Pub Date : 2022-09-02DOI: 10.1080/13869795.2022.2065342
R. Bluhm, L. Cabrera
ABSTRACT Deep brain stimulation (DBS) uses electrodes implanted in the brain to modulate dysregulated brain activity related to a variety of neurological and psychiatric conditions. A number of people who use DBS have reported changes that affect their sense of self. In the neuroethics literature, there has been significant debate over the exact nature of these changes. More recently, there have been suggestions that this debate is overblown and detracts from clinically-relevant ways of understanding these effects of DBS. In this paper, we offer an alternative approach to understanding the effects of DBS on the self, drawing on John Sadler’s work on self-illness ambiguity. We argue that self-illness ambiguity is a complex concept, with at least three different aspects, and that each of the three aspects we identify also characterizes one kind of DBS-related change. Our analysis also suggests ways of helping patients to adjust to life as a DBS user.
{"title":"Self-implant ambiguity? Understanding self-related changes in deep brain stimulation","authors":"R. Bluhm, L. Cabrera","doi":"10.1080/13869795.2022.2065342","DOIUrl":"https://doi.org/10.1080/13869795.2022.2065342","url":null,"abstract":"ABSTRACT Deep brain stimulation (DBS) uses electrodes implanted in the brain to modulate dysregulated brain activity related to a variety of neurological and psychiatric conditions. A number of people who use DBS have reported changes that affect their sense of self. In the neuroethics literature, there has been significant debate over the exact nature of these changes. More recently, there have been suggestions that this debate is overblown and detracts from clinically-relevant ways of understanding these effects of DBS. In this paper, we offer an alternative approach to understanding the effects of DBS on the self, drawing on John Sadler’s work on self-illness ambiguity. We argue that self-illness ambiguity is a complex concept, with at least three different aspects, and that each of the three aspects we identify also characterizes one kind of DBS-related change. Our analysis also suggests ways of helping patients to adjust to life as a DBS user.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45466214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-02DOI: 10.1080/13869795.2022.2116473
S. Wilkinson
ABSTRACT I explore the relationship between psychiatric fictionalism and the attribution of moral responsibility. My central claim is as follows. If one is a psychiatric fictionalist, one should also strongly consider being a fictionalist about responsibility. This results in the ‘intrinsic view’, namely, the view that mental illness does not just happen to interfere with moral responsibility: that interference is an intrinsic part of the narrative. I end by discussing three illustrative examples.
{"title":"Psychiatric fictionalism and narratives of responsibility","authors":"S. Wilkinson","doi":"10.1080/13869795.2022.2116473","DOIUrl":"https://doi.org/10.1080/13869795.2022.2116473","url":null,"abstract":"ABSTRACT I explore the relationship between psychiatric fictionalism and the attribution of moral responsibility. My central claim is as follows. If one is a psychiatric fictionalist, one should also strongly consider being a fictionalist about responsibility. This results in the ‘intrinsic view’, namely, the view that mental illness does not just happen to interfere with moral responsibility: that interference is an intrinsic part of the narrative. I end by discussing three illustrative examples.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46721839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-25DOI: 10.1080/13869795.2022.2115533
Cory Davia
ABSTRACT According to the moral encroachment thesis, moral features of a situation can affect not just what we’re practically justified in doing but also what we’re epistemically justified in believing. This paper offers a new rationale for that thesis, drawing on observations about the role of reflection in agency.
{"title":"Moral encroachment and the ideal of unified agency","authors":"Cory Davia","doi":"10.1080/13869795.2022.2115533","DOIUrl":"https://doi.org/10.1080/13869795.2022.2115533","url":null,"abstract":"ABSTRACT According to the moral encroachment thesis, moral features of a situation can affect not just what we’re practically justified in doing but also what we’re epistemically justified in believing. This paper offers a new rationale for that thesis, drawing on observations about the role of reflection in agency.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47873269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-19DOI: 10.1080/13869795.2022.2111454
Juliette Vazard
ABSTRACT Incessant checking is undeniably problematic from a practical point of view. But what is epistemically wrong with checking again (and again)? The starting assumption for this paper is that establishing what goes wrong when individuals check their stove ten times in a row requires understanding the nature of the doxastic attitude that compulsive re-checkers are in, as they go back to perform another check. Does the re-checker know that the stove is off, and is thus looking for more of what she already has (Whitcomb, D. 2010. “Curiosity was Framed.” Philosophy and Phenomenological Research 81 (3): 664–687.)? Or is she an inquirer who repeatedly loses her knowledge and finds herself inquiring again and again into the same question (Friedman, J. 2019. “Checking Again.” Philosophical Issues 29 (1): 84–96.)? I present what I see as the three main hypotheses currently available, and propose a refinement to Taylor's ‘what-if questioning’ account (2020).
