The sublime and the abject -- Sade pro and contra Sade -- Dark enlightenment or barbaric science -- The Auschwitz confessions -- The perverse society.

In The Rules of Insanity, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders. Arguing that there is little useful that can be said about the responsibility of mentally ill offenders in general, Elliott looks at specific mental illnesses in detail; among them schizophrenia, manic-depressive disorders, psychosexual disorders such as exhibitionism and voyeurism, personality disorders, and impulse control disorders such as kleptomania and pyromania. (...) He takes a particularly hard look at the psychopath or sociopath, who many have argued is incapable of understanding morality. Making extensive use of psychiatric case histories, Elliott explores the various ways in which mental illness can affect a person's intentions and thus excuse him or her from moral responsibility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychopathy, Other-Regarding Moral Beliefs, and ResponsibilityLloyd Fields (bio)AbstractIn this paper I seek to show that at least one kind of psychopath is incapable of forming other-regarding moral beliefs; hence that they cannot act for other-regarding moral reasons; and hence that they are not appropriate subjects for the assessment of either moral or legal responsibility. Various attempts to characterize psychopaths are considered and rejected, in particular the widely held view (...) that psychopaths are, in general, incapable of understanding moral concepts. The particular disability proposed here, the incapacity to form other-regarding moral beliefs, is then derived from an analysis of what is required for someone to be a responsible agent. This is illustrated with a detailed case history. A defect of this kind is shown to vitiate moral responsibility, because it renders the psychopath irresponsive to the social pressures which normally ensure respect for moral norms. It is also shown that the psychopath is not a suitable subject for the assessment of legal responsibility, because he lacks the capacity to act from common prudence to avoid sanctions. I conclude that the attempt to characterize particular defects from among the heterogeneity of psychopathic subjects, could lead to better targeted, and hence to more effective, management of particular cases.KeywordsCriminality, mental illness, personality disorder, blame, liability, moral beliefs, guilt, social moralityIntroductionThe term “psychopath” has been used with a wide variety of different meanings and, no doubt, covers a heterogeneous group of subjects (Criminal behaviour and mental health 1992). My aim in this paper is to argue that at least a subgroup of those subjects are characterized by an inability to form other-regarding moral beliefs—and hence, for this particular reason, are not morally responsible agents—and that they also lack the capacity for prudence, and hence are not legally responsible agents.I begin by distinguishing the particular sense in which I will be using the term “psychopathy.” I then consider some suggestions in the literature regarding the defect by which psychopaths might be characterized—that they are mentally ill, or incapable of understanding moral concepts. In rejecting these, I come to the suggestion that the relevant defect is an inability to form other-regarding moral beliefs, a defect which is graphically illustrated by a case report from the literature. I explore the implication of this kind of defect for [End Page 261] moral responsibility as a socially-embedded notion, and the implication of the psychopath’s inability to exercise prudence in relation to legal liability.Nothing in this paper should be taken to suggest that psychopaths are irredeemable. On the contrary, as I argue in an endnote, correctly characterizing the defect from which they suffer leads directly to forms of treatment whose effectiveness has acquired a measure of empirical support.The Nature of PsychopathyPsychopathy is not a homogeneous concept; there are different types of psychopaths. For example, Henderson identified a type of psychopath who he classified as “Predominantly Creative,” exemplified by such figures as T. E. Lawrence and Joan of Arc. In people of this type genius is associated with heightened sensitivity, psychosexual immaturity and emotional instability (Henderson 1939, 108–20; Henderson and Gillespie 1969, 317). Predominantly creative psychopaths do not come within my purview.By “psychopathy” I shall mean the specific form of personality disorder described by Cleckley in his book, The Mask of Sanity (Cleckley 1964). Cleckley’s description forms the basis of Hare’s Revised (20-item) Psychopathy Checklist. The Checklist includes the following personality traits and deviant behaviors:1. Glibness/superficial charm.2. Grandiose sense of self-worth.3. Need for stimulation/proneness to boredom.4. Pathological lying.5. Conning/manipulative.6. Lack of remorse or guilt.7. Shallow affect.8. Callous/lack of empathy.9. Parasitic lifestyle.10. Poor behavioral controls.11. Promiscuous sexual behavior.12. Early behavior problems.13. Lack of realistic, long-term plans.14. Impulsivity.15. Irresponsibility.16. Failure to accept responsibility for own actions.17. Many short-term marital relationships.18. Juvenile delinquency.19. Revocation of conditional release.20. Criminal versatility (Hare 1986, 18). 1This conceptualization resembles in many respects the category of Antisocial Personality Disorder as described in the American Psychiatric... (shrink)

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with (...) symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

Within a relatively brief period of time, there has been a veritable outpouring of research on anorexia nervosa and bulimia nervosa. This article presents a concise overview of some of the major works on these eating disorders from a variety of disciplines including biomedicine, psychology, sociology, and history. The article establishes a general context of Americans' preoccupation with food and diet. However, since the majority of those suffering from anorexia nervosa and bulimia nervosa are female, this article places (...) these eating disorders in the specific historical context of American women's history. In earlier times, some women reacted to their role expectations with physical responses. While linking modern phenomena to these earlier physical reactions of American women, the article also highlights the various twentieth-century social and cultural factors that push some modern girls and women to respond to their situations either by refusing food or consuming and regurgitating large quantities of food.In addition to the historical perspective, which points to the relevance of social and cultural factors as well as biomedical and psychological ones, the article offers an overview of the various theories currently suggested to explain the meaning of food to those who suffer from these disorders. These theories range from the addiction model to food as a metaphor for control and self-definition. Whatever the meaning of food, it is important to note that both anorexia nervosa and bulimia nervosa are determined by an interaction of many factors both personal and biological and social and cultural. (shrink)

Qualitative inquiry into eating disorders is burgeoning, offering valuable and innovative insights into various aspects of the condition. This study used life‐history interviews with 20 women who had recovered from anorexia nervosa, bulimia nervosa or both and who had remained healthy. The interviews focused on the women's narratives and experience rather than a diagnostic therapeutic model. Three themes of control, connectedness and conflict emerged as significant in the development, experience of, and recovery from an eating disorder. The development (...) of the condition was attributed to a lack of control, a sense of non‐connectedness to family and peers and extreme conflict with significant others. Recovery occurred when the women re‐engaged with life, developed skills necessary for conflict resolution and rediscovered their sense of self. Rather than viewing the development of, and recovery from an eating disorder as separate and discrete events, the data from the life‐history interviews suggest they are better viewed as one entity — that is, the journey of an individual attempting to discover and develop their sense of self. This perspective challenges some current constructs of eating disorders; it is not a condition in and of itself but a symptom of deeper issues that if addressed, when the individual is ‘ready’ to make that choice, will lead to recovery. (shrink)

