Imperfect Cognitions

Here  Martino Belvederi Murri (University of Ferrara) discusses research on epistemic justice and dignity for people with psychosis. A version of this post appeared on the EPIC blog in July 2024. Martino Belvederi Murri Individuals experiencing acute psychosis in inpatient psychiatric settings face unique challenges. Consider the case of Jake, a student who is struggling between familial conflicts and economic difficulties, as well as choices related to his life career. Auditory hallucinations may take the form of “voices” that comment on his everyday actions, and may lead Jake to think that people spy on him with malevolent intent. These symptoms can lead to angst and withdrawal from social activities, possibly culminating into severe anxiety and agitation. The grave societal stigma that is attached to mental illness exacerbates feelings of isolation and diminishes help-seeking. The promotion of patient empowerment is a key component of recovery, and is increasingly seen as a du...

Today’s post is by Richard Gipps, clinical psychologist and philosopher. Richard’s psychotherapy practice is in Oxford, UK, where he also teaches some philosophy. Along with Michael Lacewing he edited The Oxford Handbook of Philosophy and Psychoanalysis (2019).  Gipps' philosophical interests concern the nature of psychotherapeutic action, psychotic thought, and the significance of love and moral virtue for mental health. Today he writes about his new book On Madness: Understanding the Psychotic Mind   (Bloomsbury 2022). How is madness to be met with? What kind of recognition can we show, and justice can we do, to its sufferer? On hearing his fragmented and delusional discourse we’re troubled by it - not so much because we fear what he'll say or do, but because now, trying to empathically relate to them, our minds judder and the ground slips out from under our feet. On the one hand: here’s a deeply troubled human being; on the other, our mustering of ordinary humane sense-mak...

This is the first in a series of posts reporting outcomes from a  project on Agency in Youth Mental Health,  led by  Rose McCabe  at City University. Today Joe Houlders, Matthew Broome and Lisa Bortolotti (University of Birmingham) talk about the risks of young people with unusual experiences and beliefs experiencing epistemic injustice in clinical encounters.  Joe Houlders Epistemic injustice occurs when a person is not given authority and credibility as a knower in an exchange, due to negative stereotypes associated with the person's identity (age, gender, ethnicity, social class, education, sexual orientation, health). Young people with unusual experiences and beliefs are particularly at risk of being on the receiving end of epistemic injustice, and when their agency is undermined the effects are likely to be pervasive and impact negatively on their health outcomes.  Why is this population more vulnerable? In the mental health context, the...

Today's post is by Wouter Kusters , a philosopher, linguist and independent writer, teacher and consultant living in the Netherlands. In 2014 his comprehensive and transgressive book Philosophy of Madness was published in the Netherlands, and later this month the English translation will appear at MIT Press . Here you find an excerpt from the Preface to the English Edition (there is also a video presentation you can watch). Wouter Kusters Madness as I discuss it in this book is the imperfect translation of the Dutch waanzin , with which I focus on the range of experiences of all those who are deemed in medical jargon to be psychotic, as I myself was twice. Its first thematic line is a philosophical examination of the experience of being psychotic. I examine what happens in the various phases of the psychotic experience. What happens to the experience of time and space? What happens to reality? How are other persons perceived, and what happens to thought? It was this highlighting,...

Today's post is by Michael Larkin and William Day (both at the University of Aston). They are reporting on the Phenomenology of Health and Relationships conference, which was sponsored by project PERFECT and held at the University of Aston on 22-23 May 2019. We're both participants in the Phenomenology of Health and Relationships group at Aston University. In planning our inaugural  conference , the group initially considered a narrower focus on Interpretative Phenomenological Analysis (IPA). There is a regular (more-or-less annual) IPA Conference, and we had agreed to host it. Eventually we settled on a broader theme (Creativity and Affect). IPA is one approach which many of us use in our work, but it is not the only one, and methods are not the sole focus of our meetings. When we meet as a group, we do discuss creative innovations in methodology, but we also read phenomenology, and explore studies which offer experiential insights on health and relationships. We hop...

