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A Theory of Feelings Anger and Forgiveness"My Madness Saved Me"10 Good Questions about Life and Death12 Modern Philosophers50 Reasons People Give for Believing in a GodA Cabinet of Philosophical CuriositiesA Case for IronyA Companion to BioethicsA Companion to Buddhist PhilosophyA Companion to FoucaultA Companion to GenethicsA Companion to GenethicsA Companion to HumeA Companion to KantA Companion to Phenomenology and ExistentialismA Companion to PragmatismA Companion to the Philosophy of ActionA Companion to the Philosophy of BiologyA Companion to the Philosophy of LiteratureA Conceptual History of PsychologyA Critical Overview of Biological FunctionsA Critique of Naturalistic Philosophies of MindA Cursing Brain?A Delicate BalanceA Farewell to AlmsA Frightening LoveA Future for PresentismA Guide to the Good LifeA History of PsychiatryA History of the MindA Life Worth LivingA Manual of Experimental PhilosophyA Map of the MindA Metaphysics of PsychopathologyA Mind So RareA Natural History of Human MoralityA Natural History of Human ThinkingA Natural History of VisionA Parliament of MindsA Philosopher Looks at The Sense of HumorA Philosophical DiseaseA Philosophy of BoredomA Philosophy of Cinematic ArtA Philosophy of CultureA Philosophy of EmptinessA Philosophy of FearA Philosophy of PainA Physicalist ManifestoA Place for ConsciousnessA Question of TrustA Research Agenda for DSM-VA Revolution of the MindA Sentimentalist Theory of the MindA Stroll With William JamesA Tear is an Intellectual ThingA Theory of FreedomA Thousand MachinesA Universe of ConsciousnessA Very Bad WizardA Virtue EpistemologyA World Full of GodsA World Without ValuesAbout FaceAbout the Beginning of the Hermeneutics of the SelfAction and ResponsibilityAction in ContextAction Theory, Rationality and CompulsionAction, Contemplation, and HappinessAction, Emotion and WillAdam SmithAdaptive DynamicsAddictionAddictionAddiction and ResponsibilityAddiction Is a ChoiceAdvances in Identity Theory and ResearchAftermathAfterwarAgainst AdaptationAgainst AutonomyAgainst BioethicsAgainst HappinessAgainst HealthAgency and ActionAgency and AnswerabilityAgency and EmbodimentAgency and ResponsibilityAgency, Freedom, and Moral ResponsibilityAl-JununAlain BadiouAlain BadiouAlasdair MacIntyreAlien Landscapes?Altered EgosAn Anthology of Psychiatric EthicsAn Ethics for TodayAn Intellectual History of CannibalismAn Interpretation of DesireAn Introduction to EthicsAn Introduction to Kant's Moral Philosophy An Introduction to Philosophy of EducationAn Introduction to the Philosophy of MindAn Introduction to the Philosophy of MindAn Introduction to the Philosophy of PsychologyAn Introductory Philosophy of MedicineAn Odd Kind of FameAnalytic FreudAnalytic Philosophy in AmericaAncient AngerAncient Models of MindAncient Philosophy of the SelfAngerAnimal LessonsAnimal MindsAnimals Like UsAnnihilationAnother PlanetAnswers for AristotleAnti-ExternalismAnti-Individualism and KnowledgeAntigone’s ClaimAntipsychiatryAre We Hardwired?Are Women Human?Arguing about DisabilityArguing About Human NatureAristotle and the Philosophy of FriendshipAristotle on Practical WisdomAristotle's ChildrenAristotle's Ethics and Moral ResponsibilityAristotle, Emotions, and EducationArt & MoralityArt After Conceptual ArtArt in Three DimensionsArt, Self and KnowledgeArtificial ConsciousnessArtificial HappinessAspects of PsychologismAsylum to ActionAtonement and ForgivenessAttention is Cognitive UnisonAutobiography as PhilosophyAutonomyAutonomy and Mental DisorderAutonomy and the Challenges to LiberalismBabies by DesignBackslidingBadiouBadiou's DeleuzeBadiou, Balibar, Ranciere: Rethinking EmancipationBare Facts And Naked TruthsBasic Desert, Reactive Attitudes and Free WillBattlestar Galactica and PhilosophyBeautyBecoming a SubjectBecoming HumanBehavingBehavioral Genetics in the Postgenomic EraBeing AmoralBeing HumanBeing Mentally Ill: A Sociological Theory Being No OneBeing Realistic about ReasonsBeing ReducedBeing YourselfBelief's Own EthicsBending Over BackwardsBerlin Childhood around 1900Bernard WilliamsBertrand RussellBetter than BothBetter Than WellBetween Two WorldsBeyond HealthBeyond Hegel and NietzscheBeyond KuhnBeyond LossBeyond Moral JudgmentBeyond PostmodernismBeyond ReductionBeyond the DSM StoryBioethicsBioethics and the BrainBioethics in the ClinicBiological Complexity and Integrative PluralismBiology Is TechnologyBiosBipolar ExpeditionsBlackwell Companion to the Philosophy of EducationBlindsight & The Nature of ConsciousnessBlues - Philosophy for EveryoneBlushBob Dylan and PhilosophyBody ConsciousnessBody Image And Body SchemaBody ImagesBody LanguageBody MattersBody WorkBody-Subjects and Disordered MindsBoundBoundaries of the MindBoyleBrain Evolution and CognitionBrain FictionBrain, Mind, and Human Behavior in Contemporary Cognitive ScienceBrain-WiseBrainchildrenBrains, Buddhas, and BelievingBrainstormingBrave New WorldsBreakdown of WillBrief Child Therapy Homework PlannerBrief Inquiry into the Meaning of Sin and FaithBrief Therapy Homework PlannerBritain on the CouchBrute RationalityBuffy the Vampire Slayer and PhilosophyBut Is It Art?Camus and SartreCartesian LinguisticsCartographies of the MindCarving Nature at Its JointsCase Studies in Biomedical Research EthicsCassandra's DaughterCato's TearsCausation and CounterfactualsCauses, Laws, and Free WillChanging Conceptions of the Child from the Renaissance to Post-ModernityChanging the SubjectChaosophyCharacter and Moral Psychology Character as Moral FictionCharles DarwinCherishmentChildhood and the Philosophy of EducationChildrenChildren, Families, and Health Care Decision MakingChoices and ConflictChoosing Not to ChooseChristmas - Philosophy for EveryoneCinema, Philosophy, BergmanCinematic MythmakingCity and Soul in Plato's RepublicClassifying MadnessClear and Queer ThinkingClinical EthicsClinical Psychiatry in Imperial GermanyCodependent ForevermoreCoffee - Philosophy for EveryoneCognition and the BrainCognition of Value in Aristotle's EthicsCognition Through Understanding: Self-Knowledge, Interlocution, Reasoning, ReflectionCognitive BiologyCognitive FictionsCognitive Neuroscience of EmotionCognitive Systems and the Extended MindCognitive Systems and the Extended Mind Cognitive Theories of Mental IllnessCoherence in Thought and ActionCollected Papers, Volume 1Collected Papers, Volume 2College SexComedy IncarnateCommitmentCommunicative Action and Rational ChoiceCompetence, Condemnation, and CommitmentConcealment And ExposureConceptual Analysis and Philosophical NaturalismConceptual Art and PaintingConceptual Issues in Evolutionary BiologyConfessionsConfucianismConnected, or What It Means to Live in the Network SocietyConquest of AbundanceConscience and ConvenienceConsciousnessConsciousnessConsciousnessConsciousness ConsciousnessConsciousness and Its Place in NatureConsciousness and LanguageConsciousness and Mental LifeConsciousness and MindConsciousness and the NovelConsciousness and the SelfConsciousness EmergingConsciousness EvolvingConsciousness ExplainedConsciousness in ActionConsciousness RecoveredConsciousness RevisitedConsciousness, Color, and ContentConsole and ClassifyConstructing the WorldConstructive AnalysisContemporary Debates In Applied EthicsContemporary Debates in Moral TheoryContemporary Debates in Philosophy of BiologyContemporary Debates in Philosophy of MindContemporary Debates in Political PhilosophyContemporary Debates in Social PhilosophyContemporary Perspectives on Natural LawContested Knowledge: Social Theory TodayContesting PsychiatryContext and the AttitudesContinental Philosophy of ScienceControlControlling Our DestiniesConversations About Psychology and Sexual OrientationCopernicus, Darwin and FreudCrazy for YouCreating a Life of Meaning and CompassionCreating ConsilienceCreating HysteriaCreating Mental IllnessCreating Scientific ConceptsCreating the American JunkieCreation, Rationality and AutonomyCreatures Like Us?Crime and CulpabilityCrime, Punishment, and Mental IllnessCrimes of ReasonCritical New Perspectives on Attention Deficit/Hyperactivity DisorderCritical PsychiatryCritical PsychologyCritical ResistanceCritical Thinking About PsychologyCritical VisionsCross and KhoraCruel CompassionCTRL [SPACE]Cultural Psychology of the SelfCultural Theory: An IntroductionCulture and Psychiatric DiagnosisCulture and Subjective Well-BeingCulture of DeathCultures of NeurastheniaCurious EmotionsCurrent Controversies in Experimental PhilosophyCustom and Reason in HumeCustomers and Patrons of the Mad-TradeCutting God in Half - And Putting the Pieces Together AgainCylons in AmericaDamaged IdentitiesDamasio's Error and Descartes' TruthDangerous EmotionsDaniel DennettDaniel DennettDark AgesDarwin and DesignDarwin's Dangerous IdeaDarwin's LegacyDarwin, God and the Meaning of LifeDarwinian PsychiatryDarwinian ReductionismDarwinizing CultureDating: Philosophy for EveryoneDeathDeathDeath and CharacterDeath and CompassionDeath and the AfterlifeDebating DesignDebating HumanismDecision Making, Personhood and DementiaDecomposing the WillDeconstructing PsychotherapyDeconstruction and DemocracyDeeper Than DarwinDeeper than ReasonDefending Science - within ReasonDefining Psychopathology in the 21st CenturyDegrees of BeliefDelusion and Self-DeceptionDelusions and Other Irrational BeliefsDelusions and the Madness of the MassesDementiaDemons, Dreamers, and MadmenDennett and Ricoeur on the Narrative SelfDennett’s PhilosophyDepression Is a ChoiceDepression, Emotion and the SelfDepthDerrida, Deleuze, PsychoanalysisDescartesDescartes and the Passionate MindDescartes' CogitoDescartes's Changing MindDescartes's Concept of MindDescribing Inner Experience?Descriptions and PrescriptionsDesembodied Spirits and Deanimated Bodies Desert Islands and Other Texts (1953-1974)Desire and AffectDesire, Practical Reason, and the GoodDeveloping the VirtuesDiagnosing the Diagnostic and Statistical Manual of Mental DisordersDialectics of the SelfDid My Neurons Make Me Do It?Difference and IdentityDigital SoulDimensional Models of Personality DisordersDisability, Difference, DiscriminationDisjunctivismDisorders of VolitionDisorientation and Moral LifeDispatches from the Freud WarsDisrupted LivesDistractionDisturbed ConsciousnessDivided Minds and Successive SelvesDo Apes Read Minds?Do Fish Feel Pain?Do We Still Need Doctors?Does Consciousness Cause Behavior?Does the Woman Exist?Doing without ConceptsDon't Believe Everything You ThinkDonald DavidsonDonald Davidson on Truth, Meaning, and the MentalDoubting Darwin?Dreaming and Other Involuntary MentationDSM-IV SourcebookDSM-IV SourcebookDSM-IV-TR CasebookDworkin and His CriticsDying to KnowDynamics in ActionDysthymia and the Spectrum of Chronic DepressionsEccentricsEducational MetamorphosesEffective IntentionsElbow Room: The Varieties of Free Will Worth WantingEmbodied Minds in ActionEmbodied RhetoricsEmbodied Selves and Divided MindsEmbryos under the MicroscopeEmergencies in Mental Health PracticeEmerging Conceptual, Ethical and Policy Issues in BionanotechnologyEmotionEmotion and ConsciousnessEmotion and PsycheEmotion ExperienceEmotion RegulationEmotion, Evolution, And RationalityEmotional IntelligenceEmotional ReasonEmotional ReasonEmotional TruthEmotions in Humans and ArtifactsEmotions in the Moral LifeEmotions in the Moral LifeEmotions, Value, and AgencyEmpathyEmpathy and AgencyEmpathy and Moral DevelopmentEmpathy and MoralityEmpathy in the Context of PhilosophyEmpirical Ethics in PsychiatryEnchanted LoomsEngaging BuddhismEngineering the Human GermlineEnjoymentEnvyEpicureanismEpistemic LuckEpistemologyEpistemology and EmotionsEpistemology and the Psychology of Human JudgmentEros and the GoodErotic MoralityEssays in Social NeuroscienceEssays in the Metaphysics of Mind Essays on Derek Parfit's On What MattersEssays on Free Will and Moral ResponsibilityEssays on Nonconceptual ContentEssays on Philosophical CounselingEssays on Reference, Language, and MindEssays on the Concept of Mind in Early-Modern PhilosophyEssential Sources in the Scientific Study of ConsciousnessEsssential Philosophy of PsychiatryEternal Sunshine of the Spotless MindEthical Conflicts in PsychologyEthical Issues in Forensic Mental Health ResearchEthical Issues in Human CloningEthical TheoryEthicsEthicsEthics and the A PrioriEthics and the Metaphysics of MedicineEthics and Values in PsychotherapyEthics Done RightEthics ExpertiseEthics in Plain EnglishEthics in PracticeEthics in Psychiatric ResearchEthics of PsychiatryEthics without OntologyEuropean Review of Philosophy. Vol. 5Everyday IrrationalityEvil in Modern ThoughtEvolutionEvolution and the Human MindEvolution's RainbowEvolutionary Origins of MoralityEvolutionary PsychologyExamined LifeExamined LivesExistential AmericaExistentialismExistentialism and Romantic LoveExperimental PhilosophyExperimental PhilosophyExperimental PhilosophyExperimental Philosophy, Rationalism, and NaturalismExperiments in EthicsExplaining ConsciousnessExplaining the BrainExplaining the Computational MindExplanatory PluralismExploding the Gene MythExploring HappinessExploring the SelfExpression and the InnerExpressions of JudgmentFaces of IntentionFact and ValueFact and Value in EmotionFacts, Values, and NormsFads and Fallacies in the Social SciencesFaith and Wisdom in ScienceFatherhoodFear of KnowledgeFearless SpeechFeeling Pain and Being in PainFeelings and EmotionsFeelings of BeingFellow-Feeling and the Moral LifeFeminism and Its DiscontentsFeminism and Philosophy of ScienceFeminist Ethics and Social and Political PhilosophyFeminist Interpretations of Rene DescartesFeminist TheoryField Notes from ElsewhereFinding Consciousness in the BrainFingerprints of GodFlesh in the Age of ReasonFolk Psychological NarrativesFolk Psychology Re-AssessedForces of HabitForgivenessForgiveness and LoveForgiveness and RetributionFoucault 2.0Foucault and PhilosophyFoucault NowFoucault, Psychology and the Analytics of PowerFoundational Issues in Human Brain MappingFoundations of Ethical Practice, Research, and Teaching in PsychologyFour Views on Free WillFree WillFree WillFree WillFree WillFree Will and Action ExplanationFree Will and LuckFree Will And Moral ResponsibilityFree Will as an Open Scientific ProblemFree Will, Agency, and Meaning in LifeFree: Why Science Hasn't Disproved Free WillFreedomFreedom and DeterminismFreedom And NeurobiologyFreedom and ResponsibiltyFreedom and ValueFreedom EvolvesFreedom RegainedFreedom vs. InterventionFreedom, Fame, Lying, and BetrayalFreudFreud and the Question of PseudoscienceFreud As PhilosopherFreud's AnswerFreud, the Reluctant PhilosopherFriedrich NietzscheFrom Chance to ChoiceFrom Clinic to ClassroomFrom Complexity to LifeFrom Enlightenment to ReceptivityFrom Knowledge to Wisdom: A Revolution for Science and the HumanitiesFrom Morality to Mental HealthFrom Passions to EmotionsFrom Philosophy to PsychotherapyFrontiers of ConsciousnessFrontiers of JusticeFurnishing the MindGalileo in PittsburghGenderGender and Mental HealthGender in the MirrorGender TroubleGenesGenes, Women, EqualityGenetic Nature/CultureGenetic ProspectsGenetic ProspectsGenetic SecretsGenocide's AftermathGenomes and What to Make of ThemGerman Idealism and the JewGerman PhilosophyGetting HookedGilles DeleuzeGlobal PhilosophyGluttonyGod and Phenomenal ConsciousnessGoffman's LegacyGoing Amiss in Experimental ResearchGoodness & AdviceGrassroots SpiritualityGrave MattersGrave MattersGreedGreek Models of Mind and SelfGut ReactionsHabilitation, Health, and AgencyHabits of MindHallucinationHandbook of BioethicsHandbook of EmotionsHappinessHappinessHappinessHappinessHappiness and EducationHappiness and the Good LifeHappiness Is OverratedHappiness, Death, and the Remainder of LifeHard LuckHarmful ThoughtsHaving the World in ViewHealing PsychiatryHealing the Soul in the Age of the BrainHealth, Illness and DiseaseHealth, Science, and Ordinary LanguageHegelHeidegger and a Metaphysics of FeelingHeidegger, Metaphysics and the Univocity of BeingHermann von Helmholtz's MechanismHermeneutics As PoliticsHeterophobiaHeterosyncraciesHeuristics and BiasesHeuristics and the LawHidden ResourcesHidden SelvesHiding from HumanityHigh Art LiteHistorical OntologyHistory of Psychiatry and Medical