Enactive approaches to emotion are rare and to anxiety and anxiety disorder even more. This article aims to show how an enactive paradigm might be helpful in solving some problems in the clinical and scientific understanding of anxiety and anxiety disorder. I begin by pointing at a number of relevant clinical features of anxiety and anxiety disorder and by sketching how and why anxiety theories have difficulties with doing justice to these features. I specifically focus on two themes: a) how (...) to conceptualize anxiety as the expression of a dynamical interaction with the environment instead of as just a reaction to the environment (or to... (shrink)

This book focuses on two important, interlinked themes in psychiatry, i.e., the relation between self (or: person), context and psychopathology; and the intrinsic value-ladenness of psychiatry as a practice. -/- Written against the background of scientistic tendencies in today’s psychiatry, it is argued in Part I that psychiatry needs a clinical conception of psychopathology alongside more traditional scientific conceptions; that this clinical conception of psychopathology must be based on a fundamental rethinking of the interaction between illness manifestations, contextual influences and (...) the patient as person, such that psychopathology is conceived as the product of this interaction rather than as the outward manifestation of a broken mechanism within the patient. -/- In Part II, it is shown that self- and context-related factors have a large impact on who one is as a professional. I argue that an analysis is needed of the normative aspects of the relations that sustain and frame professional role-fulfilment. This analysis culminates into a so-called normative practice model (NPM) which distinguishes between qualifying, conditioning and foundational principles (or: rules, norms). The normative practice model helps to locate and resist scientistic defenses of the legitimacy of psychiatry and to replace them by a positive account that provides clinicians (and scientists) the conceptual tools they need to justify what they do in broader contexts. The main thrust of the argument is to show that psychiatry needs a value-sensitive account of its legitimacy, in which other normative dimensions are recognized than those that sustain the expert role. Psychiatrists should in other words not defend the legitimacy of their profession by referring to the expert role solely but provide a broader account in which justice is done to the broader social, legal, and economic contexts of professional activity. The analysis of this inherent normativity begins within clinical practice, it extends to the concept of disease as well as to wider domains of psychiatric care and the sociology of professions, and, finally, amounts into an analysis of the value-ladenness of interactions between healthcare institutions, the government, professional organizations and patient groups. (shrink)

Over the last years, self-management has become a central value in the practice of mental health care. Patients are positioned as expertclients who are actively involved in the management of their disease. Some of the ideas that are implied in the concept of self-management may raise important and intriguing questions. For instance, in the context of psychiatry impaired agency and altered self-experience are often part of the psychopathological process itself. The capacity to manage oneself may be impeded by the very (...) problem that needs to be managed. Therefore, how should self-management be conceived in... (shrink)

The article investigates the concept of self-illness ambiguity (SIA), which was recently re-introduced in the philosophy of psychiatry literature. SIA refers to situations in which patients are uncertain about whether features (symptoms, signs) of their illness should be attributed to their illness or to their ‘selves’. Identification of these features belongs to a more encompassing process of self- definition and -interpretation. The paper introduces a distinction between the notions of self-relatedness, self-referentiality (or: implicit self-signification), self-awareness and self-interpretation. Each of these (...) notions offers a different perspective on SIA, but these perspectives do not exclude one another. A further distinction will be developed between primary, secondary and tertiary forms of self-referentiality. The practical and conceptual relevance of these distinctions will be illustrated with case vignettes. Throughout the paper our findings will placed in the context of other philosophical work on the self, especially in the field of narrative theory (Ricoeur), phenomenology (Ratcliffe) and philosophy of mind. The article closes with a brief discussion about the appropriateness of the term ambiguity and the potential of SIA as concept in the context of clinical psychiatry. Directions for future work will be indicated. (shrink)

In this paper I explore possibilities of bringing post-positivist philosophies of empirical science to bear on the dynamics of mathematical development. This is done by way of a convergent accommodation of a mathematical version of Lakatos's methodology of research programmes, and a version of Kuhn's account of scientific change that is made applicable to mathematics by cleansing it of all references to the psychology of perception. The resulting view is argued in the light of two case histories of radical conceptual (...) innovations. (shrink)

The aim of this article is to give the proof-theoretic analysis of various subsystems of Feferman's theory T1 for explicit mathematics which contain the non-constructive μ-operator and join. We make use of standard proof-theoretic techniques such as cut-elimination of appropriate semiformal systems and asymmetrical interpretations in standard structures for explicit mathematics.

