Louis C. Charland

(1958 - 2021)

The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for consumers of mental health services, as well as psychiatrists and other mental health professionals. The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for consumers of mental health services, as well as psychiatrists and other mental health professionals.

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half of William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia.

Mental competence, or decision‐making capacity, is an important concept in law, psychiatry, and bioethics. A major problem faced in the development and implementation of standards for assessing mental competence is the issue of objectivity. The problem is that objective standards are hard to formulate and apply. The aim here is to review the limited philosophical literature on the place of value in competence in an attempt to introduce the issues to a wider audience. The thesis that the assessment of competence must incorporate elements of value and rationality is defended, and some tentative suggestions offered about how this might be achieved in a clinical setting.

The York Retreat is famous in the histor y of nineteenth-centur y psychiatr y because of its association with moral treatment. Although there exists a substantial historical literature on the evolution of moral treatment at the Retreat, several interpretive problems continue to obscure its unique therapeutic legacy. The nature of moral treatment as practised at the Retreat will be clarified and discussed in a historical perspective. It will be argued that moral treatment at the Retreat was pr imar ily a matter of affective conditioning guided by `benevolent theory'.

Alexander Crichton (1763—1856) made significant contributions to the medical theory of the passions, yet there exists no systematic exegesis of this particular aspect of his work. The present article explores four themes in Crichton's work on the passions: (1) the role of irritability in the physiology of the passions; (2) the manner in which irritability and sensibility contribute to the valence, or polarity, of the passions; (3) the elaboration of a psychopathology of the passions that emphasizes their physiological form rather than meaningful content or connections; and (4) the insistence that medical science ought to ignore ethical and other `moral' psychological and social aspects of the passions.

Building on what he believed was a new ‘medico-philosophical’ method, Philippe Pinel made a bold theoretical attempt to find a place for the passions and other affective posits in psychopathology. However, his courageous attempt to steer affectivity onto the high seas of medical science ran aground on two great reefs that still threaten the scientific status of affectivity today. Epistemologically, there is the elusive nature of the signs and symptoms of affectivity. Ethically, there is the stubborn manner in which fact and value are intermingled in affectivity. Both obstacles posed insuperable difficulties for Pinel, who never really managed to extricate his affective psychopathology from the confines of the Lockean intellectual paradigm.

Purpose of review This review considers the literature on ethical and conceptual issues in eating disorders from the last 18 months. Some reference to earlier work is necessary in order to provide context for the recent findings from research that is ongoing. Recent findings Empirical ethics research on anorexia nervosa includes novel ethical and conceptual findings on the role of authenticity and personal identity in individuals’ reports of their experience, as well as new evidence on the role of affective states and values in decision making at later stages of the illness. Evidence points to the hypothesis that anorexia nervosa may be a distinct affective syndrome that organizes feelings and emotions in accordance with a fixed idea. Summary There has been impressive progress in empirical ethics research on anorexia nervosa, with important implications for ethical and conceptual issues that surround decision-making capacity and our understanding of the illness.

Locke is famous for defining madness as an intellectual disorder in the realm of ideas. Numerous commentators take this to be his main and only contribution to the history of psychiatry. However, a detailed exegetical review of all the relevant textual evidence suggests that this intellectualist interpretation of Locke’s account of madness is both misleading and incomplete. Affective states of various sorts play an important role in that account and are in fact primordial in the determination of human conduct generally. Locke’s legacy in this domain must therefore be revised and the intellectualist bias that dominates discussions of his views must be redressed.

Following a Canadian Supreme Court ruling invalidating an absolute prohibition on physician assisted dying, two reports and several commentators have recommended that the Canadian criminal law allow medical assistance in dying (MAID) for persons with a diagnosis of mental disorder. A key element in this process is that the person requesting MAID be deemed to have the ‘mental capacity’ or ‘mental competence’ to consent to that option. In this context, mental capacity and mental competence refer to ‘decision-making capacity’, which is a distinct area of clinical study and research in the theory of informed consent. The purpose of this discussion is to bring several controversial but insufficiently acknowledged problems associated with decision-making capacity to the forefront of the proposed extension of MAID to persons diagnosed with mental disorders. Open-ended access to MAID by persons who suffer from mental health conditions already exists in Belgium and the Netherlands, where the issues raised here are equally relevant. In this paper, we highlight the serious limitations of relying on capacity assessments to allow access to MAID/Euthanasia.