PsychologyHistory, Historicity And ScienceHobbesHomosexualitiesHope and Dread in PsychoanalysisHot ThoughtHow Can I Be Trusted?How Can the Human Mind Occur in the Physical Universe?How Children Learn the Meanings of WordsHow Could Conscious Experiences Affect Brains?How Do We Know Who We Are?How Emotions WorkHow Emotions WorkHow History Made the MindHow Images ThinkHow is Nature Possible?How Propaganda WorksHow Science WorksHow Scientific Practices MatterHow Scientists Explain DiseaseHow The Body Shapes The MindHow the Body Shapes the Way We ThinkHow the Mind Explains BehaviorHow the Mind Uses the BrainHow to Make Opportunity EqualHow to Solve the Mind-Body Problemhow to stop timeHow to Think More About SexHow We HopeHow We ReasonHuman CloningHuman Development, Language and the Future of MankindHuman EnhancementHuman Evolution, Reproduction, and MoralityHuman GoodnessHuman Identity and BioethicsHuman NatureHuman NatureHuman Nature and the Limits of ScienceHuman-Built WorldHumanismHumanism, What's That?HumanityHumans, Animals, MachinesHumeHumeHume on Motivation and VirtueHusserlHystoriesI of the VortexI Was WrongIdeas that MatterIdentifying the MindIdentity and Agency in Cultural WorldsIgnorance and ImaginationIllnessImagination and Its PathologiesImagination and the Meaningful BrainImagining NumbersImmortal RemainsImproving Nature?In Defense of an Evolutionary Concept of HealthIn Defense of SentimentalityIn Love With LifeIn Praise of Athletic BeautyIn Praise of the WhipIn Pursuit of HappinessIn Search of HappinessIn the Name of GodIn the Name of IdentityIn the Space of ReasonsIn Two MindsIncompatibilism's AllureIndividual Differences in Conscious ExperienceInfinity and PerspectiveInformation ArtsInformed Consent in Medical ResearchIngmar Bergman, Cinematic PhilosopherInhuman ThoughtsInner PresenceInsanityIntegrating Psychotherapy and PharmacotherapyIntegrity and the Fragile SelfIntelligent VirtueIntentionIntentionality, Deliberation and AutonomyIntentions and IntentionalityIntentions and IntentionalityInterpreting MindsInterpreting NietzscheIntroducing Greek PhilosophyIntrospection and ConsciousnessIntrospection VindicatedIntuition, Imagination, and Philosophical MethodologyIntuitionismInvestigating the Psychological WorldIrrationalityIrrationalityIs Academic Feminism Dead?Is It Me or My Meds?Is Long-Term Therapy Unethical?Is Oedipus Online?Is Science Neurotic?Is Science Value Free?Is the Visual World a Grand Illusion?Is There a Duty to Die?Issues in Philosophical CounselingJacques LacanJacques RancièreJacques RanciereJean-Paul SartreJohn McDowellJohn SearleJohn Searle's Ideas About Social RealityJohn Stuart MillJohn Stuart Mill and the Writing of CharacterJoint AttentionJokesJonathan EdwardsJudging and UnderstandingJustice for ChildrenJustice in RobesJustice, Luck, and KnowledgeKantKant and MiltonKant and the Fate of AutonomyKant and the Limits of AutonomyKant and the Role of Pleasure in Moral ActionKant on Freedom, Law, and HappinessKant on Moral AutonomyKant's Anatomy of EvilKant's Anatomy of the Intelligent MindKant's Theory of VirtueKarl JaspersKarl PopperKey Concepts in PhilosophyKierkegaardKierkegaard as PhenomenologistKierkegaard's Concept of DespairKinds of MindsKinds, Things, and StuffKnowing, Knowledge and BeliefsKnowledge MonopoliesKnowledge, Belief, and CharacterKnowledge, Possibility, and ConsciousnessLacanLack of CharacterLack of CharacterLanguageLanguage in ContextLanguage, Consciousness, CultureLanguage, Culture, and MindLanguage, Vision, and MusicLaw and the BrainLaw, Liberty, and PsychiatryLaws, Mind, and Free WillLeaving YouLectures on the History of Political PhilosophyLevelling the Playing FieldLiberal Education in a Knowledge SocietyLiberatory PsychiatryLife and ActionLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLife of the MindLife's FormLife, Death, & MeaningLife, Death, and Meaning: Key Philosophical Readings on the Big Questions Life, Liberty, and the Pursuit of UtilityLife, Sex, and IdeasLight in the Dark RoomLike a Splinter in Your MindLiving and Dying WellLiving NarrativeLiving Outside Mental IllnessLiving with DarwinLiving With One’s PastLockeLocke LockeLogic and the Art of Memory Loneliness in Philosophy, Psychology, and LiteratureLooking for SpinozaLooking for The StrangerLost SoulsLOT 2LoveLoveLove's ConfusionsLove's VisionLove, Friendship, and the SelfLove, Sex & TragedyLuckyLudwig WittgensteinLustLyingMachine ConsciousnessMad for FoucaultMad TravelersMade with WordsMadness And Death In PhilosophyMadness and DemocracyMadness at HomeMadness Is CivilizationMaking Natural KnowledgeMaking Sense of EvolutionMaking Sense of Freedom and ResponsibilityMaking the DSM-5Making the Social WorldMaking TruthMale Female EmailMan, Beast, and ZombieMandated Reporting of Suspected Child AbuseManiaManic Depression and CreativityMapping the Edges and the In-betweenMapping the Future of BiologyMarcus AureliusMaster PassionsMatters of the MindMe++Meaning and Moral OrderMeaning and Value in a Secular AgeMeaning in LifeMeaning in Life and Why It MattersMeaning, Basic Self-Knowledge, and MindMeasuring HappinessMeasuring PsychopathologyMedia MadnessMedical Enhancement and PosthumanityMedicine and Philosophy in Classical AntiquityMedicine of the PersonMedicine, Mental Health, Religion, Science and Well-BeingMelancholy And the Care of the SoulMelancholy and the Otherness of GodMementoMemory and NarrativeMental ActionsMental CausationMental Causation and OntologyMental HealthMental Health At The CrossroadsMental Health Policy in BritainMerit, Meaning, and Human BondageMerleau-PontyMerleau-Ponty and the Possibilities of PhilosophyMetacognition and Theory of MindMetacreationMetaethical SubjectivismMetaethicsMetal and FleshMetaphors of MemoryMetapoliticsMethods in MindMichel FoucaultMill's UtilitarianismMindMindMind and ConsciousnessMind and CosmosMind and MechanismMind GamesMind in a Physical WorldMind in Everyday Life and Cognitive ScienceMind in LifeMind TimeMind's LandscapeMind, Brain and the Elusive SoulMind, Brain, and Free WillMind, Reason and ImaginationMinding MindsMindreadersMindreading AnimalsMinds and PersonsMinds, Brains, and LawMinds, Ethics, and ConditionalsMindshapingMindsightMindworldsMirror, MirrorMixed FeelingsMockingbird YearsModels of the SelfModern Social ImaginariesModern Theories of JusticeModernity and SubjectivityModernity and TechnologyMoody Minds DistemperedMoral BrainsMoral DimensionsMoral FailureMoral ImaginationMoral LiteracyMoral MachinesMoral ParticularismMoral PsychologyMoral Psychology and Human AgencyMoral Psychology, Volume 1Moral Psychology, Volume 2Moral Psychology, Volume 3Moral Psychology: Volume IVMoral RepairMoral Responsibility and Alternative PossibilitiesMoral TribesMoral Value and Human DiversityMorality and Self-InterestMorality in a Natural WorldMorality, Moral Luck and ResponsibilityMotherhoodMotive and RightnessMoving Beyond Prozac, DSM, and the New PsychiatryMultiple Analogies in Science and PhilosophyMultiple Identities & False MemoriesMusic, Madness, and the Unworking of LanguageMy Brain Made Me Do ItMy Double UnveiledMy WayNarrativeNarrative and IdentityNarrative MedicineNarrative PsychiatryNarrative Theory and the Cognitive SciencesNatural Ethical FactsNatural Kinds and Conceptual ChangeNatural MindsNatural-Born CybogsNaturalism and the First-Person PerspectiveNaturalism and the Human ConditionNaturalism in the Philosophy of HealthNaturalism in the Philosophy of HealthNaturalized BioethicsNaturalizing the MindNatureNature and NarrativeNear Death ExperienceNeither Bad nor MadNeither Victim nor SurvivorNeuro-Philosophy and the Healthy MindNeuroethicsNeuroethicsNeurological Foundations of Cognitive Neuroscience Neurophilosophy at WorkNeurophilosophy of Free WillNeuropoliticsNeuropsychoanalysis in PracticeNeuroscience and PhilosophyNew Essays on the Explanation of ActionNew Philosophy for a New MediaNew Versions of VictimsNew Waves in Philosophy of ActionNietzscheNietzsche and Buddhist PhilosophyNietzsche on Ethics and PoliticsNietzsche's TherapyNietzsche, Culture and EducationNietzsche: The Man and His PhilosophyNihil UnboundNoir AnxietyNormative EthicsNormativityNorms of NatureNotebooks 1951-1959Notes Toward a Performative Theory of AssemblyNothing So AbsurdOblivionOn AnxietyOn ApologyOn Being AuthenticOn Being AuthenticOn BeliefOn BetrayalOn BullshitOn DelusionOn DesireOn EmotionsOn HashishOn Human RightsOn Loving Our EnemiesOn Nature and LanguageOn PersonalityOn ReflectionOn Romantic LoveOn the EmotionsOn the Freud WatchOn the Government of the LivingOn the Human ConditionOn the InternetOn the Meaning of LifeOn the Philosophy of LawOn the Pragmatics of CommunicationOn the Punitive SocietyOn TruthOn Virtue EthicsOn What MattersOn What We Owe to Each OtherOne Hundred DaysOnflowOnly a Promise of HappinessOntology of ConsciousnessOpen MindedOpen Your EyesOrgans without BodiesOther MindsOur Last Great IllusionOur Own MindsOur Posthuman FutureOur StoriesOut of Its MindOut of Our HeadsOxford Guide to the MindOxford Handbook of Psychiatric EthicsOxford Textbook of Philosophy of PsychiatryPanic DisorderPanpsychism in the WestPartialityPassionate EnginesPassionate EnginesPathologies of BeliefPathologies of ReasonPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perceiving the WorldPerception & CognitionPerception and Basic BeliefsPerception, Hallucination, and IllusionPerceptual ExperiencePerfecting VirtuePerplexities of ConsciousnessPersistencePersonal AutonomyPersonal Autonomy in SocietyPersonal IdentityPersonal Identity and EthicsPersonal Identity and Fractured SelvesPersonhood and Health CarePersonsPersons and BodiesPersons, Humanity, and the Definition of DeathPersons, Souls and DeathPerspectives on ImitationPerspectives on PragmatismPessimismPhenomenal Concepts and Phenomenal KnowledgePhenomenal ConsciousnessPhenomenal IntentionalityPhenomenology and ExistentialismPhenomenology and Philosophy of MindPhilosophersPhilosophers on MusicPhilosophers without GodsPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical DevicesPhilosophical Foundations of NeurosciencePhilosophical History and the Problem of ConsciousnessPhilosophical Issues in PsychiatryPhilosophical Issues in PsychiatryPhilosophical Issues in Psychiatry IIPhilosophical MethodologyPhilosophical MidwiferyPhilosophical Myths of the FallPhilosophical Perspectives on DepictionPhilosophical Perspectives on Technology and PsychiatryPhilosophical PracticePhilosophical Reflections on DisabilityPhilosophizing About Sex Philosophizing the EverydayPhilosophy and HappinessPhilosophy and LivingPhilosophy and PsychiatryPhilosophy and PsychotherapyPhilosophy and Science FictionPhilosophy and the EmotionsPhilosophy and the EmotionsPhilosophy and the Interpretation of Pop CulturePhilosophy and the Moving ImagePhilosophy and the NeurosciencesPhilosophy and This Actual WorldPhilosophy As FictionPhilosophy BitesPhilosophy Bites BackPhilosophy for Counselling and PsychotherapyPhilosophy for LifePhilosophy in a New CenturyPhilosophy in an Age of SciencePhilosophy in Children's LiteraturePhilosophy of ActionPhilosophy of ActionPhilosophy of BiologyPhilosophy of BiologyPhilosophy of BiologyPhilosophy of BiologyPhilosophy of BodyPhilosophy of Film and Motion PicturesPhilosophy of LovePhilosophy of Love, Sex, and MarriagePhilosophy of MindPhilosophy of Mind and CognitionPhilosophy of Personal Identity and Multiple PersonalityPhilosophy of PsychologyPhilosophy of Public HealthPhilosophy of SciencePhilosophy of SciencePhilosophy of Technology: The Technological ConditionPhilosophy of the Social SciencesPhilosophy on TapPhilosophy PracticePhilosophy the Day after TomorrowPhilosophy's Role in Counseling and PsychotherapyPhilosophy, Neuroscience and ConsciousnessPhilosophy, Politics, DemocracyPhotography and PhilosophyPhysical RealizationPhysicalism and Its DiscontentsPhysicalism and Mental CausationPhysicalism, or Something Near EnoughPhysician-Assisted DyingPillar of SaltPin-up GrrrlsPlatoPlatoPlato, Not Prozac!Platonic Ethics, Old and NewPluralistic CasuistryPolarities of ExperiencesPolitical EmotionsPopper, Objectivity and the Growth of KnowledgePornPorn StudiesPornography, Sex, and FeminismPortrait of the Psychiatrist as a Young ManPostcolonial DisordersPostpsychiatryPosttraumatic Stress DisorderPower and the SelfPower SplitPractical Autonomy and BioethicsPractical ConflictsPractical Identity and Narrative AgencyPractical PhilosophyPractical RulesPractical Tortoise RaisingPractically ProfoundPracticing Feminist Ethics in PsychologyPragmatic BioethicsPragmatismPragmatism, Old And NewPraise and BlamePredicative MindsPreferences and Well-BeingPrescriptions for the MindPresocraticsPrimary and Secondary QualitiesPrimates and PhilosophersPrivacyPrivileged AccessProblems in MindProblems of RationalityProzac As a Way of LifeProzac BacklashProzac on the CouchPsyche and SomaPsychiatric Aspects of Justification, Excuse and Mitigation in Anglo-American Criminal Law Psychiatric Cultures ComparedPsychiatric Diagnosis and ClassificationPsychiatric EthicsPsychiatric HegemonyPsychiatric PowerPsychiatric SlaveryPsychiatry and Philosophy of SciencePsychiatry and ReligionPsychiatry as a Human SciencePsychiatry as Cognitive NeurosciencePsychiatry in SocietyPsychiatry in the New MilleniumPsychiatry in the Scientific ImagePsychiatry, Psychoanalysis, And The New Biology Of MindPsycho-Physical Dualism TodayPsychoanalysis and Narrative MedicinePsychoanalysis and the Philosophy of SciencePsychological Concepts and Biological PsychiatryPsychology and PhilosophyPsychology and the Question of AgencyPsychology's Interpretive TurnPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychotherapy and ConfidentialityPsychotherapy As PraxisPublic PhilosophyPunishmentPure ImmanencePurple HazePursuing MeaningQuality of Life and Human DifferenceQueer PhilosophyQuestions for FreudQuestions for FreudQuine and Davidson on Language, Thought and RealityRaceRace in Contemporary MedicineRadiant CoolRadical AlterityRadical ExternalismRadical HopeRational and Social AgencyRational CausationRational Choice in an Uncertain WorldRationality + Consciousness = Free WillRationality and FreedomRationality and the Reflective MindRationality in ActionRawls, Dewey, and ConstructivismRe-creating MedicineRe-EmergenceRe-Engineering Philosophy for Limited BeingsReading AutobiographyReading Bernard WilliamsReading SartreReadings in the Philosophy of TechnologyReal MaterialismReal Natures and Familiar ObjectsReal ScienceRealism in ActionReason & EmancipationReason in ActionReason in PhilosophyReason's GriefReasonably ViciousReasoning About Rational AgentsReasoning in Biological DiscoveriesReasons from WithinReasons without RationalismReclaiming CognitionReclaiming the SoulReconceiving SchizophreniaReconstructing Reason and RepresentationReconstructing the Cognitive WorldRecreative MindsRediscovering EmotionRediscovering EmpathyReference and ExistenceReference and the Rational MindReflections On How We LiveReframing Disease ContextuallyRefusing CareRegulating SexReinventing the SoulRelativism and Human RightsRelativism and the Foundations of PhilosophyRelativism and the Foundations of PhilosophyReliable ReasoningReligion without GodRelying on OthersRemembering HomeResponsibility and PunishmentResponsibility and PunishmentResponsibility from the MarginsRestraining RageRethinking ExpertiseRethinking IntrospectionRethinking Mental Health and DisorderRethinking RapeRethinking the DSMRethinking the Sociology of Mental HealthRethinking the Western Understanding of the SelfReturn to ReasonRevolt, She SaidRichard RortyRichard RortyRichard RortyRichard RortyRichard RortyRichard Rorty's New PragmatismRightsRights, Democracy, and Fulfillment in the Era of Identity PoliticsRise And Fall of Soul And SelfRitalin NationRobert NozickRousseauRousseau and the Dilemmas of Modernity Routledge Philosophy Guidebook to Derrida on DeconstructionRules, Reason, and Self-KnowledgeSaints, Scholars, 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Moving Beyond Prozac, DSM, and the New PsychiatryReview - Moving Beyond Prozac, DSM, and the New Psychiatry
The Birth of Postpsychiatry
by Bradley E. Lewis
University of Michigan Press, 2006
Review by Jennifer Hansen, Ph.D.
Jun 27th 2006 (Volume 10, Issue 26)

