In lieu of an abstract, here is a brief excerpt of the content:Narcissism, Empathy and Moral ResponsibilityRonald W. Pies, MD (bio)Professor Fatic’s timely and wide-ranging essay demonstrates how the topic of narcissism has undergone a resurgence of interest in recent decades. This may owe, in part, to the controversial claim that narcissism is on the rise in the United States, at least among American college students (Twenge & Foster, 2010). As I discuss presently, the term “narcissism” is open to (...) many interpretations, and differs somewhat from the specific designation, Narcissistic Personality Disorder (NPD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (American Psychiatric Association, 2013). As Fatic rightly notes,Narcissism as a personality structure may or may not be diagnosed as NPD, depending on various criteria, perhaps most importantly on whether the narcissistic person actually encounters functional and emotional difficulties and shows up for diagnosis and evaluation.As Professor Fatic’s essay clearly shows, narcissism (variously defined) has important “ethical ramifications.” Fatic is primarily interested in exploring the relationship between what he calls the narcissist’s “emotional incompetence” and that person’s degree of moral responsibility. To oversimplify Fatic’s complex set of interlinked arguments, Fatic concludes that “emotional incompetence does not in fact reduce the moral responsibility of a narcissist person, whether diagnosed with Narcissistic Personality Disorder or not.” Drawing on the moral theories of Philip Pettit and Michael Slote—in particular, Slote’s “sentimentalist ethics” with its emphasis on empathy (Slote, 2004)—Fatic argues that narcissism is both “a moral failure and a psychopathology.” Nevertheless, for Fatic, narcissists remain “fully morally responsible for their insensitivity and interpersonal emotional incompetence.” Why? Because they have the moral duty “to acquire the moral and emotional competence required for the making of moral choices.”Some Philosophical ConcernsAs I understand Fatic’s argument, he is asserting that the narcissist ought to be held responsible for a kind of self-education process that will ameliorate his or her emotional incompetence. Fatic writes,[W]e develop our morality through constant moral education and testing, which we receive both through socialization and through our own efforts later in life, as autonomous human beings. [End Page 173]We are thus responsible for what kind of moral actors we are and are becoming based on our way of life, and have a moral duty to improve our own moral senses and sensibilities by constantly working on the development of virtues.It seems to me that this line of reasoning assumes that all, or most, narcissists possess the capacity to seek and acquire this “moral education.” Perhaps so—but I am not sure Fatic has demonstrated this. It seems at least plausible that, in virtue of the adverse developmental and perhaps even neurological factors that may generate the narcissistic personality (Fan et al., 2011), some narcissists may lack the capacity to modify their psychopathology by means of “moral education.” This leads me to wonder whether Professor Fatic has adequately explored the very heterogeneous nature of narcissism. Indeed, Fatic’s thesis seems to point toward a kind of Platonic “essence” of narcissism, conveyed by his frequent allusion to “the narcissist”—one of whose defining or essential features is said to be a lack of empathy.But, as I will suggest presently, this is at best an oversimplification of narcissism as psychiatrists understand the term. Indeed, there are degrees and varieties of narcissism, differing in their capacity for empathy—which is itself a psychologically complex term. Recent research suggests that “narcissistic personality disorder symptomatology does not reflect a “narcissist” category but rather a continuum of narcissistic pathology” (Aslinger, Manuck, S. Pilkonis, Simms, & Wright, 2018).Furthermore, Professor Fatic’s thesis seems to view “moral responsibility” as a binary construct; i.e., either one possesses, or does not possess, full moral responsibility. But as I have argued elsewhere, moral responsibility may be viewed as lying along a continuum that reflects varying degrees of voluntariness for any given individual (Pies, 2007).Consequently, in my view, any valid assessment of the “the narcissist’s” moral responsibility must consider both the heterogeneity of narcissism and the non-binary (i.e., continuous) nature of moral responsibility.One way of conceptualizing this “two-track” model is... (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

" This, explains Pies, "is the keystone in the arch of Stoic philosophy." In a sense, then, the rest of the book is an extended meditation on how we might avoid letting things touch our souls too much.

This 'user's guide' to becoming a better person takes readers through a process of personal growth by means of modern-day vignettes that draw upon the Talmud's ancient wisdom. Readers of any or no faith learn what it takes to become a 'mensch' —- a decent and honorable human being.

