Monday, 1 July 2019

just published



Previous multi-author collections of English language essays in phenomenological psychopathology include Rollo May, Ernest Angel and Henri Ellenberger (1958) Existence: A New Dimension in Psychiatry and Psychology; John Cutting and Michael Shepherd (1986) The Clinical Roots of the Schizophrenia Concept: Translations of Seminal European Contributions; and Matthew Broome, Robert Harland, Gareth Owen and Argyris Stringaris (2013) The Maudsley Reader in Phenomenological Psychiatry. Unlike the Maudsley Reader, which is the only other collection still in print, the Oxford Handbook of Phenomenological Psychopathology is a 98 chapter collection of newly written essays, covering a wide variety of topics.
  1. The 23 essays in its first section cover the history of phenomenological philosophy (Husserl to Levinas) and phenomenological psychopathology (Jaspers to Laing).
  2. The 7 essays in section two consider the meaning of taking a phenomenological approach and its relation to other approaches.
  3. Section three consists of 12 essays on key concepts of phenomenology such as the self, emotion, and various of what Heidegger called the existentialia (essential dimensions of human existence).
  4. Section four comprises 15 chapters on descriptive psychopathology, chapters which amongst other things consider the psychopathology of the various existentialia.
  5. The 8 chapters of section five look holistically at the different life worlds of persons with different conditions (schizophrenia, mood disorders, hysteria, BPD, addictions, autism, eating disorders).
  6. Section six entitled ‘Clinical Psychopathology’ contains 9 essays on different aspects of (mainly) psychotic experience.
  7. Finally section 7 contains 13 chapters on the relationship between phenomenological psychopathology and other disciplines from neuroscience to psychoanalysis.

1: Introduction, Giovanni Stanghellini, Matthew Broome, Anthony Vincent Fernandez, Paolo Fusar Poli, Andrea Raballo, and René Rosfort

Section One: History


2: Edmund Husserl, Roberta de Monticelli

3: The Role of Psychology According to Edith Stein, Angela Ales Bello
4: Martin Heidegger, Anthony Vincent Fernandez
5: Jean-Paul Sartre, Anthony Hatzimoysis
6: Merleau-Ponty, Phenomenology, and Psychopathology, Maxine Sheets-Johnstone
7: Simone de Beauvoir, Shannon M. Mussett
8: Max Scheler, John Cutting
9: Hans-Georg Gadamer, Andrzej Wiercinski
10: Paul Ricoeur, René Rosfort
11: Emmanuel Levinas, Richard A. Cohen
12: Critiques and Integrations of Phenomenology: Derrida, Foucault, Deleuze, Federico Leoni
13: Karl Jaspers, Matthias Bormuth
14: Eugène Minkowski, Annick Urfer-Parnas
15: Ludwig Binswanger, Klaus Hoffmann and Roman Knorr
16: Medard Boss, Franz Mayr
17: Erwin Straus, Thomas Fuchs
18: Ernst Kretschmer, Mario Rossi Monti
19: Hubertus Tellenbach, Stefano Micali
20: Kimura Bin, James Phillips
21: Wolfgang Blankenburg, Martin Heinze
22: Franco Basaglia, John Foot
23: Frantz Fanon, Lewis R. Gordon
24: R.D. Laing, Allan Beveridge

Section Two: Foundations and Methods


25: On the Subject Matter of Phenomenological Psychopathology, Anthony Vincent Fernandez and Allan Køster

26: The Phenomenological Approach, Dermot Moran
28: Genetic Phenomenology, Anthony Steinbock
29: Phenomenology and Hermeneutics, René Rosfort
31: Phenomenology and Cognitive Science, Shaun Gallagher
32: Phenomenology, Naturalism, and the Neurosciences, Massimiliano Aragona
33: Normality, Sara Heinämaa and Joona Taipale

Section Three: Key Concepts


34: Self, Dan Zahavi

35: Emotion, René Rosfort
36: The Unconscious in Phenomenology, Roberta Lanfredini
37: Intentionality, Joel Krueger
38: Personhood, René Rosfort
39: Befindlichkeit: Disposition, Francesca Brencio
40: Values and Values-based Practice, KWM (Bill) Fulford and Giovanni Stanghellini
41: Embodiment, Eric Matthews
42: Autonomy, Katerina Deligiorgi
43: Alterity, Søren Overgaard and Mads Gram Henriksen
44: Time, Federico Leoni
45: Conscience, Marcin Moskalewicz
46: Understanding and Explaining, Christoph Hoerl

Section Four: Descriptive Psychopathology


47: Consciousness and its Disorders, Femi Oyebode

48: The Experience of Time and its Disorders, Thomas Fuchs
49: Attention, Concentration, Memory, and their Disorders, Julian C. Hughes
50: Thought, Speech and Language Disorders, John Cutting
51: Affectivity and its Disorders, Kevin Aho
52: Selfhood and its Disorders, Josef Parnas and Mads Gram Henriksen
53: Vital Anxiety, Maria Inés López-Ibor and Dra Julia Picazo Zapinno
54: Hallucinations and Phenomenal Consciousness, Aaron Mishara and Yuliya Zaytseva
55: Bodily Experience and its Disorders, John Cutting
56: The Psychopathological Concept of Catatonia, Gabor S. Ungvari
57: Eating Behavior and its Disorders, Giovanni Castellini and Valdo Ricca
58: The Phenomenological Clarification of Grief and its Relevance for Psychiatry, Matthew Ratcliffe
59: Gender Dysphoria, Giovanni Castellini and Milena Mancini
60: Hysteria, Dissociation, Conversion and Somatisation, Maria Luísa Figueira and Luís Madeira
61: Obsessions and Phobias, Claire Ahern, Daniel B. Fassnacht, and Michael Kyrios
62: Thoughts without Thinkers: Agency, Ownership and the Paradox of Thought Insertion, Clara S. Humpston

Section Five: Life Worlds


63: The Life-World of Persons with Schizophrenia (considered as a Disorder of Basic Self), Louis Sass

