Louis C. Charland

(1958 - 2021)

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

THE TARGET OF ERICA LILLELEHT'S interesting comparison between 19th-century moral treatment and 20th-century psychiatric rehabilitation is contemporary psychiatric rehabilitation. Using Foucault's (1979) Discipline and Punish as her critical foil, she argues that psychiatric rehabilitation is "an approach to madness fraught with paradox." The paradox lies in the fact that the techniques of psychiatric rehabilitation can be practiced in a manner that contradicts its professed humanitarian intentions; notably, liberating the mad from "resource dependency and segregated living." The lesson to be drawn from this paradox is that "our practices, may be shaped and reformulated to serve goals of which we are only dimly aware." The resulting "mindfulness" is supposed to make us more careful and critical of what to count as success and progress in psychiatric treatment...

In his target article, Barsalou cites current work on emotion theory but does not explore its relevance for this project. The connection is worth pursuing, since there is a plausible case to be made that emotions form a distinct symbolic information processing system of their own. On some views, that system is argued to be perceptual: a direct connection with Barsalou's perceptual symbol systems theory. Also relevant is the hypothesis that there may be different modular subsystems within emotion and the perennial tension between cognitive and perceptual theories of emotion.

Over the past several decades, geneticists have succeeded in identifying the genetic mutations associated with disease. New strategies for treatment, including gene transfer and gene therapy, are under development. Although genetic science has been welcomed for its potential to predict and treat disease, interventions may become ethically objectionable if they threaten to alter characteristics that are distinctively human. Before we can determine whether or not a genetic technique carries this risk, we must clarify what it means to be “human”. This paper inquires how “humanness” has been defined within various academic fields. The views of several legal theoreists, scientists, bioethicists, psychologists, philosophers and anthropologists whose works seem to best reflect how “humanness” is understood in their respective fields of study are considered. Our survey attempts to chart a path for a more detailed study on the meaning of “humanness” in the future.

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...

La thérapie rationnelle des émotions est basée sur l’hypothèse qu’un trouble de la pensée conduit à des troubles du sentiment qui eux-mêmes conduisent à des troubles de comportement. Du point de vue thérapeutique, la stratégie consiste à corriger les sentiments et le comportement en modifiant le trouble de raisonnement. Cette forme très en vogue de psychothérapie des troubles émotionnels fournit une illustration intéressante des relations nomologiques intriquées qui peuvent exister entre les patrons relativement fixes d’états émotionnels, d’états comportementaux et d’états sensoriels physiologiques. En tant que telle, elle fournit une source d’évidences plausible en faveur de l’hypothèse que les émotions sont une forme spécialisée de système nomologique ou une « espèce ». Le succès de la théorie rationnelle des émotions jette le doute sur le mantra philosophique actuel qui refuse aux émotions le statut d’espèce naturelle, car elle suggère précisément l’inverse, c’est-à-dire que les émotions sont bel et bien une forme d’« espèce naturelle ». Cet appui n’a pas été pris en considération dans le débat en cours au sujet du statut d’espèce naturelle de l’émotion. Il est particulièrement intéressant de noter la façon dont il nous force à repenser la notion d’espèce naturelle telle qu’elle est employée dans les débats philosophiques sur la question. D’autres formulations qui correspondent mieux aux pratiques des sciences concernées pourraient être nécessaires. [English abstrast] Rational Emotive Therapy is based on the hypothesis that disordered thinking leads to disordered feeling, which then leads to disordered behavior. Therapeutically, the strategy it is to correct disordered feeling and behavior by changing the disordered thinking. This immensely popular form of psychotherapy for emotional disorders provides an interesting illustration of the intricate law-like relationships that can exist between relatively fixed patterns of emotional, behavioral, and physiological sensory states. As such, it provides a plausible source of evidence for the hypothesis that emotions form a specialized law-like system or ‘kind’. Evidence of the success of Rational Emotive Therapy casts doubt on the contemporary philosophical mantra that emotions do not form a natural kind. It suggests precisely the opposite, namely, that emotions do form a ‘natural kind’ of some sort. This evidence has not been considered in the ongoing debate over the natural kind status of emotion. Especially interesting is how it forces us to rethink the way in which the notion of a natural kind is usually deployed in philosophical debates in this area. Alternative formulations more in line with the practices of the relevant sciences may be needed

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.

In a recent survey of contemporary philosophy of emotion, Ronald de Sousa states that "in recent years … emotions have once again become the focus of vigorous interest in philosophy, as well as in other branches of cognitive science" (de Sousa 2003, 1). He then goes on to make the important observation that "in view of the proliferation of increasingly fruitful exchanges between researchers of different stripes, it is no longer useful to speak of the philosophy of emotion in isolation from the approaches of other disciplines, particularly psychology, neurology and evolutionary biology" (de Sousa 2003, 1). This last remark is particularly apt in the case of a topic like modularity and emotion, which represents an ideal opportunity for reflecting on the emerging alliance between the philosophy of emotion and emotion science. In addition to being interesting in its own right, the topic also illustrates some of the perils associated with the new alliance, as different academic traditions must adapt to interdisciplinary dialogue...

