The work of Gregory Bateson offers a metaphysical basis for a “process psychology,” that is, a view of psychological practice and research guided by an ontology of becoming—identifying change, difference, and relationship as the basic elements of a foundational metaphysics. This article explores the relevance of Bateson's recursive epistemology, his re-conception of the Great Chain of Being, a first-principles approach to defining the nature of mind, and understandings of interaction and difference, pattern and symmetry, interpretation and context. Bateson's philosophical contributions (...) will be drawn into relationship with Wittgenstein's philosophy of language as use, Melnyk's theory of causal levels of explanation, Korzybski's account of map and territory, the rejection of the heuristic rigidity of substantialist ontologies, and a cybernetics communication science-informed approach to contextual bi-directionality of causality. We thereby arrive at an understanding of Bateson's process psychology that, given its ecological-systemic nature, is explanatorily applicable across the mind sciences. This process psychology equips us to answer the question: What is mind? Not by explanatory appeal to substantial entities contained within mind, but instead by recourse to the contextually relevant patterns for understanding mind to a particular purpose. We have thereby attended to the gulf between heuristics and fundamentals, between psychological models and an onto-epistemic account of reality. Insufficient attention has been given to characterising the vital nature of Bateson's philosophical oeuvre to psychological practice. This article draws out Bateson's relevance to establishing foundational principles for a process psychology capable of reinvigorating psychological thought. (shrink)

Nonliteral uses of mental illness terms abound. Common examples include criticizing a person’s mood swings by saying “you’re bipolar”, hyperbolically exclaiming that a particularly difficult college exam “gave me PTSD”, or responding to a compliment about the cleanliness of one’s home by saying “I just have OCD.” There has been some pushback in recent years, both socially and within the philosophical literature, against using mental illness terms nonliterally to imply something negative about the subject. The focus so far has been (...) on the pejorative nature of the utterances. Nonliteral uses which imply something positive about the subject have all but gone ignored. One might think that these positive uses are innocent, perhaps even helpful in combatting stigma. On the contrary, as I argue in this paper, all nonliteral uses of mental illness terms are harmful, and they are harmful for the same reason. I argue that they contribute to what I call hermeneutic hijacking. Hermeneutic hijacking occurs when a term’s literal meaning is eclipsed by a nonliteral usage in a way that prevents the original term from functioning as it should. Though people have recognized the harm of pejoration, they have overlooked the way that nonliteral uses of mental illness terms, even absent pejoration, cause hermeneutic injustice. (shrink)

I introduce the concept pathophobia, to capture the range of morally objectionable forms of treatment to which somatically ill persons are subjected. After distinguishing this concept from sanism and ableism, I argue that the moral wrongs of pathophobia are best analysed using a framework of vice ethics. To that end I describe five clusters of pathophobic vices and failings, illustrating each with examples from three influential illness narratives.

This chapter lays the groundwork for a novel objectivist theory of ill-being, by exploring what harmonism, a theory of well-being, can and should say about ill-being. As the constituent principles of harmonism bear resemblance to (aspects of) other theories of well-being, these discussions should be of broad interest to well-being theorists. According to harmonism, human well-being is constituted by harmony between mind and world. Harmonism is a pluralist objectivist theory of well-being and it recognizes three aspects of harmony: non-accidental correspondence, (...) positive orientation, and appropriate response. The theory posits three independent axiological principles each capturing one of these aspects. The primary goal of this chapter is to develop a menu of options for extending each of these axiological principles to cover ill-being. Even without making definitive recommendations about which of these options harmonism should incorporate, we are able to show that the view is better positioned to be extended from well-being to ill-being than some prominent rival theories. (shrink)

Hegel reads the poet Novalis as an expression of terminal irony, a pathological case of Gemüt, where the conscious mind is alienated from reality and turns its negativity inwards on the contents of its own natural soul. The condition of self-feeling, presented in Hegel’s “Anthropology”, is a self-consumption that manifests itself somatically in the physical disease (consumption) from which Novalis dies. The poet’s literary production represents a pathological fixation that impedes the dynamic organicity of Hegelian Science. As such, Novalis’s mental (...) illness and death constitute an expression of romantic irony and an ongoing threat to Hegel’s philosophy. (shrink)

Exemption from blameworthiness is often bound to implicit or explicit claims of diminished agency, or even non-agency. This poses a dilemma in navigating moral relationships affected by mental illness. While it is crucial for assessments of responsibility to be responsive to the significance of mental illness, must this responsiveness come at a cost to symmetrical moral relations? In this paper we argue, contra recent critiques, that Strawsonian accounts of responsibility are able to navigate this dilemma, and can accommodate significant exculpation (...) on the basis of mental illness while maintaining symmetrical relations. We understand this to be part of the larger recognition that while we have certain fundamental entitlements within our moral relationships, it is also possible to be over-entitled, and to expect too much of others. Our account draws, in particular, on the moral significance of difficulty. Difficulty is inherently scalar, and in drawing on this explanatory framework we explicate a theory of both excuse and exemption by degree. We argue for a significant realm of excuse on the basis of mental illness that is fully compatible with symmetrical relations. However, we also acknowledge the limits of this accommodation on Strawsonian grounds, and argue that these limits are justified and appropriate. (shrink)

In this short piece I discuss how thinking about medical care and gestation as intimate can give us new insights into experiences of illness and the wrongness of gestation mandates.

