At the very beginning of Lavallee’s article on addictive craving, they note that they will avoid using the term addict in an attempt to avoid essentializing the identities of people who experience addiction. Neuroscientific approaches to the study of mental disorders could benefit from a similar level of caution with regard to discouraging essentialism. Zachar characterized psychological essentialism as the “cognitive predisposition to view entities as possessing underlying natures that make them be the kind of things that they are”. The (...) view that the brain is the underlying “essence” of the person has been dubbed neuroessentialism. Neuroessentialism entails that mental disorders have an inherent... (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)

I would like to thank Scott Waterman for sharing what must have been very challenging personal circumstances. Waterman's reflections touched upon many complex issues. For my part, I would like to explore how Waterman's experience underscores the importance of epistemic humility regarding the limits of scientific knowledge and our sense of the meaning of scientific knowledge while still recognizing the significance and power of scientific knowledge. The first epistemic challenge presented by Scott Waterman's experience of "patienthood" that demonstrates the limits (...) of scientific knowledge is the ability to know pain. Of course, we have all known pain, but such firstperson knowledge would not qualify as scientific... (shrink)

Dennis Porter argues in Rousseau's Legacy that this cultural idea of the writer - as distinct from the more traditional "man of letters" - first emerged in France in the decades preceding the French revolution, and has continued to exercise a nominative power over intellectual life well into our own day. In Porter's paradigm, Jean-Jacques Rousseau serves as a seminal figure who combined radical critique of existing institutions with a new form of confessional writing and a suspicion of the art (...) of literature. (shrink)

If the morphology of baseball is similar to that of the fairy tale, it is obviously not because baseball is a form of narrative art. As my title suggests, insofar as baseball resembles literature at all in the way it manifests itself, it is clearly much closer to drama. Baseball takes place within a fixed, carefully delimited space that may be improvised but is reserved specifically for the purpose wherever the game is institutionalized. It is an ensemble performance carried out (...) by specially trained "players" in front of an audience for whom the occasion is a festive event that occurs as a suspension of ordinary life. It possesses a plot that develops in a limited period of time from initial situation through complication to denouement and has a relatively large number of dramatis personae who are sent into the playing area at a given moment in order to perform specific roles. Dennis Porter, associate professor of French and comparative literature at the University of Massachusetts, Amherst, has published widely on nineteenth- and twentieth-century French and English novels. He is currently an NEH fellow and is working on two books: one on plot and ideology in the novel, the other, The Alibi of Crime, on detective fiction. (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)

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)