Firmly ensconced in the biopsychiatry age, wherein wonder drugs like Prozac have revolutionized psychiatric care, and the advent of neuroscience has convinced psychiatric researchers that mental illnesses are essentially diseases best understood via the medical model, Bradley Lewis writes a book calling for the urgent need of a new academic discipline of 'Postpsychiatry.'  In Moving Beyond Prozac, DSM, and the New Psychiatry, Lewis diagnoses how the field of psychiatry has walled itself off from external or internal critiques of its methodological practices, eclectic approaches to healing mental illness, and cultural studies exposés of the political maneuvers of the pharmaceutical industry responsible for the paradigm shift to biopsychiatry.  Without drawing on the innovative theoretical perspectives of the humanities--specifically, postmodernism and post-structuralism--which lay bare the origins of disciplinary practices, examines 'who' are authorized to speak, and what powerful interests conspire to create the boundaries of a discipline in such a way to distinguish the experts from the mere amateurs, psychiatry deludes itself into thinking that it is in sole possession of the 'truth," it is the arbiter of 'good' and 'bad' practices and, above all, that its knowledge is unsullied by ideology or theoretical perspectives.  That is, psychiatrists believe themselves to be 'value-neutral' scientists who are dutifully describing 'real' diseases (read: objective) and held to accountability in their findings by the scientific method.