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.

We are grateful for these two insightful commentaries, which both see novelty and value in the manner in which we invoke the hypothesis that anorexia nervosa is a passion, to help explain data from the Anorexia Experiences Study, which provides the basis of our inquiry. In this response, we wish to clarify and elaborate on our hypothesis; in particular, the difference between passions and moods, the manner in which our hypothesis touches on issues of authenticity and identity, and the compelling parallel with addiction. We also wish to emphasize that, in proposing the hypothesis that anorexia nervosa is a passion, our primary aim is not so much to exclude or replace alternative theoretical approaches. Our focus, really, is to argue that the hypothesis that anorexia nervosa is a passion adds something rich and unique to our current understanding of that condition, which is not fully or adequately captured by alternative accounts...

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.

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.

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.

In Passion and reason, acclaimed social psychologist Richard Lazarus and co-author Bernice Lazarus attempt a project they say is unique. Their goal is to provide a popular account of the emotions for the lay reader which is comprehensive, does not over-simplify, and can serve as a guide to greater self-knowledge and understanding. The book is intended to strike a balance between the naive `formulaic genre' of typical self-help books on the subject, while at the same time avoiding the complexity and technical jargon typical of academic treatises. The theoretical basis of the book is Lazarus's own work on emotion, of which Emotion and adaptation (Lazarus, 1991) is the most recent and thorough expression...

Hyman (2007) should be commended for bringing up the vexing question of how “loss of control” in addiction relates to issues of moral responsibility. However, his account suffers from a cognitive bias that overlooks the affective and emotional dimensions of addiction. To fully understand these issues, we need to look beyond the confines of cognition and cognitive neuroscience. It is not the case that addiction must be either a brain disease or a moral condition, which is Hyman’s starting point (2007, 8). This dilemma is false. Addiction is both a brain disease and a moral condition and only by admitting the perspective of affective neuroscience can we explain why...

Addiction of the variety discussed in this chapter, is a condition that by its very nature compromises decision-making capacity across the decisional spectrum. The impairment is present not only at moments of withdrawal and intoxication, but at all stages of the active addictive cycle, as long as the pathological dispositions to overvalue addictive drugs remain entrenched and operative. In light of this entrenched and pervasive reorientation in pathological values, it seems reasonable to question the unilateral presumption of capacity for cases of this sort. The reason is that there is an important, but restricted, sense in which the addicted individuals in question are not ‘responsible’ for their decisions regarding drug use. The high likelihood of relapse means that, as a clinical matter of fact, they are usually not accountable. At the same time, clinical experience also suggests that we should treat addicted individuals as if they are responsible because that empowerment is crucial to their recovery. In the end, there is probably only one safe course of action to take when faced with such a difficult situation. This is to suspend the unilateral global presumption of capacity and instead assess decision-making capacity on a case-by-case basis, with careful monitoring and encouragement.

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...

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.

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.

Psychopathology is the science of what mental illnesses are. Affective psychopathology – or, alternately, the ‘psychopathology of affectivity’ – is the branch of psychopathology devoted to the study of mental disorders that implicate mental states associated with moods and emotions and what used to be called ‘passions’. Some segments of the history of affective psychopathology have been skillfully traced. However, there is one episode in that history that has not received the attention it deserves. It concerns medical writers in France, England, and Scotland, during the latter half of the eighteenth century. The issue at stake is whether affective psychopathology should include or exclude questions of morality.

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.

The question of decision-making capacity for informed consent to experimental brain surgery for severely ill anorectic patients is about as dramatic an ethical issue one can imagine. Sabine Muller and her co-authors (2015) should be commended for this extremely timely and original clinical and ethical discussion of decision-making capacity in relation to the issues raised by informed consent to such therapies. In this commentary, I elaborate on the new account of the nature of anorexia nervosa that the authors allude to in order to frame their discussion. This is the hypothesis that anorexia nervosa is a passion: a view with important implications for how we think about decision-making capacity in anorexia nervosa and elsewhere

The question of decision-making capacity for informed consent to experimental brain surgery for severely ill anorectic patients is about as dramatic an ethical issue one can imagine. Sabine Müller and her co-authors (2015) should be commended for this extremely timely and original clinical and ethical discussion of decision-making capacity in relation to the issues raised by informed consent to such therapies. It is not only the therapies themselves that are innovative in this discussion, but also the overall theoretical approach taken to decision-making capacity and informed consent. Even the understanding of anorexia nervosa is novel. The ethical stakes are certainly very high, since by some measures this is the deadliest off all mental disorders...

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.