Tuesday 27 December 2011

Time management, J-style planning and finding meaning in life

At an end of term away day we were treated to a session on time management by Carolyn Blunt from Real Results. Although I have deep constitutional resistance to such sessions, she conducted it well and it was only as patronising as it probably had to be.

The session started with mention of one of the four oppositions in the Myers Briggs Type Indicator: judging versus perceiving with the interpretation that J-type strategies involve planned and step-wise progress whereas P-type strategies were more intuitive, deadline driven and perhaps spontaneously creative. Carolyn stressed that she had herself attempted to resist a typical managerial dominance of the J-type and instead think that one cannot adopt strategies in conflict with underlying personality types. One could not adopt the other approach whole heartedly. Hence one should avoid a kind of J-envy and instead aim to maximise the strengths of either aspect.

That said, the session as a whole seemed to keep pushing what seems a broadly J approach. Now there’s some difficulty here insofar as J vs P is merely one of four distinctions on the Myers Briggs picture. The others are extraversion vs introversion, sensing vs intuition, thinking vs feeling as well as judgement vs perception. And thus the broad hunch we (my colleagues in the mental health division and I) had might not be have been taken by Myers and Briggs to be faithful to their theory of personality. But I think we can let that ride given the worries there are about the reliability and validity of their picture. Let’s just go with a bit of face validity here.

One instance of this was a slide that represented life as a week with 0-10 years as Monday, 11-20 as Tuesday etc. With Christmas spirit, Carolyn suggested that whilst there might be the odd bank holiday Monday available to some, most of us ought not to count on it for getting anything done. Thus I, for example, am well into Friday afternoon already with not much time left.

But, as Gloria pointed out, this is surely just an instance of a J conception, broadly and loosely interpreted. To conceive of one’s life in advance in this way is just to plan in the way Js are supposed to value but not the way Ps do. A P-person might instead say that it is better to have a loose conception of what is worth doing without anticipating how it is mapped into the rest of the week. (Gloria wondered whether she’d spent too much of Tuesday and Wednesday like that and was planning on a bit more of a P-approach to Thursday.) So the very way of setting up the issue is not theory neutral but already an instance of J-envy.

Another instance was Carolyn’s response to my colleague Geoff’s worry that this planning failed to accommodate the necessity of a family life alongside work. (He was perhaps unnerved to find himself already on Saturday and beginning to think how to spend Sunday: more beer would hopefully be involved.) Not at all, she replied, it is necessary to have to some ‘hippo time’: some permitted time wallowing in the mud. This again seems to me to be a typical J misunderstanding (already I believe in the typology enough to blame the J-s!). Once it is thought of as allowed hippo time – once it is so conceptualised – that seems to kill the real attraction of such time which should feel unplanned and unstructured.

More generally, she suggested, it is better to make explicit what one values in order to work out better how to approach and realise it. Now I wouldn’t want to disagree with planning. I live by the to do list and social calendar. (I suspect I’ve imposed a J-like structure on suspect P-tendencies.) Still, it seems it is also worth noting the limits of making one’s values explicit in this way. If one evaluates one’s projects by placing them in a broader – J-preferred – structure then this threatens to initiate a regress about the value of the bigger picture. The worry is that as one approaches the end of Sunday one realises that the J-picture one has structured one’s life by is arbitrary and ungrounded by anything bigger than it. Precisely because they always approach it locally rather than relative to a broader structure which must ultimately fail (since the largest structure to which one does appeal will not itself be grounded in a broader structure and thus must appear arbitrary; any appeal to yet one more bigger structure merely postpones the problem for a moment), the P-s may be on safer ground when it comes to the meaning of life.

(I said to colleagues that I would write this thought down a week ago. But then I thought: that is what the J-s would want me to do!)

Tuesday 13 December 2011

Draft abstract for INPP 2012

Non-rational understanding? Can psychiatry draw on Wittgenstein’s discussion of other cultures?

Since Jaspers’ time, an important issue for psychiatry has been assessing the role of understanding, by contrast with explanation, for making the experiences and beliefs of people suffering mental illnesses intelligible. More recently, the key feature of understanding that has been taken to mark it off from other forms of scientific intelligibility has been a connection to the rationality and normativity of thought, influenced by Wittgenstein, Davidson and McDowell. But especially within recent philosophy of psychiatry this has also been criticised (eg recent work by Campbell and Bortolotti).

If, however, one does think that the connection between understanding something and fitting it within a rational pattern is a genuine insight, how can one approach phenomena which apparently resist such rational capture? In this presentation I attempt to balance two themes from the later Wittgenstein which, although both are contestable, are, I will argue, sound. The limits of sense coincide with the limits of rationality. Nevertheless, consideration of behaviour from quite different cultures can suggest, precisely because of its strange quality, a way of approaching phenomena which cannot be fitted within familiar rational patterns.

Monday 12 December 2011

Social science according to the Journal of Mental Health Training Education and Practice?

I return to the rather dismal readerreport I had from the Journal of Mental Health Training Education and Practice last week to make, I can at least hope, a general point. (I guess someone will tell me if this is just sour grapes!)

‘Whilst the review was useful the main issues were in relation to the methodology. The review did not follow a systematic review format either in standard or a shortened version. There were no questions which were being used to interrogate the literature and there was no summary of the studies that were included. Databases searched were no[n-] existent if very limited without adequate justification and therefore the findings of the review would not stand up to academic scrutiny. For the review to be acceptable it needs to be extended and a clear recognised methodological framework used. The methodology adopted beyond a systematic review is a limited use of philosophical logic. There a wealth of resources that might be applied to the paper. For example, Critical Theory, Feminism, Deconstruction, etc. I appreciate this might reflect interests that are not represented in the paper...’

The more I think of this report, the more baffled I am. I fear that, if typical, it suggests something rather worrying about the approach taken to social science but of course my reaction may be as much my own familiar responses to a negative review. They are never very enjoyable. Still it may be worth explaining my more general qualm in case it is on the right lines.

So the back story is that I was invited by this particular journal to submit a paper based on a presentation I’d given at a conference in the area a couple of years ago. I sent them the reply 18 months ago and had a response a couple of weeks ago. (The editor and administrators all seem very helpful and charming, by the way, if anyone is thinking of submitting article.) The paper, previously posted here, was an attempt to answer its titular question ‘Why teach the philosophy of mental health?’ taking as its stalking horse (not quite the right metaphor) a view that the purpose of such philosophy is to defend a conception of mental health care against criticism and thus presupposing an equal and opposite view that the purpose of philosophy is to advance an anti-psychiatry view. My claim was that philosophy was a self-conscious critical examination of mental healthcare and thus shouldn’t be seen as an external perspective on it (offering independent and either critical or supportive views) but rather an organic part of what good mental healthcare would involve. It is not a second order supportive, or critical, add-on but part of what a good first order approach would be. That is why it is worth teaching the philosophy of mental health. What is more, it can and has been so taught at UCLan and elsewhere.

In the light of this I’m struck by two features of the referee’s report. First, it assumes that my paper was a review and then rather a bad one. It would indeed fail rather badly as a review if they must follow some essential rules governing the inclusion of summaries of studies and searches of databases. But that suggests it is witless to assume it aimed to be one and good social science avoids witless interpretation. That, maybe, is just my frustration. What may be more worth sharing is this worry. Look at this.

For the review to be acceptable it needs to be extended and a clear recognised methodological framework used.’ My worry is that someone who writes this has not thought about what the point of a ‘clear recognised methodological framework’ is. It sounds here as though it’s a kind of fashion. As long as we all agree that lapels are wide this year, then we are fine. But providing that there is valid argument, a sustained justification of a claim to truth, who cares if there’s an appropriate off the peg name for the way the argument works? (The approach would also be subject to a vicious regress concerning the recognised name of the second order application of the recognised first order method in any particular context. Each such application would need a name, naming the process of application. But then that process would also have to be applied, calling for another named process of application at the next level up. The regress should be blocked by the realisation that there is a successful argument in play. But if so, it can be blocked at the zeroth stage.) This same disappointing attitude seems present in two further comments.

First, ‘The methodology adopted beyond a systematic review is a limited use of philosophical logic’. Now, in philosophy, ‘philosophical logic’ is a slightly old fashioned name for the philosophy of logic. (There was a tendency in the 1960s, I think, to say philosophical X to mean philosophy of X more generally.) But, given that no part of my paper was about the philosophy of logic, I’m confident that this is not what the reviewer means. What they seem to mean is this: the method of the paper was a merely limited application of logical argument. But if this is right, this way of raising the objection is depressing indeed but not critical enough. If the problem with the paper is this, then it means that the argument is very bad. In which case, the worry is not that this method – philosophical logic – wasn’t used enough: five times, maybe, when ten times would be the industry standard. It is that the argument was invalid: the conclusion didn’t follow from the premises etc. If so, say so! And say which arguments were poor. Offer a counter argument.

