A RELATIVISTIC THEORY OF PHENOMENOLOCICAL CONSTITUTION: A SELF-REFERENTIAL, TRANSCENDENTAL APPROACH TO CONCEPTUAL PATHOLOGY. (Vol. I: French; Vol. II: English) -/- Steven James Bartlett -/- Doctoral dissertation director: Paul Ricoeur, Université de Paris Other doctoral committee members: Jean Ladrière and Alphonse de Waehlens, Université Catholique de Louvain Defended publically at the Université Catholique de Louvain, January, 1971. -/- Universite de Paris X (France), 1971. 797pp. -/- The principal objective of the work is to construct an analytically precise methodology which (...) can serve to identify, eliminate, and avoid a certain widespread _conceptual fault_ or _misconstruction_, called a "projective misconstruction" or "projection" by the author. It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. The dissertation identifies, perhaps for the first time, a _projective_ variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a _critique of impure reason_. The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with _projective_ uses of concepts. The approach initiates an analysis of concepts from a perspective which views _knowledge as coordination_. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of _identifying reference_ to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of _phenomenological constitution_. The "_de-projective methodology_" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

Pathologizing ugliness refers to the use of disease language and medical processes to foster and support the claim that undesirable features are pathological conditions requiring medical or surgical intervention. Primarily situated in cosmetic surgery, the practice appeals to the concept of “aesthetic pathology”, which is a medical designation for features that deviate from some designated aesthetic norms. This article offers a two-pronged conceptual analysis of aesthetic pathology. First, I argue that three sets of claims, derived from normativist (...) and naturalistic accounts of disease, inform the framing of ugliness as a disease. These claims concern: (1) aesthetic harms, (2) aesthetic dysfunction, and (3) aesthetic deviation. Second, I introduce the notion of a hybridization loop in medicine, which merges the naturalist and normative understanding of the disease that potentially enables pathologizing practices. In the context of cosmetic surgery, the loop simultaneously promotes the framing of beauty ideals as normal biological attributes and the framing of normal appearance as an aesthetic ideal to legitimize the need for cosmetic interventions. The article thus offers an original discussion of the conceptual problems arising from a specific practice in cosmetic surgery that depicts ugliness as the disease. (shrink)

Conceptual therapy seeks to eliminate from our vocabulary of concepts those that are conceptually pathological. The very use of such concepts—which is much of the time—brings about dysfunctional thinking: thought, that is to say, that leads us astray, paving the way for beliefs and claims to knowledge that are fundamentally nonsensical. A therapy for such concepts may be likened to holding a selective sieve and pouring the ideas with which we attempt to make sense of the world through it, (...) allowing the sieve to filter out those that would otherwise infect our thinking with meaninglessness. -/- Conceptual Therapy: An Introduction to Framework-relative Epistemology was written by the author as an introductory text for university classes in applied skills in epistemological analysis. (shrink)

Pathologizing ugliness refers to the use of disease language and medical processes to foster and support the claim that undesirable features are pathological conditions requiring medical or surgical intervention. Primarily situated in cosmetic surgery, the practice appeals to the concept of "aesthetic pathology", which is a medical designation for features that deviate from some designated aesthetic norms. This article offers a two-pronged conceptual analysis of aesthetic pathology. First, I argue that three sets of claims, derived from normativist (...) and naturalistic accounts of disease, inform the framing of ugliness as a disease. These claims concern: (1) aesthetic harms, (2) aesthetic dysfunction, and (3) aesthetic deviation. Second, I introduce the notion of a hybridization loop in medicine, which merges the naturalist and normative understanding of the disease that potentially enables pathologizing practices. In the context of cosmetic surgery, the loop simultaneously promotes the framing of beauty ideals as normal biological attributes and the framing of normal appearance as an aesthetic ideal to legitimize the need for cosmetic interventions. The article thus offers an original discussion of the conceptual problems arising from a specific practice in cosmetic surgery that depicts ugliness as the disease. (shrink)

This essay discusses four key criticisms recently leveled against the main attempts to use conceptual analysis to understand health and disease. First, it examines the weaknesses of these attempts and suggests a better way to proceed. Next, it briefly discusses another disease debate concerning pathological mechanisms and suggests that this approach could be more fruitful than that of conceptual analysis. The final section demonstrates how Georges Canguilhem's biological philosophy of disease avoids some of the problems associated with (...) class='Hi'>conceptual analysis, and how he can contribute to both debates. Canguilhem's appeal to biological normativity is understood as contributing to a theoretical explanation, and a possible naturalization, of what is specific to healthy and pathological phenomena. (shrink)

The Pathology of Man is the first comprehensive study of the psychology and epistemology of human evil, long urged by leading psychiatrists and psychologists, including Freud, Jung, Menninger, Fromm, and Peck. The book breaks new ground by offering a clear, empirically based, and theoretically sound understanding of human evil as a widespread, real, non-metaphorical pathology. With deliberate and thorough scholarship the author proposes a new framework-relative theory of disease and justifies the provocative thesis that human evil should be (...) classified as a pathology which is not a deviation from an accepted norm, but rather is a normal state. This break with tradition provides the necessary psychological foundation for the familiar concept of the banality of human evil, a foundation which in the past it has lacked. (shrink)

In this article I argue that the method of normative reconstruction that is underlying Freedom’s Right undermines Critical Theory’s aspiration to be a force that is unreservedly critical and progressive. I start out by giving a brief account of the four premises of the method of normative reconstruction and unpack their implications for how Honneth conceptualizes social pathologies and misdevelopments, specifically that these notions are no longer linked to radical critique and normative revolution. In the second part, I demonstrate that (...) abandoning forms of radical critique and normative revolution is internally linked to adopting this method, before arguing that Freedom’s Right entails no resources to account for why abandoning them does not amount to a deficiency. In the final part, I point out two problematic implications of turning away from radical critique and normative revolution for the very project Honneth pursues in Freedom’s Right. I show that Honneth’s own view about the limited scope of application of the method of normative reconstruction and his account of the dangers associated with social misdevelopments give us reasons to consider this method to be incomplete. Finally, I contend that the explanatory power of Freedom’s Right is dubious because methodological premises that form part of normative reconstruction lead Honneth to ignore relevant alternative explanations of processes of deviation and disassociation from norms of social freedom, which he characterizes as social misdevelopments. (shrink)

This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.'' I argue that pathologists do not use ``disease'' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; (...) class='Hi'>pathology's goal is to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease'' but also such terms as ``nerve'' and ``organ''are laden with conceptual values. (shrink)