从实践的角度来看，不断的检查无疑是有问题的。但是一次又一次的检查在认识论上有什么错呢?本文的初始假设是，当一个人连续检查炉子十次时，要确定哪里出了问题，需要理解强迫性复核者在回去进行另一次检查时所持的对立态度的本质。复核员是否知道炉子已经关闭，因此正在寻找更多她已经拥有的东西(Whitcomb, D. 2010) ?“好奇心被陷害了。”哲学与现象学研究，81(3):664-687。或者她是一个不断失去知识的询问者，发现自己一次又一次地询问同一个问题(Friedman, J. 2019)。“检查一遍。”哲学问题29(1):84-96。我提出了我认为目前可用的三个主要假设，并对泰勒的“假设质疑”(2020)提出了改进。
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Pub Date : 2022-08-04DOI: 10.1080/13869795.2022.2099564
Line Ryberg Ingerslev
ABSTRACT In this comment, I argue that transformative experiences such as experiences of grief often imply a break in one's coherent, non-fictional and biographical narratives and practical identities. The nature of these breaks is of a certain kind, as they interrupt even the process of narration. To insist that the process of narration as well as the narratives themselves belong to one and the same process of adjustment in transformative experiences such as grief might overlook the importance of such breaks, namely that the contain a moment of refusal and revolting against mourning. The tension involved in such breaks might not allow to be circumscribed into narratives nor do they fit into the process of narration as a destabilizing moment; the breaks insist on the incomprehensibility of each loss and they remain part of what it means to survive and to undergo transformative experiences.
{"title":"On the importance of breaks: transformative experiences and the process of narration","authors":"Line Ryberg Ingerslev","doi":"10.1080/13869795.2022.2099564","DOIUrl":"https://doi.org/10.1080/13869795.2022.2099564","url":null,"abstract":"ABSTRACT In this comment, I argue that transformative experiences such as experiences of grief often imply a break in one's coherent, non-fictional and biographical narratives and practical identities. The nature of these breaks is of a certain kind, as they interrupt even the process of narration. To insist that the process of narration as well as the narratives themselves belong to one and the same process of adjustment in transformative experiences such as grief might overlook the importance of such breaks, namely that the contain a moment of refusal and revolting against mourning. The tension involved in such breaks might not allow to be circumscribed into narratives nor do they fit into the process of narration as a destabilizing moment; the breaks insist on the incomprehensibility of each loss and they remain part of what it means to survive and to undergo transformative experiences.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41864463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-27DOI: 10.1080/13869795.2022.2093393
Anna Bortolan
ABSTRACT This paper investigates from a phenomenological perspective the origins of self-illness ambiguity. Drawing on phenomenological theories of affectivity and selfhood, I argue that, as a phenomenon which concerns primarily the ‘personal self’, self-illness ambiguity is dependent on distinct alterations of affective background orientations. I start by illustrating how personhood is anchored in the experience of a specific set of non-intentional affects – i.e. moods or existential feelings – alterations of which are often present in mental ill-health. Also through the exploration of the phenomenology of acute and long-term anxiety, I suggest that self-illness ambiguity originates in the presence of moods or existential feelings that are in tension with the ones that structure the person’s experience prior to the onset of the illness or when its symptoms are not experienced. More specifically, I claim that due to their ability to ‘block’ or ‘suspend’ some of the person’s affective and cognitive responses, such affective orientations may unsettle one’s self-defining evaluative perspective, leading to uncertainty and doubting about one’s personal self.
