There’s always a lump somewhere under the rug

Here is a stab at summarising a thought I seem to return to often.

At the MMU workshop on placebo, Phil Hutchinson sketched an account of a form of intentionality (in the philosophical sense of aboutness) which could be shared by linguistic humans and non-linguistic animals. Subjects have an intentional directedness towards the world if they take in features of the world in experience under an aspect and conceptually, but not necessarily propositionally, structured, he claimed. In response to my question about what sort of entities such concepts were, Michael Loughlin - spotting an implication - spoke forcefully in defence of (Phil and) animals and against my apparent slight. It is merely a philosophical absurdity, he argued, to deny that a dog knows where its bone is eg., left behind the sofa, or is afraid of thunder. Hence I re-summarised what seems to be a problem for everyone in the debate: whatever one can plausibly smooth over always leaves a lump somewhere under the philosophical rug.

If one adopts a full blown Davidsonian views that thought and language are co-dependent, then Lois’ cat Snufkin is a thoughtless brute. But this leaves the intellectual ‘lump’ that Michael was stressing: it certainly seems that he knows some things and not others. He knows where I sleep and hence where is warm once the stove has gone cold at 3am, for example. He knows that he needs to get to the kitchen to be fed.

But if one takes these examples as the starting place and grants them the obvious interpretation, smoothing over the worry of denying animal thought, then a lump springs up elsewhere. If Snufkin can think then he can think thoughts. But if so, what thoughts does he think? He knows hence thinks that he is fed in a particular room: the kitchen, I might say. But does he know he is fed in the kitchen, ie. the room in which we, his owners, cook? Or does he think of it as, say, the most northerly room in the house? Or (demonstratively) that! room? But if so, what is his understanding of ‘room’? And if not room  then place? If so what is the geometry of places he grasps? In general, under what aspects or concepts or Fregean senses does he think any of this? There seems to be no principled way to ascribe intensional distinctions to Snufkin (hence distinguishing between thinking of the room as the kitchen and as the most northerly one) because he cannot help out linguistically. But then the transition from his thinking to his thinking specific thoughts breaks down. He thinks, but we cannot begin to say what he thinks.

A third possibility is to try to outline a primitive form of telic directedness, short of full blown thought (eg the aim of full blown teleosemantics) but richer than mere cause and effect (Dan Hutto pressed this idea on me once.) Such a position might be an explanatory stepping stone to full blown conceptually structured thoughts. One might argue that there must have been some such stage in evolutionary history. But that doesn’t solve the problem of now describing the states of telic directedness. Use of ‘concept’ for example is illicit given its original home in articulating propositional form.

Hence whatever justification there is for irritation towards philosophers denying that animals have thoughts, that doesn’t solve the problem of saying what they have if they do have thoughts.

(My own preference is to think that the ascription of thoughts has its primary application with linguistic creatures whose thoughts have propositional structure for the reason hinted at in Philosophical Investigations §445 and Davidson’s roughly parallel account in his paper ‘What is present to the mind?’and hence are, of necessity, conceptually articulated. It is a contingent fact that we can self ascribe such states but not that they have the satisfaction conditions they do. This is our vocabulary for discussing intentional states. It is also of some use with some animals. To deny that animals have thoughts would thus be to deny that it had the use it does have. But the usual distinctions that comprise the whole framework do not apply well to animals. We should not, however, boggle over what they are really thinking.)

Placebo Workshop MMU

I have spent the day at a workshop on placebo organised at MMU by Phil Hutchinson and Michael Loughlin. I came to the workshop because it is an area about which I know nothing but obviously ought to.

Dan Moerman kicked off and pushed a particular minimal line. Placebos are inert substances. So although they seem sometimes to have effects, it isn’t because of the placebo because they are, by definition, inert. So why? He suggested that this might be a matter of regression to the mean because of homeostatic mechanisms. Or natural history: the resolution of viral colds in about a week. But these are some cases which do not reduce to those. Since in his phrase ‘there is never nothing going on’ in such cases he suggests that there is a ‘meaning reaction’.

