Tuesday 27 December 2022

Philosophical Perspectives on Memory and Imagination

This post is by Anja Berninger (University of Göttingen) and Íngrid Vendrell Ferran (University of Marburg). Today their post is on the edited volume Philosophical Perspectives on Memory and Imagination (Routledge 2022).

Íngrid Vendrell Ferran

Having been neglected for many years, the subjects of memory and imagination have started to gain more attention in recent philosophical debates. While there has been some interaction between philosophers working in these different fields (for publications that make significant headway towards establishing a more integrative perspective, see, for instance, Perrin and Michaelian 2017; MacPherson and Dorsch 2018; Michaelian, Debus, and Perrin 2018, and Michaelian, Perrin, and Sant’Anna 2020), we still lack a properly integrative approach to these issues. 

With this volume our aim is to fill this lacuna. Our objective is to both broaden and deepen current debates on memory and imagination within the philosophy of mind. This volume explores the structure and function of memory and imagination, as well as the relation and interaction between the two states. The papers contained in the volume address a series of questions that can be summarized under the following main headings:

  • What are the central structural features of memory and imagination?
  • Are memory and imagination two clearly distinct kinds of mental states?
  • What are the norms that govern imagination and memory?
  • How do memory and imagination interact with each other and with other mental states (such as emotions)?
  • What roles do memory and imagination play in our lives? 

The contributors to this volume have chosen a wide array of different approaches and methods to discuss the topic. Some authors draw heavily on empirical research, while others take inspiration from phenomenology or conceptual analysis. Quite a few of the papers take novel perspectives on the issues by looking at memory and imagination through the lens of other central concepts such as skills, abilities or directions of fit or by putting both in relation to other concepts such as the notion of forgetting.

Anja Berninger

The volume is structured into four main parts. The first consists of novel contributions to ontological issues regarding the nature of memory and imagination and their respective structural features. These topics are explored in chapters by Langland-Hassan, McCarroll, Barner, Michaelian and Noordhof.  The second part focuses on questions of justification and perspective regarding both states. 

These issues are explored in chapters by Miyazono and Tooming, Arcangeli, and Peeters, Cosentino, and Werning. The papers in the third part discuss issues regarding memory and imagination as skills or powers. These issues are explored by Kind, Hopkins and Robins. The last part explored by Vendrell Ferran, Berninger and Teroni focuses on the relation between memory, imagination, and emotion. 

Each contribution to this volume contains pioneering work in examining the interrelation between memory and imagination. We hope that this volume will be of value and interest to researchers working in fields relevant to both mental states, and that this collection will serve to advance the recently inaugurated debate on memory and imagination. 

Tuesday 20 December 2022

Bipolar Autonomy: Excellent Agency and Marginal Agency

This post is by Elliot Porter. Elliot is a lecturer in bioethics at Brighton and Sussex Medical School, and is finishing his PhD at the University of Kent. His research focuses on personal autonomy and mental disorder.  His research involves themes in metaethics, moral epistemology, and epistemic justice.

Elliot Porter

We have largely, but not entirely, moved past the intuition that significant mental disorder constitutes, ipso facto, an injury to an agent’s autonomy. Part of this shift stems from increasingly multidimensional approaches to autonomy that allow us to track, in finer detail, where injuries to autonomy do and do not lie.

We can identify autonomy-threatening influences at a higher resolution than simple ‘mental disorder’ language offers. The movement has also been pushed by the significant and growing literature that articulates the substantive normative and identity claims made by the neurodiversity movement.

The status of minority minds as test cases, to sharpen theories at their edges, is increasingly replaced by status as interlocutors in discussions about what typical and atypical, ordered and disordered, or appropriate or inappropriate workings of the mind involve. Where these influences meet, we have an opportunity to think about autonomy in quite new ways.

The core questions about autonomy are still hotly contested. Is it constitutively social, or only formatively? Are there contexts, such as in bioethics, where procedural conceptions of autonomy are sufficient, or do we need to bring in more substantive content there? Do substantive theories undercut autonomy by imposing values that even apparently autonomous agents are not free to reject? 

An attractive way of framing these disagreements focuses on autonomy’s status as an agency concept, casting these as disagreements about when agency flourishes. Even among theorists who do not share eudaemon approaches to ethics, there is an underlying teleology involved in taking autonomy to be an agency concept. How far we think agency relies on favourable social conditions to meet its teleological end tells us where we lie on the constitutively/non-constitutively social axis. 

Substantive and procedural conceptions of autonomy differ on whether agency is an engine more for making appropriate moves, or producing appropriate outputs. Our position on the substantive/procedural axis is set by how we characterise that teleological end.

What it takes to flourish is hostage to the description under which we are a subject of flourishing. The classical Aristotelian model considers what an excellent example of a man looks like: a political animal with rational capacities, who excels insofar as he exercises those capacities in ways conducive to his living well with others. 

On the far side of this tradition, Philippa Foot takes the subject of flourishing to be an organism; an entity defined in part by a set of biofunctional norms. To flourish is to be an excellent example of the kind of organism one is, and so humans flourish insofar as we reason and pursue goods accordance with a normative structure confined by our biological nature. In both of these cases, excellence in the kind of thing that we are turns on the description of what we are (rational political animal, a sapient organism). On a more or less eudaemon framework, someone can be autonomous when they flourish qua agent.

This is where the freedom to think about autonomy in new ways is liberating. We need an account of agency to understand flourishing if autonomy involves flourishing qua agent, but if agency admits of a plurality of models, as the growing neurodivergence literature indicates, then we can excel as agents under many different descriptions. Whilst we’re used to trading in cases of depression or mania as negative examples, where normal or ideal functioning has gone wrong, or as a test case to clarify the margins of normal agency, these shifts in the literature invite us to consider how depressive, manic, or any other type of mad agency works and what it’s excellent state would involve. 

