Psychodynamic Psychiatry and the Therapeutic Space in the Era of COVID-19

Psychodynamic psychiatric practice during the COVID-19 pandemic has required most clinicians to conduct treatment online or by telephone. The result is a natural experiment that appears to endorse the efficacy of distance therapy. Consequently, the brick-and-mortar consulting room is no longer the presumptive therapeutic space for the conduct of psychodynamic psychiatric or other treatment approaches. The therapeutic space is reconceived as the place or medium intended for treatment and is distinguished from both the therapeutic relationship and conduct of treatment that occurs within that space. How different therapeutic spaces impact treatment is discussed with specific application to psychodynamic psychiatry and virtual venues. The “digital object” becomes a new presence; the patient's freedom to disclose mental contents is retained though empathic attunement is diminished; a shift in power dynamics may occur; timing of sessions gains greater precision in the online environment. Beyond the pandemic, practicing online is likely to become an accepted supplementary therapeutic space for evaluation and treatment by psychodynamic psychiatrists.

Representing Representations

This chapter champions the priority of objectual representations and reference to the world over fine-grained “inner” mental representations. The main argument rests upon demonstrating that our attitude ascriptions practices give priority to de re ascriptions of mental contents over de dicto ascriptions of mental contents. The argument thereby advances a rejection of the Fregean tradition that construes modes of presentations of objects as essential to the characterization of mental contents within attitude ascriptions. A novel argument is advanced invoking the evaluative commitments expressed with embedded referential slurring terms in argument position, showing them to reveal derogatory attitudes of the ascriber, not the ascribee, and then showing by analogy that the same obtains for existential and referential commitments: they do not typically invoke Fregean modes of presentation by which the ascribee cognizes the world. The chapter ends by reexamining substitution puzzles and the nature of de re belief.

What Is It Like to Be a Bot?

This chapter seeks to further develop, define, and differentiate human-technics alterity relations within postphenomenological philosophy of technology. A central case study of the Alexa digital assistant establishes that digital assistants require the adoption of the intentional stance, and illustrates that this structural requirement is different from anthropomorphic projection of mindedness onto technical objects. Human-technics alterity relations based on projection are then more generally differentiated from human-technics alterity relations based on actual encoded pseudo-mental contents, where there are matters of fact that directly correspond to user conceptualizations of “intentions” or “knowledge” in technical systems or objects. Finally, functions and user benefits to different alterity relations are explored, establishing that there is a meaningful set of cases where the projection of a mind in human-technics alterity relations positively impacts technical functions and user experiences.

Olson E. T. Was I Ever a Fetus? / trans. from Engl. V. A. Sermaksheva

The Standard View of personal identity says that someone who exists now can exist at another time only if there is continuity of her mental contents or capacities. But no person is psychologically continuous with a fetus, for a fetus, at least early in its career, has no mental features at all. So the Standard View entails that no person was ever a fetus-contrary to the popular assumption that an unthinking fetus is a potential person. It is also mysterious what does ordinarily happen to a human fetus, if it does not come to be a person. Although an extremely complex variant of the Standard View may allow one to persist without psychological continuity before one becomes a person but not afterwards, a far simpler solution is to accept a radically non-psychological account of our identity

Reading the User’s Mind: Designers Show High Accuracy in Inferring Design-Related Thoughts and Feelings

The success of design needfinding is largely dependent on how well designers understand their users. It is further claimed that user understanding and designers’ capacity to adopt users’ perspective, i.e. designers’ ability to understand others, are key skills that should lead to successful design outcomes. The general ability to understand someone else’s mental contents, such as what they else think, feel, wish, and believe, is called theory of mind. In this study, we connect concepts of human-centered design and theory of mind through empathic accuracy, a performance-based method for measuring empathy. We state two hypotheses. First, that designers are equally accurate at inferring thoughts as they are at inferring feelings. Second, that designers are more accurate in inferring design-related mental contents than those that are not related to design. We answer these hypotheses by analyzing results of altogether 24 designers watching recorded needfinding interviews of 6 users and inferring their mental contents. We observed that feelings were more accurately inferred than thoughts, although the data showed some inconsistencies. A stronger case can be made for designers’ accuracy of design-related entries, where designers were consistently more accurate at inferring design-related entries than non-design-related ones. These results provide concrete insight into how designers understand users and how empathy could be quantified in the design context.

Mistaking an Intention for a Behavior: The Case of Enacting Behavioral Decisions Versus Simply Intending to Enact Them

Five experiments investigated a previously unrecognized phenomenon—remembering that one enacted a mundane behavioral decision when one only intended to do so—and its psychological mechanisms. The theoretical conceptualization advanced in this research proposes that this error stems from a misattribution when an intention and a behavior are similar. Intentions and behaviors are similar when the physical aspects of the behavior resemble the intention (e.g., both require similar keystrokes) and when the behavior and the intention share mental contents (e.g., both rely on the same criterion). Experiments 1 and 2 introduced a paradigm with similar intentions and enactments and showed misreports and subsequent performance errors even when controlling for guessing. Experiments 3 and 4 demonstrated greater confusion when the physical involvement and mental criteria for intention and behavior were similar. Finally, Experiment 5 indicated that monitoring enactment is highly effective at reducing this error and more effective than monitoring intention.

Philosophy

This chapter examines how the late seventeenth-century British philosophy of sensation, feeling, and selfhood responded to the challenges of mechanism with the idiom of the insensible. It shows how this idiom carries forward from John Locke and Robert Boyle to philosophers of the mid-eighteenth century, the age of sensibility, who use it to address a variety of problems. The consistent, Lockean element in these usages by David Hartley, Étienne Bonnet de Condillac and David Hume, Eliza Haywood and Adam Smith, is that they do not refer to mental contents. One does not hear of “insensible perceptions.” There are no “unconscious thoughts” or “unfelt sensations” in the British tradition surveyed here. Writers in this tradition rather describe insensible powers that affect the mind without themselves being mental. They are nonconscious, not unconscious. This is an implication carried by the idiom into articulations of quite a wide variety of other ideas. All of them indicate the persistent usefulness in philosophies of feeling of a stylistic gesture toward something beyond the reach of both feeling and philosophy.

Ineffability: the Very Concept

In this paper, I analyze the concept of ineffability: what does it mean to say that something cannot be said? I begin by distinguishing ineffability from paradox: if something cannot be said truly or without contradiction, this is not an instance of ineffability. Next, I distinguish two different meanings of ‘saying something’ which result from a fundamental ambiguity in the term ‘language’, viz. language as a system of symbols and language as a medium of communication. Accordingly, ‘ineffability’ is ambiguous, too, and we should make a distinction between weak and strong ineffability. Weak ineffability is rooted in the deficiencies of a particular language while strong ineffability stems from the structure of a particular cognitive system and its capacities for conceptual mental representation. Mental contents are only sayable if we are able to conceptualize them and then create signs to represent them in communication.

Portrayals of Mind

This essay offers readings of episodes from Crime and Punishment, in particular Raskolnikov’s receipt of the letter from his mother and his discussions with Zametov and with Porfiry Petrovich, with a view to identifying how Dostoevsky depicts the nature of the mind. In Dostoevsky’s picture, it is shown, mental privacy is itself socially grounded and contextual, and subject to destabilizing self-descriptions; mental contents are knowable only through our discursive connection to others; and the expressive potential of language far exceeds anyone’s intentional control. Dostoevsky’s presentation of the mind is compared to the philosophical views of Wollheim, Moran, and Murdoch.