Ideologies, worldviews, or simply personal theories, often acquire a distorted and pathological character, and become a factor of alienation rather than an epistemic resource and an aid for personal existence. This paper attempts to better define the limits and characteristics of this experience, which we call distorted intellectual beliefs, or general conceptual beliefs (GB), while trying to highlight both its sometimes dramatic background and its personal and social consequences, which are no less potentially deleterious. We believe that such experiences (...) should not be confused tout court with a broader and more complex phenomenon, such as extremism and politico-religious radicalism, but are a specific typology of that broader and multifaceted fact that is self-deception. We hypothesize that the self-deception implicit in experiences of intellectual distortion produces a cognitive dissonance of which the subject is normally, though with varying intensity, aware (or may become aware through honest introspection). The phenomenon occurs in two extreme forms: one is normal (sporadic), the other is exceptional (systematic). The passage from one to the other is a complex process of escalation and de-escalation, on which multiple external and internal variables act. In its ascending path, it essentially coincides with a process of psychological polarization and cognitive "de-pluralization", while its descending phase marks a return to reality and a "re-pluralization", where the subject returns to being what he basically is, namely, an active and tireless meaning seeker. In the central part of the chapter, similarities and differences between processes of deradicalization and phenomena of religious deconversion are analyzed, with reference, among others, to the case of the Austro-Hungarian writer Arthur Koestler. -/- An abridged version of this text has been delivered for the Workshop "Explaining Extreme Belief and Extreme Behavior", September 15-16, 2022, Vrije Universiteit Amsterdam. I am grateful to David Konstan (NYU) for reading and commenting on a first version of this chapter and to Rik Peels (VUA) for his comments and questions during the Workshop. I would also like to thank my bachelor's and master's students at UDG, who discussed these topics at length with during semester 2022-B. (shrink)

Ideologies, worldviews, or simply personal theories, often acquire a distorted and pathological character, and become a factor of alienation rather than an epistemic resource and an aid for personal existence. This paper attempts to better define the limits and characteristics of this experience, which we call distorted intellectual beliefs, or general conceptual beliefs (GB), while trying to highlight both its sometimes dramatic background and its personal and social consequences, which are no less potentially deleterious. We believe that such experiences (...) should not be confused tout court with a broader and more complex phenomenon, such as extremism and politico-religious radicalism, but are a specific typology of that broader and multifaceted fact that is self-deception. We hypothesize that the self-deception implicit in experiences of intellectual distortion produces a cognitive dissonance of which the subject is normally, though with varying intensity, aware (or may become aware through honest introspection). The phenomenon occurs in two forms: one is normal (sporadic), the other is exceptional (systematic). The passage from one to the other is a complex process of escalation and de-escalation, on which multiple external and internal variables act. In its ascending path, it essentially coincides with a process of psychological polarization and cognitive "de-pluralization", while its descending phase marks a return to reality and a "re-pluralization", where the subject returns to being what he basically is, namely, an active and tireless meaning seeker. In the central part of the chapter, similarities and differences between processes of deradicalization and phenomena of religious deconversion are analyzed, with reference, among others, to the case of the Austro-Hungarian writer Arthur Koestler. -/- An abridged version of this text has been delivered for the Workshop "Explaining Extreme Belief and Extreme Behavior", September 15-16, 2022, Vrije Universiteit Amsterdam. I am grateful to David Konstan (NYU) for reading and commenting on a first version of this chapter and to Rik Peels (VUA) for his comments and questions during the Workshop. I would also like to thank my bachelor's and master's students at UDG, who discussed these topics at length with during semester 2022-B. (shrink)

Aside from the systematic theory of recognition, Honneth’s work in the last decade has also centered around a less commented-upon theme: the critical social theoretic diagnosis of social pathologies. This paper claims first that his diverse diagnoses of specific social pathologies can be productively united through the conceptual structure evinced by second-order disorders, where there are substantial disconnects, of various kinds, between first-order contents and second-order reflexive understandings of those contents. The second major claim of the paper is that (...) once we understand social pathologies as second-order disorders, it becomes apparent that critical social theory must do more than accurately identify and explicate these disorders at the phenomenological and action-theoretic levels. It must further engage in insightful sociological explanations of the social causes of those pathologies in order to further the prognostic and therapeutic tasks implied by the aim of developing a social theory with emancipatory intent. The paper argues that the identificatory and explicative components of diagnostic social theory have been fulfilled by Honneth to a much greater degree than the latter components of explanation, prognosis and therapy. (shrink)

This chapter aims to distinguish between pathologies of agency in the strict sense and mere sources of impediments or distortion. Expanding on a recent notion of necessarily less-than-successful agency, it complements a mainstream approach to mental disorders and anomalous psychological conditions in the philosophy of mind and action. According this approach, the interest of such clinical case studies is heuristic, to differentiate between facets of agency that are functionally and conceptually separate even though they typically come together. Yet, in the (...) absence of independent criterion for a pathology of as opposed to inner obstacle to agency, this heuristic is at risk of becoming circular or uninformative, falling back on a clinical diagnosis it is meant to take as a starting point only. The chapter develops such a criterion and shows how it could work tracking agential achievement across two core dimensions of agency: planning and responsiveness to reasons. The discussion concludes with some implications on assessing decisional capacity and safeguarding agent autonomy in psychiatric settings. (shrink)

This article provides a historical perspective on how both American and European psychiatrists have conceptualized and categorized sexual deviance throughout the past 150 years. During this time, quite a number of sexual preferences, desires, and behaviors have been pathologized and depathologized at will, thus revealing psychiatry's constant struggle to distinguish mental disorder--in other words, the "perversions," "sexual deviations," or "paraphilias"--from immoral, unethical, or illegal behavior. This struggle is apparent in the works of 19th- and early-20th-century psychiatrists and sexologists, but it (...) is also present in the more recent psychiatric textbooks and diagnostic manuals, such as the consecutive editions of the Diagnostic and Statistical Manual of Mental Disorders. While much of the historical literature revolves around the controversy over homosexuality, this article also reviews the recent medicohistorical and sociohistorical work on other forms of sexual deviance, including the diagnostic categories listed in the latest edition, the DSM-IV-TR: exhibitionism, voyeurism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, and transvestic fetishism. (shrink)