This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We claim that these stereotypes (...) and structural features render ill persons especially vulnerable to these two types of epistemic injustice. We end by proposing five avenues for further work on epistemic injustice in healthcare. (shrink)

This conversational opinion article between two parties – Kate, a disability performance scholar and Sarah, an interdisciplinary artist-scholar with lived experience of disability – considers the dancing body as redeemer in the specific case of a dancer experiencing ‘chemo fog’, or Chemotherapy-Related Cognitive Impairment (CRCI) after undergoing oncological treatments for Hodgkin Lymphoma. This work draws on Pini’s own lived experience of illness (Pini & Pini, 2019) in dialogue with Maguire-Rosier’s study of dancers with hidden impairments (Gibson & Maguire-Rosier, 2020). In (...) an exploratory account based on an interview with one another, the authors ask: when our senses and perceptions of ourselves and the world we become are obfuscated, what is the nature of the new relationship between the performing self and its absent body/mind/world? How can we shape our narrative and articulate who we are, what we are doing or where we are going, if we are moving in the ‘fog’? Our discussion reveals how Pini’s dancing body elucidates healing, while recovering an agentic perspective in her experience of alienation and frustration tied to chemo fog and related impairments. With this work we offer an original perspective on how a dancing body can resist theoretical diagnosis. (shrink)

One bi-lingual - hungarian-ENGLISH - meditation and research about the Illness and the Living Being. Concentrated, of course, to the specific HUMAN reporting to them. The book investigates philosophically the issue of human illness and its organic pertinence to the meaning of human life starting from the recognition that the dangerous encounter with the experience of illness is an unavoidable – and as such crucial – experience of the life of any living being. As for us humans, there is probably (...) no mortal man who has never suffered of some – any! – kind of disease from his birth to the end of his life… Illness is therefore an experience or outright a danger of existence and its possibility, as well as a way of being that nobody has ever been and will ever be ontological or existentially exempted from. So, it may well be “arbitrary” or “accidental” which disease affects which being or person, when and to what degree, in what way, etc., but it is factually unavoidable that in the course of one’s entire life – from its very beginning to its very end – one would never fall ill in some respect. The paper discusses this issue by the ontological investigation of possibility. Together with the analyses about of the origins and history of the MEDICINE. -/- The english CONTENTS -/- Illness – A Possibility of the Living Being Prolegomena to the Philosophy of Human Illness ............................................. 127 -/- Excursus Sketchy considerations regarding the problems of Christian medicine and Christian healing ...................................................... 135 -/- A dialogue-attempt with Aristotle: Dynamis, energeia, entelecheia, and steresis ...................................................... 147 . (shrink)

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the self and that which (...) belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (shrink)

As a contribution to a wider discussion on moral discernment in theological anthropology, this paper seeks to answer the question “What is the impact of mental illness on an individual’s ability to make moral decisions?” Written from a clinical psychiatric perspective, it considers recent contributions from psychology, neuropsychology and imaging technology. It notes that the popular conception that mental illness necessarily robs an individual of moral responsibility is largely unfounded. Most people who suffer from mental health problems do not lose (...) the capacity to make moral decisions, and mental illness on its own rarely explains anti-social or criminal behaviour. Moreover, the assumptions of some scientists, that recent developments in neuropsychology and brain imaging suggest biological determinism, must be treated with caution. (shrink)

Many people report that reading first-person narratives of the experience of illness can be morally instructive or educative. But although they are ubiquitous and typically sincere, the precise nature of such educative experiences is puzzling—for those narratives typically lack the features that modern philosophers regard as constitutive of moral reason. I argue that such puzzlement should disappear, and the morally educative power of illness narratives explained, if one distinguishes two different styles of moral reason: an inferentialist style that generates the (...) puzzlement and an alternative exemplarist style that offers a compelling explanation of the morally educative power of pathographic literature. (shrink)

Among John Henry Newman’s contributions to epistemology, his notion of the “illative sense” may be both the most significant and yet the least understood. In this chapter, we seek to rectify this problem. First, we carefully lay out Newman’s notion of the illative sense. Second, we discuss and evaluate three ways in which the illative sense might be understood in light of contemporary epistemology and psychology. Third, we create a model that attempts to fill out Newman’s sketch of the illative (...) sense. We close by answering two prominent objections to the illative sense in light of our model. If we are correct, the illative sense was not only an important innovation in epistemology in the nineteenth century but is also a defensible notion today. (shrink)

An essay review of Havi Carel, 'Phenomenology of Illness' (OUP 2015).