Philippe Pinel is widely regarded as one of the founders of modern evidence-based psychiatry. Yet, until recently, his most important contributions to psychiatric theory and practice were effectively lost in myth, or lost in translation. It is instructive to review the history of these developments in order to correct any errors or omissions that may stand in the way of an accurate recognition of Pinel’s contributions to psychiatry, while at the same time highlighting some of his achievements that have been hidden by his celebrated mythical status as a pioneering humanitarian reformer. The aim of this article is to motivate further historical study of Pinel’s work, especially his 1809 Medico-Philosophical Treatise on Mental Alienation, which has only recently become available in English translation.

The engine of reason, the seat of the soul: a philosophical journey into the brain, Paul M. Churchland. Cambridge: Bradford Books, MIT Press, 1995 ISBN: 0–262–03244–4Cognition in the wild, Edwin Hutchins. Cambridge, MA: MIT Press, 1995. ISBN: 0–262–08231–4Dimensions of creativity, Margaret A. Boden, (Ed.) Cambridge, MA: MIT Press, 1994 ISBN 0–262–02368–7Contemplating minds: a forum for Artificial Intelligence, William J. Clancey, Stephen W. Smoliar & Mark J. Stefik (Eds) Cambridge: Bradford Books, MIT Press, 1994 ISBN 0–262–53119–4Passion and reason: making sense of our emotions, Richard S. Lazarus & Bernice N. Lazarus. Oxford: Oxford University Press, 1994. ISBN 0–19–508757–7Mental reality, Galen Strawson. Cambridge, MA: MIT Press, 1994 ISBN 0–262–19352–3The body and the self, Jose Luis Bermudez, Anthony Marcel & Naomi Eilan (Eds) Cambridge, MA: MIT Press, 1995. ISBN 0–262–02386–5.

First ever English Translation of Philippe PInel's 2nd Medico-Philosophical Treatise on Mental Alienation. The founder of French psychiatry wrote Medico-Philosophical Treatise on Mental Alienation in 1800 and reworked it nine years later. This book is the "Entirely Reworked and Extensively Expanded" version from 1809. Today, it can give historians of medicine and psychiatrists an overview of mental illnesses as they were viewed in that era. The author, Philippe Pinel, became known as the doctor who worked to free the insane from chains.

There is a large amount of scientific work on emotion in psychology, neuroscience, biology, physiology, and psychiatry, which assumes that it is possible to study emotions and other affective states, objectively. Emotion science of this sort is concerned primarily with 'facts' and not 'values', with 'description' not 'prescription'. The assumption behind this vision of emotion science is that it is possible to distinguish factual from evaluative aspects of affectivity and emotion, and study one without the other. But what really is the basis for distinguishing fact and value in emotion and affectivity? And can the distinction withstand careful scientific and philosophical scrutiny? The essays in this collection all suggest that the problems behind this vision of emotion science may be more complex than is commonly supposed.

This case study in the history of “passion” and “emotion” is based on the writings of William James. James is famous for his (1884) theory of emotion. However, like his illustrious colleague, Théodule Ribot, he also recognized the importance of “passion” in psychology. That aspect of James’s work is underappreciated. Ribot explicitly defends the necessity of including “passion” in psychology. James does not go that far. But he does utilize a very similar concept in connection with the term “passion” and there can be little doubt he considered it scientifically legitimate. Consequently, like Ribot, James must be considered an exception to historical accounts of this period which describe a transition from “passion” to “emotion” in which “passion” plays no part.

There are reasons to believe that decision‐making capacity (mental competence) of women in labor may be compromised in relation to giving informed consent to epidural analgesia. Not only severe labor pain, but also stress, anxiety, and premedication of analgesics such as opioids, may influence women’s decisional capacity. Decision‐making capacity is a complex construct involving cognitive and emotional components which cannot be reduced to ‘understanding’ alone. A systematic literature search identified a total of 20 empirical studies focused on women’s decision‐making about epidural analgesia for labor pain. Our review of these studies suggests that empirical evidence to date is insufficient to determine whether women undergoing labor are capable of consenting to epidural analgesia. Given such uncertainties, sufficient information about pain management should be provided as part of prenatal education and the consent process must be carefully conducted to enhance women’s autonomy. To fill in the significant gap in clinical knowledge about laboring women’s decision‐making capacity, well‐designed prospective and retrospective studies may be required.

I very much enjoyed reading the interesting and original article by Steel and colleagues (2017). But I found myself strongly disagreeing with its conclusion once the real point of the argument became clear to me. At the same time, I believe that the authors are correct to draw attention to the importance of context and inequities in framing discussions of the ethics of voluntary consent in heroin prescription research. I begin with a brief summary of the authors’ conclusion, quoting directly and adding my own emphases, since there are major philosophical points I wish to make that hinge on nuances in wording...

