Philosophy, psychiatry and anti-psychiatry

Julia asked:

I am very interested in anti-psychiatry and what philosophy has to offer in this field today. I believe it is more and better than psychiatry. I am also very interested in the modern philosophers who have accessed this field through existentialism, phenomenology and ethics. Any comments, suggestions or criticism? Or even guidance.

Answer by Craig Skinner

You ask for suggestion, comment, criticism and guidance.

I have all of them for you.

Suggestion: move on from anti-psychiatry. Its job is done.


  *psychiatry and philosophy are not in competition

  *psychiatry helps (or can help) people with mental illness

  *philosophy helps (or can help) all of us to achieve inner harmony and live well

Criticism: to be against abuse of psychiatry is fine, but claims that mental diseases are a myth, a social construct or a means of oppression of individuals by institutions are seriously misguided.

Guidance: limited (see below).

To enlarge slightly:

Anti-psychiatry got going in the 1960s as a reaction to perceived abuses. These were real. Patients were often treated inhumanely, typically in forbidding asylums, nasty treatments such as insulin shock therapy, lobotomy and ECT were overused, and in some countries, dissidents were labelled mentally ill and institutionalized by a coercive state abetted by doctors. But all this has changed (my experience is of the UK). Asylums have closed, patients are now mainly in the community, treatment is a partnership between patient and professional, insulin coma and lobotomy are history, ECT is used sparingly. So now, anti-psychiatry is as silly as anti-gynaecology or anti-cardiology. Of course we should oppose abuse whether it be by psychiatrists, cardiologists or anybody else.

My view of mental illness is shaped by my 50 years as a doctor (not a psychiatrist, rather a physician) and by family experience of mental illness. Like all families, mine has all kinds of illness from cancer to heart disease to mental illness. In particular I had two sisters with schizophrenia and have two other close relatives with bipolar disorder. My sisters’ lives were ruined by their disease. To tell them, as some of the anti-psychiatry advocates claim, that their illness was a myth or social construct, would be a cruel joke indeed. I saw them live with it for decades. The only thing that helped was medication backed by psychiatric nursing/ social work. Similarly, my bipolar loved ones benefit from medication, and one has had an intractable severe depressive episode ended with outpatient ECT. Severe mental illness is as real as cancer, and one day we will understand how and why exactly the brain wiring/ chemistry is scrambled, and will be able to arrest, reverse or prevent these conditions. Meantime, drugs and cognitive therapies can help.

The idea that philosophy (as discourse plus a way of life striving for wisdom) aims for harmony of the soul is an ancient tradition and still thriving. It is central to Socrates, Plato, Aristotle. Stoics, Epicurians, Pyrrhonists, and many modern thinkers such as Heidegger and Wittgenstein. One can call this philosophy-as-therapy, but let’s not confuse this with treating illness. Philosophy as therapy aims to help us all, well or ill, lead a good life, whether the latter is seen in terms of reason, virtue, tranquility, suspension of belief, acceptance of fate, contemplation of the Form of the Good, dissolving pseudoproblems and seeing things aright, more than one of these, or whatever.

My own views of philosophy as therapy have been formed mostly by the Stoics ancient and modern (Epictetus, Marcus Aurelius’ Meditations with Hadot’s commentary The Inner Citadel as a must-read companion, and writings by the Stoicism Today team of academics/ psychotherapists), and by Heidegger and Wittgenstein (both difficult, especially the former, even with guidebooks). But I am light on other existentialists and know next to nothing about phenomenology, and so cant offer guidance there.


Role of the muses in Hesiod’s Theogony

Leslie asked:

How do mythical stories attain authority, and what is the role played by the Muses who are often cited at the beginning of them? What does Hesiod’s term Theogony mean?

Answer by Jürgen Lawrenz

As your question involves the Muses, the answer is simple. Hesiod himself gives it in Lines 25-8 of his Theogony, where the Muses tell him that although they like to dress up their stories (myths) in pleasing apparel, nevertheless they also tell unvarnished truths.

The point here is, that myths usually appeal to witnesses to the events being narrated. It is essential for them to have this kind of authority behind them, so that doubts about their veracity are silenced. The Muses are such witnesses. As they are ever-present, they know everything.

Hence the invocations to them at the beginning of many a Greek poet’s tale. It is a plea to the Muse(s) to share their knowledge with the poet. For the poet, the Muses vouchsafe the truth of the tale.

