Tuesday 21 September 2010

The Value of Knowledge

I am teaching a first year undergraduate module on the value of knowledge this term. This is the, still in development, website for it.

Sunday 19 September 2010

Emotions and Feelings in Psychiatric Illness

The final conference in the Durham AHRC workshop and conference series on Emotions and Feelings in Psychopathology was more focused than the first one. Most papers (sadly not including mine) addressed the issue of the nature and underpinnings of emotions. Thus we heard presentations on developmental, cognitivist, enactivist and phenomenological accounts of emotions. In the main, my lingering worry concerned the relation between the person level and sub-personal accounts coupled with the issue of whether the states invoked were intentional or not. (For example, if one thinks that ‘moods’ are preconditions of intentional states, that prompts the question of whether the moods are or are not intentional states themselves. If not, then there should be nothing it is like to have them and thus they should not be the proper study of phenomenology.)

In my presentation (based on these prior thoughts) I began to address what might still be left to be done in the face of a failure to understand – in the sense of fitting into a rational pattern – someone’s experiences and utterance by way of understanding them. The kind of understanding that Wittgenstein suggests one might have of more or less ritualistic behaviour by comparing it to our own was the lead I followed. The question that caused me most worry was from Phil Gerrans who asked how it might help to understand one person’s crazy and irrational habits by realising that one has crazy and irrational habits oneself (and vice versa). My hunch was that this might simply be the limit case of a habit where there is no understanding but to be told that there’s nothing to be understood might be helpful in some contexts.

Later Mog Stapleton and I chatted about kitten ownership (I have two devon rex kittens to fill the gap left by Brix’ death) and we were both surprised by a failure to agree on whether the proper response to a beautiful kitten is a kiss. Why would it be, I thought, when it isn’t right for a shapely sofa, for example? Trying to fathom her alien kissing view, I asked whether it included sucking the tail or licking the, perhaps, oysterish taste from the cat’s ear. But this did not lead to any further shared insight of our mutually alien habits. Everyone involved in the discussion was too tactful to draw attention to the challenge this disagreement implicitly raised to my earlier Wittgensteinian hopes about the prospects for understanding.

A manifesto for teaching medical ethics

When I was the course leader for medical ethics in the Warwick Medical School a BMA ethics adviser commented to me, deliberately contentiously, that the thing that had done medical ethics teaching most harm in recent time was the Four Principles approach. His complaint was that, despite explicit guidance as to their use by the authors Beauchamp and Childress, the BMA regularly received calls from doctors saying that they had applied the four principles ‘method’ to a case about which they had worries but seemed to get the wrong answer. This worry formed the base for a paper I wrote at the time in which I tried to diagnose what led to this confusion. I do not think, however, that I aimed at the most significant target.

What seems to have gone wrong in the examples I was told about is not so much a failure to think through the metaphysics of values, a thinking through which would lead, I thought and still think, to a realisation that there must be something more in play than ethical principles, but rather an underlying picture of the ethical knowledge in play. The misunderstanding of the Four Principles approach (a misunderstanding which is inevitable, I think) is to think that the kind of ethical knowledge that they might underpin as a form of technical knowledge. The idea of technical knowledge I have in mind is that of a relatively insulated domain which works in accordance with general principles. Perhaps the checking of computer algorithms or the initial servicing of a modern car. Applying the four principles method, if there were one, would be a similar technical matter.

The irony of this is that medical ethics teaching was often seen as a necessary adjunct to a proper training in medical science. The latter gave students a theoretical grounding in pathology and treatment options but did not provide a way of thinking about more broadly proper care. Getting the science bit right – as Jennifer Aniston has taught us to say – threatened to decontextualise students’ understanding of the practice of medicine. A dollop of medical ethics teaching was supposed to address this. The irony is that the most common vehicle for an ethical education – B&C’s four principles – might then be taken by the students as a similar technical exercise.

There are a number of solutions to this which include abolishing the ghetto of a free-standing medical ethics week and moving ethical considerations into the rest of the syllabus; looking seriously at the kind of ethical framework guidance offered; and widening the role and range of values to be taken into consideration (Bill Fulford’s work on values based practice is a good starting point). But I think a key issue is the idealised view of technical expertise. If one teaches students about the importance of a background of context-sensitive empirical judgements (both practical and theoretical) to underpin islands of well behaved technical knowledge, they will neither have an unrealistic aim to have merely technical knowledge of ethical matters nor be suspicious if uncodified judgement is found to play a role in assessing values. It’s all part of clinical judgement.

