Tuesday, 26 April 2022

Group Beliefs without Group Minds?

Today's post is by Umut Baysan. Umut teaches philosophy at the University of Oxford and works in philosophy of mind and metaphysics. Most of his published work is available on his website.

Umut Baysan

I am grateful to the Imperfect Cognitions blog for inviting me to write a post on my recent publication “Are propositional attitudes mental states?”, forthcoming in Minds and Machines.

In the paper, I explore some implications of the view that some group entities (e.g., clubs, governments, companies) can have beliefs and desires. I argue that if group entities can have beliefs and desires, this would show that beliefs and desires are not mental states. I am not entirely convinced that group entities can really have beliefs and desires---though I think there are some reasons to take this possibility seriously, as I discuss in the paper. What I really want to achieve in the paper is to show that if you are prepared to accept this position, you should be prepared to accept the somewhat surprising conclusion that beliefs and desires are not mental states. If you find this result unacceptable, perhaps you should also find the view that group entities can have beliefs and desires unacceptable.

My main argument is this: If beliefs and desires are mental states, then only minded beings could have them. After all, a physical property can be had only by physical beings. So, by analogy, a mental property or state can only be had by mental, or minded beings. But group entities are not minded beings. In other words, there are no group minds. So, if group entities can have beliefs and desires, then beliefs and desires are not mental states.

Why do I think that group entities are not minded beings? As I explain in the paper, I work with a conception of mind according to which a being is minded only if it is of such a kind that there is something it is like to be it. We are minded beings, and there is something it’s like to be us. In contrast, there is nothing it’s like to be a rock or an electron---sorry panpsychists!---and rocks and electrons are not minded beings. I hold that group entities are like rocks and electrons in this respect.

One interesting implication of this conclusion (i.e., beliefs and desires are not mental states) is that it gives us a way to refute the idea that there is “cognitive phenomenology”, i.e., there is something it’s like to believe that p. My proposal is that beliefs are “multiply realizable” states: they are realized by non-mental states in non-minded beings such as groups, and they are typically realized by mental states in minded beings like us, especially when we have occurrent beliefs. When the state that realizes a belief is a phenomenally conscious mental state, there is something it’s like to be in that relevant mental state. But that relevant mental state is not the belief in question; rather, it is a realizer of the belief. I think this is a good way of rejecting cognitive phenomenology because it acknowledges the intuitive idea that there is often something it’s like to be us when we have beliefs, but it doesn’t entail that there is something it’s like to believe that p.

Another interesting implication of the arguments of the paper is that they make certain claims about group beliefs and desires easier to digest. If I am right, saying that groups have beliefs or desires should not amount to saying that there are group minds. If one has qualms about the idea of a group mind, that shouldn’t thereby be a reason to reject group beliefs or group desires.

Friday, 22 April 2022

Significance and Impact of the Agency Project

This is the last in a series of posts reporting outcomes from a project on Agency in Youth Mental Health, led by Rose McCabe at City University. Today, Rachel Temple, Public Involvement in Research Manager at the McPin Foundation, and members of the Young Person Advisory Group [YPAG] tell us about how the project impacted them. 

In the course of the project, YPAG members provided detailed feedback on the application for funding, shaping research questions and outputs; contributed to the research, analysing videos of interactions between practitioners and young people struggling with their mental health; participated in public engagement events and prepared resources for schools on agency and youth mental health; shared their valuable insights, knowledge, and experience on blog posts and podcasts; and co-authored some of the project publications with the other members of the team. 
Prior to working on the Agency project, I held a lot of shame and secrecy around my mental health difficulties. Although I occupied spaces in psychological research and clinical work, I was always terrified that my lived experience would be somehow ‘found out’, and I would be seen as ‘less than’ by those around me—less competent, less worthy, less able.
Working with the YPAG changed that for me. We were never treated as less knowledgeable or less capable, and our ideas were meaningfully integrated into the project. Having my own experiences (and that of my peers) be seen as valid and worthy of respect by the research team allowed me to find value and meaning in my own lived experience, and showed me how co-production (when done right) can be an empowering and deeply fulfilling process. —M


I have gained a new outlook on how I approach mental health conversations.

Professionally, when discussing my feelings, I can evaluate my sessions and interactions more critically, rather than just using “good” or “bad”. I struggled to put into words how I felt afterwards, whereas hearing and seeing other’s experiences, I can now make sense of them and what may have made me feel that way.

When helping others, I am more mindful of validation. Rather than just looking engaged and being present, I make sure to also follow this up with something like, “That’s completely okay to feel like that.”
– Carmen


Being a part of the project has gained me cognisance. I now appreciate even more, when practitioners and professionals practice positive methods of helping to make you feel that you do have agency. I would feel comfortable educating others on why agency is so important. I'm more aware of how integral a part of treatment agency is.

