Home Congressen - De jonge psychiater Too mad to be true II – The promises and perils of the first-person perspective

Organisator

Stichting Psychiatrie en Filosofie
Email
info@psychiatrieenfilosofie.nl
Website
https://www.psychiatrieenfilosofie.nl/
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Datum

27 - 28 mei 2023

Tijd

Gehele dag

Too mad to be true II – The promises and perils of the first-person perspective

In September 2021, we held the first Too Mad To Be True conference that was dedicated to exploring the various links between philosophy and madness. Because of its vibrant atmosphere and the way it initiated new ways of thinking and communicating around issues of madness and philosophy, we organise a second edition – and do a call for papers – with a new central theme that is both relevant to philosophical and mad theories and practices: ‘ The promises and perils of the first-person perspective’.

 

Accreditation for Dutch and Belgian psychiatrists is being applied for.

 

Introduction

Subjectivity and the first-person perspective have become central and popular ideas in various disciplines, such as philosophy, psychiatry, psychology and in psychopathological research. This popularity is due to several reasons. Firstly, in scientific research, a revaluation of the first-person perspective is claimed to lead to more sophisticated diagnostic approaches and explanatory models that would be better informed by the phenomena they seek to explain. For example, common-sense views of psychosis — e.g., hallucination as mistaken perception, delusion as false belief — could be challenged and corrected by a more explicit focus on the subjective experience of psychosis. Secondly, in psychiatric practice it is argued that more attention to the first-person perspective would improve empathic understanding of the difficulties patients concretely experience which in turn would contribute to a better therapeutic relationship. Thirdly, from the perspective of patient groups, there has long been a similar demand for using so-called ‘experiential knowledge’, i.e. knowledge grounded in first-person experience, to empower patients and improve mental health care and self- care.

 

Despite this convergence by the well-willing regarding the importance and value of the first-person perspective, different sorts of critical questions can and should be raised. For example, is it really that straightforward what the first-person perspective contains, what methods should be employed to examine it, and who is authorized to do so? In this regard, phenomenological approaches are sometimes criticized for taking an unwarranted expert position that would sideline the concrete voice of patients. Furthermore, what are the nature and limits of experiential knowledge? When does the first-person perspective offer not so much a clarification of phenomena but rather a philosophical or even ideological fallacy? For example, the analytic tradition of Wittgenstein has traditionally been critical of the exclusive focus on “experience” to understand concepts such as self, action, free will – how does such criticism relate to the tradition of phenomenological psychopathology? In addition, in most philosophical strands after phenomenology proper (e.g., materialist and poststructuralist thought), a similar skepticism can be found surrounding the constant focus on the ‘I’, ‘ experience’ and ‘consciousness’ which would relegate the concrete material conditions of people to the background. What implications do these theoretical decenterings and deconstructions of subjectivity have for modern psychiatric discourse around first-person experience?

Keynote speakers

Robert Chapman (Senior Lecturer in Education at Sheffield Hallam University)
Sam Fellowes (Lecturer in Philosophy at the University of Lancaster)
Phoebe Friesen (Assistant Professor in the Biomedical Ethics Unit at McGill University).
Alastair Morgan (Senior Lecturer Mental Health/ Critical Theorist at the University of Manchester)
Elizabeth Pienkos (Assistent Professor in Psychology at the Clarkson University, New York)
Richard Saville-Smith (Independent scholar at the Isle of Skye)
Angela Woods (Professor of Medical Humanities at the Durham University)

Registration and tickets

Online participation: € 20,00 + € 1,00 administration.
Participation in person + lunch/drinks (students) € 40,00 + € 1,00 administration.
Participation in person + lunch/drinks: € 80,00 + € 1,00 administration.
Participation in person + lunch/drinks (psychiatrists + accreditation available): € 120,00 + € 1,00 administration.
(Donors of the Stichting Psychiatrie en Filosofie receive 15% reduction)
Ticketshop, click here