Accountability is a norm basic to several aspects of medical practice. We explore here the benefits of a more explicit focus on the virtue of accountability, which as distinct from the state of being held accountable, entails both welcoming responsibility to others and welcoming input from others. Practicing accountably can limit moral distress caused by institutional pressures on the doctor patient relationship. Fostering a mindset that is welcoming rather than resistant to feedback is critical to enhancing a culture of learning. (...) Analysis of failures of accountable practice offers opportunities for improving the delivery of clinical care. (shrink)

Borsboom and colleagues have recently proposed a “network theory” of psychiatric disorders that conceptualizes psychiatric disorders as relatively stable networks of causally interacting symptoms. They have also claimed that the network theory should include non-symptom variables such as environmental factors. How are environmental factors incorporated in the network theory, and what kind of explanations of psychiatric disorders can such an “extended” network theory provide? The aim of this article is to critically examine what explanatory strategies the network theory that includes (...) both symptoms and environmental factors can accommodate. We first analyze how proponents of the network theory conceptualize the relations between symptoms and between symptoms and environmental factors. Their claims suggest that the network theory could provide insight into the causal mechanisms underlying psychiatric disorders. We assess these claims in light of network analysis, Woodward’s interventionist theory, and mechanistic explanation, and show that they can only be satisfied with additional assumptions and requirements. Then, we examine their claim that network characteristics may explain the dynamics of psychiatric disorders by means of a topological explanatory strategy. We argue that the network theory could accommodate topological explanations of symptom networks, but we also point out that this poses some difficulties. Finally, we suggest that a multilayer network account of psychiatric disorders might allow for the integration of symptoms and non-symptom factors related to psychiatric disorders and could accommodate both causal/mechanistic and topological explanations. (shrink)

We characterize the proof-theoretic strength of systems of explicit mathematics with a general principle asserting the existence of least fixed points for monotone inductive definitions, in terms of certain systems of analysis and set theory. In the case of analysis, these are systems which contain the Σ12-axiom of choice and Π12-comprehension for formulas without set parameters. In the case of set theory, these are systems containing the Kripke-Platek axioms for a recursively inaccessible universe together with the existence of a stable (...) ordinal. In all cases, the exact strength depends on what forms of induction are admitted in the respective systems. (shrink)

Much is said about Middle Eastern and North African publics opposing gender equality, often referring to patriarchal Islam. However, nuanced large-scale studies addressing which specific aspects of religiosity affect support for gender equality across the MENA are conspicuously absent. This study develops and tests a gendered agentic socialization framework that proposes that MENA citizens are not only passively socialized by religion but also have agency. This disaggregates the influence of religiosity, highlights its multifacetedness, and theorizes the moderating roles that gender (...) and sociocognitive empowerment play via gendered processes of agentic dissociations. Using 15 World Values Surveys and multilevel models, our analyses show that most dimensions of religiosity fuel opposition to gender equality. However, the salience of religion in daily life is found to increase women’s support for gender equality and cushion the negative impact of religious service attendance. Also, gender and education moderate the impacts of several religiosity dimensions; for instance, women’s support for gender equality more sharply declines with increased service attendance than men’s. Altogether, this study finds that religious socialization is multifaceted and gendered, and that certain men and women are inclined and equipped to deviate from dominant patriarchal religious interpretations. (shrink)

We thank Sanneke de Haan for her thoughtful response. We agree with what she says and consider it as a further specification of our intentions. We particularly endorse the two main points she raises, that is, that dealing with self-illness ambiguity requires a relational perspective; and that relying on reflection solely is problematic since it plays an only modest role in the resolution of self-illness ambiguity. We discuss both points in reverse order.With respect to the role of reflection, we have, (...) as a matter of fact, been very explicit: “we should not overemphasize the importance of reflection”; and “self-ambiguity is more likely to be a diachronic process”, with a “back and forth between narrative... (shrink)

