Tim Thornton

The very idea of mental illness is contested. Given its differences from physical illnesses, is it right to count it, and particular mental illnesses, as genuinely medical as opposed to moral matters? One debate concerns its value-ladenness, which has been used by anti-psychiatrists to argue that it does not exist. Recent attempts to define mental illness divide both on the presence of values and on their consequences. Philosophers and psychiatrists have explored the nature of the general kinds that mental illnesses might comprise, influenced by psychiatric taxonomies such as the Diagnostic and Statistical Manual and the International Classification of Diseases, and the rise of a rival biological ‘meta-taxonomy’: the Research Domain Criteria (RDoC). The assumption that the concept of mental illness has a culturally invariant core has also been questioned. This book serves as a guide to these contested debates.

I argue that Wright’s constructivist action of intention is fundamentally flawed and that the source of its error can be diagnosed by locating it within its strategic context; Wright’s response to Wittgenstein on rules. Wright deploys intentions as an analogy to disarm Kripkean scepticism. Since we can have direct knowledge of the content of our intentions, Kripke’s claim that knowledge of the content of rules cannot be direct and must be inferential is question begging. But Wright goes on to concede that a substantial explanation should be given of how first person grasp of content is possible for which he deploys constructivism. I raise a number of criticisms to show that constructivism fails to explain our knowledge of intentions. Finally I show that Wright’s failure fits into a pattern anticipated by Wittgenstein. The ongoing judgments that are supposed to determine the content of intentions are like the interpretations of rules which fail because they stand in need of further interpretation. Contra Wright I claim that the moral of the rule following considerations is precisely that no substantial answer can be given to the question of how the content of mental states can be grasped. The phenomenon of mental content must simply be presupposed and not reductively explained.

John McDowell's contribution to philosophy has ranged across Greek philosophy, philosophy of language, philosophy of mind, metaphysics and ethics. His writings have drawn on the works of, amongst others, Aristotle, Kant, Hegel, Frege, Russell, Wittgenstein, Sellars, and Davidson. His contributions have made him one of the most widely read, discussed and challenging philosophers writing today. This book provides a careful account of the main claims that McDowell advances in a number of different areas of philosophy. The interconnections between the different arguments are highlighted and Tim Thornton shows how these individual projects are unified in a post-Kantian framework that articulates the preconditions of thought and language. Thornton sets out the differing strands of McDowell's work prior to, and leading up to, their combination in the broader philosophical vision revealed in "Mind and World" and provides an interpretative and critical framework that will help shape ongoing debates surrounding McDowell's work. An underlying theme of the book is whether McDowell's therapeutic approach to philosophy, which owes much to the later Wittgenstein, is consistent with the substance of McDowell's discussion of nature that uses the vocabulary of other philosophers including, centrally, Kant.

John McDowell is one of the most widely read philosophers in recent years. His engagement with a philosophy of language, mind and ethics and with philosophers ranging from Aristotle and Wittgenstein to Hegel and Gadamer make him one of the most original and outstanding philosophical thinkers of the post-war period. In this clear and engaging book, Tim Thornton introduces and examines the full range of McDowell's thought. After a helpful introduction setting out McDowell's general view of philosophy, Thornton introduces and explains the following topics: Wittgenstein on philosophy, normativity and understanding; value judgements; theories of meaning and sense; singular thought and Cartesianism; perceptual experience and knowledge, disjunctivism and openness to the world; Mind and World, the content of perceptual experience and idealism; action and the debate with Hubert Dreyfus on conceptual content and skilled coping. This second edition has been significantly revised and expanded to include new sections on: McDowell's work on disjunctivism and criticisms of it; a new chapter on McDowell's modification of his account of perceptual experience and conceptual content, and criticisms by Charles Travis; and a new chapter on action and McDowell's engagement with Hubert Dreyfus and the debate concerning skilled coping and mindedness. The addition of a glossary and suggestions for further reading makes John McDowell, second edition essential reading for those studying McDowell, philosophy of language, philosophy of mind, ethics and epistemology, as well as for students of the recent history of analytical philosophy generally.