64: The Life-World of Persons with Mood Disorders as Disorders of Temporality, Thomas Fuchs
65: The Life-World of the Obsessive-Compulsive Person, Martin Bürgy
66: The Life-World of Persons with Hysteria, Guilherme Messas, Rafaela Zorzanelli, and Melissa Tamelini
67: The Life-World of persons with Borderline Personality Disorder, Giovanni Stanghellini and Milena Mancini
68: The Life-World of Persons with Drug Addictions, G. Di Petta
69: The Life-World of Persons with Autism, Francesco Barale, Davide Broglia, Giulia Zelda De Vidovich, and Stefania Ucelli di Nemi Translated by Martino Rossi Monti
70: Eating Disorders as Disorders of Embodiment and Identity, Giovanni Castellini and Valdo Ricca

Section Six: Clinical Psychopathology


71: First Rank Symptoms of Schizophrenia, Lennart Jansson

72: Schizophrenic Delusion, Arnaldo Ballerini
73: Delusional mood, Mads Gram Henriksen and Josef Parnas
74: Delusion and Mood Disorders, Otto Doerr
75: Paranoia, Paolo Scudellari
76: Auditory Verbal Hallucinations and their Phenomenological Context, Matthew Ratcliffe
77: Affective Temperaments, Andrea Raballo and Lorenzo Pelizza
78: Schizophrenic Autism, Richard Gipps and Sanneke de Haan
79: Dysphoria in Borderline Persons, Mario Rossi Monti and Alessandra D'Agostino
80: Psychosis High Risk States, Luis Madeira, Ilaria Bonoldi, and Barnaby Nelson
81: Psychopathology and Law, Gareth S. Owen
82: Atmospheres and the Clinical Encounter, Cristina Costa, Sergio Carmenates, Luis Madeira, and Giovanni Stanghellini
83: The Psychopathology of Psychopaths, Jerome Englebert
84: A Phenomenological-Contextual, Existential, and Ethical Perspective on Emotional Trauma, Robert D. Stolorow

Section Seven: Phenomenological Psychopathology


85: Phenomenological Psychopathology and Neuroscience, Georg Northoff

86: Phenomenological Psychopathology and Qualitative Research, Massimo Ballerini
87: Phenomenological Psychopathology and Quantitative Research, Julie Nordgaard and Mads Gram Henriksen
88: Phenomenological Psychopathology and Psychotherapy, Giovanni Stanghellini
89: Phenomenological Psychopathology and Psychiatric
90: Phenomenological Psychopathology and America's Social Life-World, Jake Jackson
91: Phenomenological Psychopathology and the Formation of Clinicians, Giovanni Stanghellini
92: Phenomenological Psychopathology and Psychiatric Classification, Anthony Vincent Fernandez
93: Phenomenological Psychopathology and Clinical Decision Making, Eduardo Iacoponi and Harvey Wickham
94: Phenomenological Psychopathology and Psychoanalysis, Federico Leoni
95: Phenomenological Psychopathology and Autobiography, Anna Bortolan
96: Phenomenological Psychopathology, Neuroscience, Psychiatric Disorders and the Intentional Arc, Grant Gillett and Patrick Seniuk
97: The Phenomenology of Neurodiversity, Marco O. Bertelli, Johan De Groef, and Elisa Rondini
98: The Bodily Self in Schizophrenia: From Phenomenology to Neuroscience, Francesca Ferri and Vittorio Gallese

Friday, 7 June 2019

shades of gaslight

Notes for a talk on narcissistic abuse.

i. introduction

The 1938/1940/1944 play/film Gaslight gave rise to the pop-psychological term 'gaslightling'. To cite Wikipedia:
Gaslighting is a form of psychological manipulation that seeks to sow seeds of doubt in a targeted individual or in members of a targeted group, making them question their own memory, perception, and sanity. Using persistent denial, misdirection, contradiction, and lying, it attempts to destabilize the victim and delegitimize the victim's belief. Instances may range from the denial by an abuser that previous abusive incidents ever occurred up to the staging of bizarre events by the abuser with the intention of disorienting the victim.
The reality of narcissistic abuse has come out of the shadows in the last 10 years, mainly thanks to the internet. Isolated victims struggle by themselves to gain or regain any meaningful perspective on their experience, in no small part because of the manipulation of their self-esteem and self-understanding by the narcissist. But now we have available the ideas of 'empaths' and 'codependents' and 'echoists' and a new rhetorics of manipulation: 'hoovering', 'enablers' and 'flying monkeys', 'scapegoating', 'going gray-rock', strategies of 'divide and conquer', 'fauxpologies', 'smear campaigns', etc. We know something too of the lifetime prevalence of NPD (apparently around 1%), prevalence in the population (apparently from 1% to 6%), and in clinical populations (apparently 2%-16%). The strategies of isolating victims from other sources of support, spreading lies about the victim's alleged difficulties to others, love-bombing, projective identification of vulnerabilities into the victim, are becoming well-known.

Even so the focus on 'incidents' and 'events' in the above quote encourages us to think that what's most at stake in gaslighting is our perception of  facts that are determinate and concern external reality - whether or not something really happened, whether or not what someone said is a misrepresentation, a lie, etc. This, after all, is what happens in the play/film: the evil protagonist persuades his victim that she must be hallucinating and otherwise imagining things (that the gaslight is dimming, footsteps sounding, objects not going missing, etc). With this talk of 'external reality', determinacy, and facts, I mean to elicit a contrast with three matters: matters of the inner life (especially moral motivation), indeterminate matters, and matters of meaning. But I also want to highlight something about the way the narcissistic manipulation intended by talk of 'gaslighting' has its effects: not so much by persuading us to doubt what we perceive and understand, but by bending out of shape our very perception, understanding, moral emotions, and the fabric of the self.