Call for papers

In this second edition of the Too Mad to be True congress, we aim to further develop and question the promises, limits and risks of the first-person perspective through invited presentations by international keynote speakers and an open call for papers for interested researchers. Possible themes for the presentations include the following non-exhaustive list:
  1. What is the importance of the first-person perspective in philosophy, psychiatry and scientific research? How can diagnostics, explanatory models, and treatments be informed and improved by taking this first-person perspective into account?
  2. What is the first-person perspective? Is it related only to concepts such as the “self,” “consciousness,” “subjectivity,” and “lived experience,” or should it be understood more broadly through a focus on language, intersubjectivity, or unconsciousness?
  3. How can the first-person perspective be explored? What are the possibilities and limits of phenomenological methods? How does the transcendental ambition of phenomenological philosophy relate to the concrete experience of everyday life?
  4. What is the nature of subjective experience in various forms of madness: e.g., in psychosis, autism, depersonalization, obsessions, …? For example, is psychosis just about an altered “experience,” or is there more at stake? And, to what extent are psychotic, psychedelic, mystical or religious experiences comparable?
  5. What are the nature, possibilities and limits of ‘experiential knowledge’?
  6. What critical questions can be raised about the focus on ‘subjective experience’ from various philosophical movements after phenomenology (e.g., Wittgenstein, Deleuze, Lacan, Foucault, Meillassoux)? What implications do these critiques have for psychiatric research and practice?
  7. Finally, and related to the next caveat: How do discourse, concepts and experiences, of madness on the micro level of phenomenology, psychology and psychiatry relate to the madness on the planetary level?

Mad world caveat

Around conferences like this we are used to apply the predicate of madness to individual and, at its most, to group level instances. However, when we consider the state of the world in our times, we cannot deny that humanity as a whole with respect to its planetary self-destructive tendencies counts as a prime candidate for this predicate. And, although we have an agnostic and detached stance with respect to the desirability of ‘madness’ as a theoretical concept or individual experience, we do not appreciate, let alone want to stimulate, its planetary destructive aspect. Therefore, we would like to urge all those who consider to attend this conference, to do this in a ecologically friendly way. Please, consider your way of attending the conference, in live presence or online, and if you attend live, please consider your means of transport.

Practical information

  • Date: 27-28 May, 2023
  • Location: Ghent, Museum dr. Guislain
  • Call for Papers: Please send us your abstract and a short bio, in max 400 words, before April 1, via: info@psychiatrieenfilosofie.nl
  • Registration: to be followed. Both for speakers as for participants there will be both an online attendance option and a physical attendance possibility
  • When you want to receive more information, send us an email, info@psychiatrieenfilosofie.nl, and we put you onto the list for our newsletter

 

Organisers

University of Ghent, Jasper Feyaerts
Foundation for Psychiatry and Philosophy, Wouter Kusters

Information keynote speakers

Sam Fellowes 

I am an autistic philosopher of psychiatry who is based at Lancaster University. I am interested in the ontology and epistemology of psychiatric diagnoses whereby I portray psychiatric diagnoses as idealised models. I am interested in understanding how expert-by-experience involvement in psychiatric research relates to scientific models and the theory-laden nature of evidence. More info: https://www.samfellowes.com/about-me/
Title: How the lived experience of experts-by-experience relates to the abstract nature of science

Abstract: One key justification of experts-by-experience being involved in psychiatric research is lived experience. An expert-by-experience has experiences which others lack. This means they can contribute unique data which other individuals cannot provide. As such, there is good reason to include experts-by-experience within psychiatric research.

    However, significant parts of science involve abstracting from the data to create idealised models that do not accurately reflect the world. For example, physics includes models like frictionless planes, ideal gases and perfectly spherical objects which abstract away parts of the world. Psychiatric diagnoses are themselves idealised models that do not reflect particular people. They are generalisations that abstract away many aspects of particular people by not covering aspects of the individual like past life experience, present life situation and future life goals. A particular psychiatric diagnoses also abstractly join together aspects of different individuals since diagnoses typically cover many more symptoms than any particular individual with the diagnosis actually exhibits.
    I argue that abstract scientific elements are already present when experts-by-experience draw upon lived experience. For example, if an autistic person gives a description of what it is like to be autistic we are, firstly, demarcating that person as being autistic rather than, say, schizophrenic and, secondly, the person is interpreting some experiences as being instances of autism. As such, abstract scientific elements are present when an expert-by-experience uses lived experience to provide data. This means lived experience is not unmediated but is influenced by abstract aspects of science.
    I then consider what role experts-by-experience should play in formulating abstract science. Abstract scientific models are typically formulated by abstracting away parts of the data using general modelling principles. Experts-by-experience cannot directly use lived experience to decide which data to abstract away and how to model the remaining data. The data itself does not show which data needs abstracting away. I suggest that experts-by-experience should approve of typical modelling techniques for abstracting data which are typically employed within science and psychiatry. This significantly constrains which views of experts-by-experience should be considered scientific.