Second: ‘There [are]a wealth of resources that might be applied to the paper. For example, Critical Theory, Feminism, Deconstruction, etc. I appreciate this might reflect interests that are not represented in the paper...’ Again this is the thought that a method is a more or less arbitrary but fashionable way of going on. Add in a few more methods and we’re, again, fine because we will have mentioned enough of this year’s X-Factor ideas. What a dire misunderstanding of the aims of academic argument and  analysis.

The more I think of it, the more the kind of approach to social science suggested in these comments seems something I want no part of. Perhaps it is good to have been rejected. I turn out to be with Groucho Marx.

Evaluativism versus objectivism

A draft paper hopefully to be translated into Italian for a special issue of Rivista Sperimentale di Freniatria on neuroscience.

Evaluativism versus objectivism: Is the question of facts versus values in the analysis of mental illness a factual or a value-laden question?

Abstract

The degree of insight into the nature of mental illness that neuroscience can offer depends on the nature of mental illness itself: on whether it is an objective, internal matter or evaluative and socially constituted. But there has been long-standing disagreement about this. To shed light on the debate, I draw on, and refine, Zachar and Kendler’s proposed framework for debating psychiatric taxonomy. I argue that a radical externalist account of mental illness (constitutive evaluativist externalism) threatens the role of neuroscience. But, further, the disagreement between such an evaluativist position and its objectivist opposition may concern not only the nature of mental illness but also the terms of the debate. The evaluativist can argue that the disagreement itself is not a factual, but rather an evaluative, matter.

Introduction

How much can we hope to learn about the nature of mental illness through neuroscientific inquiry? Here is an analogy. If mental illness is like physical illness then a scientific perspective will be as helpful in the former case as it is in the latter. But there is a long-standing debate about how similar mental and physical illness is. In his paper ‘The myth of mental illness’ Thomas Szasz, for example, claims that there is an important distinction between them.

The concept of illness, whether bodily or mental, implies deviation from some clearly defined norm. In the case of physical illness, the norm is the structural and functional integrity of the human body. Thus, although the desirability of physical health, as such, is an ethical value, what health is can be stated in anatomical and physiological terms. What is the norm, deviation from which is regarded as mental illness? This question cannot be easily answered. But whatever this norm may be, we can be certain of only one thing: namely, that it must be stated in terms of psychological, ethical, and legal concepts... [Szasz 1972: 15]

On Szasz’ view, physical illness implies deviation from the functional norms of the body, the norms governing its correct functioning. Mental illness, if it existed, would imply deviation not from bodily functional norms but from a different kind. One possibility is that they imply deviation from mental functions modelled as close analogues of bodily functions. Indeed, Szasz suggests that the norms are psychological. But he adds that they are also ethical and legal. His view is that mental illness differs from physical illness by being essentially social and evaluative.

Szasz himself does not rest content with the claim that mental illness answers to different norms from physical illness. Combining this claim with the claim that mental illness is supposed to be medically treatable and that medical interventions address bodily functional norms, he argues that there is no such thing as mental illness. Nothing could possibly satisfy these constraints. This argument, at least, can be blocked, however. Even if mental illness is defined by, or identified through, psycho-social norms, this need not imply that it is identical to, or constituted by, such deviation. It may be that the illness is the cause of the deviation such that, even though it is picked out by its characteristic effects, it is not identical to them. If so, that idea is compatible with medical intervention and so Szasz’ argument fails.

Nevertheless, if Szasz’ initial claim were true, it would still have important consequences for a neuroscientific investigation of mental illness even without his more radical sceptical conclusions. The most that a neuroscientific inquiry could find would be the causes of mental states and behaviour which, as a matter of fact, deviated from social and evaluative norms. It would not be able to investigate the nature of mental pathology as such: what makes something an illness. If mental illness is essentially socially and evaluatively constituted, then the investigation of what makes something pathological is a matter for sociological and perhaps moral inquiry, not neuroscientific inquiry. Thus Szasz’ initial claim is still of significance for understanding the connection between scientific inquiry and mental illness.

To give an example of this potential limitation, consider the experience of hearing voices. This counts as a first rank symptom of schizophrenia: a clear indication of pathology. But it is also asserted by some of those who experience it as merely an aspect of a different kind of subjectivity, in no sense intrinsically pathological. Is it pathological or not? Can neuroscience shed light on this question? Not, I suggest, if Szasz’ initial claim is true.

But is that initial claim true? One might have expected that in the 40 years since Szasz published ‘The myth of mental illness’, an agreement would have been reached as to what kind of norms are involved in a diagnosis of mental illness. But it has not been. In this paper I will explore one basic reason for that. It is not clear whether mental illness is partly constituted by values or not. But it is not even clear whether the debate about that is itself an evaluative or a factual matter. That is: is the aim of inquiry an analysis of mental illness that is true? Or is it an analysis that is good: one which fixes a desirable view of what we should mean by ‘mental illness’?

I will approach this question in the light of two distinctions from Peter Zachar and Kenneth Kendler’s recent conceptual framework for psychiatric taxonomy. In their paper ‘Psychiatric Disorders: A Conceptual Taxonomy’, Zachar and Kendler attempt to outline the many potential initial questions which have to be answered before one can draw up a taxonomy of mental illness. These questions all concern general issue of what sort of things mental illnesses are. The aim of their paper is to set an agenda for thinking about a scientific taxonomy rather than to settle it. The two distinctions with which I will be concerned are objectivism versus evaluativism and internalism versus externalism. I will take these in turn.

Evaluativism

The first distinction is defined like this:

Is deciding whether or not something is a psychiatric disorder a simple factual matter (“something is broken and needs to be fixed”) (objectivism), or does it inevitably involve a value-laden judgement (evaluativism)? [Zachar and Kendler 2007: 558]

The example picked for objectivism may seem surprising. It may not seem to be a simple factual matter, a matter to be contrasted with an evaluation, whether something is broken and needs to be fixed. Contrast this idea with a paradigmatic objective taxonomy such as the Periodic Table in chemistry. The Periodic Table classifies on the basis of atomic number (the number of protons in the atomic nucleus). To model the example on that would require thinking of ‘needing to be fixed’ as an objective property of the layout of the world which is there anyway, like atomic number, irrespective of the values of a judging subject. It would be a property the detection of which would be enough, without complementary desires, to motivate a subject to bring about its repair. Against a stark contrast of facts and values, such an objective and yet at the same time essentially motivating property seems, using John Mackie’s term, rather queer [Mackie 1977: 38-42].

In fact, even the first element of their example is not such a simple descriptive idea. Being broken is not a simple physical property. Nor need it even supervene on (simple) physical properties since, for example, a device which is broken with respect to one function might successfully possess a different function.

These considerations would motivate an inversion of the role of the example in the definition to give, instead, this:

Is deciding whether or not something is a psychiatric disorder a simple factual matter (objectivism), or does it inevitably involve a value-laden judgement (evaluativism) (“something is broken and needs to be fixed”)?

Two things, however, make the choice of example less surprising. Firstly, outside the explicit contrast with an evaluation there is something obviously right in saying that whether something is broken and needs to be fixed is a factual matter which can be of a simple and everyday kind. Unprejudiced by neo-Humean philosophy, one would naturally say that this is the kind of thing that can be the content of a descriptive judgement. A small child viewing a freshly dropped cup might take in both that it is broken and the corresponding urgent need at a glance.

Secondly, whilst it may not have the conceptual simplicity of atomic number it more closely reflects the kind of taxonomic kinds found in psychiatry. Objectivists – as contrasted with evaluativists – will have be able to analyse such claims – broken and needs to be fixed – in value-free and objective terms. The task is fundamentally harder for objectivists than for evaluativists as the former are committed to a purely factual analysis whereas the latter allow both facts and values; they are not committed to a values-only analysis of disorder. In picking this example, Zachar and Kendler are helpfully reminding us of the challenge for objectivists.

Having now clarified this distinction, I will turn to the second one of relevance to this paper before drawing out their combined significance.

Constitutive externalism

The second distinction is summarised thus:

Should psychiatric disorders be defined solely by processes that occur inside the body (internalism), or can events outside the skin also play an important (or exclusive) defining role (externalism)? [ibid: 558]

Zachar and Kendler further characterise the distinction with the following hints. Modern psychiatry has been largely internalist and holds that events within the body are ‘critical for understanding and defining’ mental disorders [ibid: 558]. Externalists are either moderate and hold that ‘what goes on inside the head cannot be isolated from an organism’s interaction with the world’ or radical, in taking external events to be definitional, as exemplified in syndromes which are considered to be ‘reactions to harsh societal demands’ [ibid: 559].

It is helpful to draw attention to a further distinction which Zachar and Kendler do not make but which can shed light on their distinction. One can think of externalism as characterising a claim about causation or constitution. If one, plausibly, thinks that environmental factors sometimes cause mental illness then one is a causal externalist. But one may think that they cause mental illness by affecting states – perhaps neurological – within the body. If so, whilst a causal externalist, one is also a constitutive internalist. (Constitution is not quite the same thing as what defines a mental illness. Even a constitutional internalist may find it helpful to label illnesses by their causes.)

