Tuesday, 17 January 2012

limning disorder

Neil Pickering has recently published a nice paper on the derivation of the concept of 'mental disorder' from that of 'physical disorder'. A family resemblance (perhaps his own?), and a secondary sense (mine), account of how this works are evaluated. (One rather nice if odd thing for me is that Pickering argues that my secondary sense account is more original than I thought it was - since I'd always assumed I was merely elaborating on T S Champlin's argument in To Mental Illness via a Rhyme for the Eye.) The question is asked: What makes for the validity of an extension of a concept from its primary domain to the new domain?

Pickering does a good job of undermining certain essentialist prejudices regarding what makes for the validity of a conceptual extension. The family resemblance account (that mental and physical disorders may share various features in common but none essentially) is shown to satisfy a certain somewhat relaxed understanding of what demands for determination (distinguishing members from non-members of a set) and coherence (inner unity of the set) impose on the acceptability of proposed extensions. The secondary sense account is shown to not meet these - but this is perhaps not surprising since the whole idea of secondary sense (and of Lakoff and Johnson's 'conceptual metaphors') is that our uses of such terms are governed by the unprincipled associative whims (as it were) of our culture-bound CNSs.

What all of this makes me think, though, is how rather strange it is that so many (well, a few) philosophers (like me) take themselves to be called to provide 'accounts' of what mental disorder consists in - and how odd it is really that it isn't just obvious whether the concept of 'mental illness' is a prototypical, family resemblance, secondary sense, subtype of physical illness, natural-(dys)function-explicable, etc. concept. Is it really the case that the language-games of mental disorder ascription are that opaque - that we must all be rather left merely gesturing from afar at what it is we are doing when we say of someone, as we all sometimes do, that they are or are not mentally disordered?

I have (groan) another (somewhat deflationary) theory of all this. Which is that there probably just isn't really any such thing as 'the' language game of 'mental disorder'. Rather there are a range of different aspirations, phantasies, habits, understandings, cultural histories, departmental quirks, etc., underlying talk of 'mental disorder', 'mental disease', 'emotional disturbance', etc. Different presentations of different kinds of patients pull us this way and that both within and between the deployment of these notions; the seas and shores of language shift a little between regions and nations, or over historical times, or between the clinic and the academy.

So perhaps there is not really any determinate language-game being played out by different people with terms like 'mental disease', but a set of overlapping and ill-defined moves in conceptual space are nevertheless constantly being made. It's all a bit of a mess, but we get by. The philosopher however strives for tidiness - and perhaps even more so wishes that the tidiness is already there waiting to be discovered. So they project a conceptual structure underneath all this mess, and generate accounts which propose what the language game is 'really' all about.

Reading Kuusela's lovely Struggle against Dogmatism gives me another idea of how to proceed. Which is that, rather than trying to determine 'the' logical structure of 'our' (whose?) concepts, we could instead steer our philosophy to two other ends: a) noticing when muddles arise due to the un-noticed using of terms in different senses, or due to prejudices about what 'must' be meant by the terms in use, and b) articulating clear stipulative paradigms for the use of such terms for the purposes of clarification. Whether that will ever be enough to dent the wish or need or phantasy of philosophers to take themselves to be uncovering deep facts about existence is however another matter.

Sunday, 15 January 2012

normality and the language game of reason giving

Here is a frequently encountered dialectical situation well known to the philosophically minded clinician. Someone is carrying on, in speech and behaviour - in a very odd way. You and I are wondering if we can make sense of what they are saying. 'Why did you not put your bins out?' 'Because the aliens are keeping me under surveillance.' That, I propose, just doesn't provide what counts as a good reason for acting. As Roger Teichmann has it, in his super little book Nature, Reason, & the Good Life, 'Roughly speaking, a reason for an action is meant to show why the action was, is, or would be a good idea; and the content of 'good' is provided by the context, by what is at stake, and, in an important class of cases, by what is normal and natural for human beings.' (p.12)

But you are in an anti-conservative mood and ask me 'Aren't you being rather restrictive in saying that often only what is normal and natural for human beings can count as fixing what the goodness of a reason for acting is?' 'Isn't that rather discriminatory of you?' 'What if doing something else had been normal?' 'Don't we need to be able to critique what is normal and natural as well - to hold it up to some standard?' 'Doesn't an unwillingness to do this show that our judgements as to what is and what is not humanly intelligible, sane, are grounded in nothing more than fiat?'

Now, I have come to think that there are different ways in which we can make sense of actions, and providing reasons for them is only one such (albeit the most important). There is also making sense as we might say psychologically, of why people do the strange things they do. That, it seems to me, amounts not to articulating the reasonable grounds but, on the whole, to looking at the inner motivational push for believing this or that - in terms of what is made thereby more manageable, more bearable, less galling, in one's experience and in one's self-conception. But when it comes to the rational sense-making of (which as Roger Teichmann notes, is not itself to be conflated with the giving, ad infinitum, of justifications for) actions, I suspect that less good sense can be made of madness than we sometimes hope. In what follows I'm going to borrow from my ancient PhD thesis to explicate what I see as the form of the conceptual temptation which underlies the anti-conservative move above.

The move was, I think, one to which Isaac Newton succumbed in the Preface to the Scholium of his Principles of Natural Philosophy. A man is walking along a ship from stern to bow. He crosses the top of the boat west to east at 4 mph. But, Newton wonders, what is his 'real' speed? For the boat itself is travelling east to west across the sea at 6 mph. So is the man 'really' going at 2mph? But then, Newton considers, perhaps the earth is itself in motion relative to the 'fixed stars'. And so on. What has happened here is that the notion of 'real motion' has floated free of the contexts which give the very idea of motion (one thing changing position relative to another) its sense. To ask 'yes, but free of such local restrictive contexts what is his motion?' is not as yet to ask an intelligible question - since the contexts provide the meaningful conditions for the very notion of motion.

So too, I suggest, with the idea that 'the content of 'good' is provided by the context, by what is at stake, and, in an important class of cases, by what is normal and natural for human beings.' To abstract away what is normal and natural for human beings is often not to emancipate reason from excessively restrictive, conservatively patrolled, parochial boundaries - to the greater purpose of bringing the psychotic subject within the fold of the humanly intelligible. It is, instead, to traduce the language game of reason giving by abstracting from the preconditions for the intelligibility of the practice.

This, ultimately, is I think what we find when we consider those phenomenological alternative universes which the psychotic person is supposed to inhabit. Whilst we can shed light on what it means to be insane by referring to a profoundly altered background of embodied dispositions, we do not thereby also get to shed light on the meaning, in an alternatively structured world outlook, of what they say and do. For to suppose that we still here have to do with a 'world outlook' is to imagine that we can talk about motion in abstraction from a stipulated frame of reference.

It is important to get the analogy right. The point is not that, just as we can talk about different motions relative to different frames of reference, different sets of reactive dispositions make for different frames of reference of intelligibility. That really is precisely not the point at all. The analogy is rather between a particular ('normal, natural') set of reactive dispositions (which provide a frame of reference for different utterances and actions) and a particular (namely a non-abstract, physical, fairly rigid and internally static) kind of object (providing a frame of reference for talking of an object's movement). (To go on '2+2=5' is not to add differently but not to do what is called 'adding'.)