Titles and abstracts of some of my recent work are shown below. Please contact me if you would like the most recent draft of a paper.
CONTRIBUTORY INJUSTICE IN PSYCHIATRY
2019 Journal of Medical Ethics (45:2): available here
I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs regularly within psychiatric services; in particular, I argue that it affects those who experience auditory hallucinations of voices. I argue that abstract effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; mitigating the injustice will require open and meaningful dialogue between clinicians and service user organisations, as well as individuals. I suggest that clinicians must become familiar with and take seriously concepts and frameworks for understanding mental distress developed in service user communities, such as Hearing Voices Network, and by individual service users. This is especially necessary when these concepts and frameworks explicitly conflict with medical or technical understandings of users’ experiences. Further, I defend this proposal against the claim that it might produce conflict with clinicians’ responsibility to inform service users of all medically pertinent information prior to obtaining consent for treatment.
A PREDICTIVE PROCESSING THEORY OF MOTIVATION
2019 Synthese: available here
In this paper I propose minimal criteria for a successful theory of the mechanisms of motivation (i.e. how motivational mental states perform their characteristic function), and argue that extant philosophical accounts fail to meet them. Further, I argue that a Predictive Processing (PP) framework gives us the theoretical power to meet these criteria, and thus ought to be preferred over existing theories.
The argument proceeds as follows – motivational mental states are generally understood as mental states with the power to initiate, guide, and control action, though few existing theories of motivation explicitly detail how they are meant to explain these functions. I survey two contemporary theories of motivational mental states, due to Wayne Wu and Bence Nanay, and argue that they fail to satisfactorily explain one or more of these functions. Nevertheless, I argue that together, they are capable of giving a strong account of the control function, which competing theories ought to preserve (all else being equal).
I then go on to argue that what I call the ‘predictive theory’ of motivational mental states, which makes use of the notion of active inference, is able to explain all three of the key functions and preserves the central insights of Wu and Nanay on control. It thus represents a significant step forward in the contemporary debate.
ANHEDONIA AND THE AFFECTIVELY SCAFFOLDED MIND
2019 Ergo (6:23): available here
Anhedonia, roughly defined as the diminishment or absence of the capacity to experience pleasure or joy in the performance of daily activities, is a core symptom of Major Depressive Disorder, as well as other psychiatric illnesses. I argue that the two major psychological theories of anhedonia are committed to the view that anhedonia cannot, in the general case, be explained with reference only to neurobiological states and processes. This is despite the overwhelming explanatory focus on neurobiological factors in the existing literature. Instead, it is to be understood as the breakdown in the function of what Colombetti & Krueger (2015) term a subject's affective niche. Since affective niches are composed of elements of a person's natural and social environments, including artefacts, activities, and other people, anhedonia turns out to be a phenomenon deeply integrated into a subject's environment, inscrutable within the boundaries of skin and skull. I briefly discuss ramifications of this view for diagnosis and treatment.
EMPATHY, DEPRESSION, AND EXPERIENTIAL DIFFERENCE
(in review at Philosophy of Science)
Matthew Ratcliffe has argued that experiencing depression will tend to hinder more than it helps a person’s ability to empathise with other people’s experiences of depression (2015: 247-8). Call this the Bad Similarity Claim (henceforth, BSC). In this paper, I evaluate three arguments for BSC. The first will be Ratcliffe’s own, based on his somewhat idiosyncratic Difference View of empathy. I conclude that, even granting Ratcliffe his view and supporting claims, the argument fails to secure BSC, properly understood. The second and third are my own suggestions, based on the more standard but also more restrictive Imagination View of empathy (Coplan 2011). I argue that though one of them also ultimately fails, the second offers some evidence that BSC could be true. I also argue that the way in which BSC might turn out to be true (i.e. what kind of empathic failure is most likely to be involved) gives us some interesting insight into the nature of interpersonal disability in depression more generally; failures of empathy between two depressed people, if they are indeed any more likely than would be expected pre-theoretically, will probably involve the empathiser getting too close (emotionally speaking) to empathise properly, rather than failing to bridge the gap between themselves and the other.
AGENTIAL PATHOLOGY IN DEPRESSION
(in review at Nous)
I introduce the notion of agential pathology; a characteristic feature of clinical depression, whereby a subject experiences significant difficulty initiating and sustaining day-to-day actions. I present the existing theories in the philosophical psychopathology literature purporting to explain this phenomenon and sort them into two broad kinds; mental state theories (which emphasise the role of absent, interfering, or degenerate mental states, such as beliefs, desires, and intentions) and somatic theories (which emphasise the role of disturbances to certain kinds of bodily feelings). I present three central features of agential pathology, which should act, I argue, as minimal explanatory desiderata for a theory of the phenomenon. I go onto argue that neither of the aforementioned kinds of theory can account for each of these three features, though each can account for some of them. I then introduce a novel class of theories to the ongoing discussion; perceptual theories (which emphasise the role of disturbances to certain kinds of perceptual representations that are either necessary for, or at least enabling of, action). I argue that these sorts of theory cannot account for the central three features of agential pathology either, though can, once again, account for some of them. Finally, I argue that we can satisfy all three desiderata by adopting a pluralistic view of agential pathology, on which all three kinds of factors typically, though not necessarily, play a significant role in impeding a subject’s efforts to act.
THE COLLECTIVE HARMS OF PSYCHIATRIC DETENTION
Debates surrounding the harms and appropriateness of psychiatric detention and compulsory treatment focus on harms to the service users who are detained, or at risk of detention. Though widespread disagreements exist regarding exactly where to draw the line on the appropriateness of detention and involuntary treatment, the central thought is that the harms that require balancing (including potential rights violations, preference violations, and self-inflicted injury) are those that will (or may) accrue to those being considered for detention.
In this paper, I argue that this focus will tend to underestimate and (in part) incorrectly locate the harms involved in the clinical response to service users presenting to primary care in a state of psychological crisis. Deploying Kristie Dotson’s concept of testimonial smothering (2011), I argue that current responses will tend to result in the unjust silencing of all service users, including those who are neither subject to, nor at risk of, detention; a fact necessarily missed by analyses focused exclusively on the rights of, and harms accrued by, those service users at risk of detention. This indicates that more ethical attention should be paid to the atmosphere in which primary psychiatric care operates, rather than merely the permissibility or advisability of detaining individual service users.
FUTILITY JUDGMENTS IN PSYCHIATRY
WHY WE MUST NOT PRESUME INCAPACITY IN ANOREXIA NERVOSA: A REPLY TO IP