As to the word Theogony, it means ‘Birth of the Gods.’ (The syllable ‘gony’ also occurs in such words as ‘cosmogony’ = Birth of the Universe).


Philosophy of decapitation

Joshua asked

What kind of thinking may be going on in the mind of a headless man ? Existentialism, or… what ?

He had a sudden accident where his head was cut clean off, but managed to walk for some meters before falling down cold.

What may he be thinking before falling down dead, and do philosophers think about this?

Answer by Craig Skinner

The mind is closely associated with the brain. A common view, which I share, is that the mind just is the mental activity of an embodied brain embedded in an environment.

Like most normal people I feel that ‘I’ (my self) am situated just behind my forehead. But this is not because the brain is there. It is because this is where I view the world from. And in experiments with special goggles where I look at the world as seen by a video camera placed somewhere else, I feel that ‘I’ am at that other viewing point. This point can be well away from my body so that I see my body in front of me, or over in the corner, and feel that I am situated some distance from it rather than in it. But normally I, my self, my mind are in my head.

So, in the case of the man who suddenly loses his head, his mind will be in the head not in the detached body, and he might think ‘that’s my body over there’. Indeed, a car crash victim whose passenger was suddenly beheaded reported that his friend’s head registered shock, then horror as it saw it’s detached body, then eye closure/ stillness, all in a few seconds.

A person will only be conscious if the brain has a continuous oxygenated blood supply — cardiac arrest leads to unconsciousness in about 10 seconds. So, decapitation taking longer than this (blood gushing from the neck all the while) will yield a head already unconscious. As in the botched execution of Mary Queen of Scots when the axeman couldn’t get the head off after three strikes and had to finish the job with a dagger. However, if decapitation is immediate, as by the expert swordsman hired by Henry to despatch Ann Boleyn, the head will fall off conscious and remain so for some seconds.

The classic era of such beheading was at the time of the French revolution when the guillotine was invented to deal efficiently with the numbers involved. And there are plenty of anecdotes of heads communicating with a friend using a prearranged eye blinking code, or swivelling eyes towards the friend’s voice. But I doubt there was much philosophical thought, existential or otherwise, in the few seconds before death. This would be different if the head were removed as a planned surgical procedure with connection of neck blood vessels to a heart-lung machine. Then a head could live much longer. As far as I know, this hasn’t been done with a human, but, rather horribly, has with some other animals. I suppose it wouldn’t be all that different from being paralysed from the neck down, when the inert body is effectively a heart-lung machine, and these unfortunate people are perfectly capable of philosophical thought.

Craig Skinner at


Answer by Geoffrey Klempner

“Even if one’s head were to be suddenly cut off, he should be able to do one more action with certainty.” (Hagakure by Yamamoto Tsunetomo, translated by William Scott Wilson)

Existentialism is a philosophy of anguished reflection and doubt. I would have thought that Aristotle is more your man.

Aristotle would have understood perfectly the process of training a Samurai warrior. You draw the sword, say, a hundred thousand times, or however many times it takes until the action is one of perfect precision. (Careless trainees will lose a finger or two.)

The Aristotelian person of virtue knows what to do, without agonizing about it — unlike one who is merely ‘continent’, who has to fight against wayward passions. True, the virtuous judgement is not ‘headless’. To hit the mark you need to use your eyes. But only up to a point. A skilled archer, having aimed at the target, should be able to complete the action of releasing an arrow blindfold.

There is some ambiguity in the quote from Yamamoto. We can read this as making a point simply about the benefits of self-discipline and practice, or being about the intense level of determination required to defeat one’s enemy. (The quote continues, ‘…with martial valor, if one becomes like a revengeful ghost and shows great determination, though his head is cut off, he should not die.’) Aristotle would reply that heroic determination is itself a practised virtue, not something you can just conjure up in your head.


Kant versus Hume on the nature of causation

Angelika asked:

I’m trying to understand the differences and similarities to Kant and Hume’s theory about cause and effect.

Can you explain the the basics in which they are similar and different from each other?

Answer by Martin Jenkins

David Hume

In his Enquiry Concerning Human Understanding (1748) Hume argues that all human knowledge is derived from ideas, the relation between ideas and impressions, matters of fact. This knowledge, when reflected upon, displays regularity, displays coherence, it is not chaotic and arbitrary although Hume finds the opposite or contrary of this regularity perfectly possible. So he deduces experience displays resemblance, contiguity and causality.