In contrast to the “normativist” view, “naturalist” theorists claim that the concept of health refers to natural or normal states and propose different characterizations of healthy and diseased conditions that are meant to be objectivist and biologically grounded. In this article, we examine the core concept of these naturalist accounts of disease, i.e., the concept of biological malfunction, and develop a new formulation of the notion of malfunction following the recent organizational approach to functions in the philosophy of biology. We (...) focus on the notions of adaptive regulation and functional presupposition to develop a new conceptual framework that justifies the ascription of malfunctional behaviors to biological systems according to the embodied normativity of biological organizations. (shrink)

Medicalization appears to be an issue that is both ubiquitous and unquestionably problematic as it seems to signal at once a social and existential threat. This perception of medicalization, however, is nothing new. Since the first main writings in the 1960s and 1970s, it has consistently been used to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the (...) expanding realm of “the medical” can be more or less clearly delineated. Moreover, while intended to establish the reality of this growing threat, this research often requires making arbitrary or unjustified distinctions between different practices. To better clarify the concept of medicalization, I will focus more on capturing the variety of medical practices than on the sociological aspects of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing is closely tied to medicalizing, both can occur independently. I will then further develop this distinction in terms of the different individual and social effects of these practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 313-316 [Access article in PDF] Normativity and Pathology Mike Gane Keywords: positivism, sociology, pathology, normativity. THE STRENGTH OF VICTORIA MARGREE'S contribution to the examination of the thematic of pathology and its Nietzschean/Canguilhemian variation is that it reveals the challenging complexity of this theme. My comments on this contribution are developed from an interest in the ways that the concern with (...) pathology was part of the initial program of the social sciences, particularly sociology, as it was inaugurated by Auguste Comte and Emile Durkheim in its formative period. Margree touches on the importance of social analysis at the end of her paper; my comments work to some extent in the opposite direction—from the social to the psychological. My concerns lead me to contest a number of her epistemological positions, particularly those concerning the notion of positivism and "objective" analysis.For the first positivist philosophers, positivism was primarily a method; in fact it embraced the set of methods developed by the sciences to obtain the highest degree of objectivity. It was explicitly opposed to methodological reductionism, arguing that each science had specific methods applicable to its own domain. Canguilhem was certainly against methodological reductionism (Renard 1996, 127), but Margree's conception of positivism in psychology as biological reductionism is quite a different and is a later-derived variation of positivism. As such perhaps it should not be conflated with early notions of pathology. Sociological positivism as developed in Durkheim's methodology, although different in many aspects from that of Comte, retained the idea that scientific objectivity was to be the result of epistemological procedures, not what might be called ontological reduction to a physical level of the object. Durkheim tries to clarify the rules governing the analysis of abnormal forms and to define social dysfunction and teratology. The general field of abnormal forms or pathology in the analysis of social life fell into decline after Durkheim and was abandoned in favor of the study of social deviance. The very idea of a study of social pathology itself was critiqued by Szasz and Foucault in particular as a new form of power, which came into existence at the end of the eighteenth century as an essential component of the disciplinary society. Foucault was himself clearly indebted to Canguilhem, and he made this evident on several occasions, such as his lectures at the Collège de France Les Anormaux given in 1974 and 1975 (Foucault 1999). Thus, although the field of pathology and abnormal forms continues in psychology it has been abandoned in sociology, leaving only traces (such as the concept of anomie) in the works of some thinkers such as Baudrillard, whose usage may be ironic more than an attempt to revive the terrain. Could it be that Canguilhem and Foucault [End Page 313] have then more or less swept the field clear of such scientism, even though the reconceptualization in terms of normativity suggested by Canguilhem has not been widely taken on? Indeed there may be important differences between the conceptualization of Canguilhem and Foucault (after all, as Margree points out, Canguilhem can be read as attempting to invert the relation between normativity and normative, not to withdraw from the terrain altogether). Foucault seems to approach a position elaborated in sociology earlier by Max Weber in his rejection of the attempt to use the field of pathology as a way of evading moral choices. Canguilhem discusses responsibility in "Thérapeutique, expérimentation, responsibilité" (1983, 391), noting the importance of professionalization and legal controls on professional practice.The fundamental issues posed by the project of social science continue to be haunted by the same set of problems as established in analysis of pathological phenomena, whether it be conceived in terms of order and disorder (chaos), social breakdown, radical evil, "failed states," even deviation or noncompliance with "correct" forms of language or behavior (harassment, racism, child abuse) and so on, or pathology (perversion, dysfunction, disease, illness, abnormalities). The question in part is: is there anything lost by replacing pathology with more political, religious, moral, and legal terminologies? From Foucault's point... (shrink)

The critical theory of the Frankfurt School starts with an explanatory-diagnostic analysis of the social pathologies of the present followed by anticipatory-utopian reflection on possible treatments for these disorders. This approach draws extensively on parallels to medicine. I argue that the ideas of social pathology and crisis that pervade the methodological writings of the Frankfurt School help to explain critical theory’s contention that the object of critique identifies itself when social institutions cease to function smoothly. However, in reflecting on (...) the role that reason and self-awareness play in the second stage of social criticism, I contend that this model is actually better conceptualized through the lens of the psychoanalyst rather than the physician. Although the first generation’s explicit commitment to psychoanalysis has dissipated in recent critical theory, faith in a rationalized ‘talking cure’ leading to greater self-awareness of existing pathologies remains at the core of the Frankfurt School. (shrink)

The aim of this paper is to explore a new framework for personality assessment that may function as sanity nosology of personality traits: the Positive Personality Model. The recent publication of DSM-5 created the opportunity to assess personality traits as dimensional constructs (American Psychiatric Association, 2013). In Section III, five maladaptive personality traits are proposed as the maladaptive versions of Five Factor Model (FFM) traits (Costa and McCrae, 1985). This approach draws on the existing idea of conceptualizing pathological and typical (...) personality traits as part of a continuum. It places DSM-5’s maladaptive traits in a sickness pole and FFM’s traits in a “typical” pole. This spectrum, however, does not include a positive perspective that represents healthy behavior: a sanity nosology. The Positive Traits Inventory-5 (PTI-5; de la Iglesia and Castro Solano, 2018) is a measure designed to assess the positive reverse of the Personality Inventory for DSM-5-Adult (PID-5; Krueger, Derringer, Markon, Watson and Skodol, 2013). The 220 positive personality criteria were studied psychometrically using a sample of 1902 Argentinean adults from the general population (Mage = 39.10, SD = 13.81, Min = 18, Max = 83; 50.1% females, 49.9% males). Exploratory and confirmatory factor analyses resulted in a five-factor solution. The dimensions were labeled Sprightliness, Integrity, Serenity, Moderation, and Humanity and subsumed under the denomination of Positive Personality Model (PPM). Analyses of convergent validity provided some grounds for interpreting the five positive traits as positive versions of the pathological traits and the typical traits. When tested for its predictive capability on mental health, the PPM outperformed the variance explained by the FFM. It is concluded that the PPM may constitute a positive pole in the continuum of personality traits –possibly functioning as a sanity nosology– and that it is somewhat more related to optimal functioning than to typical trait models. The PPM should be confirmed in other populations, its predictive capability ought to be tested with other relevant variables, and longitudinal studies should be done to analyze the stability of the traits over time. (shrink)