The problem with bipolar autonomy, to take the example I have focused on in my research, is not that it involves defective agency, but that it extends more and less far in various dimensions in unusual ways. It is a lumpy and strange looking autonomy if we are used to the autonomy we get from neurotypical kinds of agency, but the key claim of the neurodiversity movement is that madness is owed recognition on its own terms. If there are different kinds of agency at work when we are depressed, anxious, manic, or even psychotic, questions of autonomy must address what kind of agency that is, what it looks like when it works as well as it can, and so what autonomy might look like when built on that kind of agency. 

Whilst we will often want our affective or psychotic episodes to end as quickly as possible, these episodes still can’t be written off for a great many people. They will come back over an over again, and so the kinds of agency available during these episodes will make up a significant portion of the tapestry of a life. We can try build autonomy around them, and find a spotty, porous, and inconstant kind of recognisable autonomy. 

Alternatively, we can build a relevant sort of autonomy on top of the agency we have. It will be lumpy, it will vary in its qualities as episodes begin and end, and will look a little foreign to familiar conceptions of autonomy. But if autonomy is a value we should aspire to and support others in achieving, it is still valuable when it is lumpy and built on atypical sorts of agency. Mad agents have as much reason to pursue the kinds of autonomy available to them as do neurotypical peers.


Tuesday 13 December 2022

Emotions, Cognition, and Behaviour

Emotions Brain Forum

BrainCircle Italia and BrainCircle Lugano organised a series of events where women scientists presented their work on emotions in various cities from October 2021 to November 2022 (see full itinerary). The initiative, conceived by Viviana Kasam, was inspired by the work of Nobel Prize winner Rita Levi Montalcini who promoted the work of scientists worldwide and was interested in supporting research on the brain. 

Campus Biotech
Campus Biotech

The last stop of the itinerary was Geneva, where on 25th November 2022 the Emotions Forum featured an interdisciplinary programme of talks on the relationship between emotions and cognition, and emotions and behaviour. The event was hosted by the Centre for the Study of Affective Sciences in the stunning Campus Biotech.

Eva Illouz, Professor of Sociology in Paris and Jerusalem, discussed the role of emotions in democracy. Eva started from Adorno's idea that fascism is not alien to democracy but is like a worm in the apple: we don't see it but it rots the fruit from the inside. Only emotions shape motivation and compete with self-interest. Emotions are neither rational nor irrational: they are responses to social conditions that come in the form of collective narratives that offer solutions to predicaments. Democracy is under attack from nationalist populism. People feel alienated from institutions. 

What characterises populism is a combination of four emotions:

  1. fear of destruction of the state, leading to tyranny;
  2. disgust of minorities, leading to racism;
  3. anger against enemies, leading to discrediting adversaries;
  4. love for one's country, leading to a common culture of patriotism.

Hermona Soreq's photo
Hermona Soreq

Hermona Soreq, Professor of Molecular Neuroscience at the Hebrew University of Jerusalem, talked about the hidden long-term impact of traumatic experiences. Seneca said that the everyone is a slave of fear and indeed we are all susceptible to fear. What is the impact of fear on people? People who experience earthquakes have bad health and die earlier. Why? 

Hermona's research found that living in a traumatic environment, for instance one where the person is severely affected by terror, causes changes in health that can be measured by merely taking the person's pulse regularly over a period of time. For instance, when people have more traumatic experiences, their heart beat increases, and this reflects a higher risk for heart attack. In the series of studies Hermona presented, the effects of different emotions (such as stress) were observed and interesting differences were noticed between men's and women's health which has important implications for clinical practice.

Julie Peron
Julie Peron

Julie Peron is both a clinical and an academic based at the University of Geneva and is Professor of Clinical Neuropsychology. Julie talked about a long-covid project where she observed that prevalence of cognitive disorders and fatigue have increased in people who experienced COVID. This has a very negative impact on quality of life and productivity. 

Julie described a case study of a 50-year-old man who was hospitalised with COVID and as a consequences of this presented a series of problems, especially with memory, concentration, and emotion recognition. However, the man did not acknowledge such cognitive impairments and claimed his memory and concentration was fine. This is a case of anosognosia (denial of illness). The impact of viral infection on the central nervous system is well-known--but the conclusion from this study was specifically that self-monitoring is altered after COVID.

Geraldine Coppin
Geraldine Coppin

Geraldine Coppin looks at the psychology and neuroscience of olfactory world. She is a Senior Researcher at the University of Geneva and Unidistance Suisse. Her presentation was focused on the relationship between olfaction and emotions. Humans have incredible olfactory capacities and smell triggers vivid memories (the Proust effect). 

Odours are considered triggers of emotional reactions and have important functions: (1) they help us to avoid environmental hazard by identifying food; (2) they help us regulate our expectations (is it sweet or savoury? is it rotten or still fresh?); (3) they help us detect fire or gas or decaying matter; (4) they assist with social communication, helping us choose sexual partners and feel other people's emotions.

Carien Van Reekum
Carien Van Reekum

Carien Van Reekum is Professor of Psychology and Neuroscience at the University of Reading and she delivered a talk on being emotionally flexible. People differ in their emotional responses to the same situation. Does the situation determine our emotions? Not really: it is the meaning that I give to that situation that generates my emotional response. This is good news, because if the meaning is what counts, then we can modify the meaning and change our emotional response. 