ABSTRACT The paper is a discussion of moral responsibility and excuses in regard to psychiatric disorders involving abnormal desires (e.g. impulse control disorders such as kleptomania and pyromania, psychosexual disorders such as exhibitionism, obsessive‐compulsive disorder and others). It points out problems with previous approaches to the question of whether or not to excuse persons with these disorders, and offers a new approach based on the concept of duress. There is a discussion of duress in regard (...) to non‐psychiatric cases based on the core notion of duress involving a choice between undesirables, and the paper concludes with an argument that moral blame for individuals with these sorts of disorders should often be lessened and in some cases removed entirely. (shrink)

This book offers a comprehensive study of the views of ancient philosophers on mental disorders. Relying on the original Greek and Latin textual sources, the author describes and analyses how the ancient philosophers explained mental illness and its symptoms, including hallucinations, delusions, strange fears and inappropriate moods and how they accounted for the respective roles of body and mind in such disorders. Also considered are ethical questions relating to mental illness, approaches to treatment and the position of mentally (...) ill people in societies of the times. The volume opens with a historical overview that examines ancient medical accounts of mental illness, from Hippocrates' famous Sacred Disease to late antiquity medical authors. Separate chapters interpret in detail the writings of Plato, Aristotle, Galen and the Stoics and a final chapter summarises the views of various strains of Scepticism, the Epicurean school and the Middle and Neo-Platonists. Offering an important and useful contribution to the study of ancient philosophy, psychology and medicine. This volume sheds new light on the history of mental illness and presents a new angle on ancient philosophical psychology. (shrink)

Bizarre delusions are not specific to schizophrenia and can be found in other psychotic disorders. However, to date, there are no studies investigating socio-demographic and clinical characteristics associated with BizD across the psychosis spectrum. In this study 819 subjects with a diagnosis of SZ, schizoaffective disorder and bipolar I disorder were included. Patients with history of BizD and with no BizD were compared with respect to socidemographic and clinical variables, and predictors of BizD were explored. Patients with BizD (...) were less educated, less likely to be married, had higher Positive and Negative Syndrome Scale negative scores and lower Young Mania Rating Scale scores. Younger age, SZ and SZA diagnoses, higher PANSS positive scores, presence of reference delusions, tactile and olfactory hallucinations were predictors. Our results indicate that BizD are associated with higher illness severity, lower functionality and specific set of symptoms. (shrink)

An important international discussion began because of some pioneer studies carried out by Young (1996a) on the internet addiction disorder (IAD). In the fifth and most recent version of the Diagnostic, and Statistical Manual of Mental Disorders (DSM) there is no mention of this disorder and among researchers there are basically two opposite positions. Those who are in favor of a specific diagnosis and those who are claiming the importance of specific criteria characterizing this behavior and the precise role (...) it has in the patient’s life. The aim of the present paper is to answer the question whether it is possible or not to formulate diagnoses of internet-related disorders. We revised literature on the history of diagnostic criteria, on neurocognitive evidence, on the topic debate and on IAD instrumental measures. We found that the disorder was not univocally defined and that the construct was somehow too broad and generic to be explicative for a diagnosis. Indeed, the models are borrowed from other addiction pathologies and they are often formulated before the development of internet as intended in current society. In conclusion, we think we need a more innovative, integrated and comprehensive model for an IAD diagnosis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Makes a Mental Disorder Mental?Jerome C. Wakefield (bio)Keywordsharmful dysfunction, mental disorder, intentionality, mental dysfunction, mental functioning, phenomenality, somatic disorderWhat makes a medical disorder mental rather than (exclusively) somatic or physical? Psychiatry to some extent depends for its existence as a medical specialty on the distinction between mental and somatic disorders, yet the history of this distinction presents a bewildering array of puzzling judgments, radical shifts, and (...) seemingly arbitrary distinctions. The historical observation that putative mental disorders are often reclassified as physical disorders as soon as their physiologic basis is understood further confuses matters. Moreover, recent debates about such classifications often seem to reflect desires to protect professional turf or obtain optimal reimbursement for treatment more than they do the application of a coherent conceptual distinction. No wonder that Brülde and Radovic (2006) disarmingly admit at the outset of their exploration of this question that there is a case to be made that their topic is relatively unimportant or even meaningless intellectually, a rare way to start an inquiry!Could there nonetheless be a cogent conceptual distinction lurking here? Brülde and Radovic usefully invite us to reframe the question, in effect as follows: Suppose we pay attention to professional and lay judgments as evidence but at the same time try to avoid being ensnared by the distortions resulting from turf issues and other pragmatic motives and constraints. Can we then identify some principled distinction in this domain that is worth making and that interestingly corresponds to the distinction generally made between mental disorders and strictly somatic disorders? Brülde and Radovic do not come to any confident or compelling conclusion about this.My answer, based on my harmful dysfunction analysis of disorder (Wakefield, 1992a, 1992b, 1999a, 1999b), is that a mental disorder is a harmful mental dysfunction, where a mental dysfunction is a failure of the capacity of some mental mechanism to perform a function for which it was biologically designed. I argue that, owing to a series of logical missteps, Brülde and Radovic needlessly reject this view. After some preliminary comments and clarifications, I defend the internal dysfunction approach from the objections posed by Brülde and Radovic, and then conclude by elaborating this view in some new ways. Note that Brülde and Radovic critique something they call the "internal cause view" of what makes a disorder mental, and they name others who hold that view. However, my work figures prominently in their discussion, and for expository simplicity, I will presume to simply construe their arguments as aimed at the harmful dysfunction analysis. [End Page 123]Clarifying the QuestionIt is easy to misconstrue the question "What makes a mental disorder mental" as demanding a precise account of the mental, an error to which Brülde and Radovic succumb in their repeated complaints that various writers do not present principled accounts of the mental but rely on lists of prototypical mental states or tentative guidelines to fix the reference of mental. We would need a precise definition of mental if the problem were how to classify cases in which it is ambiguous whether some phenomenon is mental or physical. We might imagine, for example, someone being genuinely puzzled as to whether inability to sleep is failure of a mental function or process. But this sort of puzzle about the boundaries of the mental is not the problem with which Brülde and Radovic are concerned; anyway, ambiguous cases may just be inherently ambiguous. The problem, which a crisp definition of mental will not resolve, is what relation mental states or mechanisms must have to a disorder to make it a mental disorder; must there be mental symptoms, or mental dysfunctions, or either one, and so on? But, even if a precise resolution of the nature of the mental is not needed, some notion of the mental domain is essential in pursuing this discussion. We can pick out the mental ostensively, by pointing to lots of examples (e.g., perception, motivation, emotion, thought, and sensation) much more confidently than we can define it in a principled way. But because Brülde and Radovic find fault in such ostensive reference fixing, let me... (shrink)

