How are we to make sense of madness and psychosis? For most of us the words conjure up images from television and newspapers of seemingly random, meaningless violence. It is something to be feared, something to be left to the experts. But is madness best thought of as a medical condition? Psychiatrists and the drug industry maintain that psychoses are brain disorders amenable to treatment with drugs, but is this actually so? There is no convincing evidence that the brain is (...) disordered in psychosis, yet governments across the world are investing huge sums of money on mental health services that take for granted the idea that psychosis is an illness to be treated with medication. Although some people who use mental health services find medication helpful, many do not, and resist the idea that their experiences are symptoms of illnesses like schizophrenia. Consequently they are forced into having treatment against their wishes. So, how do we make sense of this situation? Postpsychiatry addresses these questions. It involves an attempt to rethink some of the fundamental assumptions of mental health work, showing how recent developments in philosophy and ethics can help us to clarify some of the dilemmas and conflicts around different understandings of madness. Throughout, the authors examine the conflicting ways in which politicians, academics, and mental health professionals appear to understand madness, and contrast this with voices and experiences that are usually excluded - those of the people who use mental health services. They then examine the power of psychiatry to shape how we understand ourselves and our emotions, before considering some of the basic limitations of psychiatry as science to make madness meaningful. In the final section of the book they draw on evidence from service users and survivors, the humanities and anthropology, to point out a new direction for mental health practice. This new direction emphasises the importance of cultural contexts in understanding madness, placing ethics before technology in responding to madness, and minimising 'therapeutic' coercion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.2 (2002) 187-188 [Access article in PDF] Listening to Foucault Patrick J. Bracken ERICA LILLELEHT'S INTERESTING PAPER combines philosophy, history, service analysis, and social commentary. The philosophical themes are below the surface, implicit rather than explicit. As such the paper echoes the work of Foucault himself. The subjects of his books and other writings ranged from histories of madness and psychiatry, hospitals and medicine, (...) prisons and punishment, to sexuality and ethics. But these were clearly more than histories. In doing what he initially called archaeology and later genealogy, Foucault was writing about different dimensions of how the Western world has come to understand what it is to be human. In Foucault's hands history becomes philosophy. The essence of his work is an invitation to question the project of Enlightenment. However, his interrogation of the legacy of Enlightenment is far from a rejection of reason as has sometimes been claimed. Rather it represents a realization that there are different forms of reason, none of which can claim a place of privilege over others. Foucault challenged the idea that we have to choose to be for or against Enlightenment (Foucault, 1984).Of central concern for him is the idea that knowledge and power imply each other and cannot be separated. This, of course, is anathema to both Marxist and liberal analysts who hold out the idea that truth and ideology are mutually exclusive. The assumption is that if we get the starting point of our analysis right, the truth ("pure and simple") will emerge. For Foucault there are "regimes of truth," discourses through which certain things can be said and statements can be judged as true or false. Such regimes are social products, bound up with the economic, cultural, and political realities of their times. This is not some sort of mindless relativism nor a nihilistic advocacy that, when it comes to knowledge claims, "anything goes." As human beings in an imperfect world we have to struggle continuously toward a better understanding of ourselves and the make-up of this world. As individuals, we have to continue to debate and argue about ideas, facts, and the nature of knowledge. We have to present evidence, argue our case, and prepare to be contradicted as well as supported. This is not in question. Instead, what is involved here is recognition that there is no neutral asocial, acultural, or apolitical vantage point from we can judge the validity of one position over another. Foucault's work nurtures a healthy skepticism of those who claim to have found such a vantage point.Importantly, he rejected the idea that power is always repressive in its nature: working to silence, obscure, and suppress. Particularly in the modern era power is more characteristically productive. Its operations are bound up with the ever-multiplying discourses we produce about ourselves. While increasing scientific knowledge about the human condition appears to represent progress, listening to Foucault means coming to appreciate that things are a great deal more complex. The title of Lilleleht's paper reflects this. At [End Page 187] a time when there is a great deal of talk about "progress" in the area of mental health, her analysis is opportune. Unless we pay attention to the micropolitics of clinical encounters we are at some risk of simply endorsing new forms of professional power. In one light, the psychiatric rehabilitation approach of William Anthony and colleagues appears obviously progressive. It does not depend on the "medical model" and the use of medication and seems genuinely committed to the idea of empowerment. However, with the sort of sensibility engendered through an encounter with Foucault, other issues come into view. Beneath its focus on skills and training we see a very clear normative framework centered on the idea that the person with psychiatric problems should be guided and trained toward fitting in with "his or her particular environment." At stake here is the assumption that the deficit is in the patient. It is he or she who needs to change. Herein lies the issue of power: who is in control of the way in which... (shrink)