Lewis' goal is to make a case for devoting resources and energy toward erecting a field of Postpsychiatry, which would move beyond the seemingly unbridgeable science/humanities divide in academic research.  Towards this goal, Lewis clarifies in the first two chapters--"Theorizing Psychiatry" and "Dodging the Science Wars"--how psychiatry has come to see itself, wrongly, as a value-free science and actively rejects the perspectives of humanists, particularly those steeped in the very theories Lewis argues are crucial for exposing the scientific pretense of psychiatry.  Psychiatry has become another player, Lewis argues, in the "Science Wars," where the "fashionable nonsense" of humanists is exposed as the worst kind of relativism, unable to ferret out what is real from what is cultural preference.  Lewis ends chapter two by calling for a détente between these warring factions, and proposes that we might find a third way to the realist/relativist debates by paying careful attention to the epistemological and ontological presuppositions of the realists, pragmatists, and post-structuralists.  Chapter two is a very accessible introduction to the theoretical insights of these three camps and hence does a nice job of setting up a possible compromise between the mutually exclusive stance of the hard-nose scientists vs. the post-structuralist cultural studies professors, by highlighting Lewis' own "semiotic realism," which affirms that knowledge is both rooted in a real world and affected by cultural representations that influence how we make sense of the real.  Bolstering Lewis' epistemological approach are the writings of Charles Sanders Pierce, William James, and Michel Foucault, all of who acknowledged that there was a real world that humans interact with, even though our representations of that world would inevitably be affected by both our larger cultural values and assumptions as well as our human desires to transform it. Hence, Lewis argues that the proper metaphysical stance to take toward the "real world" is to acknowledge that all of our inquiries are motivated by practical questions and that how we make sense of the world will be inextricably shaded by those human desires.

