Philosophy Special Interest Group of the Royal College of Psychiatrists
Philosophy
Psychiatry
Newsletter 40
of
July 2015
Editors: Dr Abdi Sanati (Consultant Psychiatrist, North East London NHS Foundation Trust) &
Dr Steve Ramplin (Consultant Forensic Psychiatrist, Tees Esk and Wear Valleys NHS Foundation Trust)
Our four years at the helm of the newsletter for the Philosophy Special Interest Group have been an amazing
experience, during which we have learned many things and met many interesting people. Since our first issue of
May 2011, we have strived to keep our readers interested and to simultaneously act as a voice in the world of
philosophy of psychiatry, in which 2015 promises to be an exciting year indeed, as there are several prestigious
conferences where leading figures in the discipline will gather to exchange ideas. The details are all within the
newsletter—we encourage you all to attend, thereby adding to the intellectual substance of these events.
Introduction to ‘The Other Side of Child Sex Offenders’
One of the roles of philosophy is to shed light into aspects of humanity, including, or perhaps especially, those
which are provocative or difficult. The opening lines of the next article introduce a theme of this nature: the
vilification of child sex offenders. As a forensic psychiatrist, this is a group with which I have some familiarity.
Typically in psychiatry, however, it is the past victims of such individuals who are more commonly
encountered; understandably, it is with such people where sympathies lie. However, while it might be
discomforting to reflect upon reasons why the perpetrators of such admittedly heinous acts are subject to such
vehement disapprobation, it may engender new philosophical understanding. Such an analysis is attempted in
the following article, written by Aaron Ben-Joseph, a medical student who recently did a selective student
component in philosophy of psychiatry, based within a secure psychiatric setting. Of relevance, Aaron is also a
volunteer for Circles, a charitable organisation that aims to help rehabilitate sex offenders into the community
by providing a supportive social network. We do anticipate that this article might provoke some strong views—
such is the spirit of philosophical debate and of course we would welcome your comments.
Dr Steve Ramplin (Consultant Forensic Psychiatrist, Tees Esk and Wear Valleys NHS Foundation Trust)
‘The Other Side of Child Sex Offenders’
By Aaron Ben-Joseph, Medical Student, University of Newcastle
Child sex offenders are one of the most vilified groups in our society. This attitude even extends to our prisons,
where they are considered the lowest in the inmate hierarchy and can be subject to bullying and assaults. The
demonization of child sex offenders in my view exacerbates the problem they present. People with deviant
sexual thoughts towards children are told by society that they are evil which discourages them from seeking
help. Consequently, when child sex offenders are released into the community they are socially isolated rather
than supported, which leads to higher rates of reoffending. It is interesting to consider why child sex offenders
are treated in this way, especially considering it is so obviously counter-therapeutic. I believe that the general
attitude towards child sex offenders can be better understood through the work of Edward Said (pictured above,
on the cover of ‘The Edward Said Reader’, by Said [author] and Bayoumi and Rubin [editors], published by
Granta Books, 2001) and his concept of ‘Othering’.
In his 1978 book, Orientalism, Said criticises Western depiction of ‘the East’ highlighting the patronising
language and romanticised fiction used to represent it. He argues that discourse surrounding ‘the East’, even if it
is not all immediately obviously negative, is used to define its people as intellectually inferior, irrational
‘Others’ outside of the Western social identity. Said believes this is connected to imperialism because defining
non-westerners as an ‘Other’ justifies the expressed responsibility to ‘civilise’ and hence control ‘the East’.
1
The ‘Othering’ concept helps elucidate society’s depiction of child sex offenders; the language and caricatures
surrounding child sex offenders immediately distinguishes them as ‘Others’ outside the social identity of formal
society. Phrases such as ‘sexual predator’ and ‘preying on young children’ portray child sex offender as subhuman, closer to an animal, before one even consciously considers the true meaning of such a term.
Why might child sex offenders be particularly loathed by the public? One obvious reason might include the fact
that such offences represent a departure from the natural protectiveness an adult would ordinarily have for a child.
