Jennifer Radden

  • Divided Minds and Successive Selves

    Divided Minds and Successive Selves

    Ethical Issues in Disorders of Identity and Personality

    Jennifer Radden

    If people change radically as a result of mental disturbance or brain damage or disease, how should we acknowledge that change in the way in which we respond to them? And how should society and the law acknowledge that change, particularly in cases of multiple-personality and manic-depressive disorders? This book addresses these and a cluster of other questions about changes in the self through time and about the moral attitudes we adopt in the face of these changes. The result is a broad-ranging interdisciplinary discussion at the boundaries of psychiatry, philosophy, law, and social policy. Theories of personal identity are applied to, and clarified in light of, the appearance of multiple selves in a variety of personality and identity disturbances. Divided minds force us to clarify our thinking about human subjectivity, Radden points out, and when they result in a succession of "selves," they provoke interesting ethical and legal issues. Radden provides a clear and thorough discussion of basic issues faced by clinicians and philosophers contending with the unity of consciousness and personal identity, particularly in the area of dissociative disorders, where issues of unity of consciousness have a direct impact on clinical and forensic decisions. Part 1 takes up the divisions and heterogeneities associated first with the normal self and then with the pathological self and identifies a "language of successive selves." Part 2 provides an extended analysis of personal responsibility and culpability with regard to extreme multiplicity. Part 3 takes up the notion of a metaphysics of successive selves. And part 4 addresses theoretical concerns associated with clinical material in an effort to further our understanding of the concepts of self-consciousness and subjectivity. A Bradford Book

    • Hardcover $13.75 £10.99

Contributor

  • Scaffolded Minds

    Scaffolded Minds

    Integration and Disintegration

    Somogy Varga

    A comprehensive account of cognitive scaffolding and its significance for understanding mental disorders.

    In Scaffolded Minds, Somogy Varga offers a novel account of cognitive scaffolding and its significance for understanding mental disorders. The book is part of the growing philosophical engagement with empirically informed philosophy of mind, which studies the interfaces between philosophy and cognitive science. Varga draws on two recent shifts within empirically informed philosophy of mind: the first, toward an intensified study of the embodied mind; and the second, toward a study of the disordered mind that acknowledges the convergence of the explanatory concerns of psychiatry and interdisciplinary inquiries into the mind.

    Varga sets out to accomplish a dual task: theoretical mapping of cognitive scaffolding; and the application/calibration of fine-grained philosophical distinctions to empirical research. He introduces the notion of actively scaffolded cognition (ASC) and offers a taxonomy that distinguishes between intrasomatic and extrasomatic scaffolding. He then shows that ASC offers a productive framework for considering certain characteristic features of mental disorders, focusing on altered bodily experience and social cognition deficits. With Cognitive Scaffolding, Varga aims to establish that shifting attention from mental symptoms to fine-grained sensorimotor aspects can lead to identifying diagnostic subtypes or even specific sensorimotor markers for early diagnosis.

    • Hardcover $40.00 £32.00
  • Real Hallucinations

    Real Hallucinations

    Psychiatric Illness, Intentionality, and the Interpersonal World

    Matthew Ratcliffe

    A philosophical account of the structure of experience and how it depends on interpersonal relations, developed through a study of auditory verbal hallucinations and thought insertion.

    In Real Hallucinations, Matthew Ratcliffe offers a philosophical examination of the structure of human experience, its vulnerability to disruption, and how it is shaped by relations with other people. He focuses on the seemingly simple question of how we manage to distinguish among our experiences of perceiving, remembering, imagining, and thinking. To answer this question, he first develops a detailed analysis of auditory verbal hallucinations (usually defined as hearing a voice in the absence of a speaker) and thought insertion (somehow experiencing one's own thoughts as someone else's). He shows how thought insertion and many of those experiences labeled as “hallucinations” consist of disturbances in a person's sense of being in one type of intentional state rather than another.