Carien reported on a fascinating study where people trained to reappraise either the emotional context of feeling pain or the interpretation of their sensation felt less intense pain and this was shown not only in their self-reports but in the pain sensation itself. Although this flexibility can be preserved with ageing, when cognitive decline starts then the capacity to regulate our emotional responses also decreases.

I also presented at the Emotions Brain Forum event, and it was a great honour for me to participate in an initiative dedicated to Rita Levi Montalcini featuring so many women-in-science heroes. To learn more about what I discussed, please see this post, as I presented one aspect of our agency in mental health project, the idea that healthcare practitioners need to be empathetic and curious to preserve young people's sense of agency in clinical encounters.

Tuesday 6 December 2022

Educating Character through the Arts

In this post, Laura D'Olimpio (University of Birmingham) asks whether we can educate for good character by drawing upon the arts, presenting a new book co-edited with Panos Paris and Aidan Thompson and entitled Educating Character Through the Arts (Routledge 2022).

Laura D'Olimpio

Can we learn, morally, from artworks? Is it possible that the various multiple arts may shed light on what it means to be human and help us come to better understand what we mean by ‘good character’? How might one distinguish morally insightful from morally dubious art? And might we be able to cultivate virtuous character habits through engagement with non-narrative or non-traditional art (such as music, video games or gardening)? 

The publication of a new edited collection, Educating Character through the Arts (Routledge, 2022) seeks to probe such questions and stimulate a dialogue on the intersection between the arts, ethics, and education. Our guiding question asks how might the arts be taught in a morally educative manner?

Over the last two decades, considerable interest in three overlapping areas of aesthetics, ethics, and education has developed. First, the question of whether or not, and in what ways, artistic value and moral value are related. Second, the question of whether artworks have the capacity to teach us, about matters including human psychology, character, virtues, and vices. Third, in the burgeoning field of character education, which includes moral education, civic education, etc., the question of whether or how the arts may contribute to the formation of one’s character is among many important topics. The theoretical links between these areas and the potential for fruitful interaction between them should be immediately obvious. It is therefore all the more striking that there has been little, if any such interaction.

From antiquity to the present, the virtues—which include such excellences of character as honesty, fairness, compassion, and courage—have been widely regarded as fundamental to a human life well lived. But how might human agents—particularly the young—come to understand, or acquire, virtuous character? While many might nowadays look to empirical psychology or neuroscience for pathways to understanding and cultivating virtuous character, the arts offer a time-honoured source of insight into good and bad or virtuous and vicious human behaviour and its relationship to human flourishing.

We believe that these classical sources of reflection on character—and their contemporary counterparts—deserve closer attention. Of course, some might doubt—in an age of science with its emphasis on empirical research—the potential of works of art to serve as credible sources of ethical understanding. There exist both ancient arguments for the view that poetry and other arts are more conducive to moral corruption than improvement, and modern claims to the effect that the aesthetic purposes of the arts have little to do with moral value. It is far from clear what ethically edifying role the arts may play, if any, and thus there is a need for further critical investigation into the place of the arts in character education. 

Narrative artworks have long been considered as fruitful sources of ethical knowledge and enlightenment. Yet, the mass art of our time appears to be increasingly preoccupied with ethical questions, including questions about character, as seen in pop songs (from Beyoncé’s Lemonade to Kendrick Lamar’s D.A.M.N.), television series (Breaking Bad and Succession), and Oscar-winning films like Parasite. At a time where the audience loves an antihero, we ought to delve into the educational potential of such artworks.

This edited collection, with contributions from Karen Bohlin, David Carr, Noël Carroll, Amanda Cawston, Laura D'Olimpio, John Haldane, Ian James Kidd, Jeremy Page, Panos Paris, Nathan Wildman, and James O. Young, attends to how certain artworks—such as music or television series, poetry, or video games, or even gardening—may offer ethical insights and how more traditional artforms like the novel can not only offer such insights but contribute to character formation and education.

Tuesday 29 November 2022

Why are you talking to yourself?

Today's post is by Elmar Unnsteinsson (University College Dublin). Here Unnsteinsson asks why we talk to ourselves.

The other day I saw someone enjoying a walk while deeply engaged in conversation but I couldn’t see the other person. The ledge between us was too high. When I turned the corner I saw that the person was alone and actually talking to no one. Well, no one else I should say. It’s unremarkable that I had assumed that there was a pair of people, dancing conversational tango, but, it does raise the question why we think of conversation as, essentially, a multi-player game?

As a matter of fact, many of us thoroughly enjoy having conversations. We seek them out to achieve catharsis, form strong social bonds of trust and friendship, learn surprising new things, and obviously the list could be endless. So, it never even occurs to us to ask why we would spend our time talking to others. We couldn’t even list half of the good reasons to do so. Why is it then so surprising to us that people might get exactly the same types of enjoyment and benefit from talking to themselves? More poignantly, why is there such a strong social norm against self-talk, such that we experience shame and embarrassment when caught in the act?

In an article I recently published open access in Mind and Language, called ‘The Social Epistemology of Introspection,’ I try to show that talking to oneself and talking to others are much more alike than people have usually assumed. A little more precisely, I argue that the cognitive mechanisms, motivational profiles, and normal functions associated with each kind of action are essentially the same. 

When we introspect our own emotions or attitudes we basically tell ourselves what we feel or believe, for reasons that are similar to the reasons why we would tell such things to others. But we also rely on the normal operation of a mechanism designed for communication; roughly, the mechanism underlying our capacity to intentionally produce cognitive effects in minded creatures.

There is reason to suppose that we can derive enjoyment and benefit merely from the skillful exercise of this singular capacity; just like the poet or public speaker we can seek the pleasures of communicative acts for their own sake. And so, it should not be surprising that people might like to talk to themselves. More surprisingly, perhaps, we should also expect various epistemic or practical benefits from self-talk, which would mirror the benefits of conversing with others. So, for example, by posing a question to myself directly in a communicative act, I may unearth an answer which otherwise might remain hidden from consciousness.