Throughout its history, the insanity defense specifically and the more general concept of mental defect or incompetence have been grounded in the assumption that those people fit for the rule of law are able to give and to comprehend reasons for their actions. This chapter traces the evolution of perspectives on the nature of mental illness and the manner in which cultural and extra-scientific influences have shaped perspectives. These perspectives are most saliently expressed in statutory provisions and relevant case (...) law summarized here and covering historical developments from ancient Greece and Rome to the present. Significant interactions between law and psychiatry are further highlighted and informed by core and controversial philosophical assumptions. Attention is given to differences between juridical and medical conceptions of responsibility. (shrink)

It has been suggested that language disorders can serve as real windows onto language evolution. We examine this claim in this paper. We see ourselves forced to qualify three central assumptions of the the ‘disorders-as-windows’ hypothesis. After discussing the main outcome of decades of research on the linguistic ontogeny of pathological populations, we argue that language disorders should be construed as conditions for which canalization has failed to cope fully with developmental perturbations. We conclude that a robust (...) link exists between developmental disturbances and evolutionary history that allows language disorders to be used as real windows onto the evolution of the neuronal substrate of language, and emphasize that our conclusion is more compatible with views of language evolution as the result of reorganizational changes as opposed to radically novel emergences. (shrink)

Objective: The aim of the study was to identify clinical variables associated with changes in specific domains of self-reported depression during treatment by antidepressant and/or repetitive Transcranial Magnetic Stimulation in patients with Major Depressive Disorder.Methods: Data from a trial involving 170 patients with MDD receiving either venlafaxine, rTMS or both were re-analyzed. Depressive symptoms were assessed each week during the 2 to 6 weeks of treatment with the 13-item Beck Depression Inventory. Associations between depression changes on BDI13 domains, treatment arm, (...) time, and clinical variables were tested in a mixed linear model.Results: A significant decrease of self-reported depressive symptoms was observed over time. The main characteristics associated with persistent higher depressive symptomatology on Negative Self-Reference domain of the BDI13 were personality disorders, a past history of suicide attempt, age under 65 years old, and female sex.Conclusions: Early cognitive intervention targeting specifically negative self-referencing process could be considered during pharmacological or rTMS treatment for patients with personality disorders and past history of suicide attempt. (shrink)

Introduction. Eating Disorders (EDs) are serious psychiatric disorders, impacting physical and psychosocial functioning, often with a chronic course and high mortality rates. The two continua model of mental health states that mental health is a complete state, that is not merely the absence of mental illness, but also the presence of mental health. This model was studied among ED patients by comparing the levels of well-being to the Dutch general population and by examining the of well-being and psychopathology. (...) Method. A total of 468 female ED patients participated in this study during application and intake at a specialized ED treatment centre in the Netherlands. They filled out questionnaires about well-being (MHC-SF), general psychopathology (OQ-45), and ED psychopathology (EDE-Q). Categorical and mean well-being levels were calculated. Also, the correlates of these variables were examined with Pearson correlation and multiple hierarchical regression analysis. Results. ED patients showed lower levels of emotional, psychological and social well-being on average compared to the general population. About 26% of the ED patients experienced low levels of well-being (languishing). However, also 13% experienced high levels of well-being (flourishing), varying between 9% in Anorexia Nervosa to 25% in Binge Eating Disorder. ED psychopathology and general well-being showed a moderate negative correlation. For patients with Bulimia Nervosa and Binge Eating Disorder however no such correlation was found. Lower general psychopathology, not having a history of hospitalization for the ED, and adaptive personal functioning were correlated with well-being among ED patients. Conclusion This study shows initial support for the two continua model of mental health among ED patients. Psychopathology and well-being should be considered as related, but distinct dimensions of mental health in ED patients. Further research should focus on the possible reciprocal relationships between psychopathology and well-being during recovery. It is recommended to monitor well-being during treatment and to implement interventions for well-being to realize complete recovery for those patients with inadequate levels of well-being. (shrink)

