Professor Duff Waring
dwaring@yorku.ca
Office Location:  S428 Ross
Phone Number:  (416) 736-2100 Ext. 33522
Office Hours:  I will be available every Monday from 2:30 until 3:30. I am also available during the week by appointment.

Is schizophrenia a brain disease or is it better understood as a troubled mode of being-in-the-world? There has been a recent growth in philosophy of psychiatry that draws heavily on two philosophic traditions. Analytic philosophy is applied to better understand psychiatry through an analysis of its fundamental concepts. There is much unease about these concepts and the extent to which some of them are equivocal as between moral and biomedical interpretations. Indeed, this unease runs through the concept of mental disorder itself. [1] The  phenomenological/existential tradition is applied to better understand the lived experience of those diagnosed with mental disorders and to complement a neuroscientific, brain-based analysis of biochemical causation. Schizophrenic pathology might make greater sense if we see it as a response to a personal type of suffering that is mediated by the network of interpersonal relations with which the schizophrenic must cope.

Many philosophers attempt utilize these traditions as frameworks for collaboration by which the split between humanistic and biological models of psychiatry might be overcome. The established biological model of psychiatry is premised on the viewpoint that “mental disorders” have a causal basis in specific biochemical and physico-functional irregularities of the brain. It minimizes the relevance of lived experience in favour of a detached, often reductionist, third-person emphasis on biochemical etiology. The humanistic model of psychiatry aims to reclaim the lived experience of mental disorder as an explanandum in its own right. An emerging idea in the philosophy of psychiatry is that knowledge of neurobiological processes and a method of phenomenological description that stays close to the lived experience of mentally disordered persons might complement each other in research and treatment. Hence the growing interest in making connections between neuroscientific findings about the brain and phenomenological descriptions of experience that would integrate the biological as an aspect of a patient’s lived experience that “does not assume explanatory power for the totality of that patient’s life.”[2] This course will explore current work from both philosophical traditions in an attempt to better understand four areas of interest: 1) the role of moral values in psychiatric diagnosis and treatment; 2) the limits of our ability to understand the meaning of a mentally disordered person’s experiences, beliefs and utterances; 3) the conceptual, normative and scientific foundations of psychiatry and 4) ethical and epistemological issues pertaining to psychiatric research and pharmaceutical and psychotherapeutic treatments.

[1] K.W.M. Fulford, Katherine J. Morris, John Z. Sadler, and Giovanni Stanghellini, “Past Improbable, Future Possible: The Renaissance in Philosophy and Psychiatry,” in Nature and Narrative: An Introduction to the New Philosophy of Psychiatry, eds. K.W.M. Fulford, Katherine J. Morris, John Z. Sadler, and Giovanni Stanghellini (Oxford: Oxford University Press, 2003), 10. See also Natalie Banner and Tim Thornton, “The New Philosophy of Psychiatry: Its Recent Past, Present and Future: A Review of the Oxford University Press Series International Perspectives in Philosophy and Psychiatry,” Philosophy, Ethics, and Humanities in Medicine 2 (2007): 1-14.

[2] Larry Davidson, “Developing an Empirical Phenomenological Approach to Schizophrenia Research.”

Journal of Phenomenological Psychology 23 (1992): 3–15.

All required readings are electronically accessible via the links provided or through the Yorku Libraries Catalogue. I have uploaded a bibliography of supplementary readings for every seminar on the eClass website. These readings are optional. They expand upon key ideas that emerge in the seminars and may assist you in compiling a bibliography for your major paper. All supplementary readings are electronically accessible via the links provided or through the Yorku Libraries Catalogue.

Major Paper Outline with Bibliography (8 pages minimum, or 10 pages max, double-spaced, not including bibliography): 25%.  It is due on Fri. Oct. 10. Submit as a Word doc to Turnitin on the eClass website by midnight. Do not submit PDF files.

