One of the novel features of the network approach to psychopathology defended in the target article by Borsboom et al. is their explicit recognition of an explanatory role played by intentional content. According to the authors,
because symptoms are often described in intentional terms, the covariations observed between symptoms in a network can be seen to make sense: Only at this level of description can we understand why the presence of one symptom (e.g., a person believing that the CIA spies on him or her) leads to another (e.g., the person closes the curtains and withdraws from social life). (sect. 5, para. 3)
We are sympathetic to the proposed analysis, and we think that the explicit inclusion of intentional content strengthens earlier defences of the view. But what, exactly, does “sense making” and “understanding” mean here? The target article suggests answers to this question in terms of (1) causality and (2) rationality – intentional states are supposed to cause and/or rationalize behaviour associated with specific psychiatric symptoms. Both options are associated with an interpretivist view of intentional content that, as indicated in the target article, we share with the authors (Francken & Slors Reference Francken and Slors2014; Reference Francken and Slors2018). Nevertheless, we will argue that both options are problematic and sketch an alternative view on what “sense-making” involves.
Interpretivism Dennett-style (Dennett Reference Dennett1987) – the version of interpretivism that is closest to what the authors have in mind – rejects the idea that intentional states are concrete items with straightforward causal powers (Slors Reference Slors2007). From an interpretivist point of view, intentional states are abstract concepts that describe and identify specific patterns in human behaviour. Exploiting these patterns for explanatory purposes does involve exploiting the causal processes that underlie them (so interpretivism does not rule out “mental causation” altogether; see Eronen Reference Eronen2017). But interpretivists emphasize that we cannot identify these patterns – and hence exploit their causal underpinnings for explanatory purposes – other than by using the mentalistic idiom of “beliefs,” “desires,” “fear,” “hopes,” and so forth. Hence, the explanatory value of ascribing intentional states does not hinge solely on the causal relevance of intentional contents.
On the standard interpretivist picture, the explanatory value of ascribing intentional states hinges on the fact that these states “rationalize” behaviour: they provide reasons for actions, which are intelligible against the background of real or assumed rationality. The problem, however, is that this background seems to be lacking, at least in part, in the case of psychopathologies. Pathological intentional states such as delusions do not conform to the holistic constraints of our folk-psychology. Having the delusion that you are being spied on by the CIA will explain actions such as drawing the curtains. But it is not rationally connected with the agent's perceptions, other thoughts, motivations, and behaviour in the same way that a regular belief would be. Somewhere in the network of relations that delusions have with other intentional states, irrationality slips in. This is why many philosophers – certainly those of an interpretivist bent – would emphasize that delusions are not beliefs (Gerrans Reference Gerrans2013; Radden Reference Radden2011). They do not rationalise behaviour as beliefs do.
The explanatory role of intentional content in network analyses of psychopathologies hinges neither on causality nor on unqualified rationality, then. What does it hinge on? Part of the answer here is bounded rationality. The connection between the delusion that one is being spied upon by the CIA and the action of drawing the curtains can be seen as “rational,” but only as long as the irrational inconsistencies within the larger context of the individual patient (or, by generalization, a particular population) are deliberately disregarded. To interpret pathological reasoning is to draw islands of reason in a sea of confusion, so to speak. Knowing how to demarcate these islands, however, requires familiarization with the mental status and history of the patient. This calls upon skills that do not take rationality as the main criterion for ascribing intentional content, such as empathic understanding (by means of simulation (Gordon Reference Gordon, Carruthers and Smith1996), phenomenological analysis (Ratcliffe Reference Ratcliffe2015), and the targeted use of diagnostic tests and practice-based, theory-informed clinical scripts of the unfolding of psychopathological phenomena. Clinical understanding of the connection between symptoms, like everyday folk psychology, is essentially pluralistic (Andrews Reference Andrews2012).
We suggest that this whole body of social skills and practical knowledge – rather than rationality – provides the necessary heuristics for network analyses of psychopathologies at the intentional level of description. Within a particular network, targeted application of the criterion of rationality may help draw connections between specific symptoms, but only against this pluralistic background.
In short, we claim that the network view of psychopathologies defended in the target article is not supported by classic interpretivist views on intentional state ascription. We do not take this to be a criticism of the network view or to undermine its argument against reductionism in psychopathology research, however. Rather, we suggest that the fruitful use of intentional contents in forging connections between symptoms in a network analysis of psychopathologies, as argued for in the target article, points to a necessary expansion and improvement of interpretivism and its non-reductionist implications. Ascription of intentional states does not merely make behaviour intelligible and predictable by depicting the agent as being fully rational. Specifically in pathological cases, we use a range of further, non-rationalizing interpretive strategies, including simulation, empathizing, and using clinical knowledge and experience.
