Jack Sadler

Values are action-guiding dispositions that are subject to praise or blame, and as such are fundamental in making choices and taking action in any human context, including clinical practice and research. The first half of the chapter reviews the contemporary role of philosophical value theory in understanding the clinical process of diagnosis and the development of formal classifications of psychopathology. The second half of the chapter discusses the kinds of values evident in these areas and raises unanswered questions for the field. Despite two decades of progress in understanding the key role of values in clinical and classificatory work, the open disclosure and negotiation of values in psychiatry remains a novel idea for many, and psychiatric and philosophical research into the area of values and diagnosis/classification is only in its infancy.

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.

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.

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.

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.

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.

The Oxford Handbook of Psychiatric Ethics is the most comprehensive treatment of the field in history. The volume is organized into ten sections which survey the scope of the text: Introduction, People Come First, Specific Populations, Philosophy and Psychiatric Ethics, Religious Contexts of Psychiatric Ethics, Social Contexts of Psychiatric Ethics, Ethics in Psychiatric Citizenship and the Law, Ethics of Psychiatric Research, Ethics and Values in Psychiatric Assessment and Diagnosis, Ethics and Values in Psychiatric Treatment. Written and edited by an international team of experts, this landmark book provides a powerful and compelling review of psychiatric ethics in the 21st Century.

Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. The series will aim to build links between the sciences and humanities in psychiatry. Our ability to decipher mental disorders depends to a unique extent on both the sciences and the humanities. Science provides insight into the 'causes' of a problem, enabling us to formulate an 'explanation', and the humanities provide insight into its 'meanings' and helps with our 'understanding'. Psychiatry, if it is to develop as a balanced discipline, must draw on input from both of these spheres. Nature (for causes) and Narrative (for meanings) will help define the series as a whole by touching on a range of issues relevant to this 'border country'. With contributions from an international star-studded cast, representing the field of psychiatry, psychology and philosophy, this volume will set the scene for this new interdisciplinary field. This will be of interest to all those with practical experience of mental health issues, whether as providers or as users/consumers of services, as well as to philosophers, social scientists, and bioethicists

This essay introduces a thematic issue focused on the contributions to clinical ethics and the philosophy of medicine by Richard M. Zaner. We consider the apparent divorce of Zaners philosophical roots from his recent narrative immersions into the blooming, buzzing confusions of clinical-moral lifeworlds. Our considerations of the Zanerian context and origins of the clinical encounter introduce the fundamental questions faced by Zaner and his commentators in this issue, questions about the role of ethics consultants, moral authority, and clinical truths.

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and much more. The Oxford Handbook of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic.

The concept of vice-wrongful or criminal conduct-poses a metaphysical clash with the non-moral values of impairment, injury, and incapacity that drive illness/disorder concepts. Nevertheless, vice and disorder concepts have interpenetrated psychiatry past and present through practical social-service interactions between the mental health, adult and juvenile criminal justice, and intellectual disability systems. This chapter will unpack and briefly review the philosophical issues, including considerations of moral and legal responsibility, diagnostic constructs, and the medicalization of vice in contemporary psychiatry.

A recent literature review of commentaries and ‘state of the art’ articles from researchers in psychiatric genetics (PMG) offers a consensus about progress in the science of genetics, disappointments in the discovery of new and effective treatments, and a general optimism about the future of the field. I argue that optimism for the field of psychiatric molecular genetics (PMG) is overwrought, and consider progress in the field in reference to a sample estimate of US National Institute of Mental Health funding for this paradigm for the years 2008 and 2009. I conclude that the amounts of financial investment in PMG is questionable from an ethical perspective, given other research and clinical needs in the USA

Friends, family, and the Association of the Advancement of Philosophy and Psychiatry community mourn the death of Osborne "Ozzie" Wiggins this past May 18. In many ways, his story contributes a large portion to the founding of the AAPP, this journal, and the philosophy/psychiatry community worldwide.I met Professor Wiggins as a sophomore at Southern Methodist University in Dallas in 1974. I was a student in his twentieth-century humanities class. I didn't know at the time that he was in his early years as an academic, having recently obtained his PhD in philosophy from the New School for Social Research in New York. Moreover, I hadn't yet encountered a teacher who was so audacious as to tell his students on...