Major Paper (18 pages minimum, or 20 pages max, double-spaced, exclusive of bibliography): 40%. It is due on Wed. Dec. 3. Submit as a Word doc to Turnitin on the eClass website by midnight. Do not submit PDF files.

These essays must be argumentative. See the Essay Writing Handbook for Philosophy Students posted on the Course Website.

In-Class Presentation: 25%. Each student will be assigned a Required Reading to Present in class. Dates TBA.

Attendance: 10%. Students must attend 10/12 seminars. Attendance will be taken before the end of each class. This is a seminar class, so attendance and participation are crucial components, and worth a combined 35% of your final grade. And it’s not just participating with me. Engaging with your student colleagues is a big part of what our discussions will involve.

Students are expected to attend in person, to read the assigned materials beforehand, and to participate actively in class discussions. Essay questions will be related directly to the materials discussed in class. We will be discussing some very contentious moral issues about which reasonable people disagree. Civility and intellectual respect for colleagues are virtues we will cultivate.

* To understand how analytic and existential/phenomenological traditions in philosophy are applied to the analysis of basic psychiatric concepts as well as the problems of value, meaning, and fact that this medical discipline presents.

* To understand competing models of psychiatry.

*To understand competing modes of psychiatric treatment

* To understand key conceptual and methodological issues in psychiatric research.

Grading: Assignments and tests* will bear either a letter grade designation or a corresponding number grade (e.g.  A+ = 90 to 100, A = 80 to 90, B+ = 75 to 79, B 70 to 74, C+ 65 to 69, C 60 to 64, D+ 55 to 59, D 50 to 54, E 40 to 49 and F is anything below 40).

For a full description of York grading system see the York University Undergraduate Calendar - http://calendars.registrar.yorku.ca/pdfs/ug2004cal/calug04_5_acadinfo.pdf.

The Senate Grading Scheme and Feedback Policy stipulates that  (a) the grading scheme (i.e. kinds and weights of assignments, essays, exams, etc.) be announced, and be available in writing, within the first two weeks of class, and that, (b) under normal circumstances, graded feedback worth at least 15% of the final grade for Fall, Winter or Summer Term, and 30% for ‘full year’ courses offered in the Fall/Winter Term be received by students in all courses prior to the final withdrawal date from a course without receiving a grade (see the policy for exceptions to this aspect of the policy - http://www.yorku.ca/secretariat/legislation/senate/gradfeed.htm).

Late Penalties:

It is your responsibility to speak with me if you have an SAS Accommodations Letter. Otherwise, late submissions will be penalized 5% per day. In exceptional cases (e.g., serious illness with proper and legible documentation from a physician), I may exercise discretion and waive the late penalty.

Academic Integrity and AI:

I take academic integrity very seriously. I require that you be honest about submitting your own work and that you cite your sources with accuracy. Plagiarism will not be tolerated. I will not grade a paper unless I am satisfied that my academic honesty requirements have been met. I use Turnitin.com to assess this and will provide instructions for submission on the Moodle course website. I authorize one use of AI technology: to correct spelling and grammar. Otherwise, I do not permit using AI to complete an assignment either in whole or in part, or to find quotes to insert into an assignment. Do your own thinking, writing, and research.

SEMINAR SCHEDULE:

Mon. Sept. 8.  Seminar 1: Introduction to the Field.

No Required Readings.

Part A: Psychiatry as a Medical Discipline.

Mon. Sept. 15 Seminar 2: Biological Conceptions of Psychiatry.

Required Readings:

Available online at: https://www.youtube.com/watch?v=3RX41PwHALY

Anne Harrington, "The 1980s Biological Revolution in Psychiatry: What Really Happened.”

Available online at: https://www.youtube.com/watch?v=TVs2LAAMgv4

Anne Harrington, "The 1980s Biological Revolution in Psychiatry: What Really Happened Next."

