This is a very helpful piece Awais, and I think it all on point. ... On "4. The difference between acting on a psychological mechanism that produces symptoms and a psychoactive effect that suppresses symptoms is a conceptually important one, but the drug-centered account doesn’t seem to have the conceptual resources to articulate it." I'm wondering whether this is always so clear. Is it that I've not noticed my tinnitus today, or that it's not been there? Is it that my low mood is the same but I don't care about it so much, or is that very idea of a separation between mood and caring about mood itself a nonsense? Does the lucid dreamer really wake up in their dream, or do they dream they wake up in their dream? etc etc. We can sometimes find ways to make such suggestions cogent, but I'm not sure we always can, nor that we should always want to.
Thanks Richard. That’s a great point, I agree, it’s not always clear and in many cases may not even be a meaningful question to ask. To elaborate, here’s what I hand in mind when I wrote that. Moncrieff only seems to consider two sorts of mechanisms: acting on physiological mechanisms vs psychoactive effects masking symptoms (or distracting you from them, etc). She cannot seem to recognize that medications may have psychological effects that can interact with psychological mechanisms. I’m thinking of hypotheses such as antipsychotics targeting brain prediction errors or facilitating extinction learning of delusions, or psychedelics changing the “weighting of priors” or changing beliefs about self & the world, etc. Interactions of a quite different sort than alcohol drowning your sorrows.
Yes! I think that at the least tho she sets a helpful challenge: we can sometimes distinguish between masking/distraction and effects on the constitutive processes of the system itself (though if we start to think auto-poetically a la de Haan then things rightly get more complex), so if anyone wants to argue that their drug is doing more than masking they should actually demonstrate it. The drug effects you mention are fairly specific; the drug effects she suggests are very general so will show up in other domains too; whether the effects outlive the half-life will I imagine be an important deciding factor.
This is a very helpful piece Awais, and I think it all on point. ... On "4. The difference between acting on a psychological mechanism that produces symptoms and a psychoactive effect that suppresses symptoms is a conceptually important one, but the drug-centered account doesn’t seem to have the conceptual resources to articulate it." I'm wondering whether this is always so clear. Is it that I've not noticed my tinnitus today, or that it's not been there? Is it that my low mood is the same but I don't care about it so much, or is that very idea of a separation between mood and caring about mood itself a nonsense? Does the lucid dreamer really wake up in their dream, or do they dream they wake up in their dream? etc etc. We can sometimes find ways to make such suggestions cogent, but I'm not sure we always can, nor that we should always want to.
Thanks Richard. That’s a great point, I agree, it’s not always clear and in many cases may not even be a meaningful question to ask. To elaborate, here’s what I hand in mind when I wrote that. Moncrieff only seems to consider two sorts of mechanisms: acting on physiological mechanisms vs psychoactive effects masking symptoms (or distracting you from them, etc). She cannot seem to recognize that medications may have psychological effects that can interact with psychological mechanisms. I’m thinking of hypotheses such as antipsychotics targeting brain prediction errors or facilitating extinction learning of delusions, or psychedelics changing the “weighting of priors” or changing beliefs about self & the world, etc. Interactions of a quite different sort than alcohol drowning your sorrows.
Yes! I think that at the least tho she sets a helpful challenge: we can sometimes distinguish between masking/distraction and effects on the constitutive processes of the system itself (though if we start to think auto-poetically a la de Haan then things rightly get more complex), so if anyone wants to argue that their drug is doing more than masking they should actually demonstrate it. The drug effects you mention are fairly specific; the drug effects she suggests are very general so will show up in other domains too; whether the effects outlive the half-life will I imagine be an important deciding factor.