However, this does not explain why perpetrators of this particular offence category are more ‘Othered’ than
perpetrators of offences against children in different crime categories (such as domestic violence). One hypothesis
is that many ordinary people have anxieties about the nature of their sexual thoughts, particularly whether or not
they are ‘normal’. Given society’s disapprobation for child sex offenders, this might engender a fear of being
mislabelled as such an individual. By way of illustration, 10% of patients with OCD present with a primary sexual
obsession and a significant number of these worry that they are paedophiles [Foa et al, 1995]. If one accepts that
obsessions in OCD are representative of the anxieties of the many this might explain some of the drive within
society to ‘Other’ child sex offenders. Demonising them, and therefore ‘Othering’ them, reinforces to the rest of
society that one is not a paedophile, simultaneously allaying any contrary anxiety.
Edward Said’s concept of ‘Othering’ provides a new lens to consider why child sex offenders are so viewed by
society, yet it proves to be pessimistic reading from the perspective of treatment to reduce recidivism. Until, as a
society, we allow people who experience deviant sexual thoughts to seek help, rather than to hide the need to do
so, we will struggle to prevent child sex offences. One project attempting to do this is Circles.
Circles is a volunteer organisation originating in Canada that aims to help sex offenders (or core members, as they
call them) rehabilitate into the community. After release from prison each core member is allocated a ‘Circle’ of
four or five volunteers, who meet them on a weekly basis for the next eighteen months. In order to be eligible for a
Circle, a core member must have a conviction for a sexual offence against a child and be deemed at high risk of
reoffending. Circles boasts a 70% reduction in sexual reoffending, which is impressive considering the eligibility
criteria [Wilson et al, 2007]. The project is based upon restorative justice, focussed upon meeting the needs of both
offender and victim. Circles is not a fully restorative model, however, as it does not engage the victim as well, but
it does help meet some of the needs of the core members. The most obvious problem Circles addresses is social
isolation. The stigma associated with a sex offence often leads to core members losing contact with friends and
family, causing increased isolation and increasing the risk of re-offending. The support network provided by a
Circle can provide a core member with a safe space to build their confidence in social situations as well as
modelling ‘normal’ relationships through conversations between the volunteers.
When a Circle begins, the first meeting involves the core member and their probation officer explaining all of the
core member’s offences and risk factors. The disclosure of the core member’s offending history proves to each
core member that a group of people can hear the exact details of their offence and still want to get to know them as
a person. This is a vital aspect of Circles, as it shows core members that people can condemn their offence but still
want to connect with them and not simply view them as an offender. While Circles can have a massive impact
individually, it also aims to address public attitudes about sex offenders by trying to change the way that people
think about them. One aspects of volunteering for Circles that assists with this is when volunteers tell people about
the project.
As long as people with deviant sexual thoughts towards children are made to feel like ‘Others’ in our society, they
will continue to keep offending without seeking help. If, as a society, we can make people with these thoughts feel
able to seek help, we will reduce the amount of sexual offences against children. Circles is a project that begins to
challenge the way that people think about child sex offenders by breaking down the sense of ‘Othering’.
References
Wilson, R. J., Picheca, J. E. and Prinzo, M. (2007), Evaluating the Effectiveness of Professionally-Facilitated
Volunteerism in the Community-Based Management of High-Risk Sexual Offenders: Part Two – A Comparison
of Recidivism Rates. The Howard Journal of Criminal Justice, 46: 327–337.
Foa, E.B,. Kozak, M.J., Goodman, W.K., Hollande, E., Jenike, M.A., Rasmussen, S.A. DSM-IV field trial:
Obsessive-compulsive disorder. American Journal of Psychiatry. 1995;152:90–96
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A reflection: Reading Wittgenstein in Tehran⃰
A few months ago I had to visit Tehran, the city where I grew up, for a family emergency. This was a period of
uncertainty for us as a family. Knowing that the trip was going to be a very stressful and long one I decided to
take a difficult book to keep me focused. For some reason I cannot explain I decided to take Wittgenstein’s ‘On
Certainty’. Published posthumously, it is considered the third masterpiece by (arguably) the 20 th Century’s most
revered philosopher. I had come across ‘On Certainty’ when preparing an article on Campbell’s rationalist idea
of delusions, but had not read it in its entirety. I am not so grandiose to write a review of this book (at least not
yet), but I wanted share my thoughts as a non-scholar who managed his way through ‘On Certainty’.