Available online at: https://www.schematherapysouthafrica.co.za/wp-content/uploads/2020/01/2019-Gardner-Kleinman-Medicine-and-the-mind.pdf, or through the Yorku Libraries Catalogue.

Caleb Gardiner & Arthur Kleinman, “Medicine and the Mind – The Consequences of Psychiatry’s Identity Crisis,” The New England Journal of Medicine 381 (2019): 1697-1699.

Available online at: http://www.jemh.ca/issues/v3n2/index.html. Or just Google Journal of Ethics and Mental Health and go to vol. 3, no. 2.

Walter Glannon, “The Blessing and Burden of Biological Psychiatry,” Journal of Ethics in Mental Health 3, no. 2 (2008): 1-4.

Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647424/

Estelle Dumas-Mallet & Francois Gonon, “Messaging Biological Psychiatry: Misrepresentations, Their Causes and Potential Consequences,” Harvard Review of Psychiatry 28, no. 6 (2020): 395-403.

Mon. Sept. 22 Seminar 3: Existential/Phenomenological Conceptions of Psychiatry:

Required Readings:

Available online at: https://www.researchgate.net/publication/232250607_Existential_phenomenology_psychiatric_illness_and_the_death_of_possibilities

Matthew Ratcliffe & Matthew Broome, “Existential Phenomenology, Psychiatric Illness and the Death of Possibilities,” The Cambridge Companion to Existentialism, ed. Steven Crowell (Cambridge: Cambridge University Press, 2012), 361-382.

Electronically accessible through the Yorku Libraries Catalogue:

Barnaby Nelson, Josef Parnas , & Louis A. Sass, “Disturbance of Minimal Self (Ipseity) in Schizophrenia: Clarification and Current Status,” Schizophrenia Bulletin 40 no. 3 (2014): 479–482.

Evan J. Kyzar & George H. Denfield, “Taking Subjectivity Seriously: Towards a Unification of Phenomenology, Psychiatry, and Neuroscience,” Molecular Psychiatry 28 (2023):10 – 16. Available at: https://www.nature.com/articles/s41380-022-01891-2

Larry Davidson, “Developing an Empirical Phenomenological Approach to Schizophrenia Research.” Journal of Phenomenological Psychology 23, no. 1 (1992): 3–15.

Part B: Mental Disorder.

Mon. Sept. 29 Seminar 4: Conceptions of Mental Illness/Disorder.

Required Readings:

Electronically accessible through the Yorku Libraries Catalogue:

388. C. Wakefield, “The Concept of Mental Disorder: On the Boundary Between Biological Facts and Social Values,” American Psychologist 47, no. 3 (1992): 373-388.

Kenneth W.M. Fulford & Tim Thornton, “Fanatical About ‘Harmful Dysfunction,’” World Psychiatry 6, no. 3 (2007): 161-162.

Eric Mathews, “Moral Vision and the Idea of Mental Illness,” Philosophy, Psychiatry, and Psychology 6, no. 4 (1999): 299-310.

Matthew Ratcliffe, “Loss of Hope,” in Experiences of Depression: A Study in Phenomenology (Oxford and New York: Oxford University Press, 2015), 574-591.

Mon. Oct. 6: Seminar 5: Classification and Diagnostic Criteria of Mental Disorders.

Required Readings:

Electronically accessible through the Yorku Libraries Catalogue:

Jerome C. Wakefield, “The Concept of Mental Disorder: Diagnostic Implications of the Harmful Dysfunction Analysis,” World Psychiatry 6, no. 3 (2007): 149-156.

Awais Aftab & Elizabeth Ryznar, “Conceptual and Historical Evolution of Psychiatric Nosology,” International Review of Psychiatry 23, no. 5 (2021): 486-499.

Kenneth W.M. Fulford, Mathew Broome, Giovanni Stanghellini, and Tim Thornton, “Looking With Both Eyes Open: Fact and Value in Psychiatric Diagnosis?” World Psychiatry 4, no. 2 (2005): 78-86.

