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In recent years, autopoietic enactivism has been used to address persistent conceptual problems in psychiatry, such as the problem of demarcating disorder, that other models thus far have failed to overcome. There appear to be three main enactive accounts of psychopathology with subtle, although not incompatible, differences: Maiese characterizes disorder as distinct disruptions in autonomy and agency; Nielsen characterizes disorder as behaviors that relevantly conflict with the functional norms of an individual; De Haan emphasizes patterns of disordered sense-making, that are transformed through the existential dimension. Given that these accounts are intended to provide not only an ontologically richer account of psychopathology but also reduce the stigma experienced by individuals with mental disorders by accounting for lived experience, a critical analysis of these approaches is needed. Russell provides a problematization of enactive accounts of mental disorder, showing that this particular framework does not, as it stands, necessarily reduce the harm and suffering experienced by individuals with mental disorder because of its ontological openness; enactivism leaves much to be interpreted and applied by the clinician (or patient) such that practical and ethical problems in its use arise.Jacobson, Anne J.. Norms and Neuroscience: The Case of Borderline Personality Disorder2022, In McWeeny, J. and Maitra, K. (eds) Feminist Philosophy of Mind, New York: Oxford University Press, pp.207-220-
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Cognitive neuroscience can offer us new explanations of episodes human behavior that, unlike many explanations traditionally available, do not draw on questionable past theories arising from cultures and traditions that are in fact patriarchal. At the same time, feminists have had a number of reasons for regarding it suspiciously as, among other things, reductive and dehumanizing. In this paper, new work on borderline personality disorder provides an illustrative example of the first. It is also used in an extended argument against the second. Cognitive neuroscience is interested principally in explaining how creatures function well in their niches. It is replete with covert references to values and interests. The paper draws an important distinction between cases in which culture creates new conditions for old functions to be realized and those where it creates new functions.Comment (from this Blueprint): Jacobson's chapter is an insightful exemplar of feminist philosophy of neuroscience that charts a course between hard-naturalism of mind in science and the pure social-constructivist theories of mental disorder. Jacobson's case study of Boderline Personality Disorder (BPD) demonstrates the ways in which values may be embedded in psychiatric categories, but the phenomena can nevertheless be accounted for using normatively-informed neuroscience. Feminist philosophy of science at large is an influence here, and thus this chapter is an important bridge between this topic and our own, feminist philosophy of mind.
Brison, Susan J.. Outliving oneself: trauma, memory, and personal identity2022, in McWeeny, J. and Maitra, K. (eds) Feminist Philosophy of Mind. New York: Oxford University Press, pp. 313-328-
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Added by: Adriana Alcaraz Sanchez and Jodie RussellAbstract:
"How can one die in Vietnam or fail to survive a death camp and still live to tell one's story? How does a life- threatening event come to be experienced as self- annihilating? And what self is it who remembers having had this experience?" By examining the lived experience of survivors from traumatic events, Brison sets to explore what exactly "the self" is. According to Brison, the self is "both autonomous and socially dependent", which makes it prone to be disrupted by traumatic events, but also, can be healed through safe and healthy relationships.Comment (from this Blueprint): Trigger warning: This article discusses accounts of trauma, including descriptions of an event of sexual assault that occurred to the author, as well as its aftermath. If used in a syllabi, this text should be presented as "optional" and students should be warned about its sensitive nature. A brief notice of TW should also be presented a the beginning of a session where the text is discussed. Also note that the suggested prompted questions for guiding reading of this article, as well as prompting discussion, also treat sensitive topics. Susan Brison provides a compelling argument about the embodied nature of the self by examining how traumatic events can have an impact on our personal identity and highly disrupt our personhood. Brison defends a relational account of the self in which the self is constructed through our interactions with others, and at the same time, affected by those interactions, making it vulnerable. By drawing first-hand from her own experience with trauma, Brison shows the importance of integrating lived experiences in the development of philosophical accounts.