Sam Vaknin, a writer on narcissism and himself an NPD sufferer, talks helpfully here of
ambient abuse as the stealthy, subtle, underground current of maltreatment that sometimes goes unnoticed even by the victim herself until it's too late. Ambient abuse penetrates and permeates everything, but is difficult to pinpoint and identify. Gaslighting is vigorous, equivocal, atmospheric and diffuse, hence its insidious and pernicious effects. It is by far the most dangerous kinds of abuse there is. ... Ambient abuse yields an irksome feeling, a kind of disagreeable foreboding, a premonition, a bad omen; it's in the air. In the long term such an environment erodes the individual's sense of self-worth. 
The ambient abuse may result in a feeling of walking on eggshells, being constantly on edge, feeling like you ought to apologise for no particular reason, like there's something wrong with your own moral character that you didn't previously realise, all of this for no very obvious reason. It is the nature of such 'ambient, atmospheric' abuse that I want to focus on today.

ii. omission

Acts of omission are rather more subtle and pernicious than acts of commission, usually because they can go unnoticed or can be more easily denied. Here's a rather obvious example:
When I was in my late teens, my mother had about 10 of her closest friends over for a party right after Christmas. I was sitting among them (the only one of my mother's children present) enjoying the banter when all of a sudden, my mother grabbed everyone's attention and asked "would you all like to see what my children gave me for Christmas?" They all chimed in "absolutely"!! And I knew she was about to pull one of her classic gaslighting moves as she's done it so many times. She doesn't realize she has a tell (a certain tic in her facial muscles) when she's about to go full on narc. She walked over to the tree and grabbed two gifts - the one my brother got her and the one my sister got for her. She showed both as her friends ooohhhhed and awwed over them, and then she went and put them back under the tree. Her two closest friends' eyes got very wide and puzzled but neither would look over in my direction. I did not take the bait. I knew she wanted me to spout off so that she could humiliate me in front of the group and say she just forgot about my gift - I guess she forgot she has 3 children. It was beautiful though the way her move completely backfired as everyone got very quiet and uncomfortable as I sat completely silent. I'm almost certain that her best friend railed her when she got her alone as their relationship went quickly south after that. But that goes to show you how sinister and calculating these people are and the damage they do to their children is so unnatural. [by kris777]
Other cases are more subtle. Think of how long someone takes to reply to a message, how often they forget to reply, how often someone keeps you waiting, how often someone 'just doesn't hear' what you say to them, says very little to you compared with to another, or how someone doesn't reply to a verbal question and then - if you ask why not - will tell you 'I was thinking'. Even a slight pause in a conversation, or heeding only part of a call, can manifest a narcissistic temptation to put someone else on the back foot.

iii. defeasibility and plausible deniability

Here I stress two things. First, that none of the above behaviours are criterial of narcissism. They're only expressive of it in particular contexts, when engaged in above certain frequencies, as part of a general pattern, etc. The criteria for narcissism, we might say, are defeasible. In various contexts the above-described behaviours could all be perfectly normal and morally innocent. In this they share a key feature of psychological concepts quite generally: the absence of any one to one correlation between behaviour and mental attribute. Such attributes are only ascribable in particular historical and social circumstances. And what shall count as the right circumstances against which to read any particular stretch of behaviour as expressive of this or that feeling or tendency or characteristic is always a matter of judgement. What is the context in which that raised eyebrow shall count as non-accusatory surprise, or as an unwarranted accusation, or as a warranted accusation? Second, that this lends to them all a degree of plausible deniability; contrast a flat-out lie.

iv. indeterminacy

As well as the heavily contextual nature and defeasible character of the ascription of psychological qualities there's another quality of psychological and moral life which adds to the possibility of spurious plausible deniability exploited by the narcissistic abuser. This is the constitutive indeterminacy of the mental and moral. When it comes to various physical qualities (height, weight, etc) and other qualities (e.g. quantity measured by integers), indeterminacy in our measurements can by and large be eradicated through the use of more refined measures or more clearly specified questions. How many elephants are there in the room? Well, four but one's on his way out with his arse still sticking through the door. So, ok, we ask 'How many whole elephants are there in...?' But when it comes to certain moral or mental matters there need - so the thought goes - be no such agreement even amongst perfectly competent psychological and moral judges. There can occasionally be expressions which to one person looks to be of annoyance, to another of mere indifference, and for which consulting the subject in question may provide no clear answer. We may take ourselves to be motivated by entirely selfless ambitions; another may find a sliver of selfishness there - and there be no fact of the matter as to who is right. Was he being annoying or just insistent? Was it thoughtless or merely casual? Uncertainty here can be "constitutional. It is not a shortcoming. It resides in our concepts that this uncertainty exists, in our instrument." (Wittgenstein, Remarks on the Philosophy of Psychology, vol II, 657)

In our everyday life we do well to accommodate to this indeterminacy by attempting to err on the side of thinking the best of one another. Even so many of us suffer sundry 'attribution errors': we tend to overstate the significance of personal as opposed to situational variables in determining others' unfortunate behaviour, and to understate the significance of personal as opposed to situational variables in accounting for our own unfortunate behaviour. Amongst us depressives are the least vulnerable to the fundamental attribution error. It is not then surprising that they (in the guise of empaths, echoists and codependants) are the most vulnerable to abuse by narcissists who are the most vulnerable to, or exploitative of, the fundamental attribution error. The narcissist reads every encounter in such a way as to sap the presumption of moral decency from his victims and accrue it to his own ledger. S/He can do this, in part, because of the constitutive indeterminacy of the mental and because of the contextually situated defeasibility of behavioural criteria for mental states.

v. co-enaction of conscience and sense of being wronged

Matters of conscience are often portrayed in entirely inward terms. And of course there's much right about this: you can't outsource your voice of conscience. Someone else may recall you to your morally better self, thereby reawakening your inner moral voice, but they can't take the place of that inner voice itself. (This is just a 'grammatical remark'.) Nevertheless our sense of what is right and wrong - what is deserving of reproach or praise - in our behaviour and in the behaviour of others with whom we interact is itself something which emerges in the context of certain relationships. The sense of conscience and the correlative sense of being well or badly treated by another, arise (are enactively constructed) in the context of those close relationships in which they're worked out. And this, I suggest, has something to do with what it means to even be in a close relationship.