{"title":"Selves hijacked: affects and personhood in ‘self-illness ambiguity’","authors":"Anna Bortolan","doi":"10.1080/13869795.2022.2093393","DOIUrl":"https://doi.org/10.1080/13869795.2022.2093393","url":null,"abstract":"ABSTRACT This paper investigates from a phenomenological perspective the origins of self-illness ambiguity. Drawing on phenomenological theories of affectivity and selfhood, I argue that, as a phenomenon which concerns primarily the ‘personal self’, self-illness ambiguity is dependent on distinct alterations of affective background orientations. I start by illustrating how personhood is anchored in the experience of a specific set of non-intentional affects – i.e. moods or existential feelings – alterations of which are often present in mental ill-health. Also through the exploration of the phenomenology of acute and long-term anxiety, I suggest that self-illness ambiguity originates in the presence of moods or existential feelings that are in tension with the ones that structure the person’s experience prior to the onset of the illness or when its symptoms are not experienced. More specifically, I claim that due to their ability to ‘block’ or ‘suspend’ some of the person’s affective and cognitive responses, such affective orientations may unsettle one’s self-defining evaluative perspective, leading to uncertainty and doubting about one’s personal self.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49145497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-22DOI: 10.1080/13869795.2022.2100458
Alva Stråge
ABSTRACT Many philosophers take mental causation to be required for free will. But it has also been argued that the most popular view of the nature of mental states, i.e. non-reductive physicalism, excludes the existence of mental causation, due to what is known as the ‘exclusion argument’. In this paper, I discuss the difference-making account of mental causation proposed by [List, C., and Menzies, P. 2017. “My Brain Made Me Do It: The Exclusion Argument Against Free Will, and What’s Wrong with It.” In H. Beebee, C. Hitchcock, & H. Price (eds.), Making a Difference: Essays on the Philosophy of Causation. Oxford Scholarship Online: Oxford University Press], who argue that their account not only solves the problem of causal exclusion but also saves free will. More precisely, they argue that it rebuts what they call ‘the Neurosceptical Argument’, the argument that if actions are caused by neural states and processes unavailable to us, there is no free will. I argue that their argument fails for two independent reasons. The first reason is that they fail to show that difference-makers are independent causes. The second reason is that physical realizers of mental states can be individuated in a way that makes both mental states and their realizers difference-makers.
{"title":"Why difference-making mental causation does not save free will","authors":"Alva Stråge","doi":"10.1080/13869795.2022.2100458","DOIUrl":"https://doi.org/10.1080/13869795.2022.2100458","url":null,"abstract":"ABSTRACT Many philosophers take mental causation to be required for free will. But it has also been argued that the most popular view of the nature of mental states, i.e. non-reductive physicalism, excludes the existence of mental causation, due to what is known as the ‘exclusion argument’. In this paper, I discuss the difference-making account of mental causation proposed by [List, C., and Menzies, P. 2017. “My Brain Made Me Do It: The Exclusion Argument Against Free Will, and What’s Wrong with It.” In H. Beebee, C. Hitchcock, & H. Price (eds.), Making a Difference: Essays on the Philosophy of Causation. Oxford Scholarship Online: Oxford University Press], who argue that their account not only solves the problem of causal exclusion but also saves free will. More precisely, they argue that it rebuts what they call ‘the Neurosceptical Argument’, the argument that if actions are caused by neural states and processes unavailable to us, there is no free will. I argue that their argument fails for two independent reasons. The first reason is that they fail to show that difference-makers are independent causes. The second reason is that physical realizers of mental states can be individuated in a way that makes both mental states and their realizers difference-makers.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43422893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-11DOI: 10.1080/13869795.2022.2097300
Ş. Tekin
ABSTRACT In a compelling and provocative paper, ‘Solving the Self-Illness Ambiguity: The Case for Construction Over Discovery,’ Sofia M.I. Jeppsson distinguishes two ways of addressing the self-illness ambiguty problem. The first is the Realist Solution, which postulates a pre-existing border between the self and the illness and frames the goal of treatment in psychiatry as helping the patient ‘discover’ this boundary. Addressing the shortcomings of the Realist Solution, both in terms of its feasibility and possible outcomes, Jeppsson proposes and defends the Constructivist Solution, according to which the patient, through self-reflection and deliberation with others, including the clinicians, decides, which parts of her experiences they identify with themselves and which parts they attribute to their illness. This paper critically evaluates Jeppson’s arguments and addresses some of the shortcomings of Jeppsson’s positive argument, i.e. the Constructivist Solution.