We argue that an understanding of livestock farming as normative practice clarifies how sustainability is to be understood in livestock farming. The sustainability of livestock farming is first approached by investigating its identity. We argue that the economic aspect qualifies and the formative aspect founds the livestock farming practice. Observing the normativity related to these aspects will be the first task for the livestock farmer. In addition, we can distinguish conditioning norms applicable to the livestock farming practice which should be (...) observed for competent performance of the practice. Failing to do justice to this normativity might affect the practice’s sustainability only in the long term—this is especially the case with conditioning norms. Motives to observe normativity have, therefore, the character of an ultimate conviction regarding the flourishing of the practice. Finally, the sustainability of the livestock farming practice crucially depends on the broader food system of which it is part. (shrink)

The aim of this paper is the analysis of uniformity in Feferman's explicit mathematics. The proof-strength of those systems for constructive mathematics is determined by reductions to subsystems of second-order arithmetic: If uniformity is absent, the method of standard structures yields that the strength of the join axiom collapses. Systems with uniformity and join are treated via cut elimination and asymmetrical interpretations in standard structures.

On the whole our study has made a plea for the combined research into the history, methodology and philosophy of science. There is an intricate communication between these aspects of science, philosophy being both a fruit of scientific developments and a higher-level frame of reference for discussion on the inevicable metaphysical issues in science.As such philosophy can be very useful to science, but should never impose its ideas on the conduct of scientists . ... Zie: Summary.

Recent philosophical accounts of mathematics increasingly focus on the quasi-Empirical rather than the formal aspects of the field, The praxis of how mathematics is done rather than the idealized logical structure and foundations of the theory. The ultimate test of any philosophy of mathematics, However idealized, Is its ability to account adequately for the factual development of the subject in real time. As a text case, The works and views of felix klein (1849-1925) were studied. Major advances in mathematics turn (...) out to be most adequately understood as shifts to new conceptualizations at different levels of idealization and abstraction. The implications of the model are explored with special reference to modern philosophical views of the nature and the warrants of mathematical claims to knowledge, And the methodology of the development of this knowledge. (shrink)

As a final project for a business and society course, students presented analyses of ethical dilemmas in business settings; each dilemma was different, chosen either from the student’s personal business experience or from a recent business news event. Students identified multiple decision criteria (financial, ethical, etc.) relevant to the dilemma and then recommended a decision, reflecting a prioritizing of the multiple decision criteria. The goal of this research was to learn whether personal experience led to different decision priorities. Analyses from (...) 121 students taken from six semesters of the course were sorted by choice of topic, as well as by which decision criterion was given top priority. Results showed significant differences (Chi-square value of 38.50562, significance level of 5.45963E-10) between the personal examples and the news examples. Students typically put ethical concerns first when analyzing news events. However, whenit came to personal events, more self-serving concerns often took priority. These disparate results suggest that even when knowledge is gained from study of theory and cases, it may not be applied to dilemmas that arise in students’ own experiences. (shrink)

Public debates depict Arabs as opposed to gender equality because of Islam. However, there may be substantial numbers of Arab Muslims who do support feminist issues and who do so while being highly attached to Islam. This study explains why certain Arabs support feminism while remaining strongly religious. We propose that some Arab citizens are more likely to subvert patriarchal norms, especially in societies that construct Islam and feminism as more compatible. Empirically, we apply three-level multinomial analyses to 51 Arab (...) Barometer and World Values Surveys, which include 57,000 Arab Muslims. Our results show that one in four Arab Muslims supports Muslim feminism—far more than those who support a more secularist version of feminism. Employed women, single people, people who distrust institutions, and more highly educated people support Muslim feminism more than do others—especially in societies that construct feminism and Islam as less contradictory, such as those with strong feminist movements. The presumption that Islam and feminism are necessarily opposed may hinder feminism. A more effective way to boost gender equality in the Arab region may be to embolden emancipatory religious interpretations. (shrink)