A close relationship, of a recognisable and important sort, involves trust and attachment. One might say that letting someone in involves in part, and in certain contexts, partly giving over one's judgement to them. But we might put that better: usually the starting point is of them already being ‘in’, in there with us, here where we co-constitute one another, and what we don’t do is take the artificial step of keeping them out. You found what I said hurtful; I wasn't sensitive enough - I don't judge entirely for myself now whether this is or is not true, but in part take you at your word. I allow – or don’t take the unnatural step of preventing – my moral sense to be part-calibrated by you. To not do this would involve not being in the kind of relationship which here I'm focusing on. Later in life deep friendship and committed romantic relationships have this quality. Our happiness may be one another's but, as well, our sense of our own decency and desert is partly given over to the other. In this way a close friendship or deep romantic relationship recapitulates the structure of a young child's relationship with her primary care-givers. And it is here that her conscience, sense of self-worth and sense of justice are typically formed. And the two of these - knowing that I've wronged another, my sense of my worth - are typically corollary. We might call this the non-autonomous character of conscience's ongoing (re)formation (i.e. of its enaction). Important to this enaction is that my sense of your moral worth and my sense of my own moral worth are constant corollaries - they are a function of one another - since the fabric of moral sense - of conscience - is itself enacted in the context of this relationship.

vi. bending the soul out of shape

So long as the other is well-formed and well-motivated the partial giving over of one's moral self-definition, this trust, is all well and good - in fact constitutive of forms of relationship we particular treasure. But along with the defeasibility and indeterminacy of the mental, this trust leaves one open to narcissistic abuse. Leaves one open to abuse by those who will urge on one a sense of one’s own badness - of responsibility for a relational badness that has come up between us - and thereby spuriously exculpate themselves. What I in particular want to make clear is the difference between i) somebody pretending to someone that matters are other than they are, when the first person has a well-developed and autonomous conscience and sense of self-worth into which is simply fed, for a moment, misleading data, and ii) the case where someone's very sense of worth and conscience is being consistently bent out of shape, perversely enacted, by a consistent skewing or queering of the pitch of the allocation of blame and reward in the relationship. An image may help here: in the one case a point is misplaced on a graph. In another the 0 axis itself becomes shifted. It is this more fundamental matter of this shifting of the axis of one's morale and moral sense - the disturbance to the formation of the faculties of judgement and not to this or that judgement - to which I'm here drawing attention. In the second diagram below I, the narcissist, have perverted the co-enaction of sense of guilt and being wronged in such a way that we both now allocate to you more moral culpability for certain unhappy incidents that occurred between us.

The narcissistic abuser does what she can to make unavailable to her victim other sources of recalibration. The victim is no longer able to meet with his friends, is ostracised from his family. The victim's friends are fed lies or spurious concerns ('oh his mental health is playing up at the moment so he can't come out'. 'Oh, did you hear what he said about so-and-so, how he treated so-and-so; he's in the dog house at the moment') so they don't make themselves available as aids to help recalibrate the victim's sense of self-worth. Duped 'flying monkeys' and pseudo-friends keep alive the narcissist's image of moral worth and reinforce the victim's sense of low self-worth. Word salad is used to confuse the narcissist’s victim, to get the upper hand, to provoke a preoccupation in the victim of regaining a sense of meaning, as an obfuscating shield, to provoke helplessness, to disturb the sense of the reliability of memory, to control the conversation. Body language and verbal tone is used which in itself may be easily deniable (compared to explicit verbal content) but which serves to queer the moral pitch of the interaction and leave the interlocutor feeling on the moral back foot. At stake in all of this is a distortion of the very moral fabric of the self of the victim. The sense of blame, desert, self-worth and admiration of the other are all thereby skewed.

vii. ontological depths of enactive perversions of conscience

In distinguishing between perversions of the scale itself - the scale which we are in ourselves (an ontological matter), which scale constitutes our sense of self-worth that provides the backbone of our character - and perversions of the perception of the placement of individual points of data on the scale (a merely epistemic matter) I don't mean to invoke an everywhere firm distinction. No doubt the one blends into the other in the way that the conceptual and the empirical do more generally, but most always they exclude one another. But by making the distinction we can preserve the former from being described only in terms appropriate to the latter, and thereby preserve it from being trivialised. This is akin to the importance of preventing delusion from being theorised in terms which are only appropriate for false atypical intransigent belief – i.e. in representational terms. In this way we prepare the way for a phenomenology of the depths of narcissistic abuse, of the way it affects the entire being of the victim, how it spreads out into their entire sense of their own value compared with that of others (in particular that of the narcissist), how it affects their ability to make moral judgement, take apt (not too much) responsibility, allocate blame appropriately (not too little). We can start to understand how someone can really come to think that of course they deserve it if their partner is having another affair, or how someone can come to be so skilled at walking on eggshells without even realising that they're doing so, or what it's like to endlessly receive devaluing disrespectful comments and to be ignored in such a way that one habituates to it so that it becomes the new normal, a new placement for the 0 of the X axis, a new 'normal' which also involves cutting the narcissist far more moral slack than would normally be tolerated.

The narcissist’s tricks work to detach her victim from moral reality and from sources of morale. She degrades the very fabric of his moral being. For when the enaction of the moral subject is perverted in this way, it is not merely prone to mistakes, but prone to distortions which are so off they’re not even wrong. One’s whole moral sensibility thereby gets bent out of shape and meaninglessness starts to take shape in the heart. The black emptiness inside the narcissist inevitably finds its complement. The inhumanity of the narcissist thereby infects the victim who now loses his sense of self, the backbone of his morale; he falls apart, becomes mentally and physically ill, shows signs of trauma. Again it is not simply the victim’s judgements that become skewed, but his very ability to make moral judgement: judgements like 'this treatment is wrong', 'I'm not a fundamentally bad person', etc.. They are in a trance state, a delusion, one that is necessarily blind to its own conditions, conditions which here are being twisted out of shape.

viii. conclusion

Let’s summarise the main points:

Gaslighting does not simply mean making someone feel crazy by lying to them a lot.

It involves a disturbance not only to representation but also to the enaction of morale and the moral sense.

This enaction can be carried not simply by the verbal content of what's said, but by variously subtle or unsubtle communications - the use of silence, selective memory, world salad, paralinguistic communication (an intake of breath, a raised eyebrow) - by forms of communication which provide the embedding sense-providing background to explicit verbal communication. This is 'ambient abuse'.

There are special features of the mental – indeterminacy, particularism, defeasibility, and co-constituted intersubjectivity – which enable the narcissist to gaslight.

The enaction of moral selfhood is co-enaction: who’s to blame for this upset we’re now in? is the fundamental relational question asked in a row, rows which the narcissist will provoke, the normally shared premises of which they will try to pervert.

Narcissism is ontological – it runs deep in the narcissist and its effects run deep in his victim – since it affects the enaction of the very axes of that moral graph, the enaction of the moral spine of the subject, her sense of worth and justice and culpability, and not merely the placement of this or that judgement upon it.