The history of mental illnesses is as old as human history. Mental disorders are affected by changing social and cultural factors during the historical process, and have been conceptually restructured and their definitions and classifications have been changed. The evolution of obssessive-compulsive disorders with roots as old as human history into modern concepts took place in the 19th century. The first scientific views on the spiritual origin of OCD belong to S. Freud. Freud observed that (...) mental causes in OCD are different from other mental disorders, and he examined obsession as a separate and specific disorder. Over time, it has been understood that OCD is a very common disorder. The American Psychiatric Association (APA) has classified OCD under an independent title in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by removing it from the category of anxiety disorders. OCD is a mental disorder caused by mental actions such as obsessive thoughts (obsessions) and / or repetitive and compulsive behaviors (compulsion). The patient is often aware that such thoughts and behaviors are irrational and absurd. For this reason, he tries to get away obsessive thoughts that he finds contrary to his beliefs, opinions, moral values and logic from his mind. However, as he tries, obsessive thoughts become more and more frequent and create a great anxiety in the person. This time, the patient resorts to compulsions to alleviate the anxiety he feels or to get rid of it completely. As his compulsions repeat, his anxiety increases and he goes into a vicious circle. There are many symptom subgroups of OCD that seriously worsen the quality of life of the individual. One of these, and even the most overwhelming, is religious obsessions. It has been thought that there has been a relationship between religion and OCD for a long time in the psychology literature, and some remarkable studies have been conducted to clarify this relationship. Although there are many research findings showing that religion is an indispensable element in the protection of the mental health integrity of the individual, some forms of religious understanding and some experiences gained as a result of religious experiences may affect the concerns about OCD. This stage of religiosity is closely related to some sub-symptom groups of OCD. The explanations of the founder of the psychoanalytic method, Freud psychoanalytic method, and his followers made a great contribution to the understanding of OCD. However, since the psychoanalytic method exhibits a theoretically reductionist approach to religion, it is possible that the individual's devotion to religion is initially evaluated as a pathology or at least an important obstacle to insight. Today, cognitive behavioral psychotherapies are considered the most effective psychological treatment method for OCD, but their success rates in the treatment of religious OCD are low. Since religious OCD concerns often involve spiritual issues rather than concrete repeatable situations, behavioral methods can be quite difficult to apply in the treatment of religious OCD. Therefore, traditional psychotherapy approaches, even if they are not openly against religions, are insufficient to relieve the suffering in the lives of individuals with religious obsessions, as they generally neglect the religious dimension. Due to the vacuum that arises from restricting spiritual treatments to secular approaches, religious patients are threatened by the illegal practices of people who abuse religious feelings. Clinically, religious obsessions are more worrying and overwhelming. Therefore, their treatment is more difficult than others. Selective approaches that use different scientific disciplines together in the treatment of OCD and can stretch around religious beliefs and values can create more effective treatment models. Thus, the success rate in the treatment of religious OCD can be carried to higher levels thanks to the appropriate cooperation of the disciplines of medicine, psychology and theology. There is a rich religious cultural heritage that can support this collaboration in terms of theological disciplines. As an example, Abū Zayd al-Balkhī (d. 322/934), in his Maṣāliḥ al-abdān wa-l-anfus, probably made a clear distinction between neuroses and psychosis and classified neurotic disorders for the first time about ten centuries before Freud. In this study, the importance of approaching to religious obsessions as both a psychological disorder and a theological problem is emphasized. For this reason, cooperation of psychiatric and psychological approaches with spiritual counseling and guidance is recommended in the treatment of religious OCD. The difficulty in distinguishing whether the symptoms seen in a religious person are normal, natural religious thoughts and behaviors of religious life or abnormal appearances in the religious guise necessitates this interdisciplinary cooperation. (shrink)

Safe stair negotiation is an everyday task that children with developmental coordination disorder are commonly thought to struggle with. Yet, there is currently a paucity of research supporting these claims. We investigated the visuomotor control strategies underpinning stair negotiation in children with and without DCD by measuring kinematics, gaze behavior and state anxiety as they ascended and descended a staircase. A questionnaire was administered to determine parents' confidence in their child's ability to safely navigate stairs and their child's fall (...) class='Hi'>history. Kinematics were measured using three-dimensional motion capture, whilst gaze was measured using mobile eye-tracking equipment. The parents of DCD children reported significantly lower confidence in their child's ability to maintain balance on the stairs and significantly more stair-related falls in the previous year compared to the parents of typically developing children. During both stair ascent and stair descent, the children with DCD took longer to ascend/descend the staircase and displayed greater handrail use, reflecting a more cautious stair negotiation strategy. No differences were observed between groups in their margin of stability, but the DCD children exhibited significantly greater variability in their foot-clearances over the step edge, which may increase the risk of a fall. For stair descent only, the DCD children reported significantly higher levels of state anxiety than the TD children and looked significantly further along the staircase during the initial entry phase, suggesting an anxiety-related response that may bias gaze toward the planning of future stepping actions over the accurate execution of an ongoing step. Taken together, our findings provide the first quantifiable evidence that safe stair negotiation is a significant challenge for children with DCD, and that this challenge is reflected by marked differences in their visuomotor control strategies and state anxiety levels. Whilst it is currently unclear whether these differences are contributing to the frequency of stair-related falls in children with DCD, our findings pave the way for future research to answer these important questions. (shrink)

Adam Smith is usually associated with a notion of social harmony which results from each individual in a given society striving to realize his or her interest indifferent or even antagonistic to the interests of others. According to this reading, the effect of such self-seeking, however, is quite the opposite of what individuals intend: without intending to help others or contribute in any way to their welfare, they nevertheless contribute to the prosperity of the whole. When we examine Smith's understanding (...) of ancient philosophy, however, we must confront the fact that Smith is an exponent of suffering and sacrifice in the service of providence. Lucretius's notion of individuals breaking the pact of necessity which guarantees the providential order so that they may follow where pleasure may lead, could only discompose the order of things. Lucretius, whose arguments could only complicate Smith's worldview, must be effaced from the history of philosophy. (shrink)

Factitious disorder is the deliberate simulation of illness for the purpose of seeking the sick role. It is a 20th-century diagnosis, though the grounds for its introduction are uncertain. While previous authors have considered the social changes contributing to growth in the disorder, this article looks at some of the pressures on doctors that may have created the diagnostic need for a disorder between hysteria and malingering. The recent history of those disorders suggests that malingering would no longer (...) be acceptable when applied to the potentially larger numbers involved in workers’ compensation or in mass conscription. Equally, the absolution given to hysteria on the basis of the Freudian subconscious would survive only as long as that model retained credibility. Growing egalitarianism and changing doctor—patient relationships in the 20th century would no longer tolerate a sharp division between culpable malingering and exculpated hysteria, which may previously have been made on grounds of class or gender. They would contribute to the need for a mediating diagnosis, such as factitious disorder. (shrink)

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trials having shown this method to be effective, this book presents the first account of mentalization (...) treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimed at mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder. (shrink)

ABSTRACT: After World War Two a gigantic effort was made in order to build a viable and stable international order, beginning with the Bretton Woods agreement that was aimed to stabilize the international monetary system, and with the United Nations, that were intended to restore legality in interstate affairs and somehow initiate a cosmopolitan conversation among Nation States. This order is now slowly crumbling down, paradoxically through globalization, and a triumphant neoliberalism. A new, but indeed quite old narrative, rather a (...) myth, of what a national identity means is again getting the upper hand.KEYWORDS: international relations, international law, European Union, globalization, national identity. (shrink)