This project also played a role in my self-development. I feel it's lent me an opportunity to do something sanguine and helpful, in turn, allowing me to look at past negative experiences as muse to draw from.
- Nusaybah


Being part of the project has been such a rewarding experience for me. I joined the YPAG Agency during the start of lockdown in 2020, a time when I was still at university and the whole world was learning how to adjust to new ways of working and communicating online. It was a difficult and often very lonely time for me. But I always looked forward being a part of the YPAG Zoom meetings because I knew I could be myself as everyone held a space for each other to feel seen, heard and validated. – YPAG member

Rachel Temple
I have nothing but gratitude for the Agency project. I’ve worked with wonderful people. Experts in the field, who genuinely value the importance of lived experience in research. As a young person co-applicant, I was anxious that I wouldn’t have anything to offer. If I felt brave enough to contribute a thought or idea, I worried whether it was good enough. But the team always heard me. They embraced my ideas and made me feel valued in the process. And so, I quickly grew in confidence!

The contributions of the YPAG were central to the project. It’s been especially rewarding to work with this group of young people for two years. I’ve had the pleasure of watching them thrive and bring the project to life. Together we have seized the endless development opportunities the project has offered; from research training, public speaking skills, and the space simply to share experiences. United as peers, it’s felt like we have been on a journey of growth together! The Agency project is thus a glowing example of what involvement in research can offer to young people.

Through this project, we have identified some important ways in which to improve youth mental health interactions. Because of this, I am more mindful of my own needs, as well as how I support those around me. How simply saying “that sounds like a lot to deal with” or receiving a nod of understanding can go a long way. And how the absence of these things can be crushing. These are the lessons that I will be taking with me.
- Rachel K Temple

Thursday, 21 April 2022

The Agential Stance

This is part of a series of posts reporting outcomes from a project on Agency in Youth Mental Health, led by Rose McCabe at City University. In the previous post, the project team provided some evidence of epistemic injustice in clinical encounters. Today, Clara Bergen and Lisa Bortolotti discuss a new approach to protecting the sense of agency of young people meeting a crisis team for mental health problems.

Clara Bergen

Lisa Bortolotti

In our project, we wanted to ask: How can practitioners avoid undermining a young person’s sense of agency in a mental healthcare encounter? We adopted an absolutely unique analytic approach to find out the answer.

“We” are a group of six experts in philosophy, psychology, psychiatry, clinical communication, clinical practice, and public involvement in research (Interdisciplinary Academic Researchers), and five young people aged 17-25 with experience of accessing mental health services for diagnoses including post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, autism spectrum, and emotional dysregulation (Youth Lived Experience Researchers).

Both groups collaboratively analysed clips from video-recorded mental health encounters for young people seeking crisis support for self-harm or suicidal thoughts (see Bergen & McCabe 2021). During meetings in which the Youth Lived Experience Researchers watched and analysed video data, we identified what aspects of agency were most relevant to these mental health encounters. Five aspects of agency were thought to be important to young people but often undermined in the video-recorded mental health encounters. 

The young person:

1. is a subject of experience and their perspective matters;
2. can take action to change their situation by seeking help;
3. may have multiple and conflicting needs and interests;
4. with adequate support, can contribute to positive change;
5. with adequate support, can participate in decision-making.

Next, we observed which communication practices that supported and undermined these five aspects of agency in the video-recorded mental health encounters we observed. When practitioners use practices that protect the young person's sense of agency in the encounters, we say that they adopt the agential stance towards the young person, that is, they treat the young person as an agent. 

Here, we consider the two aspects of agency that the young people identified as fundamental, validation and legitimisation. 

1. An agent is a subject of experience and their perspective matters.

Validation is a critical tool for showing that the young person’s experiences and perspectives matter. A practitioner can show understanding and acceptance of the young person’s experience, without having to express agreement or approval. Some mental health assessments lack validation, as the main focus is on risk assessment and problem solving. 

You need to say, “You’re really distressed. You’re in a lot of pain.” I think that kind of acknowledgement alone can be really, really powerful.


2. An agent can take action to change their situation by seeking help.

Legitimisation of help-seeking expresses that the young person made the right choice in seeking help. Communication techniques include for the practitioner to clearly state that the young person had genuine grounds for concern and deserves support. However, during assessments for suicidal thoughts, we observed that practitioners often implied that the young person didn’t need help, which could make them feel like they had no genuine concerns and did not deserve support.