Anna Bortolan, “Phenomenological Psychopathology and Autobiography,” Oxford Handbook of Phenomenological Psychopathology, eds. G. Stanghellini, M. R. Broome, A. V. Fernandez, P. Fusar-Poli, A. Raballo, & R. Rosfort (Oxford: Oxford University Press, 2019), 1053–1064.

Douglas Porter, “Ontological Assumptions, A Biopsychosocial Approach, and Patient Participation: Moving Towards and Ethically Legitimate Science of Psychiatric Nosology,” Philosophy, Psychiatry, & Psychology 24, no. 3 (2017): 223-226.

Fri. Oct. 10 Major Paper Outline Due. Submit to Turnitin by midnight.

Mon. Oct. 13 Reading Week. No class.

Mon. Oct. 20 Seminar 6: Mental Disorders, Mental Capacity and the Physician-Assisted Suicide Debate.

Required Readings:

Electronically accessible through the Yorku Libraries Catalogue:

David W. Kissane, “The Contribution of Demoralization to End of Life Decision-Making,” Hastings Center Report 34, no. 4 (2004): 21-31.

Ron Berghmans, Guy Widdershoven, Ineke Widdershoven-Heerding, “Physician-Assisted Suicide in Psychiatry and Loss of Hope,” International Journal of Law and Psychiatry 36 (2013): 436-443.

Jocelyn Downie & Udo Schuklenk, “Social Determinants of Health and Slippery Slopes in Assisted Dying Debates: Lessons from Canada,” Journal of Medical Ethics 47 (2021): 662-669.

Justine Dembo, Udo Schuklenk, & Jonathan Reggler, “For Their Own Good”: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness Is the Sole Underlying Condition,” The Canadian Journal of Psychiatry 63, no.7 (2018): 451-456.

Jukka Varelius, “On the Moral Acceptability of Physician‐Assisted Dying for Non‐Autonomous Psychiatric Patients,” Bioethics 30, no. 4 (2016): 227-233.

Patrick Craine, “Questioning the Ethics of Assisted Dying for the Mentally Ill,” Canadian Journal of Bioethics 6, no. 3 (2023): 115-127.

Hane Htut Maung, “Externalist Argument Against Medical Assistance in Dying for Psychiatric Illness,” Journal of Medical Ethics 49 (2023): 553-557.

This open access journal is available on the web. Google search Journal of Ethics in Mental Health Vol. 9, 2014. Scroll down to XI Special Theme Issue: Legislation and Medical Assistance in Dying.

Louis C. Charland, Trudo Lemmens, and Kyoko Wada, “Decision-Making Capacity to Consent to Medical Assistance in Dying for Persons with Mental Disorders,” Journal of Ethics in Mental Health Vol. 9 (2014).

Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047832/

Scott Y.H. Kim & Trudo Lemmens, “Should Assisted Dying for Psychiatric Disorders Be Legalized in Canada?” CMAJ 188, no. 14 (2016): E337-E339.

Mon. Oct. 27 Seminar 7: Psychiatry and Moral Agency.

Required Readings:

Anne Brice, “Psychopathy Goes Undetected in Some People. Why?” UC Berkeley News Oct. 28, 2024. Available at: https://news.berkeley.edu/2024/10/28/berkeley-voices-transformation-episode-1-psychopathy/

Electronically accessible through the Yorku Libraries Catalogue:

Neil levy, “The Responsibility of the Psychopath Revisited,”

 Philosophy, Psychiatry, and Psychology 14, no.2 (2007): 129-138.

Robert J. Smith, “The Psychopath as Moral Agent,” Philosophy and Phenomenological Research 45, no. 2 (1984): 177-193.

Walter Glannon, “Psychopathy and Responsibility,” Journal of Applied Philosophy 14, no. 3 (1997): 263-275.

Part C: Psychiatric Research.

Mon. Nov. 3 Seminar 8: Methodological and Conceptual Issues in Psychiatric Research.