With resemblance, there is a picture and what the picture represents or resembles; with contiguity there is the inherence of one thing in another as when we think of a room, we cannot but think it as being in a house, and with causality, one thing is said to cause an effect as when an injury causes pain. Without the one thing, the consequent cannot follow or where the impression of one thing leads us to the impression of another.

Causality is for Hume, the basis for many of our inferences and deductions about the world. We infer that the daylight is the effect caused by the sun rising every morning and that this will continue; that the intentions (cause) of a friend to travel to France are evidenced by a letter received from him (effect); that bread has a positive effect on me caused by the nourishing powers contained therein. In other words, our experienced world of matters of fact is assumed to continue as it has in the past; so much so that we make causal inferences and predictions on their basis.

It is perfectly and logically possible that such continuity may cease. That falling snow may taste of salt, that bread may cease to be nourishing, that the sun may not rise tomorrow. Yet as someone once remarked: ‘Would you want to put money on it?’

Yet thinking about the issue raises problems: what demonstrative grounds can we have that prove, that guarantee the future will be the same as the present and past? Only upon such grounds can we genuinely infer from the present into the future and more importantly, rest secure in all our causal reasoning.

The answer for Hume, was that the impressions of the constant conjunction of things such as bread and nourishment, the sun and daylight, snow and cold, candle flame and heat give rise to the custom or habit of associating the qualities. The cause of an effect is not any ‘power’ or ‘necessary connection’; it is again, the constant conjunction of events giving rise to the habit, expectation associating the two events.

"Our idea of necessity and causation arises entirely from the uniformity observable in nature, where similar objects are constantly conjoined together and the mind is determined by custom, to infer the one from the appearance of the other. These two instances form the whole of that necessity which we ascribe to matter. Beyond the constant conjunction of similar objects and the consequent inference from one to the other, we have no notion of any necessity or connexion." (VII. Liberty and Necessity)

There is just the constant conjunction of things and the experience of this displayed uniformity of nature. People abstract from this and project it into the future and why shouldn’t they? There is just the uniformity of nature and where there are experienced anomalies, they do not threaten the uniformity of nature. There is no necessary connection or cause and effect, this being a predisposition of humans to posit a necessity in phenomena. This is superfluous, there is just the uniformity of nature and the constant conjunction of events. Nothing more is required.

Immanuel Kant

Kant remarked that Hume had woken him up from his dogmatic slumber. Despite Hume concluding that epistemologically, all we can observe is the constant conjunction of events and apparently finding this unproblematic, Kant did not.

Besides having interests in philosophy, Kant had interests in the natural sciences. He was perturbed by the possibility of Newtonian natural science being undermined if there were no necessary causal connection with phenomena. Similarly, Hume had not solved the problem of future experience being radically different to present experience which remained possible if, there were no further guarantee than that of experience alone. As such, human knowledge would be contingent, lacking certainty. In his Critique of Pure Reason Immanuel Kant outlines his Critical Idealism which was proffered as the true foundation of Human Knowledge.

Essentially, there are ‘transcendental categories’ which are synthesised with empirical intuitions, an act which both creates and limits human knowledge by synthetic a priori judgements. Relying on impressions alone — as Hume had argued — cannot provide apodeictic certainty for human knowledge claims. (Apodeictic: knowledge claims which are incontestably true because clearly, logically demonstrated.) Knowledge claims based on experience alone would be contingent, unreliable and wholly subjective. With reference to cause and effect, Hume concludes that we never observe the power of cause and effect. From an empirical perspective, this is correct — all that can be observed is one event then another. Hume’s solution of constant conjunction, does not provide any grounds for causality, it more or less dismisses it — laying the grounds for scepticism. Nor can it provide any empirical evidence for the succession of time. On the other hand, according to Kant, transcendental categories of relation (relation: substance, causality, interaction) actualised under the forms of time and space account for the matter of causality (the observed act itself) and the form of causality (what makes the act possible).