    Ratcliffe goes on to argue that such experiences occur against a backdrop of less pronounced but wider-ranging alterations in the structure of intentionality. In so doing, he considers forms of experience associated with trauma, schizophrenia, and profound grief.

    The overall position arrived at is that experience has an essentially temporal structure, involving patterns of anticipation and fulfillment that are specific to types of intentional states and serve to distinguish them phenomenologically. Disturbances of this structure can lead to various kinds of anomalous experience. Importantly, anticipation-fulfillment patterns are sustained, regulated, and disrupted by interpersonal experience and interaction. It follows that the integrity of human experience, including the most basic sense of self, is inseparable from how we relate to other people and to the social world as a whole.

    • Hardcover $40.00 £32.00
  • Extraordinary Science and Psychiatry

    Extraordinary Science and Psychiatry

    Responses to the Crisis in Mental Health Research

    Jeffrey Poland and Şerife Tekin

    Leading scholars offer perspectives from the philosophy of science on the crisis in psychiatric research that exploded after the publication of DSM-5.

    Psychiatry and mental health research is in crisis, with tensions between psychiatry's clinical and research aims and controversies over diagnosis, treatment, and scientific constructs for studying mental disorders. At the center of these controversies is the Diagnostic and Statistical Manual of Mental Disorders (DSM), which—especially after the publication of DSM-5—many have found seriously flawed as a guide for research. This book addresses the crisis and the associated “extraordinary science” (Thomas Kuhn's term for scientific research during a state of crisis) from the perspective of philosophy of science. The goal is to help reconcile the competing claims of science and phenomenology within psychiatry and to offer new insights for the philosophy of science.

    The contributors discuss the epistemological origins of the current crisis, the nature of evidence in psychiatric research, and the National Institute for Mental Health's Research Domain Criteria project. They consider particular research practices in psychiatry—computational, personalized, mechanistic, and user-led—and the specific categories of schizophrenia, depressive disorder, and bipolar disorder. Finally, they examine the DSM's dubious practice of pathologizing normality.

    Contributors Richard P. Bentall, John Bickle, Robyn Bluhm, Rachel Cooper, Kelso Cratsley, Owen Flanagan, Michael Frank, George Graham, Ginger A. Hoffman, Harold Kincaid, Aaron Kostko, Edouard Machery, Jeffrey Poland, Claire Pouncey, Şerife Tekin, Peter Zachar

    • Hardcover $50.00 £40.00
  • Disturbed Consciousness

    Disturbed Consciousness

    New Essays on Psychopathology and Theories of Consciousness

    Rocco J. Gennaro

    Essays defend, discuss, and critique specific theories of consciousness with respect to various psychopathologies.

    In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail.

    Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry.

    Contributors Alexandre Billon, Andrew Brook, Paula Droege, Rocco J. Gennaro, Philip Gerrans, William Hirstein, Jakob Hohwy, Uriah Kriegel, Timothy Lane, Thomas Metzinger, Erik Myin, Inez Myin-Germeys, Myrto Mylopoulos, Gerard O'Brien, Jon Opie, J. Kevin O'Regan, Iuliia Pliushch, Robert Van Gulick

    • Hardcover $50.00 £40.00
  • Being Amoral

    Being Amoral

    Psychopathy and Moral Incapacity

    Thomas Schramme

    Investigations of specific moral dysfunctions or deficits that shed light on the capacities required for moral agency.

    Psychopathy has been the subject of investigations in both philosophy and psychiatry and yet the conceptual issues remain largely unresolved. This volume approaches psychopathy by considering the question of what psychopaths lack. The contributors investigate specific moral dysfunctions or deficits, shedding light on the capacities people need to be moral by examining cases of real people who seem to lack those capacities.

