There was an interesting moment in a supervision with Laura Buckley today, this time prompted by something my colleague Bernie Carter (pictured) said. Thinking about how effective the older people whom Laura had interviewed were in thinking through and communicating their thoughts about their wellbeing, Bernie, who is interested in children's pain on the nicest interpretation of that phrase, commented on the broad opposing views of pain and language. On one, language fails to communicate the real nature of pain, which is private to the sufferer. On the other, there is an essential connection between pain, expressing pain, and communication and hence no gap between what is felt and what communicated. (As an ex Wittgensteinian, my hand is tied in this debate, of course.)
Now in the somewhat boisterous cut and thrust of supervision without the steadying hand of Laura's director of studies, I missed the exact nature of the connection Bernie was suggesting. But it prompted the following thought. Unlike the pain case, where maintaining the second view takes a bit of philosophical work against the insidious idea that pain is pain whether or not it is there to be expressed (and hence it would be merely good fortune if it could be put into words), my intuitive thought about wellbeing goes the other way.
Roughly, it is a pre-philosophical view that to enjoy wellbeing is already to be in the space of reasons. A state of wellbeing is not one which one can enjoy without some conception of a life to be lived and a realisation that one is living it, even if merely in part.
(Perhaps one needn't have a conception of a life as a whole but merely of an aspect. For example, that one likes the conviviality of the pub with friends on a Sunday lunchtime. But my hunch, an argument for which I rather owe, is that that only works in the context of at least an inchoate conception of a life into which that aspect fits. The context in which the beer is pulled by slaves and the pub heated by burning kittens is not one which will enable such a visit to sustain wellbeing. One will need to take it - truely or falsely - to be the case that that is not how things are. Hence an escalation of conceptions from the specific to the general.)
But although I want to suggest that it is pre-philosophical, the hunch comes under threat from the fact that 'wellbeing' simply isn't a word in vernacular use. Laura has had to fish for an appropriate understanding of it whilst not pressing specific interpretations (and thus undermining the objectivity of her research). So how could it be that one must be self-conscious to enjoy wellbeing if neither the word, nor a convenient synonym (had there been one, Laura would have used it) is in popular use?
I think that the answer to that is that there are a number of distinct ways for agents or actors to pick out aspects of living which the interpretator or theorist take to be wellbeing. So the conception under which the life is so conceived is a mere aspect for which the theorist can provide a rationale for taking it to be an aspect of wellbeing.
This suggests something like the following interesting possibility. There may be a different kind of gap to the one Bernie was sketching. Not between a preconceptualised state (wellbeing as akin to pain on a non-Wittgensteinian view) and its linguistic expression but between the theorist's conception of wellbeing at an abstract level and the agents' conceptions of different ways in which it can be realised. Perhaps agents' conceptions of what the theorist takes to be wellbeing have nothing independent of the theorist in common?
Friday, 17 May 2013
Wednesday, 15 May 2013
Tacit Knowledge book out now
My co-authored book, with Neil Gascoigne, Tacit Knowledge, Durham: Acumen, is out now in hard and soft covers.
Later, I must try to frame some thoughts about the co-authoring process which really is quite a strange one in philosophy, a subject in which no two people would be expected to think alike.
Later, I must try to frame some thoughts about the co-authoring process which really is quite a strange one in philosophy, a subject in which no two people would be expected to think alike.
Health Research with Real Impact conference
I've been at the Health Research with Real Impact conference today. With a wide ranging programme across the field of health research, I wasn't sure how much, as a mere philosopher, I would be able to understand. But the unifying theme of the morning, although called 'knowledge management', was more specific even than that. Roughly, why is it that potential innovations backed by good quality evidence are not easily adopted? Why are 45% of well researched innovations not taken up?
