Introduction

Alice trusted Howard, her husband. She had reason for doing so. He was devoted to her. Or so she thought. When Howard died unexpectedly, Alice, in preparing for his memorial service, opened his

computer file only to discover that Howard recently had been leading a secret and complex second life. He had married another woman, fathered a child with her, and periodically lived with both second wife and child, as he described things, while “out of town doing regular business” in Kansas City. Alice’s grief over Howard’s death, which was profound, was mixed with anger and pain, which

was deep. A positive interpretation of her husband’s character (“Howard was a good man; he loved me and our children; and, I will miss him terribly”) may have led to a better emotional and behavioral adjustment to the loss than her bitter negative evaluation (“He lied to me and to the children; I did not really know him”). Alice fell into a protracted despondent mood. Two years later, still despondent, she was diagnosed with clinical depression. Ian believes that he is the victim of a government plot. He is convinced that he is the object

of a conspiracy conducted by the Federal Bureau of Investigation (FBI). “The FBI believes that I am running a terrorist cell.” Ian refuses to leave his home for fear that he will be arrested. The business he owns, a men’s clothing store, is faltering in his absence. When asked to describe evidence of being persecuted, Ian says that he cannot discuss the matter lest agents overhear the conversation. “The shirts in my closets are bugged with voice detectors.” “The cuffs on my trousers contain electronic devices that signal my physical position to the FBI.” He is diagnosed with paranoid delusional disorder. What to do with the Alice’s and Ian’s of this world? How should they be understood? Treated?

Sigmund Freud (1856-1939), the Austrian psychologist and founder of psychoanalysis, famously

fretted over them. He tried to fathom the mind’s emotional and behavioral fault lines: the creaks, cracks, and crevices of persons divided within themselves. Freud also recognized that mentally disturbed human beings may and often do reclaim mental health and well-being. People recover from a mental illness. For Freud, though, there is a prudent precondition for taking wise and measured aim at reclamation or construction of mental health. This is not to set the bar for emotional and psychological well-being too high. The philosopher Owen Flanagan eloquently writes of the “wish to flourish, to be blessed with

happiness, to achieve eudaimonia – to be a ‘happy spirit’” (Flanagan 2007: 1). If Flanagan is right, that’s a wish we all share. Truly to be happy, to be blessed. Freud, however, promoted a more modest aspiration. When asked by a despondent patient how he hoped to assist her in regaining mental well-being, he had this to say: “No doubt fate will find it easier than I do to relieve you of your illness.” “But you will be able to convince yourself that much will be gained if we succeed in transforming your hysterical misery into common unhappiness” (Breuer and Freud 2000: 305). Common unhappiness? Was Freud being ironic? In part, yes. Mainly, however, he was trying

to be pragmatic or realistic. The conditions or circumstances of human existence, Freud thought, are such that an absolutely healthy, unified, orderly, stable, trouble-free mental life is much too optimistic for a person to expect, whether recovering from a disorder or not. Why so? Why not absolute mental health, behavioral and emotional well-being? Why not total and pure flourishing? Because, he said, “our body is doomed to decay and dissolution”, “the external world [rages] against us”, and suffering comes from our relations with other people. “The suffering which comes from this… source is perhaps more painful to us than any other” (Freud 1989/1930: 26). We are psychologically vulnerable and unstable creatures, whom the vicissitudes and tragedies of life may inevitably wear down or pull apart. As persons we must therefore try to live dignified, productive lives, all the while remaining susceptible to periods, perhaps pronounced or protracted periods, of distress, discord and instability. In order to elicit an intuitive sense of our vulnerability to instability or distress, consider

a brief thought experiment. The experiment is counter-factually presumptuous to be sure. Contrary-to-fact presumption, however, is no impediment to imagination. Suppose you are none other than Mother Nature, although endowed with powers of

deliberation, foresight, and decision making of which she herself is not privy. Imagine that humankind has yet to appear on the earthen landscape. You wish to build the sort of mind that will help us as human beings to engage with life on the planet. You are not going to rely on Father Time to do this. (He takes forever.) You are going to do it yourself. If a supernatural or divine agent is behind your efforts, you are not aware of its assistance. You are, as you conceive of the task, utterly on your own. You wish the human mind to have different and various modes of operation and component

psychological competencies, faculties or capacities. You want us to perceive, reason, desire, feel, remember, learn, intend, deliberate, and decide. You want us to enter into productive social relationships. You want us to be properly situated or embedded, not just in the natural landscape, but in multiplex social ecologies and forms of social and cultural life. You want our mental activities to initiate, guide and complete goal-directed behavior and bodily movement. You want us to walk, grip, grasp, run, swim, open, close and climb. You wish us to achieve