He then proceeded to outline his favourite dozen or so published studies of meaning responses. These included cases where cases where patients were given doses of pain killers, some knowing and some not. In such a case, there was no placebo and hence could be no placebo effect. But there was a meaning response. In other cases, a drug that blocks opiates also blocked meaning-response reductions in pain, too. Perhaps most helpful for me was a study in which stomach ulcers were cured through a meaning response. In other words meaning responses (or placebo effects if one speaks that way) need not be merely mental.

Catherine Blease extracted some ideas of what placebos and placebo effects might be from the recent philosophy of science literature. She favoured an idea based, I think, on an expectation response and then outlined an evolutionary theoretical account of why there might be such a response based on the idea that an evolutionarily selected mechanism connected to status detection and requests for help. I wasn’t sure whether this second element of the talk was supposed to be an independent explanation of an assumed concept or whether, additionally, it served as a condition of adequacy of any definition of placebo that such an account must be possible: an expression of a prior metaphysical commitment. Perhaps it didn’t matter.

David Teira asked whether the relevant contributions of different elements of the placebo effect could be measured, contrasting merely being on a waiting list, receiving a sham treatment, and receiving such a treatment with additional interpersonal factors. The gist of the presentation was that this could only be researched by a RCT in which social factors could be standardised. But from any perspective on meaning, there are reasons to hold this cannot be done. I was left with a kind of confusion about how surprising this should seem. It seemed to me that it relied on an implicit comparison between placebos and drugs and hence deploying the methods for assessing the latter to the former. But one might think of placebo effects merely negatively: as what disrupts the drug treatment RCT not as a something with a general pattern to be tracked. (I don’t think that there could be a RCT about the reasons why relationships break up. No talk of ‘the reasons’ would imply that they should generalise.)

Phil Hutchinson gave a paper which connected the placebo response to emotions. Both of which were meaning responses (he cited Moerman) pitched at a level higher than merely brute causation but lower than fully propositionally thought. One motivation was to avoid the worry that that latter position ruled out animal emotion. His positive suggestion was that there could be a middle ground in which humans or animals ‘take in’ the world but short of propositional thought. This had conceptual structure and involved taking it in under aspects. I had all the usual worries. What kind of concepts are involved given that various intensional differences won’t be available? And what is the aspect under which animals and people see the world if not ordinary concepts? All of this was more puzzling because Phil denied that thoughts have propositional structure. So I was less clear as to what analytic role talk of ‘concepts’ played.

An enjoyable day wrapped up with pleasant conversation over a beer in a micro pub, sadly a sweaty dash from the station afterwards.

Conference Announcement - Montgomery and Me

“Dear Colleague,

We are delighted to announce the attached conference hosted by the Collaborating Centre for Values-based Practice and the Nuffield Department of Surgical Sciences, Oxford

Confirmed Keynote speakers are

· Baroness Hale, Deputy President of the Supreme Court and one of the Montgomery judges · Professor Sir John Bell, Regius Professor of Medicine, Oxford University · Professor Jonathan Herring, Professor of Law, Oxford University

The conference aims to raise awareness of the importance of the Supreme Court Montgomery ruling on consent in healthcare and medicine

We would be very grateful if you would circulate the announcement through your own networks and forward this email to any of your colleagues to whom it may be of interest

Many thanks Jenette Sefton VBP Website Manager

Professor Bill Fulford Director of The Collaborating Centre for Values-based Practice, St Catherine’s College, Oxford; Emeritus Professor of Philosophy and Mental Health, University of Warwick

Professor Ashok Handa Director of Surgical Education, University of Oxford; Co-Director of The Collaborating Centre for Values-based Practice, St Catherine’s College, Oxford.”

Travis on seeing aspects

Two months of not being able to think or write (and making very slow progress on a chapter about the differences between McDowell and Wittgenstein on the harmony of thought and reality) may be coming to an end in some conversations with Peter Lucas initially inspired by a paper on aspect perception by Charles Travis called ‘Suffering intentionally?’.