With that sort of interaction, of “Oh you’re not planning to do anything now so it’s fine.” … You know, the department said it’s not an issue so it’s fine sort of having these thoughts… You wouldn’t think “Well maybe it’s really serious, maybe I do need to tell someone to help me.”


If you want to know more, the McPin Foundation created a podcast on our study, summarising all the findings.

Wednesday, 20 April 2022

Epistemic Injustice in Clinical Encounters

This is part of a series of posts reporting outcomes from a project on Agency in Youth Mental Health, led by Rose McCabe at City University. In the previous post, the project team explained why young people may have heightened risks of experiencing epistemic injustice in clinical encounters. Today, Clara Bergen and Rose McCabe provide evidence that young people's sense of agency is sometimes undermined in such encounters.

By analysing video recordings of police interactions, courtroom cross-examinations, and political news interviews, researchers have learned a lot about how institutional figures challenge what other people have felt or experienced. 

For example, police and lawyers use subtle practices like asking questions that imply inconsistency or implausibility (Stokoe et al 2020), anticipate a compromising response (Drew 1992), or imply disagreement (Jol & van der Houwen 2014). Lawyers and political interviewers may take an adversarial stance (Clayman & Heritage 2002) or imply that evidence suggests an alternative characterization (Antaki et al 2015).

In this study, we asked whether these communication practices are also used by practitioners in mental health services. We examined 46 video-recorded psychosocial assessments for people attending the Emergency Department with thoughts of suicide or self-harm.  

Clara Bergen

Rose McCabe

What we found was striking – across these data, mental health practitioners used all these communication practices for challenging what a person had felt or experienced. Most often, practitioners used these practices to downplay a person’s distress or their risk of suicide. This aligned with what our young lived experience researchers described about their own interactions with mental health services.

This fits into a wider institutional context. In the Emergency Department, practitioners are under a lot of pressure to discharge patients quickly and there are limited inpatient beds and services in the community for people in distress. Practitioners are forced to take the role of gatekeeper (Fisher 2022) and ration referrals to overwhelmed mental health services.

See the example below. Patrick, an 18-year-old man, has come to the Emergency Department to get hel for suicidal thoughts. He describes himself as feeling miserable. We use Conversation Analysis, a way of micro-analysing verbal and nonverbal features of communication (see Sidnell & Stivers 2012), to analyse these data.

Rather than accepting Patrick’s [PT] description of his experience (feeling “miserable”, line 1), the practitioner [PR] cites Patrick's facial expressions (“you smile” lines 4-6) as evidence (“So” line 8) that he has “times when” he isn’t miserable (line 8) and is “enjoying things” (line 9). In this way, the practitioner cites contrasting information (lines 4-6) as evidence against Patrick’s description of himself as “miserable”. 

The contrastive framing (“yet” line 2), lack of acceptance (e.g., okay), and assertion that Patrick isn’t always miserable (lines 8-9), discount Patrick’s characterization as untrue. Patrick responds minimally (lines 3, 7, 10), showing signs of disengagement (Peräkylä et al 2021) and passive participation without agreement. The practitioner concedes that the Patrick could just be giving the impression of enjoying things (lines 9, 11). At this point, Patrick nods, showing some affiliation with this last statement.

Practitioners feel a sense of powerlessness and burnout in the face of exclusionary referral criteria and long waiting lists (O’Keeffe et al 2021). This minimization of patient distress may be one consequence of forcing practitioners to ration overwhelmed mental health services.

National Health Service slogans like “just talking can help” and “don’t be afraid to ask for help” aim to encourage early intervention and help-seeking for mental health problems (Health and Social Care Committee 2021). However, the communication practices identified in this study undermine public health initiatives for early intervention, leaving patients to question whether they truly deserve care (Liberati et al 2022). Examples like Patrick's above help us understand why so many people seeking help for self-harm describe feeling excluded from services and “unworthy of help” (Xanthopoulou et al 2021).

Tuesday, 19 April 2022

Threats to Epistemic Agency for Young People

This is the first in a series of posts reporting outcomes from a project on Agency in Youth Mental Health, led by Rose McCabe at City University. Today Joe Houlders, Matthew Broome and Lisa Bortolotti (University of Birmingham) talk about the risks of young people with unusual experiences and beliefs experiencing epistemic injustice in clinical encounters. 

Joe Houlders

Epistemic injustice occurs when a person is not given authority and credibility as a knower in an exchange, due to negative stereotypes associated with the person's identity (age, gender, ethnicity, social class, education, sexual orientation, health). Young people with unusual experiences and beliefs are particularly at risk of being on the receiving end of epistemic injustice, and when their agency is undermined the effects are likely to be pervasive and impact negatively on their health outcomes. 

