This post is by Eleanor Harris. Eleanor Harris is a Philosophy PhD candidate at the University of Birmingham, funded by the AHRC Midlands4Cities Doctoral Training Partnership. Her research explores Delusions, Epistemic Injustice, and Epistemic Vigilance. Here, she provides a report on The Association for the Advancement of Philosophy and Psychiatry's (AAPP) annual conference.
The Association for the Advancement of Philosophy and Psychiatry (AAPP) held their 33rd annual conference on 21st-22nd May 2022 at the Hilton Riverside in New Orleans, Louisiana. Unlike previous years’ conferences that had a set theme which was narrower in focus, the theme for this year’s annual conference was open to all topics that address either philosophical issues that are relevant to psychiatry, or psychiatric issues with relevance to philosophy. Over two days there were a total of 19 talks, on a wide range of topics such as psychiatric euthanasia, policing and the production of the mental health crisis, and issues with defining and taxonomizing mental illness. I give a brief summary of four of the talks below.
On the first day of the conference, I gave a talk entitled ‘Delusions: Epistemic Injustice and Epistemic Vigilance’. I argued that speakers with delusions are vulnerable to epistemic injustice due to the existence of negative stereotypes. I also argued that Sperber and colleagues’ (2010) notion of epistemic vigilance – evolved mechanisms for guarding ourselves against misinformation – could explain why we are epistemically on our guard when evaluating claims issuing from speakers with delusions.
On the first day of the conference, I gave a talk entitled ‘Delusions: Epistemic Injustice and Epistemic Vigilance’. I argued that speakers with delusions are vulnerable to epistemic injustice due to the existence of negative stereotypes. I also argued that Sperber and colleagues’ (2010) notion of epistemic vigilance – evolved mechanisms for guarding ourselves against misinformation – could explain why we are epistemically on our guard when evaluating claims issuing from speakers with delusions.
I suggested that we face a prima facie epistemic-ethical dilemma between preserving the epistemic benefits of epistemic vigilance and avoiding epistemic injustice and its ethical costs. I aimed to dissolve the dilemma by picking out some of the distinctly epistemic costs of epistemic injustice, such as discounting informative testimony, and therefore concluded that epistemic injustice leaves us epistemically, as well as ethically, worse off.
The Edward Wallace Lecture keynote speech was given by Åžerife Tekin from the University of Texas at San Antonio. Tekin talked about ‘Ethics of Distributing Psychotherapy Chatbots to Refugees: Stuff WEIRD People Do’. Tekin applied Heinrich’s (2020) exploration of WEIRD (Western, Educated, Industrialised, Rich and Democratic) people to raise concerns about recent attempts to meet the need for mental health care during refugee crises by using chatbot apps. Tekin argued that distributing AI psychotherapy chatbots to refugees is problematic because such chatbots assume that WEIRD characteristics are universal across cultures, and therefore impose WEIRD standards to understanding and treating mental illness.
For example, the psychotherapy chatbots Tekin investigated assumed that its users would be analytical (the chatbots suggest users should reason better to help their mental health) and control-oriented (users should “take charge” of their thoughts and feelings). Tekin suggested that characteristics such as analytical and control-oriented are not universal but are instead particular characteristics of WEIRD people. Thus, AI psychotherapy chatbots problematically impose WEIRD standards on treating refugees with mental illness, and there is no conclusive data that using these bots helps refugees. Moreover, Tekin argued that using chatbots rather than actual therapists to treat refugees contributes to dehumanisation.
On the second day of the conference, Kathryn Petrozzo from the University of Utah gave a talk entitled ‘Less Than Whole: Implications of Reduced Agency of Individuals with Psychiatric Disorders’. Petrozzo opened her talk by appealing to the intuition that if someone is less than fully agential, then they are less responsible (and less blameworthy) for their actions. Therefore, if individuals with mental illnesses have reduced agency, then they should be held less accountable for their crimes. However, Petrozzo argued that the suggestion that those with mental illness have reduced agency can actually have negative real-world consequences because of how mental illness is perceived as dangerous.
On the second day of the conference, Kathryn Petrozzo from the University of Utah gave a talk entitled ‘Less Than Whole: Implications of Reduced Agency of Individuals with Psychiatric Disorders’. Petrozzo opened her talk by appealing to the intuition that if someone is less than fully agential, then they are less responsible (and less blameworthy) for their actions. Therefore, if individuals with mental illnesses have reduced agency, then they should be held less accountable for their crimes. However, Petrozzo argued that the suggestion that those with mental illness have reduced agency can actually have negative real-world consequences because of how mental illness is perceived as dangerous.
For example, Petrozzo cited Hall and colleagues (2019), who found that individuals with a prior diagnosis of a mental illness face 50% longer prison sentences than those without a diagnosis of mental illness. Therefore, Petrozzo argued that we face a “dual-use dilemma” for reduced agency: the notion of reduced agency of individuals with psychiatric disorders was put forward to promote good, however labelling those with mental illness as less than fully agential also has the potential to cause harm.
Justin Garson, from City University of New York, gave the talk ‘Madness and Idiocy: Rethinking the Problem of Defining Mental Illness’. Garson suggested that although we usually define madness via negativa, in opposition to sanity, Late Modern theorists of madness (19th century) distinguished madness from sanity and idiocy. Garson argued that these three concepts (madness, sanity and idiocy) were distinguished in relation to the functioning of the reasoning capacity: sanity involves proper functioning, idiocy involves diminished or even abolished functioning, and madness involves perverse functioning.
Justin Garson, from City University of New York, gave the talk ‘Madness and Idiocy: Rethinking the Problem of Defining Mental Illness’. Garson suggested that although we usually define madness via negativa, in opposition to sanity, Late Modern theorists of madness (19th century) distinguished madness from sanity and idiocy. Garson argued that these three concepts (madness, sanity and idiocy) were distinguished in relation to the functioning of the reasoning capacity: sanity involves proper functioning, idiocy involves diminished or even abolished functioning, and madness involves perverse functioning.
Therefore, madness could not be defined via negativa as a lack of reason, as madness contains reason. Garson presented various Late Modern attempts to solve the following problem: how can madness contain reason, and yet a mad person not be reasonable? For example, Arthur Wigan (1844) suggested that rather one brain with two hemispheres, we have two brains. Madness occurs when one brain is healthy and the other is sick, and therefore madness necessarily involves a clash between reason (the healthy brain) and unreason (the sick brain). Garson concluded that recasting the problem of defining madness as Late Modern theorists did – contrasting madness with sanity and idiocy, rather than sanity alone – encourages us to seek a positive definition of madness, rather than defining madness merely as an absence of reason.
Many thanks to the conference organisers Peter Zachar (Auburn University Montgomery), John Tsou (Iowa State University) and John Z Sadler (UT Southwestern), and everyone at AAPP.
Many thanks to the conference organisers Peter Zachar (Auburn University Montgomery), John Tsou (Iowa State University) and John Z Sadler (UT Southwestern), and everyone at AAPP.