Tuesday 31 August 2021

Discounting Responsibility as Epistemic Injustice

This post is by Kelly Saunders. Kelly did an undergrad degree three decades ago. She completed a Bachelor of General Studies at Simon Fraser University in greater Vancouver. Philosophy was by far her favourite. After her degree she worked at a few jobs, including as a mental health worker, before ultimately deciding to open a small business. 

During all the years of running her business, she never quite lost the feeling of wishing she had pursued philosophy to a greater extent. When she came to a "fork in the road" a year ago, she discovered the M.A. in Philosophy of Religion and Ethics at Birmingham. Her hope is to use her M.A. to work as a philosophical counsellor.

When it comes to the issue of responsibility and psychopathology, Hanna Pickard's contributions are immensely valuable for the subject of addiction. She helpfully differentiates between responsibility and blameworthiness in addiction. That is, she maintains that while it may be unhelpful, and morally questionable to blame an addict for their behaviour, the opposite is the case when it comes to responsibility. This distinction paves the way for a practically, as well as morally constructive means to approach addiction, and offers actual hopefulness for the addict.

Clinical practice in addictions and the rehab industry, as well as societal opinion, in large part operate on and accept an approach that eliminates all responsibility from the addicted individual. Addiction practice and philosophy generally follows a predominantly biological model, wherein agential choice is by-passed. Alcoholics Anonymous is a very well known example of this. The first tenet of their program is to admit that "we were powerless over alcohol." Interestingly, although statistics are not easily obtainable, a 2014 book about the efficacy of 12-step programs such as A. A., reports a 5 to 10% "success rate". Another in-depth article debunking myths surrounding the success of A. A.'s approach, can be found in this 2014 article in The Atlantic.

Along with Pickard, I suggest that denying agency to the addict is wrong-headed. At bottom, we have available to us our agency - the possibility to say yes, or the possibility to say no. Exercising this agency may be difficult, but it is not impossible. It is a grave disservice to struggling addicts to further the narrative that it is impossible. I see such treatment of addiction as representing a form of what Miranda Fricker has referred to as "epistemic injustice". 

Epistemic injustice can manifest as testimonial injustice (unwillingness to accept the addict at their word, as a "knower"), or as hermeneutic injustice (an inability or unwillingness to understand or interpret the addict's experience - this can occur in both the addict as knower, and the clinician as "hearer"). When hermeneutic injustice results in the addict being poorly understood, this contributes to the oversimplified view that an addict cannot change. This results in a loss of opportunity for the addict to understand her addiction in a way that recognizes her agency.

When the addict is a priori attributed a lack of agency, this "controls" their personal narrative in a way that is unjust. Arguably, what prevents the addict from making changes is lack of awareness of responsibility, and the accompanying lack of awareness of actual ability to exercise options. It is not so much the addiction being in control of the addict's behaviour, but rather a belief that addiction controls their behaviour that is maintaining the status quo.

With her clear-eyed approach to addictions and responsibility, Pickard nicely swims against the tide of common assumptions that addicts have no responsibility for their addictions. By returning agency to the addict, Pickard does the addict a great service, and helps to work against epistemic injustice.

Tuesday 24 August 2021

Does our metaphysics determine our definition of mental illness?

This post is by Laura Roklicer. Laura is an MA student in Philosophy of Mind and Cognitive Science at the University of Birmingham, alongside which she is attending the Expansions of Quantum Theory Towards Consciousness course organized by ECR-Institute (Berlin) and hosted by the Dev Sanskriti University (Haridvar). She holds a First-Class Honours bachelor’s degree in Psychology and in Media Production, and she is looking to pursue a PhD next year through which she hopes to continue exploring the mind.

Laura Roklicer

How the world actually is beyond our apparent understanding matters greatly in defining our views on many important topics. If consciousness were seen as a mere illusion, a great trick played by an unintentional Nature, then we would all be deluded in thinking that we’re thinking. Similarly, if the whole of existence were a single, unified mind, we would again be deluded in thinking we exist apart from each other, in our own private heads on our own two shoulders, and with our own palette of experiences. 

However, a contemporary framework will have us believe that there is a proper mind, and a less proper mind. That is, that those who see the world – and especially their own minds – differently, are delusional and, more often than not, ill. I want to present a rather controversial view that the ‘mentally ill’ schizophrenics might actually be the sane(r) ones considering a specific type of ontology, but not limited to it.

