(Christian Perring has kindly offered me a right of reply to a very negative review which he published. Here's my draft.)
I am grateful to Neil Levy for engaging with the underlying philosophical themes of my book even if not with the details of its arguments.
To take one example of this lack, Levy ascribes to me the argument that since ‘we live in a space of reasons, a non-normative account of mental illness cannot be given’. This is merely a caricature of the discussion of chapter 1 which turns on the question of whether biological functions can be used to reduce the normative notions particular to illness, especially mental illness. Having, it seems, more faith than I have in evolutionary theory to defend reductionism, Levy must disagree with my conclusions but it is a pity he has not engaged more closely with the arguments.
In order to set up one of his two challenges, he ascribes to me the same kind of brisk dismissal of reductionist accounts of meaning: ‘since we live in the space of reasons we cannot give accounts of significance according to which they are built up from non-significant elements’. But again this ignores my actual arguments, [eg the 5 page discussion ibid: 129-133] (against what I concede in the text is still a live research project [ibid: 129]) which look, inter alia, to the problems reductionists have answering the ‘disjunction problem’ or showing how causal theories of reference are of the right form to explain intentionality.
Levy likewise merely parodies my argument for moral particularism. I cannot claim originality for this line of thought (I cite John McDowell) but the argument [ibid: 68-71] starts from the prima facie appearance that such value judgements cannot be codified and then considers why this appearance is often disregarded in philosophy. The discussion of codified judgements is meant to challenge a deep seated prejudice about rationality which can blind us also to the nature of uncodified judgements. Thus when Levy ascribes to me the view that arithmetic also is uncodifiable he simply ignores the text itself which says:
Thus even in the case of a judgement that can be codified – by the axioms of Peano arithmetic, for example – the principle itself has to be applied through a kind of practical judgement. Whatever principles can be used to encode such practice their application relies on practical judgements which are not themselves codified. Wittgenstein’s discussion should undermine the prejudice that wherever there is a rational judgement it must be encoded in a principle, since principles themselves cannot govern judgement unaided. Without the prejudice, however, there is no reason to doubt the appearance that value judgements are made without a close framework of principles. [ibid: 71]
Levy suggests that the main target of my book is ‘an entire metaphysics and philosophy of mind’ rather than an engagement with particular views within philosophy of psychiatry. Whilst he is right that I oppose reductionism, his description is again an unhelpful way of presenting the way the general and particular inform each other. To take just one area, my discussions of the different accounts of delusion offered by Jaspers, Maher, Frith, Sass, Campbell, Davies and Bolton and Hill turn on the particular details of their theories and models. There can be no one size fits all response. The overall argument for a relaxed (non-reductive) naturalism emerges out of piecemeal discussion of key authors and key issues within the philosophy of psychiatry.
This is not the place to attempt to resolve the longstanding debate about the prospects of reductionist naturalism but let me suggest a way to respond to Levy’s remaining challenge. He asks how we could have evolved to grasp real values, worrying that ‘If there are values independent of us, we have no reason to think that what we take to be values actually are’. If, however, one takes seriously the idea of values as genuine features of the world then there might well turn out to be an evolutionary account of grasp of them. (Since we have no wish to explain values in other, eg evolutionary, terms, this issue is not pressing for non-reductionist, relaxed naturalists. Reductionists face a bigger challenge.) But if so it had better not eliminate the potential gap between being right and merely seeming right that characterises any judgement that aims to track real features of the world. Levy’s sceptical worry is both under motivated and misplaced.
In addition to misrepresenting my book, I fear Levy also misrepresents the abilities of those with an interest in the philosophy of mental health and psychiatry. My ten years’ experience of teaching psychiatrists, mental health nurses and service users, with a passionate interest in the fundamental issues surrounding mental healthcare but without a philosophy background, has in turn taught me that such students thrive by getting stuck into the complexities of the real debates and real figures, from Jaspers to EBM. Understanding my little book should be no problem at all, to them at least.