The category of substance provides the foundation upon which, changes, modifications occur as mediated by time. For something has to underpin the changes that occur, something which changes without ceasing to exist. An object may be red at one moment and brown at another but something has to be subject to the change. Kant writes in the Critique:

"In other words, the objective relation of the successive phenomena remains quite undetermined by means of mere perception. Now in order that this relation may be recognized as determined, the relation between the two states must be so cogitated that it is thereby determined as necessary, which of them must be placed before and which after, and not conversely. But the conception which carries with it a necessity of synthetical unity, can be none other than a pure conception of the understanding which does not lie in mere perception; and in this case it is the conception of ‘the relation of cause and effect,’ the former of which determines the latter in time, as its necessary consequence, and not as something which might possibly antecede (or which might in some cases not be perceived to follow). It follows that it is only because we subject the sequence of phenomena, and consequently all change, to the law of causality, that experience itself, that is, empirical cognition of phenomena, becomes possible; and consequently, that phenomena themselves, as objects of experience, are possible only by virtue of this law." (B. Second Analogy. Analogies of Experience)

Due to the transcendental intuition of time, we perceive phenomena as occurring successively. Kant employs the example of pouring water into a jar which causes it to overflow. Thus the actions of cause and effect, determined in time are observable. Whilst determined in time, surely, time itself is not the determination of causality?

The example of the water and jar causality leads to the conception of action; action to the conception of force and this, to the conception of substance. Action involves force(s). Forces can alter the state(s) of a substance in varying degrees of intensity; this is a process in matter determined by the form of time.

"Now every change has a cause which evidences its causality in the whole time during which the change takes place. The cause therefore, does not produce the change all at once, in one moment but, in a time so that, as the time gradually increases from the commencing instant A to its completion B, in like manner also, the quantity of the reality B — A is generated through the lesser degrees which are contained between the first and the last. All change is therefore possible only through a continuous action of causality which, insofar as it is uniform, we call momentum. The change does not consist of these momenta but is generated or produced by them as their effect." (ibid)

So causality is understood through the synthesis of the forms of the transcendental categories in time and the forces, changes in matter. This is not acquired through empirical observation alone (as the empiricists maintain) thereby having no guarantee of its necessity and universality (i.e. it might not happen again) but through the synthesis of the categories and intuitions thereby guaranteeing necessity and universality.

I don’t think Hume is similar to Kant in any way. Hume, strictly adhering to his position that knowledge is derived from experience or the relation between ideas, denies the existence of cause concluding that there is only constant conjunction upon which we customarily accept the uniformity of the world. For Kant, this is almost tautologous: experience will continue as it has because experience teaches so. There is no external guarantee beyond experience which is contingent, unreliable and subjective. Apodeictic certainty is required and this is contained in the structuring of our experience by the transcendental categories — which includes causality.

Hope this is useful Angelika.


Friendship and intellectual elitism

Abby asked:

Is there such a thing as intellectual elitism? To what extent should we allow our intellectual pursuits to run our lives and is it better to have friends with the same intellectual interests as you?

I have a close friend of mine who I feel I’m drawing away from because for months I’ve been feeling that we are too different mainly because I can’t be myself with her. I can’t talk to her about anything serious and when I try she shows absolutely No interest. The problem is I spend a lot of time with her and when I do I feel like I’m losing a part of myself I can’t afford to. I’m afraid of being elitist. At the same time being an introvert I value the friends I have but this one is suffocating me.

Answer by Geoffrey Klempner

There is such a thing as intellectual elitism, but your question isn’t really about that. What is intellectual elitism? At a first pass, I would define it as the over-valuation of intellectual ability, at the expense of under-valuing other abilities.

Plato is famously quoted as saying that philosophers should be kings — in other words, we should appoint philosophers as our leaders/ rulers — but few persons, least of all professional philosophers would give any credence to such an absurd proposition. The first and most important qualification for a leader is a capacity for leadership, which is only accidentally related (if at all) to the ability to think about the mind-body problem or the ontological status of numbers.

Yes, we want our leaders to be smart. We want our doctors and lawyers and CEOs to be smart. However, overall, intellectual elitism is harmful rather than beneficial. That would be the default, common sense view. Give credit where it is due, but remember that the well being of society requires the contribution of those with other attributes besides attributes of the intellect.

As I said, your question is about something quite different. Your story is of a person who wants to better themself and a (formerly) close friend who is holding them back. It could be the plot of a movie. Imagine that you had taken a strong interest in sport but your friend refused to go on runs with you (she’s too fat and lazy). Well, you can still watch TV with her, go to movies, or go out for a drink.

You should be careful about dropping old friends, you never know when you need them.


Heraclitus on change and permanence

Lauren asked:

I have a question in my textbook that I was wondering if you could help. The question is:

How would Heraclitus have responded to the following statement? ‘Heraclitus’ theory is wrong because the objects we see around us continue to endure throughout time; although a person, an animal or plant may change its superficial qualities, it still remains essentially the same person, animal or plant throughout these changes. In fact, we recognize change only by contrasting it to the underlying permanence of things. So permanence, not change, is the essential to reality.’