Here are two specific examples, both from cancer care. My colleague Kinta Beaver discussed resistance to the idea of using telephone follow-up consultations in place of hospital based face to face encounters despite both its popularity with patients and with its clinical effectiveness. Thomas Hack, from the University of Manitoba, discussed the problem of first consultations for those diagnosed with cancer. Typically, he reported, patients are anxious and as a result fail to take in or retain information put to them. The answer, which is hardly rocket science, is to record the consultation and give the patient a copy at the end. But the interesting thing was that despite good quality Cochrane review evidence for its effectiveness in a variety of degrees there was little initial uptake for it
Different speakers gave different examples of specific approaches to addressing the gap between good evidence and change of healthcare practices. For example, Janice Eng of British Columbia showed a website which ranked research papers relevant to spinal cord injury but also made available unpublished research (which interestingly increased subsequent journal publication rather than diminishing it).£But I was more interested in the reason for the inertia in the first place. Tom Hack reported that whilst all the clinicians he interviewed about recording consultations shared a view of its probable efficacy (there being much published evidence) they disagreed about the specifics of the perceived obstacles. It seems oddly coincidental that all agreed that there would be obstacles but they disagreed about the particular reasons. What, I want to ask, is the real reason? Is it simply a universal conservatism? Is there anything more interesting behind this?
I was also struck by an ironic reversal. At the start of the morning, a couple of speakers invoked the idea of 'mind-lines' to explain entrenched habits of thought which might explain inertia in the face of change. This is not an idea I have heard expressed before in UCLan. But in questions later, this conceptual innovation was eagerly embraced by nearly everyone. No inertia there.£
Here are two specific examples, both from cancer care. My colleague Kinta Beaver discussed resistance to the idea of using telephone follow-up consultations in place of hospital based face to face encounters despite both its popularity with patients and with its clinical effectiveness. Thomas Hack, from the University of Manitoba, discussed the problem of first consultations for those diagnosed with cancer. Typically, he reported, patients are anxious and as a result fail to take in or retain information put to them. The answer, which is hardly rocket science, is to record the consultation and give the patient a copy at the end. But the interesting thing was that despite good quality Cochrane review evidence for its effectiveness in a variety of degrees there was little initial uptake for it
Different speakers gave different examples of specific approaches to addressing the gap between good evidence and change of healthcare practices. For example, Janice Eng of British Columbia showed a website which ranked research papers relevant to spinal cord injury but also made available unpublished research (which interestingly increased subsequent journal publication rather than diminishing it).£But I was more interested in the reason for the inertia in the first place. Tom Hack reported that whilst all the clinicians he interviewed about recording consultations shared a view of its probable efficacy (there being much published evidence) they disagreed about the specifics of the perceived obstacles. It seems oddly coincidental that all agreed that there would be obstacles but they disagreed about the particular reasons. What, I want to ask, is the real reason? Is it simply a universal conservatism? Is there anything more interesting behind this?
I was also struck by an ironic reversal. At the start of the morning, a couple of speakers invoked the idea of 'mind-lines' to explain entrenched habits of thought which might explain inertia in the face of change. This is not an idea I have heard expressed before in UCLan. But in questions later, this conceptual innovation was eagerly embraced by nearly everyone. No inertia there.£
Friday, 10 May 2013
LSE panel discussion on mental illness
I took part in a panel discussion at the LSE this week under their Consilience series. Matthew Broome and Bonnie Evans were the other panel members, it was chaired by Kristina Musholt, and organised by Juliana Cardinale. In a packed - and very swish - lecture theatre, I found the questions from the audience varied and helpful and, despite the contested nature of mental healthcare, surprisingly good natured. But I regretted afterwards that we failed to provide a really clear outline of the logical geography of the philosophy of mental illness: mainly my fault, I could have done so but chose instead to give an overview of activity in philosophy and psychiatry. (There is a podcast of the event available here.) But one other coincidental aspect of the evening struck me.
