Thursday, 25 August 2016

Thought in Action

Today's post is by Barbara Gail Montero.

I’m a philosophy professor at the City University of New York (with a rather unusual background since prior to studying philosophy I worked as a professional ballet dancer for a number of years). Thought in Action: Expertise and the Conscious Mind (Oxford University Press) is a book I’ve written that challenges the widely held view that, once you are good at something, thinking about your action, as you’re doing it, hampers your skill.

In it, I argue that experts think in action—consciously, not merely unconsciously—and, when thinking about the right things, this is in no way diminishes their prowess.

One of my goals in the book is to dispel various mythical accounts of experts who proceed without any understanding of what guides their actions. Those chicken sexers that philosophers are fond of citing who can’t explain why they makes their judgments—they don’t exist. Coleridge’s “Kubla Khan,” which supposedly came to him fully formed in a dream, actually took nearly ten years to write. Kekulé’s well known story that in 1862 the idea for the ring structure for benzene came to him in a flash after dreaming of a snake biting its tail, is contradicted by his own lesser known written account that his theory was formed in 1858. Such stories, I argue, are attractive, but misleading.

I also critically analyze research (in both philosophy and psychology) that extrapolates from everyday skills to draw conclusions about expert performance. I argue that experts’ extended analytical training, as well as the relatively higher stakes involved in expert action, make quotidian tasks (such as everyday driving) different enough from expert-level actions (such as professional race-car driving) so as to not warrant extrapolation from the former to the latter. Extended deliberate training, I argue, enables experts to perform while engaging their self-reflective capacities without any detrimental effects; it allows them to think and do at the same time.

Tuesday, 23 August 2016

Belief, Quasi-Belief, and Obsessive-Compulsive Disorder

This post is by Robert Noggle (pictured above), Professor of Philosophy at Central Michigan University. Robert is interested in psychological conditions that appear to undermine or threaten personal autonomy. His other main interests are in normative and applied ethics. In this post he summarises his recent paper ‘Belief, Quasi-Belief, and Obsessive-Compulsive Disorder’, published in Philosophical Psychology. 

Obsessive-Compulsive Disorder (OCD) is fascinating because it can lead to a radical disconnect between professed belief on the one hand, and affect, motivation, and behaviour on the other. Someone with OCD might sincerely profess her disbelief in the idea, say, that flipping a light switch poses a significant fire hazard if you do not do it just right. Yet such a person might also feel anxiety when flipping a switch, and a strong urge to flip it repeatedly to get it just right.

Of course, psychologists face the puzzle of how people get into such a state, and how best to help them get out of it. But there is a philosophical puzzle here about how to describe the mental state of such a person. Does she believe that flipping light switches is a dangerous activity, or not? Her verbal reports will typically suggest that she does not believe in the hazards of improperly flipping switches. Yet her anxiety and urge to check and re-flip suggest just the opposite. 

It is tempting to suggest that such a person moves back and forth between believing and not believing in the danger of improperly flipped switches. But this suggestion does not pan out when we look at what goes on in one of the most common and effective treatments for OCD, a treatment called Exposure and Response Prevention, or ERP. If our compulsive switch-flipper were to undergo ERP, she would likely be asked to flip a switch once and then leave it alone.

During the early phases of treatment, we would expect her to experience anxiety and a strong urge to re-flip or check the switch. But after repeated treatments, the anxiety and compulsion would likely subside. Here is the puzzling part: During ERP, the patient appears to have contradictory beliefs at the very same instant. The fact that she submits to the treatment at all suggests that she does not believe that improperly flipped switches pose a danger. Yet her anxiety and urges to check or re-flip (which will likely be quite strong at the early stages of ERP) suggest that, at the very same time, she does believe in the danger of improperly flipped switches. Hence, we cannot explain the mental state of an OCD patient during ERP in terms of changing beliefs. 

Thursday, 18 August 2016

Culture, Extended and Embodied Cognition, and Mental Disorders

The Helsinki Network for Philosophy of Psychiatry organized the symposium ”Culture, Extended and Embodied Cognition and Mental Disorders” on June 30-July 1, 2016, in Helsinki. The symposium was dedicated to cultural issues related to diagnostics, definitions and classifications of mental disorders, as well as phenomenological questions of experience, affectivity and embodiment. The symposium took place in Lapinlahti Hospital that was one of the first modern psychiatric hospitals in Northern Europe when it first opened its doors 175 years ago (on 1st of July 1841) - and now is a cultural venue.

Culture-Bound Syndromes and Mechanisms

Several talks focused on the ways culture affects disorders and their classification. In his introduction, Tuomas Vesterinen argued that definitions of mental disorders are inalienably value-laden, and that socio-cultural forces should be taken into account in explanations and classifications in order not to spread the diagnostic categories inadvertently from culture to culture through looping effects.