Here’s a naïve way of thinking why Travis’ take on aspect perception might be interesting. The duck-rabbit is an ambiguous figure and one can see it as a duck or as a rabbit (and as a duck-rabbit, a Jastrow figure etc etc). One can see that it is all these things too. But it is also possible to experience changes in the aspect seen, perhaps best expressed by the spontaneous exclamation “Now it’s a duck!”. Given that, obviously (in two senses of that word), the figure does not itself change, it seems that the perceptual experience must change in some other way. Whilst Wittgenstein criticises the explanatory resources of any shifting inner image with differing ‘organisation’, it is tempting to think that there is an innocent account of the organisation of experience in which different elements of one’s conceptual repertoire are drawn on in the structure of experience itself when one takes in the differing aspects.

In the philosophy of science, NR Hanson concludes that all seeing is conceptually-articulated seeing-as. Stephen Mulhall claims that the point of the discussion of cases of changes in aspect is to illustrate the general nature of continuous aspect perception where the latter characterises our normal immediate response to words and to the world. I’ve never liked this because it seems to me that Wittgenstein makes it clear that the experience of aspect perception is contingent. It would be possible to be aspect-blind – ie not see shifting aspects even whilst able to judge that there is a duck and rabbit image in the picture – and hence changing aspects do not highlight the general nature of thought’s bearing on the world. Still, it is tempting to think that whatever is going on in aspect changes is a matter of the nature of the content of the visual experience. And hence it seems necessary to think that visual experience has some representational content to accommodate aspect changes. Travis famously rejects that claim, however, so what can he say about this?

Having sketched Wittgenstein’s rejection of an inner image to explain things, with the thought: ‘The inner image offers no better candidate for what a shift in looks consists in than the Necker does itself. It makes no progress.’ He gives part of his own positive view.

On my understanding of the Necker (perhaps not Wittgenstein’s) what changes in a shift is what is seen, ‘see’ here a straightforward perceptual verb, its object thus something there for one to see. For what I see to change here would then be for there to be a change in uptake – in what, there anyway to be seen, impressed me, was registered – under those special conditions the Necker poses, in which taking in one thing precludes taking in another. If this view of the Necker is correct, then I may say, ‘I see the A-cube’, if that is what I am doing, using ‘see’ as a straightforward perceptual verb. [ibid 51]

The first element of this is that Travis offloads the two aspects onto a feature of the world: the ambiguity of the picture. This stems from something I have often forgotten:

The thing to remember is that the rabbit, the duck, the tiger or the yacht difficult to pick out among the mass of dots, are, first of all, images in pictures, and, second, things which are there to be seen. [ibid: 48]

We are not talking about seeing actual ducks and rabbits. In this context it may seem illicit to appeal to the intentional properties of pictures but I don’t think it is. Pictures only depict on the basis of background practices – as Wittgenstein stresses using examples of signposts – but assuming those practices, then there are looks or appearances there to be noticed (for those with eyes to see).

So the first clue to an account of aspect perception which denies that perceptual experiences have content is that there is ambiguity in what is there in the world to be seen. The pattern of lines making up the Necker cube or the duck rabbit is there to be seen but so is the image / picture of a cube, duck or rabbit. The duck-rabbit really does look like a duck and look like a rabbit. Both of those looks or appearances are there in the cunningly constructed figure and so both are there to be seen.

Two (related) things are distinctive about the Necker (and the duck–rabbit, the black/white cross, etc.). First, while it provides us two different things to see, it does this while occupying a given location, and providing us the same thing at that location to be seen (or missed) no matter which of the two options we take up. At that location is a pattern of lines. It remains the same where we see the A-cube and where we see the B-cube. And (unless we miss it, hence see neither cube) that occupant of the location is something we do see throughout. [ibid: 52]

But that is only part of the solution because it has yet to accommodate the fact that, at any particular instant, the visual experience of looking at such figures is not ambiguous. The figure is experienced as a duck (not that Travis deploys the word ‘as’ to mark this). The passage continues:

Second, in this case, seeing the one thing (the A-cube, say) excludes seeing the other. The exclusion lies in the seeing: what is there to be seen leaves either option open. So the question is how seeing can impose a choice between these two. Here, clearly, uptake is all. Our responses to what we are presented with visually must choose what kind of visual experience we have, or what it is of. Without varying what we are presented with, our responses, or uptake, might make what we see either of two things. [ibid: 52]

Given that the worldly object does not change, the change has to lie on the side of the subject or agent in their ‘uptake’, or in what they ‘register’. But this idea is also put under tension in Travis’ account because he stresses here, as in a number of other papers, a distinction between seeing construed as a perceptual verb and seeing-that as an expression of thought or judgement.