Answer by Graham Hackett

Lauren, there is a great deal in this quote. Incidentally, I don’t recognise it so I am wondering where it comes from. Heraclitus would not have responded in ordinary everyday language, he would have responded gnomically, so that we would have great difficulty understanding his answer. That’s Heraclitus the obscure for you!

Incidentally, I don’t read Greek, so you will have to take my comments on the fragments of Heraclitus as referring to their English translation. In fact, the version I am looking at now, as I try to comment on your question, is due to GWT Patrick. This is rather an old translation (1889) but I have not found that reading anything more recent alters my answer.

The key to understanding Heraclitus lies in grasping the meaning of expressions such as ‘flux and process’ and the ‘unity of opposites’.

In talking about flux, it is usually the case to stress that fire is a key element for Heraclitus, and that this means that he regards nothing as permanent. The cosmos is in a state of perpetual flux, and this view is often contrasted with the Milesian philosophers search for a constant, an arche; something which is unchanged throughout the perpetual change which the perceptual world seems to suggest is the norm. Or as Heraclitus famously puts it himself;

"Into the same river you could not step twice, for other and still other waters are flowing."

Or, even more mysteriously,

"Into the same river we both step and do not step. We both are and are not."

And Heraclitus also says;

"All things are exchanged for fire and fire for all things, just as wares for gold and gold for wares."

This all suggests that Heraclitus is denying that there is anything permanent; all is in flux, to be consumed by eternal fire. There is nothing wrong about this view; it is the orthodox one and can be strongly supported by reference to the fragments. But all is not as it seems in the words of Heraclitus. Things can change almost constantly and still retain an identity. Take the metaphor of the river — surely a good example of something which is ever flowing and ever-changing. Yet a river cannot be a river unless it is constantly changing in this way. If a river ceases to flow, then it arguably stops being a river, and becomes something else — a lake, say. The ship of Theseus can still (arguably) be the ship of Theseus even though it has changed considerably through constant repair and improvement over the years.

Heraclitus would no doubt argue that if you wish to find a permanent feature in the cosmos, then you should stop looking for a substance, and look for a process instead. Fire is a metaphor for this process. Even in the case of the Milesian philosophers, it is still possible to discern an interest in an underlying process rather than searching for an unchanging stuff, or arche. Was it not Anaximenes, who, whilst suggesting that air might be the permanent underlying substratum of reality, nevertheless identified observable reality as being the result of changes in this substance? Air could become more rarefied or solidified, and so perpetual change would be a feature of the cosmos just as much as the permanence of air.

As if to reinforce his insistence on a process of change rather than a permanent unchanging substance, Heraclitus is also seen to stress an underlying rule (i.e. ‘logos’ ) in the cosmos, which is often referred to as the ‘unity of opposites’. We can find the following among the fragments of the works of Heraclitus;

"Cold becomes warm, and warm, cold; wet becomes dry, and dry, wet They do not understand: how that which separates unites with itself. It is a harmony of oppositions, as in the case of the bow and of the lyre.

‘Unite whole and part, agreement and disagreement, accordant and discordant; from all comes one, and from one all."

There are more examples of these to be found. In the cosmos, an object moves from point A to point B, thus creating a change, but the underlying law remains the same. Thus, a unity of opposites is present in the universe. So I would argue that Heraclitus would not disagree outright with much of the wording of your question, which states that the underlying logos of the cosmos is permanence. He might use the same words but insist that the underlying logos is change, not permanence.

Instead of saying (as in your quote),

‘… the objects we see around us continue to endure throughout time; although a person, an animal or plant may change its superficial qualities, it still remains essentially the same person, animal or plant throughout these changes. In fact, we recognize change only by contrasting it to the underlying permanence of things. So permanence, not change, is the essential to reality,’

Heraclitus might say,

‘… the objects we see around us perpetually change throughout time; although a person, an animal or plant may remain the same in its superficial qualities, it is always in flux. In fact, we recognize permanence only by contrasting it to the underlying changing of things. So change, not permanence, is the essential to reality.’

Is it not possible to regard permanence and change as being opposites, to be included in Heraclitus’s own idea of the unity of opposites? Perhaps it is possible to argue that permanence and flux are a matter of perspective, and furthermore, that Heraclitus seems to capture something important about them in his logos.