This does have other, more troubling consequences, however. Any malignant purpose we are afraid others might have in talking to us, we are just as likely to have ourselves in the privacy of our own minds. Thus, social epistemology has been too focused on various doxastic or epistemic effects of informational interactions between agents, to the detriment of studying the very same effects as they manifest themselves in reasoning and cognition themselves. 

Perhaps, this is just the pernicious social norm against self-talk working its way into the work of the scientist. If we were more enlightened as a society about the potential pleasures of self-talk, we would presumably do more of it. In turn, we might also be more interested in exploring the non-pathological aspects of engaging in this – in this imagined world – common and unremarkable activity. It never occurs to us to ask why chess players would bother playing chess to themselves. And why would we not train or just enjoy the exercise of one of our most cherished capacities, namely the capacity to converse?

Tuesday 22 November 2022

MANTO: Predicting Depression

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 scarcity of information, stigma, or insufficient public mental healthcare resources.

The early identification and prevention of depression is an innovative, desirable approach. Everyone can develop depression under difficult circumstances, but some people have higher risk than others. Risk factors for depression include being female, experiencing sleep disturbances, pain, or other physical symptoms, and a previous history of depression.

The Manto Depression Risk Calculator is the first tool available worldwide to provide a personalized estimate of the risk of developing depression over the next two years. It takes its name from Manto who, according to legend, was the prophetess who created the lake of the city of Mantua with her tears. To use Manto, it is sufficient to go to the site and answer some questions about symptoms of depression and some other aspects of life. 

Anonymity is guaranteed and it is not mandatory to fill in all of them, but the more answers are provided, the more accurate the estimate will be. At the end of the short questionnaire (currently in the Italian and English language) the site will produce an estimate of the individual risk score, expressed as a percentage. The calculator is intended for use by adults aged 55 or over without severe cognitive problems. 

Manto calculates the risk score processing data that derive from information on risk factors. Researchers used estimates from the scientific literature and European population data to obtain a statistical model with good discriminatory capacity. The study has just been published in the American Journal of Geriatric Psychiatry and is the product of the collaboration between Martino Belvederi Murri, from the University of Ferrara,  Luca Cattelani, Federico Chesani and Pierpaolo Palumbo, from the University of Bologna, Federico Triolo, from the Karolinska Institutet of Stockholm, and George Alexopoulos from Cornell University in New York. 

Martino Belvederi Murri presents MANTO

The project could have important positive effects for people who will use the site and could be used to develop healthcare strategies. Depression in old age has in fact significant personal and health costs. Manto can be used to identify populations at risk to target public health interventions. The researchers responsible for Manto said:

"It is a great satisfaction to make our work available. Manto is the first model of its type that can be used freely. For years, anyone could use online tools to predict the risk of developing heart disease, but no similar instrument was available for mental health, which is too important. We hope that Manto serves people and professionals in the sector, such as General Practitioners or mental health specialists. We would also like to draw attention to the issue of depression, which must be recognized without shame and can be treated at all ages. However, we will not stop here: we aim to develop newer versions of Manto, further improving personalization and precision"

One key question is what a person should do if the Manto Depression Risk Calculator says they are at high risk of depression. If Manto's "prophecy" says that the person's risk score is high (for instance, higher than 60%), there is no need to panic. Several risk factors for depression can be modified. For example, one can treat sleep disturbance or pain, exercise, engage in pleasurable or intellectually stimulating activities. Other preventive treatments and actions are also available, such as psychological, pharmacological and behavioral strategies, alone or in combination. If a person believes that are already depressed, then they need to consult their healthcare provider.

Tuesday 15 November 2022

Temporal Asymmetries in Philosophy and Psychology

This post is by Alison Fernandes (University of Dublin). Alison works in the metaphysics and philosophy of science, with a focus on temporal asymmetries, foundations of physics and agency. Today Alison presents the edited volume Temporal Asymmetries in Philosophy and Psychology (OUP 2022).

Alison Fernandes

We have very different attitudes towards past and future events. Events looming in our futures are those we might worry about, plan for, or look forward to. Events that are already in our pasts, on the other hand, are those we might regret, contemplate, or remember fondly—but not plan for in the same way. Why is this?


There are, in fact, many temporal asymmetries in how we engage with the world. Most people prefer bad events to be in the past and good events to be in the future, all else being equal (Lee et al 2020). Strikingly, people assign work more compensation when it is described as taking pace in the future, compared to the past (Caruso et al 2008). There are also asymmetries in how extensively we simulate events, how strongly we feel about them (van Boven and Ashworth 2007), and how close we judge them to be (Caruso et al 2013).


While philosophers have long been interested in these asymmetries, traditional work in this area was interested in using these asymmetries to support a particular ‘metaphysical’ view of time—one in which the past and future were radically different, independently of our relationship to them. While psychologists were interested in giving detailed accounts of how we relate to events in time—particularly contrasting events that are close and distant—asymmetries took a back seat. Indeed, some of these asymmetries appear so fundamental that’s it’s difficult to see an empirical project of explaining them. Isn’t it obvious that future events, not having happened, are those we should care about more?


Christoph Hoerl, Teresa McCormack and I, working under an AHRC grant (see interview about the project with Hoerl), hosted a workshop with philosophers and psychologists with the aims of exploring psychological asymmetries—leading us to co-edit the first interdisciplinary volume on these issues, Temporal Asymmetries in Philosophy and Psychology. One of our key aims was to relate the more speculative big-picture thinking in philosophy to detailed empirical work from psychology.


