experience – a thought that casts doubt not just on the detectability of episodic memory, but of any experiential capacity. My response, similarly, generalises: behavioural tests may be unable to rule out that animals are zombies, but can nevertheless provide evidence about what nonhuman experience is like.