Schizophrenia is defined in phenomenological terms as a holistic account of a self-disorder rather than by a vast number of unrelated symptoms as it is predominately seen in psychiatry. Thus, an enactivist views it as ipseity disturbance (Ipseity derives from ipse, Latin for “self” or “itself,” Sass, Parnas & Zahavi, 2011, p. 7) characterised by hyper-reflexivity, or the exaggerated reflection on the subject’s own thoughts and experience, and diminished self-affection. The latter means that an individual has lost their ‘self’, and this is interpreted in varying ways.

Some consider this loss of the self to be a delusion in an epistemological sense, claiming that a schizophrenic is not seeing things clearly, confusing their own identity. On the opposite side of the spectrum, Gipps (2020) proposes that this is an ontological matter. What this means is that instead of an individual with schizophrenia wrongly interpreting or not appreciating their self as existing within their ego boundary, they are actually right in saying that their ‘self’ is lost or dissolved. Put simply, an ego boundary is a formal, non-materialist, non-psychological, non-spiritual concept of an axis where Other begins and I end, and when it breaks in an ontological sense, the individual’s self truly ‘disappears’.

"I do not know my boundaries; I am unable to differentiate between inside and outside myself; I feel unsheltered; Parts of the body are outside myself; My brain is outside myself; I feel unprotected; Everything is intruding into me, penetrates me; What others think is transferred into me; What I suffer all others have to bear; I cannot keep my thoughts to myself, everybody can know them; I feel unsheltered and open for every external influence." (Scharfetter’s study in Gipps, 2020, p. 94)


However, there is still ‘someone in there’ who feels and thinks, and who observes this perishing individual and judges his interactions with the external world. So, who is this ‘self’ that has taken the place of a diminished person? The answer largely depends on our view of metaphysics, of how the world really is.

One view is Bernardo Kastrup’s (2017) idealist ontology, which postulates That Which Experiences (TWE) as the true nature of existence. TWE is all that exists, a unified whole, or a mind of us all, and we are but dissociated alters of this single entity. As individuated ‘alters’ of TWE, we interact with each other, with the external world, and with ourselves, as belonging to the illusion of separation in which we own an ‘ego’. In this kind of ontology, a person whose ego had dissolved into nature would in fact be breaking the delusion and approaching a higher form of sanity, rather than having it the other way around in a physicalist framework.

I have concluded two things, both of which favour the non-delusional interpretation of schizophrenic’s diminished self. First, a schizophrenic is not delusional about having its self dissolved with the rest of reality, because their ego boundaries are ontologically, rather than epistemologically, broken, and thus the individual’s self in fact diminishes. Second, a schizophrenic’s diminished self-affection is not a product of a delusion in an idealist ontology, in which the whole of reality, our individual minds included, are really just one holistic thing – the unified mind or That Which Experiences. In the latter sense, the schizophrenic is on a ‘journey to a higher form of sanity’ (Laing, 1967), that is on their way to a unified reality that underlies our individuated existences.

Tuesday 17 August 2021

Problems of Living

Today's post is by Dan Stein (University of Cape Town) who writes about his new book, Problems of Living (Elsevier, 2021).

It seems to me hard to practice psychiatry without asking some key “big questions”, both about the nature of the mind (and mental illness) in particular, and about the nature of life (and mental suffering) in general. More than a decade ago I published a volume, Philosophy of Psychopharmacology, in which I addressed some of the “hard problems” faced by mental health clinicians, with a particular focus on philosophical issues raised or addressed by advances in psychiatric medication. 

This year I’ve published my second volume at the intersection of psychiatry and philosophy, Problems of Living, in which I look at a range of “hard problems” raised by life as a whole, with a particular focus on philosophical issues raised or addressed by advances in the cognitive-affective sciences including psychology and neuroscience.

I view my approach in both of these volumes is “integrative” in a number of ways. First, I often spell out debates in the psychiatric or philosophical literature, and then take a “middle way” that I see as drawing on the best points made by the protagonists in the debate. 

Second, in thinking through the “big questions” and “hard problems”, I draw on a range of disciplines, including not only philosophy, but also psychiatry, psychology, and neuroscience. 