How « the Father » became the cause of the pathologies affecting the family. When, in the 1960s, fathers lost their control over procreation and their control over women and children, some cracks started to appear in the edifice of patriarchal domination. There followed a reaction in which all the disorders today troubling the order of the family came to be traced back to this eclipse of the father figure. From this there emerged a veritable « State psychological apparatus » (...) whose aim was the sanctification of the traditional domestic functions : the father as the figure of authority, the mother as carer. Indifferent to its social and historical dimensions, Oedipus assumed the status of a, presumably universal, « symbolic order », dominated by the father and master. MT here calls into question the entire conceptual order of Lévi-Strauss and Lacan : the idea that the foundation of power and reason is naturally a masculine prerogative. Above all else, the article calls into question the interpretation put forward by Pierre Legendre, which assigns to a (patriarchal) juridical order the task of structuring the psyche. (shrink)

The article aims at elaborating a non-speculative concept of social pathology. In the first section, various conceptualizations (e.g. Habermas, Honneth) are critically revaluated. It is argued that (a) applying the originally medical concept of ‘pathology’ on social entities has untenable connotations (due to the lacking social equivalent of death); (b) grounding social pathology on the level of ‘social suffering’ is not in accordance with the actors’ horizon shaped by biomedical- and psy-discourses. To avoid these dead-ends, social pathologies (...) are reinterpreted as structural distortions causing diseases or mental disorders. To refine this initial definition, in the second section, Merleau-Ponty’s concept of chiasm is used as an ontological framework translating between medical and social diagnoses. The proposed concept of social pathology refers to those patterns of disrupted pre-intentional, intentional and mediated intertwining, which manifest as ill or psychopathological chiasm. In the third section, two case studies are elaborated: the intersubjective structures of depressed and asthmatic chiasm. Finally, the implications for critical theory and praxis are overviewed. (shrink)

Competence is central to informed consent and, therefore, to medical practice. In this context, competence is regarded as synonymous with decision-making capacity. There is wide consensus that competence should be approached conceptually by identifying the abilities needed for decision-making capacity. Incompetence, then, is understood as a condition in which certain abilities relevant to decision-making capacity are lacking. This approach has been helpful both in theory and practice. There is, however, another approach to incompetence, namely to relate it to mental disorder. (...) This approach has been followed in recent research that has shown, for instance, that in anorexia nervosa a person's values may be changed, resulting in ‘pathological’ values. We explore some advantages and disadvantages of both abilities-based and pathology-based approaches. We argue that both can be valuable for further clarification of the concept of competence and improving clinical practice. Given the current predominance of the abilities-based approach, we make a plea for a greater focus on pathology-based practice and research. (shrink)

Traditionally, autoimmune disease has been considered to be a case of false recognition; the immune system mistakenly identifies 'self' tissues as foreign, attacking them thus causing damage and malady. Accordingly, the history of autoimmunity is usually told as part ot the history of immunology, that is, of theories and experiments relating to the ability of the immune system to discriminate between self and nonself. This paper challenges this view, claiming that the emergence of the notion of autoimmunity in the 1950s (...) must be considered as part of a long develolpment in thought about pathology throughout the twentieth century, namely the conceptualisaiton of disease as a reactive and self-destructive process. During the first part of the twentieth century this notion became one of the cornerstones of pathology and was increasingly employed for the explanation of the non-infections, slow-burning diseases. Thus, the category of chronic disease had been defined anew, now encompassing all those diseases characterised by a persistent inflammatory process. Inflammation, in turn, was conceived as double-eged physiological mechanism, which was usually the direct mediator of damage, of the essence of disease. The paper also shows how this kind of analysis could emable a unified historical discussion of autoimmunity and allergy, hitherto considered to have distinct conceptual origins. (shrink)

Although the network model represents a promising new approach to conceptualizing comorbidity in psychiatric diagnosis, the model applies most directly to Axis I symptom disorders; the degree to which the model generalizes to Axis II disorders remains open to question. This commentary addresses that issue, discussing opportunities and challenges in applying the network model to DSM-diagnosed personality pathology.

