Louis C. Charland

(1958 - 2021)

I am delighted that Zachar and Potter have chosen to refer to my work on the DSM-IV cluster B personality disorders in their very interesting and ambitious target article. Their suggestion that we turn to virtue ethics rather than traditional moral theory to understand the relation between moral and nonmoral factors in personality disorders is certainly original and worth pursuing. Yet, in the final instance, I am not entirely sure about the exact scope of their proposed analysis. I also worry whether they may have inadvertently presented a slightly inaccurate account of my views on the cluster B personality disorders, as they seek to formulate and defend their own views, which seem to be far wider in scope. I ..

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...

How does one scientifically verify a psychometric instrument designed to assess the mental competence of medical patients who are asked to consent to medical treatment? Aside from satisfying technical requirements like statistical reliability, results yielded by such a test must conform to at least some accepted pretheoretical desiderata; for example, determinations of competence, as measured by the test, must capture a minimal core of accepted basic intuitions about what competence means and what a theory of competence is supposed to do. The concepts of “face validity” and “content validity” are both important here. Face validity “indicates that an instrument appears to test what it is supposed to and that it is a plausible method for doing so” (Portney and Watkins 2000, 82). Content validity “means that the test contains all the elements that reflect the variable being studied” (Portney and..

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...

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.

In this paper I link two hitherto disconnected sets of results in the philosophy of emotions and explore their implications for the computational theory of mind. The argument of the paper is that, for just the same reasons that some computationalists have thought that cognition may be a natural kind, so the same can plausibly be argued of emotion. The core of the argument is that emotions are a representation-governed phenomenon and that the explanation of how they figure in behaviour must as such be undertaken in those terms. I conclude with some interdisciplinary reflections in defence of the hypothesis that emotions might be more fundamental in the organization of behaviour than cognition; that, in effect, we may be emoters before we are cognizers . The aim of the paper is: (1) to introduce a number of promising results in philosophical and empirical emotion theory to a wider audience; and (2) to begin the task of organizing those results into a computational theoretical framework

Paradoxically, the profession whose primary mandate is to instruct and comment on matters of ethics spends inordinately little time reflecting on its own ethical practices. Consider the fact that while professional ethicists of all stripes crusade to expose and denounce conflicts of interests in all other branches of the health care system, they typically fail to pay much attention to their own potential ‘ethical’ conflicts of interest. Admittedly, there have been some efforts to address the problem. However, despite laudable intentions, they are highly unsatisfactory. Unenforceable ‘model’ draft codes of ethics on professional websites,1 and obscure addenda to technical reports that are only available at a cost,2 do not constitute acceptable responses to this predicament. Th is is a problem of profound social importance, a matter that threatens the very foundation, integrity and accountability of one of the most powerful forces in the modern health care system.

It has been argued recently that some basic emotions should be considered natural kinds. This is different from the question whether as a class emotions form a natural kind; that is, whether emotion is a natural kind. The consensus on that issue appears to be negative. I argue that this pessimism is unwarranted and that there are in fact good reasons for entertaining the hypothesis that emotion is a natural kind. I interpret this to mean that there exists a distinct natural class of organisms whose behavior and development are governed by emotion. These are emoters. Two arguments for the natural kind status of emotion are considered. Both converge on the existence of emotion as a distinct natural domain governed by its own laws and regularities. There are then some reasons for being optimistic about the prospects for consilience in emotion theory. 1 The mantra 2 Griffiths on emotions as natural kinds 3 Panksepp on emotions as natural kinds 4 Emotion as a neurobiological kind 5 Emotion as a psychological kind 6 Response to the mantra 7 Unification or fragmentation? 8 Concluding remarks.

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.

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

Clinton is certainly correct that there can be serious ethical problems with mental health professionals referring clients with substance dependence and other addictionrelated problems to 12-step programs. But the philosophical doctrine of representationalism he proposes is not a helpful way to address those issues. It seems more like red herring that only serves to detract attention from the real problem. This is the coercive nature of referrals to 12-step programs in many treatment and rehabilitation centres. Clinton’s discussion is helpful because it invites us to consider this important ethical issue. But unfortunately his analysis fails to address the issue satisfactorily. At the same time, it seriously misconstrues the nature of 12- step programs, obscuring their own ethical stance on consent, eligibility and membership...

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...

Contemporary diagnostic criteria for anorexia nervosa explicitly refer to affective states of fear and anxiety regarding weight gain, as well as a fixed and very strong attachment to the pursuit of thinness as an overarching personal goal. Yet current treatments for that condition often have a decidedly cognitive orientation and the exact nature of the contribution of affective states and processes to anorexia nervosa remains largely uncharted theoretically. Taking our inspiration from the history of psychiatry, we argue that conceptualizing anorexia nervosa as a passion is a promising way forward in both our understanding and treatment of that condition. Building on the theory of the passions elaborated by Théodule Ribot, the founder of scientific psychology in France, we argue that there is convincing empirical evidence in defense of the empirical hypothesis that anorexia nervosa is a passion in Ribot’s specific, technical sense. We then explore the implications of this finding for current approaches to treatment, including cognitive–behavioral therapy, and clinical and ethical issues associated with treatment refusals.