Third, I often juxtapose authors from different times and places; Aristotle, Spinoza, Hume, Dewey, Jaspers, and Lakoff are amongst my favourites, perhaps precisely because each covered so many different areas, bringing together different disciplines, with a wisdom and practical judgment that remains relevant.

Dan Stein

I can imagine that a registrar in psychiatry, working in the trenches, and swotting neuroscience for exams, might well shrug his or her shoulders in response to this all, perhaps even rolling their eyes at the disjuncture between intellectual pretension and clinical reality. 

Similarly, an individual suffering from a mental disorder, that perhaps has not responded successfully to modern interventions, may be less interested in conceptual niceties, than in psychiatry making practical progress. 

On the other hand, for a philosopher doing cutting-edge work in metaphysics or epistemology, this volume doesn’t cut the mustard; it lacks the rigour that sophisticated philosophy requires. And for the hard-nosed neuroscientist, the excursions made by the volume into brain research may similarly smack of over-simplification.

But perhaps this is a space worth holding: stepping back far enough from clinical realities to try to contribute to work on the “big questions” and “hard problems”, but not stepping back so far as to lose touch with key concerns for clinicians and patients working and living at the coalface. 

And I’d also like to hold a space that tries to make a contribution, but that doesn’t necessarily offer resolution: the thing about the “big questions” and “hard problems” is that there isn’t necessarily a single best answer, these involve “essentially contested” constructs and issues, which don’t give way to simple solutions, but which entail complexity and wickedness, and which it is therefore crucial to keep discussing.

Philosophy of Psychopharmacology argues that psychiatry is precisely the sort of field that should on the one hand acknowledge its own fallibility, while at the same time try to make a positive difference - even though we have still so much to learn about the brain-mind and its disorders, and even though our interventions are far from ideal. 

Problems in Living argues that any answers to the problems of living can only be partial and tentative, but that we should nevertheless persist in trying to live meaningful lives – even though we have still so much to learn about human nature and the world, and despite life’s apparent absurdity. Taken together they argue that it’s key to find a balance between overly optimistic Panglossian views of psychiatry and of life, and unremittingly pessimistic perspectives, and to keep moving forwards - as best we can - with each.

Tuesday 10 August 2021

A Virtue Theory of Memory (Error)

Today's post is by Kourken Michaelian (Centre for Philosophy of Memory, Université Grenoble Alpes).

Kourken Michaelian

With her 2016 article on misremembering, Sarah Robins drew the attention of philosophers of memory to the need to provide an account not only of successful remembering but also of unsuccessful remembering—an account of memory errors such as confabulation, to which William Hirstein had previously devoted a book but which had been neglected in subsequent discussions in the field.

The debate triggered by Robins’ article continues to unfold, with Robins herself defending an approach to memory errors inspired by the causal theory of memory in articles in 2019 and 2020, Sven Bernecker defending a similar causalist approach in an article in 2017, and myself defending an approach based on the simulation theory of memory in articles in 2016 and 2020. There are other approaches that merit discussion; André Sant’Anna, for example, argues in a forthcoming article that relationalist approaches to memory have difficulty accommodating unsuccessful remembering.

But the debate so far has unfolded primarily between causalists and simulationists, with the former holding that unsuccessful remembering is characterized by the lack of an appropriate causal connection between the apparent memory and the apparently remembered event and simulationists holding that it is characterized not by lack of appropriate causation but rather by the unreliability of the memory process.


Robins’ and Bernecker’s recent articles both develop versions of the causalist approach and attack the simulationist approach, and, in my article forthcoming in Synthese“Imagining the past reliably and unreliably: Towards a virtue theory of memory”—I respond to these attacks. But I also argue that, for reasons internal to simulationism, existing versions of the simulationist approach are inadequate. I argue, in particular, that they fail to fully acknowledge the involvement of a form of mnemic luck in many instances of unsuccessful remembering.

Mnemic luck is broadly analogous to the form of epistemic luck involved in Gettier cases, and the paper sketches a potential analogy between the development of the family of externalist epistemologies and the development of the family of (post)causal theories of memory of which simulationism is a member. Simplifying greatly, we might say that the limitations of the causal theory of knowledge led to the emergence of the process reliabilist theory of knowledge and that the limitations of process reliabilism led reliabilists to move to the virtue reliabilist theory of knowledge. Similarly, the limitations of the causal theory of memory led to the emergence of the simulation theory of memory (modelled on process reliabilism), and the limitations of simulationism suggest that simulationists move to a virtue reliability theory of memory.