    The volume proceeds from the basic assumption that psychopathy is not characterized by a single deficit—for example, the lack of empathy, as some philosophers have proposed—but by a range of them. Thus contributors address specific deficits that include impairments in rationality, language, fellow-feeling, volition, evaluation, and sympathy. They also consider such issues in moral psychology as moral motivation, moral emotions, and moral character; and they examine social aspects of psychopathic behavior, including ascriptions of moral responsibility, justification of moral blame, and social and legal responses to people perceived to be dangerous.

    As this volume demonstrates, philosophers will be better equipped to determine what they mean by “the moral point of view” when they connect debates in moral philosophy to the psychiatric notion of psychopathy, which provides some guidance on what humans need in order be able to feel the normative pull of morality. And the empirical work done by psychiatrists and researchers in psychopathy can benefit from the conceptual clarifications offered by philosophy.

    Contributors Gwen Adshead, Piers Benn, John Deigh, Alan Felthous, Kerrin Jacobs, Heidi Maibom, Eric Matthews, Henning Sass, Thomas Schramme, Susie Scott, David Shoemaker, Walter Sinnott-Armstrong, Matthew Talbert

    • Hardcover $50.00 £40.00
  • Classifying Psychopathology

    Classifying Psychopathology

    Mental Kinds and Natural Kinds

    Harold Kincaid and Jacqueline A. Sullivan

    Scholars question the extent to which current psychiatric classification systems are inadequate for diagnosis, treatment, and research of mental disorders and offer suggestions for improvement.

    In this volume, leading philosophers of psychiatry examine psychiatric classification systems, including the Diagnostic and Statistical Manual of Mental Disorders (DSM), asking whether current systems are sufficient for effective diagnosis, treatment, and research. Doing so, they take up the question of whether mental disorders are natural kinds, grounded in something in the outside world. Psychiatric categories based on natural kinds should group phenomena in such a way that they are subject to the same type of causal explanations and respond similarly to the same type of causal interventions. When these categories do not evince such groupings, there is reason to revise existing classifications.

    The contributors all question current psychiatric classifications systems and the assumptions on which they are based. They differ, however, as to why and to what extent the categories are inadequate and how to address the problem. Topics discussed include taxometric methods for identifying natural kinds, the error and bias inherent in DSM categories, and the complexities involved in classifying such specific mental disorders as “oppositional defiance disorder” and pathological gambling.

    Contributors George Graham, Nick Haslam, Allan Horwitz, Harold Kincaid, Dominic Murphy, Jeffrey Poland, Nancy Nyquist Potter, Don Ross, Dan Stein, Jacqueline Sullivan, Serife Tekin, Peter Zachar

    • Hardcover $45.00 £38.00
  • A Metaphysics of Psychopathology

    A Metaphysics of Psychopathology

    Peter Zachar

    An exploration of what it means to think about psychiatric disorders as “real,” “true,” and “objective” and the implications for classification and diagnosis.

    In psychiatry, few question the legitimacy of asking whether a given psychiatric disorder is real; similarly, in psychology, scholars debate the reality of such theoretical entities as general intelligence, superegos, and personality traits. And yet in both disciplines, little thought is given to what is meant by the rather abstract philosophical concept of “real.” Indeed, certain psychiatric disorders have passed from real to imaginary (as in the case of multiple personality disorder) and from imaginary to real (as in the case of post-traumatic stress disorder). In this book, Peter Zachar considers such terms as “real” and “reality”—invoked in psychiatry but often obscure and remote from their instances—as abstract philosophical concepts. He then examines the implications of his approach for psychiatric classification and psychopathology.

    Proposing what he calls a scientifically inspired pragmatism, Zachar considers such topics as the essentialist bias, diagnostic literalism, and the concepts of natural kind and social construct. Turning explicitly to psychiatric topics, he proposes a new model for the domain of psychiatric disorders, the imperfect community model, which avoids both relativism and essentialism. He uses this model to understand such recent controversies as the attempt to eliminate narcissistic personality disorder from the DSM-5. Returning to such concepts as real, true, and objective, Zachar argues that not only should we use these metaphysical concepts to think philosophically about other concepts, we should think philosophically about them.

