Pub Date : 2023-06-01DOI: 10.1353/ppp.2023.a899942
Pablo Hubacher Haerle
Abstract:It is a common assumption in psychiatry and psychotherapy that mental health conditions are marked out by some form of epistemic irrationality. With respect to obsessive-compulsive disorder (OCD), the mainstream view is that OCD causes irrational beliefs. Recently, however, this ‘doxastic view’ has been criticized from a theoretical and empirical perspective. Instead a more promising ‘zetetic view’ has been proposed which locates the epistemic irrationality of OCD not in irrational beliefs, but in the senseless inquiries it prompts. Yet, in this paper, I present a special class of cases—sexual OCD (S-OCD)—that cannot be explained by existing doxastic and zetetic accounts of the epistemic irrationality of OCD. Some people with S-OCD appear to adhere too well to a plausible set of norms for inquiry. Their experiences seem to be partially caused by an excess of rationality, and not a lack thereof. They appear, if anything, too rational. This suggests that we are unlikely to find one form of epistemic irrationality common to all people living with OCD. Also, it should lead us to rethink the epistemic categories we use in classifying mental health conditions such as OCD.
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Pub Date : 2023-06-01DOI: 10.1353/ppp.2023.a899948
R. Pies
* SUNY Upstate Medical University piesr@upstate.edu The author reports no conflict of interest. P rofessor Fatic’s timely and wide-ranging essay demonstrates how the topic of narcissism has undergone a resurgence of interest in recent decades. This may owe, in part, to the controversial claim that narcissism is on the rise in the United States, at least among American college students (Twenge & Foster, 2010). As I discuss presently, the term “narcissism” is open to many interpretations, and differs somewhat from the specific designation, Narcissistic Personality Disorder (NPD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (American Psychiatric Association, 2013). As Fatic rightly notes,
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Pub Date : 2023-06-01DOI: 10.1353/ppp.2023.a899938
R. Chapman
Abstract:The contemporary form of critical psychiatry and psychology focused on here follows Thomas Szasz in arguing that many of the concepts and practices of psychiatry are unscientific, value-laden, and epistemically violent. These claims are based on what I call the ‘comparativist’ critique, referred to as such since the argument relies on comparing psychiatry to what is taken to be a comparatively objective and useful somatic medicine. Here I adopt a Sedgwickian constructivist approach to illness and disability more generally to argue that the theoretical commitments of the comparativist critique are not just untenable, they are also epistemically harmful in much the same way criticals identify in psychiatry. This is because they commit to an unrealistic understanding of bodily health that reifies the ‘normal’ body in ways that are harmful for those who fall outside bodily, neurological, gendered, sexed, and racialized norms. Far from being a merely theoretical problem, I show how maintaining these commitments routinely contributes to the at least partial, and unintentional, marginalization of neurodivergent, disabled, and LGBTQI identity, agency, and history in critical psychiatry discourse and practice. I conclude that, although some of its critique of mainstream psychiatry is pertinent, the problems with Szaszianism’s core theoretical commitments are likely to be incompatible with critical psychiatry’s liberatory aims in the long run.