One set of topics concerns how different asymmetries arise developmentally (explored by Lee and McCormack in their chapter), evolutionarily (Campbell) as well as how they relate to each other and to psychological mechanisms more broadly (Ramos et al, De Brigard, Greene et al, Fernandes, Hoerl and Rinaldi):
  • Are some asymmetries more basic than others? 
  • Do we already conceive of the past and future differently before we value past and future events differently? 
  • Or is our thinking about the past and future shaped by the kinds of attitudes we develop?

A second set of topics concerns the rationality of these asymmetries, explored in chapters by O’Brien, Callender, Sullivan and Hoerl. It might seem reasonable to care about future events more. But is it reasonable to assign more compensation to future wrongs versus past wrongs? Finally, there’s a set of questions about what picture of time we are left with—explored particularly by Deng but relevant throughout the volume:
  • Do we have a stable intuitive conception of time? 
  • Or are our attitudes too complex to support a single view?

By framing these questions and showcasing of up-to-date work in this area, the volume aims to provide a strong foundation for future research on psychological temporal asymmetries.

Tuesday 8 November 2022

How Stable are Moral Judgments?

Today's post is by Paul Rehren at Utrecht University on his recent paper (co-authored with Walter Sinnott-Armstrong at Duke University) "How Stable are Moral Judgments?" (Review of Philosophy and Psychology 2022).

Paul Rehren

Psychologists and philosophers often work hand in hand to investigate many aspects of moral cognition. One issue has, however, been relatively neglected: the stability of moral judgments over time [but see, Helzer et al. 2017].

In our paper, Walter Sinnott-Armstrong and I argue that there are four main reasons for philosophers and psychologists to consider the stability of moral judgments. First, the stability of moral judgments can shed light on the role of moral values in moral judgments. Second, lay people seem to expect moral judgments to be stable in a way that contrasts with tastes. Third, philosophers also assume that their moral judgments do and should not change without reason. Finally, stability may have methodological implications for moral psychology.

Next, we report the results of a three-wave longitudinal study that probes the stability of one type of moral judgment: moral judgments about sacrificial dilemmas [see, Christensen and Gomila 2012]. In each wave (6-8 days apart), participants rated the extent to which they thought that individuals in a series of sacrificial dilemmas should or should not act. We then investigated how stable these ratings remained between the first and second wave using two different approaches. 

First, we found an overall test-retest correlation of .66. Second, we observed moderate to large proportions (M = 49%) of rating shifts (any change in rating between waves), and small to moderate proportions of rating revisions (M = 14%)—that is, the participants in question judged p in one wave, but did not judge p in the other wave.

Walter Sinnott-Armstrong

If our findings are not due to measurement error and so do shed light on a genuine feature of real-life moral judgment, then what explains the unstable moral judgments we observed? In our paper, we investigate three possible explanations, but do not find evidence for them. First, because sacrificial dilemmas are in a certain sense designed to be difficult, moral judgments about acts in these scenarios may give rise to much more instability than moral judgments about other scenarios or statements. 

However, we compared our test-retest correlations with a sampling of test-retest correlations from other instruments involving moral judgments, and sacrificial dilemmas did not stand out. Second, we did not find evidence that moral judgment changes occur because people are more confident in their moral judgments the second time around.

Third, we did not find evidence that rating changes were often due to participants changing their minds in light of reasons and reflection. We tested for this in a few different ways. Moral judgment changes between the first two waves did not tend to persist when participants judged the same dilemmas for a third time. 

Also, Actively Open-minded Thinking [Baron 1993], Need for Cognition [Cacioppo and Petty 1982] and scores on the Cognitive Reflection Test [Frederick 2005] all failed to predict whether participants changed their ratings. Last, participants who self-reported having changed their mind about at least one scenario because they thought more about the scenario or because they discussed the scenario with others accounted for only a small proportion of moral judgment changes.

We think that our findings of instability without reason may raise serious questions for moral philosophy (though of course, they do not finally settle any of these controversial issues). For example, many moral philosophers treat moral judgments about specific cases like sacrificial dilemmas as part of the “data of ethics” [Ross 2002, p. 41] when they use these judgments to choose among competing normative moral theories [e.g., Kamm 1993, Rawls 1971]. 

However, this data is unreliable when moral judgments change in the ways we observed, because incompatible moral judgments about the same act in the same circumstances cannot both be correct. Such a shifting foundation seems not to be a good place to build a moral theory if you want them to last. In addition, we also suggest that instability can create trouble for the meta-ethical theory known as intuitionism [e.g., Audi 2007, Huemer 2005], as well as for virtue theories of ethics [e.g., Aristotle, Nicomachean Ethics].

Tuesday 1 November 2022

Subjective Experience and Meaning of Delusions in Psychosis

Today's post is by Rosa Ritunnano (University of Birmingham). Rosa is a consultant psychiatrist and PhD candidate at the Institute for Mental Health. Here she talks about a recent paper she co-authored with an interdisciplinary group of international researchers at the Universities of York, Melbourne, Warwick and Ohio State. The paper entitled “Subjective experience and meaning of delusions in psychosis: systematic review and qualitative evidence synthesis” has been published in The Lancet Psychiatry and is available Open Access.

Rosa Ritunnano

This paper is the result of a big team effort, and my hope is that it will encourage delusion and psychosis researchers across disciplines to go beyond commonplace assumptions (deeply ingrained especially within clinical psychiatry) about the nature and meaning of delusional phenomena.

