Martin Stokhof

Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes that OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study.We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c)characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one’s abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research.

This paper is about a topic in the semantics of interrogatives.1 In what follows a number of assumptions figure at the background which, though intuitively appealing, have not gone unchallenged, and it seems therefore only fair to draw the reader’s attention to them at the outset. The first assumption concerns a very global intuition about the kind of semantic objects that we associate with interrogatives. The intuition is that there is an intimate relationship between interrogatives and their answers: an interrogative determines what counts as an answer.2 Given a certain, independently motivated, view on what constitutes the meaning of an answer, this intuition, in return, determines what constitutes the meaning of an interrogative. For example, starting from the observation that answers are true or false in situations, we may be led to the view that answers express propositions, i.e., objects which determine a truth value in a situation. Given that much, our basic intuition says that interrogatives are to be associated with objects which determine propositions. Such objects will be referred to as ‘questions’ in what follows. Notice that all this is largely framework independent: we have made no assumptions yet about what situations, propositions, and questions are, we have only related them in a certain systematic way. In fact we will use a more or less standard, but certainly not uncontroversial, specification in what follows: situations are identified with (total) possible worlds; propositions with sets of worlds; and questions with equivalence relations on the set of worlds. The second assumption that plays a role in what follows is of a more linguistic nature. Interrogatives typically occur in two ways: as independent expressions, and as complements of certain verbs. The assumption is that these two ways of occurring are systematically related, not just syntactically but also semantically.3 Notice that the exact nature of this relationship is underdeter..

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment.

When one looks into the role of artificial languages in philosophy of language it seems appropriate to start with making a distinction between philosophy of language proper and formal semantics of natural language. Although the distinction between the two disciplines may not always be easy to make since there arguably exist substantial historical and systematic relationships between the two, it nevertheless pays to keep the two apart, at least initially, since the motivation commonly given for the use of artificial languages in philosophy of language is often rather different from the one that drives the use of such languages in semantics. Of course, this difference in motivation should not blind us for the commonalities that exists between the two disciplines. Philosophy of language and formal semantics have a common history, and arguably also share some of their substance. Philosophy of language is by and large an outgrowth of work in the analytical tradition in philosophy in the first half of the twentieth century. Both ordinary language philosophy, with its emphasis on the description of actual language use, as well as the more logic-oriented and formally inclined school of logical positivism contributed to the definition of philosophy of language as a separate philosophical discipline, with its own set of problems and methods to solve them. Another major contributor to the establishment of philosophy of language as a distinct discipline has been modern linguistics, in particular generative grammar in the tradition of Chomsky that became the dominant paradigm in linguisticsin the fifties and sixties of the previous century. And as it happens, both the generative tradition of Chomsky and analytic philosophy in its formal and less formal guises have been important factors in the development of formal semantics as well. Thus, it should come as no surprise that the two have something in common. That the communalities go beyond a common ancestry, but are reflected in substance and methods as well, will be argued later on. However, be that as it may, it is still a good idea to keep philosophy of language and formal semantics separate, at least initially, since the role that is assigned to artificial languages and the ways in which these languages are employed in both does differ in a number of respects that are worth keeping in mind..

This paper1 explores, quite tentatively, possible consequences for the concept of semantics of two phenomena concerning meaning and interpretation, viz., radical interpretation and normativity of meaning. Both, it will be argued, challenge the way in which meaning is conceived of in semantics and thereby the status of the discipline itself. For several reasons it seems opportune to explore these issues. If one reviews the developments in semantics over the past two decades, one observes that quite a bit has changed, and one may well wonder how to assess these changes. This relates directly to the status of semantics. If semantics is an empirical discipline, one might expect that most changes are informed by empirical considerations. However, one may also note that the core notion of semantics, meaning, today is conceived of quite differently than in, say, the seventies. How can that be? How can that what semantics is about, be different now from what is was back then? Or is this perhaps an indication that semantics is not as empirical as it is often thought to be? Moreover, it seems that in some deep sense meaning as explicated in semantics and interpretation as studied in various philosophical approaches are strangely at odds. Meaning is what interpretation is concerned with: meaning is, at least so it seems, what in the process of interpretation language users try to recover (or analogously, what they try to convey in production). Yet, the way meaning is conceived of in semantics seems not to square all that neatly with how the process of interpretation is supposed to proceed. In particular it seems to lack some of the intrinsic features that various approaches to interpretation assume it to have. Given these discrepancies, one wonders how the two can be incorporated within a single theory. And that such a theory is desirable goes, it may be presumed, without saying These are the reasons that figure in this paper. At the background there are some others..