Jack Sadler

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 4.1 (1997) 91-93 Concurrent Contents: Recent and Classic References at the Interface of Philosophy, Psychiatry, and Psychology Articles Allen, J. F., J. Hallperin, and R. Friend. 1985. Removal and diversion tactics and the control of auditory hallucinations. Behavior Research and Therapy 23:601-605.Baker, H. D. 1995. Psychoanalysis and ideology: Bakhtin, Lacan, and Zizek. History of European Ideas 20:499-504.Bernet, R. 1994. Derrida-Husserl-Freud: The trace of transference. Southern Journal of Philosophy 32 suppl.:141-158.Boden, M. A. 1996. Commentary on "Towards a design-based analysis of emotional episodes." Philosophy, Psychiatry, & Psychology 3, no. 2:135-136.Castelfranchi, C., and M. Miceli. 1996. Commentary on "Towards a design-based analysis of emotional episodes." Philosophy, Psychiatry, & Psychology, no. 2:129-133.Fowes, B. J., and F. C. Richardson. 1996. Why is multiculturalism good? American Psychologist 51, no. 6:609-621.Frith, C. 1996. Commentary on "Free will in the light of neuropsychiatry." Philosophy, Psychiatry, & Psychology 3, no. 2:91-93.Forde, R. 1996. Inclusion of psychosocial conditions in clinical practice and the problem of medicalization. Theoretical Medicine 17, no. 2:151-161.Gaylin, W., and D. Doukas. 1995. The second-hand suicide threat. Hastings Center Report 25:20-22.Gillet, G. 1995. Consciousness, thought, and neurological integrity. Journal of Mind and Behavior 16, no. 3:215-233.Haskell, R. E. 1993. Realpolitik in the addictions field: Treatment-professional, popular-culture ideology, and scientific research. Journal of Mind and Behavior 14, no. 3:257-276.Kuys, T. 1995. The tally argument again. Methodological Science 28, nos. 2-3:43-55.Lear, J. 1995. The heterogeneity of the mental: Sebastian Gardner's irrationality and the philosophy of psychoanalysis. Mind: A Quarterly Review of Psychology and Philosophy 104:863-879.Libet, B. 1996. Commentary on "Free will in the light of neuropsychiatry." Philosophy, Psychiatry, & Psychology 2, no. 3:95-96.Lloyd, D. 1996. Commentary on "Toward a design-based analysis of emotional episodes." Philosophy, Psychiatry, & Psychology 3, no. 2:127-128.Pepper-Smith, R., W. R. C. Harvey, and M. Silberfeld. 1996. Competency and practical judgment. Theoretical Medicine 17, no. 2:135-150. [End Page 91]Spence, S. A. 1996a. Free will in the light of neuropsychiatry. Philosophy, Psychiatry, & Psychology 3, no. 2:75-90.------. 1996b. Response to the commentaries. Philosophy, Psychiatry, & Psychology 3, no. 2:99-100.Stein, D. J. 1996. The philosophy of psychopathy. Perspectives in Biology and Medicine 39:569-580.Stephens, G. L. 1996. Commentary on "Free will in the light of neuropsychiatry." Philosophy, Psychiatry, & Psychology 3, no. 2:97-98.Varela, C. R. 1995. Ethnogenic theory and psychoanalysis: The unconscious as a social construction and a failed explanatory concept. Journal for the Theory of Social Behavior 25:4.Weisberger, A. M. 1995. The ethics of the broader usage of Prozac: Social choice or social bias? International Journal of Applied Philosophy 10, no. 1:69-74.Wright, I., A. Sloman, and L. Beaudoin. 1996a. Response to the commentaries. Philosophy, Psychiatry, & Psychology 3, no. 2:137.------. 1996b. Towards a design-based analysis of emotional episodes. Philosophy, Psychiatry, & Psychology 3, no. 2:101-126. Books American Psychiatric Association. Task Force on Consent to Voluntary Hospitalization. 1993. Consent to voluntary hospitalization. Washington, DC: American Psychiatric Association.Christiansen, H. D. 1972. Ethics in counseling: Problem situations. Tucson: University of Arizona Press.Clark, P., and C. Wright, eds. 1988. Mind, psychoanalysis and science. New York: Blackwell.Comerchero, V., ed. 1970. Values in conflict: Christianity, marxism, psychoanalysis, existentialism. New York: Appleton-Century-Crofts.Epstein, R. S. 1994. Keeping boundaries: Maintaining safety and integrity in the psychotherapeutic process. Washington, DC: American Psychiatric Press.Fairbairn, G. J. 1995. Contemplating suicide: The language and ethics of self harm. New York: Routledge.Grubb, A., ed. 1991. Decision-making and problems of incompetence. New York: John Wiley & Sons.Haas, L. J., and J. L. Malouf. 1995. Keeping up the good work: A practitioner's guide to mental health ethics. 2nd ed. Sarasota: Professional Resource Exchange.Hacking, I. 1995. Rewriting the soul: Multiple personality and the sciences of memory. Princeton: Princeton University...