But, as Frege noted (1897: 149; 1918: 61), ‘see’ has non-perceptual uses. When we say, for example, ‘He sees that that flower has five petals’ (one of Frege’s examples), ‘see’ is not used to report perceptual awareness. One way to see this is to note that, while the petals are on the flower in the garden, and from thence form images on retinas – they are that sort of thing – that the flower has five petals is not in the garden. Nor is it on the kitchen table. It is not the sort of thing to be located, a fortiori, to form images on retinas. Rather, it is the sort of thing one recognises by exercising capacities of thought. In thought, one can represent the flower as falling under a certain generality; as being a certain way there is for a flower to be – five-petalled. [ibid: 46]

Elsewhere, he suggests that ‘recognition’ is ambiguous between two senses. One is to re-cognise the same individual. The other is to make a judgement that an item is sufficiently alike others to count as an instance of a generality. Again, these divide between perceptual and non-perceptual seeing.

The distinction between perceptual seeing and thought or judgement seems threatened by cases of aspect perception.

As I read Wittgenstein, he is developing reasons for caution in how we appeal to responses here, or in just what in responses might do that selecting which, patently, is done. Where ‘see as’, read non-perceptually, adds something to what would be said here in the simple ‘see’, prima facie, at least, that something is not something appeal to which would do the needed selecting. So, for example, I may see how it could be a diagram of an A-cube, or see it to be, or see it as one (as Sid may see Vic as a rival). But that sort of uptake, if it belongs to what is added in seeing-as – an addition purely in thought, on a par with recognising what I see as the cube on the exam yesterday – cannot be what distinguishes seeing an A-cube from seeing a B-cube in looking at a Necker. If uptake does the choosing, then I see the A-cube just where I am responsive in a given way to what I see. For me, things are, visually, just as they would be in seeing the A-cube. Such is an attitude on my part. But it is not the same as seeing that such-and-such, nor seeing the Necker as such-and-such, where ‘see-as’ does not speak of perceptual awareness. [ibid: 52]

The most obvious ideas for an uptake, for what is made of a visual experience, is a form of judgement or thought (and hence the second form of recognition). But that cannot be the distinction between the two aspects as one can judge that the duck-rabbit can be seen as a duck even whilst having the rabbit aspect. Subsequent judgement of that sort cannot explain how the aspect is fixed at any given moment. In aspect perception it seems that the experience is a matter of object perception not of judgement.

In fact, contrary to popular usage, Travis doesn’t use ‘seeing-as’ to signal aspect perception. He suggests instead (aside from some cases of illusion) that seeing-as denotes the judgement or thought made on the basis of a properly visual experience.

Obviously, though, Wittgenstein is not thinking of such uses [ie. cases of illusion] of ‘see as’ (whether he allows them or not). The particular case he mentions is seeing the rabbit–duck as a rabbit. This is not to be a matter of seeing the rabbit-likeness. It is not a matter of visual awareness. So it is not to be classed with seeing convex as concave; nor with the sort of Necker-like switch one experiences when he finally gets what he knows ought to be a rabbit–duck to look like the rabbit, and not the duck. So, presumably, it is something which may occur or not no matter which way the picture looks to the viewer at the moment. Someone might say, for example, ‘The funny thing about this rabbit picture is that, sometimes, if you screw your eyes up right, it looks just like a duck-picture.’ Someone who said that would be one who took the picture for, classified it as, a rabbit picture. This, of course, is a way of thinking of it, and not a form of visual awareness. [ibid: 57]

Given that neither seeing that nor seeing as will do to mark the nature of the uptake that transforms a properly visual experience, it is hard to know how that notion can be characterised. But if I follow the line of thought, this is part of the point.