In chapter three, "The New Psychiatry as Discursive Practice," Lewis borrows the analytical tools of Michel Foucault as laid out in the Archeology of Knowledge  and The Order of Things to illustrate how psychiatry set itself up as value-neutral science dedicated to unveiling the 'truth' of mental illness.  Lewis brings Foucault's tools to bear on the a textbook crucial to training new psychiatrists, Introductory Textbook of Psychiatry, and reads this book against the grain.  He illustrates the rhetorical moves within that help set up biopsychiatry as the one and only true method of treating mental illness, that identify descriptivism and neuroscience as the best scientific approaches, and that set up the trusted. Lewis' ultimate goal is to belie the myth that any science, psychiatry in particular, is the only method for accurately grasping the world as it really is, undistorted by human interests.  He persuasively argues that the paradigm shift in psychiatry, away from eclectic and hybrid approaches to mental illness toward neuroscience and the medical model, was really a political coup, orchestrated by various powerful interests invested in making psychiatry fit mainstream medicine.

In chapter four, "Psychiatry and Postmodern Theory," Lewis begins to unfold his positive program of creating Postpsychiatry as either a replacement to biopsychiatry or as an important critical voice.  What is interesting about this and subsequent chapters is that Lewis sets himself up to be criticized in the same vein that he criticized the biopsychiatrists. Namely, he is setting up an exclusive domain of inquiry "best" suited to help us grapple with mental illness and its consequences.  He lays out a methodology--semiotic realism--a metaphysical approach--pluridimensional consequences, acceptable jargon that separates insiders from outsiders, and, sets up the trusted authorities.  By adopting a postmodern frame, psychiatrists would have to abandon the belief that any form of human knowledge is an unobstructed view of the real world.  He explains: "If psychiatrists practiced from within the worldview of a postmodern 'crisis in representation,' they would be much less obsessed with 'getting it right.'  Psychiatry would understand its knowledges not as universal truths but as useful heuristics, necessarily formulated through the constraints of a nontransparent language . . ."(70). Chapter five--"Postdisciplinary Coalitions and Alignments"--focuses particularly on what Lewis takes to be the foundational texts to the field of Postpsychiatry.