Medicine is facing several significant challenges as the twenty-first century unfolds, which represent barriers or limitations that threaten to cripple the advancement of medicine and its practice. One of the responses to these challenges is the emergence of systems medicine. And one of the more pertinent challenges is identifying and clarifying systems medicine's conceptual and theoretical foundations. The present book represents a sustained effort to examine this challenge and to map the terrain by which to engage it and to (...) pursue possible solutions. This conceptual and theoretical challenge in particular needs to be addressed to ensure the future success of systems medicine. To that end the book explores the conceptual and theoretical foundations of systems medicine, including the major concepts of organicism, emergence, and robustness, and contrasts these concepts to those for biomedicine, including mechanism, resultant, and homeostasis. Moreover, this challenge is critical because its resolution provides the intellectual scaffolding necessary for structuring the concepts and theories required to understand and explain more adequately or completely biological, physiological, and pathological mechanisms and processes. Importantly, with a robust conceptual and theoretical scaffolding, systems medicine must be implemented interdisciplinary not only within the medical community but also within the social and political communities, which the COVID-19 pandemic made so painfully obvious. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 387-394 [Access article in PDF] Psychosis Good and Bad:Values-Based Practice and the Distinction Between Pathological and Nonpathological Forms of Psychotic Experience Mike C. Jackson and K. W. M. Fulford IN TWO PAPERS in this issue of Philosophy, Psychiatry, and Psychology, Marek Marzanski and Mark Bratton (2002) and Caroline Brett (2002) develop important critiques, from the perspectives respectively of Christian theology and Eastern philosophy, (...) of our 1997 analysis of the distinction between pathological and nonpathological forms of psychotic experience (Jackson and Fulford 1997).In this response, we briefly summarize the main points from our 1997 analysis; we consider, separately, the important although very different challenges to that analysis from the perspectives of our two critics; and we briefly indicate the main lines of recent developments in policy, practice, and research in mental health as they relate to this important area of human experience. The Jackson and Fulford (1997) Analysis In our 1997 paper, we presented three case studies from a larger series (Jackson 1991, 1997, 2001) selected with the express aim of bringing into focus the conceptual difficulties that arise at the borderline between psychotic illness and what we called benign spiritual experience. On the basis of these case studies we argued thatspiritual experiences, which are essentially benign, can involve explicitly psychotic phenomenology; traditional psychiatric diagnostic methods, which focus on the form and content of beliefs and experiences, are not capable of distinguishing between pathological and nonpathological forms of such psychotic experiences; [End Page 387]evaluation of such experiences (and claims about "illness" and health more generally) necessarily involves value judgments as well as judgments about matters of fact (specifically, the "facts" of traditional descriptive psychopathology); and more specifically, the distinction between pathological and nonpathological phenomena concerns the way in which they are embedded in the structure of the values and beliefs by which the actions of the subjects concerned are defined: "In the case of pathological psychotic phenomena," we argued, "there is a radical failure of action.... In the case of spiritual psychotic phenomena, action is radically enhanced" (Jackson and Fulford 1997, 55).We then proposed a cognitive problem-solving model of psychotic experiences. This model suggests that such experiences can be a normal and adaptive psychological response to existential crises, such as loss of meaning or purpose in life, coming to terms with death or bereavement, and so on (Batson and Ventis 1982; Jackson, 1991, 1997, 2001). The model is consistent with a subsequent position paper published by the British Psychological Society arguing the case for a psychological formulation of psychotic experiences and cognitive-behavioural methods in their management (2000).In the case of nonpathological psychotic experience, the psychotic elements of the experience promote a paradigm shift in the individual's underlying assumptions, which effectively resolves their impasse and allows them to move forward. This is normally a self-limiting process, in that when the individual is able to utilize their insight, it acts to resolve the stress which triggered it. In pathological psychosis, this process fails for various possible reasons, which were not explored in any depth in that paper (but see Jackson 2001 for a more detailed discussion). The Challenge From Marzanski and Bratton Marek Marzanski and Mark Bratton reexamine the questions raised by our cases from a Christian theological perspective (Marzanski and Bratton 2002). They suggest a theologically based definition of spiritual experience according to which the criteria for "genuine" experience concerns its context within the development of the individual's religious faith. In Bratton and Marzanski's account, these criteria are based on a Christian value system.They present three cases of their own, which, in contrast to the three cases in our 1997 paper, vividly illustrate how phenomena that may be valued negatively from a medical perspective (i.e., as defined by us in terms of their consequences for action), may, at one and the same time, be valued positively from a religious perspective (i.e., in terms of their consequences for the... (shrink)

This article is focused on the notions of health and illness, as they appear in the context of philosophical reflections on finitude and contingency of human existence. Criticizing Heidegger's approach to health and illness which is based on the Aristotelian concept of privation, the author tries to find an alternative to the privative concept of illness with the help of Schelling's treatise on human freedom which explicates Evil not as a privation of Good, but as a sort of illness that (...) has its own phenomenal positivity. Even Schelling's philosophical investigation of the nature of Evil, however, doesn't seem to provide a solid ground for a non-privative and non-normative approach to pathological phenomena. Only when Schelling's treatise on human freedom is de-contextualized and radicalized in a way suggested, for instance, by Deleuze in his Difference and Repetition, does it seem possible to elucidate pathological, and especially psychopathological phenomena, as they show themselves from themselves, and not from the perspective given by the normative ideal of health. (shrink)

In conjunction with the growing feminist literature on pregnancy and visualization, this paper uses Foucault’s The Birth of the Clinic to demonstrate how the effort to make the interior of the pregnant body visible in medical discourse was a crucial part of the development of the modern medical gaze. In doing so I develop two concurrent arguments. First, I argue that the pathological corpse of the Clinic can conceptually serve as a double for the pregnant body as it emerged in (...) modern medicine in the 20th century. At the same time I use the insights of the Clinic to illustrate changes in pregnancy from early modernity to the 20th century. In early modernity, the pregnant body was understood in terms of generation, as a tree that bears fruit; by the 19th century, the pregnant body was a machine that reproduced the species. This transition can be seen in the overlap of pathology and pregnancy in early modernity, an overlap that continued throughout the 19 century and is inadvertently reinforced through the practice of ultrasound. (shrink)

Cognitive neuropsychiatry attempts to understand psychiatric disorders as disturbances to the normal function of human cognitive organisation, and it attempts to link this functional framework to relevant brain structures and their pathology. This recent scientific discipline is the natural extension of cognitive neuroscience into the domain of psychiatry. We present two examples of recent research in cognitive neuropsychiatry: delusions of control in schizophrenia, and affective disorders. The examples demonstrate how the cognitive approach is a fruitful and necessary supplement to (...) the otherwise successful biological psychiatry paradigm, which tend to bypass the cognitive level. Philosophy concerns some of the core concepts involved in psychiatric illness, particularly concerning rationality, thought and action, reality testing, and the self. We present concrete examples that illustrate how philosophical conceptual tools can be particularly important for the construction and interpretation of the cognitive models relevant to the understanding of psychiatric illness. We conclude that cognitive neuropsychiatry is a fruitful and necessary supplement to biological psychiatry. Furthermore, cognitive neuropsychiatry itself may benefit significantly from employing philosophical conceptual tools in the interpretation and construction of its cognitive models. The cognitive and philosophical approaches may thus be further steps towards a scientific psychopathology. (shrink)

Alexander Raven Thomson was a British fascist philosopher, active from 1932 to 1955. I outline Thomson’s Spenglerian views on civilization and decline. I argue that Thomson in his first book is an orthodox Spenglerian who accepts that decline is inevitable and thinks that it is morally required to destroy civilization in its final stages. I argue that this suffers from conceptual issues which may have caused Thomson’s change to a revised form of Spenglerianism, which is more authentically fascist. This (...) authentically fascist view is then seen to fall prey into the problem inherent in the very idea of permanent rebirth. (shrink)

