In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 57-62 [Access article in PDF] Listening to People Or Listening to Prozac?Another Consideration of Causal Classifications Jennifer Hansen Keywords causal classification, descriptivism, melancholia, neurasthenia, depression, cultural relativism. The shape and detail of depression have gone through a thousand cartwheels, and the treatment of depression has alternated between the ridiculous and the sublime, but the excessive sleeping, inadequate eating, suicidiality, withdrawal from social interaction, (...) and relentless despair are all as old as the hill tribes, if not as old as the hills. In the years since man achieved the capacity for self-reference, shame has come and gone; treatments for bodily complaints have alternated and crossed with treatments for spiritual ones; pleas to external gods have echoed pleas to internal demons. To understand the history of depression is to understand the invention of human being as we now know and are him. Our Prozac-popping, cognitively focused, semi-alienated postmodernity is only a stage in the ongoing understanding and control of mood and character. (Solomon 2001, 286) ALTHOUGH ANDREW SOLOMON clearly believes that "the shape and detail of depression have gone through a thousand cartwheels," Jennifer Radden gives us pause before assuming that depression is just another name for Dame Melancholy. Solomon's claim depends on a deeper metaphysical claim about the nature of depression and its causes. The current method of psychiatric nosology, descriptivism, does not necessarily support equating melancholia and depression. Furthermore, it appears that adopting descriptivism as the sole method of classifying mental disorders commits us to cultural relativist psychiatry. Below I reconsider whether we want to rule out causal classifications and suggest that embracing both descriptivism and causal classifications offer us greater possibilities in understanding human illness and culture.Although the occasion for Jennifer Radden's essay is to investigate whether or not melancholia and depression refer to the same thing, her essay detours into a consideration of extra-descriptivist models of psychiatric illness versus the descriptivism of current psychiatric nosology. This detour turns out to be warranted; her purely academic question yields to a timelier question concerning the proper methodology for classifying mental disorders. Whereas debates about psychiatric nosology are perennial, the recent success of the new generation of antidepressants [End Page 57] is reviving biological psychiatry and its search for the neurochemical origins of depression. Hence, embedded in Radden's question concerning whether or not melancholia is the same thing as clinical depression, is another important question concerning the causes of mental illness, particularly depression.Currently, with its descriptivist approach, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not classify mental illness, such as clinical depression, based on underlying causes. The cluster of symptoms and behavioral signs that lead a clinician to diagnose one as depressed that are contained in either the DSM or the International Classification of Diseases (ICD) may be too fuzzy or elusive to give any clear distinction between major depression, mild depression, and the blues. For example, one group of epidemiologists points out that [t]he DSM-III, DSM-III-R, and DSM-IV acknowledge that depression, like many mental disorders, has no currently obvious natural classes... If natural classes of depression exist, then their nosology awaits the discovery of distinct and reliable genetic, biological, clinical, or other predictors of risk, severity, or clinical course. Clinicians have a tradition of separating depressions into subtypes; however, this subtyping has not yet led to clear-cut delineations of syndromes in populations. (Kaelber 1995, 4) The evidence is still insufficient to establish the biological or psychological origins of depression. Although many theories exist that explain why people become depressed, scientifically we are not yet in a position to determine which is the right theory. From a pragmatic perspective, however, whether or not we know what causes depression, we can nonetheless attempt to alleviate suffering from depression. And it is with this goal in mind that the DSM-IV and ICD-10 classify mental disorders.Now, given that our current methodology for psychiatric nosology does not establish causes, it is also insufficient for determining what... (shrink)

In what follows, I offer some friendly amendments to Potter’s psychotherapeutic model—‘the hinge narrative’ (HN)—designed to help bipolar patients cultivate self-trust. My primary contribution is to suggest an alliance between narrative theory and feminist phenomenological theories of embodiment. I argue that these projects are mutually supporting in both the metaphysical and therapeutic project of constituting a rich moral self, that is, a self who has self-trust and thereby satisfying relationships with others. I also register a slight disagreement with Potter concerning (...) the effect that bipolar illness has on agency. Potter claims that with conventional narratives patients have difficulty perceiving .. (shrink)