Tuesday, 4 June 2019

grammar's autonomy and phenomenology's revelations


I was recently asked how one could be both a philosophical phenomenologist who seeks to do justice to his experience of (the diverse facets of) reality in language, whilst also accepting Wittgenstein's dictum that grammar is arbitrary/autonomous. Doesn't the fidelity to experience intrinsic to the first jar with the autonomy of conceptual structures from experienced world mooted by the second?

Let's first bring the 'autonomy of grammar' claim into clear focus. ('Grammar is not accountable to any reality. It is grammatical rules that determine meaning (constitute it) and so they themselves are not answerable to any meaning and to that extent are arbitrary.' PG 184.) Now, to take him at his word involves acknowledging that Wittgenstein is not in the business of proposing philosophical theses. The 'autonomy of grammar' claim, then, isn't well understood as asking us to accept that whilst we understand what it would mean for 'grammar' (i.e. rules of language use) to be justifiable by reference to something, to be beholden to something for its correctness, what in fact we have to grasp is that grammar is not so justifiable or beholden. What Wittgenstein is instead doing is taking a stand against a certain picture of what a grammatical truth is and pointing out the pitfalls that come along with that picture.

The picture in question would have us compare a 'grammatical' truth to an empirical truth. It makes sense to ask for the truth conditions of an empirical truth. I claim there are five snails in the garden - this is true iff the garden happens to contain five snails. It is true in virtue of something. The claim can be justified by reference to that something. But when we have a 'metaphysical' or 'necessary' or 'grammatical' truth - 2+2=4, humans are mammals, there are 4 primary colours - there is no such 'in virtue of' in play. '2+2=4' is neither true in virtue of (just picture it, pretend the following words mean something...) the 'logical superstructure of' the universe (big 'R' Realism), nor in virtue of what humans think or do (Idealism) - it is not the kind of truth which is intelligibly paired with an 'in virtue of'. A necessary truth is instead a rule or a human convention - and (in case we're now tempted by 'conventionalism') since it is a convention it also can't be true in virtue of a convention! ('One is tempted to justify rules of grammar by sentences like "But there really are four primary colors". And the saying that the rules of grammar are arbitrary is directed against the possibility of this justification, which is constructed on the model of justifying a sentence by pointing to what verifies it.' Z 331)

Now, what about the existential-phenomenological ambition of doing justice, in our philosophy, to the reality of our experience of 'the things themselves'? Simon Glendinning offers us this: 'What characterises an investigation in phenomenology is a work of convincing words which, in an age dominated by science, aims to cultivate and develop your capacity faithfully to retrieve (for) yourself (as from the inside) a radically re-vis(ion)ed understanding of yourself and your place in the world and with others.' Anthony Rudd has it that 'expressive perception is the ability to perceive patterns in such a way as to recognise, in and through the phenomena which one sees as related, what it is that they all express. ... The phenomenologist - like the ordinary language philosopher appealing to our sense of how we would use words - is not providing a chain of arguments; she is asking us to reflect on our experience and to consider "isn't this how it is?"' ... The later Heidegger, as Rudd understands and quotes him, understood our phenomenological task to be one of answering without ourselves, via a 'responsive thinking' which involves emotional attunement, to the appeal of the world's being, taking 'the step back from the thinking that merely represents - that is - explains - to the thinking that responds and recalls.'

Now, what is this 'recognising', 'responding' and 'recalling' which is not 'representing'? This offering of recognition shows itself, I think, in two ways. First in a refusal of such metaphysical thought as would assimilate the being of, say, an emotional attitude to the being of an object. (Wittgenstein, referring to King Lear, mentioned 'I will teach you differences!' as a possible motto for the Investigations.) This isn't a matter of providing a positive description of what it is to be an emotional attitude in some special philosophical vocabulary - the finding, for example of some genus and species to which it belongs. Rather it's a matter of noting differences between different concepts - here we would say this, but there we wouldn't; here such and such an inferential step would be valid but there it wouldn't be, etc. Second it's an offering of expressive voice to the phenomenon in question - allowing it, through 'poiesis', to body forth in language in its own distinctive way. This is not a matter of using language to represent an emotional attitude but rather of lending the attitude one's tongue, so to speak, elaborating and honouring its ownmost idioms.

Now, I think, we can see how Wittgenstein's conception of grammar as arbitrary and Heidegger's poietic phenomenology are complementary. Neither philosopher imagines that our concepts could be justified by reference to the facts - in fact it is in this way that the idea of arbitrariness and non-representationality can be seen to be, far from in conflict, very much of a piece. And the very idea of justification by facts here is absurd since the facts could only ever be referenced by using the concepts in question, so any putative justifications would simply be circular. The only fidelity at play is expressive fidelity; authenticity not accuracy is here the only issue. Is the expression a (not representationally, but expressively) true one? Does an expression talk over a phenomenon or instead constitute that phenomenon's voice? Does it disclose or obscure?

Thursday, 2 May 2019

self-regulation

The concept of self-regulation is popular in psychology, and in my (clinical) part of psychology it crops up especially in relation to 'affect regulation' and 'mood regulation'. I've a worry about it. My worry is that it too-often looks like an explanation of why we don't go manic or get in a funk, or how it is that a toddler or PD sufferer may struggle in situations when others don't, or how (in non-clinical contexts) we're able to use words correctly - when instead it's (at best) very often no more than a non-elucidatory re-description of these facts.

The concept of regulation implies, I suggest, that we meet with two things: one is the regulator (like a
servo), the other is that which is regulated. These two are in a causal (often negative-feedback-providing - i.e. dampening) relation. The ballcock regulates the water level in the cistern: as it rises it shuts off the water supply.

Now, I take it that the brain is full of 'servo mechanisms' - that there are myriad negative feedback processes at play within it and between it and the body and environment. I'm not here concerned with these. What I'm concerned about is the utility of the 'regulation' idea when we stay at the psychological level of description.

There are cases where it's clearly apt. A toddler needs her emotional reactions to be regulated by her mother. Here we have two things (a toddler, a mother) in relation. She picks her up, soothes her; the toddler calms down. Perspective is returned. So here we have bona fide (external) regulation.

Over time the toddler benefits from these maternal soothings. And now, when faced by the upsetting wait for food or the pang of hunger or the disappointing absence of a toy, she no longer has a meltdown. She tolerates the situation.

It's always tempting to ask for explanations of how we're able to exercise abilities. Unfortunately, however, this temptation is too often followed by another - to attempt their answer.