Between 1991-3, I worked at the LSE as a university administrator before going round the world for a year. It was an emotionally charged period in that I had to learn a lot quickly about non-academic work in which I was hugely helped by a fine boss (Michael Arthur); there was a surprising degree of pressure elsewhere in the administration (much shouting on other floors); and I had simultaneously to rewrite my PhD from scratch with a new supervisor. Memories from those two years often come back to me. And hence, I assumed that if I were to walk into the building in which I used to work and where I would arrive with some trepidation every morning that memories would flood back, that I would have an affective response. Weirdly, I tried the experiment and nothing happened. I cannot project myself back into that life any more. All the facts are the same - I remember just as much - but the affective colouring has gone. Odd to have no first person authority in advance over this.
Between 1991-3, I worked at the LSE as a university administrator before going round the world for a year. It was an emotionally charged period in that I had to learn a lot quickly about non-academic work in which I was hugely helped by a fine boss (Michael Arthur); there was a surprising degree of pressure elsewhere in the administration (much shouting on other floors); and I had simultaneously to rewrite my PhD from scratch with a new supervisor. Memories from those two years often come back to me. And hence, I assumed that if I were to walk into the building in which I used to work and where I would arrive with some trepidation every morning that memories would flood back, that I would have an affective response. Weirdly, I tried the experiment and nothing happened. I cannot project myself back into that life any more. All the facts are the same - I remember just as much - but the affective colouring has gone. Odd to have no first person authority in advance over this.
Wednesday, 24 April 2013
Tanney, J. (1995 / 2013) ‘De-individualising norms of rationality’
I’m reading Julia Tanney’s recent
collection Rules, Reason and Self
Knowledge. A preliminary skim read has given me a sense of the landscape
and that familiar sense that when, for example, an author points in a
particular direction and says “There’s a vicious regress here” it seems
entirely plausible that there is, even though I could not teach it. So now I’m going back a little more carefully.
As a collection of papers, not all seem
to me to be of equal importance or depth. (I should add that one is one of my
all time favourite philosophy papers, so I am not being particularly rude.) But
one of the key papers is the first: ‘De-individualising norms of rationality’.
A key passage, part way through goes:
In ‘How is weakness of the will possible?’ Davidson suggests
that the judgment that manifests the relative ranking of reasons — i.e., the
result of deliberation — is an “all things considered judgment”. An all things
considered judgment is “doubly relativized”. First it is relativized according
to the way in which the desire would be satisfied in the commission of the
action (say, as in the prima facie judgment: “Spending the weekend in Barcelona
is desirable insofar as it is likely to yield adventure”). It is relativized
also according to its place with respect to other desires and in light of the
agent’s beliefs, principles, and values. This judgment might be something like:
“In light of my ranking the opportunity for adventure over prudential concerns,
and in light of my beliefs about what spending the weekend in Barcelona will
involve, and so on, spending the weekend in Barcelona is desirable”. According
to Davidson, this all things considered judgment is conditional in form and
thus, like the singly relativized judgments that logically precede it, does not
entail the kind of judgment which is a necessary concomitant to intentional
action. Again, this latter judgment — which Davidson identifies as an intention
— must be unconditional, or derelativized. So the logical gap that exists between
the contents of prima facie evaluations, or sentences describing them, and the
contents of intentions, or sentences describing them, is still preserved on the
extended model between all things considered judgments and actions. The move
from a doubly relativized judgment like “Assuming that I have considered all
relevant things, I ought to spend the weekend in Barcelona” to an unconditional
(derelativized) judgment like “I ought to spend the weekend in Barcelona” is
not a move that is prescribed by first-order logic since, presumably, some
piece of relevant information not considered might always defeat the claim that
I ought to spend the weekend in Barcelona. Thus, the failure to make such a
move in one’s thinking cannot (yet) be taken to exhibit a kind of logical
inconsistency. [Tanney 2013: 27-8]
We get to this point via the fact that the elements in a standard
Davidsonian account of action contain pro-attitudues and beliefs such as:
·
Any act of mine which is likely to yield
adventure is desirable
·
Spending the weekend in Barcelona is likely to
yield adventure
But these will generate conclusions to a practical syllogism of
this form:
·
Any act of mine which is my spending the weekend
in Barcelona is one I may judge to be desirable
which seems too strong because other factors might make some such
acts undesirable. So Davidson changes the form in ‘How is weakness of the will
possible?’ to make the premises and conclusion all expressions of merely prima
facie desirability: Any action of mine is desirable insofar as it is likely to yield adventure thus permitting trumping
by other factors.