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the 30th Anniversary Issue of Philosophy, Psychiatry, & PsychologyJohn Z. Sadler (bio)This issue marks the 30th anniversary of Philosophy, Psychiatry, and Psychology (PPP). All of us at the journal are grateful to our authors, readers, editors, and publishers for enabling this landmark. To commemorate this event, I invited our Founding Editor and Chair of the Advisory Board, K.W.M. "Bill" Fulford to write a brief essay, along with our panel of smart and industrious senior editors. Their instructions were simple: 500 words on PPP past, present, and/or future. These essays appear in the pages to follow. As Editor-in-Chief, I write about PPP's early commitments as a scholarly journal, situate these in the history of academic publishing, and muse over our current moment.Bill Fulford briefly discusses the early years of the journal in his essay. My perspective emerges from an editor's perspective. As co-editors in the early years, Bill and I were committed to an international authorship with comparable editorial oversight. We wanted to build a journal that would equally recognize clinical science and practice and philosophy, maintaining the rigor of each field. We saw philosophers and mental health practitioners as equal partners, collaborators, innovators, and educators. More important, PPP was intended to offer up the best criticism of the mental health and related fields.The scattershot history of scholarly editing has identified several functions of the editor over the centuries following Gutenberg's invention of the printing press in the mid-1440s. The earliest editors took liberties with the language of the Bible, trying to make it more accessible to the public; the printing press permitted fast and inexpensive reproduction. Not surprisingly, this popularizing of the Bible led to praise as well as outrage. The printing of other scholarly works followed quickly. In 1470, only about 25 years after the invention of the printing press, Niccolo Perroni called for Pope Paul II to censor Andrea Bussi's edition of Pliny the Elder's Natural History, an anthology of then-ancient writings about the natural world. This marked the first recorded instance of censorship of a more-or-less secular scholarly work (Monfasani, 1988). In the ensuing centuries, "editors" initially were the popularizers, and later the gatekeepers of texts worth (and not worth) reading. In the [End Page 1] ensuing centuries into the present, editors have been venerated both as defenders of good reading and reviled as censors or intellectual selfaggrandizers.The current moment, in my view, represents a crisis in the history of editing and editorship. Digital communications have liberated communications worldwide. However, this liberty has come at the cost of colossal amounts of material not worth reading and an explosion of divisive, destructive discourse. Even worse, internet "trolls" on social media have moved bullying out of the schoolyard and into international cyberspace. Determining what is worth reading has moved away from a cluster of (hopefully) responsible editors to anyone who wants to go to the small effort of silencing others through online harassment and even violent threats. Such cyberbullying does not eliminate elitism, but instead substitutes a toxic online "elite" without principle other than self-promotion and the alienation of others. Our contemporary online culture has yet to figure out how to shape what is, and is not, worth reading.My wish and intent for the future of PPP is to maintain and grow our place of rational, deliberative, and open discourse, even in the face of such disruptive cultural change.John Z. Sadler John Z. Sadler, MD, is the Editor-in-Chief of PPP. He is the Daniel W. Foster, MD, Professor of Medical Ethics at the University of Texas Southwestern Medical Center, as well as a Professor of Psychiatry there. He has been a PPP editor since its inception.ReferenceMonfasani, J. (1988). The first call for press censorship: Niccolo Perotti, Giovanni Andrea Bussi, Antonio Moreto, and the editing of Pliny's Natural History. Renaissance Quarterly, 41, 1–31. Google ScholarCopyright © 2023 Johns Hopkins University Press...

Readers, please welcome the new Philosophy, Psychiatry, & Psychology editorial team of Senior Editors and our Managing Editor. We are grateful to keep our veteran Senior Editors Tim Thornton, Nancy Potter, Mona Gupta, and Werdie van Staden. However, we are equally grateful to have our new cohort of Senior editors, Awais Aftab, Anna Bergqvist, Derek Strijbos, and Michael Wong, revitalize our efforts. Many of you already know our efficient and capable Managing Editor, Sébastien Arviset, who has been with us for several years now. This new influx of talent and energy we hope will invigorate the Journal and keep our editorial operations smooth and efficient. In alphabetical order, our editors can tell you a little...