George Graham

Psychiatry is unique in medicine in being on the border between science and the humanities. Science provides insight into the 'causes' of a problem, enabling us to formulate an 'explanation', while the humanities provide insight into its 'meanings' and helps with our 'understanding'. The new interdisciplinary field of 'philosophy of psychiatry' has developed to explore the range of issues relevant to this border country. The Oxford Textbook of Philosophy and Psychiatry is a unique textbook which provides a detailed introduction to the field, a framework for study and skill development, and an overview of current research. It focuses on case studies in 5 key topic areas. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading

Les délires sont des composantes cruciales de nombreux troubles psychiques, surtout la schizophrénie. Que sont les délires? Selon l’opinion courante, il s’agit d’un type de croyance, plus précisément, une croyance pathologique. Malheureusement, l’opinion courante ne correspond pas rigoureusement, dans tous les cas, à la pratique clinique, où l’expression « délire » est souvent appliquée à des états qui ne sont pas des croyances. Nous examinons les raisons pour lesquelles des états qui ne sont pas des croyances peuvent être considérés comme des délires. Nous soutenons que les délires sont des structures complexes d’attitudes d’ordre supérieur et inférieur. Ils constituent un type spécifique de défaillance de la connaissance et de la gestion de soi. Nous fournirons une description du type en question. Notre point de vue implique sur le plan conceptuel que les croyances ne sont pas essentielles aux délires.Delusions are critical components in a number of mental disorders, schizophrenia formost. What are they? The standard view is that they are a type of belief — a pathological belief. Unfortunately, the standard view does not consistently correspond to clinical practice, where the term « delusion » often applies to non-beliefs. We review the case for saying that non-beliefs can count as delusions. We argue that delusions are complexes of higher and lower order attitudes. They constitute a distinctive type of failure of self-knowledge and self-management. We describe the relevant type. One of the conceptual implications of our view is that beliefs need not be central to delusions.

Are delusions best understood as a species of belief? Can I be deluded that p without believing that p? Because delusion is a clinical symptom, there are conflicting data at every turn. Perhaps it is best to think of delusions as beliefs not because they necessarily are beliefs, but because doing so helps patients. If one thinks that “denying that delusions are beliefs” means denying deluded patients “a voice in their own treatment” and that this would cut them off from alternative and healthier ways of thinking of themselves or the world, then one may wish to classify delusions as beliefs (see Kinderman and Bentall 2007, 288). I do not wish to classify delusions as beliefs (and I doubt ..

In lieu of an abstract, here is a brief excerpt of the content:In and Out of MeGeorge Graham (bio)An important role in many recent philosophical analyses of personal well-being and psychological health has been played by a principle I call the "the principle of responsible innerness." This principle states that a person is psychologically healthy and well only if she or he acts in critical situations on preferences and desires that are responsibly in her or him rather than being merely in her or him. Various analyses have been proposed of what it means for a desire or preference to be responsibly in a person—namely, that he or she identify with it or that the desire or preference be part of his or her wholehearted or decisive identity as a person. Harry Frankfurt (1988) has formulated a version of the principle in his accounts of personal caring and freedom of will. Charles Taylor (1976) has deployed a version of the principle in his account of self-assessment and personal redefinition. In this issue of Philosophy, Psychiatry, & Psychology, Mark Rego with deference to Frankfurt suggests how a responsible innerness principle (Rego does not name the principle as such, of course, because the neologism is my own) might be deployed in a therapeutic setting. In this brief commentary I explore an obvious commitment of the principle, namely that there is a difference between the responsible psychological inside of a person and both the mere (nonresponsible) inside and the outside. In connection with the presupposition I include some comments on Rego's thoughtful and suggestive paper.Individuating MeWhat individuates a person? What makes a person one person or individual as opposed to another person or individual?One hypothesis is that an individual person is individuated by their being a particular living human animal (see Olson 2003; Van Inwagen 1990). Mark Rego (the name) refers to one particular living human animal. George Graham (the name) refers to another. In my case an animalist (someone who holds that an individual human person is a particular living human animal) would say that I am nothing other than the six-foot tall living human animal whose photograph you would take if you were to take a picture of me writing this brief commentary. I am not an immaterial substance nor am I a composite made out of any such substance and this animal body (or some part of it). I am, instead, a biological being, made of biological parts—the organs, cells, and so forth of which living human animals are made.Although one might worry about just how animals themselves are individuated, it is not too hard to appreciate what philosophers (like Eric Olson and others) who favor animalism must be attracted to. The attraction of animalism is this: individuation requires limits or boundaries and, for animalism, whatever is in the animal as a proper part of its being alive therein is in the person, whereas whatever is outside of the animal therein is outside of the person. So, if I am a particular living human animal, and if something is in or out of me, this means it is inside or [End Page 323] outside, respectively, my living body. Various neurons are in me; the heavenly stars are out of me. Various information processes are in me; the athletic dispositions of the Boston Red Sox are out of me.Suppose animalism is true. Suppose I am nothing other than this particular six-foot tall living human animal. Suppose also that I have a mental health problem. Suppose I am a pathological gambler. Suppose, in addition, that I am under the care of a therapist. With her help I have learned various facts about my addiction: that it thrives on a variable ratio schedule of reinforcement, that it is strengthened by my quasi-prayerful invocations of a mythic figure I call "Lady Luck," and that it relieves albeit severely imprudently assorted stresses and strains in my professional career. Alas, though, such lessons notwithstanding, I gamble. I am in the grips of an addiction. My therapist tells me that I should avoid self-deception and acknowledge or own up to the fact that I am addicted. She claims, too, that I should disown or...