When we think on self-regulation of affect we tend to imagine that we become able to not freak out so frequently either because we can now bring thought to bear on feeling or because we use self-soothing techniques (breathing, calming self-talk, self-distraction, etc.). We may consider that we've now 'internalised the mother's soothing voice', for example - and now we 'tell ourselves' the things that she used to tell us.

Now, and of course, something like this sometimes happens! You start getting upset with your partner but this time, because you've recently been going to therapy, you find your therapist's words ringing round your head: 'You tend to find in him what you experienced from your father / what you don't want to see in yourself'. 'Hmm', you think: the thought, perhaps accompanied by a memory of your therapist's firm but kind tone of voice, puts a check on the development of your anger.

What I want to object to, however, is the idea that this story - of an external servo mechanism becoming internalised where its actions can still properly be described in terms of regulation - is anything like a good account of our normal human ability to not get in a tizz.

Here's another kind of story about emotional development: You have a primitive set of far-too-black-and-white reactions to the world. The dismal ones overwhelm you and prevent you from learning from experience - prevent you learning that, in fact, matters aren't as dismal as you take them to be. Luckily your mother soothes you, and helps you see things differently. She brings to bear a more refined set of discriminations. You learn these discriminatory capacities, and the next time you're in the previously difficult situation you respond in a more nuanced way ab initio.

In this second story there's no answer to the question 'How do you now exercise this ability to not get in a tizz?' There are neurobiological or developmental histories that could be given ('Well, admittedly I used to wig out quite often, but then my mother/therapist taught me some other ways of seeing things, and the dampening interconnections between my prefrontal cortex and my amygdala became more abundant as as result(!), so now the difficult feelings just don't come up...'). But taken as a question about how it is that people exercise their abilities the 'how' question strikes us now like someone asking 'How were you able to speak the last sentence you spoke?' (after all, you couldn't always speak with such poise and precision) or 'How were you able to read what I just wrote?' There's just no good answer to these questions if we take them as inquiries into psychological rather than neurological processes. There's no reason to suppose that there's any 'how' when it comes to reading. If there had been some obstacle to our simple non-methodical exercise of our capacities, then there would still be space for a 'how?' question, but in the absence of an obstacle it's not clear what it's doing.

Psychologists too often take their theoretical lead from a perceived consilience of three stories about our ability to not freak out in difficult situations. One of these comes from neurology: the emotionally mature person has a richer set of negative-feedback-generating mechanisms in the relations between (say) the frontal cortex, the mid-brain, and the right hemisphere. (I'm not saying this is a true story - for all I know it may be crazy - but something like it is at least out there and it has a ring of plausibility.) These mechanisms are then thought of as the neural embodiment of (second story) the learning we do at our mother's or therapist's knee. (And that's fair enough.) The latter experiences are of external psychological regulation, the former mechanisms are of internal neurological regulation. Furthermore (third story) we do sometimes do something worth calling psychological self-regulation: we bring thought to bear on feeling, engage in self-soothing behaviours, etc. All of this then tempts us into falsely imagining that normal healthy adult emotionally apt responses to the environment, and the cessation of emotionally in-apt overblown responses, must be a function of having developed an ability to psychologically self-regulate. But that's a terrible inference. It overlooks the significance of the simple progressive conditioning of our emotional responses through experience. It overlooks the possibility that, because of my past learning, because of my therapy, I'm no longer in a situation where I have affective responses which will escalate unless they receive psychological regulation.

The concept of 'self-regulation' also gets used in non-clinical and non-affective contexts. Here's a quote from José Medina's The Unity of Wittgenstein's Philosophy; he's talking about language learning:
The normative background that the teacher brings to bear upon the behaviour of the novice is progressively made available to the learner through the training, up to the point where the learner's behaviour becomes regulated by norms without the assistance of the teacher, thus becoming an autonomous practitioner. In other words, by interacting with masters who structure and regulate the learning environment, novices come to adopt structuring and regulatory activities of their own. The process of initiate learning is, therefore, a process of acquiring autonomy or gaining control in normative practices. What characterises this process is a gradual shift of responsibility and authority, a developmental progression from other regulation to self-regulation. Initiate learning is thus conceived as a process of enculturation or apprenticeship: we learn norms by being enculturated into rule-following practices, by mastering their techniques. (p. 165)
The questions I have are: 1. What is it for linguistic behaviour to be 'regulated by norms'? Or: what does it mean to describe language learning as 'gaining control in normative practices'? 2. Are we sure that 'by  interacting with masters who structure and regulate the learning environment, novices come to adopt structuring and regulatory activities of their own'?

With respect to that 2nd question, undoubtedly that is how novices come to adopt such activities when they do, but what I'm concerned by is rather the implicit suggestion that the ability to use language correctly need involve the ability to correct oneself when one errs. But let's focus on the first question. Linguistic behaviour, I take it, is properly described as normative if by that we mean simply that it involves uses of words which are meaningfully described as either correct or incorrect in the circumstances of their deployment. A child may use the word 'cow' when she means 'horse'; the teacher corrects the child; the child learns to speak without making such mistakes. But in what way do these norms regulate the behaviour? For sure, the norms license what is and isn't to count as correct linguistic behaviour. But that's a conceptual point about what here counts as correct behaviour. It 's not a causal point about how correct behaviour is produced. But the concept of 'regulation' seems to incline us towards the thought that the behaviour in question is now under 'control' of some sort.

Something of a slip between the logical and the causal also seems to me to appear in the following (also from Medina):
For Wittgenstein, an essential part of the training into [sic] a rule-governed practice is treating the learner as if she were (already) a member of the practice, as if she could not only conform to the rules of the practice but actually follow them. The teacher treats the pupil's correct responses as indicative of an incipient competence and her incorrect responses as "mistakes". But the learner's reactions to the training are invested with normative significance only when viewed against the background of the whole rule-governed practice. And this is something which, by definition, the initiate learner cannot yet do by herself. Because of her lack of competence, the initiate learner does not yet exhibit self-corrective behaviour; her behaviour is subject to the check and correction of the teacher. These evaluations and corrections of the pupil's response are essential for structuring her behaviour normatively. (p. 164)
Now, perhaps Medina is just reserving the word 'normative' or 'rule governed' for behaviour which is engaged in by a person who could, if it came to it, self-correct the behaviour in question. In which case I've no problem with the passage. But it seems to me natural to use the word 'normative' for any behaviour which can properly be described in terms such as 'correct' or 'incorrect', and unnatural to say that a behaviour couldn't properly be so described unless the agent in question could self-correct that very behaviour. For I can only self-correct my use of a word if I accidentally use it in a way which goes against my current (or future, if the correction is in retrospect) understanding of how the word is properly used, but I may use words wrongly, and benefit from the correction of others, without doing that. After I've learned the meaning of the word I shan't, on the whole, need to self-correct my uses of it, although when I'm tired I can tend to mis-speak.