Academic programs in the medical/health humanities have proliferated widely in recent years, and the professional, academic, and cultural drivers of this growth promise sustained new program development. In this article, we present the results of a survey sent to representatives of one hundred twenty-four baccalaureate and ten graduate programs in the medical/health humanities to assess the experiences and needs of existing programs. Survey results confirm the interest in and need for a descriptive toolkit as opposed to a prescriptive manual; indicate (...) what data and materials are most needed to support the successful development of new academic programs in the field; and identify areas for future research. Recognizing a need for program development resources, the Health Humanities Consortium has initiated the creation of a comprehensive online toolkit. We discuss survey results and the toolkit in relation to the drivers of new program growth. Finally, we describe resources now available through the HHC’s new online program toolkit, including existing programs; sample syllabi; sample curricula templates; program rationale; proposal templates; and graduation data. (shrink)

In God, Chance and Purpose, David Bartholomew uses probability theory to show how Divine Providence can be active in a world governed by chance and necessity. At the micro-level of Nature God uses a statistical formula to control the outcome of seemingly random events; at the macro-level God influences but does not control the outcome of events. From a Whiteheadian perspective “the common element of form” of a society could be seen as the equivalent of Bartholomew’s statistical formula but generated (...) in each case from the bottom-up rather than imposed from the top-down. Yet Bartholomew’s insistence that statistical formulas only work with large groups of entities suggests that more attention should be given by Whiteheadians to the workings of Divine Providence on societies as opposed to individual actual entities. (shrink)

RECENT THEOLOGICAL SPECULATION ON THE TRINITY HAS CONCEIVED THE DIVINE NATURE AS AN INTERPERSONAL PROCESS. WHITEHEADIAN PHILOSOPHY MAY POSSIBLY BE USEFUL HERE. ON THE ASSUMPTION THAT NOT ONLY ACTUAL ENTITIES, BUT LIKEWISE WHITEHEADIAN SOCIETIES POSSESS AN ONTOLOGICAL UNITY AND EXERCISE AN AGENCY PROPER TO THEMSELVES, THEN THE TRINITY MAY BE VIEWED AS A DEMOCRATICALLY ORGANIZED STRUCTURED SOCIETY WITH EACH OF THE DIVINE PERSONS AS A SUBORDINATE PERSONALLY ORDERED SOCIETY OF ACTUAL OCCASIONS.

The concept of vulnerability is widely used in research ethics to signal attention to participants who require special protections in research. However, this concept is vague and under‐theorized. There is also growing concern that the dominant categorical approach to vulnerability (as exemplified by research ethics regulations and guidelines delineating vulnerable groups) is ethically problematic because of its assumptions about groups of people and is, in fact, not very guiding. An agreed‐upon strategy is to move from categorical towards analytical approaches (focused (...) on analyzing types and sources of vulnerability) to vulnerability. Beyond this agreement, however, scholars have been advancing competing accounts of vulnerability without consensus about its appropriate operationalization in research ethics. Based on previous debates, we propose that a comprehensive account of vulnerability for research ethics must include four components: definition, normative justifications, application, and implications. Concluding that no existing accounts integrate these components in a functional (i.e., practically applicable) manner, we propose an integrative and functional account of vulnerability inspired by pragmatist theory and enriched by bioethics literature. Using an example of research on deep brain stimulation for treatment‐resistant depression, we illustrate how the integrative‐functional account can guide the analysis of vulnerability in research within a pragmatist, evidence‐based approach to research ethics. While ultimately there are concerns to be addressed in existing research ethics guidelines on vulnerability, the integrative‐functional account can serve as an analytic tool to help researchers, research ethics boards, and other relevant actors fill in the gaps in the current landscape of research ethics governance. (shrink)

Originally published in 1986. All students of social science must confront a number of important philosophical issues. This introduction to the philosophy of the social sciences provides coherent answers to questions about empiricism, explanation and rationality. It evaluates contemporary writings on the subject which can be as difficult as they are important to understand. Each chapter has an annotated bibliography to enable students to pursue the issues raised and to assess for themselves the arguments of the authors.