But now the problem is that there is a gap between the outcome of
the practical syllogism if, as Davidson thinks, the ‘action itself must
correspond to something stronger than a ‘prima facie’ evaluation that the act
is desirable in a certain respect; it must correspond to an unconditional or
all-out, singular judgment expressing the desirability of a particular action’
[ibid: 25-6] So by what rational step does one get from a relativised prima
facie judgement to an un-relativised all out judgement? One thing that is
needed is a ranking of competing prima facie reasons. And this is the all
things considered judgement (NB not
an all out judgement, unconditional) of the passage with which I began. This
judgement – which Tanney suggests might be ‘In light of my ranking the
opportunity for adventure over prudential concerns, and in light of my beliefs
about what spending the weekend in Barcelona will involve, and so on, spending the
weekend in Barcelona is desirable’ – still does not imply an all out judgement
and no such logical transition is available in standard logic.
So the patch Davidson adds is an extra principle: the principle of
continence. This has the additional virtue that its violation promises an
account of akrasia.
The principle says that I ought to act in accordance with my all things considered
judgment (and form derelativized judgments or
intentions consistently with it). Davidson calls this a second-order
principle, presumably because it speaks
about the deliberation process itself, and does not necessarily get bandied around
within it. Introducing the second-order principle allows Davidson to diagnose
what goes wrong in a case of akrasia by
pinpointing the norm that has been flouted. [ibid: 30]
The akratic subject is guilty of irrationality, according to
Davidson, because s/he violates this second order principle. Tanney cites this
bit of Davidson to make plain the idea that the holding of this second order
principle is necessary for the akratic to count as properly irrational.
If the agent does not have the principle that he ought to act
on what he holds best, everything considered, then though his action may be
irrational from our point of view, it need not be irrational from his point of view — at least
not in a way that poses a problem for explanation. For to explain his behaviour
we need only say that his desire to do what
he held to be best, all things considered, was not as strong as his
desire to do something else. [Davidson
1982: 297]
So the akratic helps illustrate – through a kind of deficit study
– the structure of the normal case. But that prompts the question of whether
the ‘patch’ (in Tanney’s phrase) really helps. The key objection is that the principle
is not sufficient without begging a question of its own application. The
problem is: ‘if my implementation of the principle of continence, say, is
needed to move me from an all things considered judgment to action, then why is
not a higher-order principle of continence needed to tell me how I am to
implement the principle of continence non-akratically, and so on?’ [ibid: 35]
At this point Tanney deploys the regress argument to this initial
target.
Is my holding the principle of continence, for example,
tantamount to my having a pro-attitude toward my acting in accordance with my
all things considered judgment?...
Perhaps the principle of continence is the content of an all things considered judgment. Then I judge, all things considered, that I ought to act in accordance with my all things considered judgments. Now the internal regress is explicit. If holding the principle (judging that I ought to act in accordance with my all things considered judgment) were explanatory of my rational abilities at all, it would only be if the connection between my all things considered judgments and my actions were presupposed. But this was precisely the connection that the principle was invoked to explain. [Ibid: 36]
Perhaps the principle of continence is the content of an all things considered judgment. Then I judge, all things considered, that I ought to act in accordance with my all things considered judgments. Now the internal regress is explicit. If holding the principle (judging that I ought to act in accordance with my all things considered judgment) were explanatory of my rational abilities at all, it would only be if the connection between my all things considered judgments and my actions were presupposed. But this was precisely the connection that the principle was invoked to explain. [Ibid: 36]
But the problem doesn’t just lie with the norm expressed by the
principle of continence. That is only one aspect of the ‘practical reasoning
process or the logical structure of deliberation’. Others include the links between
perception and judgement, conceptual links within judgement as well as
judgement to action. But no patch – no higher principle grasped by the subject
– will be able explain the subject’s ability to play what Tanney elsewhere
calls the ‘rule following game’.