To summarise: we shouldn't think that just because we learn to use words correctly by learning from the feedback of others, that our ongoing correct use amounts to providing ourselves with ongoing internal feedback. That sits too close to the cognitivist idea that learning a language involves internalising / implicitly learning the rules against which our practices can be judged as correct or incorrect. But that way with rules and norms puts the ruly cart before the normy horse: it encourages the spurious idea that the normativity of language can be explained in terms of the rules which we can formulate to describe linguistic praxis, when in fact the normativity of that praxis is sui generis, and the rules in question are only described as correct or incorrect depending on whether they aptly articulate the praxis. Similarly with affect regulation: we shouldn't think that just because we manage to approach situations with a more level emotional disposition than we had when we toddlers, and just because we achieved this level headedness as a result of the soothing our therapists and mothers et al gave us, that we must now be engaged in self-soothing. That may sometimes occur, as may self-correction in linguistic praxis, but very often may be utterly irrelevant to our achievement of affective and linguistic finesse.

To conclude, I'd like to make a partly concessionary remark in favour of the idea of self-regulation, one which saves it by refusing to read into it the grammar I read into it above (where I said that the concept of regulation inexorably presupposes relata in an e.g. dampening relation). When we think on 'knowing thyself' - i.e. on achieving that kind of self-knowledge that was commanded by the Delphic oracle and aimed at by psychoanalysis - we can see that it rarely involves positively coming to know facts about oneself. Rather it involves removing certain defensive obstacles to straightforward self-expression. It involves an absence of self-deception. (Augustine said something like this: self knowledge is not the gaining but the removing of something within.) So perhaps we can similarly be more charitable in our estimation of the grammar of 'self-regulation'? We might put it like this: The person who comes to 'self-regulate' was previously in the grip of unhelpful vicious spirals of 'negative thoughts' inspiring 'negative feelings' and 'negative behaviours' etc. These spiralling interactions of allegedly separate moments of psychic life throw the person off emotional kilter, disturbing her perception of her situation. So coming to 'self-regulate' may accordingly be read as meaning not that one is actually in some self-dampening relation to oneself, but instead only that one is not now prey to some self-intensifying form of emotional reaction, or that one simply does not need other-regulation. And I think that would be fine. However the idea of self-regulation remains unhelpful to the extent that one is tempted by the idea that as we emotionally mature we no longer need the regulating presence of others because we can now self-regulate. It's the 'because' that here is spurious.

Tuesday, 30 April 2019

recently published




1: Introduction: Know Thyself, Richard Gipps and Michael Lacewing


I. Intellectual Pre-History


2: Intellectual Pre-History: Introduction, Richard Gipps and Michael Lacewing
3: Psychoanalytic Theory: A Historical Reconstruction, Sebastian Gardner
4: From Recognition to Intersubjectivity: Hegel and Psychoanalysis, Molly Macdonald
5: Schopenhauer and Freud, Andrew Brook and Christopher Young
6: From Geschlechtstrieb to Sexualtrieb: The Originality of Freud's Conception of Sexuality, Stella Sandford
7: A Better Self: Freud and Nietzsche on the Nature and Value of Sublimation, Ken Gemes


II. 20th Century Engagements


8: Twentieth Century Engagements: Introduction, Richard Gipps and Michael Lacewing
9: Merleau-Ponty and Psychoanalysis, James Phillips
10: Wittgenstein and Psychoanalysis, Donald Levy
11: "In Psychoanalysis Nothing is True but the Exaggerations": Freud and the Frankfurt School, Martin Jay
12: Ricoeur's Freud, Richard Bernstein


III. Clinical Theory


13: Clinical Theory: Introduction, Richard Gipps and Michael Lacewing
14: Imagination and Reason, Method and Mourning in Freudian Psychoanalysis, Jonathan Lear
15: "A Ritual of Discourse": Conceptualizing and Re-conceptualizing the Analytic Relationship, Judith Hughes
16: 1. Symbolism, the primary process, and dreams: Freud's contribution, Agnes Petocz
17: Wishfulfilment, Tamas Pataki
18: Integrating Unconscious Belief, Adam Leite
19: Making the Unconscious Conscious, David Finkelstein


IV. Phenomenology and Science


20: Phenomenology and Science: Introduction, Richard Gipps and Michael Lacewing
21: Complexities in the Evaluation of the Scientific Status of Psychoanalysis, Morris Eagle
22: Psychoanalysis and Neuroscience, Jim Hopkins
23: How Should We Understand the Psychoanalytic Unconscious?, Michael Lacewing
24: A New Kind of Song: Psychoanalysis as Revelation, Richard Gipps
25: Body Memory and the Unconscious, Thomas Fuchs


V. Aesthetics


26: Aesthetics: Introduction, Michael Lacewing and Richard Gipps
27: On Richard Wollheim's Psychoanalytically Informed Philosophy of Art, Damien Freeman
28: Literary Form and Mentalization, Elisa Galgut
29: Psychoanalysis and Film, Damian Cox and Michael Levine


VI. Religion


30: Religion: Introduction, Michael Lacewing and Richard Gipps
31: Psychoanalysis and Religion, John Cottingham
32: Psychoanalytic Thinking on Religious Truth and Conviction, Rachel Blass
33: The No-Thing of God: Psychoanalysis of Religion After Lacan, Richard Boothby


VII. Ethics


34: Ethics: Introduction, Michael Lacewing and Richard Gipps
35: Hiding from Love: The Repressed Insight in Freud's Account of Morality, Joel Backström
36: Human Excellence and Psychic Health in Psychoanalysis, Edward Harcourt
37: Evolution, Childhood and the Moral Self, Darcia Narvaez


VIII. Politics and Society


38: Politics and Society: Introduction, Michael Lacewing and Richard Gipps
39: Psychoanalysis, Politics and Society: What Remains Radical in Psychoanalysis?, Stephen Frosh
40: Epistemic Anxiety, Michael Rustin
41: Psychoanalysis in the 21st Century: Does Gender Matter?, Louise Gyler
42: 1. Political Philosophy in Freud: War, Destruction, and the Critical Faculty, Judith Butler

Monday, 29 April 2019

schizophrenic

Uses of the term 'schizophrenic', a fortiori 'a schizophrenic', have come in for some heavy criticism in recent years, some of this well-earned.