In an era of dramatic technological progress, the consequent economic transformations, and an increasing need for an adaptable workforce, the importance of education has risen to the forefront of the social discourse. The concurrent increase in the awareness of issues pertaining to social justice and the debate over what this justice entails and how it ought to be effected, feed into the education policy more than ever before. From the nexus of the aforementioned considerations, a concern over the so-called education (...) gap has emerged, with worldwide efforts to close it. I analyse the premises behind such efforts and demonstrate that they are founded upon fundamentally flawed ideas. I show that in a society in which education is delivered equitably, education gaps emerge naturally as a consequence of differentiation due to talents, the tendency for matched mate selection, and the heritability of intellectual traits. Hence, I issue a call for a refocusing of efforts from the ill-founded idea of closing the education gap, to the understanding of the magnitude of its unfair contributions, as well as to those social aspects which can modulate it in accordance to what a society deems fair according to its values. (shrink)

In her book, Illness as Metaphor, Susan Sontag focuses on metaphors and myths on diseases such as cancer and tuberculosis, which occur in different historical periods. Sontag argues that the metaphors produced related to illness overhaul illness and the things that define illness now have become metaphors produced related to them rather than their concrete and physical aspects. Illness becomes not just an illness, but a phenomenon defined by evil, mystery, fear, evil, madness, passions, wealth and poverty, temporal loginess or (...) speed, and a set of metaphors or myths that are spatially identified with the space. Metaphors and myths turn into means of socially stigmatizing the illness itself rather than giving a meaning to illness. The disease literally turns into a situation that needs to be hidden in order to avoid social stigma. The explanation of mass diseases through metaphors and myths has been seen since ancient times and this understanding of mass diseases continues to exist today. As a matter of fact, the Covid-19 pandemic has also ceased to be the subject of only medical science since it first emerged, and it has turned into an issue that concerns many areas from politics to economics, from sociology to psychology. The metaphors generated on the Covid-19 disease, which we have witnessed its reflections in many areas from the discourses of daily life to the discourse of politicians, from art to literature, have a similar function with the metaphors attributed to diseases like cancer and tuberculosis that Sontag discussed. Covid-19 is not only seen as a disease, but as a disease defined by a series of metaphors such as mysterious, evil, invisible enemy, insidious danger, and democratic virus. The metaphors generated on the disease cause the struggle against the disease itself to be explained with various metaphors. The metaphors derived from Covid-19 such as "invisible enemy" and "biological war" cause the struggle against it to be turned into a military terminology, and the metaphor of "Chinese virus" is a means of social stigmatization / marginalization by racializing the virus directly. This study tackles the issue of how Covid-19, which is the subject of medical science, has become the subject of unscientific myths and metaphors attributed to the disease, and that the disease is perceived through metaphors rather than itself in the context of Susan Sontag's thought. In the study, answers for the questions of what kind of effects appeared due to the stigmatizing power of metaphors derived from the Covid-19 and whether the metaphors are the outcomes of the strategy for coping with the pandemic will be sought. (shrink)

In some quarters within philosophy of medicine, more particularly in the phenomenological approaches, naturalism is looked upon with suspicion. This paper argues, first, that it is necessary to distinguish between two expressions of this attitude towards naturalism: phenomenological approaches to illness disagree with naturalism regarding various theoretical claims and they disapprove of naturalism on an ethical level. Second, this paper argues that both the disagreement with and the disapproval of naturalism are to a large extent confused. It then offers some (...) proposals to set up an agenda for future collaboration. (shrink)

Does having a mental disorder, in general, affect whether someone is morally responsible for an action? Many people seem to think so, holding that mental disorders nearly always mitigate responsibility. Against this Naïve view, we argue for a Nuanced account. The problem is not just that different theories of responsibility yield different verdicts about particular cases. Even when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced (...) approach is needed. (shrink)

This chapter has two aims. The first aim is to compare and contrast three different conceptual-explanatory models for thinking about mental illness with an eye towards identifying the assumptions upon which each model is based, and exploring the model’s advantages and limitations in clinical contexts. Major Depressive Disorder is used as an example to illustrate these points. The second aim is to address the question of what conceptual-theoretical framework for thinking about mental illness is most likely to facilitate the discovery (...) of causes and treatments of mental illness in research contexts. To this end, the National Institute of Mental Health’s Research Domain Criteria (RDoC) Project is briefly considered. (shrink)

Prof. Cohen and I answer six questions: (1) Why do we lock people up? (2) How can involuntary civil commitment be reconciled with people's constitutional right to liberty? (3) Why don't we treat homicide as a public health threat? (4) What is the difference between legal and medical approaches to mental illness? (5) Why is mental illness required for involuntary commitment? (6) Where are we in our efforts to understand the causes of mental illness?