ABSTRACT In considering the hopeful rhetoric that pervades the “nothing but” psychopharmacological approaches to depression—a contemporary version of what William James calls medical materialism—this article argues that only a thorough-going pluralist account of hope is a hope worth wanting. Medical materialist hope is better conceptualized as a variation of optimism, which assumes a single universe that is already the best of all possible universes, and thereby only promotes optimization of the status quo, rather than encourage a wider undertaking of a (...) variety of experiments in living. A pluralist hope, as opposed to optimism, cannot logically infer what the future will bring from a reigning scientific model of the brain. Rather, a pluralist hope is a passionate belief that a not-yet unimagined, and therefore indeterminate, future will meliorate current human ills should humans strenuously work toward achieving it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Written on the Body, Written by the SensesJennifer L. Hansen"Explore me," you said and I collected my ropes, flasks and maps, expecting to be back home soon. I dropped into the mass of you and I cannot find the way out. Sometimes I think I'm free, coughed up like Jonah from the whale, but then I turn a corner and recognize myself again. Myself in your skin, myself lodged (...) in your bones, myself floating in the cavities that decorate every surgeon's wall. That is how I know you. You are what I know.1Ever since Plato wished to banish the poets from the republic (Republic 607b2),2 philosophy has stood in a vexed relationship to literature. There seem to be at least three reasons for philosophy's traditional contempt for literature as a reliable means to truth: (a) because literature engages the passions of a reader, it may cloud the reader's ability to deliberate calmly and rationally about any given account of how things really are; (b) literature most commonly deals with the particular and concrete and therefore cannot claim to a more general or universal truth, and; (c) literature is too open-ended and ambiguous in its meaning, which, again, obstructs the reader's view of how things really are. Though the writer is imitating the world, is holding up a mirror to it—a speculum mundi—literature's images are mere appearances.Philosophy, on the contrary, aims for a kind of "transcendental vision." Either philosophy looks beyond the particular appearances of things in the world to find the one structure which unites all instances of the thing, or philosophy claims that the structure of each object is supplied by consciousness, which then delimits and bounds each object, and places it in space and time so that the scientist can better dissect, measure, and catalogue it. That is, either philosophers, in the [End Page 365] tradition of Parmenides, aim to find the one in the many—as Socrates explains in the Republic "we are accustomed to assuming one Form in each case for the many particulars" (596a4–5)—or as in Kant's Copernican revolutionary thinking, consciousness renders the object of experience a knowable thing.While this transcendental vision proves quite useful for the scientist who deals with the empirical, it proves less useful where the task would be to conceptualize what is not a possible object of experience. While the scientist can indeed dissect and probe the body to understand how it functions, the scientist is less likely to discover what it means for a body to love, or to be free. In the "The Antinomy of Pure Reason" in the first Critique, Kant, in fact, left us with a choice about what philosophy's true object should be: either we restrict philosophy to the empirical world and its logic, or we pursue metaphysical questions about God or Freedom which cannot be grasped.3 On pain of contradiction, we cannot have both. In chapter three of the Transcendental Doctrine Judgment, "The Ground of the Distinction of all Objects in General into Phenomena and Noumena," Kant uses a wonderful metaphor to illustrate the dangers of Pure Reason venturing into metaphysical questions, and thereby employing the categories beyond the empirical: "This domain is an island, enclosed by nature itself with unalterable limits. It is the land of truth—enchanting name!