Disordered Minds/Minding Disorder The Philosophy of Psychiatry

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Disordered Minds/Minding DisorderThe Philosophy
of Psychiatry

• Bryan Miller
• JHU Philosophy Dept.

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1. Preliminary remarks

• Minding Disorder Philosophys role
• Address issues deemed to be meta-scientific
• Is psychiatry a science? Are there laws of
  psychiatry?
• Are mental disorders natural kinds? Or social
  kinds?
• Help tidy-up potential conceptual confusions
• What is a mental disorder?
• Categorization of disorders?

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1. Preliminary remarks

• Disordered Minds Psychiatrys role
• The self
• Belief states
• Perception Cognition
• Human nature
• Cognitive architecture

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1. Preliminary remarks

• What is philosophy of psychiatry?
• Applied philosophy of science
• Philosophy of physics
• Philosophy of biology
• Philosophy of social sciences
• Philosophy of psychology
• philosophy of mind

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2.a. Minding Disorder What is psychiatry?
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2.a. What is Psychiatry?

• A branch of psychology?
• A branch of medicine?
• Is it a science?
• What demarcates science from non-science?

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2.a. Is psychiatry a science?

• It is, at the least, reasonable to think that
  psychiatry is a science.
• Of course, whether it is will depend on the
  nature of the phenomenonmental disordersthat
  psychiatry is concerned with.
• What is a mental disorder?

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2.b. What is a mental disorder?

• Schizophrenia
• Bipolar Disorder
• Depression
• OCD
• Autism
• Alzheimers
• Capgras Syndrome

• Cotard syndrome
• Alcohol/drug addiction
• Depression
• Sociopathy
• ADHD
• Cortical Blindness
• Drapetomania

What do all these things have in common?
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2.b. Psychoanalysis

• Mental disorder is the behavior resulting from an
  underlying cause (the unconscious)
• Unconscious mechanisms drive conscious
  experiences and behavior and can be revealed and
  rendered intelligible by the psychoanalytic
  technique of interpretation.

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2.b. The Myth Approach

• Thomas Szasz
• Mental disorders are not true disorders because
  there are no accompanying lesions
• Mental disorder as problems in living
• Diagnosis as a means of power and control
• Note As far as I know, Szasz is not a
  scientologist!

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2.b. Harmful Dysfunction Analysis

• Mental disorder has a normative as well as an
  objective component
• Harm Conditions
• Dysfunctioning mental mechanism

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2.b. Disorder as Disease

• Mental Disorders are neuropathologies

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2.c. Categorization of mental disorders

• If psychiatry is a science, then the categories
  it investigates should support inductive
  generalizations.
• We want to be able to investigate a few instances
  of a category and project what we learn to all
  members of the category.
• Only certain categories/classes support
  scientifically interesting inductive
  generalizationsnatural kinds.

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2.c. Categorization of mental disorders

• What is a natural kind?
• A Natural kind is a class that has a property
  cluster that result from some causal
  mechanism(s).
• The mechanism(s) which causally sustain the
  relevant property cluster can be considered the
  defining feature of a natural kind.

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2.c. A category crisis

• Psychiatry ought to only investigate mental
  disorders that are natural kinds.
• DSM-IV categories of mental disorder are symptom
  basedcategories are based on symptom-clusters.
• These categories are often treated as though they
  are natural kinds, kinds that should be
  scientifically investigated and that possess
  underlying causal unity.

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2.c. A category crisis

• The problem
• Many DSM IV categories are probably not natural
  kinds!!!
• Whats the big deal?
• Investigating non-natural kinds may stall
  progress.

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2.c. An example delusions

• DSM-IV Delusion
• A false belief
• The belief is based on incorrect inference about
  external reality
• Entrenched and rigid.
• The belief is not one ordinarily accepted by
  other members of the person's culture or
  subculture (e.g., it is not an article of
  religious faith).

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2.c. An example delusions

• Some delusions are probably caused by
  motivational factors employed for coping.
• e.g., erotomania
• Some delusions are likely caused by
  cognitive/perceptual impairments.
• e.g., Capgras
• Suggests various causal mechanisms.

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2.c. An example delusions

• Bottom-up abnormal experience that then modifies
  belief system.
• Top-down start with modified beliefs that give
  rise to strange experiences.
• Suggests various causal mechanisms.