This clarification can be applied to an example of externalism that they give, the Interpersonal Model:

Contrary to any of the medical models, an interpersonal systems model is staunchly externalistic. Most fundamentally, this model views disturbed behaviour as arising from disturbed relationships. Rather than deriving from psychopathology in individuals, psychiatric disorders are seen to develop dynamically from pathology in interpersonal contexts. The notion of patients being containers of internal psychological states is minimised, whereas the view of them as persons trying to adapt to their social worlds is maximised. The context or the interpersonal system is both locus of pathology and the cause of pathological behaviour. [ibid: 562]

Most of the characterisation in this passage would fit a causal externalist but at the same time a constitutive internalist view of disorder. The fact that disturbed behaviour arises from disturbed relationships is consistent with the causation being mediated by states of the brain. Similarly, dynamic changes in response to interpersonal contexts may be dynamic changes of the brain. And there is no reason to rule out a central role for brain-mediated responses for persons adapting to social worlds. The ‘context as cause’, in the final sentence of the passage above, again exemplifies merely causal externalism.

A causal externalist but constitutive internalist view of disorder poses little threat to the insight that neuroscience can offer. If what makes something a mental illness is constituted by matters within the skull then neuroscience looks the best tool to investigate it. To generate a threat to that one needs to more radical externalism. One needs, for example, to think of the Interpersonal Model in constitutive externalist terms (and thus play up two so far neglected hints of that in the quotation). On such an account, disturbed behaviour is constituted in or by disturbed relationships. Interpersonal contexts are themselves literally pathological. (Thus, for example, family relationships do not cause pathology in a disturbed child; the relationships, rather than the child, are pathological.) The context or the interpersonal system is the locus of pathology (and thus not the cause of pathological behaviour since the interpersonal system includes the behaviour). Constitutive externalism in the philosophy of mental health is a radical view (whilst causal externalism is not). It also threatens the role of neuroscientific inquiry by locating that factors that constitute mental illness outside the body. Its role would be limited to examining those causal factors which, as a matter of fact, led to these effects not the direct investigation of illness itself.

Having now clarified the nature of both evaluativism and externalism, and suggested how constitutive forms of externalism limit the kind of insight that neuroscience can offer, I will now consider, in the next two sections, a further importance distinction: between disciplined and undisciplined evaluativism. It is this that makes the debate about mental illness particularly complex.

Constitutive evaluativist externalism

Evaluativism is a particular kind of constitutive externalism. According to it, the reason why deciding whether something is a psychiatric disorder involves a value judgement is that psychiatric disorder is constituted in part by values. (Only ‘in part’ because the values either inhere in or apply to – a distinction to which I will return – other, perhaps physical, properties.)

So, for example, according to the Szaszian view mentioned at the start of this paper, the problems that are misleadingly labelled mental illnesses are deviations from psycho-social and ethical norms: they are constituted by that deviation [Szasz 1972]. According to the ‘lost tribe’ view influenced by Laing and Foucault, madness is just another way of going on [Foucault 1989; Laing 1960]. To be mad is just to be evaluatively out of step with the rest of the community. On Bill Fulford’s more moderate picture, mental illness has to be bad for its sufferer and more specifically is bad for his or her ‘ordinary doing’ [Fulford 1989]. For Jerome Wakefield, though illness involves a supposedly factual biological dysfunction, it has also to be harmful where harm is construed as essential value-involving [Wakefield 1999]. On all of these views, the status of a condition as a mental illness is determined in part by the values in play.

Consider again the claim of some people that the experiences they have such as hearing internal voices, whilst fitting a psychiatric diagnostic category, are not pathological. On a non-evaluativist or objectivist view, this is a simple factual claim. It is true or false and, further, its truth or falsity is independent of the value judgements of the subjects of the experiences (or anyone else). But on an evaluative view, how people value experiences is a constitutive element of whether they are pathological. This raises the question of how to respond to differences of opinion about such values and the consequence of such divergence for psychiatric taxonomy.

Zachar and Kendler offer the following brief discussion of one sort of difference of value judgement.

How do we respond to historical claims that slaves who had a compulsion to run away and advocates for change in the former Soviet Union were mentally ill? An objectivist would claim that those classifications contained bad values and progress was made when those values were eliminated. Their opponents would claim that the elimination of bad values is not the same as becoming value-free, and progress has been made by adopting better values. [ibid: 558]

For an objectivist, however, the fact that a classification reflected any values (aside from the epistemic values that shaped its constructions) would be an error. Values, whether good or bad, feature merely as distortions in a classificatory scheme which should reflect the underlying facts. This mirrors the way that, in Lakatosian rational reconstructions of the history of science, social factors enter only to explain deviations from rational sensitivity to the facts [Lakatos 1970]. When all goes well, there is no need for sociological explanation. So, equally, an appeal to the presence of distorting values in the pathological construction of drapetomania is significant, for an objectivist, in pointing out the presence of values at all rather than specifically bad values.

The characterisation of the contrasting evaluativist’s response raises a further question. Talk of eliminating the bad values implicit in drapetomania suggests (though it does not strictly imply) the idea of moral or more broadly evaluative progress. It suggests that value judgements are disciplined by the attempt to reflect real values. This contrasts with a view in which nothing disciplines such judgements. What appear to be value judgements are really merely expressions of subjective preference and answer to nothing external to them. Their being right is no more than their seeming right. (This is not to downplay their seriousness or importance merely to highlight a view of their logic.) The contrast between disciplined and undisciplined evaluativism is significant in understanding the nature of mental illness. But, as I will argue in the final section, it also runs deep in why the debate about mental illness is so difficult. It is not clear whether that debate aims at truth or goodness.

Disciplined and undisciplined constitutive evaluativist externalism

On a disciplined account, psychiatric taxonomy can aim to get right the mixture, or the compound, of simple facts and values that make up the complex realm of psychopathological phenomenology. Such judgements need not merely reflect motivationally inert features of the world, as the objectivist, assumes. Nor need concepts of disorder (akin to the earlier example of what is broken) be analysed into simple factual terms in order to be accommodated in the taxonomy. But aside from these relaxations, a psychiatric taxonomy based on a disciplined evaluative account would resemble an objectivist approach in one important respect. It would aim to underpin literally true judgements. It would aim, in other words, at validity.

But an undisciplined evaluativist approach is more radical. Mental illnesses are constituted, at least in part, by matters external to the body. In addition, these matters are not features of the world, broadly construed, but rather expressions of subjectivity. If this were the correct approach to the nature of mental illness, however, it fits uneasily with the very idea of a psychiatric taxonomy. Whilst one the aims of taxonomy is validity – to cut nature at the joints – so as to enable the framing of true judgements, on an undisciplined evaluativist approach, that idea of correctness is missing.

Returning to the example of subjects who argue against the pathologising of what are conventionally taken to be pathological symptoms, this distinction is important. For disciplined evaluativists, like objectivists, their claim is a judgement that might be right or wrong and thus would inform, and be informed by, the development of a valid taxonomy. (Unlike objectivists, it is not a simple, that is value-free, factual matter.) But for an undisciplined evaluativist, this is not the case. The claim is an expression of subjectivity. This is not to downplay its importance and seriousness. But it is to suggest that its assessment is more a matter for liberal politics than empirical and more broadly academic inquiry. It is more a matter for decision (of how to act) than judgement (as to what is the case) and the recognition that psychiatric taxonomy is fundamentally the wrong tool for the job.

So far I have merely flagged two subsidiary, but still important, distinctions within Zachar and Kendler’s framework without offering a judgement as to how they might actually apply to psychiatric taxonomy. I have argued that if mental illness is best thought of according to undisciplined constitutive evaluativist externalism then it will not fit well within taxonomic thinking at all. I will end with two final thoughts which will, hopefully, shed light on such a judgement.

Firstly, might there not still be a role for taxonomy and neuroscientific inquiry even given the antecedent of that conditional? There are two immediate possibilities. An undisciplined evaluativist is committed to a fundamental ontological difference between facts and values. One might thus attempt to factor out the values from the underlying facts and develop a scientific taxonomy of merely factual elements. On this account – and by contrast with an objectivist view – what would be left would not amount to a taxonomy of illnesses but rather the factual conditions that motivate competing expressions of illness status. There are two reasons to be sceptical of such a possibility. Philosophically, the prospects for a successful analysis of value judgements into simple facts and the evaluative reactions that they prompt looks poor [see Thornton 2007: 66-67]. Practically speaking, past attempts to purge psychiatric taxonomy of evaluative elements have been unsuccessful.

The other taxonomic possibility would be to attempt to encode expressions of subjectivity without any commitment to their underlying validity: a subjective ‘hit parade’ of mental illness. The problem at root with this thought is that, in the face of disagreements about how to think about diverse experiences and with no metaphysical account of why there might ever be convergence of opinion, there seems to be no rational way to agree any single taxonomy. Pluralism would seem a politically more satisfactory response than framing a taxonomy.