I read the book on the plane, in the house, by the hospital bed and on the plane again. Initially I found it quite
impenetrable and paradoxically also very absorbing. Like some of Wittgenstein’s other books, such as
Philosophical Investigations, it is written in the style of aphorisms. As a first time reader, I found it hard to
understand but had to persevere as it was the only book I had taken along. I sometimes felt like Dr B, the
protagonist of Stefan Zweig’s novella The Royal Game (also translated as Chess) who steals a book while in
incarceration only to find it a collection of chess matches - and like Dr B, I ended up fascinated by the book.
I learned certain things from it: the notion of framework propositions became slightly clearer (it is a hard book
after all!) and the application of this idea to delusions made more sense, although my half formed views
diverged from Campbell’s. To quote the book, light dawned gradually over the whole. The most important
effect of the book, however, was its therapeutic effect. Dealing with a very uncertain situation I felt in company
of a wise man who gave me courage. Not that ‘On Certainty’ is a manual to cope with uncertainty, but because
it opened something new for me - it is always reassuring to experience this therapeutic effect of philosophy,
even when you don’t read it for that reason.
Also, given the fact that Wittgenstein is one of the most quoted philosophers, I learned again how important it is
to put quotes in context and to ensure their applicability. In the end, I decided two things. First, to study this
magnificent text in more detail, as hopefully I will learn much more from it. Secondly, I will never again accept
a Wittgenstein quote at face value without checking it first in the original!
⃰ The title refers to the book Reading Lolita in Tehran by Azar Nafisi.
Dr Abdi Sanati (Consultant Psychiatrist, North East London NHS Foundation Trust)
Book Reviews
Alien Landscapes? Jonathan Glover, Harvard University Press, 2014
Once in a while along comes a book with an idea that is at once obvious and so damned
clever that it makes you wonder why no one has done it before (or indeed, why you did
not think of it yourself!) This book opens with such an idea: to interview mentally
disordered offenders in a high secure hospital about morality, in the hope that doing so
will offer broader insights. And of course it does, to a point: yes, the emergent themes of
moral shallowness and dominance of self interest over imaginative concern for others are
unsurprising, but the theme of a morality emphasising fairness and rights, albeit not rooted
in empathy, is more nuanced. Glover then explores the origins of such moral thinking,
before attempting an interpretative analysis and then considering how moral thinking
might be nurtured, citing the intriguing real life example of when the Royal Shakespeare Company performed in
Broadmoor. This is all riveting stuff, but is merely one section of a larger book full of interesting material.
In part 2, Glover deconstructs the process of human interpretation, asking ‘how should we try to understand
another person’s inner life?’ He considers this from two different angles: intuitive interpretation, illustrating this
by evaluating self portraits Rembrant painted at different times in his life, and reflective interpretation, meaning
the use of systems honed by evolution—this introduces autistic disorders, which, alongside delusions, are aspects
of experience that can make interpretation challenging that are considered more deeply in Part 3.
Part 4, which considers the proper boundaries of psychiatry, opens with a sobering exposition of the dark
side of psychiatry, much of which will be familiar. Glover then considers the medicalisation of social disapproval
before tackling the weighty topics of personality disorder and then paraphilia, asking whether or not people with
such conditions should be candidates for psychiatric treatment. He then unpicks Wakefield’s concept of Harmful
Dysfunction, before returning again to autism, personality and sexual desire, asking questions about when
intervention and treatment are warranted. Part 5 considers ‘Agency, Control and Responsibility’ and opens with a
tragic case of infanticide. Addiction, weakness of will, character—each of these is considered in turn. Finally, in
part 6, Glover tackles identity, embracing eating disorders, dementia and schizophrenia, among other issues.
What more can I say? In summary, an absolute gem of a book.
