Mental Illness and Transformative Experience

Hi again, everyone! For my last post I’d like to take the mental illness and agency cluster of issues in a slightly unusual direction… I’ve been advised to avoid the TL;DR problem in my internet philosophizing, but this one may take some time to walk toward, so bear with me!

First off, I’ve been impressed with L. A. Paul’s recent work on transformative experience. For those yet unfamiliar, the example here is becoming a vampire (or if you like, a parent). This is a difficult decision for two reasons, and the first is epistemic. You don’t have epistemic access to what being a vampire would be like. You can hear testimony from vampire friends, but you won’t really know what being a vampire is like until you become one. The second reason concerns personal transformation. Putting the epistemic difficulty aside, becoming a vampire is such a radical transformation that the very person you are—your values, goals, and preferences—would change dramatically. So there is some sense in which it doesn’t matter whether the person you are now would prefer being a vampire or not… if you become a vampire, you’ll be someone else with different, vampire-like preferences and values. (With apologies to Laurie for the slapdash summarization!)

I’ve become increasingly motivated by the personal transformation bit of this problem, for reasons to do with the transformations involved in changing from sick to well, or a typical to typical. As we’ve alluded to all month, a number of ways in which people can deviate from psychological ‘norms’ involve strange or atypical desires, values, or motivations. Depression, addiction, anxiety, and delusion are all conditions which may “gum up the works”, and it can be tempting to see this not just as a problem for our powers of self-control, but for our motivational systems themselves. To see what I mean, let’s consider the following case:

VINCENT lives alone on a remote piece of property in the Pacific Northwest. After college he began to remove himself from his social circles, and now spends most of his time in his home, making highly detailed wooden sculptures, based on the suggestions of ‘other voices.’ Vincent has no phone or internet access, and interacts mostly with the owner of the general store in a nearby town. He make a modest living by occasionally making a sale of a sculpture. His buyers find him to be distant and abrasive, and are often disturbed by his behavior, and lack of adherence to social norms.

We might say that Vincent is not responsive to a suite of reasons that most of us are (I wonder, but he is likely not rational in the RIT sense either). But what about his motivations themselves? Is Vincent acting in his best interest? Perhaps it’s true, counterfactually, that if Vincent valued family and friends more than his aesthetic pursuits, following those values would allow Vincent to flourish more, all things considered. And perhaps there are facts about his psychological condition which underlie his current preferences. So too for all of us! But whose best interests are we concerned with here… Vincent as he is now, or some possible, future Vincent-transformation? In light of the problem of personal transformation—and perhaps of Nina Strohminger and Shaun Nichols recent insights on the self—I wonder what are we asking of Vincent if we enjoin him to realign his preferences as part of being well. How should Vincent himself weigh these considerations? What grounds are there to justify change if Vincent does not already desire to?

Here are two competing intuitions one might have: first, that is it never rational to end a current self in favor of a future one (the parenthood example is especially distressing in this regard), and second that it isn’t rational to privilege a current self just because it’s yours (cases of mental disorder might pull you in this direction, especially the case of addiction). Of course, we should take care to remember that what supports flourishing all things considered is an empirical question (following Dan Haybron’s work on happiness, I am taking this for granted). And finally, lurking around the corner, we must deal with Aldous Huxley’s specter of a Brave New World. Depending on how we countenance the original counterfactual, we may have to allow that clinical paternalistic action to modify a person’s values or motivations is justified. Or maybe, in denying it, we allow that Vincent—the man he is now—is living his best life, flourishing.

Anyway, perhaps the best course of action here is to join the American tradition, and just pretend to be vampires for a day. Happy Halloween, everyone!

Comments

[Dan Haybron]

Cool post! Jim Sinclair, who has autism, once said (as I recall) "when people say 'I wish my kid weren't autistic', what they're really saying is, 'I wish I didn't have this kid, and had a different one instead.'" He wouldn't want to be transformed into someone without autism, b/c that's essential to who he is.

I tend to think psychiatric issues are a good reason to want an authenticity constraint in a theory of well-being--that is, to think that well-being depends partly on the authenticity of one's values/emotional responses etc. Eg, psychiatric meds can (in principle) work both ways on this count: if your depressed mood reflects who you really are, then you might reasonably worry that medication could weaken the authenticity of your emotions ("uplift anxiety"), and hesitate to use it on that basis. But if you see your depression as suppressing who you really are--it's genuinely disordered, say--then you might regard the meds as *enhancing* the authenticity of your state of mind ("I'm finally myself again").The basic issue here is what counts as an authenticity-preserving transformation.

Importantly, there can also be reasons having nothing to do with authenticity: at least, that life will be more pleasant. You might think taking antidepressants during healthy grieving slightly diminishes the authenticity of your emotions, but is worth it anyway, b/c you feel better. A spiritual analgesic, as it were, just like aspirin. If the meds were Brave New World-effective, however, that might be a different story, as you might prefer pain to losing yourself altogether.

Re. Vincent: if "treatment" would yield an inauthentic result--it wouldn't really be him--that would be a reason not to do it. Even then, if it would make his life more enjoyable or satisfying, then that'd be a reason the other way. Or so it seems to me! Thanks for the shout-out, and a fun post!

[V. Alan White]

Hi Natalia--

First, your stint as guest author has been terrific--but it made me realize just how difficult this must be for interested readers like me who are just swamped with mid-semester work. Made me realize that timing of being guest author relative to the academic calendar is a big factor in participation.

Second, your scenario made me think of a different perspective on it--social influences that not only do not serve the best interests of the personality development of a creative sort like Vincent, but in some instances provide both positive and negative feedback to marginal personalities that respectively keep that person in a marginal state and fail to encourage change. The example that flew into my mind is Seinfeld's Soup Nazi (apparently based on a real and similar character). The SN is not at all nice, and is demanding of customers to toe lots of lines literally and figuratively in asking for soup--but the soup is so damn good that customers meet those demands (the SN is positively reinforced in that obnoxious behavior) and deviations from demands that are punished--"No soup for you!"--are met with apologetic behavior that only embolden SN attitudes (negative reinforcement). So the socially-perceived value of the SN's soup as a product is so great that there is no effective way that interactions with the SN will dilute his so-called Nazi side; the soup is more treasured than any concern for SN transformation into a less obnoxious person. Something like this must be at work with giving us artists, athletes, and actors who are also assholes. (Though I'm mindful of the complexities of perception and reality here: Muhammad Ali presented himself as self-absorbed, confident, and defiant publicly (and thus deliberately a role-model for an oppressed generation), yet it seems that he was anything but that in his own private life.)

Anyway, thanks again for thoughtful posts this month.

[Natalia Washington]

Hi Alan--

I'm glad you enjoyed it! (It's a busy time of the year!)

You make an interesting point about celebrity... I often worry that becoming an asshole is inevitable when everyone starts treating you not as a real person. I wonder, though, what the SNs feelings on his social status are. I suppose he may or may not feel alienated, and I think that whether or not he does should matter for our prescriptions for him to change.

Unless maybe the intuition is that the SN can clearly become better despite whether he wants to or not?