Monday 6 September 2010

Not a review of Collins’ Tacit and Explicit Knowledge...

Not a review of Collins’ Tacit and Explicit Knowledge but just a ‘live’ first reaction to the early chapters and thus I may have got hold of entirely the wrong end of the stick.

Collins’ book starts by aiming to shed light on tacit knowledge by contrasting it with a suitable account of what is explicit. But whereas I aim to do something similar starting with what can be made explicit through utterance of natural language sentences, Collins starts not with that, nor with a merely syntactic structure (such as uninterpreted but well formed logical sentences using logical symbols) but rather what he calls ‘strings’.

Strings are ‘bits of stuff inscribed with patterns: they might be bits of air with patterns of sound waves, or bits of paper with writing, or bits of the seashore with marks made by waves, or patterns of mould, or almost anything’...’ [Collins 2010: 9] The motivation for this seems to be to avoid the ‘freight of inherent meaning that makes the notions of signs, symbols and icons so complicated’ [ibid: 9].

One worry repeated in the book is that signs do not have an essential meaning, only one in the context of a use. By contrast, ‘a string is just a physical object and it is immediately clear that whether it has any effect and what kind of effect this might be is entirely a matter of what happens to it.’ [ibid: 9]

The worry – that signs do not have meanings essentially – is reasonable but this response seems to make mischief in a couple of ways. One is that Collins still wants to say something about the sign side of the contribution to meaning (not that he would talk of signs and meaning) and has explicitly uneasily to use ‘affordance’ to pick this out. (See p36 for the unease.) Second, when he does talk about meaning he says something very odd: ‘Though strings are sometimes used to represent meanings [careful!], their relationship to meanings cannot be stablised... because meaning is continually changing as it lives its life in society.’ [ibid: 44] Echoes, perhaps, of the later Heidegger here.

The second oddness is the account of the relation of language and thought which, compressing madly, runs like this:

Language translation or just plain conversation within one natural language consists of three stages... Stage 1: inscription. In “telling” the attempt is made to represent lived meaning with the inscribed string. For example, in the case of conversation an attempt is made to represent the meaning as a string comprising vibrations in the air... Stage 2: transmission and transformation... Stage 3: interpretation. This is the attempt to recreate meaning from the string – to interpret it. [ibid: 27-8]

In this picture, Collins seems to subscribe to a C17 view of communication which Wittgenstein summarises, before going on to criticise it, rather nicely thus:

It seems that there are certain definite mental processes bound up with the working of language, processes through which alone language can function. I mean the processes of understanding and meaning. The signs of our language seem dead without these mental processes; and it might seem that the only function of the signs is to induce such processes, and that these are the things we ought really to be interested in... We are tempted to think that the action of language consists of two parts; an inorganic part, the handling of signs, and an organic part, which we may call understanding these signs, meaning them, interpreting them, thinking. [Wittgenstein 1958: 3]

But, so far at least, I have no reason to think that this really matters to the book. What does worry me more is this. The clue to the tacit is charting the explicit. And that is approached through the idea of strings: ‘“Explicit” is something to do with something being conveyed as a result of strings impacting with things.’ [Collins 2010: 57] But as the second chapter emphasises, ‘communication’ by strings is continuous at least with ordinary everyday causation. (Communication is more like the communication of impulse in physics than human communication although it is used to refer to that too.)

[S]tring transformations [I think the pattern gets transformed, not the stuff, by the way] and mechanical causes and effects are, to speak metaphysically, just two aspects of the same thing. This is why we have a strong sense that when we explain some process scientifically we have made it explicit; this is the “explicable” part of the antonym of tacit with its “scientifically explained” connotation. [ibid: 50]

Because strings are just stuff in patterns, including patterns on beaches and of mould, there is no restriction to the realm of meaning or human intentionality. But this suggests two potential worries:

The idea that either tacit or explicit knowledge is knowledge seems likely to go missing. Even if the content of the knowledge (the fact that p, eg.) is a worldly happening, the knowledge of p is not the same as p itself. Collins says things like: ‘[somatic tacit knowledge] is continuous with that possessed by animals and other living things. In principle it is possible for it to be explicated, not by the animals and trees themselves (or the particular humans who embody it), but as the outcome of research done by human scientists.’ [ibid: 85] Two worries here. First, surely trees were never thought to have tacit knowledge?!? There may be a pattern to their growth but trees don't know this, nor do they know how to grow. Later there is a similar passage which blurs what seem - in the context of a book on tacit knowledge - to be important differences.

