Reflections on the use of patient records: Privacy,ethics, and reparations in the history of psychiatry

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in an ethical manner that respects the privacy of people in the past who never imagined their intensely personal psychiatric encounter as subject for future historians? In this paper, we want to think through some of the issues that we deal with as white historians of psychiatry especially at the intersection of privacy, ethics, and racism. We present our thoughts as a conversation, structured around questions we have posed for ourselves, and building on discussions we have had together over the past few years. We hope that they act as a catalyst for further discussion in the field.     

The Metaphysics of Degrees

Degree‐sentences, i.e. sentences that seem to refer to things that allow of degrees, are widely used both inside and outside of philosophy, even though the metaphysics of degrees is much of an untrodden field. This paper aims to fill this lacuna by addressing the following four questions: [A] Is there some one thing, such that it is degree sensitive? [B] Are there things x, y, and z that stand in a certain relation to each other, viz. the relation that x has more y than z? [C] In those cases in which degree sentences do not refer to phenomena that are degree sensitive, what is responsible for their prima facie seeming to do so? [D] If there are degree sensitive things, to which ontological categories do they belong? We answer each of these questions by arguing that there are, metaphysically speaking, different phenomena that degree sentences refer to: some refer to determinates that emanate from a certain determinable, others to tokens that are instantiations of a certain type, and yet others to what we call ‘complex, resultant properties that are constituted by stereotypical properties’. Finally, we show the relevance of our answers by applying them to the notions of freedom and belief.     

Kicking over the traces: A note in response to Zurif and Piñango (1999)

Zurif and Pi?ango (1999) claimed that they excluded the four agrammatic patients reported by Druks and Marshall (1991) from their review article because two of the patients were nonnative speakers of Hebrew and because the Hebrew sentences we used in our investigations were ungrammatical. In Druks and Marshall (1991) we have shown that the presence or the absence of a trace in two types of Hebrew passives had no effect on the patients' performance. Two patients, without comprehension deficits, performed equally well on both types of passives and two patients, with comprehension deficits, were equally impaired on both types. We remind Zurif and Pi?ango of our previous response to the claims of ungrammaticality of our materials (Druks & Marshall, 1992) and argue that there were no justifiable reasons for excluding these cases from the review. We also comment on Zurif and Pi?ango's (1999) and Grodzinsky's (2000) new proposal that the association of agrammatic comprehension should be with Broca's aphasia and not with agrammatism.     

The influence of male and female best friends on adolescent sexual behavior

Using panel data from a junior high school system in an urban area of Florida, we examine whether adolescents' best same-sex and best opposite-sex friends' sexual intercourse behavior increases the likelihood that respondents who are virgins at round 1 will make the transition to intercourse between rounds of our study. We find no significant influence effects of friends of either sex for black males or females, or white males. In contrast, white females are influenced by the sexual behavior of both their best female friend and best male friend. A virgin white female whose best friends of both sexes were sexually experience at round 1 was almost certain to have sexual intercourse within the two years of our study.     

The Complete Work

What is it for a work of art to be complete? In this article, we argue that an artwork is complete just in case the artist has acquired a completion disposition with respect to her work—a disposition grounded in certain cognitive mechanisms to refrain from making significant changes to the work. We begin by explaining why the complete/incomplete distinction with respect to artworks is both practically and philosophically significant. Then we consider and reject two approaches to artwork completion. Finally, we set out and defend our own account.     

Gender Differences in Associations with Deviant Peer Groups: Examining Individual,Interactional, and Compositional Factors

Researchers have long known that boys are more likely to have deviant peers than are girls. Yet, little research has tried to explain why boys and girls differ in their decision to associate with deviant peers. With the salience of deviant peers well established as a robust predictor of delinquency, we address the question, are the predictors of association with deviant peers different for boys and girls? In our examination of family and community processes, individual effects, and peer group composition factors, we find that the predictors of association with deviant peers differ by gender. In addition, our findings suggest gender divergences in the causes of both deviant peer association and deviant peer pressure. We discuss the implications of our research for both theoretical development and appropriate model estimation.     