The point above concerning the philosophical implausibility of factoring facts and values is a point that counts against undisciplined evaluativism. Suppose however, as a significant strain of neo-Humean moral philosophers hope, that an analysis into facts and values were possible, would that establish the truth of undisciplined constitutive evaluativist externalism about mental illness? Here a distinction between philosophical debate about moral and psychiatric values is relevant. Whilst there is disagreement about particular ethical judgements in difficult cases, there is to be sufficient agreement about the broad outline of the practices of making moral judgements to make descriptive accuracy a rational aim of meta-ethical moral philosophical debate. It seems plausible to say that Kantian deontology, utilitarianism or neo-Aristotelian moral particularism may simply be the correct description of the moral realm. But that may not be true of the debate about mental illness.

Imagine, for example, that objectivists succeeded in developing a consistent and intuitively plausible account of mental illness, reducing concepts of mental disorder to simple facts. Suppose that on this account, hearing voices turned out to be pathological. Suppose also that undisciplined evaluativists succeeded in developing a rival account on which hearing voices was not in itself pathological. How should the two accounts be assessed? One problem, of course, is that whilst the status of hearing voices is evidence one way or the other, it is contested. If one somehow knew, antecendently, its pathological status that would be a crucial test for the two accounts. But, as Neil Pickering argues, no such pre-theoretical knowledge is possible [Pickering 2006]. In fact, however, the problem goes deeper.

Setting out the debate as I have suggests that whether or not mental illness is simply factual or whether it is irreducibly evaluative – and if so of what sort – is itself a deeper level factual matter. But it is open to an undisciplined evaluativist to argue that that deeper level matter is not factual but rather, also, evaluative. It is a case of ‘values all the way down’. They can argue that we should, for reasons expressive of better subjective value, choose their model of mental illness not because it is true but because it is (evaluatively) right.

This is the consequence of adopting one of the possible positions within debate about mental illness hinted at, though not made explicit, in Zachar and Kendler’s framework. To repeat the two key claims: if one adopts a constitutive and evaluativism, that undermines the role of a neuroscientific understanding of mental illness. Neuroscience cannot explain what it is about a condition that makes it an illness. But second, the debate between such evaluativism and an objectivist counterpart need not even be as simple as a debate as to their relative truth. Evaluativists may claim that their position should be adopted because it is a more desirable view of illness, of what we should mean by illness.

In this paper, I have not argued for a particular view of the nature of mental illness, merely explored some of the options. I hope, however, that I have indicated just how deep the disagreement may go.

Bibliography

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Thornton, T. (2007) Essential Philosophy of Psychiatry, Oxford: Oxford University Press
Wakefield, J.C. (1999) Mental disorder as a black box essentialist concept. Journal of Abnormal Psychology 108: 465-472
Zachar, P. and Kendler, K. (2007) ‘Psychiatric Disorders: A Conceptual Taxonomy’ American Journal of Psychiatry 164: 557-565

Thursday 1 December 2011

Housekeeping

Yesterday I submitted my co-authored (with Neil Gascoigne) book on tacit knowledge, a year late, to the very forgiving Steven Gerrard of Acumen. The manuscript will need to go to readers and, even if they like it enough, we will obviously still need to respond to their suggestions and criticisms so it is by no means done. But it is good to pass this stage even if it has taken rather longer than any previous book about which I feel rather bad.

I therefore wonder about getting contracts in advance again. If I can be so late with a contract, what would be the harm of not having one? Then, at least, I wouldn’t feel the extra guilt which can be a block to getting on. (Still, a couple of book ideas at the moment: a book on tacit knowledge and clinical judgement / decision making, possibly aimed at the CUP series on values based practice edited by Bill Fulford, were he interested; and a more speculative idea: a book on Charles Travis.)

Aside from that, I seem to have published 4 articles in 2011 but no book chapters or bulletin entries.

(2011) ‘Capacity, mental mechanisms and unwise decisions’ Philosophy Psychiatry and Psychology 18: 127-32
(2011) ‘Radical liberal values based practice’ Journal of Evaluation in Clinical Practice 17: 988-91
(2011) ‘Recent developments for naturalising the mind’ Current Opinion in Psychiatry 24:502-506
(2011) Thornton, T. and Schaffner, K. ‘Philosophy of science for psychiatry for the person’ International Journal of Person Centered Medicine 1: 128-30

There are a few things in the pipeline.

‘Delusional atmosphere, the everyday uncanny and the limits of secondary sense’ is about to enter the production process with the newish journal Emotion Review.

Two short entries on tacit knowledge and explict knowledge are in production for a textbook: Lanzer, P. (ed) Mastering Endovascular Techniques; Guide to Excellence 2nd edition.

A chapter for Fulford, KWM (Bill) et al (ed) Oxford Handbook of Philosophy and Psychiatry has had very perceptive criticisms and suggestions made by Richard Gipps and I will try to deal with that in the next couple of weeks.

Otherwise ‘The recovery model, values and narrative understanding’ is forthcoming sometime in Rudnick, A. (ed) The Recovery of People with Mental Illness, Oxford University Press; ‘L'esprit et le monde, une anthropologie transcendentale?’ (translated A Le Goff) is forthcoming in an edited French book on John McDowell's Mind and World / L'esprit et le monde and an entry called ‘Why taxonomise anti-psychiatry?’ will come out, hopefully, with the next Association for the Advancement of Philosophy and Psychiatry Bulletin.

I have given up on ‘Why teach the philosophy of mental health?’ which was requested by the Journal of Mental Health Training Education and Practice 18 months ago ever appearing.**

I must write something before the end of December on ‘The normativity of diagnosis’ to be translated into Italian for a special issue of Rivista Sperimentale di Freniatria on neuroscience.

I regret bitterly failing to write something collaboratively on the MCA having been politely asked ages ago though I think the time has now passed. I regret my rudeness most.

There's ‘Naturalism and dysfunction’ for an MIT collection on Harmful Dysfunction edited by Denis Forest (Philosophie, Histoire et Sociologie de la Médecine Mentale (PHS2M) programme University of Paris Descartes).

Gloria Ayob and I plan to write a paper on psychopathy for a special issue of Theoretical Medicine & Bioethics on Neuroethics and Psychopathy. David Morris and I are ‘working up’ (the mot juste, I think) a paper on values based practice and service user roles. Finally, I have been asked by Claudine Verheggen whether I would be interested in writing a chapter on Wittgenstein and Davidson for an edited book on them.

Oh, and an invitation this week from Christoph Demmerling to be an international co-operation partner of a bid to a German DFG funding agency for a research project called ‘Between Language and Life. Understanding, Significance and Practical Concepts’.

** PS: Having typed this, I emailed the journal and discovered that the reviews of my submitted paper had come in in September this year but there had then been an administrative hiccough. In a spirit of sharing the downs as well as ups of an academic life, this is a review for the Journal of Mental Health Training Education and Practice which pulls no punches about the fact that I would make a terrible social scientist (I do not think they or I said I was when they invited the paper 17 months ago) though help might be at hand if I added some ‘Critical Theory, Feminism, Deconstruction, etc.’ into my work. I think it is the final ‘etc’ that is most wounding!

Whilst the review was useful the main issues were in relation to the methodology. The review did not follow a systematic review format either in standard or a shortened version. There were no questions which were being used to interrogate the literature and there was no summary of the studies that were included. Databases searched were no[n-] existent if very limited without adequate justification and therefore the findings of the review would not stand up to academic scrutiny. For the review to be acceptable it needs to be extended and a clear recognised methodological framework used. The methodology adopted beyond a systematic review is a limited use of philosophical logic. There a wealth of resources that might be applied to the paper. For example, Critical Theory, Feminism, Deconstruction, etc. I appreciate this might reflect interests that are not represented in the paper...

See this entry for an attempt to draw some general conclusions about the nature of social science from this passage.

Tuesday 29 November 2011

Julian Dodd on performing musical works authentically

Last week Julian Dodd, professor of philosophy at the University of Manchester, gave an excellent talk at UCLan called ‘Performing musical works authentically’. The aim was to articulate a concept of fidelity to musical works to serve, I suppose, as part of account of aesthetic judgements both by audiences and performers. I liked every aspect of the paper except for its central metaphysical claim and was left wondering how much the central claim of a paper should matter to one’s attitude to it.

I’ve borrowed from the handout in the summary here but I should say both that Julian emphasised that this was a work in progress (and so his views might change) and also that my memory of key claims may be wrong. This is how the performance struck me.

To move towards the key idea, Julian outlined two opposing view of authenticity, both of which he rejected.