In lieu of an abstract, here is a brief excerpt of the content:Editors’ IntroductionK. W. M. Fulford and John Z. SadlerThe editors are delighted to present the debut of a new feature in Philosophy, Psychiatry, & Psychology, “Clinical Anecdotes.” Clinical Anecdotes are short narrative essays that present, in concise fashion, several philosophical/conceptual issues concerning the experience of psychiatric practice in a realistic, nitty-gritty story format. A Clinical Anecdote essay serves as a stimulus to selected commentators from diverse fields, who will prepare short responses that address any feature of the anecdote that captures their interest and imagination. Clinical Anecdote authors may then conclude the section with their own brief response, if desired.We encourage anyone (clinicians, patients, philosophers, others) interested in the conceptual aspects of psychiatric practice to submit their own Clinical Anecdotes for publication. Submissions should be formatted as a PPP Main Paper, with no requirement for references or an abstract. Clinical Anecdotes should not exceed a 1,500-word limit, and should have an original title relevant to the narrative content of the piece.How will Clinical Anecdotes submissions be evaluated? They will be sent out for peer review as with any other PPP main article, however, what reviewers will be looking for is:• a vivid, engaging, and compelling writing style,• a story that generates multiple areas of conceptual, philosophical, or ethical interest,• relevance to the editorial focus of PPP, and• novelty of theme (the submission addresses issues that have not previously been considered as a Clinical Anecdote).We hope you will find this inaugural essay from Dr. Christopher Bailey thought provoking. [End Page 221]Copyright © 2009 The Johns Hopkins University Press...

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.4 (2005) 307-310 [Access article in PDF] Aesthetics, Criticism, and Psychotherapy John Z. Sadler Keywords aesthetics, psychiatry, psychotherapy, Sibley In his wide-ranging survey of how Kantian aesthetic theory is implicated in psychothera-py, John Callender has raised at least a dozen potentially profound and rewarding possibilities in applying aesthetic theory to psychiatry and psychotherapy. Although the idea of marrying aesthetic theory to psychiatry and psychotherapy is not new, Callender's direction of the merger is distinctively novel. The mid-twentieth century had a distinct literature in applying psychoanalytic and psychiatric theory to aesthetic experience, summarized by the sizable bibliography by Norman Kiell, Psychiatry and Psychology in the Visual Arts and Aesthetics: A Bibliography (1965). This line of interdisciplinary work influenced a later generation of art historians and literary theorists in applying (particularly) psychoanalytic theory to interpretation and appreciation of the arts, contributions that are still being developed today, along with the emergence of complementary viewpoints from cognitive neuroscience (Peretz and Zatorre 2003; Rose 2004; Zeki 1999). Callender's project, however, is quite the converse—he wishes to show how philosophical aesthetics can contribute to psychiatry and clinical psychology. Exploring the aesthetics of psychiatry is the innovation.Before focusing my own comments on a few of Callender's points, I wish to call attention to the substantive questions he has directly raised or implied by his discussions. These questions are worthy of further development in this and other journals, and I hope that Callender will succeed in engaging the minds of his readers and inspire them to work in this exciting area in the philosophy of psychiatry. In his elegant review of Kant's key theoretical points of aesthetics, his discussion provokes us to consider the kinds of evaluations that patients make of themselves (moral? aesthetic? others?), as well as the kinds of evaluations clinicians make in their judgments of psychopathology. Evolutionists may wonder about the adaptive significance of aesthetic capacities (e.g., derivatives of grooming? mating displays?). In presenting Kant's notion of "disinterestedness" or contemplative judgment, readers may wonder about overlap with notions of therapist neutrality and unconditional positive regard. Should therapist relationships with patients be dominated by a similar aesthetic sensibility? What does the aesthetic posture have to do with the therapist posture?Importantly, Callender notes the connections and ambiguities between moral values and aesthetic values. This is borne out in his later discussions of clinical case material (considered again below). He focuses primarily on the duplication of aesthetic and moral values in the same terms of praise (honesty, integrity, originality), but there is no question that aesthetic experiences are had by viewers of art exhibiting perverse or depraved [End Page 307] imagery (consider, for instance, Francis Bacon's "3 Screaming Popes" or, even more extremely, the grotesque staged photographs of Joel-Peter Witkin). The implication here is that (as an example) to understand the aesthetics of sadomasochistic art may help us to understand the psychology of sadomasochistic people.By the time he introduces his case material, Callender has raised the issue of intersubjectivity in aesthetic experience, an experience that may be devoid of discursive cognitive content but may be profound with emotional content, thus challenging tenets of cognitive psychology and psychotherapy. His discussion of cases reflecting elements of Kant's components of aesthetic judgment point toward new ways of understanding psychopathology as disturbances in aesthetic self-appraisal.I would like to return to the problem of moral and aesthetic judgments in psychotherapy and in psychopathology. Dr. Callender presents three cases—a woman who has been traumatized by multiple instances of sexual abuse, a young girl with postpartum depression with fears of losing her child because of bad mothering, and a third patient with anorexia nervosa who demonstrates the typically distorted body self-image. I suggest that the aesthetic nature of these patients' self-judgments is not so clear cut as Callender suggests. His sexual abuse case summary certainly suggests a woman consumed by shame. Because shame is a typical "moral emotion," the question is raised of moral badness being involved in her self-concept as well as, or perhaps...