This present book explores recent advances in modeling discourse processes, in particular, new approaches aimed at understanding pathological language behavior specific to schizophrenia. The contributors examine the modeling paradigm of formal semantics, which falls within the scope of both linguistics and logic while providing overlapping links with other fields such as philosophy of language and cognitive psychology. This book is based on results presented during the series of workshops on Coherence and Discourse organized by SLAM, a project developed to systemize (...) the study of pathological language processing by taking an overarching interdisciplinary approach combining psychology, linguistics, computer science and philosophy. The principle focus is on conversations produced by people with psychiatric disorders such as schizophrenia and autism. The contributions come from young and experienced researchers, and invited speakers. The book appeals to likeminded students and researchers. (shrink)

Understanding Eating Disorders is an original contribution to the field of healthcare ethics. It develops a new theory concerning the moral basis of eating disorders, and places such disorders for the first time at the centre of philosophical discourse. The book explores the relationship that people have with food and their own body by looking at genetics and neuro-physiology, sociology and family studies, clinical psychology and psychiatry, and frames abnormal eating at the extreme of a spectrum of normal behaviours, directed (...) by moral values. Giordano argues that abnormal eating is not a psycho-pathological phenomenon, but the coherent implementation of ordinary moral values with a long tradition in Western culture. The book also contains a detailed analysis of UK legislation, accompanied by a timely critique of the law on treatment of mental disorders in general and of eating disorders in particular. (shrink)

Anchoring his schema in the belief that nonorganic disorders are disturbances in _adaptation_ explicable within a depth-psychological framework, Gedo posits two broad categories of functional disorder: "apraxias" that represent any failure to learn adaptively essential skills, and disorders of what her terms "obligatory repetition." Within both categories of disorder, Gedo avers, the vicissitudes of mental functioning are understandable in terms of regression to relatively archaic modes of function and the reversal of regression and return to expectable modes of adult function. (...) It follwos from Gedo's understanding of how and why the mind becomes disordered, that diagnosis utilizing psychoanalytic principles can only be based on the succession of transference constellations encountered in treatment, since these constellations invariably pinpoint the developmental impasses in which maladaptive repetitive patterns and the failure to learn basic psychological skills are rooted. For purposes of understanding a variety of apraxic and repetitive disorders, Gedo equates such basic skills not only with the three major psychobiological attainments he has invoked in the past, but with the development of adequate perception, cognition, affectivity, and communication skills. Beautifullu organized, lucidly written, and richly illustrated with case vignettes, _The Mind in Disorder_ is not only the thoughtful yield of an outstanding clinician's three decades of experience. It is also the first psychoanalytic book since Otto Fenichel's masterwork of 1945, _The Psychoanalytic Theory of Neurosis_, to take the issue of how we conceptualize psychopathology as its central focus. (shrink)

The article conceptualizes the term Pedagogy of Fear as the master narrative of educational systems around the world. Pedagogy of Fear stunts the active and vital educational growth of the young person, making him/her passive and dependent upon external disciplinary sources. It is motivated by fear that prevents young students—as well as teachers—from dealing with the great existential questions that relate to the essence of human beings. One of the techniques of the Pedagogy of Fear is the internalization of the (...) view that without evaluation and assessment we cannot know a child’s level or “worth”—and therefore are unable to help him/her if he is “slow in learning.” In contrast, Philosophy for/with Children offers a space for addressing existential questions, some of which deal with urgent social issues. The willingness to make philosophy inquiry an alternative already from an early age seeks to allow the child to challenge him/herself with new and fresh questions. Philosophy for/with Children does not regard children as a “space of lack” (experience, knowledge, values, etc.) The new and fresh philosophical perspective of children demands the presence of a willingness to engage in dialogue and rejection of the fear of the innocent and deep questions of philosophy. Shaking free of the Pedagogy of Fear and restoring honor to children’s questions demands a fundamental conceptual change within education. The replacement of existential certainty as it is depicted by adults in the existing education system with an existential question is a heavy intellectual task that in most cases is viewed as subversive—primarily on the part of the adult. It demands a return to starting points and a willingness to allow children a free and safe educational space in which to ground preliminary and fertile questions about themselves, their lives, their environment, and, most of all, the changing world they discover with the form of originality that is right for them. (shrink)

According to Bowden (20121), anorectics’2 bodily experiences are characterized by a “corporealization,” which has notably been described as follows: “The exchange with the environment is inhibited, excretions cease; processes of . . . shrinking, and drying up prevail” (Fuchs 2005, 99). What is described here is melancholia, but a similar characterization would be applicable to anorexia. I think, however, that the notion of ‘corporealization’ is not fine-grained enough to capture the specificity of anorexic/pathological bodily experiences. To develop this point, I (...) here propose to apply some of Heidegger’s key notions to the conceptualization of bodily experience (Caron 2008). As currently defined, the .. (shrink)

The Alternative Model of Personality Disorders integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying (...) therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films. Interpersonal behaviors as well as alliance ruptures were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria ’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session. (shrink)

Ten new graduate speech pathologists recounted their experiences in managing workplace ethical dilemmas in semi-structured interviews. Their stories were analysed for elements that described the nature and management of the ethical dilemmas. Ethical reasoning themes were generated to reflect the participants’ approaches to managing these dilemmas. Finally, a conceptual model, the Dynamic Model of Ethical Reasoning, was developed. This model incorporates the elements of awareness, independent problem solving, supported problem solving, and decision and outcome evaluation. Features of the model (...) demonstrate the complexity of ethical reasoning and the challenges that new graduates encounter when managing ethical dilemmas. The results have implications for preparing new graduates to manage ethical dilemmas in the workplace. (shrink)

Weberís sociology of inner-worldly mysticism, Almaasí recent synthesis of transpersonal and psychoanalytic object relations theory, and Jungís related metaphorical psychology of alchemy, are brought to bear on the development of Heideggerís evocations of the felt sense of Being between 1927 and 1946, understood as the noetic core of spirituality. In particular, Heideggerís assumption of the Nazi rectorship at Freiburg in 1933ñ34 is seen as a specifically spiritual crisis based on the "metapathological" grandiosity that can result from the miscarriage of self (...) realization in inner-worldly mysticism. In Heideggerís case, as in much contemporary spirituality, this crisis was intensified by pre-existent narcissistic vulnerabilities of character. Heideggerís later writings are considered as expressions of a more genuine spiritual or essential realization, which, while invaluable as a conceptual framework for transpersonal psychology, nonetheless stops short of a balanced personal integration. This analysis constitutes a specific example of how the combination of transpersonal psychology and psychodynamics can be used to understand the emotional conflicts stirred up by transpersonal realization and the resultant potential for distortion in modern spiritual development, as presented by Hunt. (shrink)