    • Hardcover $45.00 £38.00
  • Applied Ethics in Mental Health Care

    Applied Ethics in Mental Health Care

    An Interdisciplinary Reader

    Dominic A. Sisti, Arthur L. Caplan, and Hila Rimon-Greenspan

    Discussions of key ethical dilemmas in mental health care, including consent, trauma and violence, addiction, confidentiality, and therapeutic boundaries.

    This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions. This book meets that need, providing foundational background for undergraduate, graduate, and professional courses.

    Topics include central questions such as evolving views of the morality and pathology of deviant behavior; patient competence and the decision to refuse treatment; recognizing and treating people who have suffered trauma; addiction as illness; the therapist's responsibility to report dangerousness despite patient confidentiality; and boundaries for the therapist's interaction with patients outside of therapy, whether in the form of tennis games, gift-giving, or social media contact. For the most part the selections address contemporary issues in contemporary terms, but the book also offers a few historic or classic essays, including Thomas S. Szasz's controversial 1971 article “The Ethics of Addiction.”

    Contributors Laura Weiss Roberts, Frederic G. Reamer, Charles P. O'Brien, and Thomas McLellan

    • Hardcover $12.75 £10.99
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  • The Ethical Treatment of Depression

    The Ethical Treatment of Depression

    Autonomy through Psychotherapy

    Paul Biegler

    A philosopher argues there is an ethical imperative to provide psychotherapy to depressed patients because the insights gained from it promote autonomy.

    One in six people worldwide will experience depression over the course of a lifetime. Many who seek relief through the healthcare system are treated with antidepressant medication; in the United States, nearly 170 million prescriptions for antidepressants were written in 2005, resulting in more than $12 billion in sales. And yet despite the dominance of antidepressants in the marketplace and the consulting room, another treatment for depression has proven equally effective: psychotherapy—in particular, cognitive behavior therapy (CBT). Antidepressants can lift mood independent of a person's understanding of symptoms or stressors. By contrast, CBT teaches patients skills for dealing with distressing feelings, negative thoughts, and causal stressors.

    In The Ethical Treatment of Depression, Paul Biegler argues that the insights patients gain from the therapeutic process promote autonomy. He shows that depression is a disorder in which autonomy is routinely and extensively undermined and that physicians have a moral obligation to promote the autonomy of depressed patients. He concludes that medical practitioners have an ethical imperative to prescribe psychotherapy—CBT in particular—for depression. To make his case, Biegler draws on a wide philosophical literature relevant to autonomy and the emotions and makes a comprehensive survey of the latest research findings from the psychological sciences.

    Forcefully argued, densely researched, and engagingly written, the book issues a challenge to physicians who believe their duty of care to depressed patients is discharged by merely writing prescriptions for antidepressants.

    • Hardcover $8.75 £6.99
  • Addiction and Responsibility

    Addiction and Responsibility

    Jeffrey Poland and George Graham

    The intertwining of addiction and responsibility in personal, philosophical, legal, research, and clinical contexts.

    Addictive behavior threatens not just the addict's happiness and health but also the welfare and well-being of others. It represents a loss of self-control and a variety of other cognitive impairments and behavioral deficits. An addict may say, "I couldn't help myself." But questions arise: are we responsible for our addictions? And what responsibilities do others have to help us? This volume offers a range of perspectives on addiction and responsibility and how the two are bound together. Distinguished contributors—from theorists to clinicians, from neuroscientists and psychologists to philosophers and legal scholars—discuss these questions in essays using a variety of conceptual and investigative tools.

    Some contributors offer models of addiction-related phenomena, including theories of incentive sensitization, ego-depletion, and pathological affect; others address such traditional philosophical questions as free will and agency, mind-body, and other minds. Two essays, written by scholars who were themselves addicts, attempt to integrate first-person phenomenological accounts with the third-person perspective of the sciences. Contributors distinguish among moral responsibility, legal responsibility, and the ethical responsibility of clinicians and researchers. Taken together, the essays offer a forceful argument that we cannot fully understand addiction if we do not also understand responsibility.