1: Score-compliance authenticity
On this view, faithfulness to a musical work is a matter of accurately following the score (‘rendering the score faithfully’ (Davies, ‘Transcription, authenticity and performance’, BJA 28 (1988): 223)). It can be combined with a view of historical authenticity, the use of traditional instruments etc. When deviation from a score is justified it can only be because of a higher order intention ascribed to the composer. Perhaps he/she would have scored things differently had more capable instruments been available. But any such deviation is an exception, merely tolerated by this sort of approach.

2: Personal authenticity: faithfulness to the performer’s artistic persona.
On this view authenticity is to the performer (NB not the composer).
[W]hen we say of a musical performance that it is ‘authentic’ in the sense of being ‘personally authentic’, we are praising it for bearing the special stamp of personality that marks it out from all others as Horowitz’s or Serkin’s, Bernstein’s or Toscanini’s, Casals’s or Janigro’s: we are marking it out as the unique product of a unique individual, something with an individual style of its own – ‘an original’. (Kivy, Authenticities, Cornell U.P. 1995: 123)
Julian’s brief key argument against personal authenticity was that it is not an accurate rendition of our interest in the performance of c lassical music. A distinctive feature of this practice is that we value listening to multiple interpretations of classical works in performance. But, he argued, listening to multiple interpretations is valuable, not because this brings us into acquaintance with a wide variety of artistic personas, but because (a) we value interpretations that enrich or deepen our understanding of works, and (b) we realise that no one interpretation will have a monopoly on such insight.

Although he suggested that he was relying mainly on bald assertion, this seems quite right. Translating into the medium of theatre, my interest in Jacobi’s and McKellan’s different King Lears wasn’t in the actors but in their distinctive playing of Lear, of their different ways of realising the possibilities of the parts. (I did not, for example, want to put Lear in a relation to Emperor Claudius or Magneto, for example.)

The argument against score-compliance authenticity was more measured and turned as much as anything on its comparative weakness in relation to Julian’s favoured view of authenticity. There is a kind of faithfulness to the work that is valuable for its own sake in performance which is not score-compliance authenticity, but interpretive authenticity.

A couple of quotes from the handout give a feel for this:

‘A performance of a work is interpretively authentic to the extent that it offers an interpretation of the work that evinces an understanding of it.’
‘Such a performance makes certain musical and expressive features salient and others unsalient in such a way as to add up to an expressive and structural vision of the work that: convincingly represents how the work’s’s thematic material and expressive character develop; thereby conveys something of the significance of the work’s having the detail it has; displays a feeling for the nature of its style; and, as a result of having the aforementioned features, has a nicely judged sense of what really matters in the presentation of it in performance.’

Interpretive authenticity is a critical and evaluative matter. It cannot be undertaken from a sideways on position but, rather, is a matter of working out, from within an aesthetic sensibility, an understanding of a work and thus what the demands of authenticity to it are. Further, it is not merely a filler to make up for the under-determination of performance by score since it can, more fundamentally, dictate global approaches to pieces of music.

To bring out the distinction between this view of authenticity to a work and mere score compliance authenticity, Julian mentioned a couple of examples.

First, Beethoven’s metronome marks in the Hammerklavier Sonata are, we learnt, impossibly fast. As a result most performers do not follow them and play the piece more slowly. Brendel comments

‘In the first movement particularly, the prescribed tempo cannot be attained, or even approached, on any instrument in the world, by any player at all, be he the devil incarnate, without a grievous loss of dynamics, colour and clarity.’ (Brendel, ‘Werktreue: an afterthought’, Alfred Brendel on Music, Robson Books, 2001: 33 italics added).

So Brendel plays up the importance dynamics colour and clarity. He sees these features of the piece as making more important demands than the tempo.

Second, the recapitulation of the first movement of Beethoven’s 5th Symphony. Here, in the score, the theme first played by horns is repeated by oboes. But since it seems to serve as a fanfare this is unsatisfactory. Given that modern brass instruments are up to the job of playing both the initial fanfare and the recapitulation, that is what typically happens now. That is what responding best to the work is judged, by most performers, to require.

Thus, a proper understanding of the demands of a musical work do not seem to be a matter of merely complying with the score but rather a fidelity or faithfulness to the work itself even when, as in the Hammerklavier Sonata this involves in disregarding the composers intentions. The composer is merely one interpreter of his/her work. ‘A performer might have the utmost understanding and respect for the composer’s achievement, and yet conclude, justifiably, that something of the work’s character, or aesthetic potential, is compromised by slavishly following every instruction in the score.’

I agreed with the thrust of all of this, especially the focus on the normativity of understanding. What I didn’t understand was the underlying metaphysical story Julian wished to promote. I think that this view had two motivations. First, he wanted to pay due attention to the fact that our interest in classical music performance is a form of understanding. Further, performances can be revelatory. They can reveal the work. Second, the two rival theories he opposed explained this understanding as a matter of faithfulness either to a score or to a performer’s character. In both of these cases, and whatever else may be unattractive about them, that notion of faithfulness is quite concrete. We can see what it is that faithfulness might involve as a kind of correspondence (though this is obviously clearer for score-compliance authenticity, the main target of the paper). I wonder whether it is because of the stage setting that Julian thought that the only explanation of the normativity of understanding was one of fidelity (which seemed to be a form of correspondence) neither to the score nor the performer’s character but to the work itself.

How else, he asked, could one think that an interpretation was revelatory? How else could performance seem to be an act of discovery? But the alternative that struck me was that might discover, simply, that something worked. That playing a work, or a part of a work, like this! was a good way to play it. After all, the method of discovery would look remarkably similar: a matter of trial and demonstration with piecemeal contextual aesthetic explanation. Julian wanted to add to this a further underlying metaphysical explanation. Such a process reveals the nature of the work to which it aims to be faithful. But I do not see that that idea adds anything helpful. And it may be unhelpful in that it suggests that the work (the Work, perhaps) has a single identity, demanding to be played in just one way. Julian suggested that he did not think that that need be true. But he rather implied that such multiple readings would be exception rather than norm in accord with the basic picture of faith to an abstract, possibly platonic, work. It seems to me, by contrast, that it may always be the case with a good work that there are many and various ways to realise it. If so, the idea of fidelity to the work seems the wrong metaphor.

Tuesday 15 November 2011

Anne Rogers on ‘Social Networks and the Patient Work of Chronic Illness Management’

I went to a talk today by Professor Anne Rogers, Head of the Health Sciences Research Group, University of Manchester called ‘Social Networks and the Patient Work of Chronic Illness Management’. The abstract ran as follows:

The effective targeting and promotion of self-care support for long-term conditions needs to acknowledge the importance of everyday living and people’s social contexts and networks. Social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support.

It was an interesting talk, more an overview of some ideas than an argument but one line of thought seemed of note.

This thread began – actually five minutes into the talk – with mention of some research by Corbin and Strauss (1985) who identified 3 types of work relevant to the long term management of illness:
  • illness work: symptom management
  • everyday life work: practical tasks eg housework
  • biographical work: reconstruction of ill person’s biography
Anne suggested that there were other forms of work, too, including articulation and emotional work. As a technological term ‘work’ was helpful, she suggested, because it suggests division of labour. These forms of work can be shared between different participants in a social network. But if so, what’s the nature and type of knowledge needed to do work?

There is, we heard, evidence that professionals and patients do indeed view self-management as a form of work but they diverge in their degree of optimism about it. In general, she suggested, although there are aspects of management which are individualistic, it also involves collective work. There was, however reason to believe from previous surveys that this collective element was downplayed by individuals who stressed, instead, their own responsibility for their pain management. In other words, the thought, by patients, that the work was or was not carried out by others was not enough to make that claim true. I'll return to this.

The second main element of this thread of the talk was the nature of social networks or rather networks of networks, Anne suggested, which might include group plus family plus personal communities. In other areas of sociology, empirical work suggested that often quite weak or distant relationships were key to connect individuals to resources (the person who can get one’s son an internship, for example). Might this also be true for self-management of illness? Sadly, she reported, we don’t yet know: it is an epidemiological gap.

But in the US Nicolas Christakis has looked at a major US database and found that weight gain in one person is associated with others in their social network. Likewise, smoking spreads through close and distant ties. Health or illness behaviours should thus be seen as collective phenomena.

Anne thus reported her own recent survey of 300 people in Greater Manchester asking them to identify their personal supportive communities or networks. The empirical work included quantitative data based on interviews and the use of a kind of network diagram: a set of concentric circles centred on the subject in which they were asked to locate their relevant social support networks. Professionals tended to be out a bit from the centre except amongst those who were otherwise socially isolated. Outside that might be the lunch club, diabetes club, the church, particular individuals.

Another finding was that, of those surveyed, 18% owned 1 or more pets. Some familiar findings about health and pets were replicated but, more interestingly, people suggested that pets were part of their social networks. Pets as person substitutes, as it were. But, further, the survey implied not only that but also that pets were taken to have unique qualities. For example, they did not nag. And, Anne argued, they were found to mediate relationships with others, in weak relations. Dog walking, for example, prompted chance conversations. Thus, she argued, pets take on aspects of illness work in social networks. Whilst partners provide most emotional support. pets come second, higher than health professionals. She was tempted but did not say that pets are better than doctors at emotional support.