{"title":"My Illness, My Self, and I: when self-narratives and illness-narratives clash","authors":"Ş. Tekin","doi":"10.1080/13869795.2022.2097300","DOIUrl":"https://doi.org/10.1080/13869795.2022.2097300","url":null,"abstract":"ABSTRACT In a compelling and provocative paper, ‘Solving the Self-Illness Ambiguity: The Case for Construction Over Discovery,’ Sofia M.I. Jeppsson distinguishes two ways of addressing the self-illness ambiguty problem. The first is the Realist Solution, which postulates a pre-existing border between the self and the illness and frames the goal of treatment in psychiatry as helping the patient ‘discover’ this boundary. Addressing the shortcomings of the Realist Solution, both in terms of its feasibility and possible outcomes, Jeppsson proposes and defends the Constructivist Solution, according to which the patient, through self-reflection and deliberation with others, including the clinicians, decides, which parts of her experiences they identify with themselves and which parts they attribute to their illness. This paper critically evaluates Jeppson’s arguments and addresses some of the shortcomings of Jeppsson’s positive argument, i.e. the Constructivist Solution.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44127592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1080/13869795.2022.2094999
M. Maiese
ABSTRACT Self-illness ambiguity involves difficulty distinguishing between patterns of thought, feeling, and action that are the ‘products’ of one's illness and those that are genuinely one's own. Bortolan maintains that the values, cares, and preferences that define someone’s personal identity are rooted in intentional emotions and non-intentional affects (i.e., existential feelings and moods). The uncertainty that comprises self-illness ambiguity results from the experience of moods or existential feelings that are in tension with ones that the patient experienced prior to the onset of illness. Building on these ideas, I examine how the notion of ‘affordance’ can shed further light on the dynamics and phenomenology of self-illness ambiguity. In my view, such ambiguity results from a lack of diachronic continuity and stability in a subject’s field of affordances.
{"title":"Self-illness ambiguity, affectivity, and affordances","authors":"M. Maiese","doi":"10.1080/13869795.2022.2094999","DOIUrl":"https://doi.org/10.1080/13869795.2022.2094999","url":null,"abstract":"ABSTRACT Self-illness ambiguity involves difficulty distinguishing between patterns of thought, feeling, and action that are the ‘products’ of one's illness and those that are genuinely one's own. Bortolan maintains that the values, cares, and preferences that define someone’s personal identity are rooted in intentional emotions and non-intentional affects (i.e., existential feelings and moods). The uncertainty that comprises self-illness ambiguity results from the experience of moods or existential feelings that are in tension with ones that the patient experienced prior to the onset of illness. Building on these ideas, I examine how the notion of ‘affordance’ can shed further light on the dynamics and phenomenology of self-illness ambiguity. In my view, such ambiguity results from a lack of diachronic continuity and stability in a subject’s field of affordances.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48192525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-12DOI: 10.1080/13869795.2022.2086995
Benjamin Winokur
ABSTRACT Neo-expressivism is the view that avowals – first-personal, present tense self-ascriptions of mental states—ordinarily express the very mental states that they semantically represent, such that they carry a strong presumption of truth and are immune to requests for epistemic support. Peter Langland-Hassan (2015. “Self-Knowledge and Imagination.” Philosophical Explorations 18 (2): 226–245) has argued that Neo-expressivism cannot accommodate avowals of one’s imaginings. In this short paper I argue that Neo-expressivism can, in fact, accommodate them.
{"title":"Authoritatively avowing your imaginings by self-ascriptively expressing them","authors":"Benjamin Winokur","doi":"10.1080/13869795.2022.2086995","DOIUrl":"https://doi.org/10.1080/13869795.2022.2086995","url":null,"abstract":"ABSTRACT\u0000 Neo-expressivism is the view that avowals – first-personal, present tense self-ascriptions of mental states—ordinarily express the very mental states that they semantically represent, such that they carry a strong presumption of truth and are immune to requests for epistemic support. Peter Langland-Hassan (2015. “Self-Knowledge and Imagination.” Philosophical Explorations 18 (2): 226–245) has argued that Neo-expressivism cannot accommodate avowals of one’s imaginings. In this short paper I argue that Neo-expressivism can, in fact, accommodate them.","PeriodicalId":46014,"journal":{"name":"Philosophical Explorations","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45791861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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