Theory of illness causation is an important issue in all biomedical sciences, and solid etiological explanations are needed in order to develop therapeutic approaches in medicine and preventive interventions in public health. Until now, the literature about the theoretical underpinnings of illness causation research has been scarce and fragmented, and lacking a convenient summary. This interdisciplinary book provides a convenient and accessible distillation of the current status of research into this developing field, and adds a personal flavor to the discussion (...) by proposing the etiological stance as a comprehensive approach to identify modifiable causes of illness. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

Depression is a common and devastating instance of ill-being which deserves an account. Moreover, the ill-being of depression is impacted by digital technology: some uses of digital technology increase such ill-being while other uses of digital technology increase well-being. So a good account of ill-being would explicate the antecedents of depressive symptoms and their relief, digitally and otherwise. This paper borrows a causal network account of well-being and applies it to ill-being, particularly depression. Causal networks are found to provide a (...) principled, coherent, intuitively plausible, and empirically adequate account of cases of depression in every-day and digital contexts. Causal network accounts of ill-being also offer philosophical, scientific, and practical utility. Insofar as other accounts of ill-being cannot offer these advantages, we should prefer causal network accounts of ill-being. (shrink)

Definying illness is not an easy process, nor from medical perspective nor from theological one or individual perspective. However, the most important and truely significant seems to be the latter; how the contemporary man defines illnesses and how he uses this process to redefine his true being. Nowadays we face an obvious spiritual crisis meant to urge each of us to start a new process of redefining our spiritual identity. This paper is intented to remind us of the essence of (...) our being on the one hand and of the Christian duty to fight against illness on the other hand, to bear permanently with us the model of Jesus, of the Holly Parents, who were subject to deseases also out of reasons that are related to God’s iconomy. The limits of medicine are visible there where miracles start to reveal themselves and the healing of the body symbolizes and announces the healing of the entire Being. (shrink)

According to subjectivism about ill-being, the token states of affairs that are basically bad for you must be suitably connected, under the proper conditions, to your negative attitudes. This article explores the prospects for this family of theories and addresses some of its challenges. This article (i) shows that subjectivism about ill-being can be derived from a more general doctrine that requires a negatively valenced relationship between any welfare subject and the token states that are of basic harm to that (...) subject and (ii) responds to some objections, including the objection that subjectivists about ill-being cannot plausibly explain the badness of pain. (shrink)

In this chapter, I look at how deep self views assign responsibility and autonomy to individuals suffering from mental ill health. Deep self views say that an agent is only acting autonomously and responsible for their actions if these align with their deep self, if they endorse their desires and motivations. That kind of view of responsible agency seems particularly well suited to give a theoretical grounding to the everyday intuition that sometimes an action is better ascribed to the illness (...) than to the agent and that the agent is therefore not responsible. I show how deep self views differ from reasons responsiveness accounts of responsibility in who they count as responsible. I then discuss cases which deep self views are particularly well placed to deal with, where individuals are alienated from desires and motivations that arise from their mental health condition. Finally, I turn to cases deep self views struggle with, where desires that are symptomatic of the illness are endorsed by the individual but deeply harmful for them. I show that sometimes, these will have to be counted as autonomous desires that express the deep self but also suggest possible ways of avoiding this conclusion. (shrink)

Known as self-illness ambiguity, subjective confusion about whether patients or their mental illnesses are in control may partly stem from clinical methods mimicking medical models that diagnose illnesses (e.g. viruses) as present or not irrespective of sufferers’ life stories. Researchers accordingly propose narrative contextualization as a way of disambiguating self from illness. But what if heightened self-attention is symptomatic of mental illness? Wellbeing may then associate with a smaller ‘me’ versus ‘not-me’ divide, a position Csikszentmihalyi’s flow psychology and Dewey’s aesthetics (...) both support. What I call aesthetic flow involves embodied, non-linguistic dramatic structure, suggesting another way to view narrativity. By lessening self-preoccupation – and perhaps illness severity – this kind of narrativity may help dissolve self-illness ambiguity. However, a perplexity remains. Aesthetic flow depends on encountering resistance, including psychological obstacles. In life, as in art, this resistance delineates and individuates. Thus, aesthetic flow might lead to a temporary loss of self, followed by its reemergence in more immersively relational forms. A second complexity is that experiences of ‘self’ vary across time, cultures, and individuals – much like concepts of ‘justice’ or ‘love.’ This fluidity makes broad generalizations about selfhood and illness problematic. My solution partly sidesteps this by downplaying the importance of self. (shrink)