In chapter six and seven--"Decoding DSM" and "Prozac and the Posthuman Politics of Cyborgs," Lewis demonstrates what Postpsychiatric analyses look like.  In his critique of the DSM, Lewis argues that earlier attempts to discredit this foundational text for biopsychiatry have made the mistake of arguing that the DSM fails because it is "bad science."  By arguing that the DSM is bad science, the pretensions toward setting psychiatry exclusively on a scientific basis are unquestioned, and hence such critiques do nothing to expose the political interests invested in moving psychiatry toward neuroscience.  Lewis pleads for a rhetorical analysis of the DSM. For Lewis, the fact vs. value distinction is a rhetorical move, designed to elevate scientific thinking as objective, value-neutral, and true.  In fact, Lewis rejects that long hallowed distinction between rhetoric and logic, arguing instead that logical analyses are another form of rhetoric. With such crucial distinctions dislodged, it becomes far more difficult to ferret out true from false accounts of reality; in fact, there are no criteria for determining true and false, in Lewis's metaphysical frame, outside of what is practical or not practical. There is no reason to invest in any one scientific pursuit outside of its ability to bring us closer to our own, all-too-human, ideals of happiness or excellence.  Hence, we should look at the DSM as "bad rhetoric," following Sandra Harding's model of the "science as usual" critiques, which

"open up questions about the very assumptions of science.  They highlight the way dominant scientific discourses do not develop neutral methodological models, distinctions, and priorities outside of a field of power and only later hold to these methodological styles with tenacity characteristic of a battle.  The models, distinctions, and priorities themselves are part of the power struggle between dominant and alternative approaches" (106).

Adopting a frame that characterizes mainstream knowledge as the interests of the dominant group, Lewis sets out to correct what he takes to be an ethical wrong of power struggle knowledge production by insisting on greater inclusion.