Sometimes we can do things better than cats, dogs, trees and sieves can do them, and sometimes worse. A sieve is generally better at sorting stones than a human (as a fridge is better at chilling water), a tree is certainly better at growing leaves, dogs are better at being affected by strings of smells, and cats are better at hunting small animals... That teaching humans to accompalish even mimeomorphic actions is a complicated business, involving personal contact, says nothing about the nature of the knowledge, per se. The mistake is to see all problems of human knowledge acquisition as problems of knowledge. [ibid: 105]

But whatever one thinks of dogs and cats, trees and sieves do not do things in the sense of acting.

Despite its role in demystifying tacit knowledge, Collins does not finally endorse the idea that animals, trees and sieves have tacit knowledge. Although he says that insofar as humans act as animals they are not so different from cats and dogs and thus if we are going to say that humans have tacit knowledge, that does not rule out cats, dogs, trees etc [ibid: 77] he goes on to say that the idea of tacit knowledge stands in a contrast or tension with explicit knowledge. Thus where there is no possibility of explicit knowledge, neither is there tacit knowledge. 'Cats and dogs etc don't know anything; they just transform strings... In sum, animals, trees, and sieves should not be said to have tacit knowledge' [ibid: 78]. But this looks like a bare stipulation about ascription. There do not seem to be materials in the account to say why human action of an animal nature is any different from animal 'action' or even tree and sieve behaviour.

Returning to my second of the two worries mentioned above, surely what matters is not whether there is a knowable pattern (whether it is possible for it to be explicated, as he says) but that and how that pattern enters the thoughts of the knowing subject: the realm of sense not reference? That Collins does not share this hunch is evident in a passage like this:

The constraints on the methods available for efficient typing by humans [by contrast eg with machines] are somatic limits; they have everything to do with us and nothing to do with the task as a task – nothing to do with knowledge as knowledge. [ibid: 104]

This suggests that his focus is on the realm of reference, of what is being picked out in the world, which may sometimes be the content of knowledge. He is not, I think, interested in how it is known, the way it is grasped whether practically or propositionally, which seems to me to be the key question in this area. That a task might be accomplished using either explicit knowledge or tacit knowledge need not undermine its tacit status in any one particular case. So the inference from ‘task as task’ to ‘knowledge as knowledge’ in that last quote does not go through.

The same blurring (roughly, of what is in the world and what is in the mind) is present in this idea: ‘the modern world is thought of as driven by explicit knowledge – patterns’ [ibid: 80]. When comet Shoemaker Levy 9 hit Jupiter, that exemplified a pattern codified – roughly – in Newtonian physics. But it wasn’t driven along by its, or anyone’s, knowledge. Whilst one might have knowledge of patterns, patterns are not knowledge.

Putting this worry aside (ie being carefull about the distinction between the nature of knowledge and the nature of the content of the knowledge) there is still another worry (for me at least, poised to read the second half of the book). By adopting strings (stuff in patterns) as the vehicle to carry what is explicit, it is hard to see how (in the half of the book which I’ve not yet read) there can be anything left to be genuine tacit knowledge. The content of such knowledge would, I assume, have to fail to be a pattern (else it’s a string and thus explicit) but still count as knowledge. But if events happen without any pattern, it is hard to know how one might have knowledge of it. All very intriguing.

Collins, H. (2010) Tacit and Explicit Knowledge, Chicago: University of Chicago Press
Wittgenstein, L. (1958) The Blue and Brown books, Oxford: Blackwell.

PS (October 2010): I still haven’t had an opportunity to write a proper and considered review of Collins’ clearly important book on this subject but I can gesture at some of the developments in the second half and thus contextualise my own initial comments above.

One of the features that marks out this book from most of the rest of the literature on tacit knowledge is that it builds on Collins’ recent work on forms of expertise that are carried in language. (Recall talk of interactional expertise etc. from Rethinking Expertise.) Thus whilst chapter 5 concerns bodily or somatic tacit knowledge, familiar from the work of Dreyfus for example, chapter 6 is called ‘Collective tacit knowledge and social cartesianism’. It is this latter chapter that brings in the kind of distinction which I find so important between linguistic agents and mere animals or trees.