{"title":"A Critique of Critical Psychiatry","authors":"R. Chapman","doi":"10.1353/ppp.2023.a899938","DOIUrl":"https://doi.org/10.1353/ppp.2023.a899938","url":null,"abstract":"Abstract:The contemporary form of critical psychiatry and psychology focused on here follows Thomas Szasz in arguing that many of the concepts and practices of psychiatry are unscientific, value-laden, and epistemically violent. These claims are based on what I call the ‘comparativist’ critique, referred to as such since the argument relies on comparing psychiatry to what is taken to be a comparatively objective and useful somatic medicine. Here I adopt a Sedgwickian constructivist approach to illness and disability more generally to argue that the theoretical commitments of the comparativist critique are not just untenable, they are also epistemically harmful in much the same way criticals identify in psychiatry. This is because they commit to an unrealistic understanding of bodily health that reifies the ‘normal’ body in ways that are harmful for those who fall outside bodily, neurological, gendered, sexed, and racialized norms. Far from being a merely theoretical problem, I show how maintaining these commitments routinely contributes to the at least partial, and unintentional, marginalization of neurodivergent, disabled, and LGBTQI identity, agency, and history in critical psychiatry discourse and practice. I conclude that, although some of its critique of mainstream psychiatry is pertinent, the problems with Szaszianism’s core theoretical commitments are likely to be incompatible with critical psychiatry’s liberatory aims in the long run.","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"135 1","pages":"103 - 119"},"PeriodicalIF":2.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80377773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1353/ppp.2023.a899940
N. Jones
F or at least some of us, Chapman’s Critique of Critical Psychiatry represents an in fact long overdue articulation of the moral and ethical risks (and in harm) of the Szaszian legacy in critical psychiatry. Namely, a binary framework that bluntly differentiates “somatic” from “psychological” (or, for some, socially manufactured) conditions. Chapman articulates these risks in important ways—unpacking, for example, implications vis-à-vis broader disability groups, identities tied to neurodiversity, and the transgender community, among others. Implied, but less explicitly stated, are the ways in which an objectivist, Szazsian politics plays out even within and among (psychiatric) service user/ survivor activists, namely in the de facto erasure of sustained and complex (functional or as Chapman terms it, cognitive) disability. At times this has figured in arguments premised on the manufacture of disability through iatrogenic intervention (what we think of as long-term psychosis as in fact a biological condition brought about by sustained neurological damage from neuroleptic drugs, for example), and the commensurate claim that in the absence of such interventions, conditions like psychosis would either resolve on their own, or represent an opportunity for “spiritual transformation” (Grof & Grof, 1986). Without in any way downplaying the realities of either iatrogenic harm (which in fact cuts across all areas of medicine) and a range of experiences, some transient, spiritual or otherwise transformative, the problem remains the fate of those whose disabilities are in fact far-reaching and all too “real.” In many national contexts, including the United States, these are the individuals most likely to end up institutionalized, transinstitutionalized, incarcerated and/or relegated to a life of extreme poverty and political disenfranchisement (e.g., Cohen, 1993; Ramsay, Stewart, & Compton, 2012; Reiter & Blaire, 2015; Schoenbaum et al., 2017). Olufemi Taiwo’s cautions regarding elite capture, and it’s
{"title":"Making a New World: Chapman on What We’re Doing and Who is Included in the Project","authors":"N. Jones","doi":"10.1353/ppp.2023.a899940","DOIUrl":"https://doi.org/10.1353/ppp.2023.a899940","url":null,"abstract":"F or at least some of us, Chapman’s Critique of Critical Psychiatry represents an in fact long overdue articulation of the moral and ethical risks (and in harm) of the Szaszian legacy in critical psychiatry. Namely, a binary framework that bluntly differentiates “somatic” from “psychological” (or, for some, socially manufactured) conditions. Chapman articulates these risks in important ways—unpacking, for example, implications vis-à-vis broader disability groups, identities tied to neurodiversity, and the transgender community, among others. Implied, but less explicitly stated, are the ways in which an objectivist, Szazsian politics plays out even within and among (psychiatric) service user/ survivor activists, namely in the de facto erasure of sustained and complex (functional or as Chapman terms it, cognitive) disability. At times this has figured in arguments premised on the manufacture of disability through iatrogenic intervention (what we think of as long-term psychosis as in fact a biological condition brought about by sustained neurological damage from neuroleptic drugs, for example), and the commensurate claim that in the absence of such interventions, conditions like psychosis would either resolve on their own, or represent an opportunity for “spiritual transformation” (Grof & Grof, 1986). Without in any way downplaying the realities of either iatrogenic harm (which in fact cuts across all areas of medicine) and a range of experiences, some transient, spiritual or otherwise transformative, the problem remains the fate of those whose disabilities are in fact far-reaching and all too “real.” In many national contexts, including the United States, these are the individuals most likely to end up institutionalized, transinstitutionalized, incarcerated and/or relegated to a life of extreme poverty and political disenfranchisement (e.g., Cohen, 1993; Ramsay, Stewart, & Compton, 2012; Reiter & Blaire, 2015; Schoenbaum et al., 2017). Olufemi Taiwo’s cautions regarding elite capture, and it’s","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"16 1","pages":"125 - 127"},"PeriodicalIF":2.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90328877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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