Reviewed by Dr Steve Ramplin (Consultant Forensic Psychiatrist, Tees Esk and Wear Valleys NHS Foundation Trust)
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Book Reviews (continued)
Depression, Emotion and the Self: Philosophical and Interdisciplinary Perspectives (Journal of
Consciousness Studies), edited by Matthew Ratcliffe and Achim Stephan, Imprint Academic (1 July 2014)
As the editors explain in the introduction, this volume arose
out of a multidisciplinary research project, ‘emotional
experience in depression: a philosophical study’ (2009-2012)
that they both directed. The contributors bring together a
wide range of influences from different disciplines, such as
attachment theory, philosophy and neuroscience; they all
seem to agree on the importance of phenomenology in
elucidating the subjective experience and the wide ranging
and differing qualitative aspects of depression. They mostly
focus on the nature of depressive experience, discussing
themes such as emotions and affective states, selfhood, body,
intersubjectivity and world-experience, all areas of enquiry
that are ubiquitous in clinical practice but hardly ever
discussed in detail and/or theorized by clinicians. The goal of
such work is to enable clinicians and researchers to build
bridges between the ways depressed people experience
themselves and the world (first-person accounts of
depression) and the ways we approach these existential and
bodily changes with our conceptual knowledge and means of
understanding (psychopathology, psychological and
biological sciences, therapeutics). This book emphasizes and
shows evidence of the integrative role of phenomenology in
psychiatry, being able to encompass both qualitative
methodology and third-person perspectives on the same
subject matters.
However, most recent successful applications of phenomenology to psychiatry, such as the work of Louis Sass and
Josef Parnas, have centred upon schizophrenia, which makes this volume even more welcome and promising.
Each chapter provides different but overlapping perspectives on the subject, with the collection being divided into
four sections: Self and Agency; Comparative Phenomenology; Body and Culture; Phenomenological and
Neurobiological Perspectives.
I think a lot of clinicians and researchers will agree with one of the arguments shared by most authors of the
collection, which is that there is a need for further work on 'a phenomenological discrimination between different
forms of depressed mood', because they doubt that depression can be seen as a simple, unitary form of illness.
Most of these essays throw some light on how this can be made possible on a theoretical level. The central idea of
most phenomenological approaches is that depression is altering selfhood, causing changes in self-experiences,
with depressive feelings being associated with such self-changes. The phenomenological claim is that in order to
understand the common experiential features of depression, such as loss of meaningful activity, detachment from
the world, changes in sense of identity etc., one needs to have the self as the starting point of empirical analysis
and psychopathological enquiry. Following this, it is also important to compare the subjective experience of
depression with other states, such as schizophrenia, borderline personality disorder and mania. It is also essential
that any conception of depression should tackle the still prevalent dualism, showing that changes of the self are
intrinsically linked with bodily changes, which should not be examined separately from the psychological or
cognitive features of the illness.
This volume certainly provides an excellent background on the phenomenological approaches of depression. I also
think reading and discussing these essays will definitely enrich clinicians’ abilities to make fine-grained
distinctions between depressive phenomena, which can also serve as a basis to initiate new approaches and
relevant research programmes, focusing on selfhood and emotions.
Reviewed by Michalis Kyratsous, ST4-6 in General Adult Psychiatry, South London and Maudsley NHS Foundation Trust
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Conference Reviews
Testimonial Injustice: Contrasting Cases in Health Care and Mental Health, at Co-Production and Mental
Health: Beyond Therapeutic Conflict, Keble College, Oxford, 8 June 2015.
I was privileged to be invited to a series of talks at Oxford University on 8 June 2015 organised by Dr Edward
Harcourt, Dr Elianna Fetterolf and Therapuetic Conflicts, on the theme of Co-Producing Meaning in Mental
Health. Therapeutic Conflicts is a one year project organised through a collaboration between the Oxford Faculty
of Philosophy and the London-based charity the Mental Health Foundation. They use philosophy to answer the
question why has the aspiration to involve service-users and others as partners in the co-production of treatment
programmes not achieved better results?
One insightful lecture by Dr Jayasree Kalathil was on co-operation between professionals and patients/users and
carers in developing and providing services for sufferers of mental illness. I should add that the terminology of
mental illness and suffering is mine, Dr Kalathil (who defined herself as a service avoider) would probably
disagree. Nonetheless, I found her lecture interesting. The challenge of effective involvement of patients in the
services rather than a tokenistic one is a real one and we need more people like Dr Kalathil to challenge the current
orthodoxy. Her work can be accessed via http://www.survivor-research.com/who-we-are/15-jayasree-kalathil.