All this seemed to me to be interesting but I worried, and asked, about one aspect. The connection between work, social networks and pets seemed to support two conflicting views of the nature of her research. In one view, work is actually shared and the thought by individuals about who undertakes it may be wrong. Who is actually in the network doing the work is, to that extent, objective. Thinking it so does not make it so.

But on the other, dogs do not actually do emotional work. They may serve as emotional support; they may catalyse conversations in the park. But they do not undertake to take on this duty. So if they are indeed to count as part of an individual's network of those who are undertaking work then it is merely the case that thinking it makes it so. The network is subjective: it is what an individual sincerely takes it to be.

But social networks surely cannot be both?

In response, Anne replied that she did indeed intend both senses. Perhaps in her written work the distinction is clear. Perhaps she adds subscripts to the phrase ‘social network’: an ‘o’ or an ‘s’ to disambiguate them. (If so that went missing in the presentation). But I can’t help feeling that running two distinct kinds of ontological category at the very least quite closely together is likely to confuse.

Collins on the antonym of 'tacit'

In an informal introduction to tacit knowledge that starts with Polanyi’s slogan – that we know more than we can tell – Harry Collins says:

That we humans do much of what we do without following explicit rules is no more mysterious than my cat hunting without knowing rules about hunting or a tree growing without knowing rules about forming leaves. We only think it's mysterious if we think explicitness is the norm, but explicitness is a rare thing, restricted to humans, and used only now and again because it is often more efficient to allow causal, neural connections in the brain and body to execute an action with little (or, indeed, no) conscious calculation - after all, cats do pretty well this way. [Collins 2010b]

In his recent book length treatment of the subject, Tacit and Explicit Knowledge, he makes use of the same demystifying comparison.

In all the ways that do not involve the way we intentionally choose to do certain acts and not others, and the way we choose to carry out those acts, the human, per individual body and brain... is continuous with the animal and physical world. We are just like complicated cats, dogs, trees, and sieves... Sometimes we can do things better than cats, dogs, trees and sieves can do them, and sometimes worse. A sieve is generally better at sorting stones than a human (as a fridge is better at chilling water), a tree is certainly better at growing leaves, dogs are better at being affected by strings of smells, and cats are better at hunting small animals... That teaching humans to accomplish even mimeomorphic actions is a complicated business, involving personal contact, says nothing about the nature of the knowledge, per se. [Collins 2010a: 104-5]

So, although the transmission of tacit knowledge is difficult and capricious, as his earlier book Changing Order argued, there need be nothing mysterious about practical or somatic tacit knowledge itself. It is something, to a first approximation, we share with animals, trees and even machines.

Only to a first approximation, because Collins thinks that the ascription of tacit knowledge must stand in a contrast to explicit knowledge. Thus, where there is no possibility of ascribing explicit knowledge, tacit knowledge should not be ascribed either. Properly speaking, although human behaviour is ‘continuous’ with that of animals, trees and sieves, none of those have tacit knowledge [ibid: 78].

Collins does not, however, explain what marks the discontinuity in the action itself: what it is about humans, when they act like animals, that distinguishes their action from that of animals. That is, why does such animal action, though tacit, count as knowledge? Again, his account addresses the tacit status of tacit knowledge only at the cost of threatening its knowledge status.

In fact, although Collins approaches tacit knowledge, as Gascoigne and I do in our current book book, through a suitable contrast with what is explicit, he is not sensitive to the requirement to chart a kind of personal knowledge in Polanyi’s phrase: knowledge for someone. We can make this point by taking as a clue the three sentences from the informal summary of his view which immediately precede the quotation above.

In The Logic of Tacit Inference, Polanyi argues persuasively that humans do not know how they ride, but he also provides a formula: ‘In order to compensate for a given angle of imbalance α we must take a curve on the side of the imbalance, of which the radius (r) should be proportionate to the square of the velocity (v) over the imbalance r~v2/α.’ While no human can actually ride a bike using that formula, a robot, with much faster reactions, might. So that aspect of bike-riding is not quite so tacit after all. That we humans do much of what we do without following explicit rules is no more mysterious than my cat hunting...[Collins 2010b]

The suggestion is that where an action could be could be codified in a formula, that tends to undermine its tacit status. In the case of bike riding, the explicit formula is not, however, one that could be used by humans to guide their own riding, at least under normal gravitational conditions, because of human bodily or somatic limits. This idea is pursued at length in Tacit and Explicit Knowledge to suggest that there are different varieties of tacit knowledge corresponding to different impediments to the efficacy of an explicit statement.

The focus, however, is not on how something is known by an epistemic subject but rather on the nature of the task or practice and whether it could in principle be explicated by someone else. Hence having said that ‘[somatic tacit knowledge] is continuous with that possessed by animals and other living things’ he goes on to say that ‘in principle it is possible for it to be explicated, not by the animals and trees themselves (or the particular humans who embody it), but as the outcome of research done by human scientists’ [Collins 2010a: 85]. But if the focus is on the nature of the subject’s own (tacit) knowledge, its explication by others is beside the point.

This orientation is clear when he considers the ability to type. For skilled typists, conscious following of the rules they learnt when they first learnt to type slows them down. But this point ‘this seems to bear on nothing but the way humans work; it does not bear on the way knowledge works’ [ibid: 104]. By ‘knowledge’ he seems to mean roughly what is known not how it is known: the nature of the task or practice as this might be performed by someone or something else. (‘Roughly’, because how it is known – theoretically or practically, demonstratively or in context-independent terms – impacts on what is personally known.)

One clue to this is that he aims to shed light on human typists’ tacit knowledge by commenting that this task could be performed by a machine that could follow explicit rules. Such a comparison is only relevant if he is concerned not with the human typists’ knowledge but the nature of the task of typing in general. The assimilation of knowledge and task is clear:

The constraints on the methods available for efficient typing by humans [by contrast eg with machines] are somatic limits; they have everything to do with us and nothing to do with the task as a task – nothing to do with knowledge as knowledge. [ibid: 104]

This suggests that his focus is on the realm of reference, of what is being picked out in the world, which may sometimes be the content of knowledge, rather than how it is known, the way it is grasped, whether tacitly or explicitly, theoretically or practically. That a task might be accomplished using either explicit knowledge or tacit knowledge need not undermine its tacit status in any one particular case. So the inference from ‘task as task’ to ‘knowledge as knowledge’ in that last quote does not go through.

Because his underlying method of examining tacit knowledge works by contrasting it with what is explicit, but because this is sometimes taken to be a matter of explicating or explaining by, for example, ‘reproducing the effects of somatic tacit knowledge in machines and computers’ [ibid: 160] rather of focusing on the nature of the knowledge for the subject, Collins’ treatment downplays the issue of knowledge as it concentrates on what would ensure something had to be tacit.

Collins, H. (2010a) Tacit and Explicit Knowledge, Chicago: University of Chicago Press
Collins, H. (2010b) 'Tacit knowledge: you don't know how much you know' New Scientist 31st May


PS for more on Tacit and Explicit Knowledge see this.

Thursday 10 November 2011

The RSC, love and the space of reasons

In Stratford last weekend, I caught the RSC’s productions of Marat / Sade (in a less than full RST) and then A Midsummer Night’s Dream in a packed house. Both productions were typical of the main theatre of old. So it seems that despite sharing the Swan’s thrust stage, productions in it do not share the latter’s minimalism. Perhaps that makes good commercial sense and both the productions this weekend had excellent lighting and were generally visually engaging. But I suspect that less would have been more, overall, for Marat / Sade even though, or perhaps because, some of what was added was an attempt to move it out of the 1960s (smart phones, laptops etc).

By contrast, a full blown RSC production seems to be a good way to deal with A Midsummer Night’s Dream (though I couldn’t get on with Lucy Briggs-Owen’s performance - too much! – nor the very odd rockabilly interlude near the end). The foreknowledge that the mechanicals play within a play is yet to come always hangs over me. But a comment of Lois’ suggested what might be a deeper cause of dislike.

It is an infuriating play because of the way that love is presented as a kind of nomologically dangler or, rather, something utterly outside rationality or reason. The love-drug deployed by Oberon and Puck changes nothing about its victims but their love objects. So there’s nothing cognitive about their attitudes: just a brute affect. That seems odd because Shakespeare often persuasively and dramatically shows how love justifies and is justified. It is a standing, of sorts, in the space of reasons. Normally he enables us to see the breadth of that space when properly understood. But not here.

