Jeanette Kennett

Mental time travel is the ability to simulate alternative pasts and futures. It is often described as the ability to project a sense of self in the service of diachronic agency. It requires not only semantic representation but affective sampling of alternative futures. If people lose this ability for affective sampling their sense of self is diminished. They have less of a self to project hence are compromised as agents. If they cannot “feel the future” they cannot imaginatively inhabit it and hence their agency is compromised. The extent of such losses and consequent impairments to moral agency can be matters of degree.

Pickard (2012) claims that the neurobiological or disease model of addiction hinders the recovery of people because it undermines their feeling of self-efficacy and agency. Sub- stance users are “not aided by being treated as victims of a neurobiological disease, as opposed to agents of their own recovery” (40).Although Pickard acknowledges that claims of powerlessness or loss of agency can have a functional role in the self-narratives of substance users in excusing them from blame, she primarily focuses on the negative effects of the diseasemodel on the recovery of substance users. Preliminary evidence from in-depth interviews with heroin-dependent participants in our current cohort study on addiction and moral identity supports Pickard’s claims in part: Substance users describe grades of control, psychological distress, and loss of options, and an ambivalent attitude toward their belief in self-efficacy. However the interviews also provide points of critique. While Pickard is right to dismiss the more extreme claims of proponents of the disease model—namely, that drug use in addicts is literally compelled—user responses suggest that an understanding of the neurobiology of addiction might in some respects support rather than undermine a sense of agency. Moreover, there is reason to suppose that the relation be- tween substance use and psychological distress is not as straightforward as Pickard claims. In this respect we believe the debate must become more nuanced and move beyond a simple opposition between the disease model and the rational choice model endorsed by Pickard.

Kant claimed both that "moral feeling is the capacity to be affected by a moral judgment" and that moral motivation is motivation by principle. What are the psychological mechanism that could enable principles to motivate? This chapter develops in more detail a suggestion made elsewhere by the author that posits a connection between susceptibility to the discomfort of cognitive dissonance and moral motivation of a broadly Kantian kind. The chapter argues that the possession of principles is constitutively connected to one’s status as a diachronic self and to one’s rational agentive capacities. If psychopaths are insensitive to cognitive dissonance, they cannot have or be motivated by principles. This provides an explanation of the failure of moral motivation in psychopaths that differs from the usual focus on lack of empathy.

Psychopaths have long been of interest to moral philosophers, since a careful examination of their peculiar deficiencies may reveal what features are normally critical to the development of moral agency. What underlies the psychopath's amoralism? A common and plausible answer to this question is that the psychopath lacks empathy. Lack of empathy is also claimed to be a critical impairment in autism, yet it is not at all clear that autistic individuals share the psychopath's amoralism. How is empathy characterized in the literature, and how crucial is empathy, so described, to moral understanding and agency? I argue that an examination of moral thinking in high-functioning autistic people supports a Kantian rather than a Humean account of moral agency.

We argue that companion friendship is not importantly marked by self-disclosure as understood in either of these two ways. One's close friends need not be markedly similar to oneself, as is claimed by the mirror account, nor is the role of private information in establishing and maintaining intimacy important in the way claimed by the secrets view. Our claim will be that the mirror and secrets views not only fail to identify features that are in part constitutive of close or companion friendship, but that they miss the mark quite broadly and fail to capture anything significant and distinctive about the ways in which friendship has an impact on the self. The article will proceed as follows. In the first section we outline our account of the self in friendship. In the next two sections we examine the mirror and secrets views and develop our own view in counterpoint to these. In the final section we defend our own account by showing how it provides the governing conditions which do distinguish friendship from other kinds of relations between persons.

Substance use and misuse occurs at a very high rate among people with mental health problems and the relationship between the two conditions is complex. In this paper we argue that treatment of substance use in dual diagnosis clients must begin from an understanding of the losses suffered by those with mental illness. We outline the fundamental condition of effective agency, unified agency, which is disrupted in mental illness and show how this is needed to secure access to central social and moral goods such as continuing employment and satisfying relationships. We argue that drug use will be disvaluable primarily in so far as it too prevents access to this set of agential goods and focuses the agent on synchronic well-being to the exclusion of diachronic well-being. The goals and methods of treatment for dual diagnosis patients should thus reflect the primary impairment to unified agency.

What is the role and value of pleasure in addiction? Foddy and Savulescu have claimed that substance use is just pleasure-oriented behavior. They describe addiction as "strong appetites toward pleasure" and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction. Well don't get me wrong, I love using mate. If I could use successfully I would. I'd still be using. I love using. I just don't like the shit that comes with it.

Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder) is a condition in which a person appears to possess more than one personality, and sometimes very many. Some recent criminal cases involving defendants with DID have resulted in "not guilty" verdicts, though the defense is not always successful in this regard. Walter Sinnott-Armstrong and Stephen Behnke have argued that we should excuse DID sufferers from responsibility, only if at the time of the act the person was insane (typically delusional); otherwise the presumption should be that persons with DID are indeed responsible for their actions. We find their interpretation of DID and of the way in which the requirements for criminal insanity relate to this condition worrying and likely to result in injustice to DID sufferers. Our thesis is that persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency (namely, autonomy and self-control).