The next lecture from Professor Rose McCabe was based on her own work on therapeutic conflicts in psychiatric
patient communication. The analysis of a conversation between patient and psychiatrist recorded on a tape was
thought provoking—since then I have been more self-conscious in conversation with patients. Professor McCabe
has published several articles in this area which can also be accessed online. The importance of non-verbal
communication and fillers in communication cannot be underestimated and I think we do need more training in
using these communication styles.
There was also a workshop on dementia that involved a dementia sufferer, a carer and an academic (it was my
pleasure to meet Dr Ian James after 15 years). One of the main topics was that of therapeutic lying. While not a
philosophical debate on whether it is warranted and the deontological and utilitarian views for and against it, it
acknowledged that it does happen, has supportive research and considered when and how to do it. It was argued
that when used it had to be person centred and a last resort, and there also needed to be some training on the topic.
There are still questions to be answered, but the fact that it was put it under scrutiny is commendable.
Therapeutic Conflicts can be accessed via http://www.mvmh.ox.ac.uk/home/therapeutic_conflicts—I wish them
best of luck in their future endeavours.
Reviewed by Dr Abdi Sanati, Consultant Psychiatrist, North East London NHS Foundation Trust
Forthcoming Conferences
The following conferences are on the horizon. More details at the INPP website.
Mind, Value and Mental Health International Conference in Philosophy and Psychiatry 25 July 2015, St.
Hilda's College, Oxford (Click here for the Conference Programme and here for more details)
This one day international conference is delivered by renowned experts in the field of philosophy of psychiatry,
including Dr Rachel Cooper, who will present on ‘DSM-5: Stasis and Change’, Professor Gerrit Glas, who will
present ‘Psychopathology and self-relatedness: Conceptual issues’, Professor Anna Christina Nobre, presenting
‘Premembering Perception’ and Professor Owen Flanagan, who will present ‘Willing Addicts? Drinkers, Dandies,
Druggies and other Dionysians.’
Madness: The Making Sense of Madness Project: 8th Global Meeting, Tuesday 15 – Wednesday 16
September 2015, Mansfield College, Oxford (Click here for more details).
Madness: What is it? Why does it exist? Where and when does it happen? How does it happen, and to whom?
Like the relation between otherness and identity, madness might have always been used to define its opposite, or
defined by what it is not. Madness and its absence may even be intrinsically linked to everything we do and do
not, to all we aspire and escape from; it could be part of our origins and fate. But how can it be identified,
described, studied and/or treated? We propose to take an interdisciplinary approach, by which we mean one that
allows us to develop dialogues about the subject from different points of view, from and between different
disciplines and experiences. This will partly allow us to answer the questions above, in direct relation to the
specific contexts in which madness is observed, studied and/or experienced and it might also allow us all to
understand that, just by being humans, none of us is actually immune to it.
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Forthcoming conferences (continued)
THIRD UK CONFERENCE ON PHILOSOPHY AND PSYCHIATRY
PHILOSOPHY AND PSYCHIATRY SPECIAL INTEREST GROUP
Wednesday 23 - Friday 25 September 2015, Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB
The focus of this conference will be moral and legal responsibility in people who have been diagnosed with
mental disorders. This is an exciting area in which recent developments in policy and research are casting a new
light on old problems. The conference is not confined to psychiatrists and is open to anyone with an academic,
professional or personal interest in this area.