This reflects Collins’ fairly explicit initial approach to tacit knowledge. As he explained to me in a recent email:

I implicitly define ‘knowledge’ as meaning that which you have when you can do the thing and that which you don’t have when you can’t do the thing. This approach has nothing to do with self-consciousness, or intentions, or actions as opposed to behaviours. Those distinctions are discussed at length in Collins and Kusch’s Shape of Actions. At least, in so far as it does have anything to do with those distinctions, it is that Collective Tacit Knowledge is still mysterious because it is the knowledge required to carry out polimorphic actions (the subject of the earlier book). Given this much broader implicit definition of knowledge, then there are no distinctions between humans, cats, trees and sieves (I even treat the later as having the ‘knowledge’ to sort stones so that looks even dafter if you want to go there). Obviously, and this was the stated intention at the beginning, the differences between humans and other entities re-emerge at the end of the book with ‘Social Cartesianism’, which turns on Collective Tacit Knowledge.

So the starting point is very minimal indeed. ‘Knowledge’ can be possessed even by sieves. The distinction between sieves, trees and cats, on the one hand, and linguistic humans, on the other, is then earned in that later chapter from which, among other things, distinctions between mere behaviour on the one hand and action on the other can then be constructed with conceptually clean hands. Once one realises that then, radical though the minimal starting point remains, one can understand why the book begins that way. It is a deliberate methodological strategy.

There is a view of philosophy according to which philosophy does not so much tell one what to think but the cost (by way of implications and supporting accounts) of thinking what one may wish to think. Against this idea, Tacit & Explicit Knowledge, sets itself the task of earning rather than merely borrowing or stealing distinctions which seem important for characterising tacit knowledge in its various species. I remain unsure, however, whether the further cost of such a reconstruction has been fully met. But you’ll have to take a look.

Thursday 2 September 2010


I have just heard that the now renamed paper co-authored with my colleague Peter Lucas: On the very idea of a recover model for mental health has been accepted after a stern initial review by the Journal of Medical Ethics.

My paper on Psychiatric explanation and understanding in the European Journal of Analytic Philosophy came out a month ago or so.

‘Capacity, mental mechansisms and unwise decisions’ has entered the production phase with Philosophy Psychiatry and Psychology.

More interestingly, I am working on a co-authored paper with Victor Dura-Vila and his sister Gloria (although my contribution has been slow so far) on capacity for a more practical journal. This might actually be quite interesting.

I am also writing (in some sense of that present tense) a chapter on ‘Clinical judgement and tacit knowledge’ for Fulford, K.W.M et al (eds) Oxford Handbook of Philosophy of Psychiatry and ‘The everyday uncanny and the Sassian project’ for a special issue of Emotion Review.

Tacit knowledge in endovascular techniques

I have been asked to contribute to the second edition of the book Mastering Endovascular Techniques; Guide to Excellence by contributing a couple of 5 page sections on the transfer of both tacit knowledge and codified explicit knowledge. Obviously, I’ve agreed, but on the condition that I am not expected to pretend to know anything about endovascular techniques.

This however presents an interesting problem. What is the right aim for such a contribution? The best, I suspect, I can do is draw attention to the general possibility of a tacit dimension and to undermine natural prejudice against its role (this what I’ve begun to attempt in papers here and here).

There is, of course, an irony that my attempt to do this will be, in this case certainly, in quite general terms.

Wednesday 1 September 2010

Emotions and Feelings in Psychiatric Illness

I am struggling to draft my power point presentation for the Durham conference next week. In effect it’s in the same space as something Richard Gipps said to me (about his blog) in an email to the effect that he had criticised the view that “understanding something is to be equated with grasping its rational pattern” and “What I was hoping was to prompt from you a defence of the view that rationality is of a piece with understanding and that it is only on (e.g. overly codified) views of rationality that the rational appears to be only one form of intelligibility.”

That expresses a helpful thought. I do indeed think that understanding is grasping a rational pattern: putting speech and action into a rational pattern. And I am persuaded by those philosophers who argue that the demands of rationality are not in general codifiable (thanks to arguments from Dancy, McDowell and perhaps Wittgenstein). So the link between understanding and rationality does not require a general context-free pattern. There seem to be a couple of other points that makes the connection between understanding and rationality less costly (which is not to offer an argument for the positive claim).