It is thus, I think, that the Necker and its kin serve as a stepping stone to a range of further cases. Of some of these, at least, Wittgenstein makes the following remark: 
Here one must guard against thinking in traditional psychological categories – say, decomposing experience into seeing and thought; or things of that sort. (LW I 542) 
This ‘here’ refers to a particular kind of case (or several). It is not as though, for Wittgenstein, Frege was wrong to distinguish between seeing and thinking as he did. An ordinary case of seeing is just that, seeing. It is not thinking. Its objects are fundamentally different: in one case, a pig chewing turnips (an episode taking place at a particular location in history); in the other that the pig is chewing turnips, something without location, either temporal or spatial (though what it represents as some given way is the way things are at a time, and, perhaps, a place). But there are special cases of the use of ‘see’ such that something speaks in favour of regarding them as perceptual uses, something in favour of regarding them as not perceptual; and in such cases, Wittgenstein suggests, the urge to choose should sometimes be resisted. [ibid: 52-3]

One such example is seeing a similarity between two faces which Travis suggests is a matter of seeing a look which a face can have, something there to be seen. Is the difference between seeing and not seeing that look a difference in visual experience? Travis suggests that there are reasons for answering both yes and no. He suggests that to represent what is seen may involve a kind of distortion, not just sketching again the two faces in question. It will involve a representation that has to be understood a particular way: a mark of judgement or thought. Such seeing not only registers what is visually there but also brings conceptual generalities to bear. And yet it seems as though the look itself is directly visually present as an object. It distorts Frege’s distinction.

Still I am confused by the nature of the uptake needed since any attempt to fill it out seems destined to tip it into non-perceptual seeing that. There is one further example: staring at a kitchen counter and not seeing some keys there and then suddenly noticing them. Although this thus allows subsequent judgements or thoughts, Travis comments that ‘my new awareness is just of what it is that history furnishes to do the instancing’. This makes this a case of perceptually seeing. But what is the difference between not seeing and then seeing the keys in this case? What is the uptake captured in the ‘new awareness’ given that it is not framing judgements?

It now seems to me that Mulhall and Hanson offer an explanation of aspect-seeing which overly domesticates the phenomenon. Indeed, a feature of their accounts is that it is ubiquitous. Travis, correctly in my view, suggests that it is a special case and also offers a kind of explanation of why it is, pre-philosophically, an odd experience. The sense that there has been both a change and no change. But it is less clear what his account of the phenomenon itself is.

Travis, C. (2015) 'Suffering intentionally?' in Campbell, M. & O'Sullivan, M. (eds.) Wittgenstein and Perception, London: Routledge

18th INPP conference: Psychopathology of the Present: theory and practice. São Paulo (Brazil), November 3rd to 5th, 2016

Here is a link to this year's International Conference on Philosophy, Psychiatry and Psychology. Its theme/ title is Psychopathology of the Present: theory and practice.

São Paulo (Brazil), November 3rd to 5th, 2016.

International Graduate Conference in Philosophy 2016: Madness, Disorder, and Society, University of Essex

Another conference announcement, this time sent by Robert Chapman at Essex. The website is here.

International Graduate Conference in Philosophy 2016: Madness, Disorder, and Society

We are pleased to announce that the theme for this year's Essex International Graduate Conference in Philosophy will be 'Madness, Disorder and Society'. The conference seeks to bring together different philosophical perspectives on madness and disorder, especially when considered in their social contexts. It will be held on 7 May 2016, and keynote addresses will be given by Derek Bolton (Kings College London) and Lorna Finlayson (University of Essex).
Location: University of Essex, Colchester
Date: 7 May 2016

Keynote speakers
Professor Derek Bolton (Kings College London)
Dr Lorna Finlayson (University of Essex)