Expressivism and the Reliability Challenge

Suppose that there are objective normative facts and our beliefs about such facts are by-and-large true. How did this come to happen? This is the reliability challenge to normative realism. As has been recently noted, the challenge also applies to expressivist “quasi-realism”. I argue that expressivism is useful in the face of this challenge, in a way that has not been yet properly articulated. In dealing with epistemological issues, quasi-realists typically invoke the desire-like nature of normative judgments. However, this is not enough to prevent the reliability challenge from arising, given that quasi-realists also hold that normative judgments are truth-apt beliefs. To defuse this challenge, we need to isolate a deeper sense in which normative thought is not representational. I propose that we rely on the negative functional thesis of expressivism: normative thought does not have the function of tracking normative facts, or any other kind of facts. This thesis supports an argument to the effect that it is misguided to expect an explanation of our access to normative facts akin to the explanations available in regions of thought that have a tracking function. We should be content with explanations of our reliability that take for granted certain connections between our psychology and the normative truths.     

Pictorial surface attitude and local depth comparisons

We measured local surface attitude for monocular pictorial relief and performed pairwise depthcomparison judgments on the same picture. Both measurements were subject to internal consistency checks. We found that both measurements were consistent with a relief (continuous pictorial surface) interpretation within the session-to-session scatter. We reconstructed the pictorial relief from both measurements separately, and found results that differed in detail but were quite similar in their basic structures. Formally, one expects certain geometrical identities that relate range and attitude data. Because we have independent measurements of both, we can attempt an empirical verification of such geometrical identities. Moreover, we can check whether the statistical scatter in the data indicates that, for example, the surface attitudes are derivable from a depth map or vice versa. We estimate that pairwise depth comparisons are an order of magnitude less precise than might be expected from the attitude data. Thus, the surface attitudes cannot be derived from a depth map as operationally defined by our methods, although the reverse is a possibility.     

Minimizing Arbitrariness: Toward a Metaphysics of Infinitely Many Isolated Concrete Worlds

A particular fact or event often appears arbitrary and puzzling, until it is exhibited as the outcome of certain causal processes. Usually, though not always, such a causal explanation helps to relieve the feeling of arbitariness, at least for a while. But it is easy and natural for our feeling to reassert itself: We are moved to ask why just those causal processes governed the situation of that fact or event, rather than some others. To deal with this further, larger question, often we can exhibit those causal processes as being, themselves, the results of, or certain specific instances of, prior or more general causalities. Or, much the same, we can redescribe the initial particular fact, and perhaps the cited cause as well, and display the items thus described as an instance of some very general, fundamental law or phenomenon. But any of this will only push the question back one step more. For we can always press on and ask: Why is it that just that very general phenomenon, or law, should be so fundamental, or indeed obtain at all, in the world in which we have our being? Within the usual framework of explanation, law and causation, there seems no place for such curiosity to come to rest. There seems no way for us to deal adequately with the brute and ultimate specificity of the ways in which almost everything appears to happen. And what seems worse, the specific character of certain of these laws or ways, even of quite fundamental ones, often seems so quirky, the very height of arbitrariness.     

Solidarity and Social Moral Rules

The value of solidarity, which is exemplified in noble groups like the Civil Rights Movement along with more mundane teams, families and marriages, is distinctive in part because people are in solidarity over, for or with regard to something, such as common sympathies, interests, values, etc. I use this special feature of solidarity to resolve a longstanding puzzle about enacted social moral rules, which is, aren’t these things just heuristics, rules of thumb or means of coordination that we ‘fetishize’ or ‘worship’ if we stubbornly insist on sticking to them when we can do more good by breaking them? I argue that when we are in a certain kind of solidarity with others, united by social moral rules that we have established among ourselves, the rules we have developed and maintain are a constitutive part of our solidary relationships with one another; and it is part of being in this sort of solidarity with our comrades that we are presumptively required to follow the social moral rules that join us together. Those in the Polish Revolution, for example, were bound by informally enforced rules about publicity, free speech and the use of violence, so following their own rules became a way of standing in a valuable sort of solidarity with one another. I explain why we can have non-instrumental reasons to follow the social moral rules that exist in our own society, improve our rules and even sometimes to break the otherwise good rules that help to unite us.     