First, there’s no reason to think that the link has to be used to shed light on intentionality or mentality or whatever else is understood from outside those notions. It need not be a sideways on view of them. If it were, then we would need an account of the pattern of rationality couched in non-intentionality-presupposing terms and that seems too difficult. (My hunch is that that assumption helps makes Bortolotti’s criticism of a Davidsonian approach more convincing than it would otherwise be.) But I think that taking seriously the holism of belief and meaning in Davidson’s account (and emphasising the difference rather than the similarity between him and Quine) suggests that there was no hope of that.

Second, we do not in general think that the semantic norms which contribute to the rational patterns relevant to interpretation can be characterised in independent terms. (We can be modest rather than full blooded about theories of meaning.) For example:

[W]hat makes it correct among speakers of English to make a claim with, say, the words ‘Snow is white’... is that snow is indeed white. I stress ‘correct’: truth in the sense of disquotability... is unproblematically normative for the practice of using the sentence mentioned on the left-hand side of T-sentences... On the Tarskian-Davidsonian conception the ‘oughts’ in question – the ‘oughts’ that are built into the idea of, say, denotation – are not separable from the idea of correctness in assertion... I think once we see that the intuition that meaning and aboutness are ‘ought’-laden does not require the relevant ‘oughts’ to be pre-semantical... we can see that there is no ground for the idea that linguistic behaviour must be governed by... proprieties that can be formulated in non-semantical terms... [McDowell 2009: 214-6]

But even with those qualifications in place, one might still think that making the connection between understanding and a rational pattern is too strict. Surely there are things we understand (play, for example) without placing them in such a pattern?

That seems to be what is so interesting about Wittgenstein’s discussion of the fire festivals (and other bits of Frazer’s Golden Bough). He rejects Frazer’s approach which is to postulate as a causal hypothesis an original human sacrifice (to explain why the customs came about) suggesting that this is not necessary to understand the festival. The hypothesis might be false, after all. But what seems necessarily true is that the festival bespeaks something to do with human sacrifice. That seems to be part of what it expresses, its atmosphere, just on the surface (at least, like all symbolism, for the right audience).

I think one reason why the attempt to find an explanation is wrong is that we have only to put together in the right way what we know without adding anything, and the satisfaction we are trying to get from the explanation comes of itself.
And here the explanation is not what satisfies us anyway. When Frazer begins by telling the story of the King of the Wood at Nemi, he does this in a tone which shows that something stranmge and terrible is happening here. And that is the answer to the question “why is this happening?”: Because it is terrible.’... Put that account of the King of the Wood at Nemi together with the phrase “the majesty of death”, and you see that they are one. The life of the priest-king shows what is meant by that phrase. [Wittgenstein 1979: 2-3]

So one thing that Wittgenstein does is to suggest that the causal hypothesis is unnecessary because a proper description is enough to give us an understanding of the ritual. But, further, the hypotheses are not the right move to give us satisfaction, which in turn seems to be a mark of understanding by contrast with explanation. They are not right partly because they are the wrong answer to the question: what is terrible about the ritual?...

(Cioffi quotes a wonderful analogy from Paul Redding.
Wittgenstein draws attention to the fact that not all 'why' questions are requests for causal explanations. Someone bereaved might exclaim, 'Why did she die?' Such a question, uttered in a particular tone and under particular circumstances, would only be taken by the most obtuse as requests for an explanation - as being satisfied by the sort of response appropriate to the question in the context, say, of a coronial enquiry. [Cioffi: 262])

... But also because, according to Cioffi, we might have been asking the wrong question.

Wittgenstein's alternative answers work by offering reasons of a different sort. They suggest how, for those with eyes to see at least, the festivals are somehow the right expressions of feelings in question. They are the correct response. And thus even in cases as alien as fire festivals understanding does seem to be a species of rational pattern finding, though the patterns may ground out in commnets such as:

Here one can only describe and say: this is what human life is like. [ibid: 3]

That forms the bedrock against which the rational understanding gains purchase.

((To add: Why rational? why understanding?))

McDowell, J. (2009) Having the World in View, Cambridge, Mass.: Harvard University Press
Wittgenstein, L. (1978) Remarks on Frazer’s Golden Bough, Doncaster: Brynmill Press