In this paper, we explore the conceptual problems arising when using network analysis in person- centered care (PCC) in psychiatry. Personalized network models are potentially helpful tools for PCC, but we argue that using them in psychiatric practice raises boundary problems, i.e., problems in demarcating what should and should not be included in the model, which may limit their ability to provide clinically-relevant knowledge. Models can have explanatory and representational boundaries, among others. We argue that we can make more explicit (...) what kind of questions personalized network models can address in PCC, given their representational and explanatory boundaries, using perspectival reasoning. (shrink)

Philosophical issues with respect to anxiety and its pathological variants arise at the border between everyday and clinical understanding of anxiety, between clinical and scientific approaches and between scientific concepts and the philosophical frameworks they refer to. These four ways of understanding can be seen as epistemic levels that point at different aspects and qualities of anxiety. After a brief historical introduction the three interfaces will be discussed. Philosophical questions at the interface between the first two levels relate to the (...) issue of where to draw the boundary between normal and pathological manifestations of anxiety and of how to balance the medical view with everyday understandings of anxiety. At the interface between clinical and scientific approaches, the question arises whether scientific theories and models are adequate, more particularly, which aspects of the clinical picture can be explained by scientific theories and concepts. The third interface, between scientific concepts and the philosophical frameworks they presuppose, is the origin of debates about what belongs to science and what should be regarded as meta-theoretical or paradigmatic. To what extent does a particular scientific concept stand on its own and to what extent does it borrow from pre-theoretical and/or philosophical views? (shrink)

One of paradoxes of current mental health care is that we never have known more about mental disorder and at the same time been more uncertain about the conceptual basis—and, therefore, the legitimacy—of psychiatry.This is remarkable. Psychiatry as a science flourishes. Over the last three decades, there has been an enormous increase in empirical research on the genetic, neurobiological, psychological, and social determinants of mental disorder. At the same time, mental health care has improved a lot, at least in most (...) Western countries. Reform in legislation and in the organization of care has led to more autonomy of the patient, more control on the process and outcome of therapy... (shrink)

The title of this article is ambiguous in the sense that it may direct the attention to either theism as a system of beliefs of persons who are referring to particular facts that serve as external grounds for the foundation of theist beliefs or to theism as a system of beliefs of persons who are convinced of theism’s truth on grounds that are intrinsic to their belief . Traces of both conceptions of theism can be found in Alvin Plantinga’s thesis (...) of the ‘proper basicality’ of religious belief, for instance in the distinction between evidence of the ‘on the basis of …’- type and evidence of the ‘inclination’- type. However, these two types of evidence do only lead to doxastic experience. In order to be warranted with respect to a particular knowledge claim, beliefs must be produced by noetic capacities that function properly, i.e. according to their design plan and in contexts that are appropriate to these capacities. This externalist epistemology exerts its greatest power in the criticism of the ‘evidentialist objection to belief in God’. However, it raises a number of objections with respect to its positive account of theism. When every community of thinkers creates its own relevant set of examples in order to establish criteria of proper basicality, does this not lead to skepticism? And, can doxastic experience not be honoured as a proper response to being called by divine discourse and, correspondingly, be seen as the relational foundation of theist belief? (shrink)

My view on what I see as the predicament of Christian philosophy in ethics has been shaped by a number of experiences. I will first share with you some of these experiences, to give you an impression of the background against which this article has been written.

What is the purpose of Friesen’s 95 theses and what is the audience he has in mind? The title refers to a major church historical event and suggests that — like in 1517 — we are dealing with a concise statement of a new and radical doctrine that is unfolded in opposition to an established canon. But who is the opponent in this case? What is the established canon that is rejected? And what is new or radical in the summary? (...) Dooyeweerd’s philosophy was definitely new and radical at the time of its conception. It still has an enormous potential for the special sciences. It offers important resources for any critique of ‘immanence’ philosophies. However, on first reading and without knowledge of the context, Friesen does not seem to aim at offering a new or radical interpretation of Dooyeweerd’s philosophy. I read the 95 theses as an attempt to wipe off the dust, to provide the overall picture, doing justice to aspects that were neglected or were wrongly understood in the reformational tradition. However, the audience he has in mind seems to be one that is already familiar with the basic concepts and the thrust of Dooyeweerdian thinking; not an audience that is opposed to reformational philosophical thinking, but one that might be helped by a succinct summary in order to encourage further study and discussion. (shrink)

