Notable Links & Miscellanea - June 26, 2023
# If you are a psychiatry trainee (psychiatry resident or fellow) in the United States, please consider filling out this brief and anonymous survey for a study exploring attitudes toward conceptual issues in psychiatry and psychiatric education. (If you are a training director and would like to help with the distribution, email me!)
# A Critique of Critical Psychiatry — Robert Chapman argues in Philosophy, Psychiatry, & Psychology that strands of critical psychiatry relying on the the ‘comparativist’ critique are not just conceptually untenable, they are also epistemically harmful. The target article and accompanying commentaries by Sandra Steingard and Nev Jones are open-access for a few days. I’d recommend accessing (and downloading the pdfs) while you can. (A guest post for Psychiatry at the Margins by Chapman about their article is also in the pipeline.)
# I reviewed “On Madness: Understanding the Psychotic Mind” by Richard Gipps on Amazon:
“On Madness by Richard Gipps - a philosopher and a clinician - is a profound and thoughtful work of enduring value. Gipps resists what is fashionable and faddish in contemporary thought to recover something of philosophical value; in this regard, the book is wisely “anti-mimetic.” One of the central themes of the work is an apophatic approach to psychopathology: to understand madness is to understand why attempts to locate rational order within psychotic thought are futile. “... we can best understand the depth and character of the psychotic subject’s disturbance by understanding why some of the things we most want to say of her cannot strictly speaking be said. The fact is that various of our epistemic and psychological predicates presuppose, for their meaningful application, the sanity of their subject.” Gipps writes at one point. The tragedy and suffering of psychosis cannot be solved as if it were a cognitive or metaphorical puzzle. Gipps is critical of approaches that view delusions as superficial expressive distortions beneath which intelligibility exists and can be discovered, or those that take a romantic approach and see the mad as living in a private world of meaning, as well as those that see madness as nothing but dysfunction (leading to a “medicate, watch, and sympathetically wait” approach). The apophatic approach resists the alienation that accompanies viewing delusions as pure dysfunction — it strives for a genuine recognition of suffering, including suffering “which delusion itself aims to evade.” Gipps hopes that we can “sit with the patient in her brokenness” rather than try to rescue some imaginary rational order in the madness. He is insightful and compassionate in his analysis, and this is a truly innovative work. He offers a powerful philosophical challenge to dominant approaches in cognitive and psychological sciences, including approaches that I'm quite sympathetic to. Resultantly, I am quite ambivalent about the nature of my agreement or disagreement with Gipps, but this is a work that rewards deep and sustained engagement regardless. I highly, highly recommend it.”
# Resisting the ambivalent collapse from certainty to despair — a paper presented by Richard Saville-Smith at the Too mad to be true II - The promises and perils of the first-person perspective conference in May.
“… if we are going to develop ideal typical examples of extreme states of consciousness, of mad states of consciousness, these should not be restricted to the clinical encounter with all its power imbalances and semi-structured interviews which give mad people no power to choose how to frame their experiences. By breaking out of the clinical world of psychopathology we can find examples of madness in the wild which provide richer and more diverse insight into the existential states of what it means to be human, because they have been verified by the experience of those who have engaged in a recursive response, a feed back loop in which value is found through RECOGNITION. The madman in the clinic may answer the questions, but there’s no certainty that the questions asked will be the right ones and no guarantee that, in the difficulty of speaking, the answers given will be understood. If I am Jesus and you ask me about my normal behaviour, eating habits, spending patterns, my relationships at work stacking the shelves, I will return your gaze and pity your failure to believe in the power of living in the power of god. Out of the clinic, in the world of ideal typical examples, identifiable through the constructed authenticity of their words, there is a resonance with the reality of what it means to endure.”
# “Inside the war tearing psychoanalysis apart” — The Guardian
“From an argument about Israel and Palestine, the Sheehi case has become a larger debate about psychology itself. Are psychoanalysts neutral interlocutors, healing one mind at a time, or activists, diagnosing society’s pathologies and fighting injustice? Can someone be a nuanced and empathetic clinician, and also take to Twitter to issue thundering political judgments?…
A new model of psychoanalysis has arisen, another psychoanalyst said, focused less on sifting the individual unconscious and “more on the notion that because of the society we live in we’re constantly influenced by various forms of systemic racism, and that the goal of analysis is a calling-out of prejudices and almost a kind of re-education”.”
# Ellen Wayland-Smith reviews Audrey Clare Farley’s “Girls and Their Monsters” for the LA Review of Books:
“In the end, Farley uses the Genain sisters’ saga as a case study to argue that patriarchal Christian whiteness—then as now—is in and of itself a species of psychosocial pathology endemic to the United States. Carl’s preoccupation with “saving” his daughters’ white bodies from racialized public threats while himself perpetrating sexual domination over those same bodies in private is not a quirk of individual pathology; it is a long-standing national pastime.”
# Parapraxis — Editor’s Note — In The Butcher’s Shop:
“There is an excruciating paradox at work in psychical reparation. Guilt for one’s death wishes instills a primordial fear and anxiety about one’s own death. If we can harm, we can be harmed. If we can kill, even in phantasy, we can be killed. This alone can spin us out such that we become unmoored; the balance of life and death is indeed fragile. To the charge that analysis takes too long, Freud once pithily replied that it is not long enough only because we die—that a lifetime of analysis is not enough time to deal with the trauma that infancy is. For Klein, if there is hope to be had here, it is in overcoming infantile guilt just enough so that it might be sublimated into collective, creative activity toward a life worth living. Given the immense state of disrepair of the world, you don’t have to go very far to find world-destroying guilt: it might, in fact, be the reigning sentiment.”
# Justin Garson for The Philosopher’s Magazine — What Is the Philosophy of Madness?
“… a trio of recent texts form a reasonable starting point: Wouter Kusters’ A Philosophy of Madness, Sofia Jeppsson’s “Radical Psychotic Doubt and Epistemology,” and Richard Saville-Smith’s Acute Religious Experiences.
A shared premise of these texts is that madness can be a window onto reality. The mad person, far from having a defective form of reasoning, has a distinctive style of reasoning. The mad mind is not always severed from the world. Sometimes it’s plugged into the suffocating thickness of it.
It’s helpful to approach the philosophy of madness indirectly, by what it is not. First – as my student Mallory Gonzalez pointed out to me – the philosophy of madness is not, or not merely, a philosophical discourse about madness. We already possess such a discourse. It's called “philosophy of psychiatry”.”
“Updating science-relevant misinformation after a correction can be challenging, and little is known about what theoretical factors can influence the correction. Here this meta-analysis examined 205 effect sizes (that is, k, obtained from 74 reports; N = 60,861), which showed that attempts to debunk science-relevant misinformation were, on average, not successful (d = 0.19, P = 0.131, 95% confidence interval −0.06 to 0.43). However, corrections were more successful when the initial science-relevant belief concerned negative topics and domains other than health. Corrections fared better when they were detailed, when recipients were likely familiar with both sides of the issue ahead of the study and when the issue was not politically polarized.”