The ethics of medically-authorized limb amputation in individuals with Body integrity identity disorder (BIID) remains extremely controversial. One factor to consider is the putative locus of a disease process, and whether the proposed treatment--in this case, limb amputation—reasonably addresses the issue of what organ is mediating the patient’s complaint.

(2005). Letter to the Editor. Philosophical Practice: Vol. 1, No. 2, pp. 75-76.

The philosophical and scientific foundations of psychiatry -- Psychiatric diagnosis and the DSM debates -- Grief, depression and the bereavement controversy -- Psychiatry in crisis -- Psychiatry and humane values.

There is considerable controversy, both within and outside the field of psychiatry, regarding the boundaries of normal sadness and clinical depression. Furthermore, while there are frequent calls for a "pluralistic", comprehensive approach to understanding depression, few writers have tried to integrate insights from the spiritual, philosophical, and neurobiological literature. The author proposes that such a synthesis is possible, and that our understanding of ordinary sorrow and clinical depression is enriched by drawing from these disparate sources. In particular, a phenomenological analysis (...) of sorrow and depression reveals two overlapping but distinct "lifeworlds". These differ in the relational, temporal, dialectical, and intentional realms. Recent brain imaging studies are also beginning to reveal the neurobiological correlates of sorrow and depression. As we come to understand the neurobiology of these states, we may be able to correlate specific alterations in "neurocircuitry" with their phenomenological expressions. (shrink)

This book fills a long standing need for a basic introduction to Cognitive Grammar that is current, authoritative, comprehensive, and approachable. It presents a synthesis that draws together and refines the descriptive and theoretical notions developed in this framework over the course of three decades. In a unified manner, it accommodates both the conceptual and the social-interactive basis of linguistic structure, as well as the need for both functional explanation and explicit structural description. Starting with the fundamentals, essential aspects of (...) the theory are systematically laid out with concrete illustrations and careful discussion of their rationale. Among the topics surveyed are conceptual semantics, grammatical classes, grammatical constructions, the lexicon-grammar continuum characterized as assemblies of symbolic structures, and the usage-based account of productivity, restrictions, and well-formedness. The theory's central claim - that grammar is inherently meaningful - is thereby shown to be viable. The framework is further elucidated through application to nominal structure, clause structure, and complex sentences. These are examined in broad perspective, with exemplification from English and numerous other languages. In line with the theory's general principles, they are discussed not only in terms of their structural characterization, but also their conceptual value and functional motivation. Other matters explored include discourse, the temporal dimension of language structure, and what grammar reveals about cognitive processes and the construction of our mental world. (shrink)

The burgeoning field of medical ethics raises complicated questions for mental health researchers. The critical issues of risk assessment, beneficence, and the moral duties researchers owe their patients are analyzed in James DuBois's well written Ethics in Mental Health Research.

The burgeoning field of medical ethics raises complicated questions for mental health researchers. The critical issues of risk assessment, beneficence, and the moral duties researchers owe their patients are analyzed in James DuBois's well written Ethics in Mental Health Research.

This book explores aspects of William H. Poteat's philosophical anthropology, which proposes a post-critical alternative to the prevailing dualistic conception of the person and opens a path to recovery of the pre-reflective ontological ground of the person where our personhood can be recovered and re-appropriated.

William James and Education is a dynamic collection of original essays spotlighting William James as a role model for bringing philosophy to bear on the persistent issues of life and education. Using James's philosophical ideas, the contributors evade the polarization and superficiality that permeate the debate around such educational issues as standards versus diversity, cultural consensus versus multiculturalism, religion versus science, and individual freedom versus social determinism. The result is a synthetic collection of essays offering original, unique, and useful insights. (...) One of the most influential of American philosophers, William James is relevant today because he provides a way of understanding human behavior that is both rigorous and humane. James shows how we may soften and sometimes harmonize rigid ideological divisions, such as those plaguing contemporary education, with a pragmatic approach to issues of theory and practice. By reconsidering some of the roots of American thought in James's work, this volume points the way to valuing both uniqueness and universality, among other seemingly opposing concerns. The result is a lively weave of historical and contemporary thought, providing philosophical perspectives on the critical issues facing educators today. (shrink)