Arithmetic as Grammar

What is a number? Using material from Wittgenstein’s 1930s lectures, I argue that this question expresses a disorientation best overcome by recollecting rules that govern the number words. Why do we have the rules we do? We may be persuaded to adopt one rule rather than another by experience, when experiment shows it to be the more convenient way; we may also be persuaded by the “experience” of a new aspect. Mathematics is a “motley of techniques” for doing certain things; religion is a certain spirit meant to pervade everything we do. An important likeness is that in both instruction is essentially grammatical.     

Analysis of recent empirical challenges to an account of interceptive timing.

How do we perceive how long it will be before we reach a certain place when running, driving, or skiing? How do we perceive how long it will be before a moving object reaches us or will arrive at a place where it can be hit or caught? These are questions of how we temporally coordinate our actions with a dynamic environment so as to control collision events. Much of the theoretical work on the control of these interceptive actions has been united in supposing that (1) timing is functionally separable from positioning and the two are controlled using different types of information; (2) timing is controlled using special-purpose time-to-arrival information; (3) the time-to-arrival information used for the timing of fast interceptive actions is a first-order approximation to the actual time-to-arrival, which does not take accelerations into account. Challenges to each of these suppositions have recently emerged, suggesting that a complete rethinking of how interceptions are controlled may be necessary. These challenges are analyzed in detail and it is shown that they are readily accommodated by a recent theory of interceptive timing based on the points just noted.     

Analysis of recent empirical challenges to an account of interceptive timing

How do we perceive how long it will be before we reach a certain place when running, driving, or skiing? How do we perceive how long it will be before a moving object reaches us or will arrive at a place where it can be hit or caught? These are questions of how we temporally coordinate our actions with a dynamic environment so as to control collision events. Much of the theoretical work on the control of these interceptive actions has been united in supposing that (1) timing is functionally separable from positioning and the two are controlled using different types of information; (2) timing is controlled using special-purpose time-to-arrival information; (3) the time-to-arrival information used for the timing of fast interceptive actions is a first-order approximation to the actual time-to-arrival, which does not take accelerations into account. Challenges to each of these suppositions have recently emerged, suggesting that a complete rethinking of how interceptions are controlled may be necessary. These challenges are analyzed in detail and it is shown that they are readily accommodated by a recent theory of interceptive timing based on the points just noted.     

Duties to Make Friends

Why, morally speaking, ought we do more for our family and friends than for strangers? In other words, what is the justification of special duties? According to partialists, the answer to this question cannot be reduced to impartial moral principles. According to impartialists, it can. This paper briefly argues in favour of impartialism, before drawing out an implication of the impartialist view: in addition to justifying some currently recognised special duties, impartialism also generates new special duties that are not yet widely recognised. Specifically, in certain situations, impartial principles generate duties to take actions and adopt attitudes in our personal lives that increase the chance of new or different special relationships being formed—new or different friendships, family-like relationships, relationships akin to co-nationality, and so on. In fact, even if one thinks partialism is the best justification of the duties we have once in special relationships, impartialist justifications for taking steps to form such relationships should have some sway. Moreover, a little reflection shows that these duties are not as demanding or counterintuitive as one might expect.     

Self–other contingencies: Enacting social perception

Can we see the expressiveness of other people's gestures, hear the intentions in their voice, see the emotions in their posture? Traditional theories of social cognition still say we cannot because intentions and emotions for them are hidden away inside and we do not have direct access to them. Enactive theories still have no idea because they have so far mainly focused on perception of our physical world. We surmise, however, that the latter hold promise since, in trying to understand cognition, enactive theory focuses on the embodied engagements of a cognizer with his world. In this paper, we attempt an answer for the question What is social perception in an enactive account? In enaction, perception is conceived as a skill, crucially involving action (perception is action and action is perception), an ability to work successfully within the set of regularities, or contingencies that characterize a given domain. If this is the case, then social perception should be a social skill. Having thus transformed the question of what social perception is into that of what social skill is, we examine the concept of social contingencies and the manner in which social skills structure—both constrain and empower—social interaction. Some of the implications of our account for how social and physical perception differ, the role of embodiment in social interaction and the distinction between our approach and other social contingency theories are also addressed.     