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 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...

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

Heroin prescription involves the medical provision of heroin in the treatment of heroin addiction. Rudimentary clinical trials on that treatment modality have been carried out and others are currently underway or in development. However, it is questionable whether subjects considered for such trials are mentally competent to consent to them. The problem has not been sufficiently appreciated in ethical and clinical discussions of the topic. The challenges involved throw new light on the role of value and accountability in contemporary discussions of mental competence.

Louis Charland's ‘Technological reason and the regulation of emotion’ focuses on a specific area, that of the emotions, in which he sees a problematic dominance of the technical attitude. He argues that our technologically oriented psychiatry has taken an instrumentalist approach to regulation of emotion that severely limits and distorts the role of emotion in psychiatric practice. A prominent example is the exclusion of moral judgments and values, emotion-laden aspects of experience, from psychotherapy because they do not fit the technical model. To illustrate his point, Charland both contrasts the modern notion of emotion with the traditional notion of passion, and our contemporary practice of technically regulated emotion with the ‘moral treatment’ of the nineteenth century.

When emotions are mentioned in the literature on mental competence, it is generally because they are thought to influence competence negatively; that is, they are thought to impede or compromise the cognitive capacities that are taken to underlie competence. The purpose of the present discussion is to explore the possibility that emotions might play a more positive role in the determination of competence. Using the MacArthur Treatment Competence Study as an example, it is argued that appreciation, a central theoretical concept in many contemporary approaches to competence, has important emotive components that are seldom sufficiently recognized or acknowledged. If true, this means that some leading contemporary accounts of competence need to be revised in order to make more adequate provision for the positive contribution of emotion.

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...

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.

In lieu of an abstract, here is a brief excerpt of the content:Anorexia and the MacCAT-T Test for Mental Competence:Validity, Value, and EmotionLouis C. Charland (bio)Keywordsmental competence, decisional capacity, anorexia, value, emotionValidity of the MacCAT-THow does one scientifically verify a psychometric instrument designed to assess the mental competence of medical patients who are asked to consent to medical treatment? Aside from satisfying technical requirements like statistical reliability, results yielded by such a test must conform to at least some accepted pretheoretical desiderata; for example, determinations of competence, as measured by the test, must capture a minimal core of accepted basic intuitions about what competence means and what a theory of competence is supposed to do. The concepts of "face validity" and "content validity" are both important here. Face validity "indicates that an instrument appears to test what it is supposed to and that it is a plausible method for doing so" (Portney and Watkins 2000, 82). Content validity "means that the test contains all the elements that reflect the variable being studied" (Portney and Watkins 2000, 83). An adequate instrument for measuring mental competence must at minimum satisfy both of these requirements.What Tan and her colleagues (2006) have shown is that the MacArthur Competence Assessment Tool—Treatment (MacCAT-T) test for mental competence may not be an empirically valid measure of mental competence for some cases of anorexia. The data they report show that "competence," as measured by the MacCAT-T, does not conform sufficiently well with what is wanted of a clinical medical theory of competence. More specifically, the MacCAT-T is deficient in both face and content validity. This result is extremely significant; previous challenges to the validity of the MacCAT-T have often been largely theoretical in nature. My own objection that the MacCAT is inadequate because it omits the influence of emotion is based on a combination of empirical theory (Charland 1998a) and philosophical argument (Charland 1998b). However, it is entirely theoretical in nature. So is my argument that in ignoring emotion the MacCAT misses a crucial contributing ingredient in competence, namely, value (Charland 2001, see especially 136 note 2). Tan's study provides valuable empirical evidence for the second of these challenges, which deals more specifically with value. On the one hand, the study clearly demonstrates that patients sometimes do [End Page 283] base their treatment decisions on reasons derived from values. And on the other hand, it also nicely illustrates the centrality of values—"utilities" or "preferences"—in the decision-making process generally; a basic assumption of standard decision theory for which, paradoxically, there appears to be no satisfactory counterpart in the MacCAT-T model of reasoning and decision making.Thus, values figure among the reasons that patients actually use in reasoning when they weigh the risks and benefits of proposed treatment options. The MacCAT-T must be amended to incorporate this fact if it is to be a satisfactory clinical medical tool. Without such a correction, the concept of mental competence it measures is empirically invalid. At the root of the problem is a clash of intuitions. Tan's data provide convincing evidence that some of the patients who are deemed to be mentally competent by MacCAT-T standards should not in fact be considered competent. Note that the language in which this clash is expressed—"should not in fact"—involves a combination of descriptive and prescriptive elements, reminding us that the concept of competence is dual in nature: it is both prescriptive and descriptive (Freedman 1981). These problems underscore the need for greater clarity about what pretheoretically we want a clinical theory and test of competence to capture. It is of course reasonable to say that such a test must be consistent with major tenets of the relevant case law (Appelbaum 1998). But a legally valid concept of competence of this sort is too thin and arbitrary a foundation on which to build a clinical medical theory of competence. An empirically valid theory and test of the latter sort must incorporate the role of values if it is be truly helpful in medical practice.Value and the MacCAT-TI agree with Tan and her colleagues that some notion of "pathological value" needs to be...