It has often been emphasised that psychiatry is still an ‘expertise’ and has not yet reached the status of a science. Science calls for systematic, conceptual thinking which can be communicated to others. Only in so far as psychopathology does this can it claim to be regarded as a science. What in psychiatry is just expertise and art can never be accurately formulated and can at best be mutually sensed by another colleague. It is therefore hardly a matter for textbooks (...) and we should not expect to find it there. This quotation indicates that Jaspers was immersed in a major debate in nineteenth century philosophy of science: the Methodenstreit. His dismissive comments about the ‘art’ of psychiatry set the .. (shrink)

Localised configurations of the free electromagnetic field are constructed, possessing properties of massive, spinning, relativistic particles. In an inertial frame, each configuration travels in a straight line at constant speed, less than the speed of lightc, while slowly spreading. It eventually decays into pulses of radiation travelling at speedc. Each configuration has a definite rest mass and internal angular momentum, or spin. Each can be of “electric” or “magnetic” type, according as the radial component of the magnetic or electric field (...) vanishes in the rest frame, and each has an “antiparticle.” Any such configuration, of electric or magnetic type, is characterized in part by a set of labels (κ, ω0, σ,l, m), where ω0 is the mean of the angular frequencies of the plane waves making up the configuration, σ is the variance of those frequencies, κ is a positive constant with dimensions of action, andl, m are angular momentum “quantum numbers” withl a positive integer andm an integer such that ‖m‖≤l. The rest energy of the “particle” is κω0, its spin is κ ‖m‖, and its lifetime is of the order of 1/σ. Its antiparticle has ω0 replaced by −ω0. (shrink)

Because psychiatry deals specifically with ‘mental’ suffering, its efforts are always centrally involved with the meaningful world of human reality. As such, it sits at the interface of a number of discourses: genetics and neuroscience, psychology and sociology, anthropology, philosophy, and the humanities. Each of these provides frameworks, concepts, and examples that seek to assist our attempts to understand mental distress and how it might be helped. However, these discourses work with different assumptions, methodologies, values, and priorities. Some are in (...) dispute with one another. At various times in the history of psychiatry, a particular form of understanding has become dominant and worked to marginalize .. (shrink)

The phenomenon of probability backflow, previously quantified for a free nonrelativistic particle, is considered for a free particle obeying Dirac's equation. It is shown that probability backflow can occur in the opposite direction to the momentum; that is to say, there exist positive-energy states in which the particle certainly has a positive momentum in a given direction, but for which the component of the probability flux vector in that direction is negative. It is shown that the maximum possible amount of (...) probability that can flow “backwards,” over a given time interval of duration T, depends on the dimensionless parameter ε = (4ℏ/mc2T)1/2, where m is the mass of the particle and c is the speed of light. At ε = 0, the nonrelativistic value of approximately 0.039 for this maximum is recovered. Numerical studies suggest that the maximum decreases monotonically as ε increases from 0, and show that it depends on the size of m, ℏ, and T, unlike the nonrelativistic case. (shrink)

Schwinger’s algebra of microscopic measurement, with the associated complex field of transformation functions, is shown to provide the foundation for a discrete quantum phase space of known type, equipped with a Wigner function and a star product. Discrete position and momentum variables label points in the phase space, each taking \(N\) distinct values, where \(N\) is any chosen prime number. Because of the direct physical interpretation of the measurement symbols, the phase space structure is thereby related to definite experimental configurations.

Invited media scholars and journalists examine the general issue of nuclear waste, risk and the sicentific promises that were made, but not kept, about safe disposal. The mass media uncovered and reported on nuclear waste problems at Rocky Flats in Colorado and Hanford in Washington. Two environmental journalists review efforts to expose problems at these sites, how secrecy hampered reporting, and the effects of media coverage on nearby residents. An environmental communications scholar evaluates media coverage, the role of the U.S. (...) Department of Energy, and the impact of secrecy on public risk perceptions and attitudes toward government nuclear waste policies. (shrink)

Bracken synthesizes Polanyi’s notion of morphogentic field and Whitehead’s notion of societies of actual occasions. These comments emphasize the implications of the metaphors involved in these notions. The rnetaphor of plants growing in afield lies beyond the concept of a morphogenetic field, and the metaphor of a society of interacting persons lies behind the concept of a society of actual occasions. I suggest that one of the implications of this metaphor is that there is not, as Bracken argues, (...) a problem of continuity in Whitehead’s metaphysics of events. (shrink)

Quantifiers are a test case for an interface between psychological questions, which attempt to specify the numerical content that supports the semantics of quantifiers, and linguistic questions, which uncover the range of possible quantifier meanings allowable within the constraints of the syntax. Here we explore the development of comprehension of most in English, of particular interest as it calls on precise numerical content that, in adults, requires an understanding of large exact numerosities (e.g., 23 blue dots and 17 yellow is (...) an instance of “most of the dots are blue”). In a sample of 100 children 2 to 5 years of age we find that (a) successful most comprehension in cases with two salient subsets is achieved at 3 years, 7 months of age, and (b) most comprehension is independent of knowledge of large exact number words; that is, knowledge of large exact number words is neither necessary, as evidenced by children who understand “most” but not “four,” nor sufficient, as evidenced by children who understand “nine” but not “most.”. (shrink)