One of the novel features of the network approach to psychopathology defended in the target article by Borsboom et al. is their explicit recognition of an explanatory role played by intentional content. According to the authors,
because symptoms are often described in intentional terms, the covariations observed between symptoms in a network can be seen to make sense: Only at this level of description can we understand why the presence of one symptom (e.g., a person believing that the CIA spies on him or her) leads to another (e.g., the person closes the curtains and withdraws from social life). (sect. 5, para. 3)
We are sympathetic to the proposed analysis, and we think that the explicit inclusion of intentional content strengthens earlier defences of the view. But what, exactly, does “sense making” and “understanding” mean here? The target article suggests answers to this question in terms of (1) causality and (2) rationality – intentional states are supposed to cause and/or rationalize behaviour associated with specific psychiatric symptoms. Both options are associated with an interpretivist view of intentional content that, as indicated in the target article, we share with the authors (Francken & Slors Reference Francken and Slors2014; Reference Francken and Slors2018). Nevertheless, we will argue that both options are problematic and sketch an alternative view on what “sense-making” involves.
Interpretivism Dennett-style (Dennett Reference Dennett1987) – the version of interpretivism that is closest to what the authors have in mind – rejects the idea that intentional states are concrete items with straightforward causal powers (Slors Reference Slors2007). From an interpretivist point of view, intentional states are abstract concepts that describe and identify specific patterns in human behaviour. Exploiting these patterns for explanatory purposes does involve exploiting the causal processes that underlie them (so interpretivism does not rule out “mental causation” altogether; see Eronen Reference Eronen2017). But interpretivists emphasize that we cannot identify these patterns – and hence exploit their causal underpinnings for explanatory purposes – other than by using the mentalistic idiom of “beliefs,” “desires,” “fear,” “hopes,” and so forth. Hence, the explanatory value of ascribing intentional states does not hinge solely on the causal relevance of intentional contents.
On the standard interpretivist picture, the explanatory value of ascribing intentional states hinges on the fact that these states “rationalize” behaviour: they provide reasons for actions, which are intelligible against the background of real or assumed rationality. The problem, however, is that this background seems to be lacking, at least in part, in the case of psychopathologies. Pathological intentional states such as delusions do not conform to the holistic constraints of our folk-psychology. Having the delusion that you are being spied on by the CIA will explain actions such as drawing the curtains. But it is not rationally connected with the agent's perceptions, other thoughts, motivations, and behaviour in the same way that a regular belief would be. Somewhere in the network of relations that delusions have with other intentional states, irrationality slips in. This is why many philosophers – certainly those of an interpretivist bent – would emphasize that delusions are not beliefs (Gerrans Reference Gerrans2013; Radden Reference Radden2011). They do not rationalise behaviour as beliefs do.
The explanatory role of intentional content in network analyses of psychopathologies hinges neither on causality nor on unqualified rationality, then. What does it hinge on? Part of the answer here is bounded rationality. The connection between the delusion that one is being spied upon by the CIA and the action of drawing the curtains can be seen as “rational,” but only as long as the irrational inconsistencies within the larger context of the individual patient (or, by generalization, a particular population) are deliberately disregarded. To interpret pathological reasoning is to draw islands of reason in a sea of confusion, so to speak. Knowing how to demarcate these islands, however, requires familiarization with the mental status and history of the patient. This calls upon skills that do not take rationality as the main criterion for ascribing intentional content, such as empathic understanding (by means of simulation (Gordon Reference Gordon, Carruthers and Smith1996), phenomenological analysis (Ratcliffe Reference Ratcliffe2015), and the targeted use of diagnostic tests and practice-based, theory-informed clinical scripts of the unfolding of psychopathological phenomena. Clinical understanding of the connection between symptoms, like everyday folk psychology, is essentially pluralistic (Andrews Reference Andrews2012).
We suggest that this whole body of social skills and practical knowledge – rather than rationality – provides the necessary heuristics for network analyses of psychopathologies at the intentional level of description. Within a particular network, targeted application of the criterion of rationality may help draw connections between specific symptoms, but only against this pluralistic background.
In short, we claim that the network view of psychopathologies defended in the target article is not supported by classic interpretivist views on intentional state ascription. We do not take this to be a criticism of the network view or to undermine its argument against reductionism in psychopathology research, however. Rather, we suggest that the fruitful use of intentional contents in forging connections between symptoms in a network analysis of psychopathologies, as argued for in the target article, points to a necessary expansion and improvement of interpretivism and its non-reductionist implications. Ascription of intentional states does not merely make behaviour intelligible and predictable by depicting the agent as being fully rational. Specifically in pathological cases, we use a range of further, non-rationalizing interpretive strategies, including simulation, empathizing, and using clinical knowledge and experience.