Why is this population more vulnerable? In the mental health context, the manifestation of behaviours such as hearing voices and expressing paranoid beliefs can also lead to a person being silenced, dismissed, or denied agency. Without justification, perceived irrationality in one area of mental life (“In this context, this person cannot distinguish between imagination and reality”) is generalised to other areas of decision making and agency that may actually be unaffected by the person’s poor mental health. 

What is the sense of agency and why does it matter? People have a sense of agency if they see themselves as the initiators of their actions; feel in control of their bodies and minds; and feel they can intervene on their environment. Young people may already be perceived as lacking agency. This is due to the common association in popular culture between youth and restlessness, unreliability, attention-seeking behaviour, laziness, recklessness, and lying. Examples would be the press’s use of the term “snowflakes” to refer to young people, and the assumption that young mothers are irresponsible and unable to take good care of themselves and their children.

Why is it important to protect a young person's sense of agency in clinical encounters? We know that shared decision-making and empowerment are linked to good therapeutic relationships and better clinical outcomes. If young people are unable to contribute to the decision-making process because they are silenced or feel powerless, then the quality of their therapeutic relationships with medical professionals and their clinical outcomes may be compromised. 

Moreover, the identity of young people in general is still fluid and more likely to be shaped by social interactions with power imbalances—the effects of challenging the sense of agency of a young person may be more pervasive than the effects of challenging the sense of agency of a person whose identity is more securely established. In the words of a member of the Youth Project Advisory Group in our project:

Further, the sense of agency of people with unusual experiences and beliefs may be more precarious to start with, due to the fact that unusual experiences and beliefs often undermine the sense of oneself as someone capable, efficacious, and in control. Young people with such experiences and beliefs may be more inclined to question themselves.

So far, we only mention possible risks for epistemic agency, but we also have evidence that people with psychotic symptoms are dismissed in conversations during clinical encounters, and their capacity for producing and sharing knowledge is undermined by the healthcare practitioners' attitudes.

[Patients with psychotic symptoms] clearly attempted to discuss their psychotic symptoms and actively sought information during the consultation about the nature of these experiences and their illness. When patients attempted to present their psychotic symptoms as a topic of conversation, the doctors hesitated and avoided answering the patients' questions, indicating reluctance to engage with these concerns. (McCabe et al. 2002, p. 1150)


If you want to know more about the risks of epistemic injustice for young people struggling with their mental health, you can read our paper (published in Synthese in 2021, open access). 

You can also follow the other posts in this week's series: tomorrow Clara Bergen and Rose McCabe will discuss more evidence of epistemic injustice in clinical encounters; on Thursday, Clara Bergen and Lisa Bortolotti will present some findings leading to concrete suggestions about what practitioners can do to protect young people's sense of agency; on Friday, Rachel Temple and the members of the project's Young Person Advisory Group will talk about the significance of the project for them.

Tuesday, 12 April 2022

What’s wrong with the computer analogy?

Today's post is by Harriet Fagerberg at King’s College London & Humboldt-Universität zu Berlin on her recent paper “Why mental disorders are not like software bugs” (forthcoming, Philosophy of Science).

What, if anything, is the difference between mental disorders and brain disorders? Are mental disorders brain disorders? If not, are they disorders at all? According to one prominent view in the philosophy of psychiatry, mental dysfunction does not entail brain dysfunction just as software dysfunction does not entail hardware dysfunction in a classical computer. Wakefield writes: 

It is true that every software malfunction has some hardware description; that is not at issue. Rather, the point is that a software malfunction need not be a physical hardware malfunction. Analogously, even if all mental states are physical states, it does not follow that a mental dysfunction is a physical dysfunction. (p. 129, Wakefield, 2006; see also Papineau, 1994)

Nevertheless, because dysfunctions count as medical disorders (per the natural dysfunction analysis of medical disorder) purely mental dysfunctions still count as real disorders. Thus, we get real mental disorders, without brain dysfunction, and without appealing to some spooky dualism about the mental. 

The argument from the computer analogy is both intuitive and appealing. However, as I argue in ‘Why mental disorders are not like software bugs’, it is also unsound. The argument from the computer analogy rests on the false premise that mind-brain is analogous to software-hardware in all relevant ways. In fact, there is an important disanalogy between mind-brain and software hardware: software functions need not be hardware functions, but mental functions are brain functions.  

The etiological theory of function, on which the natural dysfunction account rests, states that F is a function of X iff F is a selected effect of X. 

