File Name: the philosophy and psychology of personal identity glover .zip
In order to understand the pathogenesis of autism, one needs to have an adequate framework within which to think about the nature of typical as well as atypical early human mental development.
Market , Pratanphorn Piriyakul-Frye.
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Interdisciplinary workshop on “mental disorder and self over time”
How is personal identity affected by changes in the self over the course of time? How does the experience of a severe mental disorder impact on an individual's sense of self and personal identity?
Do fluctuations in the self affect culpability for their actions? These questions are of interest to psychiatrists, philosophers, and legal scholars.
However, all too often they are studied from within disciplinary silos. We designed the workshop to be clinically relevant; approximately half of the 41 participants were clinicians. We aimed to create a collaborative and exploratory atmosphere, bringing together participants from mental health, philosophical, and legal backgrounds. This allowed us to explore issues in the philosophy of personal identity as they relate to the actual experience of mental disorder: to see what lessons clinical experience might have for this area of philosophy and to get philosophical input on questions of identity and selfhood that arise in clinical practice.
Specific disorders have their own particular patterns, which can affect sense of self and personal identity in different ways. The workshop was divided into six sessions, each focusing on a different disorder: dementia, affective disorders, bipolar, psychotic disorders, borderline personality disorder, and anorexia nervosa. In this paper, we summarize the talks and responses, giving a flavour of the discussion and drawing some general conclusions.
Five detailed papers, each based on one of the presentations given at this workshop, also appear in this issue, 6 , 7 , 8 , 9 , 10 and 3 papers on the workshop theme have appeared in the previous philosophy thematic. Juliette Brown, a psychiatrist specializing in General Adult and Older Adult Psychiatry in the East London NHS Foundation Trust, opened the day by asking how the experience of dementia affects an individual's sense of self and personal identity over the course of time.
She began by describing some of the apparent effects on selfhood and identity may accompany dementia and argued that, although dementia is often seen as synonymous with loss, the illness can also deliver remarkable insights into the capacity to navigate a fragmented identity, as well as reminding us vividly of the importance of a relational, interactive quality to identity. For those with personal experience of dementia and also within our wider culture, Brown explained dementia represents an archetype of loss of self and identity over time, which brings great sorrow and is rightly often met with horror, sadness, and shock.
Dementia forces us to confront the possibility of living with a fragmented identity and the extent to which we all rely on a notion of psychological continuity, presenting ourselves to ourselves as a coherent self over time and creating a fiction around consistency.
Moreover, dementia highlights the relational element of selfhood, as we witness the adaptive, socially constructed self diminishing through the disease and a second, experiential self, comes to prominence.
Psychodynamic insights might help us to understand the responses of people with dementia and their carers to their new realities and to support people with dementia to face the diagnosis.
Perhaps, then we can negotiate the altered sense of self and fragmentation and find creative ways to persist in our relationships with those with dementia. Agniesszka Jaworska, Professor of Philosophy at UC Riverside, took up the issues of discontinuity and fragmentation, asking what we should do about the conflict between the dementia patient's earlier and later self, when there is a mismatch between a patient's advance wishes and their current best interests.
The discussion centred on the topic of personality change and whether, for example, changes in behaviour constitute alterations of fundamental personality. Participants reflected on the extent to which continuity of identity diminishes and how far this is reflected in others' or the person's own view of themselves. Julia Bland, Consultant Medical Psychotherapist at the South London and Maudsley NHS Trust, began her presentation by suggesting that one central question in this area concerns how the formerly ill person now relates to themselves.
When fully recovered, there is a discontinuity between the sick and the well self, which must be accommodated, tolerated, and somehow made sense of. To explore these questions further, Bland took the audience through a brief history of ideas about the self including references herein 21 , 22 , She noted that there has been much emphasis within philosophy on the continuity of psychological features such as memory, beliefs, values, personality, and preferences as facilitating the continuity of the self over time.
Bland explained that she is persuaded by a theory according to which we have no static selves but are in a constantly fluctuating state of becoming and actively constructing ourselves, in a way that is dependent on the social environment.
Connecting these ideas to the therapeutic task, Bland moved on to the experience of the self in affective disorder. She noted that at the milder end of low mood, there may be no radical disturbance in the sense of self, unlike the terror of disintegration that is part of psychotic depression.
Part of the therapeutic work that can be done, she suggests, facilitates an adjustment to a new identity, which includes a vulnerability to a mood disorder, even if there is no discontinuity in the self. In her response, Jillian Craigie, an ethicist at King's College London, focused on a central idea in Bland's presentation that the healthy state is characterized by a continuity and coherence and mental ill health is characterized by a rupture in the self.