Here's the main arguments I've encountered:

  1. 'Schizophrenia' is an invalid diagnostic concept, so the idea of a schizophrenic person is medically and scientifically unhelpful.
  2. The term doesn't help us choose apt treatments. 
  3. Describing someone as schizophrenic amounts to labelling them 'schizophrenic' and labelling is stigmatising. 
  4. Labelling someone implies that the difficulties they have are intrinsic to their identity; we should (if we're to continue to use the term) instead say 'person with schizophrenia'.
  5. Labelling someone as schizophrenic implies that their problems will always be with them and so the diagnosis becomes a source of hopelessness.

1. The operationalised concept we find in ICD-10 and DSM-V, a concept created to try to improve diagnostic reliability especially in research contexts, wants for validity. I can't see that this is a problem for non-operationalised understandings of schizophrenic illness as a cluster of self-disturbances - the kinds of understandings we get from phenomenological psychopathology. We might do better to start to take our psychopathological science seriously, stop cow-towing to today's textbooks and handbooks, and reclaim our diagnostic categories from the positivists. It's sometimes said that people get diagnosed first as bipolar, later as schizophrenic etc., and that this shows that doctors don't know what they're doing. Well, no doubt they don't always know what they're doing. But why shouldn't inner and outer circumstances sometimes cause switches to the gestalt patterns of decompensation that obtain? I imagine we sometimes find something similar with psychosomatic conditions too: at first someone develops a hysterical paralysis; later they develop a fatigue syndrome; later still they get IBS, etc. If the main river flowing out of a reservoir is blocked, then at one time one dam will break, but later another dam will break. Such changes seem to me entirely in keeping with the workings of nature.

2. To talk of 'treatment' may already skew the kinds of help we give the person diagnosed with schizophrenia in an overly medical direction. But anyway, schizophrenia: someone's struggling to hold together, at risk of psychotic decompensation, etc - doesn't this already give us a sense of what might be helpful? They may sometimes benefit from major tranquillisers if suffering the terrors of self-dissolution. It will be useful to look at the kinds of inner and outer conflict situations they encounter and help them handle and work through these (build ego capacity and strength).

3. I've not yet met with clear accounts of when nouns are and aren't labels, and when labels are and aren't stigmatising. What we know is that stigma is a real problem, and that changing the terms used might well help for a while. Today the term 'psychosis' is used euphemistically as a kind of diagnostic category (which it isn't), usually to replace 'schizophrenia'. (No doubt this term in turn will become socially toxic in a few decades; the proximity to 'psychopath' ('psycho' etc) already causes problems.)

4. We often describe people as 'diabetic', or describe a diabetic person simply as 'a diabetic', without too much worry. We also relentlessly label people according to their professions (so-and-so is 'a fireman'; 'a psychiatrist' etc). Consider however the difference between describing someone as 'gay' and describing someone as 'a gay' (not 'a gay man', just 'a gay') - the latter has a deeply unpleasant ostracising twang to it. (Contrast 'genius', the scientologists' use of 'clear', 'hero'.) It's clearly certain situated uses, and not simply the noun form, that causes the problems. It has been argued - successfully in my view - by Louis Sass - that schizophrenia is, qua self-disorder, intrinsically to do with identity, and that therefore 'schizophrenic' is apt. Talk of 'someone with schizophrenia' can be useful in some contexts, but in others may be no more than 'politically correct' garbage (it's garbage when it would have us replace 'schizophrenic' without looking to see if, in any situation, it is causing problems - now we just have thoughtlessness pretending to take a stand against thoughtlessness.) We talk of 'a schizophrenic/diabetic/psychiatrist' when the condition or job in question is seen as long-term and as shaping someone's ongoing being-in-the-world - but we shouldn't forget that people can change or lose their jobs and also their physical and psychiatric conditions, and there's no reason to think that if someone is a psychiatrist or a schizophrenic that this is simply all there is to them, even if their job or illness does sometimes squeeze out or thwart the growth of other aspects of their personality and identity.

5. It's true that those mental health professionals who work with long-term patients can become pessimistic about the possibility of recovery. They need re-education. Even Kraepelin thought meaningful recovery possible. Since we've had 'schizophrenia' the standard wisdom has a third of people largely recovering without long-term medications. Plausible is the idea that sometimes sufferers may recover not only from a psychotic episode but from the schizophrenia trait if they overcome significant developmental fixations, work through significant underlying conflicts, and find a way out of dismal mentally confounding social contexts. It's also plausible that for some people an underlying neurodevelopmental schizotaxia/schizotypy will always render them at risk of schizophrenic decompensation, and may always manifest in quirks of thought and feeling, but that this can be managed. Schizotaxia could now be thought of as a condition - like, say, Aspergers - one that may make one at risk to psychosis but itself needs to be understood and accepted as the having of a certain kind of mind. Diabetes type 2 may be a useful analogues here: diabetes because sometimes weight loss can reverse a diabetic illness, but sometimes the condition will require ongoing management. But in some ways the diabetes analogy ignores the possibility of building, for the first time in someone's life, a more robust personality structure - by picking up lost developmental threads, developing in affect regulation capacities, moral/characterological growth, etc. Many mental health professionals continue to think of what it could mean to recover from mental illness only in terms of managing the decompensations from the schizophrenic trait (i.e. only in terms of the use of major tranquillisers as anti-psychotics). It's as if we're all supposed to take psychological development (especially that of the tricky late teenage years) for granted, as if it just inexorably unfolds or not by itself, as if there weren't significant tasks that can get left undone, significant characterological weaknesses that need to be addressed courageously, etc. (Anyone who's spent a decent enough number of hours in a decent enough therapy knows this to be untrue.)