Pablo López-Silva is a Reader in Philosophical Psychology at the Faculty of Medicine of the Universidad de Valparaíso in Chile . He is the leading researcher of the FONDECYT project ‘ The Agentive Architecture of Human Thought ’ granted by the National Commission for Scientific and Technological Research (CONICYT) of the Government of Chile.  His current research focuses on cognitive phenomenology, attributions of mental agency, and delusions. In this post, he summarizes his new paper titled ‘ Mapping the Psychotic Mind ’ recently published in the Psychiatric Quarterly. Thought insertion – TI henceforth – is regarded as one of the most complex symptoms of psychosis. People suffering from TI report that external human and non-human agents have inserted thoughts or ideas into their minds. Over the last years, the enigmatic nature of TI reports has become target of a number of phenomenological, empirical, and conceptual debates. In fact, TI has been used as a good excuse to de...

This post is by Moujan Mirdamadi (Lancaster University), reporting from this year's annual Philosophy of Psychiatry Work in Progress day held at Lancaster University.    My name is Moujan Mirdamadi and I am a PhD student at Lancaster University. My research is on the phenomenology of depression and how experiences of depression vary cross culturally. In particular, I look at the similarities and differences in experiences of depression in Iran and the UK, and the significance of these variations. Lancaster University hosts an annual Work in Progress conference in Philosophy of Psychiatry. The conference, rather than being concerned with presenting finished papers, aims to open a discussion in which peers and colleagues share their thoughts on an ongoing project or question to be answered. This year, I co-organised the event with Dr Rachel Cooper . The conference was held on June 2nd and covered a wide range of different topics in Philosophy of Psychiatry, with speak...

On June 9th, the University of Birmingham hosted a workshop, " Cognition, Affect, and Motivation: Conceptual and Empirical Issues ", sponsored by Project PERFECT and the Mind Association . The conference brought together academics and students from philosophy and related disciplines, as well as members of the public, who were interested in issues relating to the interaction between cognition, affective responses and motivation. It aimed to foster interdisciplinary discussion around philosophical questions about the relation between these three drivers of human behaviour. Maura Tumulty ’s talk focussed on how we can take control over our mental states, especially those with strong affective content. Many of our mental states are controlled by our judgements. However, Tumulty discussed states that are in tension with our sincerely endorsed judgements.  Say, for example, that a person is predisposed to be attracted to smoking although she sincerely endorses...

Together with Ema Sullivan-Bissett , Matteo Mameli and Matthew Broome , I have written a chapter on delusions for a new volume on gradualism in psychiatry: Vagueness in Psychiatry , edited by Geert Keil, Laura Keuck and Rico Hauswald for Oxford University Press. Matteo Mameli In the paper we argue that it is difficult to distinguish pathological and non-pathological beliefs on the basis of their epistemic features. Then we consider some of the moral and legal implications of our thesis, focusing in particular on the role of beliefs in the attribution of moral responsibility and legal accountability for criminal actions that are motivated by those beliefs. Ema Sullivan-Bissett Delusions fail to meet many epistemic standards. It might look like they are not beliefs which are aimed at truth or governed by a norm of truth, that they are not responsive to evidence in the ways which ordinary beliefs typically are. But non-delusional beliefs also share such features. For instan...

Amy Hardy (pictured above) is a Research Clinical Psychologist at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London and Psychology Lead for Posttraumatic Stress in Psychosis in the Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust.  In this post, Amy describes a paper  published in the journal  Schizophrenia Bulletin  by the Psychosis Research Partnership that supports the causal role of childhood victimisation in psychosis by demonstrating how understandable reactions to trauma contribute to psychotic experiences. We know there is a relationship between trauma and psychosis, and research is unraveling the puzzle of how they are linked. Findings point towards childhood victimisation playing a causal role in psychotic experiences, at least for some people. For example, trauma has been shown to occur before the onset of psychosis, trauma severity is associated with the magnitude of psyc...