Required Readings:

Electronically accessible through the Yorku Libraries Catalogue:

Ben Colagiuri, “Participant Expectancies in Double-Blind Randomized Placebo-Controlled Trials: Potential Limitations to Trial Validity,” Clinical Trials 7 (2010): 246–255.

39. J. Ellis & R.F. Adams, “The Cult of the Double-Blind Placebo-Controlled Trial,” International Journal of Clinical Practice 51, no. 1 (1997): 36-39.

Available at: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2018.00733/full

Eduardo Ekman Shenberg, “Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development,” Frontiers in Pharmacology 9 (2018): 1-11.

Available at: https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1951473

Eduardo Ekman Schenberg, “Letter to the Editor Regarding Blinding and Expectancy Confounds in Psychedelic Randomized Controlled Trials,” Expert Review of Clinical Pharmacology 14, no.10 (2021): 1317–1319.

Electronically accessible through the Yorku Libraries Catalogue:

William R. Smith & Dominic J. Sisti, “Ethics and Ego-Dissolution: The Case of Psilocybin,” Journal of Medical Ethics 47 (2021): 807–814.

Available through the Yorku Libraries Catalogue or online at: https://www.researchgate.net/publication/363164546_Preparing_for_the_Bursting_of_the_Psychedelic_Hype_Bubble

David B. Yaden, James B. Potash, and Roland Griffiths, “Preparing for the Bursting of the Psychedelic Hype Bubble,” JAMA Psychiatry 79, no. 10 (2022): 943-944.

Available online at: https://www.nature.com/articles/d41586-022-02875-6

Paul S. Appelbaum, “Bridging the Clinical Divide: Psychedelic Drug Research and the Real World,” Nature 609, no. 29 (2022): S95.

Part D: Modes of Psychiatric Treatment.

Mon. Nov. 10 Seminar 9: Psychopharmacology.

Required Readings:

Available online at: https://www.nature.com/articles/npp201784

Robin M. Carhart-Harris and Guy M. Goodwin, “The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future,” Neuropsychopharmacology 42 (2017): 2105-2113.

Electronically accessible through the Yorku Libraries Catalogue:

Ross J. Baldessarini, “The Impact of Psychopharmacology on Contemporary Psychiatry,” The Canadian Journal of Psychiattry 59, no. 8 (2014): 401-405.

Hartogsohn, Ido. “Set and Setting, Psychedelics and the Placebo Response: An Extra-Pharmacological Perspective on Psychopharmacology.” Journal of Psychopharmacology 30, no. 12 (2016): 1259-1267.

Hartogsohn, Ido. “The Meaning-Enhancing Properties of Psychedelics and Their Mediator Role in Psychedelic Therapy, Spirituality, and Creativity.” Fronters in Neuroscience 12, no. 129 (2018): 1-5.

Logan Neitzke-Spruill, Caroline Beit, Jill Robinson et al. “A Transformative Trip? Experiences of Psychedelic Use,” Neuroethics 17, no. 33 (2024): 1-21. Available at: https://link.springer.com/article/10.1007/s12152-024-09567-0

Mon. Nov. 17 Seminar 10: Psychotherapy.

Required Readings:

Available at: https://www.psychiatrictimes.com/authors/ross-j-baldessarini-md-phd

Alracon, Craig, Fitz & Baldessarini, “Rescuing an Essential Component of Psychiatry: Psychotherapy Training in Psychiatric Education,” Psychiatric Times February 10, 2020.

Alracon, Craig, Fitz & Baldessarini, “A Critical Moment in Psychiatry: The Need for Meaningful Psychotherapy Training in Psychiatry” Psychiatric Times February 28, 2020.

Electronically accessible through the Yorku Libraries Catalogue:

Kevin Aho and Charles Guignon, "Medicalized Psychiatry and the Talking Cure: A Hermeneutic Intervention," Human Studies 34, no. 3 (2011): 293-308.