The aim of this research was to gain a deeper and more nuanced understanding of delusional phenomena based on the experiential knowledge of those with lived expertise—as the necessary basis for person-centred assessment and intervention. Here, we (attempted to) remain agnostic as to the nature of delusions (beliefs or other), conceiving of them as occurrent experiential states which have a specific phenomenology—that is, we assumed that there is a characteristic what-it-is-likeness to be in a certain delusional state and that this what-it-is-likeness can be investigated on its own terms. Our research question was: how do individuals with psychosis experience and make sense of changes in their self, world and meaning during the onset and progression of delusions?

For the first time, we reviewed all the available published qualitative literature in English that explored the lived experience of delusions in help-seeking individuals with psychosis, irrespective of diagnosis and thematic content of the delusion. In order to do this rigorously, we followed a particular methodology called “meta-synthesis” or “qualitative evidence synthesis”, which is widely used in the social sciences for integrating the findings of multiple primary qualitative research studies. This required screening 2115 references and then 133 full-text reports against pre-established inclusion criteria, until 24 eligible high-quality studies were left for inclusion in the final synthesis.

These 24 papers contained first-person accounts from 373 individuals with psychosis and lived experience of delusions, who were interviewed by the authors of the primary papers on different aspects of their delusional experiences. After importing all the findings into a data management software, we analysed the text through thematic synthesis, first coding it line by line and subsequently developing descriptive and then analytic themes to answer our research question. This method enabled us to stay “close” to the original words spoken by the participants, while at the same time moving beyond a simple aggregation of data and producing new hypotheses.

Three main analytic themes were generated from the thematic synthesis: 1) A radical, affectively charged rearrangement of the lived world dominated by intense emotions; 2) Doubting, losing, and finding oneself again within delusional realities; 3) Searching for meaning, belonging, and coherence beyond mere dysfunction (see figure below). In the paper, you can find a full discussion of themes and subthemes, and examples of the participants’ quotations supporting them.

From these findings, we developed the “Emergence Model of Delusion” (figure below). This model suggests that delusions in psychosis are best understood as complex and multi-layered phenomena, emerging from a dynamical interaction between multiple processes happening at different levels of increasing organisational complexity (e.g., sub-personal, personal, inter-personal and socio-cultural). This in turns allows us to conceive of potentially dysfunctional mechanisms at one level, showing adaptive properties at a higher or lower level.

Notably, despite significant emotional and mental struggle, many participants described delusional experience as being accompanied by an enhanced sense of meaningfulness. This experience was interpreted by some in positive terms, albeit of short duration and often followed by a painful drop into depression and constant attempts at rebuilding self-trust. The role of interpersonal relationships appeared to be central in this process of building and rebuilding trust in self and others, both during and after the delusional period.

As a clinician myself, what I want to highlight here, is that all delusional experiences initiated a process of self-understanding and search for meaningfulness that appeared to clash painfully with the responses received by the participants from others (including mental health staff). These responses, mostly in line with a simple 'problem-solving' approach to remedying a dysfunction or a symptom of illness, could not help answering pressing existential questions such as “why is this happening to me?” or “what significance does it have?” For this reason, many described feeling alone and isolated.

Effective clinical care for individuals with psychosis might need adapting to match more closely, and take account of, the subjective experience and meaning of delusions as they are lived through by the person. Such an adaptation may also help redress power imbalances and enduring epistemic and hermeneutical injustices in mental health.

Tuesday 25 October 2022

Values and Virtues for a Challenging World: Event Report

 In this post, Kathleen reports on the public philosophy event, 'Values and Virtues for a Challenging World'. This was organised by Cardiff University in association with the Royal Institute of Philosophy. Academic philosophers had the chance to bring their work to the attention of public policy and education professionals and discuss the ideas. These ideas can now be read here in the latest issue of Royal Institute of Philosophy supplements (edited by Anneli Jefferson, Orestis Palermos, Panos Paris, and Jonathan Webber).

First up, was a panel with Sophie Grace Chappell and Panos Paris, chaired by Laura D'Olimpio. The topic was "Good Taste and the Experience of Value". Sophie Grace discussed the positive value found within the natural world, and that the appropriate response to this value is a sense of awe and beauty. We would do well to inculcate this virtue and continue to appreciate the beauty of nature, and this has a place in guiding policy on, for example, tackling climate change. Panos Paris talked about how our senses of beauty are often highly subjective, superficial, and not particularly related to our values. However, if we come to appreciate functional beauty, this can bring our tastes of beauty in line with our values. This is because functional beauty captures how well-formed something is for fulfilling its function.

Panel 1

Next, was a panel with Alessandra Tanesini, Hugh Desmond and Taylor Matthews, chaired by Auriol Miller from the Institute of Welsh Affairs. The topic was "Polarisation, Mental Health and Misinformation on Social Media". Alessandra discussed how social media can facilitate mass contagion of group-based anger, and exacerbate simplistic emotional outlooks which reduce individuals to one specific group identity. This structural feature of social media is what ought to be changed about it. Hugh questioned the image of social media as a means to "care and share", suggesting that posting about our private lives often submits them to a status competition and this has knock-on effects for mental health. Finally, Taylor talked about the dangerous consequences of the proliferation of 'deepfake' videos. These are videos of people, often very well-known and important figures, which are completely faked and never happened. This is pushing us to distrust videos as a very valuable and trustworthy source of information, and now we need to cultivate 'digital sensibility' in assessing the credibility of videos.