Final programme:
Time
Wednesday 23 September 2015
10.00-10.30
Registration and refreshments
10.30-10.45
WELCOME AND INTRODUCTION
Bill Fulford, Universities of Oxford and Warwick
KEYNOTE: FREE WILL IN THE ERA OF NEUROSCIENCE
John Callender, University of Aberdeen
10.45-11.30
11.30- 13.00 PARALLEL SESSION 1: FREE WILL, RESPONSIBILITY AND MENTAL ILLNESS
Secularism and spirituality in psychiatric understanding of personal responsibility
Rob Poole, Bangor University
Intervening on one’s own mind: The relationship between free will and mental disorder
Lieke Asma, VU University, Amsterdam
11.30-13.00
PARALLEL SESSION 2: NEUROSCIENCE AND ETHICS
The notions of proof and evidence in legal and psychiatric practice: Perspectives from
neuroscience
Drossi Stoyanov, Medical University of Plovdiv, Bulgaria
Brain Ethics: Lessons from the History of Neuroscience
Kevin Tobia, School of Law and Department of Philosophy, Yale University, USA
13.00-14.00
Lunch and poster viewing
14.00-15.30
PARALLEL SESSION 3: PSYCHIATRY IN THE PRISONS
Workshop: Ethical Dilemmas in the role of mental health clinicians in managing violence in
mentally disordered offenders: prison adjudications and assessing ‘fitness’ for placement in
segregation
Annie Bartlett, Clinical Director, Offender Care Directorate, CNWL NHS Foundation Trust
Amy Dixon, Governor of Residence, HMP Holloway
Heidi Hales, Consultant Adolescent Forensic Psychiatrist, CNWL Foundation NHS Trust
Zoe Newton, Head of Healthcare, HMP Holloway, CNWL NHS Foundation Trust
14.00-15.30
PARALLEL SESSION 4: AGENCY AND MENTAL DISORDER
Choosing self-neglect
Pam Laidman, School of Humanities, University of Brighton
Suicide and Agency
Abdi Sanati, North East London NHS Foundation Trust
15.30-15.45
Refreshments
15.45- 17.15 PARALLEL SESSION 5: PSYCHOTHERAPY AND MORAL RESPONSIBILITY
Agency and Responsibility in Mothers who Abuse or Neglect their Children
Sarah Majid, Tavistock Centre, London
Psychotherapy, Free Will and Moral Responsibility
John Callender, University of Aberdeen
15.45- 17.15 PARALLEL SESSION 6: AUTONOMY AND JUSTICE
Epistemic Injustice and Responsibility
Michalis Kyratsous, South London and Maudsley NHS Foundation Trust and Abdi Sanati, North East
London NHS Foundation Trust
Can doctors’ involvement in the infringement of autonomy inherent in the use of the Mental
Health Act be justified?
Janaki Bansal, Tavistock Centre, London
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THIRD UK CONFERENCE ON PHILOSOPHY AND PSYCHIATRY
PHILOSOPHY AND PSYCHIATRY SPECIAL INTEREST GROUP
Programme (continued):
Time
Thursday 24 September 2015
08.30-09.00
Registration and Refreshments
09.00 – 09.45
KEYNOTE: Neuroscience, memory and the law, Professor Michael Kopelman, King’s College, London
10.00- 11.30
PARALLEL SESSION 7: NEUROSCIENCE AND RESPONSIBILITY I
The Neuroscience of Criminality and the Notion of Punishment
Valerie Hardcastle, Departments of Philosophy, Psychology, and Psychiatry & Behavioral Neuroscience, Weaver
Institute for Law and Psychiatry, University of Cincinnati, USA
Is there a sense of responsibility that is distinct from moral or legal responsibility?
Lydia du Bois, University of Madison-Wisconsin, USA.
10.00- 11.30
PARALLEL SESSION 8: RESPONSIBILITY, CULPABILITY AND SENTENCING
Reforming Insanity and Automatism in English Law
Elizabeth Shaw, University of Aberdeen
How folk psychology affects the sleepwalking defence
John Rumbold, School of Law, Keele University
11.30-11.45
Refreshments
11.45- 13.15
PARALLEL SESSION 9: NEUROSCIENCE AND RESPONSIBILITY II
Neuroscientific understanding of personality disorder and diminished responsibility: implications for the
psychiatric expert witness
Olivia Tappin, Dawn Washington and Rajan Nathan, Mersey Care NHS Trust and University of Liverpool
Developmental Immaturity, Neuroimaging and Criminal Responsibility in Young People
Enys Delmage, St. Andrew’s Hospital, Northampton
11.45- 13.15
PARALLEL SESSION 10: PERSONALITY DISORDER AND RESPONSIBILITY I
Agency and responsibility in personality disorder - some findings and clinical implications from recent studies