Velleman, rightly in her view, worries about the idea seemingly implicit in coherence models such as Harry Frankfurt's that problematic emotions those experienced as alien and not reflectively endorsed should be repressed.
Could our striving for coherence and consistency undermine our mental health? In close connection with Bland's ideas about the self, Craigie described how Velleman pushes back against monolithic notions of a true self that must be sustained over time, urging us embrace multidimensionality and complexity in our understanding of self.
This presents a model of developmental achievement that does not involve the resolution of inconsistency, as many philosophers would have us believe is the ideal.
The discussion that followed revolved around question whether the proposed discontinuity in the self in affective disorder was a difference in kind or simply in degree, relative to ordinary experience. Bland was asked whether any particular philosophers had helped her in this area and suggested that different ideas were helpful in different contexts but that no particular theorist stood out.
The disorder affected how she saw her past and future. She reassessed important events and periods of her life in the light of the diagnosis. She was no longer sure she could become the sort of person she had imagined she would be: a high flying career woman and, even more importantly, a mother. Dolman also explored how bipolar disorder fundamentally impacts identity. In particular, people with bipolar disorder see themselves differently during manic episodes than they do when they recall the episode from a euthymic state.
Does the lithium keep them who they truly are or does it subdue a version of themselves, and a more creative one at that? Bipolar disorder also impacts on the relationship between memory and identity. Dolman is particularly interested in how the passage of time affects one's perception of self. We all construct our memories, which cumulatively contribute to our developing sense of identity.
But people with bipolar disorder may interpret a formative moment differently depending on whether they are manic, depressive, or euthymic when they recall it.
So the process of constructing self through memory will be more complex for with bipolar disorder, as their minds accommodate traces of several different interpretations of every event, each loaded with emotional salience, which go on accumulating over time. As well as taking the medication, they need to come to terms with the need to take it, and it helps if they can somehow assimilate the condition into their identity and make it a positive as well as a negative.
Wayne Martin, Professor of Philosophy at the University of Essex, talked about how bipolar disorder can help us to understand personal identity, a key topic in philosophy. He distinguished between 2 framings of personal identity. On the forensic version, personal identity is a fact of the matter. We care about it because we use forensic identity to impute guilt for earlier actions, to enforce contracts on later selves, and to establish the legitimacy of advance directives.
Theories of what underlines forensic identity include bodily continuity and memory. On an existential understanding, personal identity is a task to be accomplished or a status. We care about it because an existential identity is a psychological need and a social requirement. On this understanding, achieving personal identity is a kind of work. Martin identified problems for existential identity.
The Problem of the End Point is that working towards personal identity presupposes some standards of success or failure, but what are these? He argued that we can get clues to the answers from bipolar disorder. Regarding the Problem of the End Point, achieving personal identity requires making sense of the episodes as parts of a whole.
Although it is superficially appealing, sufferers feel emotions like shame and regret about episodes once they have passed, which suggests a continued sense of identity between the different phases. Eduardo Iacoponi, Consultant Psychiatrist at the South London and Maudsley NHS, explained why his main experience with patients suffering from psychosis is not actually of change but of an absence of and perhaps even a resistance to change.
In the majority of cases, he sees patients without being invited. After attempting to establish basic facts to ascertain the presence and type of psychiatric problem, his therapeutic mission is to help to eliminate symptoms, to achieve functional and occupational recovery.
A typical clinical encounter pits friends, relatives, and clinicians against the patient. Friends and relatives see the patient's identity as disrupted, while clinicians immediately present their primary objective as ridding the patient of the psychosis, which is judged as wholly negative.
By contrast, the patients do not accept this view and cling to their psychotic beliefs, asserting that they have always been as they are now. Thus, Iacoponi associates psychosis with a lack of change, a clinging to essential aspects of identity, and wonders whether part of psychosis might actually be a desperate resistance to change. To illustrate these ideas, Iacoponi described some case studies.
One patient thinks she is the mother of Christ; another that her brain is being monitored by an international atomic agency; a third that his relatives were impostors who were fiddling with the internet and poisoning his food. The patient who believes herself to be monitored says that, despite the fear this causes, the worst and most intolerable possible outcome would be to find her beliefs to be mistaken.
In Iacoponi's third case study, the patient eventually retreats into himself and becomes passive and accommodating, appearing to lose all interest in external activities. He drew a comparison with the nymph Daphne in the Ovid's tale of Daphne and Apollo, who asks to be transformed into a tree, so as to resist Apollo and remain a virgin.