This work provides an overview of attempts to assess the current condition of the concept of creation order within reformational philosophy compared to other perspectives. Focusing on the natural and life sciences, and theology, this first volume of two examines the arguments for and against the beauty, coherence and order shown in the natural world being related to the will or nature of a Creator. It examines the decay of a Deist universe, and the idea of the pre-givenness of norms, (...) laws and structures as challenged by evolutionary theory and social philosophy. It describes the different responses to the collapse of order: that given by Christian philosophy scholars who still argue for the idea of a pre-given world order, and that of other scholars who see this idea of stable creation order and/or natural law as redundant and in need of a thorough rethinking. It studies the particular role that reformational philosophy has played in the discussion. It shows how, ever since its inception, almost a century ago, the concepts of order and law (principle, structure) have been at the heart of this philosophy, and that one way to characterise this tradition is as a philosophy of creation order. Reformational philosophers have maintained the notion of law as 'holding' for reality. This book discusses the questions that have arisen about the nature of such law: is it a religious or philosophical concept; does law just mean 'orderliness'? How does it relate to laws of nature? Have they always existed or do they 'emerge' during the process of evolution? (shrink)

In response to DNA‐damage, cells have to decide between different cell fate programmes. Activation of the tumour suppressor HIPK2 specifies the DNA damage response (DDR) and tips the cell fate balance towards an apoptotic response. HIPK2 is activated by the checkpoint kinase ATM, and triggers apoptosis through regulatory phosphorylation of a set of cellular key molecules including the tumour suppressor p53 and the anti‐apoptotic corepressor CtBP. Recent work has identified HIPK2 as a regulator of the ultimate step in cytokinesis: the (...) abscission of the mother and daughter cells. Since proper cytokinesis is essential for genome stability and maintenance of correct ploidy, this finding sheds new light on the tumour suppressor function of HIPK2. Here we highlight the molecular mechanisms coordinating HIPK2 function and discuss its emerging role as a tumour suppressor. (shrink)

Understanding lone actor grievance-fueled violence remains a challenge. We believe that the concept of grievance provides an opportunity to add an engaged, first-person perspective to the assessment of lone actor extreme violence. We propose an enactivist philosophical approach that can help to understand the why and how of the pathway from grievance to violent extremism. Enactivism sees grievance as a dynamic, interpersonal, and context-sensitive construct that indicates how offenders make sense of the world they live in and how under certain (...) circumstances it fuels violent behavior. Hence, grievance should not be understood as a given thing, but as an unfolding experience that involves sense-making through interaction with the environment. This relational and ecological understanding requires another approach than looking at demographic factors or life histories, only from an outsider’s perspective. Enactivism invites us to look at such risk factors as external indices of an ongoing process of active self-regulation and sense-making, and in some cases spiraling toward extreme violence. To understand the mindset of the offender we need to look more in depth at the processes that shape this mindset: why does this person, with this history, in this context, and at this point in time, proceed to use violence? The enactivist approach to the mind offers a complementary framework that may help us to understand the dynamics of grievance as a possible precursor to violent extremism. It also helps to appreciate why the relative unpredictability of the pathway toward lone actor extreme violence is not necessarily a sign of empirical weakness but a matter of principle due to the non-linearity of the processes involved. We end by summarizing how enactivism could contribute to the prevention of extremist violence and research and how it can help to avoid reinforcing stigmas and re-establishing a confirmation bias. (shrink)

When we first anticipated the research project concluded with this special issue, about 8 years ago, it seemed timely and appropriate to investigate the opportunities and the challenges of self-management in mental health care. At the time self-management was well on the rise in general health care, offering both empowerment to patients and efficiency and cost-effectiveness to the health care system. It seemed a most promising approach in an era that celebrates individualistic self-reliance. And we were sure about our insight (...) that self-management in mental health care would deserve comprehensive investigation because “the self” that was supposed to do the management would itself be the core problem in psychiatric... (shrink)