Wednesday 9 November 2011

Tacit knowledge in science: Nancy, France 12-13 December 2011

PROGRAMME
Monday 12 December 2011

08h30 - 09h00 Registration

09h00 - 09h15 Welcome and Introduction. Léna Soler

09h15 - 10h15 Harry Collins (Cardiff University, UK)
Tacit Knowledge in the Scientific Collectivity

10h5 - 11h15 Trevor Pinch (Cornell University, USA)
Harry Collins and Tacit Knowledge

11h15 - 11h45 Coffee break

11h45 - 12h45 Léna Soler (Archives Poincaré, Nancy) and
Sjoerd Zwart (Delft university, The Netherlands)
Tacit Aspects in Science: The Collective and the Individual Level

12h45 - 14h30 Lunch

14h30 - 15h30 Oliver Kauffmann (Aarhus University, Denmark)
What Sort of Knowledge is Implicit Sensorimotor Knowledge, Really?

15h30 - 16h30 Bahram Djenab (Institut National des Jeunes Aveugles, France)
Tacit Knowledge in Faraday’s Research on Electrostatics

16h30 - 17h Coffee break

17h - 18h Tim Thornton (Central Lancashire University, UK)
Why Tacit? Why Knowledge? The Dilemma Facing an Account of Tacit Knowledge
20h. Dinner

Tuesday 13 December 2011

9h - 10h Régis Catinaud
Tacit Knowledge in Theorization Processes

10h - 11h Aviezer Tucker (Texas university, Austin, USA)
Tacit and Explicit Knowledge in Historiography

11h00 - 11h30 Coffee break

11h30 - 12h30 Baudouin Jurdant (Paris 7 University)
Assessment, Tacit Knowledge and Reflexivity

12h30 Lunch

Contact : l_soler@club-internet.fr
http://poincare.univ-nancy2.fr/Activites/?contentId=6163&languageId=1

Association for the Advancement of Philosophy and Psychiatry meeting

Association for the Advancement of Philosophy and Psychiatry
Call for Abstracts

The Biopsychosocial and Other Models for Psychiatry: Philosophical Perspectives
24th Annual Meeting, Philadelphia, PA, May 5 & 6, 2012

Conference Co-Chairs: Christian Perring, Ph.D (Dowling College) & James Phillips, M.D. (Yale University)

Full description here

Presentations will be strictly limited to 20 minutes, followed by 10 minutes for discussion.

Abstracts should be 500-600 words and should be emailed to both James Phillips
(james.phillips@yale.edu) and Christian Perring (cperring@yahoo.com)

Deadline: November 15, 2011.

Abstracts will be blind reviewed, so the author's identifying information should be attached separately.
Notices of acceptance or rejection will be distributed in early January.

Tuesday 1 November 2011

Tacit knowledge of theories of meaning

The conception of tacit knowledge I defend is that of context-dependent, conceptually-structured, practical knowledge. It stands opposed to knowledge which can be made explicit in situation-independent general terms. Thus, in general, tacit knowledge cannot be conveyed by situation-independent linguistic instruction. Such language and tacit knowledge stand opposed.

But there has, historically, been an appeal to tacit knowledge precisely in connection with language and in a way which is rather more straight forward than Harry Collins’ suggestion that tacit knowledge can reside in the patterns and frequencies of word use of linguistic communication. This is the idea that a speaker’s understanding of a language consists in tacit knowledge of a theory of meaning, or a grammar, for that language.

There are two main threads for this idea in the philosophy of language. One derives from Chomsky’s project to articulate an innate, universal grammar for human natural language.

If a person who cognized the grammar and its rules could miraculously become conscious of them we would not hesitate to say that he knows the grammar and its rules, and that this conscious knowledge is what constitutes his knowledge of language. [Chomsky 1980: 70].

The other is Donald Davidson’s aim to set out a theory of meaning for natural language based on an inversion of Tarski’s semantic conception of truth. Such a theory of meaning would contain a finite set of axioms, giving, for example, the reference of primitive terms and a recursive procedure to derive an instance of the T-schema for any declarative sentence of the language.

In Tarski’s work, T-sentences are taken to be true because the right branch of the biconditional is assumed to be a translation of the sentence for which truth conditions are being given. But we cannot assume in advance that correct translation can be recognised without pre-empting the point of radical interpretations; in empirical applications, we must abandon the assumption. What I propose is to reverse the direction of explanation: assuming translation, Tarski was able to define truth; the present idea is to take truth as basic and to extract an account of translation or interpretation. The advantages, from the point of view of radical interpretation, are obvious. Truth is a single property which attaches, or fails to attach, to utterances, while each utterance has its own interpretation; and truth is more apt to connect with fairly simple attitudes of speakers. [Davidson 1984: 134]

Under the general constraint that such a theory delivers true instances of the T-schema – true meaning theorems – across the board, individual instances such as ‘Snow is white’ is true iff snow is white will, Davidson argues, unpack the meaning of sentences of the object language.

In fact, the connection between Davidson’s project and tacit knowledge is not clear. He makes two comments on the subject. One is that knowledge of such a theory would suffice for understanding [Davidson 1984: 125]. The other is that it is a necessary condition for languages to be learnable that a constructive or compositional account of the language could be given [ibid: 3]. But he does not say explicitly, for example, that speakers have implicit knowledge of a theory of meaning which explains their ability. Others, however, have made this claim.

Michael Dummett, for example, argues that the best interpretation of Davidson’s approach is as a ‘full bloodied’ rather than ‘modest’. The requirement for full bloodedness for a theory of meaning is the requirement that it does not simply presuppose key facts about content by simply giving the meaning of the basic terms of one language by simply stating them in another language. Instead, it gives an account of the meaning of the primitive terms of a language, its basic predicates and referring terms by describing the practical abilities that an understanding of those terms gives to a speaker. This, in turn, presupposes a form of tacit or implicit knowledge.

A theory of meaning will, then, represent the practical ability possessed by a speaker as consisting in his grasp of a set of propositions; since the speaker derives his understanding of a sentence from the meanings of its component words, these propositions will most naturally form a deductively connected system. The knowledge of these propositions that is attributed to a speaker can only be an implicit knowledge. In general, it cannot be demanded of someone who has any given practical ability that he have more than an implicit knowledge of those propositions by means of which we give a theoretical representation of that ability. [Dummett 1976: 70]

The recursive structure of a theory of meaning of such a form reflects ‘our intuitive conviction that a speaker derives his understanding of a sentence from his understanding of the words composing it and the way they are put together’ [Dummett 1974: 109].

Alexander Miller suggests that this project aims at answering three question:

(a) How is it possible, given the finitude of their capacities, for speakers of a natural language to understand a potential infinity of sentences?
(b) How is it possible to understand utterances of previously unencountered sentences?
(c) How is it possible for a natural language to be learnable? (i.e. how is it possible for explicit training with only a relatively small number of sentences to secure competence with a possibly very large set of sentences outwith that initial set?).

Dummett’s outline answer to this depends on the cogency of thinking that speakers have knowledge of the axioms that encode understanding of the language and which fix the derivation of suitable, interpretative, instances of the T-schema.

There is, however, a problem with thinking of knowledge of the axioms as knowledge in any ordinary sense. The problem was highlighted by Gareth Evans as a problem for thinking of grasp of the axioms of a theory of meaning as any kind of intentional state or propositional attitude. Evans argues that ‘It is of the essence of a belief state that it be at the service of many distinct projects, and that its influence on any project be mediated by other beliefs’ [Evans 1981: **]. He then considers the ascription of a belief that a particular substance is poisonous to a rat:

It is true that many philosophers would be prepared to regard the dispositional state of the rat as a belief. But such a view requires blindness to the fundamental differences which exist between the state of the rat and the belief of the man—differences which suggest that fundamentally different mechanism are at work. We might begin with this disanalogy: the rat manifests the 'belief' in only one way—by not eating—whereas there is no limit to the ways in which the ordinary belief that something is poisonous might be manifested. The [rational] subject might manifest it by, for example, preventing someone else from eating the food, or by giving it to a hated enemy, or by committing suicide with it. These variations stem from the different projects with which the belief may interact, but similar variations arise from combining the belief with other beliefs. It might, for example, lead to the subject's consuming a small amount of the food every day, when combined with the belief that the consumption of small doses of a poison renders one immune to its effects. [Evans 1981: **]

So although the rat and the rational subject may share some dispositions to behave (in general: avoiding eating the poisonous substance), for the rat, the dispositions are tied to a narrow range of behaviours whereas for the rational subject, there is no limit to the actions to which a belief that something is poisonous may contribute. Ascribing a belief to the rat adds nothing to a more minimal stimulus response account of its behaviour. This then presents a problem which Crispin Wright summarises as follows.

[S]omeone who is credited with implicit knowledge of a meaning-delivering theorem may express his knowledge in an indefinite variety of ways, including, in appropriate contexts, lying, assent and silence. But the (implicit) knowledge of a meaning theoretic axiom would seem to be harnessed to the single project of forming beliefs about the context of sentences which contain the expression... [Wright 1986: 227-8].

Thus whilst the output of a theory of meaning, codified as a potentially infinite set of instances of the T-schema or meaning theorems, can play a role in the broader life of a rational subject and thus can be the objects of intentional states or propostional attitudes, the axioms on which such a theory is based cannot.