—surrounded by a wide and stormy ocean, the native home of illusion, where many a fog bank and many a swiftly melting iceberg give the deceptive appearance of farther shores, deluding the adventurous seafarer ever anew with empty hopes, and engaging him in enterprises which he can never abandon and yet is unable to carry to completion" (CR, 257). If we allow ourselves to be allured by the deceptive appearance of farther shores, then we are not engaged in philosophy, but speculation or mysticism. We cannot provide an account for such knowledge in universal terms, in arguments, in logic. And yet, as Kant himself very well knew, these are questions that we are, as humans, compelled to raise. At the outset of the Transcendental Dialectic, Kant makes clear that reason will ineluctably be led... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Explode and Die!A Fat Woman’s Perspective on Prenatal Care and the Fat Panic EpidemicJennifer HansenClassifying obesity as a disease provides more ammunition for the “war on obesity.” I gather that this is supposed to be a good thing. The problem is that obesity isn’t a germ or a crime; it’s a word applied to a particular kind of body—and thus to the person inhabiting it.From a fat person’s perspective, (...) the “war on obesity” is a war on fat people. It’s a license to bully, shame, and ostracize fat people and deny us employment, medical care, and even ordinary family life because we don’t look right. Fat people, proclaimed by medical authority to be the enemy and identifiable on sight as outsiders, are made into targets for all kinds of free–floating anger. For example, I am apparently sucking away people’s tax dollars via my fat, and it’s also my fault that men expecting to fantasize about every woman they see on the street encounter my distasteful fatness instead. But no matter how many times we get told that we are wrong just for existing, we go on existing, in public even. How dare we? The answer, obviously, is to keep at us. If we would just admit that we have no right to exist, then we would all either vanish or become socially acceptably thin, and then the whole world would be unicorns and butterflies and everyone would be rich and nobody would get old. Or something like that. If obesity is a disease, then phrenology is a science.Of course, we get a lot of well–meaning flak along with the bullying; after all, concentrating on weight loss can only be good for us, because fat people are always about to explode and die. This assumption has definitely affected my relationship with the only medical practice I can reach that’s in my network. During the 20–plus years since I became visibly obese, I have gotten used to the constant drone of “You’re fat, you’re fat, you’re about to explode and die, we don’t care about what you actually came in for because it’s vitally important that we bug you yet again about your pants size,” but some things can still shock me. For example, during all three of my pregnancies, I never had a result that was even borderline for gestational diabetes (GD). And yet, some time after my last baby was born, someone wrote “HISTORY OF GESTATIONAL DIABETES” in my file. I first heard about it during my annual checkup, when the doctor referred to it when talking about my increased risk of Type 2 diabetes due to age (unavoidable), my first–ever non–whitecoat–syndrome borderline blood pressure (BP) reading (taken with a standard cuff, gee how could it possibly have been inaccurate), and GD (gosh, I felt so safe and supported at this fine reality–based practice). And of course my weight.Whoever wrote that felt free to make things up because I’m fat. To repeat, somebody with access to my file at my only source for affordable health care felt free to write things in it that were completely contradicted by the facts just a few sheets below. There’s no need to fact–check your assumptions when you can tell by looking at her that she’s F–A–T, and everybody knows what they are. They’ll explode and die, every last one of them. Better medicate them now before they inevitably break down!Speaking of which, there’s a particular OB at the practice who I’ll call Doctor Eeyore. At every appointment, Doctor Eeyore would take measurements, stare, and say, “Hmm … tch.” If I asked him to tell me what he had found, he would say, “Too big,” or, “Too small,” or indicate some other inadequacy in his glum, word–miserly way. He only bothered to produce complete sentences when he enthusiastically told me that I would die if I didn’t give birth with an IV in place to administer the life–saving drugs for my inevitable cardiac event... (shrink)

Although at times criticized for its philosophical density, French cultural theory remains a flourishing, if highly contested, area of academic study. Four feminist thinkers in this tradition continue to be especially prominent: Simone de Beauvoir, Julia Kristeva, Hélène Cixous, and Luce Irigaray. This new collection from Routledge gathers together the very best secondary literature on these thinkers to provide an indispensable conspectus of their works. Each of the four thinkers is represented by an individual volume, and each volume includes a (...) newly written introduction to that thinker’s work and her philosophical relevance. (shrink)