This article explores some of the normative commitments which persist in the literature on behavioural interventions for disorders of inattention and hyperactivity. These programmatic texts grapple with a contradiction: on one hand, they posit individuals who cannot be held responsible for their behaviour on the grounds that it is pathological, rather than wilful; on the other hand, these texts are written for individuals diagnosed with these disorders and for related authorities, obliged to mitigate said behaviour on the grounds (...) that it is disvalued and impairing. Facing the practical problem of alleviating impairing and disruptive behaviours, this literature has also consistently expressed a goal of producing individuals who demonstrate self-control. Self-control, in this context, however, is not simply the manifestation of wilful autonomy over one’s body, but the capacity to be ascribed responsibility for one’s actions. In the move from bodily control to self-control, institutions responsible for treating those diagnosed with these disorders produce what Foucault has called a ‘political economy of illegality’, where the management of disvalued behaviour is not the eradication of said behaviour, but a redistribution of the right to reward and punish based on the individualization of action. (shrink)

An estimated 15% of patients seen by neurologists have neurological symptoms, such as paralysis, tremors, dystonia, or seizures, that cannot be medically explained. For a long time, such patients were diagnosed as having conversion disorder (CD) and referred to psychiatrists, but for the last two decades or so, neurologists have started to pay more serious attention to this patient group. Instead of maintaining the commonly used label of conversion disorder – which refers to Freud’s idea that traumatic events can be (...) converted into deviant behaviour – these neurologists use the term functional neurological disorder (FND) and explain that the problems are due to abnormal central nervous system functioning. The situation that some patients with medically unexplained neurological symptoms are diagnosed with CD and treated by psychiatrists while others are diagnosed with FND and stay under the control of neurologists provides a unique case for analysing how neurological and psychological explanations affect subjectivity. In this article, I compare patient reports from English-language websites from the past 15 years to find out how minds, bodies, brains, and selves act and interact in the accounts of both patient groups. I conclude that the change in label from CD to FND has not only influenced ideas of medically unexplained disorders, but also affected ideas of the self and the body; of self-control and accountability. (shrink)

The book offers an accessible account of EDs and closely examines the concept of addiction, Drawing on a wide range of medical, psychological, physiological, sociological and philosophical sources, the book examines the benefits and risks of exercise for the ED population, explores the links between EDs and other abuses of the body in the sports environment and addresses the issue of athletes with disordered eating behaviour. Importantly, the book also surveys current legislation and professional codes of conduct that guide the (...) work of fitness professionals and clinicians in this area and I presents a clear and thorough set of case histories and action points to help professionals better understand, and care for, their clients with EDs. --. (shrink)

Mental disorders are often thought to be harmful dysfunctions. Jerome Wakefield has argued that such dysfunctions should be understood as failures of naturally selected functions. This suggests, implicitly, that evolutionary biology and other Darwinian disciplines hold important information for anyone working on answering the philosophical question, 'what is a mental disorder?'. In this article, the author argues that Darwinian theory is not only relevant to the understanding of the disrupted functions, but it also sheds light on the disruption itself, (...) as well as on the harm that attends the disruption. The arguments advanced here are partially based on the view that a core feature of Darwinism is that it stresses the environmental relativity of functions and dysfunctions. These arguments show a very close empirical connection between social judgments and dysfunctions, which is of interest for psychiatric theory. Philosophically, they lead to the conclusion that the concept of mental disorder is identical to the concept of mental dysfunction. Consequently, it is both misleading and redundant to conceptualize mental disorders as 'harmful dysfunctions', and not simply as 'mental dysfunctions'. (shrink)

The history of brain-computer interfaces developed from a mere idea in the days of early digital technology to today’s highly sophisticated approaches for signal detection, recording, and analysis. In the 1960s, electroencephalography was tied to the laboratory due to equipment and recording requirements. Today, amplifiers exist that are built in the electrode cap and are so resistant to movement artefacts that data collection in the field is no longer a critical issue. Within 60 years, the field has moved from (...) simple and artefact-sensitive EEG recording to making real the vision of brain-computer communication. In the last 40 years, direct brain-computer interaction went from simple communication programs to sophisticated BCI-controlled applications. In the past two decades, much research was conducted with locked-in individuals, and since the 2010s, independent home use by exemplary patients has been demonstrated. In these patients with locked-in syndrome, BCI were installed at their home and long-term usage was established, resulting in increased quality of life. Maintaining communication in disorders leading to LIS contributes significantly to the patients’ sense of being full persons. BCI as an assistive technology will likely be perceived as integral part of the self: insofar as it can prevent total loss of communication and the ensuing social isolation, it enables essential conditions for the subjective and intersubjective experience of personhood. (shrink)

As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like (...) shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts. This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD diagnosis: boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia. (shrink)

This paper elaborates the hypothesis that the unique demography and sociology of Ashkenazim in medieval Europe selected for intelligence. Ashkenazi literacy, economic specialization, and closure to inward gene flow led to a social environment in which there was high fitness payoff to intelligence, specifically verbal and mathematical intelligence but not spatial ability. As with any regime of strong directional selection on a quantitative trait, genetic variants that were otherwise fitness reducing rose in frequency. In particular we propose that the well-known (...) clusters of Ashkenazi genetic diseases, the sphingolipid cluster and the DNA repair cluster in particular, increase intelligence in heterozygotes. Other Ashkenazi disorders are known to increase intelligence. Although these disorders have been attributed to a bottleneck in Ashkenazi history and consequent genetic drift, there is no evidence of any bottleneck. Gene frequencies at a large number of autosomal loci show that if there was a bottleneck then subsequent gene flow from Europeans must have been very large, obliterating the effects of any bottleneck. The clustering of the disorders in only a few pathways and the presence at elevated frequency of more than one deleterious allele at many of them could not have been produced by drift. Instead these are signatures of strong and recent natural selection. (shrink)

