Chapter

Intentionality in disorder

Derek Bolton and Jonathan Hill

in Mind, Meaning and Mental Disorder

Second edition

Published on behalf of Oxford University Press

Published in print March 2004 | ISBN: 9780198515609
Published online March 2013 | e-ISBN: 9780191754296 | DOI: http://dx.doi.org/10.1093/med/9780198515609.003.0008

Series: International Perspectives in Philosophy & Psychiatry

Intentionality in disorder

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In this chapter we have considered explanation of psychological disorder in terms of intentional processes. We approached the problem in two ways, firstly, in Section 8.2, as it were top-down, via consideration of the logic of representation, and secondly, in Section 8.3, as it were bottom-up, by considering conditions of intentionality in biological systems. We noted in Section 8.2.1 that radical error in intentionality is a matter of persistent misrepresentation or persistent rule-conflict, and that these admit of psychological explanation in terms of avoidance and re-enactment of unacceptable outcomes. The broad notion of trauma and the cognitive paradoxes to which it gives rise was approached from the direction of post-empiricist epistemology, and via Wittgenstein's early work on the limits of thought, in Section 8.2.2. Reference was made to post-traumatic stress reactions in the following subsection, to be taken up in the next chapter. Possibilities of disorder created by higher-order intentional processes were considered in Section 8.2.3. Along with the notion of threat to psychic integrity comes the notion of psychic defences, and this was explored in Section 8.2.4, using two quite different sources. Firstly, analogy with threats to scientific theory, relatively open to view and well-understood. And secondly, with reference to psychoanalytic theory, where the psychic defences have been first identified and explained. Several defences were alluded to, including simple denial, splitting, projection, and narcissism. More intellectualized defences, and intellectualization of the primitive defences, become possible in the context of an explicit theory of mind. Defences typically entail costs as well as benefits, and in the special case of psychic defences these costs involve perpetual movement between avoidance and re-enactment. In this paradoxical sense the problem coincides with the solution.

From a biological perspective it was evident that where rules of interpretation are hard-wired or there is limited scope for the acquisition of new representations, events that fall outside the range of the rules that are able to underpin action are not recognized as such, or lead to disorganized action or inaction. The position is different where multiple sets of rules of intentional processes can be generated. The elaboration of these intentional processes in psychological and social development, seen most dramatically in childhood, provides the basis for flexible, intelligent, and creative development. The integrity of intentional processes is however no longer guaranteed. The child may cope with trauma and other threats in development through the creation of contradictory representations, some that are accurate but cannot underpin action, and others that are inaccurate but lead to action, and especially action that retains crucial relationships with adults (Section 8.3.2). This creates the possibility of internal disruptions of the integrity of intentional processes and hence intentional origins of psychological disorder. Further mechanisms include the generation of mental representations that are either insufficiently differentiated or too narrow (Section 8.3.3), representations that are either lacking in sufficient stability or unavailable for testing and revision (Section 8.3.4), and a metarepresentational system that is unable to monitor and integrate individual and interpersonal processes (Section 8.3.5).

In Section 8.4 the nature of explanations of disorder in a range of theoretical, research, and therapeutic frameworks was discussed in the light of the operation and disruption of intentional processes.

Chapter.  20712 words. 

Subjects: Psychiatry

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