So the patch is not sufficient to explain the ability. But nor is
it necessary.
Grasp of the principle of continence is supposed to dictate how
the agent acts once he has weighed up his ‘all things considered’ judgement. It
glues that judgement to a corresponding action. But in this case, that would be
either a judgement that it is better to return to the park or a judgement that
it is better to stay on the tram. The outcome depends on the relative strength
of those desires. On Davidson’s account, the akratic is only irrational because,
despite the fact that his all things considered desire is to stay on the tram, his
desire to return to the park trumps the principle of continence which would
make him act on the desire is to stay on the tram and thus he returns to the
park. But, as Tanney argues, if his all things considered judgement is to stay
on the tram, then merely by his status as ‘an agent, a deliberator, a practical
reasoner’ he should correct his impulse to return to the park. ‘After all, what
is the point of his deliberating if he is not going to act in accordance with
his deliberations? Indeed, why would he get as far along in the deliberation process
as to reach the all things considered judgment if he will not act in accordance
with it?’ [ibid: 34]
So the higher order cannot play the explanatory role Davidson
wants for it. That is not to say that it cannot play a diagnostic role in
explaining what has gone wrong with someone’s thinking. But it cannot be an ‘object
of cognition’ which explains normal success.
In filling out this latter point, Tanney goes, in section 5 of
the paper, to reject the idea that tacit knowledge of the principle would be
explanatory. The key objection is that this also begs the question of tacitly
deploying the principle correctly. Going tacit doesn’t change things. A related
alternative is to think of grasp of the principle as a kind of causal
instantiation of it in such a way that causally yields correct moves. But this
blurs normative rules and causal laws. Causal determinants of action cannot
also prescriptively guide action.
From this, she concludes that conformity with the norms of rationality is not a cognitive achievement.
There is a strong intuition that we need to make out an internal
connection between norms and the individual who acts in accordance with them in
order to make sense of the intuition that she acts because of the norms. A disposition
to act in accordance with the norms does not seem to give us the right kind of non-contingent
relation required for explanation. But, I argue, this relation cannot be made out
as a cognitive one such that the norms themselves are objects of knowledge or
desired ends and a person engages in reasoning to implement or satisfy them.
This is because the “reasoning” here will presuppose the dispositions that
attributing these very norms was meant to explain. [ibid: 42]
Now this denial turns on an explanatory connection and seems
right to me. It’s a rejection of the ‘intellectualist’ legend. But I still want
to hang onto the idea that following a rule correctly can be a case of my
having gasped it. In fact, I think
that this is a key distinction between rule following and rule accord. Section
6 is aimed against just this idea.
Perhaps attributing to me knowledge of a norm of rationality
does not explain my rational abilities either directly, or via
second-order explicational abilities, by the arguments above; but perhaps my
having knowledge of the norms consists in my ability to justify my actions. And
perhaps my having this second-order ability is necessary for me to be considered
truly rational. If so, maybe we can make out the sought after “internal”
connection after all. My following a rule or obeying a norm, as
opposed to my merely acting in accordance with it, might consist in my ability
to justify my actions in light of the principle prescribing it. [ibid: 42]
Here Tanny points out a distinction between justifying a move in
chess by citing a rule and justifying a rational action by citing a rational
norm. In the former case, the justificatory move is not a move within a chess
game. But in the latter, the justificatory move is of just the same sort as the
ground level move it was supposed to justify.