Andrew Shepherd, Greater Manchester West Mental Health and the University of Manchester
Agency and Responsibility in Personality Disorder
Alexandra Getz, St Andrew’s Hospital, Northampton
13.15-14.00
Lunch
14.00 – 14.45
KEYNOTE ADDRESS: Responsibility, Culpability and the Sentencing of Mentally Disordered Offenders:
Objectives in Conflict, Professor Jill Peay, London School of Economics
14.45-16.15
PARALLEL SESSION 11: PERSONALITY DISORDER AND RESPONSIBILITY II
Self-knowledge and moral responsibility: the case of psychopathy
Luca Malatesti and Filip Cec, Department of Philosophy, Faculty of Humanities and Social Sciences, University of
Rijeka, Croatia
Antisocial Personality Disorder, Reasons-responsiveness and Voluntary Action
Gloria Ayob, Mental Health Division, School of Health, University of Central Lanchashire and Steve Ramplin,
Consultant Forensic Psychiatrist and Training Programme Director for Forensic Psychiatry, Tees, Esk and Wear
Valleys NHS Foundation Trust
14.45-16.15
PARALLEL SESSION 12: CAPACITY AND CONSENT I
Decision making capacity, “wise decision” and acquired frontal brain Injury
Gareth Owen, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
Self-binding directives and fluctuating-capacity: precedent autonomy, capacity, rights and responsibilities
Tania Gergel, Departments of Classics and Psychological Medicine, King's College London
16.15-16.30
Refreshments
16.30-18.00
PARALLEL SESSION 13: PERSONALITY DISORDER AND RESPONSIBILITY III
Criminal Responsibility and Personality Disorder
Clodagh Commane, Community Forensic Outreach Team, Springfield Hospital, London
Personality Disorder and Legal Responsibility
Sanja Dembic, Humboldt University, Berlin
16.30-18.00
PARALLEL SESSION 14: CAPACITY AND CONSENT II
Mainstreaming DNACPR: Ethical Approaches in the post-Tracey NHS
Reverend Dr Mark Bratton, Warwick Medical School, University of Warwick, C and Marek Marzanski, Coventry&
Warwickshire Partnership NHS Trust
‘Happy to help’ – altruism, risk and insight in assessment of assessing capacity to consent to research
participation in psychotic patients.
Benjamin Spencer, Gareth Owen, Matthew Hotopf and Tania Gergel, Institute of Psychiatry, Psychology and
Neuroscience, King’s College, London
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THIRD UK CONFERENCE ON PHILOSOPHY AND PSYCHIATRY
PHILOSOPHY AND PSYCHIATRY SPECIAL INTEREST GROUP
Programme (continued):
Time
Friday 25 September 2015
08.30-09.00
Registration and Refreshments
09.00- 09.45
FREEDOM, COUNTER-TERRORISM & PSYCHIATRY
INTRODUCTION: Dr Raj Persaud
KEYNOTE: Former Radical Maajid Nawaz, Quilliam Foundation, ‘on the Couch’ interviewed by Tazeen
Ahmad, broadcaster, writer and journalist
10.00-10.45
SESSION 1: Remembering the lessons of Communist 're-education': Does 'de-radicalisation' risk the
political misuse of psychiatry?
Alexandru Popescu, Oxford Health NHS Foundation Trust
11.00-12.30
SESSION 2
A Cure for Terror? In 2015 violent radicalism is not inevitable.
Experts: Lord Alex Carlile QC, Author of Report to the Home Secretary of Independent Oversight of Prevent
Review and Strategy 2011; DAC Helen Ball, Senior National Coordinator of Counter Terrorism Policing; Dr
Herjeet Marway, University of Birmingham Department of Philosophy Lecturer & Dr Simon Wilson, Fixated
Threat Assessment Centre (FTAC) Consultant Forensic Psychiatrist.
12.30
LUNCH AND CLOSE
POSTER PRESENTATIONS
Responsibilities of clinicians and service users. Dr Greg Baginski, Sussex Partnership Trust.
Statement of Significant Restriction of Liberty: Familiarity or Independence in Assessment and Provision
of Reports? Dr David Findlay, NHS Tayside.
The Return of the Concepts of Agency and Responsibility in the Etiology of Mental Disorders in Poland. Dr
Mira Marcinów, Institute of Psychology, Department of Philosophy, Jagiellonian University, Krakow, Poland.
Institutional Violoence and the Disciplinarian State. Carlos Andre dos Santos, Oxleas NHS Foundation Trust
Personal Identity and the Phineas Gage Effect. Kevin Tobia, School of Law and Department of Philosophy,
Yale University, USA.
