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Reflections on Narcissism (part 1): Competing Ways to Conceptualize Narcissistic Personality Disorder

 Narcissism—be it the concept or its referent—is clearly having a moment in the wider culture. The demoniacal figure of The Narcissist is all over social media. In the 2010s, a yearly average of 357 peer-reviewed articles had the word “narcissism” in their abstracts, up from 173 in the year 2000 (see Weiss and Campell in Cambridge Handbook of Personality Disorders , 2020). Of course, it’s hard to know how to interpret such numbers, and the concept of narcissism arguably went through a previous vogue in the 1970s, thanks to Kohut, Kernberg, and Christopher Lasch—maybe this will be the topic of a future post.   As Jonathan Shedler and David Puder discuss in this podcast , the popular portrayal of narcissism is frequently one-dimensional. In the psychodynamic tradition, however, among other clinical approaches, one finds distinctions between (a) normal, developmentally-necessary narcissism and (b) pathological narcissism, as well as between different types of pathological nar...
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Toward Emotional Granularity: Barrett’s Constructionism about Emotions (part 2)

  In the previous post, I discussed Lisa Feldman Barrett’s critique of the “classical theory of emotions.” I covered reasons to reject the idea that there is a simple set of crisply delimited, universal, basic emotions or the idea that such emotions have universal modes of facial expression or invariant physiological or neural “fingerprints.” In this post, I would like to sketch Barrett’s positive account—of how the brain, in interaction with human culture and the environment, constructs emotions.   A word is needed first, though, about the metaphor of “construction.” It is a complex metaphor. It’s a metaphor that can pull us in many different directions. It tugs at other none-too-crisp distinctions we are familiar with, such as the distinction between finding something and making something, or the distinction between simple parts versus complexes of many different parts. It reminds of how we tend to think of some things as natural and others as manufactured—or artificial,...

What Are All These Emotions? Lisa Feldman Barrett’s Constructionism about Emotions (part 1)

 I.   When I started this blog, I said I wanted to begin with a focus on personality disorders and emotions. I have somewhat made good on the first promise, but not the second. In this post, I want to begin to explore some of my own perplexities about emotions. I am going to start with Lisa Feldman Barrett’s book How Emotions Are Made: The Secret Life of the Brain (2017).   Barrett is a psychologist and neuroscientist whose work I first encountered through mental health Twitter, back when academic Twitter was still a thing. She is very good at popularizing her views, and I should note right away that she is very clear, if you watch her videos or listen to her podcasts, that How Emotions Are Made is a popularization—and thus at times a drastic simplification—of the views that she and her lab have worked out in hundreds of academic papers. My impression of Barrett is that she revels in being a bit of a bête noire, that she likes to play the role of depriving us of t...

Kukla's Pragmatism about the Health Concept (Part 2/2)

 (I wrote one long post on Kukla and broke it into two. This is the second part.) II. “What Counts as a Disease, and Why Does It Matter?” (2022)   Eight years later, Kukla published “What Counts as a Disease, and Why Does it Matter?” in The Journal of Philosophy of Disability ( https://doi.org/10.5840/jpd20226613 ). I downloaded a pre-print of this article at the time and have not tracked down a copy with the proper pagination, so I will treat page 1 as the first page of the article.   Kukla is a bit clearer about methodology this time. They disavow the method of conceptual analysis, which is what Boorse and Wakefield were doing. Instead, they contend that the role of the philosopher is “clarifying the pragmatic and normative conditions under which ‘disease’ is a useful concept that can be mobilized appropriately” (p. 6). This is more or less exactly what I would expect a certain kind of pragmatist to say. It seems quite close to the kind of thing Foucault tried t...

Kukla’s Pragmatism about the Health Concept (Part 1/2)

 This post marks my fifth on the concept of health. Here I will look at two texts by Quill Kukla on the topic. These are not the only texts I could have selected; Kukla is dazzlingly prolific across a wide range of topics from gender to sexual violence to bioethics to philosophy of language. I have taken these two pieces as exemplary of a certain tendency in Kukla’s thinking, but my choice perhaps comes at the expense of looking at their more “applied” work.   As the title suggests, Kukla is a pragmatist. I mean two things by this. First, Kukla draws on the philosophical tradition of American pragmatism, classically associated with Peirce, William James, and Dewey, and more recently revived by Rorty, Brandom, and others. It’s a complex inheritance, to be sure, but, to simplify a great deal for my purposes here, I think this is the main point. Pragmatists about the meaning of concepts say that what a concept means has to do fundamentally with how we use it. If we want to ex...

Wakefield’s Harmful Dysfunction Theory of Mental Disorder

This is now my fourth post in a series on health and disease. I spent the last two posts discussing Boorse’s naturalism, which attempts a purely value-free definition of health and disease.  In this post, I will discuss Jerome Wakefield’s “harmful dysfunction” theory of mental disorder, which is sometimes considered a “hybrid” of naturalism and normativism. My focus here will be on a single article, “The concept of mental disorder. On the boundary between biological facts and social values” ( 1992 ), although Wakefield follows this up with several later elaborations. Wakefield  has doctoral degrees in social work and philosophy and has extensive clinical experience, in addition to holding a professorship in the NYU school of social work . Aside from his classic articles about mental disorder, he is also known for a book co-authored with Allan Horwitz, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (2007). Wakefield has a public reach un...

Boorse’s Biostatistical Theory of Health (Disorder, Disease, and Health, part 3)

  This is the third post in a series on philosophical debates about the nature of disease and health. I am especially interested in the ramifications of this debate for how we think about the notion of mental health. In the last post, I examined what I saw as the broader sociopolitical stakes of the debate for the chief representative of the “naturalist” or “objectivist” school of thought, Christopher Boorse. This post will summarize Boorse’s account of health, which he calls the biostatistical theory (BST). I will focus principally on “Health as a Theoretical Concept” (1977) and will not discuss his later replies to critics here.   The broad position Boorse is defending is follows: Attributions of health are value-neutral and empirical. Whether someone is healthy or not is an objective matter, independent of personal or social values or judgments.   This broad position is characteristic of naturalism about health. It is worth spending a bit of time unpacking it. ...