What follows is a case study in the foundations of cognitive science. In it I explore the relation between the computational theory of mind and the theory of emotion. The argument of the thesis is that these two domains have much more to do with one another than has traditionally been supposed. The strategy adopted is to formulate a computational theory of emotion and then go on to extol its virtues. On the whole the aim of the project is to explore the possibility of interpreting information processing models of emotion computationally. The conclusion reached is that computational foundations for emotion theory are not only possible, but that in fact they provide a provocative perspective within which to reinterpret and focus a large amount of hitherto ossified and otherwise nomologically scattered results in emotion theory.

Philosophical discussions regarding the status of emotion as a scientific domain usually get framed in terms of the question whether emotion is a natural kind. That approach to the issues is wrongheaded for two reasons. First, it has led to an intractable philosophical impasse that ultimately misconstrues the character of the relevant debate in emotion science. Second, and most important, it entirely ignores valence, a central feature of emotion experience, and probably the most promising criterion for demarcating emotion from cognition and other related domains. An alternate philosophical hypothesis for addressing the issues is pro- posed. It is that emotion is a naturally occurring valenced phenomenon that is..

The distinction between cognitive and perceptual theories of emotion is entrenched in the literature on emotion and is openly used by individual emotion theorists when classifying their own theories and those of others. In this paper, I argue that the distinction between cognitive and perceptual theories of emotion is more pernicious than it is helpful, while at the same time insisting that there are nonetheless important perceptual and cognitive factors in emotion that need to be distinguished. A general representational metatheoretical framework for reconciling cognitive and perceptual theories is proposed. This is the Representational Theory of Emotion (RTE). A detailed case study of Antonio Damasio's important new contribution to emotion theory is presented in defense of the RTE. The paper is intended for readers interested in the foundations of emotion theory and cognitive science.

Most contemporary models and tests for mental competence do not make adequate provision for the positive influence of emotion in the determination of competence. This most likely is due to a reliance on an outdated view of emotion according to which these models are essentially noncognitive. Leading developments in modern emotion theory indicate that this noncognitive theory of emotion is no longer tenable. Emotions, in fact, are essentially representational in a manner that makes them “cognitive” in an important sense. This requires a reassessment of the place of emotion in the theory of mental competence. Building on Benjamin Freedman’s “recognizable reasons” account of competence, it will be argued that (1) emotions form a class of recognizable reasons of their own, and (2) that competence to consent is a matter of practical, rather than theoretical, reasoning. Emotions, then, are an essential ingredient in mental competence, and the cognitive bias that permeates the theory of mental competence today must be rejected.

Interdisciplinary work of the sort attempted in my paper is fraught with risks and obstacles. One especially pernicious obstacle is the short-sighted prejudice that insists we should always divide a problem into its various components, allocate different parts to their respective disciplines, publish each separately, and, above all, keep the ethics separate from the rest. Although this may sometimes constitute good tactical advice in the mature stages of inquiry on a complex topic, it begs the question in the early initial stages of discussion on a subject like the present one, which is tangled and complex and not suited to the traditional disciplinary boundaries of professional journals...

The main purpose of my paper was to encourage discussion on the link between contemporary emotion theory and current work on mental competence. All of the commentators appear to be sympathetic to this project, although Youngner disagrees with how I have gone about it. In this response, I will try and correct a few misunderstandings and expand on several points that obviously need a far more detailed treatment than could have been provided in a single paper. I start with a reply to some of Youngner’s more pointed criticisms...

The history and philosophy of affective terms and concepts contains important challenges for contemporary scientific accounts of emotion regulation. First, there is the problem of moral undertow. This arises because stipulating the ends of emotion regulation requires normative assumptions that ultimately derive from values and morals. Some historical precedents are considered to help explain and address this problem. Second, there is the problem of organization. This arises because multiple emotions are often organized and oriented in very particular ways over the life of the individual in a manner that cannot be adequately explained using the concept of “emotion.” A modern variant of the traditional concept of passion is invoked to help address this problem.

In this paper I review some leading developments in the empirical theory of affect. I argue that (1) affect is a distinct perceptual representation governed system, and (2) that there are significant modular factors in affect. The paper concludes with the observation thatfeeler (affective perceptual system) may be a natural kind within cognitive science. The main purpose of the paper is to explore some hitherto unappreciated connections between the theory of affect and the computational theory of mind.