One of the main tasks for an account of the Christian doctrine of the atonement is to explain how and in what ways the salvifically relevant work of Christ heals the damage wrought by human sin on our souls, our relationships with one another, and our relationship with God. One kind of damage often neglected in philosophical treatments of the atonement, but discussed at some length in Eleonore Stump’s forthcoming At-one-ment, is what she, following St. Thomas Aquinas, calls the stain (...) on the soul. The stain on the soul comprises the “moral leftovers” of serious evil, damage to the soul that goes beyond the guilt, shame, and separation from God brought about by sin and that lingers in a person even after she has repented and been forgiven. In this paper, I critically examine Stump’s account of how the work of Christ deals with the problem of the stain on the soul. I offer reasons for thinking that if the stain is exactly as she describes it, then it is indelible; and then I explore possible ways forward for her account of the atonement. (shrink)

This article exposes some culturally contingent foundations of self-illness ambiguity, wherein psychiatric patients struggle to distinguish their authentic selves from their diagnosed conditions and to determine which is in control. In cultures where the self is experienced as fairly fluid and situational, with its causal force downplayed, "losing control" or "not knowing who one is" may carry less significance. Clinicians, however, may accentuate self-illness ambiguity by uncritically subsuming Western ideals of selfhood, such as aspirations toward independent individualism-perhaps contributing to the (...) pathologization of culturally unfamiliar temperaments. Cultural environments, in turn, may range from supportive to hostile depending on how specific self-construals are valued within them, selectively exacerbating distress, though psychiatric frameworks may misinterpret such outcomes as internal disorders. The article finishes by urging a reevaluation of mental illness models to better account for cultural variability in self-understandings. (shrink)

The starting point of our considerations is the two books published in 2010: "Ill Fare the Land" by late Tony Judt and "Not for Profit" by Martha Nussbaum. The authors of both books share the conviction that neoliberal changes in the world of global capitalism radically impoverish culture and their consequences may be dramatic and irreversible. In our paper we would like to emphasize the dangers to solidarity and social cohesion posed by neoliberal postulates. We also claim that promoting the (...) neoliberal ideology in the context of higher education and institutions of civic society endangers the very democracy understood as reasonable pluralism (in John Rawls' terminology), consisting in rationality, plurality of opinions, lifestyles, and conceptions of good, as well as consensus as the aim of social and political practices. (shrink)

While non-monogamous intimacies are becoming more prevalent in our present social landscape, they still face a range of injustices on social and political fronts. Politically, non-monogamists are excluded from certain rights or privileges that their monogamous counterparts hold, such as access to marriage. Socially, non- monogamists experience a kind of hermeneutical injustice where they are estranged from their own experiences with love and intimacy due to marginalization from the collective framework of understanding, to name a few. Demographically, the existing polyamorous (...) community in the U.S. resembles that of folks in monogamous relationships. Additionally, consensual non-monogamous (CNM) relationships are fairly common among Black populations. Yet, despite the growing and diverse demographic profile of consensual non-monogamy, many people still think that “Black folks just don’t do that,” as most portrayals of consensual non-monogamy frame it as something that is only prevalent among highly educated middle to upper- class whites. This article discusses portrayals of Black non-monogamous relationships in the media and underscores the importance of accurately representing consensual non-monogamy in Black media. While some recent media portrayals of non- monogamy have featured casts and characters who are racialized as Black, I argue that many of these portrayals often reinforce harmful negative stereotypes and fail to capture the diversity and validity of Black CNM relationships. (shrink)

Since 1900, debates about the justification of punishment have also been debates about the cause of crime. In the early twentieth century, the rehabilitative ideal of punishment viewed mental illness and dysfunction in individuals as the cause of crime. Starting in the 1970s, retributivism identified the immorality of human agents as the source of crime, which dovetailed well with the “tough-on-crime” political milieu of the 1980s and 1990s that produced mass incarceration. After surveying these historical trends, Wirts argues for a (...) social critical view that crime is best understood as a product of an unjust society, not faulty human beings. This view should take the lessons learned by the critiques of rehabilitation, however, and resist the tendency to reduce human beings to recipients of social services. (shrink)

Kant’s conception of mental illness is unlikely to satisfy contemporary readers. His classifications of mental illness are often fluid and ambiguous, and he seems to attribute to human beings at least some responsibility for preventing mental illness. In spite of these apparent disadvantages, I argue that Kant’s account of mental illness can be illuminating to his views about the normative dimensions of human cognition. In contrast to current understandings of mental illness, Kant’s account is what I refer to as “non-pathological.” (...) That is, most mental illnesses are for Kant continuous with normally functioning cognition. Someone with a healthy reason can easily fall into mental illness and someone with mental illness can (perhaps not as easily) re-establish healthy reason. By accepting a non-pathological definition of mental illness, it follows for Kant that humans have more agency and responsibility regarding their mental health than current views allow, which explains why several of his writings aim to prescribe a “diet of the mind” (2:271). Contrary to popular readings of Kant as a champion of reason’s power, Kant’s conception of mental illness shows that he recognizes how fragile human reason can be. (shrink)