Panel 2

Next, was a panel with Lani Watson, Jonathan Webber and Kathleen Murphy-Hollies, chaired by Julian Baggini. The topic was "Curiosity, Integrity, and Self-Regulation". Lani talked about cultivating curiosity in a world full of easily accessible information and misinformation. The trick is to be appropriately motivated to pick out the lines of questioning and information worth knowing, and central to this will be asking good questions. Jonathan discussed the importance of ethical integrity, which is having an ongoing concern for consistently embodying our values across the very varied range of situations we come across. This will require balancing respect for existing ideas and values, with receptivity for new reasons for action. Kathleen discussed the phenomenon of political confabulation, which is when people unknowingly give false reasons for their political decisions after the fact. Instead of trying to stop confabulation ever happening, we should foster a virtue of self-regulation, which involves various skills used to align our behaviours better with our professed values. (Julian wrote a blog post discussing these ideas here). 

Panel 3

Next, was a panel with Kristján Kristjánsson and Anneli Jefferson, chaired by Wendy Thomas from Autism Wales. The topic was "Wisdom and Collective Decisions". Kristján recounted looking at which key terms were most used on social media throughout the pandemic, noting that there was a focus on single moral virtues such as resilience or compassion. The concept of wisdom was completely overlooked, when this is needed in a complex world in order to prioritise between competing moral demands and multiple relevant important virtues. Anneli discussed this notion of wisdom at not just the level of individuals, but of groups. Having a mix of cognitive styles in a group can help in making wise decisions. In particular, autistic people may have distinct advantages to bring; autistic people are often less susceptible to common biases, for example.

Panel 4

Finally, the last panel was with Nadine Elzein and Mandi Astola, chaired by Catherine Fookes from Women's Equality Network. The topic was "Uncertainty and Polarisation". Nadine discussed the importance of the having 'interpretive charity' in this world, where social media algorithms push controversial content. This can mean that opponents are often caricatured and their views distorted, which only drives polarisation and misinterpretation. We should resist this ourselves and regulate social media to stop this happening. Mandi asked who we should blame for problems caused by a large group of people consisting of many individuals, and suggested that we should see the group itself as responsible. Furthermore, she suggested that group responsibility should be treated as a virtue and that groups ought to be well-organised in this way, otherwise they are responsible as a group for wrongdoings. 

Panel 5

Many thanks to the organisers and editors of the issue for putting the event together, and to the Royal Institute of Philosophy for helping fund this event. 

Tuesday 18 October 2022

Can Process Metaphysics Help Us Understand Mental Disorders Better?

This post is by Elly Vintiadis (The American College of Greece Deree College) on her recent paper "Mental Disorders as Processes: A More Suited Metaphysics for Psychiatry" (2022, Philosophical Psychology). (This is an updated version of her previous post in 2019.) 

Elly Vintiadis
Elly Vintiadis

In most discussions about the mind and mental disorders, the metaphysical framework within which they take place is rarely questioned. It is however, important to check our metaphysical beliefs – including our beliefs about what the world is made up of - because whether they are held consciously or not, they affect the way we understand the world and how we approach it scientifically. 

For this reason, in my recent work I explore what a metaphysical framework that puts at its center the notion of a process can add to our understanding of the mind and its disorders. I contend that seeing the world as fundamentally ‘processual’ in nature rather than in terms of substances and things, provides the best explanation of what we know about the mind and mental disorders while also allowing us to sidestep the problems of essentialism, reductionism and dualism in psychiatry. In addition, pragmatically it opens up the way for better treatment and prevention options. 

Traditional metaphysics has seen the world as made up of things that are in turn made up of smaller things - and so on all the way down. In contrast, according to process metaphysics the world is made up of processes that can be understood as occurrences that take place in time and that essentially involve change. That is, the world is made up of a hierarchy of intertwining processes that exist at different time scales– and whatever stability we experience in the world is the result of processes in dynamic interaction. Viewing brains and minds within a processual framework – and therefore as dynamic and physically, socially and historically situated - can not only make better sense of the plasticity and complexity of our brains but also allows us to give pivotal importance to the self-organization - through constant feedback and feed forward loops with their environment - of the brain and the mind. 

In addition, process metaphysics can ground criticism of both the familiar biomedical and the biopsychosocial model of mental disorders while also allowing us to improve the latter. If the world is, indeed, fundamentally made up of processes rather than things, the biomedical model of mental disorders, like any reductionist model, cannot do justice to the complexity of a world that is inherently processual. On the other hand, though the biopsychosocial model incorporates the interplay of biological, psychological and environmental factors when trying to understand mental disorders, in practice - and, I argue, in virtue of the metaphysical framework within which it is embedded – it remains static and fragmented. 

The conventional dichotomies of nature vs. nurture, and biology vs. culture, are ingrained in this model, despite the fact that it tries to highlight the importance of their interaction. In contrast, because processes have no hard boundaries, but flow into one another multidirectionally and sustain each other dynamically, there is no level that is ontologically primary so such dichotomies are not available in a process framework.

I argue that reconceptualising mental disorders as the products of complex changing processes that are extended in time can do justice to the influence that past occurrences have on the present mind and can better explain the fact that mental disorders are often multicausal and causally heterogeneous. At the same time, because on a process view a person is historically and socially situated and is the product of an ongoing developmental process throughout her life, such a view can add a more dynamic aspect to the biopsychosocial model thereby helping to improve it.

Tuesday 11 October 2022

The Doxastic Profile of the Compulsive Rechecker

This post is by Juliette Vazard who recently published a paper entitled "The Doxastic Profile of the Compulsive Re-checker" in Philosophical Explorations, open access.

Juliette Vazard

What exactly is epistemically wrong with checking again (and again)? Checking is one of the most common compulsive actions performed by patients with Obsessive-compulsive disorder (OCD)(APA, 2013; Abramowitz, McKay, Taylor, 2008). And while incessant checking is undeniably problematic from a practical point of view, it is hard to pinpoint what exactly makes it inadequate from an epistemological standpoint.

