How useful are dichotomies, such as the one in the title of the book, in understanding ourselves and the world around us? Is it possible to study and comment on emotions in a scientific way without forming evaluative judgements? These are questions many scientists would rather like to banish for good to the realm of philosophy. The question is whether we can afford to do that if we are to do proper science! Also, here theory has important implications for practice – in clinical psychiatry or law, for instance.
This volume edited by Louis C. Charland and Peter Zachar does more than just pose tantalizing questions. It invites us to think about them through examples from both healthy and diseased emotional life. The paradigms the authors employ to argue their points will not let any critical reader escape without having to formulate an answer for him/herself.
In his opening chapter on the philosophical and clinical forefathers of modern psychiatric thinking, Louis Charland points out how the view that psychopathology or psychiatry, if they are to remain scientific, should avoid questions of value (and in a wider sense, morality) has become a dogma to such extent that it is now hard to imagine a time when the issue might have been debated.
In the second chapter, Mikko Salmela tackles the question of how to evaluate the factual basis of our emotions, considering the wide array of different people's responses to the same situation. After reviewing the differences between the approaches of psychologists (looking at behavioural adaptiveness or functionality) and philosophers (focusing on rational appropriateness), he offers his solution of introducing the concepts of emotional authenticity and emotional truth, the first of which refers to whether the individual's responses were justified (internally and subjectively) by the situation and the second to whether there was an external communal warrant for a particular emotional response.
Nancy Potter's philosophical approach to understanding anger in borderline personality disorder highlights the moral nature of this basic emotion – anger is a claim on respect – and the imprecision in our diagnostic classification systems foregoing a genuine exploration of the appropriateness of the patient's anger. She gives us useful insight into how giving uptake to the patient's anger and searching for the perceived wrong – which at times can be made difficult by other identifiable aspects of the patient's pathology or societal factors – helps the patient assert her/his respect as a self-respecting human being in the face of an injury or insult and to develop trust in the therapist, and how not giving uptake can be perceived as if the patient had not communicated or her/his norms were automatically dismissed as invalid.
Jennifer Radden compares two types of pain – emotional and sensory – through the examples of clinical syndromes, such as psychosomatic disorders, pain disorder, affective disorder (including masked depression), and draws attention to the important role of higher-order cognitive functions in pain experiences.
Abraham Rudnick eloquently argues his point that psychiatry is not only descriptive but also evaluative, ascribing value to abnormal phenomena, through the examples of the insanity defence, involuntary commitment, and the determination of competence to consent to treatment in narcissistic personality disorder, schizophrenia, and major depressive disorder, respectively. He concludes that moral evaluation in psychiatry can and does include emotional criteria and that a purely cognitivist approach leads to faulty ethics here.
Mainly drawing on developmental psychology, Luc Fauchet and Christine Tappolet examine the question of whether one's emotions can be controlled, cultivated, and modified, i.e. whether we have emotional plasticity. They discuss the most important models of emotional plasticity and development, separating primary emotions and those requiring self-consciousness from the evaluative ones, such as shame, guilt, pride, and hubris, and allowing for the possibility of different models applying to different emotions.
Nick Haslam and Stephen Loughnan demonstrate how through judging how much (or, more typically, how little!) and how complex emotional life we attribute to those outside the group we are in implies an evaluative judgement on our part about these people's degree of being human at all – phenomena described as de- and infra-humanization.
Anthony Landreth reviews our knowledge on the neural substrates of moral judgement and the evidence in support of two major groups of emotion theories. It appears that there is somewhat more evidence for activation in the orbito-frontal cortex related to reward and punishment than for the involvement of somatosensory areas, the parietal cortex, and the insula, which favours appraisal theories, relative to embodied theories of emotion in moral judgement paradigms.
Ralph Ellis claims that there are two fundamentally different types of alexithymia; one in which the patient can feel the bodily sensations normally associated with emotions but s/he cannot interpret these (intact interoception with impaired efferent, sensorimotor component, e.g. the classic somatizer), and another in which s/he reports no feelings but still acts as if motivated by the corresponding emotional process (impaired interoception with intact sensorimotor system).
In his thought-provoking final chapter, reviewing the relevant contribution of the philosophical movement of phenomenology, Edwin Hersch argues that all perception is evaluative and emotion is present in all human experience. He adeptly shows how, in his view, splits between the so-called ‘rational’ and ‘emotional’ or ‘cognition’ and ‘affect’ are misguided, and warns us that ‘to rely too exclusively on data gathered solely on the largely de-contextualized, third-person, thing-like aspect of human brains and bodies – no matter how carefully these are visualised and measured – will always remain an inadequate methodology when it comes to understanding human life’.
This excellent volume summarizing the most important areas in the field is a must read for everyone who endeavours seriously to understand human behaviour and how we, humans, think about it.