The main aim of this paper is to illustrate human–nature relations from a comparative study of the contexts of later Merleau-Ponty and the Zhuangzi. I argue that the Zhuangzi has its own phenomenology of the natural world, which is worth comparing to Merleau-Pontian later phenomenology. To compare the arguments on human–nature relations in the contexts of later Merleau-Ponty and the Zhuangzi in detail, first, I briefly compare the cultural philosophies of nature in ancient Greece and China and their possible influences (...) on our contemporary understanding of nature. Second, I compare the concept of “flesh” of Merleau-Ponty with the concept of “vital energy” in the Zhuangzi and point out the main roles of these concepts in their respective theories of the natural world. Third, I use the “reversibility thesis” created by Merleau-Ponty to analyze the ontological significance of illness in the arguments of Merleau-Ponty and the Zhuangzi. Fourth, inspired by Merleau-Pontian and Zhuangzian ideas about language and expression, I expound on a view of illness as a primordial language of nature and its possible role in mediating human–nature relations. Ultimately, I conclude that the comparative study of thoughts on human–nature relations in the literatures of later Merleau-Ponty and the Zhuangzi can help us reconsider and readjust our main attitudes toward nature, illness and nonhuman beings in the contemporary postpandemic era. (shrink)

This paper surveys some philosophical issues with the language surrounding mental illness, but is especially focused on pejoratives relating to mental illness. I argue that though 'crazy' and similar mental illness-based epithets (MI-epithets) are not best understood as slurs, they do function to isolate, exclude, and marginalize members of the targeted group in ways similar to the harmfulness of slurs more generally. While they do not generally express the hate/contempt characteristic of weaponized uses of slurs, MI-epithets perpetuate epistemic injustice by (...) portraying sufferers of mental illness as deserving minimal credibility. After outlining the ways in which these epithets can cause harm, I examine available legal and social remedies, and suggest that the best path going forward is to pursue a reclamation project rather than aiming to censure the use of MI-epithets. (shrink)

This article considers attempts to include the issues of ageing and ill health in a Rawlsian framework. It first considers Norman Daniels’ Prudential Lifespan Account, which reduces intergenerational questions to issues of intrapersonal prudence from behind a Rawslian veil of ignorance. This approach faces several problems of idealisation, including those raised by Hugh Lazenby, because it must assume that everyone will live to the same age, undermining its status as a prudential calculation. I then assess Lazenby's account, which applies Rawls’ (...) general theory of justice more directly to healthcare. Lazenby suggests that we should apply Rawls’ difference principle – which claims that any inequalities in social goods must benefit the worst off – to conclude that we should significantly prioritise treatment of young patients. I argue first that the existence of young terminally ill patients undermines a number of Rawlsian arguments for the difference principle. I then argue that the structure of ageing undermines the Rawlsian decision mechanism of the ‘veil of ignorance’ on which Lazenby relies. I conclude that age and terminal illness present significant problems for any comprehensive Rawlsian account of justice. (shrink)

Since Shelly Kagan pointed out the relative neglect of ill-being in philosophical discussions, several philosophers have contributed to an emerging literature on its constituents. In doing so, they have explored possible asymmetries between the constituents of ill-being and the constituents of positive well-being. This paper explores some possible asymmetries that may arise elsewhere in the philosophy of ill-being. In particular, it considers whether there is an asymmetry between the contribution made to prudential value by equal quantities of goods and bads. (...) It then considers a similar question about the contributions made to moral value by equal quantities of ill-being and positive well-being. The paper explores some of the difficulties involved in assessing these questions. It ends by considering broader differences, both practical and theoretical, between the significance of ill-being and of positive well-being. (shrink)

The dictum from the Gospel of Thomas, “Bring forth what is within you, or it will destroy you,” captures a trans-historical insight into the relationship between the human subject and its inner life. Across mystical, philosophical, and psychoanalytic traditions, this principle underscores the consequences of repressing the inner self or vital energies: when what is within remains unacknowledged or alienated from both self and relational horizons, it manifests as disorder, compulsion, or disease. This paper examines the interplay between inner repression, (...) relational attunement, and psychiatric phenomena, with particular focus on obsessive–compulsive disorder (OCD), while extending the analysis to other mental health conditions. Drawing on Jungian individuation, Lacanian psychoanalysis, Heideggerian and Fichtean existential philosophy, Galenic humoral theory, and the Stoic concept of oikeiôsis, which emphasizes the natural attunement of the self to itself and the relational world, the essay argues that modern psychiatry, in privileging symptom suppression through pharmacological intervention, often risks addressing the surface manifestations of disorder while neglecting the underlying inner disharmony. By situating contemporary psychiatric practice within a broader historical and theoretical context, this study highlights the enduring relevance of integrative approaches that recognize the symbolic, existential, physiological, and relational dimensions of human illness. Ultimately, the paper advocates for a conception of mental health that honors the inner life as both a source of vitality and a locus of potential pathology, underscoring the necessity of “bringing forth” the inner self in the pursuit of authentic healing. (shrink)