This post is by Cherise Rosen (pictured above). Cherise is an Assistant Professor in the Departments of Psychiatry and Public Health at the University of Illinois at Chicago. She has conducted extensive research on issues involving the symptoms and longitudinal course of psychosis.  Her research has focused on the phenomenological aspects of psychosis, hallucinations, delusions, metacognition, and self-disturbances. Much of her research follows mixed-methods research designs to elucidate findings that include the subjective experience.  Additionally, her research investigates the underlying epigenetic mechanisms of psychosis. In this post, Cherise summarises her recent paper (co-authored with Nev Jones, Kayla A. Chase, Hannah Gin, Linda S. Grossman, and Rajiv P. Sharma) ' The Intrasubjectivity of Self, Voices, and Delusions: A Phenomenological Analysis ', published in Psychosis.  In our recent study, we focused on the phenomenologically complex and nuanced inte...

In today's post John Read  (in the picture above) presents the recent book he co-authored with Jacqui Dillon , titled Models of Madness: Psychological, Social and Biological Approaches to Psychosis. My name is John Read. After 20 years working as a Clinical Psychologist and manager of mental health services in the UK and the USA, mostly with people experiencing psychosis, I joined the University of Auckland, New Zealand, in 1994. There I published over 100 papers in research journals, primarily on the relationship between adverse life events (e.g., child abuse/neglect, poverty etc.) and psychosis. I also research the negative effects of bio-genetic causal explanations on prejudice, and the role of the pharmaceutical industry in mental health. In February I moved to Melbourne and I now work at Swinburne University of Technology.  I am on the on the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis and am the Editor...

Today's post is by Rebecca Chamaa, who blogs at ' A journey with you '. I’m not an expert on schizophrenia based on schooling. I do, however, consider myself an expert based on the experience of schizophrenia, because I have lived with the illness for nearly a quarter of a century. I wrote a book: Pills, Poetry & Prose: Life with Schizophrenia that is a short book (approximately seventy pages) and contains essays and poetry about my life with a severe mental illness. I have fairly good recall of the times in my life when I have been psychotic and I try to take the reader on that journey with me. In one essay I talk about the delusion I had of being a healer and during this delusion I baked hundreds of cakes, because I falsely believed that the food I made would heal all of the people who ate it. This essay is a story of a harmless delusion that I had and my neighbor’s response to it. Often times my episodes start out as a somewhat pleasant experience, but ...

This post is by Rachel Upthegrove  who is a Senior Clinical Lecturer in Psychiatry at the University of Birmingham.  Childhood trauma is a risk factor for mental illness. This apparently simple statement, with such face validity hardly bears investigation does it? Of course traumatic events will increase the risk of mental distress and disorder - this is stating the obvious. However not all individuals with mental disorder have a history of trauma, or indeed childhood trauma, and certainly not all individuals who experience childhood trauma develop a mental illness. Childhood trauma has been in focus as an environmental risk factor for psychosis, with some authors proposing a causal role with significant lack of recognition and underreporting of childhood trauma in those who treat patients with psychosis. Mechanisms proposed include a process of hypervigilance leading to persecutory ideation and enhanced 'threat to self' networks. However, often studies have looked at s...

Salpetriere Hospital, Paris The 18th Meeting of the Psychopathology Section of the European Psychiatric Association (EPA) and the World Psychiatric Association (WPA) took place on the 5th and 6th December 2014 at Salpetriere Hospital in Paris, France. Over two days those invited to speak presented their talks related to the meeting’s leading theme – Nature and Narratives of Depression: Philosophical and Psychopathological Aspects , followed by plenary discussion. The meeting was chaired by Michael Musalek and the list of presenters included: Femi Oyebode, Pedro Varandas, Maria Luisa Figueira, Luis Madeira, Norbert Andersch, Raimo Salokangas and Gilberto Di Petta.

Launch of the report On 27 November 2014 the British Psychological Society (Division of Clinical Psychology) launched a new ground-breaking report on Understanding Psychosis and Schizophrenia, edited by Anne Cooke. At the meeting, contributors and other interested parties offered their own view of the challenges that need to be met to ensure that people hearing voices and having unusual beliefs can get support in an effective way. I only attended the morning session, and this is a brief report of the content of the talks I heard. Peter Kinderman (Professor of Clinical Psychology at the University of Liverpool) opened the session and welcomed the audience and the speakers. The first speaker, Luciana Berger (MP and shadow Minister for Public Health and Mental Health) highlighted the need to invest more in mental health and make sure that mental health receives the same attention and resources as physical health. She praised those sections of the report suggesting that psychosi...