    • Hardcover $45.00 £38.00
  • Psychiatry in the Scientific Image

    Psychiatry in the Scientific Image

    Dominic Murphy

    An analysis of the understanding, classification, and explanation of mental disorders that proposes that psychiatry adopt the best practices of the cognitive sciences.

    In Psychiatry in the Scientific Image, Dominic Murphy looks at psychiatry from the viewpoint of analytic philosophy of science, considering three issues: how we should conceive of, classify, and explain mental illness. If someone is said to have a mental illness, what about it is mental? What makes it an illness? How might we explain and classify it? A system of psychiatric classification settles these questions by distinguishing the mental illnesses and showing how they stand in relation to one another. This book explores the philosophical issues raised by the project of explaining and classifying mental illness.

    Murphy argues that the current literature on mental illness—exemplified by the Diagnostic and Statistical Manual of Mental Disorders—is an impediment to research; it lacks a coherent concept of the mental and a satisfactory account of disorder, and yields too much authority to commonsense thought about the mind. He argues that the explanation of mental illness should meet the standards of good explanatory practice in the cognitive neurosciences, and that the classification of mental disorders should group symptoms into conditions based on the causal structure of the normal mind.

    • Hardcover $38.00 £32.00
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  • Brain Fiction

    Brain Fiction

    Self-Deception and the Riddle of Confabulation

    William Hirstein

    Some neurological patients exhibit a striking tendency to confabulate—to construct false answers to a question while genuinely believing that they are telling the truth. A stroke victim, for example, will describe in detail a conference he attended over the weekend when in fact he has not left the hospital. Normal people, too, sometimes have a tendency to confabulate; rather than admitting "I don't know," some people will make up an answer or an explanation and express it with complete conviction. In Brain Fiction, William Hirstein examines confabulation and argues that its causes are not merely technical issues in neurology or cognitive science but deeply revealing about the structure of the human intellect.

    Hirstein describes confabulation as the failure of a normal checking or censoring process in the brain—the failure to recognize that a false answer is fantasy, not reality. Thus, he argues, the creative ability to construct a plausible-sounding response and some ability to check that response are separate in the human brain. Hirstein sees the dialectic between the creative and checking processes—"the inner dialogue"—as an important part of our mental life. In constructing a theory of confabulation, Hirstein integrates perspectives from different fields, including philosophy, neuroscience, and psychology to achieve a natural mix of conceptual issues usually treated by philosophers with purely empirical issues; information about the distribution of certain blood vessels in the prefrontal lobes of the brain, for example, or the behavior of split-brain patients can shed light on the classic questions of philosophy of mind, including questions about the function of consciousness. This first book-length study of confabulation breaks ground in both philosophy and cognitive science.

    • Hardcover $35.00 £28.00
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  • Imagination and Its Pathologies

    Imagination and Its Pathologies

    James Phillips and James Morley

    Essays on the relation between the imagination and psychopathology that retrieve imagination from the margins to place it once again at the center of psychiatric discourse.

    From John Locke's Essay Concerning Human Understanding to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, madness has been viewed as a faulty mix of ideas by a deranged and violent imagination. This book shows that the relation of the imagination to pathological phenomena is as diverse and complex as the human condition itself. The imagination has the power not only to react to the world but to recreate it. And that power is double-edged: it is as destructive as it is creative.

    Recent advances in genetics and neuroscience have reinforced the empiricist approach in psychiatry, to the neglect of subjective aspects of the pathological experience. This book argues that the study of the imagination and pathology is long overdue, and that such an integration will be both theoretically and clinically fruitful. Because imagination can be creatively integrative as well as pathological, the book emphasizes the holistic, therapeutic dimension of imagination as well as its destructive effects. The areas discussed include philosophical perspectives on pathological imagination; pathological imagination and the psychodynamic tradition; and specific cases of pathological imagination in schizophrenia, juvenile pathology, artistic creativity (Vaslav Nijinsky), and religious expression (St. Anthony).