In chapter seven, he proposes two concrete solutions for breaking up the stronghold that pharmaceutical companies have over psychiatry, an influence that has aided and abetted the turn toward neuroscience and biotechnology.  First of all, we need to rethink the role of ethics in medicine.  Lewis astutely observes that given the current fact vs. value distinction view of knowledge, ethical analyses come too late.  Ethics committees are entrusted with the task of determining whether an already existing practice is "good" or "bad."  Ethics committees rarely consider the political and social context in which a current biotechnological practice, such as Prozac, comes into existence.  Prozac comes to be seen as a "neutral" medicine that can be used well or badly, i.e. to treat diseases or to enhance human capacities.  To bolster ethical analyses of biotechnologies such as Prozac, Lewis argues that psychiatrists cannot ignore the concrete conditions under which technologies are developed.  In the final chapter, "Postempiricism," Lewis proposes that at every stage, we should be asking the following questions:

"What kinds of psychiatric knowledges are good to pursue, and for whom are they good to pursue?  Which of the available methods of knowledge inquiry are best for psychiatry?  And on what ethical or political grounds do we exclude possible contributors to psychiatric knowledge?" (144).

When we see values operating at every juncture of knowledge production (the phrase that Lewis uses to describe what others might innocently call knowledge), rather than judgments we need to make about how to use the knowledge we have, then we will better align our scientific inquiries with human interests.

Human interests are the basis of the second proposal Lewis makes.  Psychiatry, if it were to be guided by Postpsychiatric aims, would strive for greater inclusion in knowledge production.  Lewis is pessimistic about any radical reversals springing out of the hegemonic biopsychiatry institution, yet finds some hope in what he calls "posthuman activism" (140).  Models of such activism are to be found in groups like La Leche League or ACT UP. What activist groups do when they challenge mainstream medicine, according to Lewis, is reaffirm that democracy should be the most important value undergirding human action, particularly scientific and technological advances.

While I appreciate the clarity and passion with which Lewis writes this book--and find myself sympathetic with his project, I have real problems with many of the arguments put forward.  For example, in the early chapter, where Lewis explains the different "frames" of realists, relativists, and pragmatists, I couldn't help but find Lewis' description of the camp he is most at odds with--realism--to be a mere caricature.  Lewis' description of what analytic philosophers mean by the 'sign,' seems to be stuck in the early logical positivist projects of Gottlob Frege or Bertrand Russell.  Certainly, philosophers of language and logicians have developed far more subtle and sophisticated theories of representation beyond the "correspondence theory of truth."  I find the same sort of strawman arguments going on when he suggests that bioethicists take complicated questions, wherein competing values and political interests are intertwined, and then reduce these complex questions into mere judgments of "good" or "bad."  Bioethicists, in Lewis' view, aren't capable of making subtler, context-dependent arguments.  If Lewis were to spend more time carefully reading many of the folks that he characterizes with such broad brushes, he might find more allies for his project than he realizes.

I am also left wondering why we should value democracy and inclusion above all else, given that Lewis' Postpsychiatry metaphysical view has no clear way of determining which values and goals our human projects should tend toward. There is no normative force to his critique, other than descriptions of powerful interests intertwining themselves with particular practices, which only suggest something is wrong with these practices, rather than give us principled arguments about why we should avoid them.  Lewis assumes democracy to be a value to Postpsychiatry, but we are not given any reasons why. Furthermore, it is not clear how he would cope with democratic decisions that dismissed his postmodern project.

Lastly, I am concerned about the inefficacy of this project to actually transform problematic practices in psychiatry. Not only will many psychiatrists find this theoretical approach a bit too esoteric, but they will wonder how this cultural critique of psychiatry will help them better serve their patients. There is a risk inherent in these types of studies that we will sacrifice the patient to abstract and heady theories.  I wager that psychiatrists are far more practical and eclectic in their approach to treating patients than Lewis gives them credit for.  He has a tendency to conflate the views of psychiatric nosologists and academic researchers with practicing psychiatrists.  I think so many of Lewis' criticisms, such as, the unhealthy relationship between big Pharma and academic research or how advertisements create consumer preferences, are important, urgent even.  But, we seem to part ways on how best to educate the public about what is wrong.

 

© 2006 Jennifer Hansen

 

Jennifer Hansen is an Associate Professor of Philosophy at Gettysburg College.  Her research focuses on feminist theory and the intersection of psychiatry and philosophy, with particular interest in affective disorders, such as depression. 

 


August 3: 2006: Bradley Lewis responds to Jennifer Hansen's review:

I found Hansen's review of Moving Beyond Prozac, DSM, and the New Psychiatry: The Birth of Postpsychiatry to be a careful and smart reading of the book. She clearly understands the main themes and motivations, and her summary sections are excellent.

Along the way, she also raises several concerns about the book, so I will take a moment here to discuss these concerns. In Hansen's discussion of chapter four, she argues that I set myself "up to be criticized in the same vein that [I] criticized biopsychiatry." She says that I do this by making pospsychiatry "an exclusive domain of inquiry" with a particular methodology and jargon available only to initiates and experts of postpsychiatry. Hansen is right that there is a similarity between postpsychiatry and biopsychiatry in that postpsychiatry is just as much a discourse as biopsyhciatry. However, despite this similarity, there is an important difference. Postpsychiatry does not insist on being the truth or the only valid method of approaching mental suffering. Postpsychiatry does not seek to expand by the force of truth, but rather by the force of persuasion and coalition. If people find that postpsychiatry is helpful to their goals, then they are invited to join. Postpsychiatry does not claim that alternative approaches are wrong, or worse "irrational," only that they are different.

To briefly address Hansen's other concerns; she argues that I set up straw man opponents in my discussion of the science wars and bioethics. This concern seems to be a misunderstanding as much as anything. This book is about helping people see the main thrust of the discursive patterns surrounding psychiatry. Within each discursive field there are writers that develop considerable nuance, but that does not mean that the discursive field as a whole has this same nuance. Terms like "realist," "relativists," and "bioethicists" are useful terms, even if anything anyone might say about them would always be incomplete and inaccurate, and would always reduce them to straw men in important ways. This is a problem of language--indeed, a problem that I spend a good deal of time discussing in the book.

I admit to being baffled by Hansen's statement that there is "no normative force" to democracy and stakeholder inclusion in psychiatric research and knowledge making. My reading of key texts in disability studies (James Charlton's Nothing About Us Without Us), feminist philosophy of science (Sandra Harding's Whose Science? Whose Knowledge? Thinking from Women's Lives), science studies (Bruno Latour's Politics of Nature: How to Bring the Sciences into Democracy), philosophy of science (Philip Kitcher's Science, Truth, and Democracy), technology studies (Richard Sclove's Democracy and Technology) and postmodern theory (Ernesto Laclau and Chantal Mouffe Hegemony and Socialist Strategy: Towards a Radical Democratic Politics) all point to democracy and stakeholder inclusion as perhaps the most useful normative guide. This is particularly so in a time when truth and ethics have shown themselves to be cultural products rather than timeless universal necessities.

Perhaps Hansen's skepticism about democracy comes from the way that the contemporary political stage shows how easily democracy can be manipulated. If so, I agree with this problem, and it is why I turn to Benjamin Barber's work to make the distinction between "weak democracy" (voting for a U.S. president) and "strong democracy" (contributing to a local town hall style government). See page 153 for further discussion of this point.  

Hansen's final concern regards her sense that many, if not most, psychiatrists will find my theoretical approach too difficult and abstract. That is probably true, but the problem here is the assumption that psychiatry is the primary audience for the book. I don't believe it is. I believe the primary audience is critics of psychiatry, those who have a deep sense that the contemporary field of psychiatry has run amok in its relentless pursuit of science, drugs, and profits. Some of these people will be psychiatrists, but many will be cultural scholars, philosophers, intelligent readers, politicized consumers, and concerned relations. If these people develop the tools sufficient to demand a different kind of psychiatry, I believe that will be the most helpful route for changing psychiatry and developing alternative forms of care. 