Evans himself continues to speak of the speaker’s relation to axioms as a form of ‘tacit knowledge’ even though it is not, according to him, a propositional attitude. It is sub-doxastic. Further, because the form of generalisability is a condition on conceptual understanding. Evans takes this to be non-conceptual. So on his picture, a speaker’s grasp of the axioms of a theory of meaning is a non-conceptual, sub-doxastic tacit knowledge.

Given Evans’ argument that a speaker cannot have intentional attitudes towards the axioms of a theory of meaning which are merely dispositions, this presents a problem about the distinction between two possible approaches. Consider a language with a simple subject-predicate structure and ten names and ten predicates yielding 100 different possible sentences of the form Fa. Two distinct theories of meaning are now possible. One comprises a list of a meaning theorem for each of the 100 sentences. The other has one axiom for each of the names, one for each of the predicates and one setting out the meaning of a subject-predicate combination, as an instance of the T-schema (eg ‘a sentence coupling a name with a predicate is true iff the object denoted by the name satisfies the predicate’ [Evans 1981, p. 123]). Given that the speaker does not stand in any intentional attitude to the axioms and need not possess the concepts in which they are expressed, what is the rationale for preferring one theory over the other?

Evans’ suggestion is that the second theory should be preferred if it turns out that a speaker has a disposition for each of the expressions given by the theory. For the list-like theory that is 100 distinct dispositions linking each sentence to its truth condition. For the theory that articulates an underlying structure, Evans argues that there are 20 dispositions: one for each of the names and the predicates. For each name, then for each predicate, the speaker will be disposed to judge the corresponding sentence composed of name and predicate is true if the object named satisfies the predicate. Likewise, for each predicate. Using Π as a universal substitutional quantifier a speaker U has tacit knowledge that a names or denotes John if and only if U has a disposition such that:

(Πφ)(Πψ) [if U tacitly knows that an object satisfies φ iff it is ψ ; and if U hears an utterance having the form φa; then U will judge that: the utterance is true iff John is ψ].

Tacit knowledge that F means bald corresponds to this disposition:

(Πx)(Πα) [if U tacitly knows that the denotation of α is x, and U hears an utterance having the form Fα, then U will judge that: the utterance is true iff x is bald].

As Wright puts it: ‘

‘Tacit knowledge’ ought to be a disposition which constitutes understanding; and what is it to understand a sub-sentential expression... except to be disposed to make the right judgements about the truth conditions of sentences containing it provided one understands the accompanying name or predicate? [Wright 1986: 230]

Hence the 21 axioms yield 20 inter-defined dispositions. If there is evidence that a speaker possess just these dispositions, that is evidence that the second, structural theory, mirrors their competence. (The fact that there are 20 rather than 21, including the axiom of compositionality, is the subject of a criticism by Wright and response by Davies that need not detain us [Davies 1987].) But as Wright points out, even the 20 dispositions are dispositions to make judgements about whole sentences. So, still, why prefer the structured theory over the unstructured list. Both will yield the same dispositions. Evans response is to stress the underlying causal structure that grounds the dispositions.

The semanticist aims to uncover a structure in the language that mirrors the competence speakers of the language have actually acquired. This does not mean , that he aims to uncover a theory that he supposes his subjects know, in any acceptable sense of that word. It means merely this: if (but only if) speakers of the language can understand certain sentences they have not previously encountered, as a result of acquaintance with their parts, the semanticist must state how the meaning of these sentences is a function of the meanings of those parts. He must assign semantical properties to the parts and state the general significance of the construction in such a way that a statement of what those sentences mean is deductively entailed. There may be more than one way of doing this. [Evans identity and predication: 25-6]

Martin Davies develops this thought further in what he calls the ‘mirror constraint’:

The salient structural facts about the competence of speakers are here presented as being of the following form: speakers who understand sentences s1, s2... sn are able, without further training, to understand sentence s. And the salient structural facts about a semantic theory are of this form: the resources used in derivations of meaning specifications for s1, s2... sn are jointly sufficient for the derivation of the meaning specification for s. The constraint on semantic theories... is just that these two structures should match. [Davies 1987: 446]

Tacit knowledge of one theory of meaning rather than another consists in the fact that the structure described by one, rather than the other, is the causal explanation of the speaker’s ability.

To conceive of semantic structure as psychological, rather than abstract, is to conceive of it as the causal-explanatory structure of the semantic ability of actual speakers. It is the kind of cognitive structure that permits speakers to recognize the meanings of previously unencountered sentences. [Davies 1986: 132]

Evidence for this should include, not just patterns of sentence use but also patterns of acquisition and loss of linguistic understanding as well as revision of meaning.

There are in the literature a number of other worries adjacent to this general approach of ascribing tacit knowledge of the axioms of a theory of meaning on the basis of sub-doxastic dispositions. One worry that Wright develops, for example, is whether any account can be given of the dispositions governing either names or predicates in the example above [Wright 1986: 232-3]. The account of the disposition that corresponds to understanding a name has to presuppose the disposition corresponding to understanding a predicate and vice versa. Hence the objection is: no non-question-begging account has been offered of what these dispositions are.

Miller, however, argues that this worry can be assuaged by a comparison with the role of beliefs and desires in rationalising action. In that case, an account of the role of either belief or desire has to presuppose the other. But we, rightly, do not take that to threaten the elucidation of either (or both) but rather demonstrate the holism of the mental. Tacit knowledge of the axioms governing a language has to be ascribed as a whole relative to the mirror constraint [Miller ** 158-9].

But this response to the objection that the dispositions corresponding to states of ‘tacit knowledge’ of a theory of meaning cannot be given non-vacuous clarification does not undermine the earlier point. ‘Tacit knowledge’ of the axioms of the theory is no form of intentional state for the subject.

Given thattalk of tacit knowledge is not very well established in natural language and thus its use is a matter, in part at least, for stipulation, there is no very firm objection to calling the relation between a subject and his or her dispositional grasp of the axioms of a theory of meaning a matter of tacit knowledge. But it is worth stressing the difference between this use of that phrase and the use I have articulated.

First, ‘tacit knowledge’ of the axioms of a theory of meaning is not a matter of belief or any other intentional attitude. It is not conceptually articulated for the subject. It is, obviously, conceptually articulated in theories of meaning and thus conceptually articulated for the theorist. But, aside from their outputs, the contents of such theories are not objects of awareness for subjects.

Second, since they are constituted by dispositions which are not at the service of a variety of distinct projects, what is tacitly known does not play a rationalising role in the life of the subject merely a causal role [Byne 2004: 79].

Third, it is open to question whether such states carry content or meaning at all. All that the mirror constraint clearly does is establish that a theory of meaning tracks causal-enabling states of a subjects physiology. Evans even suggests that neurophysiological data would be decisive in matching a theory of meaning to a subject: behavioural evidence is merely second best. But that surely supports only a causal-structural approach rather than a content-laden one.

In the terms of the dilemma expressed in previous chapters, such a conception may merit the description ‘tacit’ but only at the cost of failing to count as knowledge. By contrast, the account we have given is pitched at the level of the rational subject, is conceptually structured and, whatever causally enables the motor skills may be involved in some aspects of practical knowledge, this does not rule out the fact that the knowledge has a content albeit one which can only be expressed in context-specific ways.

There is a further and interesting difference. The project of articulating a theory of meaning for a natural language is one of formalising the knowledge that a competent speaker has. It aims to codify the ability which is exercised in particular situations in situation-independent and universal terms. Thus what we have taken to be at the heart of tacit knowledge – its situation-specificity – is what this alternative conception aims to trump. Situation-specific expertise is explained through the provision of a general theory. But for the fact that the theory itself is merely ‘tacitly’ known, the project aims to turn what is tacit knowledge for most speakers into explicit knowledge for theorists. (Of course, knowledge of an axiomatised structural theory of meaning for a natural language cannot be a matter of explicit knowledge for most speakers. If it were the project would not be as difficult as it has proved.)

If one does not follow Evans in calling sub-personal causal dispositional states ‘tacit knowledge’ is there any sense in which linguistic understanding involves tacit knowledge? Yes. The right response to Wittgenstein’s regress argument balances what is explicit in explanations of meaning with what is tacit in the sense of situation-specific understanding. To grasp the meaning of a word is to have a potentially unlimited competence in its use even if it is explicable in finite and particular explanations. But such grasp the meaning involves the recognition of any particular use that that! use is correct, accords with its meaning. Such recognition is a context-dependent demonstrative thought which accord with what we take to be the most promising understanding of what is tacit.

Polanyi’s says that we know more than we can tell. One way to approach that claim is to sketch a concept of knowledge in which the substance that we know is somehow hidden from us, not part of the space of our reasons. Tacit knowledge of a theory of meaning is an example. Such knowledge would be tacit but it is far from clear how it would count as knowledge. It is better therefore to keep a firm grip on the nature of knowledge but grant that our ability to know outstrips our ability to summarise what we know.