In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a (...) strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

Social Constructivism about the disease concept has generally been taken to ignore the fundamental biological reality underlying diseases, as well as to fall foul of several apparently compelling objections. In this paper, I explain how the metaphysical relation of grounding can be used to tie a socially constructed account of diseases and their classification to their underlying biological and behavioural states. I then generalize the position by disambiguating several varieties of normativism, including a particularly strong ‘placeholder’ version of social constructivism, (...) and showing that the grounding approach is available to each. I go on to provide what I believe to be the first attempt at a full semantics for disease-talk and disagreement, before using the placeholder to demonstrate on that basis that the most troublesome objections to normativism can be avoided even by very strong versions of the position. (shrink)

If mental illnesses are externally constituted, then so are somatic illnesses. Will Davies makes a persuasive case for externalism in psychiatry; as I show here, parallel examples exist in somatic medicine.

The question of whether medical and psychiatric judgements involve a normative or evaluative component has been a source of wide and vehement disagreement. But among those who think such a component is involved, there is considerable further disagreement as to its nature. In this article, I consider several versions of Aristotelian normativism, as propounded by Christopher Megone, Michael Thompson and Philippa Foot, and Martha Nussbaum. The first two, I claim, can be persuasively rebutted by different modes of liberal pluralist challenge (...) — respectively, pluralism about structures of social organisation and pluralism about biological forms. Nussbaum's version, by contrast, is alert to the need for pluralism; I argue, however, that the Aristotelian aspects of her theory hamper her pursuit of those pluralistic aims. (shrink)

Following Wesley Hohfeld's pioneering analyses, which demonstrated that the concept of ownership conflated a variety of distinct legal relations, a deflationary regarding those relations as essentially unconnected held sway for much of the subsequent century. In recent decades, this theory has been thought too diffuse; it seems counterintuitive to insist, for instance, that rights of possession and alienation over a property are associated only contingently. Accordingly, scholars such as James Penner and James Harris have advanced theories that revive the concept (...) of ownership, identifying some instances of property as and regarding others as conceptually subsidiary. I propose a new interpretation of the bundle theory, based on David Lewis's idea of among physical particles. I critically examine the major antibundle positions, arguing that their criticisms result from confusion about the claims of the bundle theory, which remains the best account of property rights available. (shrink)

Grammar is now widely regarded as a substantially biological phenomenon, yet the problem of language evolution remains a matter of controversy among Linguists, Cognitive Scientists, and Evolutionary Theorists alike. In this paper, I present a new theoretical argument for one particular hypothesis—that a Language Acquisition Device of the sort first posited by Noam Chomsky might have evolved via the so-called Baldwin Effect . Close attention to the workings of that mechanism, I argue, helps to explain a previously mysterious feature of (...) the Language Acquisition Device—the sheer variety of languages it allows the child to learn—thereby revealing a far stronger case than adherents of the hypothesis have previously supposed. A further unheralded consequence of the hypothesis is a conceptual shift in the Chomskyan understanding of language, wherein the essentially public nature of language is freshly emphasised. This has the effect of bringing the Chomskyan view into closer accord with Saussurean accounts of language, as well as with recent trends in evolutionary theory. (shrink)

According to Chomsky and his followers, language as a biological phenomenon is a property of individual minds and brains; its status as a social phenomenon is merely epiphenomenal and not a proper object of scientific study. On a rival view, the individual's biological capacity for language cannot be properly understood in isolation from the linguistic environment, which it both depends on for its operation and—in collaboration with other speakers—builds and shapes for future generations. I argue here for the rival view (...) by demonstrating firstly its greater consonance with several themes in current biological theory, and secondly its ability to answer two well‐known philosophical challenges to generative linguistics due to Quine and Kripke. (shrink)

The Experimental Philosophy (“X-Phi”) movement applies the methodology of empirical sciences – most commonly empirical psychology – to traditional philosophical questions. In its radical, “negative” form, X-Phi uses the resulting empirical data to cast doubt on the reliability of common philosophical methods, arguing for radical reform of philosophical methodology.In this paper I develop two connected methodological worries about this second enterprise. The first concerns the data elicited by questionnaires and other empirical survey methods; recent work in political science suggests that (...) such surveys frequently do not elicit the participants’ candid judgements, but rather their expressions of certain attitudes and identifications. This possibility stymies the arguments from experimental data to a radical overhaul of philosophical methodology. The second builds on recent work by L.A. Paul and Kieran Healy concerning social science methodology, applying it to the use of those methods in X-Phi. It concerns experimental design where the treatment investigated is a “transformative” one; since a philosophical education is plausibly one such treatment, doubt is cast on any claim that apparent differences between the judgements of philosophers and ordinary folk has implications for philosophical methodology. (shrink)