I am not sure that I follow this. It seems to be a justificatory
analogue of the explanatory argument before. In the latter case, the charge is
that one cannot deploy higher level principles to explain rule following
behaviour because that explanation would beg the question. If rule following
behaviour needed explaining, this would not explain it. So in this case, the
analogue would be that rule following behaviour cannot be justified by appeal
to rules because the justification would beg the question. If it needed
justifying, this would not justify it. Such an argument has echoes of Carroll’s
‘Tortoise and Achilles’. But this seems to assume that the only successful
justification of rule following behaviour would have to work from a perspective
outside rule following. To justify the grasp of a particular rule, one would
need to justify the very idea of rule following at all. But that seems an
unreasonable demand. An intermediate position would connect an individual’s
grasp of a rule with their ability to explain and to justify their behaviour in
accord with their conception of the rule but only to those with ‘eyes to see’.
Tanney concludes:
But in what sense, then, do the norms of rationality govern
thought and action if they are not properly construed as objects of cognition?
The answer is that they set up the practice of ascribing thoughts and action.
This is a point often made by Davidson in discussions about the principle of
charity. The principles of rationality seem to play the same kind of role. They
are not rules or norms that figure in our attributive practices. They are
presupposed by it. But if they ground the practice of interpretation, it would
be a category mistake to explain features of the practice by individualizing
them. [ibid: 44-5]
There seem to me to be
two senses of ‘individualise’. On one, rational demands result from a kind of personal
bootstrapping of normative force from non-normative elements. But, like Wittgenstein’s
regress of interpretations, such justification or explanation faces a regress.
On the other, it means something like play a role in a subject’s mental life.
But rejecting that, as Tanney seems to, makes the difference of rule following
and rule accord merely in the eye of the interpreter. I don’t see why the
former needs escalate into the latter.
Tanney, J. (1995 / 2013) ‘De-individualising norms of rationality’ in Rules, Reason and Self Knowledge Cambridge, Mass.: Harvard University Press
Possible chapter abstract: Psychiatric classification, vagueness and tacit knowledge
Psychiatric classification, vagueness and tacit knowledge
DSM III aimed to improve the reliability of psychiatric diagnosis via an operationalist emphasis on ‘observable’ signs and symptoms and the initial downplaying of aetiological theory. Signs and symptoms are first elicited and then syndromes derived through diagnostic algorithms. Whilst this has prompted the charge that reliability has improved only at the cost of validity, there has also been a criticism, from European psychiatrists, that the signs and symptoms articulated within DSM III and IV are vague by contrast with the specification provided by explicitly phenomenological psychiatry. Rather than providing a reliable foundation, the connection between individual symptoms and conditions in the DSM lacks specificity. By contrast, phenomenological psychiatry can chart a correlation between schizophrenia, for example, and particular kinds of catatonia or delusional structure. Correlations are not between schizophrenia and delusions in general but delusions with a specific schizophrenic colouring.
In this chapter, I attempt to shed light on these claims without presupposing the phenomenological tradition but instead by forging a connection between diagnosis and one construal of tacit knowledge. Taking the latter to be a context-dependent, but conceptually structured practical skill, I suggest that the top-down approach to psychiatric symptoms contains the vagueness of DSM descriptions of symptoms through context-dependent recognitional skills. But this is merely a more than usually pronounced instance of the link between tacit knowledge and what Polanyi’ calls the ‘art of denotation’.
Sunday, 21 April 2013
Pitmen Painters
I caught the touring production of the Pitmen Painters at
the Bradford Alhambra. It’s based on the true story of the Ashington group of
untrained coalminer painters from around the time of WW II.
Although it began with some low comedy about accent
impenetrability and then some social class tension drama, things picked up to
make for quite a thought-provoking play. Two quick things stood out. The first
was a plausibly open ended question of the necessary connection (or not) of the
group, their work and their profession.
Did they have to be closely connected to their particular community to
have the artistic identity they had?
Second, there was an interesting issue of how to address
the contingency of the fact that just that group of people, gathered originally
(or so the play asserted) for other reasons came to prominence. Did it show, as
the group’s Professor Higgins asserted, that just anyone given the right
opportunities for self expression could paint? Or, as the painters themselves
suggested in response, (in the play, that is,) that just they were the people
from the community who, as a matter of fact, had any natural ability?
Appealingly, neither forced choice seemed plausible but it wasn’t clear what
that left.
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