 

© 2006 Bradley Lewis

 


August 3, 2006:  Jennifer Hansen replies:

I read Professor Lewis's comments with great interest.  While I would love to continue a debate on whether the "value-neutral" approach of biopsychiatry is less honest that the post-psychiatry stance that acknowledges the partiality and incompleteness of its discourse, I will focus instead on the issue of inclusiveness.

Lewis once again defends the importance of democratic processes in knowledge formation, which means that we should be as inclusive as possible and acknowledge that no one method or position can hope to speak the last word.  I wondered, in my review of the book, how Lewis justifies democracy, that is, inclusiveness, as an important ethical norm.  I have since concluded that his justification rests with his "semiotic realist" metaphysics, which justifies practices and norms by virtue of their usefulness. 

In abstract terms, promoting inclusiveness seems right.  It appeals to the very best of our natures, and our desire to always keep the conversation going in hopes that something we had not yet considered might be crucial for solving a particular problem or helping us articulate a inspiring vision of the future.  However, I must point out that I live just down the street from Dover, PA, where committed opponents to evolution set out to exploit the good natured intentions of inclusiveness in order to force high school biology teachers to teach Intelligent Design. In practice, inclusiveness to all ideas, without some method for sorting out better or worse ones--something like a concept of truth--can turn out disastrously.  If you embrace a kind of relativism that is, I believe, inherent to Lewis' project, then you have very few resources for warding off those who use your relativism against you: "since there are no truths, since no theory is the whole truth, then we should include as many perspectives as possible, including creation science."  It is this concern with Lewis' advocacy of activism (which the creationists certainly are) and his faith in inclusiveness that makes me ill at ease.  Unless you have a way of sorting out better ideas from worse ones--independently from political interests--then all ideas are politicized. And, frankly, nothing worries me more than the politicization of all knowledge.

 

© 2006 Jennifer Hansen


[At the request of both Bradley Lewis and Jennifer Hansen, Metapsychology is publishing one further exchange on the topics raised above.  Editor.]

 

Bradley Lewis (published 9/14/06):

Clearly, this debate could go on at some length. I appreciate Hansen's raising the issue of relations between secular world views and religious world views (which the Intelligent Design controversy is largely about). This is a critical topic--particularly in this time of tremendous tension and war around the world. Obviously I can not do justice to the topic here, but I would recommend Bruno Latour's recent book, War of the Worlds: What about Peace? (2002), for a fascinating discussion of the topic.

The issue is important for psychiatry too because so many people in the clinics live by very strong religious worldviews. Psychiatry, being a secular profession, has had great difficulty working with, taking seriously, and learning from religious perspectives. That too is one of the many problems with its overly modernist frame. Postpsychiatry helps side step either/or, truth/myth relationship to worldviews (including religious worldviews) that can be immensely helpful in these kinds of cross-cultural (cross-worldview) encounters.

And, finally, it seems that Hansen and I agree on one thing: we are both worried about the "politicization of all knowledge." The difference is that my experiences in psychiatry (watching what passes for "truth" in the field over the last many years) and my experiences reading postmodern literature have both led me to believe that there is no way to avoid the politicization of knowledge. As such, postpsychiatry does not advocate politicizing knowledge. Just the opposite, postpsychiatry tries to cope with the inevitability of politicized knowledge.

And that of course is where democracy and inclusion come in. As imperfect as democracy may be, it remains the political system I find most appealing. Plus, it is a political system that would have many advantages for the most important (and at present most disenfranchised) stakeholders in psychiatry.   

 

© 2006 Bradley Lewis


Jennifer Hansen (published 9/14/06):

Let me underscore that I agree with much of what Lewis has to say about the problems inherent to psychiatry--both epistemological and practical.  However, his latest response to me highlights, I think, where we part ways.  He writes: "my experiences in psychiatry (watching what passes for 'truth' in the field over the last many years) and my experiences reading postmodern literature have both led me to believe that there is no way to avoid the politicization of knowledge" (my emphasis).  This disagreement may hang on the ambiguity of what the phrase--the politicization of knowledge--means.  Does this mean that all knowledge is intertwined with political interests?  Is all scientific knowledge, for example, driven by human interests and thereby our desire for certain outcomes?  Do we only seek out the answers to questions that will directly benefit either our pocketbook or our ideology?  If Lewis answers yes to all of these questions, then my definition of the "politicization of knowledge" differs.

I have too read a great deal of postmodern texts and I always find myself unconvinced by the assertion that all knowledge is tainted by coercion or unequal power relationships between those who have resources and those who don't.  The bottom line, for most postmodernists, is that whatever passes as value-neutral facts are really just the views of the elite, and as such, benefit them materially. 

When Lewis sets out to explain his reasoning for why all knowledge, he says, in passing, "watching what passes for 'truth' in the field over the last many years."  Lewis, I take it, is angered by positions that are not well supported by evidence or at least that is what I take from his phrase "watching what passes for 'truth.'  The implication here is that some arguments are better than others and because they either exhibit good reasoning, good evidence or both.  If, however, all knowledge is nothing other than might made right, then it seems unlikely that anyone would be upset with what passes as truth.  Frankly, they should be unsurprised.  Those with the most access to resources will define agendas and those on the outside will be dismissed as laughably irrelevant. 

For me, the politicization of knowledge means that some arguments will be buried, misconstrued or attempts will be made to not fund them.  Take the recent example of the FDA's highly political attempt to prevent making Plan B (emergency contraception) over-the-counter.  All the evidence refuted the positions made by those who oppose this medication, e.g. that it will increase promiscuity, it is an abortion pill, or that it is unsafe.  And yet, the decision makers were still able to block its OTC status.  Alas, politics again prevail, but this time on the side of evidence, when Hilary Clinton and others pressure the FDA to finally grant OTC status to Plan B or else suffer the consequences, i.e. blocking the President's nominee for the FDA. Certainly, politics was at work at every level of this decision, but the evidence upon which to make an informed decision about the status of Plan B did not, arguably, demonstrate only what Barr Labs wanted it to say.  We are able to make strong inductive arguments--open for revision based on new evidence of new techniques--that enable us to get a better handle on the world.  I agree that politics buries good evidence sometimes, but I disagree that knowledge is politics all the way down.

Lastly, I am still dogged by Lewis' defense of democracy as the method for knowledge production in postpsychiatry.  Perhaps I just don't see democracy as always leading to greater inclusion.  There are all sorts of embarrassing laws and elections that democratically took place, and none of these has much to do with the best answer or best approach.  Democracy is, in its better moments, about the art of compromise. And, while compromises are excellent tools for keeping together a disparate body of citizens, they aren't the best way to do science.  I wholly support taking seriously the scientific method and thereby remaining a skeptic. Scientists should not rest until they have exhausted all attempts to disprove their hypotheses and towards that goal, it seems important for them to take seriously radically different ideas and approaches.  Surely the way in which psychiatric research is funded perverts the scientific method, regularly, but then the solution seems to lie in preserving the scientific method by regulating how studies get funded.  

 

© 2006 Jennifer Hansen


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