B a c k g r o u n d. The article demonstrates the development and influence of the main diagnostic systems in psychiatry, such as the DSM and the ICD, on the concept of psychiatric diseases. The problem of classification of psychiatric disorders is one of the main topics that is the field of study of the philosophy of psychiatry. The correct diagnosis within a particular diagnostic system directly affects the choice of appropriate drug treatment, psychotherapy and social (...) support for people suffering from mental disorders. Misdiagnosis has not only negative medical but also social consequences, leading to stigmatization and avoidance of people suffering from mental disorders. M e t h o d s. The research uses an integrated approach to the analysis of psychiatric diagnostic systems, including historical, comparative and interdisciplinary methods. The application of the historical method contributed to a detailed study of the evolution of psychiatric diagnostic systems and changes in approaches to the classification of mental disorders. A comparative analysis of the main diagnostic systems was carried out, considering their structure, diagnostic criteria and interaction. The interdisciplinary method involves the integration of knowledge from psychiatry, philosophy, medical history, cultural studies, and psychology, providing a deep understanding of the medical, philosophical, social, and cultural aspects of mental disorders. R e s u l t s. The article analyzes the historical development of ideas and methodology for the classification of mental disorders from ancient Greece to the present. From Hippocrates and Plato to Sydenham, Kabanis, Pinel, and Eskierol, the authors trace the evolution of understanding of mental disorders, emphasizing the shift in emphasis from etiological theories to more descriptive and categorical models. The authors describe the current state of the DSM and ICD classification systems, which play a dominant role in psychiatric science and subsequent social support and welfare for people suffering from mental disorders. Changes that have occurred in these systems and their impact on psychiatric practice and research are discussed. Considerable emphasis is placed on the history of the diagnosis of post-traumatic stress disorder (PTSD), which becomes a symbolic indicator of the complexities and challenges associated with the modern classification of mental illness. The authors consider the phenomenological method as a tool for a deeper understanding of PTSD, especially in the context of the constant psychotraumatic factors of war, the consequences of which generate new challenges for Ukrainian psychiatric practice. The authors present a case study using the phenomenological approach to diagnose PTSD, which demonstrates the need for a detailed analysis of patients' internal experience for accurate diagnosis and effective treatment. C o n c l u s i o n s. The conclusions emphasize the importance of integrating philosophical methods into the diagnosis and analysis of mental illness in clinical practice. The authors call for the development of interdisciplinary research involving both philosophers and mental health professionals to develop more detailed and person-centered approaches to the diagnosis and treatment of mental disorders. (shrink)

Louis Charland’s claim that DSM Cluster B personality disorders are moral rather than clinical kinds has recently triggered a lively debate. In order to deliver a reliable report of the latter, both (1) Charland’s arguments concerning the impossibility of identifying and treating personality disorders without applying a morally laden conceptual framework and (2) some critical responses they provoked are discussed. Then, in turn, the conceptual history of the notion of personality disorder is traced, including not only well-recognized (...) contributions from (3) medical psychiatry, psychoanalysis, and DSM nosology, but also (4) an important, but often neglected, tradition of virtue and moral character. Finally, (5) the idea of a normatively neutral concept of personality disorder is scrutinized in the context of its logical dependence on the fact-value distinction. The latter dichotomy’s recent criticism, in particular, is employed to support Charland’s argument and to suggest that the normative character of personality disorders may go much deeper than this or that DSM formulation. (shrink)

Background: The literature has shown a significant association between traumatic experiences and eating psychopathology, showing a greater symptomatology in patients with trauma history. Less is known about the associations between trauma and cognitive schemas, and personality traits and the differences between childhood and adulthood trauma experiences. Thus, this paper aims to assess the clinical and psychological characteristics of eating disorder (ED) patients, looking for differences between patients without a history of trauma and patients with trauma experiences, as well (...) as at possible differences between exposure in childhood, adulthood, or repeated events. Another aim of the paper is to evaluate the possible mediation role of cognitive schemas and personality traits in the relationship between early trauma and eating psychopathology.Methods: From January to November 2020, 115 consecutive inpatients admitted for a specific multidisciplinary ED treatment in a dedicated Unit were evaluated for trauma, differentiating between trauma occurring in childhood and adulthood. The subjects were evaluated for early maladaptive schemas (EMS), personality traits, trauma symptomatology, quality of life, and specific psychopathologies linked to EDs. Mediation analyses between childhood and adulthood trauma and eating psychopathology were performed, with EMS and personality traits as mediators.Results: Patients with a history of trauma showed higher physical and psychological symptomatology scores, with a more impaired clinical profile in patients with both childhood and adulthood trauma exposure. The mediation analysis showed a specific mediator role for the “disconnection and rejection (DR)” EMS factor in the relationship between childhood trauma (cT) and eating psychopathology.Conclusion: Trauma experiences are associated with more severe clinical symptomatology in EDs and may need a specific assessment in patients with failed outpatient standard treatments. Specific cognitive schemas linked to DR domain should be evaluated in treatments for ED patients with history of trauma due to the mediation role between trauma and eating psychopathology. The need for outcome studies about treatment approaches for ED patients with history of trauma is discussed. (shrink)

There are people where two or more personalities seem to have independent-and sometimes mutually forgetful-control of the same bodily individual. This chapter gives a brief account of the history of the diagnosis of "Multiple Personality Disorder" or "Dissociative Identity Disorder", and the conflicting judgment of therapists, lawyers, and philosophers as to whether this is a real syndrome. It is suggested that the diagnosis may be therapeutically helpful for some other disturbances, including anorexia, even if it does not carry the (...) strong metaphysical moral that some have supposed. The cases are of interest to philosophers as they purport to represent "real -life" difficulties for standard theories of "personal identity." The chapter argues that the diagnosis depend on prior assumptions about such identity, and so don't easily confirm or rebut any available theory, including more ancient theories about demonic possession. (shrink)

This paper explores moments of democratising disorderliness that interrupt a vision of the sublime as a particular ordering of subjectivity. Situated within the context of the Narmada movement against the construction of the Sardar Sarovar Dam in India in the mid-1990s, it argues that sublime regimes and ‘counter-sublime’ insurgences draw their energies from the figures of the dam and the bund, respectively. Where the dam’s walls establish the horizons of visibility, of who counts as subject, the bund’s curved surfaces reveal (...) a pluralising depth that folds the visible with/in the invisible, constituting the possibility of novel modes of seeing/subjectification. Working through oral histories, films, images, archival materials and ethnographic studies alongside the work of Foucault and the later Merleau-Ponty, the paper argues that the Narmada movement enacts a counter-sublime that contests the invisibility imposed by the dam in favour of an imbrication of the human and non-human disclosing radically different constellations of visibility and subjectification. (shrink)

Since psychiatry remains a descriptive discipline, it is essential for its practitioners to understand how the language of psychiatry came to be formed. This important book, written by a psychiatrist-historian, traces the genesis of the descriptive categories of psychopathology and examines their interaction with the psychological and philosophical context within which they arose. The author explores particularly the language and ideas that have characterised descriptive psychopathology from the mid-nineteenth century to the present day. He presents a masterful survey of the (...) history of the main psychiatric symptoms, from the metaphysics of classical antiquity to the operational criteria of today. Tracing the evolution of concepts such as memory, consciousness, will and personality, and of symptoms ranging from catalepsy and aboulia to anxiety and self-harm, this book provides fascinating insights into the subjective nature of mental illness, and into the ideas of British, Continental and American authorities who sought to clarify and define it. (shrink)