Perhaps, he speculated, to talk about identity over time in psychosis, we need to think of more than one identity, and of the relationship between a core and essential identity that must remain, and an external, malleable one that will adapt and protect according to need. In response, Tania Gergel, a philosopher at the Centre for Mental Health, Ethics and Law at King's, suggested that contemporary philosophical notions of selfhood and personal identity are a poor fit when it comes to accommodating the radical transformations of identity, which occur with psychotic disorders.
Core delusional beliefs alone are valued and become the key element of identity. Interaction with others becomes, essentially, a combative relationship, in which the need to prove the legitimacy of this new reality is all that matters. If we stick to such models, we may simply have to concede that, for Iacoponi's patients, especially those in whom the psychosis is most refractory, the onset of psychosis constitutes the loss of self.
More worryingly, perhaps, in legal or ethical terms, such a view may lead us to see psychosis as the loss or diminution of personhood. To find, therefore, some way in which identity and personhood can be maintained within psychotic disorders, it seems that we need an alternative or adapted conceptual model of identity over time. A key topic within the discussion was the tension between identity as the individual with psychosis sees themselves and their identity or loss of identity as it is perceived by others.
Angel Santos, Consultant Psychiatrist and trained psychotherapist from the South London and Maudsley NHS Trust, contrasted the discontinuity that arises from psychosis with the general disorder and chaos of self that is associated with personality disorders, especially Borderline Personality Disorder. Borderline Personality Disorder is characterized by a self that does not develop properly; by extreme emotional sensitivity, which can be compared to the physical sensitivity of a person with burns; and by rapid changes in mood, which patients feel no control over.
In both theories, emotional instability, impulsivity, and other symptoms are secondary, a result of the sufferer's experience of an incongruent and unstable self. However, there is not much empirical work on identity disturbance and the concept is very diffuse. From his clinical experience, Santos made the following observations about diagnosis and identity.
For some patients, a BPD diagnosis provides a new and useful sense of identity, helping them to make sense of their experiences and giving them a sense of hope. For others, identifying with the sick role is not useful and they resent it. It can be hard for them to accept that their problem is internal. The psychiatrist wants to help them change their narrative, to get them to accept how their experiences have led to their behaviour and to try to give them a sense that they can be helped.
If the source of the problem is inside the self, then maybe there is something they can do about it. However, the relationship between philosophical theories of identity and the disrupted self of BPD patients is not so simple. BPD patients can have a sense of not being the same person over time, changing intentions, the sense of being different selves with different people, feelings of emptiness, and hatred of themselves.
As we go through this list, we get increasingly far from philosophical accounts of the changing self over time, and hating oneself even seems to presume the existence of a persisting self.
Some of the items look like discontinuities of self, but others look like they are better described as disunities. What is the relationship between disunity and discontinuity? Might disunity be a type of or cause of discontinuity? In discussion, we distinguished the philosophical project of personal identity as articulating what individuates a person over time or being the same person from psychiatric accounts of the development of identity understood as a set of affiliations having a sense of identity.
Was I Ever a Fetus?
Personal identity deals with philosophical questions that arise about ourselves by virtue of our being people or, as lawyers and philosophers like to say, persons. This contrasts with questions about ourselves that arise by virtue of our being living things, conscious beings, material objects, or the like. Many of these questions occur to nearly all of us now and again: What am I? When did I begin? What will happen to me when I die? Others are more abstruse.
I: The Philosophy & Psychology of Personal Identity. By Jonathan Glover. London: Allen Lane. pp. £ - Volume Issue 1.
This is a challenging book about how we come to be what we are - about our need to create an identity. The author argues by drawing on philosophical and psychological points, that we create our own identity by reacting to the way others see us or howMoreThis is a challenging book about how we come to be what we are - about our need to create an identity. The author argues by drawing on philosophical and psychological points, that we create our own identity by reacting to the way others see us or how we would like them to see us.
The neuropsychiatry is now dated.
Don't have an account? The Psychological Approach implies that none of us was ever an early fetus, for none of us is in any way psychologically continuous with an early fetus. This raises several problems. There follows a discussion of when we do come into being. Oxford Scholarship Online requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter. Please, subscribe or login to access full text content.
This is a challenging book about how we come to be what we are - about our need to create an identity. The author argues by drawing on philosophical and psychological points, that we create our own identity by reacting to the way others see us or howMoreThis is a challenging book about how we come to be what we are - about our need to create an identity. The author argues by drawing on philosophical and psychological points, that we create our own identity by reacting to the way others see us or how we would like them to see us. As I wrote in Brave, as revolutionizing communication technology has far more time to repair than any time saved in firing off a quick email.
Стратмор подхватил ее и слегка обнял, пытаясь успокоить.