Staging and stratification are two diagnostic approaches that have introduced a more dynamic outlook on the development of diseases, thus participating in blurring the line between the normal and the pathological. First, diagnostic staging, aiming to capture how diseases evolve in time and/or space through identifiable and gradually more severe stages, may be said to lean on an underlying assumption of “temporal determinism”. Stratification, on the other hand, allows for the identification of various prognostic or predictive subgroups based on specific (...) markers, relying on a more “mechanistic” or “statistical” form of determinism. There are two medical fields in which these developments have played a significant role and have given rise to sometimes profound nosological transformations: oncology and psychiatry. Drawing on examples from these two fields, this paper aims to provide much needed conceptual clarifications on both staging and stratification in order to outline how several epistemological and ethical issues may, in turn, arise. We argue that diagnostic staging ought to be detached from the assumption of temporal determinism, though it should still play an essential role in adapting interventions to stage. In doing so, it would help counterbalance stratification’s own epistemological and ethical shortcomings. In this sense, the reflections and propositions developed in psychiatry can offer invaluable insights regarding how adopting a more transdiagnostic and cross-cutting perspective on temporality and disease dynamics may help combine both staging and stratification in clinical practice. (shrink)

Although clinicians and researchers working in the field of autism are generally not concerned with philosophical categories of kinds, a model for understanding the nature of autism is important for guiding research and clinical practice. Contemporary research in the field of autism is guided by the depiction of autism as a scientific object that can be identified with systematic neuroscientific investigation. This image of autism is compatible with a permissive account of natural kinds: the mechanistic property cluster (MPC) account of (...) natural kinds, recently proposed as the model for understanding psychiatric disorders. Despite the heterogeneity, multicausality and fuzzy boundaries that complicate autism research, a permissive account of natural kinds (MPC kinds) provides prescriptive guidance for the investigation of objective causal mechanisms that should inform nosologists in their attempt to carve autism’s boundaries at its natural joints. However, this essay will argue that a mechanistic model of autism is limited since it disregards the way in which autism relates to ideas about what kind of behavior is abnormal. As historical studies and definitions of autism show, normative issues concerning disability, impairment and societal needs have been and still are inextricably linked to how we recognize and understand autism. The current search for autism’s unity in neurobiological mechanisms ignores the values, social norms and various perspectives on mental pathology that play a significant role in 'the thing called autism’. Autism research needs to engage with these issues in order to achieve more success in the effort to become clinically valuable. (shrink)

Alterations in consciousness are among the most common transdiagnostic psychopathological symptoms. Therefore clinical practice would benefit from a clear conceptual framework that guides the recognition, comprehension, and treatment of consciousness disorders. However, contemporary psychopathology lacks such a framework. We describe how pathology of consciousness is currently being addressed in clinical psychology and psychiatry so far, and how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases, Tenth Edition (ICD-10) refer to this (...) subject. A brief review of the literature on consciousness is then given. After describing psychological perspectives on consciousness and discussing theoretical issues involved in exploring consciousness, we offer a practical clinical working definition of consciousness and we illustrate its connections with a variety of diagnoses. Making use of Jean-Paul Sartre’s distinctions among: states, functions, qualities, and structure, provide a conceptual framework to understand consciousness, to refine diagnostics and to guide the development of therapeutic possibilities in clinical practice. (shrink)

Critics have often misunderstood the higher-order theory (HOT) of consciousness. Here we clarify its position on several issues, and distinguish it from other views such as the global The higher-order theory (HOT) of consciousness has often been misunderstood by critics. Here we clarify its position on several issues, and distinguish it from other views such as the global workspace theory (GWT) and early sensory models (e.g. first-order local recurrency theories). For example, HOT has been criticized for over-intellectualizing consciousness. We show (...) that while higher-order states are cognitively assembled, the requirements are actually considerably less than often presumed. In this sense HOT may be viewed as an intermediate position between GWT and early sensory views. Also, we clarify that most proponents of HOT do not stipulate consciousness as equivalent to metacognition or confidence. Further, compared to other existing theories, HOT can arguably account better for complex everyday experiences, such as of emotions and episodic memories. This makes HOT particularly useful as a framework for conceptualizing pathological mental states. (shrink)

In his account of critical theory as diagnosing social pathologies of reason, Axel Honneth has rehabilitated the analogy between critical theory and psychoanalysis – according to which the critical theorist stands in relation to the pathological social order as the analyst stands in relation to the analysand, and the aim of critical theory is to effect the diagnosis and, ultimately, the cure of social disorders or pathologies. In this article, I show that Honneth, like Habermas before him, has an overly (...) rationalistic understanding of how psychoanalysis works and crucially downplays the role of affect in the therapeutic process of working through. Looking to Freud’s papers on analytic technique, I show that psychoanalysis works first and foremost not through rational insight, but rather through the dynamic reworking of affect. I then discuss some of the implications of this for Habermas and Honneth’s conceptualization of critical theory. (shrink)

Recent trends in psychiatry involve a transition from categorical to dimensional frameworks, in which the boundary between health and pathology is understood as a difference in degree rather than as a difference in kind. A major tenet of dimensional approaches is that no qualitative distinction can be made between health and pathology. As a consequence, these approaches tend to characterize such a threshold as pragmatic or conventional in nature. However, dimensional approaches to psychopathology raise several epistemological and ontological (...) issues. First, we review major sources of evidence usually recruited in support of the dimensional trend (focusing on clinical observation and biological data), and we show that these are connected to different conceptualizations of how dimensional traits extend across health and pathology. Second, we criticize two unquestioned assumptions that stand at the core of the dimensional trend: a) that there is continuity from health to pathology at the symptomatic level; b) that such continuity reflects an underlying continuity in the genetic liability for pathological conditions. Third, we argue against the idea of a conventional threshold by showing that such a view implies a linear relationship between the genotype and the phenotype. Fourth, drawing on epigenetics and developmental biology, we offer a characterization of mental disorders as stable and dynamic constellations of multi-level variables that differ qualitatively from ‘healthy states’. We conclude by showing that our account has several theoretical advantages over both categorical and dimensional approaches. Notably, it provides crucial insights into psychological development over time and individual differences, with major implications in terms of intervention and clinical decision-making. (shrink)

