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?