    • Hardcover $10.75 £8.99
    • Paperback $35.00 £28.00
  • Imagination and the Meaningful Brain

    Imagination and the Meaningful Brain

    Arnold H. Modell

    The ultimate goal of the cognitive sciences is to understand how the brain works—how it turns "matter into imagination." In Imagination and the Meaningful Brain, psychoanalyst Arnold Modell claims that subjective human experience must be included in any scientific explanation of how the mind/brain works. Contrary to current attempts to describe mental functioning as a form of computation, his view is that the construction of meaning is not the same as information processing. The intrapsychic complexities of human psychology, as observed through introspection and empathic knowledge of other minds, must be added to the third-person perspective of cognitive psychology and neuroscience.

    Assuming that other mammals are conscious and conscious of their feelings, Modell emphasizes evolutionary continuities and discontinuities of emotion. The limbic system, the emotional brain, is of ancient origin, but only humans have the capacity for generative imagination. By means of metaphor, we are able to interpret, displace, and transform our feelings. To bolster his argument, Modell draws on a variety of disciplines—including psychoanalysis, cognitive psychology, neurobiology, evolutionary biology, linguistics, philosophy of language, and philosophy of mind. Only by integrating the objectivity of neuroscience, the phenomenology of introspection, and the intersubjective knowledge of psychoanalysis, he claims, will we be able fully to understand how the mind works.

    • Hardcover $35.00 £28.00
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  • When Self-Consciousness Breaks

    When Self-Consciousness Breaks

    Alien Voices and Inserted Thoughts

    G. Lynn Stephens and George Graham

    In this book, G. Lynn Stephens and George Graham examine verbal hallucinations and thought insertion as examples of what they call "alienated self-consciousness." In such cases, a subject is directly or introspectively aware of an episode in her mental life but experiences it as alien, as somehow attributable to another person.

    Stephens and Graham explore two sorts of questions about verbal hallucinations and thought insertion. The first is their phenomenology—what the experience is like for the subject. The second concerns the implications of alien episodes for our general understanding of self-consciousness. Psychopathologists look at alien episodes for what they reveal about the underlying pathology of mental illness. As philosophers, the authors ask what they reveal about the underlying psychological structure and processes of human self-consciousness.

    The authors suggest that alien episodes are caused by a disturbed sense of agency, a condition in which the subject no longer has the sense of being the agent who thinks or carries out the thought. Distinguishing the sense of subjectivity from that of agency, they make the case that the sense of agency is a key element in self-consciousness.

    • Hardcover $11.75 £9.99
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  • The Myth of Pain

    The Myth of Pain

    Valerie Gray Hardcastle

    Valerie Gray Hardcastle argues that both professional and lay definitions of pain are wrongheaded—with consequences for how pain and pain patients are treated, how psychological disorders are understood, and how clinicians define the mind/body relationship.

    Pain, although very common, is little understood. Worse still, according to Valerie Gray Hardcastle, both professional and lay definitions of pain are wrongheaded—with consequences for how pain and pain patients are treated, how psychological disorders are understood, and how clinicians define the mind/body relationship.

    Hardcastle offers a biologically based complex theory of pain processing, inhibition, and sensation and then uses this theory to make several arguments: (1) psychogenic pains do not exist; (2) a general lack of knowledge about fundamental brain function prevents us from distinguishing between mental and physical causes, although the distinction remains useful; (3) most pain talk should be eliminated from both the folk and academic communities; and (4) such a biological approach is useful generally for explaining disorders in pain processing. She shows how her analysis of pain can serve as a model for the analysis of other psychological disorders and suggests that her project be taken as a model for the philosophical analysis of disorders in psychology, psychiatry, and neuroscience.

    • Hardcover $57.50
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