Phoebe Friesen

Phoebe Friesen is an Assistant Professor in the Biomedical Ethics Unit and Department of Social Studies of Medicine at McGill University. Trained as a philosopher, she has broad interests in research ethics, philosophy of science, and bioethics, and often utilizes qualitative research in her work. Currently, she is working on projects that consider moral dimensions of the placebo effect, community involvement in research ethics governance, and participatory research in psychiatry.
Title: Psychosis and Psychedelics: Historical Entanglements and Contemporary Contrasts
Abstract:    Experiences of psychedelics and psychosis were deeply entangled in scientific practices in the mid-20th century, from uses of psychedelic drugs that could model psychosis, to detailed phenomenological comparisons of endogenous and drug-induced madness. After the moral panic of the 1960s shut down psychedelic research, however, these two phenomena became disentangled. In the decades following, the science of psychosis transformed, shedding the language of psycho- analysis, and adopting the new scientific veneer of psychiatry. Today, as psychedelic science re-emerges, the research programs surrounding psychosis and psychedelics now stand in stark contrast. In this talk, I look closely at how these research programs respond to questions related to what is worth measuring, what is worth investigating, and how we ought to respond to these experiences. This comparison reveals radically different assumptions and values that guide each research paradigm and shape clinical practice. While psychedelic research often includes scales that seek to capture experiences of mysticism, meaningfulness, and ego dissolution, research related to psychosis focuses on the measurement of pathological symptoms and functioning. Research into psychosis primarily seeks universal and reductionist causal explanations and interventions, while psychedelic research embraces the importance of set and setting in shaping unique experiences. Responses to psychedelic crisis involve warmth, compassion, and support, while responses to psychotic experiences often involve restraint, seclusion, and weapons. I argue that these differences contain important lessons for psychiatry. However, as psychedelic research struggles to meet regulatory requirements and fit within the paradigm of evidence-based medicine, these differences may quickly dissolve.

​Alastair Morgan

Alastair Morgan is a Senior Lecturer at the University of Manchester, UK. His most recent book is Continental Philosophy of Psychiatry. The Lure of Madness, published with Palgrave MacMillan in 2022.
More information can be found here.
Twitter: @morgan_alastair

Title: Interpretation as attention to difference
Abstract: What are the ethics of approaching madness from the “outside”, from the experience of one who has never been mad? Does the authority of lived experience mean that any interpretation of madness from the safe realm of reason becomes a form of violence? Can there be an account of madness that reconstructs and rescues a meaning from mad experiences or is such an account always an exclusion, a silencing of madness?
This central question of the possibility of understanding madness without dissolving its otherness is the paradox within which continental philosophy dwells in the twentieth century and one that I outline in my recent book on Continental Philosophy of Psychiatry.
In this talk I will use Adorno’s concept of negative dialectics to try and defend a concept of interpretation as attention to difference. A practice of interpretation as care respects a final opacity of experience. The experience of madness can never be completely subsumed by reason or rendered as finally translatable. However, any interpretation from the “outside” will inevitably involve an ineliminable context of violence. Such a context needs to be reflected upon and not disavowed.

 

​Elizabeth Pienkos

Elizabeth Pienkos is a licensed clinical psychologist and an associate professor of psychology at Clarkson University in Potsdam, NY. Her research focuses on the phenomenology of schizophrenia and other psychotic disorders. Her recent work includes studies of self- and world-experiences in schizophrenia and depersonalization disorder, the phenomenology of early motherhood and postpartum psychosis, and pandemic-related changes in interpersonal and self-experience.
More info see here
Title: On the understandability of psychosis: Pushing the limits of phenomenological psychopathology

Abstract: Karl Jaspers’s famous characterization of primary delusions as “un-understandable” or incomprehensible has been widely discussed and debated. His definition of understandability points to whether a new experience or symptom can be empathically understood as a development of the personality, or whether it represents a fundamental change to the personality structure. Recent movements in phenomenological psychiatry have demonstrated the ways that psychotic forms of experience can be understood, and at least partially explained, as reflections of a disruption of the basic or minimal self, considered to be the foundation or locus of first-person experience. But many go on to suggest that this understanding is limited, and that schizophrenia does not arise from understandable psychological motivations. Instead, there is a tendency for pathogenetic explanations in this field to look to neurobiological mechanisms of causality.