Booking for this conference is on-line only and preference will be given to those who book for the whole three
days. Thereafter bookings will be made on a first come, first served, basis. There are 100 places available—to
avoid disappointment, please book early! The fees are: Whole conference (three days): £150; Wednesday 23
September 2015: £60; Thursday 24 September 2015; £60; Friday 25 September 2015: £30.
Click http://rcpsych.ac.uk/workinpsychiatry/specialinterestgroups/philosophy/philosophypsychconference.aspx
to be taken directly to the booking page.
Other up-coming conferences include:
The Brain’s Networks: Which are they and
what do they do? 18—20 September 2015,
Gothenburg, Sweden
This conference will give a snapshot of the
current state of knowledge about the brain’s
networks through perspectives from
neuroanatomy, neurophysiology, neurology,
psychiatry, psychology, structural MRI,
functional brain imaging, advanced data
analysis and mathematical modelling of neural
networks. It will feature discussions between
the speakers, and between the speakers and
the audience, on how to integrate the research
from these different fields. (Click here for
more details).
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Forthcoming conferences (continued)
Mental disorder and self over time, Tuesday 1 September 2015, King’s College, London
How does the experience of a severe mental disorder effect an individual’s sense of self and personal identity over
the course of time? How does this vary in relation to the particular patterns and course of specific disorders? The
workshop will include 6 sessions, in which clinicians/service users will reflect on these questions in relation to a
range of disorders. Each talk will be followed by a short response from a philosophical commentator and a time for
group discussion. Our aim is to create an interdisciplinary, collaborative and exploratory atmosphere, bringing
together participants from mental health, philosophical and legal backgrounds.
Speakers
 Affective (mood) Disorders: Julia Bland (South London and Maudsley NHS) with response by Jill Craigie
(KCL).
 Dementia: Juliette Brown (East London NHS) with response by Agnieszka Jaworska (University of California,
Riverside).
 Bipolar Disorder: Clare Dolman (IoPPN/KCL) with response by Wayne Martin (University of Essex).
 Psychosis: Eduardo Iacoponi (South London and Maudsley NHS) with response by Tania Gergel (IoPPN/
KCL).
 Borderline Personality Disorder: Angel Santos (South London and Maudsley NHS) with response by Natalie
Gold (KCL).
 Anorexia: Lorna Richards (Barnet, Enfield and Haringey Mental Health Trust) with response by Jonathan
Glover (KCL).
Timings/location
The workshop will run at KCL Strand Campus from 10-5:30, with lunch included, and is to be followed by drinks
at a nearby venue. Places at the workshop are limited and so we would be very grateful if you could confirm
attendance as soon as possible. Replies to [email protected]—please inform us of any dietary requirements.
Natalie Gold (KCL Philosophy), Jill Craigie (Centre for Medical Law and Ethics, KCL) and Tania Gergel (Mental Health, Ethics
and Law, IoPPN/KCL)
Books
Here are the latest two publications in the International Perspectives in Philosophy & Psychiatry series:

The Abraham Dilemma: A Divine Delusion, George Graham, IPPP, August 2015, £29.99
What is a religious or spiritual delusion? What does religious delusion reveal about the difference between good
and bad spirituality? What is the connection between religious delusion and moral failure? Or between religious
delusion and religious terrorism? Or religious delusion and despair? The Abraham Dilemma: A Divine
Delusion is the first book written by a philosopher on the topic of religious delusion - on the disorder's causes,
contents, consequences, diagnosis and treatment.
Naturalism, Interpretation and Mental Disorder, Somogy
Varga, IPPP, August 2015, £36.99
The philosophy of psychiatry can be seen as a unique area of
research because the nature of the subject matter leads to rather
unique methodological challenges. This book is unique in focusing
on challenges that concern processes of interpretation and
understanding and in integrating a hermeneutical perspective to
understanding mental illness.

Philosophy of Psychiatry SIG Website
Dr Dieneke Hubbeling continues to run the Philosophy Special Interest Group Website. Please support it by
visiting: www.rcpsych.ac.uk/college/specialinterestgroups.aspx.
Contributions invited for Autumn 2015 Newsletter—send us your book and conference reviews
As ever, we are always delighted to receive contributions and would particularly welcome book reviews and
philosophically themed articles. Please send your material to either Dr Abdi Sanati ([email protected])
or Dr Steve Ramplin ([email protected]) by 30 September 2015.
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