Many psychiatric disorders involve problems with the recognition and preservation of personal boundaries. Philosophy can help to clarify what is at stake, both socially and phenomenologically, in drawing such boundaries. In particular, assignments of responsibility and determinations of loss are deeply implicated in the determination of personal boundaries. Understanding these implications can help make sense of the volatile emotions of borderline personality disorder, for example, and it can clarify what is missing from DSM descriptions more generally.
Could psychoanalysis be a science? There are three ways of reading this question. First, is psychoanalysis the kind of investigation or activity that could, logically speaking, be "scientific"? If we can defend a positive answer here, then it makes sense to ask, second, is psychoanalysis, in the form in which it has traditionally been practiced, and continues to be practiced, a science? If there are good reasons to doubt its credentials, then we might ask, third, is psychoanalysis able to become a science? This is a question about what is needed for the necessary transformation. The chapter argues that psychoanalysis can be a science, but that the historical debate raised important challenges to its methodology, viz., confirmation bias, suggestion, and unsupportable causal inference. The chapter argues that recent developments meet these challenges, and concludes with some reflections on the interdisciplinary nature of psychoanalysis.
Grant Gillett and Rom Harré
The discursive approach to psychiatry, taking as it does an ethological approach to the human organism, directs us to rules and story lines that structure our ways of dealing with the challenges thrown up by particular situated positions in our discursive world. For human beings this means engaging with the sense they are making of the world and the words they use to try and communicate that (to themselves and others). Doing things with words is behavior that draws on certain skills attuned to prompts, cues, expectations, and so on, all of which can go seriously awry in any setting where certain features are unfamiliar or where one of the participants is "impaired" or out of step with prevailing norms and assumptions. Discursive competence and the reality of the human psyche as a mode of being-in-relation-with others crucially depends on intact neural function and brain pathways slowly and cumulatively developed throughout life and is vulnerable to disruption of that substrate. Hysteria (or conversion disorder) and dementia represent two very different situations in which the discursive mismatch between an individual and his or her context of being causes the voice (and soul) of a person to be "lost in translation" so that understanding what is happening and then care and restoration demand a great deal of us not just as biomedical scientists but also as human beings who are reaching out to those who suffer and try to endure (patients) so as to help hold them in being.
Kathleen Y. Ritter
When counselors can appreciate the unique life circumstances that lesbian, gay, bisexual, and transgender clients bring to the group experience and have the skills to lead the group through its many transitions, growth can occur for every individual involved. Understanding the concepts of oppression, minority stress, and cohort and developmental differences provides a context for effective and ethical group facilitation. This chapter briefly reviews the existing literature related to sexual minority group members as well as examines relevant guidelines, principles, competencies, and ethical codes of several professional associations. Other concepts discussed include group composition, leader sexual orientation, group management, sexual minority members and group dynamics.
William T. O'Donohue and Kyle E. Ferguson
Behavior therapy is heterogeneous and parallels what Wittgenstein called “family resemblances,” as it is impossible to delineate necessary or sufficient definitional criteria for what constitutes behavior therapy or cognitive-behavioral therapy. Since its infancy, behavior therapy has been sometimes associated with one or more forms of behaviorism, the basic learning and/or cognitive principles, and a grab bag of practical ideas, as well as the varieties of problems it endeavors to solve, among many other complex relations. Behavior therapy has become increasingly intricate as it matures and, to some extent, has developed into what Kuhn (2001) termed “micro-communities.” Subcommunities within behavior therapy employ different concepts, point to various influences, utilize different research methodologies, prioritize different problems, and incorporate diverse clinical strategies into routine practice. This chapter provides a general overview of the theoretical and philosophical underpinnings of behavior therapy.
Robert K. Conyne
Abstract This chapter’s two tables present illustrative markers of prevention events that have occurred within counseling psychology and within prevention per se. These markers are addressed selectively in the chapter’s narrative, which is organized sequentially as follows: (1) “Early Antecedents”; (2) “A Decade of Fomentation: The 1960s”; (3) “Prevention Emerges in the 1970s”; (4) “Prevention Expands: 1980s–Current,” with attention to 1980–1989, 1990–1999, 2000–2010; and (5) “Future Directions.” The thesis is that prevention in counseling psychology remains an artifact of hope. Although impressive scholarly production has occurred at an increasing pace since around 1985 and the Society of Counseling Psychology has formalized its support of prevention through its Prevention Section, “real world” demonstrations of gains—through training curricula, research, and employment—suggest that prevention remains still on the outside looking in. Yet due largely to the noticeable increase in prevention professional literature and to passage of health care reform legislation, the time for prevention in counseling psychology may finally have come—though we should be mindful that we’ve heard that refrain sung before.
Daniel D. Hutto
Getting clear about the nature and basis of interpersonal relating is a central concern of many recent debates in the philosophy of mind. The first section of this chapter highlights some basic facts about the complexity and multifaceted character of interpersonal relating and briefly overviews some of its most prominent dysfunctions. Popular mind-minding hypotheses which claim that the dysfunctions in question are rooted in impaired capacities for attending to and attributing mental states to others are then introduced. Next, recent evidence from cognitive psychology and neuroscience with which these mind-minding hypotheses must be made compatible is summarized. The important differences between two main philosophical frameworks-frameworks that offer opposing ways of understanding the nature of mind minding capacities are then highlighted. Focusing on these differences, the final section highlights how adoption of these philosophical frameworks matters to thinking about the prognosis and strategies for the treatment of certain mental disorders.
This chapter suggests that, when considering the philosophical problem of other minds, we distinguish between "thick" and "thin" versions of it. While traditional approaches take the problem to be a thick one, more recent work can be seen as addressing only a thin variant. Dretske, while acknowledging the thick problem, proposes a perceptual model of our knowledge of other minds which addresses only the thin version. The chapter proposes that, in the place of the thick problem, we consider the quality of our interactions with others. Following Wittgenstein, it suggests that where individuals share a nature their interactions exhibit a quality that it calls "depth." Where that nature is not, or is only partially, shared, there one might expect to find the quality of the interaction between persons disturbed. The chapter suggests that this disturbance might explain the impaired quality of interaction between autistic and non-autistic individuals.
Thor Grünbaum and Dan Zahavi
This chapter argues that explicit (reflective) self-conscious thinking is founded on an implicit (pre-reflective) form of self-awareness built into the very structure of phenomenal consciousness. In broad strokes, the argument is that a theory denying the existence of pre-reflective or minimal self-awareness has difficulties explaining a number of essential features of explicit first-person self-reference, and that this will impede a proper understanding of certain types of psychopathology. The chapter proceeds by discussion of a number of prominent theories of self-knowledge and self-reference relating them to forms of self-consciousness. It is then argued that getting these various relations right is important to a proper understanding of a number of psychopathological phenomena.