In this talk I will discuss the capacity of phenomenology to uncover any possible psychological motivations of psychosis, especially considering the resistance to meaning that can be inherent in psychotic experience. Despite phenomenology’s important contributions to making psychosis understandable, I propose that this approach to psychopathology should pay greater attention to the ununderstandable of human life—that which is fundamentally resistant to articulation and intersubjective understanding in subjectivity. I propose that what is needed are phenomenologies of the unspeakable to orient us to this obscure territory. These may be most clearly located in feminist, critical, and psychoanalytic traditions, ways of thinking about subjectivity that fundamentally question the idea of a coherent speaking subject. Such work, I suggest, challenges phenomenological psychiatry to stay open to the possibility of deeper empathic understanding within the ununderstandable.

Richard Saville-Smith

Richard Saville-Smith’s three careers began with and were punctuated by madness. After seeking out the low risk routines of business management in London, followed by the high risk atmosphere of a campaigning public relations firm in Edinburgh, Richard found academia to be a goldilocks playground where ideas have consequences but the stress is less. With a PhD from the University of Edinburgh and based on the Isle of Skye, Richard now seeks to persuade philosophers and scientists to engage more effectively with religious studies as an arena of common interest, particularly in the role of mad consciousness and experience within the human story. His first monograph Acute Religious Experiences: Madness, Psychosis and Religious Studies was published by Bloomsbury Academic in March 2023.
Title: Resisting the ambivalent collapse from certainty to despair
Abstract:
“I am the way, the truth and the light” (Jesus)
“It’s me, I, I’m the problem, it’s me” (Taylor Swift)
The distance between these two subjective positions is vast. But it is possible to imagine them being held by the same person at different times. It is the process of ambivalent transition which interests me, particularly how mad subjects may invest in resisting the collapse, from the excessive position to the deficit position, by invoking strategies for going higher. That the intentionality of the subject is at work in this process is found in the fact that so many ‘psychotics’ are detained rather than voluntarily seek psychiatric assistance. In the West this relationship, between the mad subject and the sane medical establishment, has become entrenched as one of alienation precisely because the threat of being returned to normal can readily be perceived as a threat to the powerful certainty of madness. Describing this certainty as delusional is no more than a deflationary tactic because in spite of Western philosophy Pontius Pilate’s question ‘what is truth?’ remains as slippery now as when first spoken. Labelling of the other’s truth delusional may lack self-reflexivity about the constructed nature of the accuser’s reality, the presuppositions of which may also be subject to a legitimate mad critique. Where social acceptance becomes the criteria for judging normal, mad dissent may be better understood as resistance to orthodoxy rather than being merely wrong.
In this presentation, I am more interested in Jesus than Taylor Swift. Jesus is an effective case study, not only because his story is better known than the case studies of psychiatry, but also because his story predates psychiatry, rendering it anachronistic. My interest in the Jesus story is in how it demonstrates both the need and the capacity to go higher. As the realization that the public ministry of proclaiming the good news to individual is like emptying the sea with a bucket, the transfiguration represents a radical gear change in which systemic change is perceived as possible through an institutionally sanctioned death. From this perspective the role of cultural context in making this idea both plausible and possible can be clarified as Jesus plays the authorities to secure his ends.
This case study puts me in a position to refocus on the contemporary fact that, according to the not very good research available, 25% of those detained in the secure units of Western psychiatry articulate their experience in religious terms. This has consequences for any renewal of phenomenological psychopathology. If the metaphysical and, more importantly, epistemological consequences of being driven by the hand of God are un-understandable, however much epoché is undertaken, the motives of the individual to do their duty, maintain their certainty and resist being collapsed into the sad world of the anti-hero in Taylor Swift’s lyric will inevitably be misunderstood.

​Angela Woods

Angela Woods is a Professor of Medical Humanities and Director of the Institute for Medical Humanities at Durham University. From 2012-2022 she was the Co-Director of Hearing the Voice, a large interdisciplinary project on voice-hearing, and co-edited a major volume arising from this work entitled Voices in Psychosis: Interdisciplinary Perpsectives.

Title: First-Person Perspectives: Questions of Form

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