complex and ennobling purposes: to do philosophy, write memoirs, make art, organize religions, uncover scientific laws, found universities, and discover cures. Suppose that for reasons of imaginative playful contrast and heuristic comparison, you

narrow your conceptions of the possible human mind down just to two. Think of these as a stable and an unstable mind. You picture each as follows. The Stable Mind. A human mind that is inherently stable and orderly. It possesses purity of

heart and soundness of reason. It does things because it believes them to be desirable and is willing to face down the often and unanticipated aversive consequences of its actions. It assesses itself with equanimity, free of regret and self-doubt. It never loses control of itself. When entering into interpersonal relationships, it aims to insure that these are harmonious, coordinated and cooperative. When it confronts the vicissitudes of life, chronic pain, physical illness and death, it does so with courage and fortitude. It loves with magnanimity, dreams contentedly, and harbors a firm sense of personal dignity and self-respect. Its life, far from being an anarchic master, is the object of single-minded dedication and intelligent direction. The Unstable Mind. A human mind that is inherently unstable and disorderly. It possesses

conflicting motives, impulses, and inhibitions as well as biases of thought and impediments to reason. It does things because it believes them to be desirable, but is unwilling to accept the negative consequences of its actions and frequently is conflicted or befuddled about just what is desirable. It is prone to regret and self-doubt. It often loses its grip on itself. When it enters into social relationships, its agency is prone to be disharmonious, discordant and uncooperative. When it confronts the vicissitudes and heartaches of life, it seeks refuge or escape. It loves with rapturous passion but also with breathtaking infelicity and self-destructive inconstancy. Its self-criticisms are harsh and unforgiving. The demands of life drive it into disarray and dissolution. Which sort of mind would you make if you were Mother Nature? “An absolute no-brainer”,

you say. “The answer is obvious.” “Stability, most certainly.” True, stability lacks high drama. Its theatricality is thin. Instability, however, is riddled with dissonance and burdened with discomfort and unhappiness. It is also, of course, grossly incompatible with the desired ends of your creation. An utterly unstable mind could never do philosophy or do so sagaciously. Discover cures? Found universities? What sort of academic institutions would these be like? (If you answer, “Like those that exist today”, then you must be a professional academic.) What has the real Mother Nature actually done? Here’s what, to the naked anthropological

eye, she has designed for us. She has composed a type of mind that is both stable and unstable. She has mixed each form of mentality in us. She has made us orderly and disorderly, content and discontent, facing life’s vicissitudes but also seeking refuge from them. True, some folks are more temperamentally secure than others. True, some people are much less able to undergo various trials and tribulations than others. But beneath our individual differences, however, is a fusion of both. Each of us is endowed with a stable/unstable mind. No person has all of the one but none of the other. Even the most unstable or discordant individual is not without some small slice or sliver of stability. Even the most stable is not without a shadow of instability. Periodically, of course, instability holds sway. When it does so, we become anxious about

small things, develop imprudent patterns of thought, and slip or slide into emotional conflicts. Small influences may unhinge a person. Then, in more sadly serious cases, dissonance,

distress, and disturbance may seize truly powerful and persistent if, hopefully still only, temporary dominion. A person’s mind may break down or become disordered or ill in a psychiatric or clinical sense. One or more mental capacities or psychological faculties may dissemble into harmful or hurtful incapacity, dysfunction or impairment. Thoughts may become obsessive, preferences addictive, perceptions hallucinatory, beliefs delusional, and post-traumatic amnesia may impose ignorance of significant parts of one’s past. Paralyzed by phobic anxiety, a person may avoid any and all public places. Numbed by major depression, an individual may listlessly disengage from people and projects once held near and dear. Mental disorder, depending on its pulse and purport, may require professional mental health

treatment or clinical address. One hopes that assistance is sound and sensible, but treatment and attention are unhelpful and even dangerous when resting on false or improper assumptions about mind and illness. The history of medical treatment for mental disorder is a checkered affair. It is benevolent and sensitive on occasion, given the state of medical knowledge at a time or in a culture. But other chapters in that history are characterized by superstition, ignorance, intolerance and inhumanity. The history of theory and treatment for mental illness is recounted in numerous texts. (It is also briefly available in a short chapter of a long book that helps to carry my name [see Fulford, Thornton and Graham 2006: 143-59].) I do not wish to repeat it here. I do, however, want briefly to sketch more recent phases. This short historical sketch should help to show why it’s important to have a sound and sensible understanding of mental disorder. Such an understanding is one, I claim, in which the subject of philosophy of mind, in particular, ought to play a prominent role, to be outlined in a moment and presented in detail throughout the book.