My suggestion is that, in order to understand exactly what goes epistemically wrong with rechecking, we first need to take a step back from the behaviors themselves, and consider the mental state that the re-checker is in as she goes through the moves. What is she looking for, as she goes back for another check?

A first intuitive answer is: although she already has sufficient evidence in favour of p (the stove is off), as she goes to perform another check the compulsive re-checker is looking for more knowledge. Along these lines, Whitcomb (2010) suggests that the individual who checks their alarm clock five times in a row is like the glutton who keeps eating after he has been sufficiently nourished. As I show, we have reasons to find this analogy is dubious.

An alternative view is that, even if she antecedently knew that the stove is off, as she goes back for a new check, she suspends judgement again on this matter (Friedman, 2019). The rechecker is then perhaps not an insatiable knowledge seeker, she is rather a repeatedly suspended inquirer who constantly shifts out of belief, in circumstances which do not warrant such a shift (Friedman, 2019). This explanation seems however to leave out what makes the whole complexity of compulsive re-checking: the fact that the vast majority of re-checkers have insight (they know that they have sufficient evidence to stop checking!) but they nonetheless feel compelled to check.

To resolve this puzzle, Taylor (2020) has recently proposed that while compulsive re-checkers in fact know that the stove is off, they also wonder “what if it is not?”. The combination of knowledge and a “question-directed attitude” explains the paradoxical epistemic position of recheckers. In my paper I object to Taylor by arguing that obsessive thinking in OCD is not mere exploration of a possible scenario through counterfactual reasoning (or “wondering”). In individuals with OCD, thoughts expressing possible threats become obsessive because they are taken very seriously, and are typically accompanied by acute anxiety (Abramowitz, McKay, Taylor, 2008).

Evidence also suggests that obsessions in OCD are cognitively underpinned by hyperactive signals of error which translate into recurring feelings of uncertainty (Cochrane and Heaton, 2017). If this is valid, then it is more plausible that their antecedent judgement that the stove is off actually gets overthrown by these recurrent “what if?” questionings that are accompanied by anxiety and feelings of threatening uncertainty. The doubts that are strong enough to motivate the intention to re-check in OCD patients are not idle doubts: they are serious doubts, able to defeat knowledge.

Tuesday 4 October 2022

On Madness: Understanding the Psychotic Mind

Today’s post is by Richard Gipps, clinical psychologist and philosopher. Richard’s psychotherapy practice is in Oxford, UK, where he also teaches some philosophy. Along with Michael Lacewing he edited The Oxford Handbook of Philosophy and Psychoanalysis (2019). 

Gipps' philosophical interests concern the nature of psychotherapeutic action, psychotic thought, and the significance of love and moral virtue for mental health. Today he writes about his new book On Madness: Understanding the Psychotic Mind (Bloomsbury 2022).

How is madness to be met with? What kind of recognition can we show, and justice can we do, to its sufferer? On hearing his fragmented and delusional discourse we’re troubled by it - not so much because we fear what he'll say or do, but because now, trying to empathically relate to them, our minds judder and the ground slips out from under our feet. On the one hand: here’s a deeply troubled human being; on the other, our mustering of ordinary humane sense-making is now severely challenged.

Confronted by this challenge, those tasked with helping the mentally ill can find themselves tempted by what On Madness describes as two characteristic evasions. One, which most bedevils biomedical psychiatry, takes refuge in the thought that, with the person in their psychosis, what we find is not so much a suffering, meaning-responsive, human being, but a currently broken mechanism. ‘Nothing to see here; medicate, watch and wait until the human subject returns to the scene’ becomes the motto. 

Such an approach voids the task of humanly relating to the psychotic subject in a more than paternalistic manner. The second, rather more characteristic of much clinical psychology, urges that what looks like broken meaning is but a surface appearance to be penetrated. ‘Discard your prejudices about madness and instead try to reach the sense-making mind behind the symptoms’ is this approach’s tagline; its corollary intellectual aim is the development of reason-retrieving resources which, when held in mind in the clinic, will enable empathic engagement to be reestablished.

Such approaches effectively privilege the significance of rationality for humane intelligibility. Either reason’s absence is taken as an invitation to adopt a merely paternalistic stance, or we’re invited to restore human contact through cleverly discerning reason’s now hidden form. On Madness takes a different tack. It asks how we may instead bear with and honour someone in her rational brokenness by taking it as an index of her overwhelm. 

Richard Gipps

The tack taken is similar to that of apophatic (or ‘negative’) theology: we come to understand God’s reality by understanding how even our most superlative attributions to Him inexorably fail to do Him justice. So too, goes the suggestion, can we come to understand the psychotic subject when we see how even our most ingenious attempts to retrieve rational order here fail to do justice to the shame, objectless dread, and brokenness which she suffers.

None of this is to say that nothing properly called understanding may be had of this subject. In truth, certain forms of intelligibility - causal explanations, phenomenological characterisations, psychodynamic motivational understanding, so-called ‘symbolic’ meaning - become all the more relevant, and sometimes only possible, once we’ve already been turned away at reason’s door. 

On Madness separates out the distinct logical forms of these modes of understanding, showing how some may yet be available whilst others are thwarted; spells out the implications of its ‘apophatic’ approach for understanding what it is to be in one’s own world (the ‘waking dream’ or ‘lost reality-testing’ of psychosis); and carefully articulates the character of delusional, confusional, and hallucinatory thought and experience. 

The book ends by considering the question of psychiatric judgement. Ought one to make one’s judgements of the psychotic subject’s delusionality and disordered thought accountable by evaluating them according to general criteria? Or might this in truth itself be an evasion of the responsibility to embody psychiatric discernment within oneself?