There remains something pertinent and gripping about Susan Sontag’s critique of illness metaphors and her broader effort to work toward a more humane and dignified view of suffering. Yet her call to liberate culture – and in particular art – from metaphor can seem perplexing. Not only does such liberation appear difficult to achieve within a medium like art, which seems inescapably figurative, but Sontag expressly highlights the value of metaphors, regarding their estranging effect not as a risk but as (...) something from which societies might learn. Nor does Sontag express unqualified confidence in how the dis- passionate ethos of modern medicine might correct a metaphor-laden discourse, ap- proaching its scientized culture instead with a degree of skepticism. In exposing these tensions, I aim to show that Sontag is not naively seeking to free us from metaphor. Rather, she invites us to ask how figurative expression might offer something of value to public life. Her critique of metaphor leads us toward the further question of art’s role in society – an issue that has faded somewhat from contemporary political thinking. (shrink)

The illness immersion condition prevents patients from enjoying everything worth living life for. In any case, according to Frank, this condition could represent one of the most insightful experiences towards understanding the meaning of life. Using the metaphor of phoenix taken from May, Frank identified four kinds of embodiments through which the phoenix can reveal itself in a patient after an illness immersion experience: the phoenix that could ever be and the phoenix that might have been; the recurrent and cumulative (...) phoenix and the reluctant phoenix. Based on these considerations, a qualitative study was conducted in order to give voice to the different phoenix embodiments focusing on several autobiographies of patients afflicted with severe or terminal illness. The analysis highlights several similarities that the different phoenixes shared ; however, a deep difference emerged in their worldview which proves able to lead them towards different epiphanies. These evidences reveal that every sick person should be understood, stimulated and accompanied throughout his lived experience of illness by an expressly designed and dedicated care. (shrink)

This chapter investigates whether John Henry Newman's epistemology encourages the intellectual vice of dogmatism. Although Newman famously endorsed a "magisterial intolerance" regarding objections, I argue that his philosophical framework supports "committed settling" rather than vicious "permanent settling." By distinguishing Newman’s position from the "tentative settling" advocated by thinkers like Karl Popper and William Froude, I illustrate how Newman views assent as an unqualified commitment that remains revisable under specific conditions. Central to this defense is an expanded definition of the "illative (...) sense," which is presented as the faculty responsible not only for closing inquiry but also for discerning when "accumulating probabilities" require it to be reopened. Drawing on contemporary research regarding "epistemic resilience" (grit) and cognitive load, I argue that Newman’s approach avoids both the "unreal" demands of excessive skepticism and the pitfalls of closed-mindedness, offering a realistic account of how human beings virtuously manage belief. (shrink)

This study investigates the influence of evaluative judgments, specifically regarding an individual's moral character, on judgments of health and disease. Though it might seem that assessments judgments of health and disease should be impervious to evaluative judgments, two hypotheses suggest that health and disease judgments might be influenced by evaluative judgments: the "naturalization hypothesis" which centers on our inclination to assign blame, and the "pathologization hypothesis" rooted in the belief of a just world. These hypotheses lead to opposing predictions about (...) how someone with a perceived negative moral character might have their condition categorized. Employing a fictional vignette and the methodologies of experimental philosophy, our research provides evidence in favor of the "pathologization hypothesis." While this phenomenon likely carries real-world implications, especially in healthcare, it also has potential for offering insights into the dynamics of medicalization and stigma. (shrink)

Predictive processing theorists have claimed PTSD and depression are maladaptive and epistemically distorting because they entail undesirably wide gaps between top-down models and bottom-up information inflows. Without denying this is sometimes so, the “maladaptive” label carries questionable normative assumptions. For instance, trauma survivors facing significant risk of subsequent attacks may overestimate threats to circumvent further trauma, “bringing forth” concretely safer personal spaces, to use enactive terminology, ensuring the desired gap between predicted worries and outcomes. The violation of predictive processing can (...) go in the opposite direction too, as when depression coincides with energy-depletion, and hence objectively strenuous situations in which things look farther away because they are (accurately anticipated to be) harder to reach. These examples partly encapsulate what predictive processing theorists call “active inference,” yet with differences. In the first case, actions fruitfully obviate predictions rather than fulfilling them. In the second, mental models do not dysregulate bodily processes, making coping harder. Instead, problems (e.g., personal obstacles, gastric illness) deplete energy, eliciting a depressive and adaptive slow-down. Some predictive proponents apply correspondence criteria when alleging mismatches between internal models and the world, while incongruously asserting that the brain did not evolve to see things veridically, but to execute actions. An alternative is to adopt pluralistic, pragmatic epistemologies suited to the complexity of mind. The upshot is that mental outlooks can depart from the norm without epistemically being distorted and that mismatches between anticipatory worries and outcomes, when they actually exist, can be a measure of adaptive and epistemic success. (shrink)

In this paper I analyze a view that is increasingly spreading among philosophers and even physicians. Many of them believe that it is right to apply the principle of responsibility for illness in the allocation of health care. I attempt to show that this idea is unacceptable.