We raise the new possibility that people diagnosed with developmental dyslexia (DD) are specialized in explorative cognitive search, and rather than having a neurocognitive disorder, play an essential role in human adaptation. Most DD research has studied educational difficulties, with theories framing differences in neurocognitive processes as deficits. However, people with DD are also often proposed to have certain strengths – particularly in realms like discovery, invention, and creativity – that deficit-centered theories cannot explain. We investigate whether these strengths reflect (...) an underlying explorative specialization. We re-examine experimental studies in psychology and neuroscience using the framework ofcognitive search, whereby many psychological processes involve a trade-off between exploration and exploitation. We report evidence of an explorative bias in DD-associated cognitive strategies. High DD prevalence and an attendant explorative bias across multiple areas of cognition suggest the existence of explorative specialization. An evolutionary perspective explains the combination of findings and challenges the view that individuals with DD have a disorder. In cooperating groups, individual specialization is favored when features that confer fitness benefits are functionally incompatible. Evidence for search specialization suggests that, as with some other social organisms, humans mediate the exploration–exploitation trade-off by specializing in complementary strategies. The existence of a system of collective cognitive search that emerges through collaboration would help to explain our species’ exceptional adaptiveness. It also aligns with evidence for substantial variability during our evolutionary history and the notion that humans are adapted not to a particular habitat but to variability itself. Specialization creates interdependence and necessitates balancing complementary strategies. Reframing DD therefore underscores the urgency of changing certain cultural practices to ensure we do not inhibit adaptation. Key improvements would remove cultural barriers to exploration and nurture explorative learning in education, academia, and the workplace, as well as emphasize collaboration over competition. Specialization in complementary search abilities represents a meta-adaptation; through collaboration, this likely enables human groups (as a species and as cultural systems) to successfully adapt. Cultural change to support this system of collaborative search may therefore be essential in confronting the challenges humanity now faces. (shrink)

Just fifteen years ago, the common non-religious consensus was that homosexual acts were immoral. Within one decade, however, this consensus waned. The secular majority no longer held, as they previously did, that such actions are morally bad. What explains this sudden change? One explanation is that many conservatives lacked adequate philosophical tools to explain the foundations of the earlier historical consensus. Another is that modern research has shown that there never existed any solid philosophical grounds for calling such actions immoral (...) in the first place. This book questions the latter narrative; for prior to this book no exhaustive historical treatment of philosophical thought on the moral question of homosexual acts existed. Both liberals and conservatives failed to research adequately the long history of thought on this issue. The current author not only argues that the earlier non-religious philosophical consensus has largely been ignored, but that the proliferation of arguments in favor of acting on homosexual inclinations reveal a strong desire to justify what isn't possible to justify morally. The non-religious arguments of the great philosopher Thomas Aquinas are then examined; they reveal that his reasoning can soundly show that acting on homosexual inclinations is morally wrong, and also that the same argument rightly entails that every untruthful assertive speech act is morally problematic. If conservatives wish to be consistent, they ought to reject lying too. And if liberals expect conservatives to believe that what they preach is true, then they ought to stand with Aquinas and reject all lying as intrinsically evil. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:AQUINAS ON DISORDERED PLEASURES AND CONDITIONS ANTHONY c. DALY, S.J. St. Louis University St. Louis, Missouri IT IS A COMMONPLACE that various philosophies, besides being supremely important intellectually and morally to individuals, have exercised a powerful influence on culture through their proponents acting individually and in schools. Sometimes, too, philosophers and theologians made venerable by antiquity are cited in policy disputes, both secular and ecclesiastical, which have a definite (...) political aspect. The obvious hope is that the struggle can be won more easily with the added support of a revered authority. This seems to have been the case recently in the debate over homosexuality. Bruce Williams, O.P., wrote a commentary 1 on a letter from the Roman Catholic Congregation for the Doctrine of the Faith, " On the Pastoral Care of Homosexual Persons," in which he adopts the position that the homosexual condition cannot be considered "all right". He bases his argument explicitly on the scholastic maxim ' agere sequitur esse' (acting fol.., lows being) ; if the action is distorted, so is the condition from which it follows. But in disputing this position another commentator on the Roman letter, Gerald D. Coleman, S.S.,2 has named Thomas Aquinas as a key scholastic philosopher who should logically be counted as his own ally. Coleman seems to say 1 "Homosexuality: The New Vatican Statement," Theological Studies 48(1987), pp. 259-77. My thanks to Jesuit Fathers Harry R. Kloeker, Robert W. Mulligan, and David A. Wayne for advice and encouragement during the preparation of this article. 2 "The Vatican Statement on Homosexuality,'' Theological Studies 48(1987), pp. 727-34. 583 584 ANTHONY C. DALY, S.J. that although Thomas" would name the homosexual activity... as ' distorted '," he would not think of the homosexual condition in this way.3 Before entering in detail into Thomas's actual thought on the matter, it seems important for humanitarian reasons to note specifically, as did the Roman Letter, Williams, Coleman, and Thomas himself, that a disordered condition need not imply moral culpability. The case is clearer when the disordered condition is a physical handicap.4 In that case it isn't morally wrong to be handicapped, yet it isn't " all right " to be physically handicapped either, except insofar as "it's all right" means that a person would rightly accept and love himself or herself, handicap and all. A disordered condition may involve a physical evil or perhaps a psychological evil, but does not necessarily involve a culpable moral evil. With this proviso the way is open for a frank discussion of Thomas's actual ideas about homosexuality. They are certainly worth the consideration of any contemporary philosopher or theologian who might be interested in this issue, and for others the subject involves a facet of the history of ideas well worth noting, expecially since from this angle it is easy to focus on Thomas's general thought about disordered conditions and pleasures. The investigation also forms a case study in the way Thomas used philosophy in forming and articulating his theology. Here, despite the fact that much of the material as Thomas expressed it has a theological formality and purpose, it is from philosophy that he derives his arguments, their thought structure, and their underlying insight. Pleasures, Actions, Habits, and States In order to help him refute Williams's point that a homosexual 8 Coleman, "Statement," pp. 732-34 (quotation from p. 733); Williams, "Homosexuality," pp. 263-69. 4 See Williams, " Homosexuality," p. 266, quoting Marc Oraison, The Homosexual Question (London: Search, 1977), p. 115; Coleman, " Statement," p. 734 and n. 30 (Coleman does not think of homosexuality as a distorted condition). Thomas's thought on the matter is treated below. AQUINAS ON DISORDERED PLEASURES, CONDITIONS 585 orientation is a disordered condition, Coleman quotes Thomas Aquinas, Summa Theologiae I-II, 31, 7.5 Coleman argues that Thomas had no idea of the contemporary notion of " homosexual orientation", but were he aware of it or something like it, he would logically have to call homosexual acts distorted, but would not call the homosexually oriented person distorted. This seems to mean Thomas would not call the homosexual orientation objectively disordered.6 Coleman's use of... (shrink)