Introduction : the times they are a changin' -- Doing their best -- Values, evidence, conflict -- What counts as evidence? -- The miracle drug -- The battle for acceptance : defining the relationship between medicine and the world of madness and distress -- The ring -- Foregrounding contexts : what kinds of understanding are appropriate in the world of mental illness? -- Losing Peter -- Mind, language, and meaning -- Beetles -- Ethics before technology : is 'treatment' the best (...) way to think about mental health work? -- Narrative and the ethics of representation -- Meaning and recovery -- Citizenship and the politics of identity -- Are you local? : responding to the challenge of globalization in mental health -- The veil. (shrink)

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative (...) analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes and one overarching theme. The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine. (shrink)

In this article I argue against the claim that “actual entity” and “actual occasion” are synonymous in Whitehead. My examination of these terms will help to illuminate the role of “society” in Whitehead’s philosophy and to prepare the way for a fruitful comparison of process thought and contemporary systems theory in the sciences.

We are very grateful to Mona Gupta and Peter Zachar for their commentaries on our paper. In our view, the main challenge for both commentators is this: do they have empirical evidence to refute our rejection (on evidence-based grounds) of the primacy of the current technological paradigm in psychiatry? Although opinions may differ about our choice of the philosophical tools we use to interpret the facts, unless there is good evidence to contradict our basic premise, their arguments will fail to (...) reach the evidence-based medicine (EBM) gold standard that they support. We do not believe their commentaries present any empirical evidence that contradicts our critique. Before we respond, we wish to stress two .. (shrink)

During the Middle Ages, philosophers and theologians argued over the extramental reality of universal forms or essences. In the early modern period, the relation between subjectivity and objectivity, the individual self and knowledge of the outside world, was a rich subject of debate. Today, there is considerable argument about the relation between spontaneity and determinism within the evolutionary process, whether a principle of spontaneous self-organization as well as natural selection is at work in the aggregation of molecules into cells and (...) the development of primitive forms of life into complex organisms. In _Subjectivity, Objectivity and Intersubjectivity_, Joseph A. Bracken proposes that what is ultimately at stake here is the age-old problem of the relationship between the One and the Many, universality and particularity on different levels of existence and activity within nature. Bracken rejects traditional models of this relationship, wherein either the One or the Many is presupposed to have priority over the other. He instead suggests that a new social ontology—one that is grounded in a theory of universal intersubjectivity—protects both the concrete particularity of individual entities in their specific relations to one another and their enduring corporate reality as a stable community or environment within Nature. What emerges is a bold reimagining of the sometimes strained relationship between religion and science. Bracken's clear writing, sophisticated philosophical analysis, and exemplary scholarship will lend this new work an enthusiastic appreciation by readers with deep interests in philosophy and philosophical theology. (shrink)

Outlining the major ideas and achievements of the great French thinker Reneescartes, this is an introductory guide to a man whose ground-breakingheories have been rocking the status quo for over three centuries.;From hisirth into the brave new scientific world of Copernicus and Galileo to hisemise and the unusual fate of his body, this book first presents a soundntroduction to the context of Descartes's life and thought. Harry M. Brackenhen draws on the words of Descartes himself to introduce the philosopher'sontroversial theories (...) on the dualism of mind and body and the supremacy ofhe rational ideal, before providing a sharp analysis of the continuing rolef Rene Descartes in our own philosophical and moral landscape. (shrink)

Derrida insists that any effort to think theological–political power “in its possibility” must begin with the death penalty. In this paper, I revisit the death of Moses Paul, “an Indian,” executed in New Haven in 1772 for the murder of Moses Cook, a white man. The Mohegan minister Samson Occom delivered Paul’s execution sermon and accompanied him to the gallows. Revised, Occom’s sermon was one of the first works published by a Native American author in English. Occom suggests there can (...) be a theological–political power that signals itself not by decreeing the death penalty, but by opposing it. Hence sovereignty can be thought, with and against Derrida, as the theologico-political power to restore life. By opposing death to grace, moreover, Occom achieves a division of sovereignties, creating an opening for Indigenous nations within the scaffolding of the settler state. Working in collaboration, then, Occom and Paul produce a political theology. (shrink)

This volume in the “Past Masters” series is a short introduction to Berkeley’s philosophy. Urmson begins with an account of the “corpuscularian philosophy,” which is followed by a discussion of Berkeley’s attack on matter. Urmson takes Locke’s philosophy to be corpuscularian. The foundation of his interpretation is that Berkeley is attacking Newton and Locke. Berkeley is, moreover, said to be an “extreme empiricist”. He also reads Berkeley as an implicit proponent of grounding language on ostensively defined terms. So it comes (...) as no surprise that Urmson provides us with a phenomenalist interpretation of Berkeley, and of course phenomenalism is a philosophical position whose flaws have long been clear to Urmson. (shrink)