The notion of capacity implicit in the Mental Capacity Act is subject to a tension between two claims. On the one hand, capacity is assessed relative to a particular decision. It is the capacity to make one kind of judgement, specifically, rather than another. So one can have capacity in one area and not have it in another. On the other hand, capacity is supposed to be independent of the ‘wisdom’ or otherwise of the decision made. (‘A person is not to be treated as unable to make a decision merely because he makes an unwise decision.’ Department of Constitutional Affairs 2005, section 1). One may have capacity even if the decision one arrives at is seen as unwise by one’s doctor. In this short note, I explore this ..

In this introduction to Section VI, the thrust of the component chapters is described. The classification and diagnosis of mental disorders collects a number of philosophical challenges to the field that call for responses from a variety of philosophical resources: hermeneutics, phenomenology, philosophy of mind, narrative theory, philosophy of science, epistemology-to name a few. The authors in this section address the general challenges in the classification of psychopathology, as well as address particular kinds of mental disorders, including autism, dementia, mania, psychotic disorders, and personality disorders.

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections.

A cross-disciplinary discussion of the basis of interpersonal relating is of interest to philosophers and psychiatrists for several reasons. The development of successful clinical practice may depend, at least partly, on having an accurate understanding of the basic character of unimpaired interpersonal relating because such understanding can shed light on the nature and source of its disturbed forms. How we think about the basis of "mind-minding" competencies influences how we think about the prognosis and possible treatment of dysfunctional interpersonal relating. Another reason is that philosophical frameworks influence the way we think about and evaluate possible psychiatric disorders and philosophical discussions may be of direct practical importance to psychiatry given that different theories suggest different potential ways of devising therapies.

Following on from Section IV on summoning concepts, this section of the Handbook presents theoretically informed descriptions of psychopathologies. The topics of the chapters range from anxiety, depression, and body image disorders, through emotion and affective disorders, to delusion, thought insertion, and the fragmentation of consciousness. These phenomena call, not only for assessment and diagnosis, but also for understanding on the part of both the engaged clinician and the philosophical commentator. They also provide case studies for general philosophical questions about different levels of description and conceptualisation and the relationships between them, and about the contributions to psychological understanding that are made by phenomenology, clinical expert knowledge, and the sciences of the mind.

This section concerns the question of how best to understand the scientific status of mental health care in general and psychiatry in particular. On the assumption that psychiatry is based, in part at least, on natural science, what is the nature or the general shape of that science? Some of the chapters aim at shedding light on component parts of a scientific world view: causation, explanation, natural kinds, models of medicine, etc. Others concern potentially fruitful scientific approaches to mental health care, drawing on brain imaging results, phenomenology, enactivism and what can be learnt from debate of the status of psychoanalysis. One overall lesson is that twenty-first-century psychiatry needs twenty-first-century philosophy of science.

In this introduction to the Section II, the thrust of the component chapters is described. An important strand in the philosophy of psychiatry since its beginnings has been sociopolitical critiques: criticism which aims to improve and humanize psychiatric practice and mental health systems. From this standpoint, the introduction provides an overview of this tradition, including considerations of "postpsychiatry," value commitments in psychiatry, the recovery movement, racism and sexism in the field, and technology.

This Section examines several moral dilemmas and epistemological aporias in clinical practice and shows how clinicians can benefit from the introduction of philosophical methods and discourse. The authors develop these issues having in mind emblematic mental disorders and typical clinical situations. One important claim shared by the Authors is that a great effort has been made to ground psychiatry on evidence-based science, and to tie it to our growing understanding of the human brain. This is obviously an exceedingly important project, but it would be a mistake to assume that the central questions of psychiatry can be completely resolved through scientific inquiry. Science offers guidance for clinical practice only in light of our concepts and normative judgments.

This chapter sets out an account of tacit knowledge as conceptually structured, situation specific practical knowledge. It sets this out against two claims from Michael Polanyi which conjoin the idea that we know more than we can tell with the suggestion that knowledge is practical. Any account of tacit knowledge which attempts to respond to Polanyi’s first claim faces a twofold test of adequacy. It must be tacit and it must be knowledge. To count as knowledge some content must be known but that puts pressure on its tacit status. What stops such a content being put into words? I reject Polanyi’s attempt to answer this based on a distinction between focal and subsidiary awareness. And I reject Harry Collins’ process-based approach that looks more to ontology than epistemology or reference more than sense. By equating tacit knowledge with conceptually structured, situation specific practical knowledge or know-how, I show the respect in which it remains tacit. Although it can be expressed in demonstrations, and is related to concepts, it cannot be expressed in words alone.