In lieu of an abstract, here is a brief excerpt of the content:Concurrent Contents: Recent and Classic References at the Interface of Philosophy, Psychiatry, and PsychologyArticlesAntonak, R. J., C. R. Fielder, and J. A. Mulick. 1993. A scale of attitudes toward the application of eugenics to the treatment of people with mental retardation. Journal of Intellect Disabilities Research 37:75–83.Arens, K. 1996. Commentary on “Lumps and bumps.” Philosophy, Psychiatry, & Psychology 3:15–16.Bavidge, M. 1996. Commentary on “Minds, memes, and multiples.” Philosophy, Psychiatry, & Psychology 3:29–30.Blashfield, R. K. 1973. Evaluation of the DSM-II classification of schizophrenia as a nomenclature. Journal of Abnormal Psychology 85(2):140–150.Braude, S. E. 1996. Multiple personality and moral responsibility. Philosophy, Psychiatry, & Psychology 3:37–54.Broverman, I. K., S. R. Vogel, D. M. Broverman et al. 1972. Sex-role stereotypes: a current appraisal. Journal of Social Issues 28:59–78.Broverman, I. K., D. M. Broverman, P. E. Clarkson et al. 1975. Sex-role stereotypes and clinical judgments of mental health. Journal of Consulting and Clinical Psychology 34:1–7.Checkland, D., and M. Silberfeld. 1996. Mental competence and the question of beneficient intervention. Theoretical Medicine 17(2):121–134.Clark, S. R. L. 1996. Commentary on “Multiple personality and moral responsibility.” Philosophy, Psychiatry, & Psychology 3:55–57.Clark, S. R. L. 1996. Minds, memes, and multiples. Philosophy, Psychiatry, & Psychology 3:21–28.Dickenson, D., and D. Jones. 1995. True wishes: The philosophy and developmental psychology of children’s informed consent. Philosophy, Psychiatry, & Psychology 2:287–303.Donaldson, T. 1978. Psychoanalyzing the practical inference model. Philosophical Research Archives 4:1215.Eekelaar, J. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:305–307.Fisher, S., and R. P. Greenberg. 1993. How sound is the double-blind design for evaluating psychotropic drugs? Journal of Nervous and Mental Disease 181:345–350.Fulwiler, C., and M. F. Folstein. 1995. Commentary on “Chris Walker’s interpretation of Karl Jaspers’ phenomenology.” Philosophy, Psychiatry, & Psychology 2:345–346.Heinze, M. 1995. Commentary on “Moralist or therapist?” Philosophy, Psychiatry, & Psychology 2:31–32.Iturrate, M. 1977. Man’s freedom: Freud’s therapeutic goal. Review of Existential Psychology and Psychiatry 15:32–45.Littlewood, R. 1991. From diseae to illness and back again. Lancet 337:1013–1015.Maddox, J. 1993. New genetics means no new ethics. Nature 364:97.McCormick, S. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:309–310.Murray, T. H. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:311–312.Muzika, E. G. 1989. Object relations theory, Buddhism, and the self-synthesis of eastern and western approaches. International Philosophical Quarterly 30(1):59–74.Parker, M. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:313–314.Phillips, J. 1996. Key concepts: Hermeneutics. Philosophy, Psychiatry, & Psychology 3:61–69.Pole, D. 1970. Self and personality. The Journal of the British Society for Phenomenology 1:30–36.Priebe, S. 1989. On the subjectivity of psychiatric diagnosis. Psychiatric Praxis 16:86–89.Radden, J. 1996. Lumps and bumps: Kantian faculty psychology, phrenology, and twentieth-century psychiatric classification. Philosophy, Psychiatry, & Psychology 3:1–14.Sampson, E. E. 1981. Cognitive psychology as ideology. American Psychologist 36:730–743.Sarbin, T. R. 1976. Contextualism: A worldview for modern psychology. Nebraska Symposium on Motivation 24:1–41.Senft, P. A. 1975. The self-contradictions (antinomies) of psychotherapy: Is a solution in social action possible? The Human Context 7:367–372.Shuman, D. W. 1996. Commentary on “Multiple personality and moral responsibility.” Philosophy, Psychiatry, & Psychology 3:59–60.Sprigge, T. 1996. Commentary on “Minds, memes, and multiples.” Philosophy, Psychiatry, & Psychology 3:31–36.Wallace, K. 1996. Commentary on “Lumps and bumps.” Philosophy, Psychiatry, & Psychology 3:17–20.Wells, L. A. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:315–317.Wiggins, O. P., and M. A. Schwartz. 1995. Chris Walker’s interpretation of Karl Jaspers’ phenomenology: a critique. Philosophy, Psychiatry, & Psychology 2:319–343.BooksAmerican Hospital Association. 1994. Values in conflict: Resolving ethical issues in health care. 2nd ed. Chicago: American Hospital Association.American Medical Association. 1992. Code of medical ethics: Annotated current opinions of the council on ethical and judicial affairs. Chicago: American Medical Association.———. 1994. Council on ethical and judicial affairs...