Can biological facts explain human morality? Aristotelian ‘virtue’ ethics has traditionally assumed so. In recent years Alasdair MacIntyre has reintroduced a form of Aristotle’s ‘metaphysical biology’ into his ethics. He argues that the ethological study of dependence and rationality in other species—dolphins in particular—sheds light on how those same traits in the typical lives of humans give rise to the moral virtues. However, some goal-oriented dolphin behaviour appears both dependent and rational in the precise manner which impresses MacIntyre, yet anything (...) but ethically ‘virtuous’. More damningly, dolphin ethologists consistently refuse to evaluate such behaviour in the manner MacIntyre claims is appropriate to moral judgement. In light of this, I argue that virtues—insofar as they name a biological or ethological category—do not name a morally significant one. (shrink)

Debates about the concept of disease have traditionally been framed as a competition between two conflicting approaches: naturalism, on the one hand, and normativism or social constructivism, on the other. In this article, we lay the groundwork for a naturalistic form of social constructivism by dissociating the presumed link between value-free conceptions of disease and a broadly naturalistic approach; offering a naturalistic argument for a form of social constructivism; and suggesting avenues that strike us as especially promising for filling in (...) the details of an alternative approach and addressing the most obvious objections. (shrink)

The philosophical dispute about linguistic normativity is one battlefield in a larger war over the nature of language as an object of scientific study. For those influenced by Wittgenstein, language involves following — or failing to follow — public, prescriptive rules; for Chomsky and his followers, language is a property of individual minds and brains, and the grammatical judgements of any mature individual speaker — her competence — cannot be, in any linguistic sense, “wrong”. As I argue here, the recent (...) “doge meme” internet fad provides surprising evidence for the prescriptivist view. Normative attitudes towards linguistic practices are a ubiquitous feature of those practices, and there is no principled basis on which to regard them as non-linguistic. (shrink)

In this paper, I outline and defend a commonly-held moral view which has received surprisingly little sustained philosophical attention. This view, which I call the ‘authority of conscience,’ states that believing ourselves to have moral obligations to act in a certain way does in fact create an obligation to act in that way. Although I do not provide a positive case for the principle of authoritative conscience, beyond its popularity and intuitive force, I defend it against several prima facie objections. (...) I then go on to demonstrate that the principle does not entail any anti-realist metaethical commitments, and is therefore compatible in particular, and contrary to appearances, with plausible formulations of moral realism. (shrink)

Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and (...) mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines. (shrink)

Werkhoven’s ‘A Dispositional Theory of Health’ is an important and original contribution to debates about the disease concept, which persuasively demonstrates that dispositions must play some role in a full account of what it is to be healthy or ill. Unfortunately, as a theory, it cannot as it stands be correct.I first demonstrate what appears to be a significant, and possibly fatal, flaw; the proliferation of dispositions which Werkhoven’s theory requires makes impossible, at least in the absence of significant further (...) metaphysical work, the comparative numerical judgements on which its account of health and illness are based. I then demonstrate two further problems, concerning the exclusion of ‘technological’ dispositions from those under consideration, and a large class of compensatory biological functions which Werkhoven’s theory seems to have overlooked. (shrink)

Werkhoven’s ‘A Dispositional Theory of Health’ is an important and original contribution to debates about the disease concept, which persuasively demonstrates that dispositions must play some role in a full account of what it is to be healthy or ill. Unfortunately, as a theory, it cannot as it stands be correct.I first demonstrate what appears to be a significant, and possibly fatal, flaw; the proliferation of dispositions which Werkhoven’s theory requires makes impossible, at least in the absence of significant further (...) metaphysical work, the comparative numerical judgements on which its account of health and illness are based. I then demonstrate two further problems, concerning the exclusion of ‘technological’ dispositions from those under consideration, and a large class of compensatory biological functions which Werkhoven’s theory seems to have overlooked. (shrink)