Radden, Jennifer. Symptoms in particular: feminism and the disordered mind2022, In McWeeny, J. and Maitra, K. (eds) Feminist Philosophy of Mind. New York: Oxford University Press, pp.121-138-
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Added by: Adriana Alcaraz Sanchez and Jodie RussellAbstract:
Contrary to influential medical and cognitivist models governing how mental disorder is usually understood today, the socially embedded, disordered "mind," or subject, of feminist theory leaves little room for idiopathic causal analyses, with their narrow focus on the brain and its functioning, and reluctant acknowledgment of symptoms. Mental disorder must originate well beyond the particular brain of the person with whom it is associated, feminist analyses imply. Because the voiced distress of the sufferer cannot be reduced to the downstream, "symptomatic" effects of brain dysfunction, symptoms can be seen differently, as central to the diagnostic identity, and constitutive of (at least some) disorders. And new attention is required for the testimony of women diagnosed with mental disorder, vulnerable as it is to epistemic injustices. Corrected explanations of women's mental disorder leave remaining concerns, both epistemological and ethical, over the madwoman narrating her symptoms.Comment (from this Blueprint): Radden's paper introduces the reader to broad concerns with the dominant medical model of disorder from a feminist perspective, highlighting the tension with a naturalistic, reductionist approach with the situated and ecological approach of Radden's feminism. This article touches on topics mentioned in other readings (such as enactive concpetions of mind and epistemic injustice) but contextualises them within the field of philosophy of psychiatry. As such, this article is a fruitful springboard for critically considering the nature of medicine and psychiatry from multiple angles. This chapter would be complimented by the further reading of Russell's (2023) paper on Enactive Psychiatry.
Ritunnano, Rosa. Overcoming Hermeneutical Injustice in Mental Health: A Role for Critical Phenomenology2022, Journal of the British Society for Phenomenology, 53(3), pp.243-260-
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Added by: Adriana Alcaraz Sanchez and Jodie RussellAbstract:
The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, Rituanno argues that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, Rituanno argues that issues of unintelligibility can be addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. She concludes by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person's subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility.Comment (from this Blueprint): Ritunnano's paper clearly situates the concept of hermeneutic injustice in the field of mental health, using psychosis as a case study. Although it predominantly deals with just one type of epistemic injustice, Ritunnano's paper is nevertheless an approachable entry into the topic that compliments Radden's chapter. The field of critical phenomenology is also introduced, which links strongly to feminist considerations when trying to understand lived experience. Thus, this paper makes for good further reading on the topic of feminist philosophy of mind and mental illness.
Wolf, Susan. Sanity and the Metaphysics of Responsibility1987, In Ferdinand David Schoeman (ed.), Responsibility, Character, and the Emotions: New Essays in Moral Psychology. Cambridge University Press. pp. 46-62.-
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Added by: Chris Blake-Turner, Contributed by: Jojanneke Vanderveen
Abstract: My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane.Comment: Super great for metaethics/the responsibility debate. The book (Freedom Within Reason) is a more elaborated version of the same argument, and continues toward value pluralism.
Kraemer, Felicitas. Authenticity Anyone? The Enhancement of Emotions via Neuro-Psychopharmacology2011, Neuroethics 4(1): 51-64.-
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Added by: Simon Fokt, Contributed by: Emma Gordon
Abstract: This article will examine how the notion of emotional authenticity is intertwined with the notions of naturalness and artificiality in the context of the recent debates about ‘neuro-enhancement- and ‘neuro-psychopharmacology.- In the philosophy of mind, the concept of authenticity plays a key role in the discussion of the emotions. There is a widely held intuition that an artificial means will always lead to an inauthentic result. This article, however, proposes that artificial substances do not necessarily result in inauthentic emotions. The literature provided by the philosophy of mind on this subject usually resorts to thought experiments. On the other hand, the recent literature in applied ethics on ‘enhancement- provides good reasons to include real world examples. Such case studies reveal that some psychotropic drugs such as antidepressants actually cause people to undergo experiences of authenticity, making them feel ‘like themselves- for the first time in their lives. Beginning with these accounts, this article suggests three non-naturalist standards for emotions: the authenticity standard, the rationality standard, and the coherence standard. It argues that the authenticity standard is not always the only valid one, but that the other two ways of assessing emotions are also valid, and that they can even have repercussions on the felt authenticity of emotions. In conclusion, it sketches some of the normative implications if not ethical intricacies that accompany the enhancement of emotions.Comment: Discusses how the idea of authenticity relates to debates on enhancement. Best read after literature exploring different types of cognitive and emotional enhancement.
