Thursday, 30 July 2020

Neil Pickering on illness as metaphor

I’m struggling to finish a short booklet on mental illness for CUP and have returned to Neil Pickering’s fine and thought provoking book, as I often do: The metaphor of mental illness. This seems right as I seem to recall Neil tutting in some review that I never myself advocated/committed myself to a view of the nature of mental illness, implying that this was a defect. So I am returning to that challenge and I must say that I continue to see attractions in his view though perhaps still more in my no-view view.

I’ve always struggled a bit with the criticism he deploys against the ‘likeness argument’. I entirely agree how the diagnosis he offers undercuts the use of the likeness argument – as he reasonably describes it – to settle the debate about the illness status of mental illness and illnesses. The likeness argument takes the fact that a condition instantiates some subsidiary features which imply that it belongs to some category to show that it belongs to that category. Neil argues that in the case of mental illness – and illnesses – typically there are rival conceptions even of the descriptions of the subsidiary features such that on the rival descriptions they do not imply the category membership. And hence this form of argument cannot settle the debate because those who hold to different broader category membership will adjust their descriptions of subsidiary features accordingly.

That seems right to me but too strong a criticism of the form of argument in general. The idea that if something quacks like a duck then it is a duck seems a helpful argument in the right context. Clearly any savvy opponent of the duck categorisation has to be wary of conceding the ‘quacks like a duck’ subsidiary feature. Still, it may be easier to tell whether it quacks like a duck than is a duck straight off. Easier too if there are a number of evidential features to tick off. (Then again, it may not be easier to do this. See McDowell on recognising the behavioural criteria for mental states.)

That said, Pickering on the likeness argument goes in the book.

But that context helps set the scene for another confusion I have. Neil argues for the idea that thinking of mental illness as an illness is a metaphorical and imaginative jump. In clarifying this, he distinguishes metaphors from 4 other ideas including secondary sense (though why he uses green ideas to do this I don’t get), similes, words with related additional duties and dead metaphors. The one that seems most relevant for my purposes is the second. John is a wolf is a metaphor. John is like a wolf is a simile. If I follow, the claim Neil wants for mental illness counts as a metaphor not a simile because a simile doesn’t involve a mis-categorisation. Now there’s a sense in which a simile doesn’t involve a categorisation and so isn’t helpful for the claim that mental illnesses are illnesses. But I think it is the ‘mis-’ that matters. It is the cognitive jarring of John is a wolf and of schizophrenia is an illness that matters.

This feeds into the idea that metaphors construct likenesses rather than answering to them. And this, I think, is the point of the critique of the likeness argument as foundational. So my qualm about the logical simplicity of a likeness argument misses the point. The point is that, when all is contested, the likenesses are not there to be tracked. They are constructed by the imaginative imposition of the metaphor.

All this, however, depends on the cognitive jarring of the mis-categorisation and the imaginative leap that suggests it. What is the status of that?

Szasz feels the jarring and takes the metaphor to imply a falsehood in the claim that mental illness is illness that Neil disavows.

Wakefield - let’s pick him! - sees no jarring. For him illness is a harmful dysfunction and that applies to both mental and physical illness. So there’s no need for imaginative metaphor because there’s no gap to be bridged by one. Mental illness is literally illness.

Pickering wants to say that Wakefield begs the question against Szasz because it is only with the metaphor of mental illness as illness in place that things can seem as they do for Wakefield with his subsidiary features of harm and dysfunction. 

Szasz agrees that a metaphor is needed but thinks it insufficient for what his opponents want. 

Neil disagrees with Szasz and thinks the metaphor is fine.

But who is to say this is a metaphor, a bridge to cross the gulf of cognitive jarring, a form of *mis*-categorization in the first place? Wakefield sees no issue. Must he be wrong? I know Szasz says that he is but that is surely not the same.

From what perspective is Neil’s account offered? Does he think we ought to see an objective chasm that can, with the one bound of metaphor, be escaped? What if we don’t see it? Are we wrong?

And lurking: what marks the boundaries of the literal? Suppose that physical illness is a fine literal concept and we come upon another novel physical condition and ask whether it is an illness. Surely this is the same dialectic as the likeness argument. What stops the application of a concept to any new case being a metaphor on this picture? Is actual disagreement necessary? If not, isn’t every case novel? And by novel I mean any next case, including any next case that we might normally class as measles. This one is the one instanced, here, now by Mr Smith and is strictly novel. We have it under a singular thought!

I’m confused.