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3. Disordered minds Psychiatrys role
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3. MPD (DID) and the self

• Origins Division of emotional labor
• Gives rise to multiple personalities?
• Fictive selves vs. Real Selves
• Are multiple personalities the same as multiple
  selves?
• Do neurotypicals only have one self? Is it a
  Fictive self

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3. Beliefs

• What is the relation between delusions and
  beliefs?
• Delusions do not integrate well and are not
  sensitive to updating in the face of new
  evidence.
• Does this suggest that delusions are not beliefs?
  
• Or does it suggest our previous notions of belief
  are too strongi.e., no account of beliefs
  consistent with empirical data suggests the
  strict conditions that are often imposed on
  beliefs.

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3. The continuum Hypothesis

• If most disorders are just deviations from the
  norm along a continuum then we learn something
  about human nature.
• Most people have multiple personalities.
• Most people have obsessive-compulsive tendencies
  in certain domains.
• Most people have delusions.
• Most people experience depression.
• We need to keep these facts in mind if
  philosophical claims hinge on alleged features of
  human nature (i.e., descriptive ethics, theories
  of rationality).

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3. Cognition and perception

• How tightly linked are cognition and perception?
• Top-down accounts of delusions suggest that
  cognition can influence perception.
• How much influence can the physiological
  component of depression have on agency and
  cognition? Do depressives perceive, or conceive,
  the world differently
• What can we learn about the content of mental
  states from mental disorders such as delusions?

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3. Disorders and Cognitive Architecture

• Do mental disorders tell us anything about the
  cognitive architecture of the human mind-brain?
• Can we infer dedicated modules from observed
  mental disorders?
• Can we infer that certain cognitive processes are
  not modular rather, that they are domain general?

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coming soon.!!Madness Religion Workshop
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Madness Religion Workshop

• Coming in April!!!
• Questions? Email madnessandreligion_at_gmail.com
• Keynote Speaker
• Prof. Pascal Boyer
• Why obsessive people and religious people perform
  rituals

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Madness Religion WorkshopProgram Abstracts

• Delusions are (probably) not a natural kind What
  Samuels missed about realization, Bryan Miller
• In Delusions as a natural kind Richard
  Samuels argues contrary to theorists such as
  Peter Zachar (2000) and Nassir Ghaemi (2004) that
  delusions probably do constitute a natural kind.
  Samuels supports his claim, the natural kind
  thesis (hereafter, NK thesis), by showing that
  several objections to it are mistaken. One of
  the strongest objections that Samuels must face
  is the heterogeneity objection, the claim that
  the NK thesis is false because delusions are
  realized by a number of heterogeneous neural
  and/or cognitive states. Samuels response to
  this objection notes that this only shows that
  delusions are multiply realizable and that this
  fact is consistent with and supportive of the NK
  thesis. In this paper, I argue that Samuels
  response to the heterogeneity objections fails to
  support the NK thesis insofar as it employs a
  form of realization that does not give rise to
  natural kinds. I conclude by remarking on how the
  failure to secure the natural kind status of
  delusions might be problematic for a special case
  of delusionsnamely, religious delusions.
• Dworkin on the Moral Psychology of Abortion,
  Jonathon Hricko
• In his book Lifes Dominion, Ronald Dworkin
  argues that, though defenders of the pro-life
  position may say that they object to abortion
  because they believe that it violates the rights
  and interests of the fetus, they actually object
  to it because they believe that it violates the
  intrinsic value of the fetus. Dworkin attempts to
  reach this conclusion by arguing that the former
  belief is incoherent. I will draw an analogy
  between the abortion debate and the conjunction
  fallacy in order to argue that Dworkin cannot
  reach his conclusion by means of the arguments he
  gives. The fact that a belief is incoherent is no
  reason to conclude that people do not hold that
  belief. Just as the probability rankings that
  people assign to a set of statements is an
  empirical issue, so is what people think about
  abortion, and so an empirical investigation is
  necessary to determine whether Dworkins
  conclusion is correct.