Embodied cognition and enactivism, as a philosophy and position in the cognitive sciences, represent the idea that the human experience is the kind of experience of a fundamentally embodied entity, and this embodiment manifests itself into consciousness through “common-sense” or “ready-at-hand” knowledge; It is in the way we interact and engage with the environment that this embodiment is experienced. But, It is only through psychopathology, or disturbances in typical engagement with the world, that this embodiment is brought into explicit awareness. (...) Phenomenology, with famous examples like Heidegger’s “Carpenter and his Hammer (Heidegger, 1967, p. 69),” or Merleau-Ponty’s “The Hand touching Itself (Merleau-Ponty, 2012, p. 106).”, illustrate that embodiment is our primary mode of being. This can be understood as embodied engagement, where cognition relies on experiences derived from having a body equipped with various sensorimotor capacities. These sensorimotor capacities exist within a broader ecological, historical, social, cultural, biological, and psychological context, known as the phenomenological life world, or being-in-the-world. Consequently, engagement implies that sensory and motor processes, perception, and action are fundamentally inseparable in lived cognition. Contrasting with the old Cartesian view, where perception is viewed as an information processing task aimed at recovering the pre-given properties of the world, the perspective here is that perception is about how the perceiver can navigate and act within their immediate environment. These local situations are in a state of constant flux due to the perceiver's activities. Therefore, the reference point for understanding perception shifts from a pre-given, perceiver-independent world to the sensorimotor structure of the perceiver. This structure, defined by how the perceiver is embodied, rather than an independent world, determines how the perceiver can act and be influenced by environmental events. A problem arises when we realize the fact, that we come into being within a world that precedes us, as Heidegger says: we are “thrown” into the world, gradually becoming aware of its presence (Heidegger, 1967, p. 135.). As we age and experience life, we start contemplating its nature. The world isn't a product of our making, but rather a revelation awaiting our discovery. However, it's this very world that enables us to engage in reflection. Thus, a cycle ensues: the world precedes our contemplation, yet it intertwines inseparably with our experience. (shrink)

This paper proposes a unified theory that reinterprets the basic structures of life—birth, aging, illness, death, and suffering—in terms of the dissipative directionality of the universe. I call this framework “thermodynamic ontology.” Its central claim is that the emergence of life (birth), the gradual decline of counter-flow capacity (aging), local breakdowns (illness), the cessation of counter-flow (death), and the suffering that pervades all these phases can all be structurally explained within a single framework: the dynamics of local counter-flow structures in (...) a dissipative universe. The universe as a whole follows the second law of thermodynamics and tends toward high-entropy states. Living beings, however, must maintain low-entropy states in order to preserve internal order. In this sense, life is positioned as a local “counter-flow” against the natural dissipative direction of the universe. I argue that the physical and informational load that unavoidably accompanies the maintenance of this counter-flow is what is subjectively experienced as suffering. Furthermore, I reinterpret the classical Buddhist thesis that “birth, aging, illness, and death are suffering,” as well as Schopenhauer’s notion of the “will to live,” as the subjective aspect of a physical process in which counter-flow structures arise, lose capacity, partially collapse, and finally return to dissipation within a dissipative universe. In doing so, the paper attempts to build a bridge between metaphysical concepts and the scientific image of the world. (shrink)

Background: Despite the at least decades long record of philosophical recognition and interest, the intricacy of the deceptively familiar appearing concepts of ‘disease’, ‘disorder’, ‘disability’, etc., has only recently begun showing itself with clarity in the popular discourse wherein its newly emerging prominence stems from the liberties and restrictions contingent upon it. Whether a person is deemed to be afflicted by a disease or a disorder governs their ability to access health care, be it free at the point of use (...) or provided by an insurer; it also influences the treatment of individuals by the judicial system and employers; it even affects one’s own perception of self. -/- Aims: All existing philosophical definitions of disease struggle with coherency, causing much confusion and strife, and leading to inconsistencies in real-world practice. Hence, there is a real need for an alternative. -/- Materials & Methods: In the present article I analyse the variety of contemporary views of disease, showing them all to be inadequate and lacking in firm philosophical foundations, and failing to meet the desideratum of patient driven care. -/- Results: Illuminated by the insights emanating from the said analysis, I introduce a novel approach with firm ethical foundations, which foundations are rooted in sentience, that is the subjective experience of sentient beings. -/- Discussion: I argue that the notion of disease is at best superfluous, and likely even harmful in the provision of compassionate and patient-centred care. -/- Conclusion: Using a series of presently contentious cases illustrate the power of the proposed framework which is capable of providing actionable and humane solutions to problems that leave the current theories confounded. (shrink)