Anne Bertolan, “Narrate It Until You Become It,” Journal of the American Philosophical Association 7, no. 4 (2021): 474-493.

Daniel D. Hutto, Shaun Gallagher. “Re-authoring Narrative Therapy: Improving Our Self-Management Tools,” Philosophy, Psychiatry, & Psychology 24 (2017): 157-167.

Gukasyan, Natalie & Sandeep M. Nayak, “Psychedelics, Placebo Effects, and Set and Setting: Insights from Common Factors Theory of Psychotherapy,” Transcultural Psychiatry 59, no. 5 (2022):  652-664.

David Smail, “Psychotherapy: Illusion With No Future?” in De-Medicalizing Misery: Psychiatry, Psychology, and the Human Condition, eds. Mark Rapley, Jacqui Dillon, Joanna Moncrieff (London: Palgrave Macmillan, 2011), 226-238.

Part E: New Directions in Philosophy of Psychiatry.

Mon. Nov. 24 Seminar 11: What is Positive Mental Health?

 Required Readings:

Electronically accessible through the Yorku Libraries Catalogue:

 Dilip V. Jeste, Barton W. Palmer, David C. Rettew, & Samantha Boardman, “Positive Psychiatry: Its Time Has Come,” Journal of Clinical Psychiatry 76, no. 6 (2015): 675-683.

Samantha Boardman & P. Murali Doraiswamy, “Integrating Positive Psychiatry Into Clinical Practice,” Positive Psychiatry: A Clinical Handbook, eds. Dilip V. Jeste, & Barton W. Palmer (Washington DC: American Psychiatric Association Publishing, 2015): 239-257.

Available at: doi: 10.1016/j.wpsyc.2012.05.006

George E. Vaillant, “Positive Mental Health: Is There a Cross-Cultural Definition?” World Psychiatry11, no. 2 (2012): 93–99.

Available at: doi: 10.1016/j.wpsyc.2012.05.023

Dan J. Stein, “Positive Mental Health: A Note of Caution,” World Psychiatry11, no. 2 (2012):107–109.

Available at: https://www.sciencedirect.com/science/article/pii/S0039368124000414

Somogy Varga, Martin Andersen, Anke Beuter, Anna Paldam Folker, “Mental Health Promotion and the Positive Concept of Health: Navigating Dilemmas,” Studies in History and Philosophy of Science 105 (2024): 32-40.

Available at: https://www.mdpi.com/2077-1444/15/4/489

Henderikus Knegtering, Richard Bruggeman, & Symen Kornelis Spoelstra, “Spirituality as a Therapeutic Approach for Severe Mental Illness: Insights from Neural Networks,” Religions 15 (2024): 1-12.

Mon. Dec. 1 Seminar 12: Where Does Psychiatry Go from Here? Major Paper Due. In-Class

Required Readings:

Available at: https://doi.org/10.1162/daed_a_02037

Anne Harrington, “Mental Health’s Stalled (Biological) Revolution: Its Origins, Aftermath, & Future Opportunities,” Daedalus (2023) 152 (4): 166–185.

Available online at: https://www.nature.com/articles/d41586-021-00187-9

Paul Tullis, “How Ecstasy and Psilocybin Are Shaking Up Psychiatry,” Nature 589 (2021): 506-509.

Available at: https://www.tandfonline.com/doi/full/10.1080/13218719.2014.915001

Warren Brookbanks, “Post-Psychiatry: A New Orthodoxy?” Psychiatry, Psychology, & Law  21, no. 6 (2014): 845-857.

Electronically accessible through the Yorku Libraries Catalogue:

Larry Davidson, Michael Rowe, Paul DiLeo, Chyrell Bellamy, & Miriam Delphin-Rittmon, “Recovery-Oriented Systems of Care: A Perspective on the Past, Present, and Future,” Alcohol Research. 41, no. 1 (2021): 1-11.