This article conceptually investigates a type of gender murder, “romantic femicide.” I understand this as the extreme form of violence that occurs as a result of men's incapacity to cope with their partners’ autonomy and power. The incapacity is not merely an individual pathology but is rather rooted in the dynamic of recognition characterizing love under structural conditions of gender dichotomy. After having sketched out the current discussion about femicide and its shortcomings, I argue for the hypothesis in three (...) steps. First, I draw on a feminist theory of recognition in order to outline a nonviolent form of love. Lovers of this sort would depend on their partners and, at the same time, try to affirm their independence of them. Second, I show how such an interdependence bond would entail a dynamic of mutual empowerment. Third, I argue that love becomes a relation of domination as result of gender dichotomy. The dichotomization of two gender identities, “man” and “woman,” splits the interdependence bond in a way that allows only man's unilateral exercise of power and makes mutual empowerment impossible. Violence might be required for maintaining the dynamic of dominance; finally, romantic femicide may result from the unsustainability of such a structure. (shrink)

Philosophical debates about the concept of disease, particularly of mental disease, might benefit from reconsideration and a closer look at the established terminology and conceptual structure of contemporary medical pathology and clinical nosology. The concepts and principles of medicine differ, to a considerable extent, from the ideas and notions of philosophical theories of disease. In medical theory, the concepts of disease entity and pathologicity are, besides the concept of disease itself, of fundamental importance, and they are essentially connected (...) to the concepts cause of disease or etiological factor, natural course or natural history of disease, and pathological disposition. It is the concept of disease entity that is of key importance for understanding medical pathology and theory of disease. Its central role is shown by a short reconstruction of its main features and its intrinsic connection to the concept of pathologicity. The meaning of pathologicity is elucidated by explicating the underlying criteria. (shrink)

In the 1940s, Georges Canguilhem has established the concept of biological normativity on the level of the organism in his key work on “ The Normal and the Pathological ”. We would like to present a contemporary analysis of Canguilhem’s work, set it in context with more recent results from the field of complexity and immunology, and evaluate the problematic whether normativity is a genuine capacity of the organism. Based on Canguilhem’s conditions of the definition of biological normativity, we show (...) that the immune system as one of the complex systems of the living equally shares the capacity to be normative. We will then conclude that normativity can also be conceptually independently displayed on the level of complex systems of the living. (shrink)

There is a conceptual crisis in the biomedical sciences that is particularly salient in psychopathology research. Underlying the crisis is a controversy that pertains to the current medical model of disease that largely draws from causal-mechanistic explanations. The bedrock of this model is the analysis of biological part-dysfunctions that aims at unequivocally defining a pathological condition and demarcating it from its neighboring entities. This endeavor has led to a quest for physiological, biochemical, and genetic signatures. Yet, so far there (...) is little evidence for reliable biomarkers for any mental disorder. The contemporary biomedical paradigm largely ignores historical, dynamic, and system-level aspects—a view that has contributed much to the conceptual disjunction of the patient as a person from his/her disease. Notwithstanding the impressive progress in the biomedical sciences, increasingly more critics question whether the constituting framework is sufficient to convey a comprehensive understanding of illnesses, especially mental illnesses. Thus, the medical model urgently requires an update. But rather than revamping it by methodological advancements, it will be necessary to critically review its philosophical roots. The most problematic issues that require reworking are: the preponderance of the biostatistical theory; the undue decoupling of physiological from evolutionary explanations of function; the clinging to the Modern Synthesis ; and the neglect of dynamic and system-level properties. The proposed overhaul requires the heeding of historical explanations that draw from the Extended Evolutionary Synthesis as well as systems biology approaches for tackling multilevel and dynamic phenomena of complex systems. (shrink)

Are conspiracy theory beliefs pathological? That depends on what is meant by "pathological." This paper begins by unpacking that ill-defined and value-laden term before making the case that widespread conspiracy theory belief should not be conceptualized through the “othering’ perspective of individual psychopathology. In doing so, it adopts a phenomenological perspective to argue that conspiracy theory beliefs can be reliably distinguished from paranoid delusions based on falsity, belief conviction, idiosyncrasy, and self-referentiality. A socio-epistemic model is then presented that characterizes the (...) broader phenomenon of conspiracy theory belief as a product of a sick society plagued by epistemic mistrust and vulnerability to misinformation that is ubiquitous in today’s post-truth world. Finally, it is proposed that for individuals, the harmfulness of conspiracy theory belief is less related to belief content as it is to belief conviction and degree of self-relevant consequentiality. Staging conspiracy theory belief in terms of ideological commitment offers a conceptual framework to estimate behavioral risks and test hypotheses about the effectiveness of interventions along a continuum of belief conviction and associated socio-epistemic dynamics. Interventions should target not only individuals, but the dysfunctional social conditions that give rise to the pervasive and enduring phenomenon of conspiracy theory belief. (shrink)

The disease debate in philosophy of medicine has traditionally been billed as a debate over the correct conceptual analysis of the term “disease.” This paper argues that although the debate’s participants overwhelmingly claim to be in the business of conceptual analysis, they do not tend to argue as if this is the case. In particular, they often show a puzzling disregard for key parameters such as precise terminology, linguistic community, and actual usage. This prima facie strange feature of (...) the debate points to an interesting and potentially instructive hypothesis: the disease debate makes little sense within the paradigm of conceptual analysis but makes good sense on the assumption that pathology is a real kind. (shrink)

This article conceptually investigates a type of gender murder, “romantic femicide.” I understand this as the extreme form of violence that occurs as a result of men's incapacity to cope with their partners’ autonomy and power. The incapacity is not merely an individual pathology but is rather rooted in the dynamic of recognition characterizing love under structural conditions of gender dichotomy. After having sketched out the current discussion about femicide and its shortcomings, I argue for the hypothesis in three (...) steps. First, I draw on a feminist theory of recognition in order to outline a nonviolent form of love. Lovers of this sort would depend on their partners and, at the same time, try to affirm their independence of them. Second, I show how such an interdependence bond would entail a dynamic of mutual empowerment. Third, I argue that love becomes a relation of domination as result of gender dichotomy. The dichotomization of two gender identities, “man” and “woman,” splits the interdependence bond in a way that allows only man's unilateral exercise of power and makes mutual empowerment impossible. Violence might be required for maintaining the dynamic of dominance; finally, romantic femicide may result from the unsustainability of such a structure. (shrink)