The paper therefore proposes a new form of simulationism, a virtue theory of memory modelled not on process reliabilism but instead on virtue reliabilism and intended to handle mnemic luck in a manner roughly analogous to that in which virtue reliabilism handles epistemic luck. The paper argues that this new theory grounds a more adequate approach to unsuccessful remembering.

Tuesday 3 August 2021

Emotion and Prediction

In this post Mark Miller (Center for Human Nature, Artificial Intelligence and Neuroscience, Hokkaido University) reports on a workshop Emotion and Prediction, which was held online on March 31- April 1, 2021.


Emotion permeates all mental life - it reflects our adaptivity, it imbues our activities and our environments with meaning and purpose, and it motivates and modulates our behaviours. We are emotional creatures through and through. While there has been a tremendous amount of work done on this topic, to date an integrative account capable of unifying the various theoretical perspectives and experimental results is still lacking.

A recent workshop Emotion and Prediction brought together philosophers, cognitive scientists and machine learning researchers to explore the implications of a leading new framework emerging within computational neuroscience for the study of feelings, emotions and moods. The Predictive Processing (or Active Inference) framework starts from the vision of the brain as a prediction machine - a machine whose modus operandi is the minimization of discrepancies between what it predicts about the world and the world itself. 

This framework offers a powerful new architecture in which distinct functions can be explained at their different time-scales by the same computational principles, and where distinct theories can find a common language. As such it has quickly become an attractive way of carrying out theoretical and experimental research in the cognitive sciences. This workshop brought together six researchers working in this field, to present their original research on the possibilities this framework offers to the study of emotion.

Regina Fabry

Day one began with philosopher of cognition Dr. Regina Fabry’s (Ruhr University) talk "What is the Relationship between Emotions and Moods? Predictive Processing and the Affective Mind". Regina developed a new computational approach to understanding the dynamic relationship between emotions and moods, all revolving around the dynamics underlying prediction error minimization.


Next, Daphne Demekas, a graduate student of machine learning at Imperial College London, presented her exciting new paper (alongside Karl Friston) "An Investigation of the Free Energy Principle for Emotion Recognition". Daphne argued that emotion recognition will soon evolve past deep learning models and onto active inference schemes. Daphne discussed how emotions could be modelled using active inference, and laid out a trajectory through “three waves” of emotion recognition technology achievable through further developing active inference methods.

Doctoral candidate Pablo Fernández (Institut Jean Nicod) gave the final talk of the day, entitled "Affective Experience in the Predictive Mind". Pablo reviewed a number of existing accounts of affective experience within Predictive Processing, and suggested a possible means of integrating these views.

Day two started with Prof. Mark Miller (Center for Human Nature, Artificial Intelligence and Neuroscience, Hokkaido University) presenting his talk "Active Inference and the Paradox of Horror". Starting from the active inference framework, Mark discussed why an agent striving to minimize surprise would find pleasure in engaging with unpredictable horror films. The answer, he proposed, lies in what he called “consumable error” - prediction errors with just the right amount of complexity. It is the carefully curated consumable errors that horror films produce that makes watching horror films enjoyable (and potentially beneficial).

Abby Tabor

Next, behavioural scientist Dr. Abby Tabor (University of the West of England) presented a talk "Pain and Suffering: An Active Inference Perspective". Abby developed a predictive processing account of the experience of pain, where the concept of suffering was understood in relation to constrained action. Anticipating a loss of bodily integrity, the individual in pain is afforded a narrowed repertoire of action. On the one hand, Abby argued, this constraint presents an opportunity to reduce the likelihood of more harm, on the other, it risks compromising the ability to attune to the environment in healthy ways. 

Dr. José M. Araya (Instituto de Filosofía y Ciencias de la Complejidad) closed the workshop with his talk "Following Your Guts: Interoceptive Expectations and the Loops of Emotion". Jose began from the assumption that an account of emotion can be gleaned by drawing an analogy with the mechanisms and dynamics within the visual modality. While this approach captures many aspects of emotion, Jose argued that this approach fails to account for the motivational character of emotion and its dynamics of self-organization. 

Videos of the talks can be found here