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Madness Religion WorkshopProgram Abstracts

• Religion, Rationality, and Altruism, John
  Waterman
• Religion is puzzling from an evolutionary
  perspective. Religious ritual and belief have
  clear adaptive costs in time and effort, but they
  don't have clear compensating benefits. By any
  right, natural selection should have eliminated
  them long ago. Instead we find religion is a
  human universal. How should we explain this? An
  age old, if now unpopular, view explains that
  religions worth derives from promoting morality.
  Costly Signaling Theory, an adaptationist
  approach gaining currency among cognitive
  scientists of religion, updates this view. It
  argues religious beliefs and rituals are
  adaptations integral to the evolution of human
  altruism. The theory claims the adaptive
  benefits of religion accrue by mitigating the
  threat narrow self-interest poses to cooperative
  behavior. In this essay I argue that Costly
  Signaling Theory fails as an explanation of the
  evolution of cooperation in populations with
  unrelated individuals. Using the framework of
  evolutionary game theory, I show that religious
  belief and religious ritual are neither necessary
  nor sufficient for eliminating the underlying
  adaptive instability of cooperative behavior. I
  conclude with a discussion of the evolutionary
  relationship between religion and morality, and
  by considering a pending question for both
  adaptationist and spandrelist theories of
  religious cognition.
• Between Adaptations and Spandrels Cognitive
  science and evolutionary psychology of religion,
  Derek Leben
• Many psychologists, anthropologists, and
  biologists currently attempt to explain religion
  as not only a biological-cognitive product, but
  as an evolutionary adaptation. This paper will
  discuss the adaptationist argument as well as the
  supposed alternative, that religion is a useless
  by-product of other cognitive systems
  (spandrelism). It will be argued that the
  adaptationist argument is not effective, due to a
  failure to distinguish beneficial uses from
  proper evolutionary functions, as well as a
  much wider variety of evolutionary causes than
  simply an adaptation or spandrel (kluge,
  exaptation, co-opted mechanism). Other cases such
  as language and moral appraisal will also be
  considered for comparison.

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Selected Bibliography
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Selected Bibliography

• Bayne, T. and Pacherie, E. (2005). In defence of
  the doxastic conception of delusion, Mind
  Language, 20 (2) 163188.
• Bermúdez, J. (2001). Normativity and rationality
  in delusional psychiatric disorders, Mind
  Language, 16 (5) 493457.
• Bermudez, J. and Cahen, A. (2008). Non-conceptual
  Mental Content. Stanford Encyclopedia of
  Philosophy.
• Bortolotti, L. (2009) Delusions. Stanford
  Encyclopedia of Philosophy.
• Boyd, R. (1999). Homeostasis, Species and Higher
  Taxa. in Species New Interdisciplinary Essays.
  Wilson, R. (ed.) Cambridge MIT Press 141-186
• Boyer, P., Lienard, P. (2006). Why ritualized
  behavior in humans? Precaution systems and
  action-parsing in developmental, pathological
  and cultural rituals. BehavioralBrain Sciences,
  29, 156.
• Cartwright, N. et al .(200?) Philosophy of
  Science Laws.
• Craver, C. F. (2007). Explaining the brain
  Mechanisms and the mosaic unity of neuroscience.
  Oxford Oxford University Press.
• Devitt, M. (1994). The Methodology of
  Naturalistic Semantics. The Journal of
  Philosophy. Vol. 91 10, pp. 545-572.
• Dretske, F. I., 1981, Knowledge and the Flow of
  Information (Oxford Blackwell).
• Fine, C., Craigie, J. and Gold, I. (2005).
  Damned if you do, damned if you don't The
  impasse in cognitive accounts of the Capgras
  delusion, Philosophy, Psychiatry Psychology,
  12 143151.
• Fodor, J., (1974), Special sciences, or the
  disunity of science as a working hypothesis,
  Synthese 28 77-115.
• Fodor, J., (1978), "Propositional Attitudes," The
  Monist 61 501-523.
• Friedlander, L., Desrocher, M., 2006.
  Neuroimaging studies of obsessivecompulsive
  disorder in adults and children. Clin. Psychol.
  Rev. 26 (1), 3249.
• Gilleen, J and David, A.S. (2005). The cognitive
  neuropsychiatry of delusions from
  psychopathology to neuropsychology and back
  again. Psychological Medicine, 35 5-12.
• Ghaemi, S.N. (2004). The perils of belief
  Delusions reexamined. Philosophy, Psychiatry, and
  Psychology. 111, 49-54.
• Griffiths, P. E. (1997). What Emotions Really
  Are The Problem of Psychological Categories.
  Chicago Univ. Chicago Press.
• Griffiths, P. E. (1999). Squaring the circle
  natural kinds with historical essences. In R. A.
  Wilson (Ed.), Species New Interdisciplinary
  Essays (pp. 208-228). Cambridge, M.A MIT Press.