Philosophers have hitherto only interpreted the world in various ways; the point is to change it.Karl marx’s distinction between interpreting the world and changing it points by extension to the state of contemporary philosophy and psychiatry. The 1990s resurgence of interdisciplinary work in this area was driven equally by phenomenological scholarship and by initiatives in analytic philosophy. The former reflected the focus in phenomenology on ‘what it is like’ to experience a given mental symptom with the aim of reconstructing the life-worlds of people experiencing mental disorders, while the latter reflected directly or indirectly the influence of J. L. Austin and others from...

Research ethics consultation is increasingly recognized as a potentially valuable mechanism for addressing the depth and breadth of ethical issues that arise in research related to human health and well-being. However, fundamental questions remain, including: What is “research ethics consultation”? And what is its justification beyond the purposes already served by existing entities? We examine how a research ethics consultation service may differ from or complement the role of an institutional review board by offering a definition of research ethics consultation and by exploring the potential scope of a consultation service in terms of types of clients served, questions addressed, and advice provided at various stages of the research process. We then consider the relationship between research ethics consultation services and IRBs, as well as the issues that may arise between them, including possible conflicts of interest

Contemporary philosophy of science tells us that scientific theories are “underdetermined” by their accompanying data in a variety of ways. Briefly put, theories are not constructed on data alone. Psychiatric classification is subject to this same kind of underdetermination. Theories may be determined by a combination of data, historical factors, practical constraints, value commitments, and other factors. While practical constraints (like user-friendliness or compatibility across diagnostic systems) are commonly admitted to be influential in shaping psychiatric classification, the idea that values shape psychiatric classification is still a controversial one. This article addresses this controversy by (1) defining a particular domain or type of value commitment (epistemic values), (2) showing how they might be assumed in psychiatric classification, (3) developing a set of conceptual tools to analyze epistemic value content, and (4) applying this set of tools to concretely illustrate how this type of value is “at work” in shaping classification. A classic paper on the dispute between categorical and dimensional models for personality disorders is systematically examined to illustrate this “epistemic value” rubric.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.4 (2004) 357-359 [Access article in PDF] A Madness for the Philosophy of Psychiatry John Z. Sadler His enthusiasm brimming over with the rich set of ideas and problems he has discovered, Louis Charland's essay on identity, ethics, and the Internet should be grist for the philosophy of psychiatry mill for years. Indeed, a brief commentary cannot answer the many questions raised by his paper. In response, I would like to focus on two general issues for this essay. Labels, Diagnoses, Reference, Experiences Many psychiatrists will take issue with Charland's use of the term label in reference to mental disorder concepts in this paper. I did not, but his relatively uncritical use of the labels and labeling terms in his essay prompts me to unpack some concepts that lurk behind the many other conceptual issues raised here. Psychiatric "labels" and "labeling" have a derogatory sense for many psychiatrists, because they are associated with a virulent antipsychiatry temperament dating back to the 1960s, at least in the United States (Sadler 2003). For many clinicians (as well as others) labeling implies that there is nothing more to psychiatric diagnosis and "mental illness" than the names given to various sorts of human diversity. This sort of psychiatric nominalism, the viewpoint goes, serves to pigeonhole people for the purposes, primarily, of political control or power. Charland's own viewpoint is more subtle than this, illustrated by his discussion of Hacking's "looping effects" and the related idea that social factors are influential in the manifestations, even causation, of mental disorders, but are not exhaustive in explaining mental disorders. However, because the whole matter of social