We can now ask, are all software functions selected effects of the hardware? It seems not. We can imagine a scenario in which the hardware designers had no idea that the hardware they were designing would eventually come to run a word processer. Thus, if there is an error in the code which prohibits (say) the deletion of text, then this is compatible with the hardware doing everything it was designed to do. The hardware was just designed to run code – and it is doing this correctly. 

Mental functions, on the contrary, are necessarily selected effects of the brain. The only way in which a mental function can be configured into the mind via evolution is by being causally efficacious in the natural selection of the implementing organ – i.e. the brain. There is not pre-neural ‘mindware’ designer through which purely mental norms of operation may arise. It follows that mental functions are brain functions. Accordingly, should one fail, that failure would constitute a brain dysfunction – whether or not we can determine this from physical facts alone. 

In this sense, mental disorders really aren’t like software bugs. 

Tuesday, 5 April 2022

Spinozan Doxasticism about Delusions

In today's post, Federico Bongiorno gives an overview of his paper "Spinozan Doxasticism about Delusions" which is forthcoming in Pacific Philosophical Quarterly. Federico is a postdoctoral researcher at the University of Oxford funded by an award from the Mind Association, working at the interface of philosophy of mind, cognitive science, and the philosophy of psychiatry.

Federico Bongiorno

There are normative standards that are widely held to be required for the practice of belief ascription. At a minimum, beliefs are to appropriately respond to the relevant evidence (epistemic rationality), to cohere with other beliefs (procedural rationality), and to drive consequential behaviour in the right conditions (agential rationality). We adult humans ascribe beliefs to ourselves, and to one another, in reliance of these standards, but belief ascription can be a tricky undertaking. It is especially tricky in cases of delusion, a clinical symptom observed across a variety of psychiatric disorders. One of the biggest issues in connection to delusions is whether they can be beliefs despite breaching all three standards listed above, that is, even if they are often (i) immune to evidence, (ii) inferentially encapsulated, and (iii) behaviourally inert.

There have been two major types of response to this issue. The most popular is what I call ‘standard doxasticism’ (Bortolotti, 2009, 2012), according to which if we deny belief status to delusions on the grounds of their being i, ii, iii, then we get the implausible result that we have very few beliefs, since many of the beliefs we routinely ascribe to each other are i, ii, iii. A second type of response is to insist that epistemic, procedural, and agential rationality are necessary for something’s being ascribed as belief, and that, since delusions tend to be i, ii, and iii, they are not beliefs, but, at best, non-doxastic, or semi-doxastic, attitudes in their vicinity.

What has been largely overlooked by both sides is the fact that ‘belief’ can refer either to a commonsense psychological category on which we rely when predicting behaviour, or to a mental type whose causal role is articulated by law-like generalisations uncovered by cognitive science. As far as I can tell, there has been scant attention paid to whether delusions are beliefs in this latter sense, and that reflects an important gap in the literature. Progress on this question can be made by asking what our belief-mechanisms are designed to do, so that we can then see how delusions stand with respect to their design specifications. If we are able to make cognitive scientific generalisations about the ways we normally fix and update beliefs, this may shed new light on the nature of delusions, for we can then ask whether or not these generalisations extend to delusions.

The sort of generalisation whose implications I explore in my paper is a theory of belief known as Spinozan Theory (see e.g., Gilbert, 1991; Mandelbaum, 2010, 2014; Asp et al., preprint). The main idea is that we acquire any proposition we entertain initially as a belief, and only after the initial acceptance, if enough cognitive resources are available, can the belief be dislodged. So, for example, even given an outlandish proposition like ‘clouds are made of cotton candy’, believing is default with the semantic comprehension of that proposition, and it takes an extra process of evaluation to either endorse it, or more importantly, disbelieve it.

What then is distinctive of the Spinozan Theory is that believing and disbelieving are performed by different cognitive processes, which also means that they are differentially affected by performance constraints. Because believing is reflexive, it is undemanding of cognitive resources, and so remains unaffected when cognitive resources are depleted by cognitive load. By contrast, evaluating (and possibly rejecting) a proposition is an effortful process which draws heavily on cognitive resources, and so can be disrupted by cognitive load.

Of course, the empirical evidence on the Spinozan Theory remains the subject of ongoing debate and investigation. But the question for me is supposing it was right, what would follow about whether delusions are beliefs? I argue that the Spinozan Theory supports a new version of doxasticism, what I call ‘Spinozan Doxasticism’, which has two advantages over the standard defence: it puts pressure on the very notion that one can be deluded that p without believing p, and it can accommodate i, ii, iii (the features of delusions that many see as most indicative of their not being beliefs) within an empirically viable theory of belief. In closing, I consider whether delusions can fit into the Spinozan picture of belief, and why this is something all doxasticists should want to accept.