Ethics and the History of Indian Philosophy (Motilal Banarsidass 2007). Regretfully, it is not an uncommon view in orthodox Indology that Indian philosophers were not interested in ethics. This claim belies the fact that Indian philosophical schools were generally interested in the practical consequences of beliefs and actions. The most popular symptom of this concern is the doctrine of karma, according to which the consequences of actions have an evaluative valence. Ethics and the History of Indian Philosophy argues (...) that the orthodox view in Indology concerning Indian ethics is false. The first half the book deals with theoretical issues in studying ethics: defining moral terms, understanding the subject matter of ethics so as to transcend culturally specific substantive commitments and touches upon issues of cross-cultural hermeneutics and translation. The second half consists of a systematic explication of the moral philosophical aspects of nine major Indian philosophical schools. I argue that “dharma” in its various uses in Indian philosophy is always rationally treated as a moral term—even in so called “ontological” employments of the term as seen in Buddhism and Jainism. In understanding “dharma” in this manner, the Indian philosophical tradition is replete with different versions of moral realism that fit tidily with other philosophical commitments of Indian philosophers. Pains are taken to show the breath of moral philosophical disagreement in this tradition. On a comparative note, some Indian moral philosophy resembles realist approaches of the Western tradition (such as the Non-natural realism of Neo-Platonism, or the Naturalism of Utilitarianism). Out of the major Indian philosophical schools, a slim minority are shown to be committed to moral irrealism while some are shown to regard their entire philosophical orientation as firmly planted within moral philosophy (such as Jainism, Buddhism, Purva Mimamsa and Yoga). In response to those who would argue that what Indian philosophers meant by “dharma” is very different from what moral philosophers in the West have meant by “ethical” or “good,” I argue that this is as vacuous as noting that Utilitarians have a different conception of the good from Deontologists. If philosophy is concerned with theoretical debate, as I argue it is, philosophical terms function to articulate such disagreements. The various seemingly desperate uses of “dharma” in the Indian tradition are no longer confusing or disorderly when we understand the theoretico-philosophical function of this term in Indian philosophical disputes. -/- The second edition contains an additional chapter that addresses the colonial and political context of the study of Indian Ethics. (shrink)

The British prison estate is characterised by an elaborate mental health infrastructure, an edifice often rearranged to meet the near-permanent mental health ‘crisis’ in its walls. From ‘trauma-informed’ prisons to behaviour change programmes, care for mentally ‘vulnerable’ people in prison has sedimented into the backbone of penal strategy. Much of this is developed through appeals to inclusion: of the vulnerable, disadvantaged, and traumatised people who are increasingly recognised as comprising a disproportionate number of prisoners. One category around which this infrastructure (...) is organised is ‘personality disorder’. Since New Labour's demarcation of this ‘offender group’ in the early 2000s, they are now thought to comprise a majority of the prison population. This article, grounded in prison documents and interviews with former prisoners, looks at the disorder's operationalisation in prison. It shows the disorder to be a broad and malleable category that works to mediate between prisoners, as individual subjects, and an expanding, complex, and shifting prison structure. Prisoners are explained in terms of the diagnosis, as the category’s borders are wide and shifting enough to absorb all kinds of behaviour, beliefs, and experiences. We thus see how the diagnosis simultaneously works to dismiss prisoners’ inner lives at the very moment it claims to understand them—and how this move facilitates penal management. The article uses Althusser's work on subjects and interpellation to make sense of this situation, and prisoners’ tactical navigation of it. The material practices that make the diagnosis real are emphasised, and connected to the imperatives of prison management. (shrink)

In _The New Order and Last Orientation,_ Eric Voegelin explores two distinctly different yet equally important aspects of modernity. He begins by offering a vivid account of the political situation in seventeenth-century Europe after the decline of the church and the passing of the empire. Voegelin shows how the intellectual and political disorder of the period was met by such seemingly disparate responses as Grotius's theory of natural right, Hobbes's _Leviathan,_ the role of the Fronde in the formation of the (...) French national state, Spinoza's _Tractatus Theologico-Politicus,_ and Locke's _Second Treatise,_ the blueprint of a modern middle-class society. By putting these responses and the thought of Montesquieu, Hume, and others in the context of the birth pains of the national state and the emergence of a new self-understanding of man, Voegelin achieves a brilliant mixture of political history and profound philosophical analysis. Voegelin's verdict of modernity is pronounced most powerfully in the opening part of "Last Orientation," in the chapter entitled "Phenomenalism." His discussion of the intellectual confusion underlying the modern project of scientistic phenomenalism is the most original criticism leveled against modernity to date. It is at the same time the first step toward a recovery of reality through philosophy conceived as a science of substance in the spirit of Giordano Bruno. Voegelin's first example of such an effort at recovering reality is the chapter on Schelling, one of the spiritual realists who has not been affected by the prevailing rationalist or reductionist creeds that are part of the modern disorder. Schelling's indirect yet powerful influence on Schopenhauer, Nietzsche, and Freud more than justifies Voegelin's interest in his philosophy and character, even though Voegelin would later distance himself from some of Schelling's positions. The volume's concluding chapter, "Nietzsche and Pascal," applies the understanding gained from the study of Schelling to the thought of the most powerful critic of the age, Nietzsche. Nietzsche's self-avowed affinity with Pascal provides the key to an analysis of the strengths and weaknesses of his thought and reaffirms the connection that links the beginning of modernity with its most recent crises and the efforts to overcome them. (shrink)