construction of clinical phenomena is at the heart of Charland's discussion, further consideration of this metaphysical territory is warranted.The notion of a mental disorder concept as "label" betrays little about what, substantively, mental disorders are. A label on a can of peas tells us little, ultimately, about the nature of the contents; indeed, it is only a clue. When we shift labeling from a can of peas to a person—a self—then such a shallow clue to the "contents" of a person is an offensive simplification of a person's identity and selfhood. Hence the railing against psychiatric labeling in the 1960s through today.The general goals for psychiatric diagnosis and classification in systems like DSM-IV is are multiple, but at minimum, such denotations of clinical conditions are intended to advance the generation of knowledge about the conditions as well as provide a "shorthand" for clinicians in communicating about and understanding patients' conditions. How successful these diagnostic classification systems are for these and other purposes is a discussion for another time, but the [End Page 357] point here is that some sort of method of characterizing people's distresses is a precondition for understanding and explaining such distresses. The scientific processes of validation of psychiatric categories, at core, are to ensure that, as Gorenstein notes (1992), our clinical concepts are not empty, self-fulfilling prophecies, but rather refer to other, hopefully predictable, features of the patient's distress. Such validation of clinical "constructs" is the basis for developing and testing specific treatments, as well as understanding more richly and deeply the clinical phenomenon. To have a label, then, under this view, is to have an empty nominalization, which is offensive and scientifically vapid. To have a diagnostic construct—a disorder—is to have a concept which empirically refers to, as Paul Meehl put it, a "nomological network" of predictable, lawlike, implications (Sadler 2004a).However, as Charland, Hacking, and others have noted, the reflexivity of the human self and our ultimately crude ways of characterizing selves leads to a serious problem, even for the most rigorously validated psychological categories. That problem is the changeability of the self, the capacity of people to remake themselves according to their own ideas along with the sociocultural ether of ideas that surrounds us all. This means that our understanding of mental disorders, both as aggregates of features, and well as individual patients over time, are "moving targets," the...

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 295 [Access article in PDF] Agency, Narrative, and Self:A Philosophical Case Conference John Z. Sadler and K. W. M. Fulford This issue of PPP features our second "philosophical case conference," which addresses three important and interrelated concepts in the philosophy of psychiatry. Our first philosophical case conference (Philosophy, Psychiatry, and Psychology Volume 5, Number 2, 1998) featured detailed case material concerning the manifold issues involved in psychiatric euthanasia. For this issue, guest edited by J. Melvin Woody, the rich cases supplied by Lloyd Wells provide the foundation for a discussion of narrative accounts of the self and what it means to be an agent.Philosophical case conferences are an occasional feature of PPP, and develop topics to satisfy one or more criteria: to provide discussions that are important to clinical practice or research, to embed current or perennial philosophical debates in the nitty gritty of clinical practice and personal experience, and/or to provide a clinical testing ground for new conceptual developments relevant to the philosophy of psychiatry.The format for this issue involves four feature articles, the first by Wells, presenting detailed case material of several patients, followed by discussions (by Kennett & Matthews, Phillips, and Woody) inspired by, or addressing explicitly, the philosophical questions implied in such cases. Following these four feature articles, a panel of commentators (Glas, Hardcastle, Radden, Thornton, Weiner, Woodbridge) respond to the four feature articles as they wish, providing the variations on the agency, narrative, and self themes. We think you will find this issue of PPP to be a fine example of what the philosophy of psychiatry can do, and we give our abundant thanks to Mel Woody for putting this issue together....

The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question "How should I live?" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process.