In his talk, Dominic Murphy showed how culture-bound syndromes (CBS) can be the linchpin for understanding how to combine cultural and neurobiological explanations. Basically there are three options: (i) CBS’s are not disorders at all; (ii) CBS’s can be incorporated into universal categories (even though there are different manifestations of illnesses, the underlying disorders are the same); or (iii) all mental disorders are to be considered as culture-bound. Murphy argued that both universalism (ii) and particularism (iii) are consistent with the idea that when a particular “culture plugs into psychology”, it creates specific outputs, making proximal mental representations the crucial explanatory system.

According to Murphy, although culture may affect everything in human psychology, it is not always relevant in explaining CBS: “Both social and psychological processes need to be entangled in our general understanding of psychopathology – and not just cross-culturally – it may be that we can imagine a spectrum.” In some cases cultural forces may be the source of explanation. On the other hand, models of cultural epidemiology may neither be suited for explaining how culture influences the non-typical mind nor do they provide relevant information in cases of severe neuropsychological collapse (e.g. advanced psychosis or dementia). This point was echoed by Marion Godman who argued that cultural explanations are needed to understand local coping with disorders but may not enhance our understanding of the disorders themselves.

Speakers were divided on whether underlying mechanisms are needed for classifying mental disorders. According to Harold Kincaid, we should direct our efforts on picking out “objective predictive kinds” instead of relying on robust definitions of natural kinds or underlying mechanisms. Kincaid, and Caterina Marchionni in her talk, maintained that disorder kinds or categories can be identified objectively by consistent shared traits without knowing why they are shared. Furthermore, Kincaid argued that ideally the categories should fit into a predictive causal network, and in order to decide which categories are predictive, we need detailed empirical studies. On the contrary, top-down approaches to mental disorders based on evolution or typical brain functioning play no real role in DSM or in other accounts of disorders. The upshot of both Kincaid’s and Marchionni’s talks was the need for pluralistic approaches to classification.

At the other extreme were Samuli Pöyhönen and Petri Ylikoski, who argued for an all-encompassing view of addiction by integrating different approaches under a matrix of mechanisms. According to their “addiction-as-a-kind” hypothesis, different forms of addiction can be united under a single kind upheld by a matrix of mechanisms that are responsible for the disorders’ typical properties (symptoms, etiology, response to treatment etc.). Moreover, different combinations of the matrix underlying different addictions provide a means for objective classification.

Tuesday, 16 August 2016

Anhedonia and Situated Cognition

This post is by Alex Miller Tate (pictured below), PhD student at the University of Birmingham. His work investigates the nature of mental illness and emotion, using insights from research into Situated Cognition. His thesis examines the role that situated theories of cognition and emotion can play in explaining and describing various symptoms common in major depression.

Anhedonia is a core symptom of many Psychiatric conditions, most commonly presenting in patients diagnosed with a depressive disorder or schizophrenia (Oyebode, 2014). It is most commonly defined as an absent or diminished ability to experience pleasure from participating in previously enjoyable activities (Treadway & Zald, 2011: 538). As an example, somebody who used to enjoy playing football and listening to David Bowie, but no longer enjoys either of these things, may be said to be exhibiting Anhedonia.

One popular theory of Anhedonia, call it sustainability theory, argues that it is characterised by a diminished ability to sustain pleasurable responses to rewarding stimuli (Tomarken & Keener, 1998; Heller et al., 2009). The immediate response to a stimulus is relatively undiminished, but enjoyment cannot be sustained. My work aims, roughly, to bring the sustainability theory together with the Situated Cognition paradigm, to see what insights into Anhedonia a situated sustainability theory might offer.

My attempts to do this have centred around the notion of affective scaffolds; aspects of our environments that significantly shape our emotional experiences and dispositions (Griffiths & Scarantino, 2009). For instance, music at a funeral may be chosen so as to support the elicitation of sadness in the moment (a synchronic scaffold) and my emotional response of sadness at funerals is (in part) structured by what I have learned is socially expected of me at funerals (a diachronic scaffold).

I draw a comparison with studies that suggest that work classically attributed to internal cognitive processes is better thought of as being offloaded into the agent’s environment via bodily interaction. For instance, skilled bag packers in grocery stores in the USA arrange items spatially by category (heavy, fragile) as they come off the conveyor belt. This later allows for an optimal distribution of items across bags without placing an extreme load on working memory. We might think of the spatial arrangement of items as functioning as a cognitive scaffold for the bag packer; it is an external structure that greatly reduces the task-burden on internal cognitive resources.