Ciurria, Michelle. Is There a Duty to Use Moral Neurointerventions?2017, Topoi 38(1): 37-47.-
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Added by: Simon Fokt, Contributed by: Emma Gordon
Abstract: Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer (Neuroethics 8(2):139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject-s brain, without her active participation, unlike ‘active- interventions. Some neurointerventions, however, appear to be relatively unproblematic, and some appear to preserve the agent-s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: (i) pass pre-clinical and clinical trials, (ii) fare well in post-clinical studies, and (iii) be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention.Comment: Proposes an account of low-risk medical interventions and argues that the risks attached to moral enhancements falling into this category are insufficient to provide us with strong reasons against our duty to undergo the intervention. Useful to read when exploring the issue of whether we are obligated to morally enhance (as e.g. Savulescu and Persson have argued).
Ventham, Elizabeth. Reflective Blindness, Depression and Unpleasant Experiences, Analysis, (forthcoming)-
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Added by: Simon Fokt, Contributed by: Lizzy Ventham
Abstract: This paper defends a desire-based understanding of pleasurable and unpleasant experiences. More specifically, the thesis is that what makes an experience pleasant/unpleasant is the subject having a certain kind of desire about that experience. I begin by introducing the 'Desire Account' in more detail, and then go on to explain and refute a prominent set of contemporary counter-examples, based on subjects who might have 'Reflective Blindness', looking particularly at the example of subjects with depression. I aim to make the Desire Account more persuasive, but also to clear up more widespread misunderstandings about depression in metaethics. For example, mistakes that are made by conflating two of depression's most prominent symptoms: depressed mood and anhedonia.Comment: Argues in favour of a 'desire account' of pleasurable and unpleasant experiences. Looks in particular at cases of depression and aims to clear up wider misunderstandings about depression in metaethics.
Heal, Jane. Mental disorder and the value(s) of ‘autonomy’2012, In Autonomy and Mental Disorder, Lubomira Radoilska (ed.). New York: Oxford University Press, 3-25.-
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Added by: Jamie RobertsonAbstract:
Summary (from Introduction of Autonomy and Mental Disorder, Radoilska ed.): In 'Mental disorder and the value(s) of autonomy', Jane Heal identifies and critically examines a form of thought which is implicit in discussions about what we, as a society, owe to people with mental disorder. This form of thought builds upon intuitions which link respect for a person with respect for a person's autonomy. In light of these intuitions, the issue of how to treat a person with mental disorder may seem to revolve around the question whether or not this person has the capacity for autonomy. However, Heal argues, inquiries that share this logical form are methodologically inappropriate and potentially unhelpful in answering either of the questions they put together: what we owe to people with mental disorder and what is involved in autonomy as a capacity. The reason for this is twofold. Firstly, the apparent consensus about autonomy as a capacity for self-determination that ought to be protected from interference by a corresponding right to self-determination is too shallow to ground a coherent course of action in terms of respect for autonomy. Even if we work with the assumption that autonomy is part of the Enlightenment project, we face an important dilemma since we have to choose between a Kantian or rationality oriented and a Millian or well-being oriented take on the nature and significance of autonomy. Secondly, even if we were to reach a substantive consensus on the concept of autonomy, it would arguably require an intricate array of mental capacities, outside the reach of at least some people with mental disorder. Getting clearer on what autonomy is will not help us find out what it means to treat these people respectfully.Comment: This text would be a good candidate for inclusion in a course about autonomy, philosophy of disability, or the ethics or political philosophy of mental health or aging (due to discussion of dementia). If assigned as part of a course on autonomy, students will benefit from considering Heal's approach to breaking down the logical components of the concept and her nuanced discussion of the limitations of autonomy as a moral principle for understanding our obligations toward people with mental disorders. This second element is the central question of the paper and would be of interest when examining disability or mental health from a philosophical perspective.
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Russell, Jodie Louise. Problems for enactive psychiatry as a practical framework
2023, Philosophical Psychology, pp.1458-1481
Comment (from this Blueprint): This cheeky inclusion of Russell's paper as further reading would suitably compliment both the readings on mental disorder, and Butnor and MacKenzie's chapter on gender, for a deeper discussion. The positive feminist thesis is left vague at the end of this paper, which provides a nice starting point to discuss solutions to the problems with enactivism raised therein. This paper also provides a nice entry-point into the enactive literature, which might provide an enticing, situated model of mind to compliment particular feminist outlooks.