32
Selected Bibliography

• Haslam, Nick. "Kinds of Kinds A Conceptual
  Taxonomy of Psychiatric Categories." Philosophy,
  Psychiatry, Psychology, 9 (2002), 203-218
• Heck, R. G. (2007). Are there different kinds of
  content? In J. Cohen and B. McLaughlin (Eds.),
  Contemporary Debates in the Philosophy of Mind.
  Oxford Blackwell.
• Hempel, C. (1965). Fundamentals of taxonomy. In
  Aspects of Scientific Explanation. (ed. C.
  Hempel), pp. 137154. NY, The Free Press.
• Hitchcock, C. and Woodward, J.C (2003)
  Explanatory Generalizations, Part II Plumbing
  Explanatory Depths, Nouˆs 37, 2.
• Humphreys, N. and Dennett, D. (1989). Speaking
  for our selves An assessment of multiple
  personality disorder, Raritan, 9(1) 6898.
• Kunert, H.J., Norra, C. and Hoff, P. (2007).
  Theories of Delusional Disorders.
  Psychopathology, 40191-202.
• Lewis, D. (1973) Causation, Journal of
  Philosophy 70, 556567.
• Machamer, P., Darden, L., Craver, C. (2000).
  Thinking about mechanisms. Philosophy of Science,
  67, 1-25.
• Mataix-Cols, D., do Rosario-Campos, M.C.,
  Leckman, J.F. (2005). A multidimensional model of
  obsessive-compulsive disorder. The American
  Journal of Psychiatry, 162, 228238.
• McDowell, J. (1994a). Mind and World. Cambridge
  MA Harvard University Press.
• Millikan, R. (1989).Biosemantics, The Journal of
  Philosophy 86.6, pp. 281-297.
• Millikan, R. (1999). Historical Kinds and the
  Special Sciences. Philosophical Studies. 95
  45-65
• Murphy, D. (2006). Psychiatry in the Scientific
  Image. Cambridge, MA, MIT Press.
• Murphy, D. (2009)Psychiatry and the concept of
  disease as pathology. in M.Broome L. Bortolotti
  (eds) Psychiatry as cognitive neuroscience
  philosophical perspectives. Oxford University
  Press.
• Murphy, Dominic and Woolfolk, Robert L. "The
  Harmful Dysfunction Analysis of Mental Disorder."
  Philosophy, Psychiatry, Psychology, 7 (2000),
  241-252.
• Peacocke, C. (2001a). Does perception have a
  non-conceptual content? Journal of Philosophy 98,
  239-264.
• Salmon, W. (1990). Four Decades of Scientific
  Explanation. University of Minnesota Press,
  Minneapolis.

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Selected Bibliography

• Samuels, R. (2009). Delusions as a Natural Kind.
  in M.Broome L. Bortolotti (eds) Psychiatry as
  cognitive neuroscience philosophical
  perspectives. Oxford University Press.
• Simpson, H. et al. (2006) Are there reliable
  neuropsychological deficits in obsessivecompulsiv
  e disorder? Journal of Psychiatric Research,
  Vol403, p 247-257
• Szasz, Thomas. The Myth of Mental Illness
  Foundations of a Theory of Personal Conduct (New
  York Harper and Row, 1974.)
• Wakefield, Jerome C. "The Concept of Mental
  Disorder On the Boundary Between Biological
  Facts and Social Values." American Psychologist
  47, no. 3. (1992) 373-88.
• Wakefield JC Spandrels, vestigial organs, and
  such a reply to Murphy and Woolfolks The
  harmful dysfunctional analysis of mental
  disorder. Philo Psychiatr Psychol 2000
  7253269
• Woodward, J., and C. Hitchcock (2003)
  Explanatory Generalizations, Part I A
  Counterfactual Account, Nouˆs 37 124.
• Zachar, P. (2000). Psychiatric disorders are not
  natural kinds. Philosophy, Psychiatry, and
  Psychology. 7167-182.

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Discussion questions

• Which account of mental disorder seems most
  correct? Why?
• If there is essentially a normative component to
  mental disorder, does this threaten the status of
  psychiatry as a science?
• Can mental disorder ever be valuable?

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