Call for papers

The mad have always challenged society. Beginning in the 1960s, however, the anti-psychiatry movement began to systematically confront psychiatric institutions and their wider social contexts by raising what were essentially philosophical questions. This movement challenged the validity of psychiatric diagnosis, the purported boundaries between the sane and the insane, and the very idea of mental illness.
In turn, psychiatry hit back, adopting a biomedical, evidence-based approach and an ever-increasing standardisation of psychiatric classifications. This has given rise to a new paradigm regarding how we understand the mad and the disordered, and today there are now more psychiatric classifications than ever before.
Nonetheless, in more recent years the neurodiversity movement has called for a full affirmation of a wide array of natural variance in human functioning. This more radical move challenges deeper assumptions regarding both what it means to be human, and in turn to function or flourish as such, in a way that may undermine even the biomedical approach designed to avoid these very issues.
From a more top-down perspective, further questions arise. Most notably, if we are mistaken in some way, about the pathological status of the mad and disordered, this further calls into question the status of those considered normal. From Nietzsche to critical theory, thinkers have suggested that it may in fact be that society is sick, and that at least some of those who fall outside its norms may have good reason to do so.
Lastly, on the ground level, an ever-increasing number of dangerous designer drugs and bizarre therapies are now produced and sold in order to restore those on the outskirts back to the realm of normalcy. This raises yet further ethical questions regarding both the treatment of those considered mad or disordered, and in turn the institutions that profit from them.
We seek high quality abstracts (200-500 words) which speak to the conference themes. Topics could include, but are not limited to:

• Topics in the analytic philosophy of psychiatry
• Foucaultian perspectives on madness
• Neurological difference in Classical and non-Western philosophy
• Psychiatric models for understanding society and/or social critique
• Social Pathologies
• The rise of neurodiversity
• Phenomenological approaches to madness and disorder
• Relevant topics in medical ethics (e.g. regarding anti-depressants, etc.)
• Autonomy, responsibility, and mental disorder
• Feminist perspectives on mental disorder
• Freud and Nietzsche on civilisation and its discontents

We will accept papers from current or recently completed graduate students working in philosophy. Interdisciplinary work is encouraged, although theses must, ultimately, be of a philosophical nature. Abstracts and questions should be sent topygradc@essex.ac.uk by 12:00pm on 10 February 2016.
Location and accessibility
The conference takes place at our University's Colchester Campus. Colchester is an hour away from London by train.
Deadline for applications: 12.00pm, 10 February 2016
Contact: pygradc@essex.ac.uk

Conference - Does the philosophy of psychiatry need a metaphysics? 3rd June, University of Lancaster

Here is notice from Dr Rachel Cooper of a conference at the University of Lancaster and also, for those in the neighbourhood, a preliminary reading group.

Conference - Does the philosophy of psychiatry need a metaphysics? 3rd June

Much recent work in the philosophy of psychiatry has presupposed some metaphysical framework or other (eg pragmatism, realism, a McDowellian or Wittgensteinian approach). This conference brings together the authors of a number of influential recent books to consider the extent to which work in the philosophy of psychiatry requires the assumption of a metaphysical framework. Speakers will speak from Wittgensteinian, McDowellian, Realist and Pragmatist perspectives. The following speakers have agreed to participate:

Prof Derek Bolton (KCL) (author of Mind, Meaning and Mental Disorder, 1996)
Dr Rachel Cooper (Lancaster) (author of Classifying Madness, 2005)
Prof Tim Thornton (UCLAN) (author of Essential Philosophy of Psychiatry, 2007)
Prof Peter Zachar (Auburn) (author of A Metaphysics for Psychopathology, 2014).

The aim of the conference is to consider whether the key claims of each writer could have been made without the controversial metaphysical assumptions that they in fact employ.
Work in the philosophy of psychiatry is perhaps marked more by metaphysical disagreements than is work in the philosophy of many other special sciences. However, similar issues have also arisen in other areas. Professor John O’Neill (Manchester) will act as a commentator and speak about the ways in which disagreements regarding basic metaphysics have impacted on the areas in which they work (environmental philosophy).

Reading group

The associated reading group will read the books that will be discussed (having read the books won’t be essential for understanding the conference, but will make it better). To get through the books we need to get going! This term we will be reading Peter Zachar’s book A Metaphysics of Psychopathology, and Tim Thornton’s book Essential Philosophy of Psychiatry. We’ll meet on Fridays at 3pm in County South B35 (starting 15th Jan). For Friday 15th Jan we’ll be reading the introduction, and Ch 1 and Ch 2 of Zachar’s book. (you can get these chapters from Google books)

Rachel Cooper
Senior Lecturer in Philosophy
r.v.cooper@lancaster.ac.uk