For almost 30 years the ion channel that initiates the ON visual pathway in vertebrate vision has remained elusive. Recent findings now indicate that the pathway, which begins with unbinding of glutamate from the metabotropic glutamate receptor 6 (mGluR6), ends with the opening of the transient receptor potential (TRP)M1 cation channel. As a component of the mGluR6 signal transduction pathway, mutations in TRPM1 would be expected to cause congenital stationary night blindness (CSNB), and several such mutations have already been identified (...) in CSNB families. Furthermore, expression of TRPM1 in both the retina and skin raises the possibility that a genetic link exists between certain types of visual and skin disorders. (shrink)

Much social theory takes for granted the core conceit of modern culture, that modern actors-individuals, organizations, nation states-are autochthonous and natural entities, no longer really embedded in culture. Accordingly, while there is much abstract metatheory about "actors" and their "agency," there is arguably little theory about the topic. This article offers direct arguments about how the modern (European, now global) cultural system constructs the modern actor as an authorized agent for various interests via an ongoing relocation into society of agency (...) originally located in transcendental authority or in natural forces environing the social system. We see this authorized agentic capability as an essential feature of what modern theory and culture call an "actor," and one that, when analyzed, helps greatly in explaining a number of otherwise anomalous or little analyzed features of modern individuals, organizations, and states. These features include their isomorphism and standardization, their internal decoupling, their extraordinarily complex structuration, and their capacity for prolific collective action. (shrink)

This book explores aspects of William H. Poteat's philosophical anthropology, which proposes a post-critical alternative to the prevailing dualistic conception of the person and opens a path to recovery of the pre-reflective ontological ground of the person where our personhood can be recovered and re-appropriated.

We address two points. First, one must explain how different, rare mutations ultimately lead to common psychopathological conditions. The developmental instability model offers one solution. Second, Keller & Miller perhaps miss the major processes other than variation fueled by rare deleterious mutations that account for interesting genetic variation in psychopathology, particularly when single alleles have non-negligible effects: Red Queen processes.

Ronald W Hepburn; Art, Truth and the Education of Subjectivity, Journal of Philosophy of Education, Volume 24, Issue 2, 30 May 2006, Pages 185–198, https://doi.

These reflections on faith, reason and certainty have the purpose of engaging again, if not anew, the fundamental intellectual elements of western civilization.

One of the greatest and oldest of images for expressing living change is that of the movement of waters. Rivers particularly, in their relentless motion, in the constant searching direction of their travel, in the confluence of tributaries and the division into channels by which identity is constituted and dispersed and once more reestablished, have stood as metaphors for movements in a variety of realms-politics, religion, literature, thought. Among philosophic movements, phenomenology and existential ism are discernible as one such movement (...) of ideas analogous in configuration to the flow of a river in its channel or network of channels. The course taken by the stream of phenomenology and existential philosophy in North America is easily seen from the contents of the six volumes of collected papers from the annual meetings of the Society for Phenomenology and Existential Philo sophy that have preceded the present selection. What soon becomes clear in general, and is evident as well in the present volume, is that phenomenological and existential philosophies are far from being homogeneous, are far from showing an identity as to the sources from which they derive their energy, or the themes that they carry forward toward clarification. And yet there is a con fluence, a convergence of orientation, sympathy, and conceptuality, INTRODUCTION 4 SO that problematics harmonize and complement and mutually enrich. (shrink)

Applied Christian Ethics addresses selected themes in Christian social ethics. Part one shows the roots of contributors in the realist school; part two focuses on different levels of the significance of economics for social justice; and part three deals with both existential experience and government policy in war and peace issues.

Review text: "Ronald W. Langacker is universally acclaimed as one of the founding fathers of the cognitive linguistics movement. His pioneering efforts towards developing a meaning-oriented, usage-based theory of grammar have given cognitive linguistics many of its key concepts, and his theory of Cognitive Grammar is not only one of the cornerstones of cognitive linguistics, it is also a magnificent achievement in its own right." Dirk Geeraerts, January 2009.

Disturbed by these acrimonious arguments, the authors - former colleagues and university-press board members - embarked on an ambitious project to reexamine a number of major literary and philosophical works dealing with the liberal arts and education. With their discussions ranging from Plato to Rousseau, from Cicero to Vico, from Erasmus to Matthew Arnold, Sousa and Weinsheimer offer not a history of education philosophy but an examination of the present.