Agency regarding our reasons

ABSTRACT

How much control do we have over our reasons for action? Not much, but some. We all have reasons to avoid pain and not to inflict it on others. What explains our shared reasons? On an externalist account, reasons are grounded in values. All reasons are external to agency. This ensures that reasons are universal, so it is an attractive feature of moral and prudential reasons. However, when our reasons differ this is less attractive. In some cases, it seems like something internal to the agent makes all the difference. There are many valuable things, but an agent can only come to care about a small set of those things. Consider your reasons that stem from your love of philosophy or punk rock. Here it seems we make some reasons our reasons by becoming committed to them. I call these our agential reasons. We express our agency by coming to care about some things in ways not required by rationality. Unlike, matters of taste though, these are not bare preferences we just find ourselves having. Rather these concerns are cultivated over time. We express rational agency by incorporating particular values into our lives.     

THE PRAYING ANIMAL

Abstract. Ritual cannot be interpreted by a root metaphor of evolution, without reducing ritual's necessary intention. We must rather understand ritual as humanizing revolution. We have therefore two questions. First, What part does ritual have in human reckoning with reality? Second, What part does ritual have in the step to the specifically human? To the first question, the answer is proposed: ritual is that embodiment of our discourse with God and one another, by which we are made available and vulnerable to reality. To the second question, the answer is proposed: as embodied prayer, ritual is the complement to that address of God which posits our ontologically specific humanity, Parodying Aristotle, we may say that we are the sacrificing animals.     

Countertransference and the Erotic

Eros is like a huge spark that ignites our passion and then confronts us with the problem of living out this fire in ordinary space and time. What do we each know of this spark, this flame? Who or what was it’s object? Where have we felt this force for unity in ourselves, with another person, with life itself? Where are we unlived erotically? Where are the chinks in our erotic life? In focusing on the erotic in clinical work, we usually begin with the analysand’s transference. I want to explore eros in the life of the analyst for our relation to eros influences the clinical work we do. When eros is constellated, two possibilities of relationship present themselves: to an actual other who must be reckoned with as real, and to a psychic content, equally real, which we do not invent or control. How do we experience this electricity? What is our desire like? What does it take us back to, and toward what unseen purpose does it propel us? Eros brings with it a sense of purpose, of going somewhere important, something that enlists body, soul, and spirit.     

The Attractions and Delights of Goodness

What makes something good for me? Most contemporary philosophers argue that something cannot count as good for me unless I am in some way attracted to it, or take delight in it. However, subjectivist theories of prudential value face difficulties, and there is no consensus about how these difficulties should be resolved. Whether one opts for a hedonist or a desire-satisfaction account of prudential value, certain fundamental assumptions about human well-being must be abandoned. I argue that we should reconsider Plato's objectivist theory of goodness as unity, or the One. This view is both consistent with and explains our most basic views both about goodness in general and human well-being in particular.     

Re‐framing systemic paradigms for the art of learning

Thoughtful people are increasingly concerned that the current paradigms for social, corporate, and educational activities are in disgraceful disarray. The “problem‐solving” or analytical model, the competitive or game model, the commercial or consumer model, the bureaucratic or institutional model, and the disease or illness model which prevail in public discourse are proving to be especially unwholesome. We cannot, however, educate ourselves without paradigms. A credible educational paradigm must be generally accessible without being simplistic, informative without being monothematic, and accommodating as well as discriminating. Given our disquiet with the current cognitive situation, a renewing paradigm must be somehow novel; given the character of human nature, a sustaining paradigm must be somehow familiar.

For a very long time now, professional Sciences have committed themselves to paradigms about “reality out there,” while professional Arts have devoted themselves to expressing “imagination from within here.” The more these two worldviews polarize in opposition to one another, the more room there is—and the more human heed there becomes—for mediation by an applied philosophy which accommodates the “real” as well as the “imaginary” in a complementary way. Such a philosophy would address not only “what do you know?” and “how do you do?” but also “how do you know?” and “why do you do?” In earlier times, people would have been considered neither educated nor wise unless they appreciated the Sciences and the Arts whole. In our time, we may not survive unless we can re‐integrate our fractured perceptions. How might we proceed to do so? There may be a systemological way.