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Letter: Invitation to a Dialogue: Psychiatric Diagnoses

Letter: Invitation to a Dialogue: Psychiatric Diagnoses: A psychiatrist addresses critics who say diagnoses are often stigmatizing and subjective. Readers are invited to reply.

Political Personology - Links

Political Personology - Links

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C.I.A. Profiling Delves Into the Minds of Global Leaders - NYTimes.com

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Mar 28, 2011 – ... prepared by analysts at the C.I.A. and the Department of Defense. ... act virtually without constraint,” said Dr. Jerrold Post, a psychiatrist who ...

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Notes

static, dynamic, field (politics) specific


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Articles

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Teasing Out Policy Insight From a Character Profile

By BENEDICT CAREY

Published: March 28, 2011   

 

He is a delusional narcissist who will fight until his last breath. Or an impulsive showman who will hop the next flight out of town when cornered. Or maybe he’s a psychopath, a coldly calculating strategist — crazy, like a desert fox.
      

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LIBYA Col. Muammar el-Qaddafi considers himself an outsider.
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The endgame in Libya is likely to turn in large part on the instincts of Col. Muammar el-Qaddafi, and any insight into those instincts would be enormously valuable to policy makers. Journalists have formed their impressions from anecdotes, or from his actions in the past; others have seized on his recent tirades about Al Qaeda and President Obama.
But at least one group has tried to construct a profile based on scientific methods, and its conclusions are the ones most likely to affect American policy. For decades, analysts at the Central Intelligence Agency and the Department of Defense have compiled psychological assessments of hostile leaders like Colonel Qaddafi, Kim Jong-il of North Korea and President Hugo Chávez of Venezuela, as well as allies, potential successors and other prominent officials. (Many foreign governments do the same, of course.)
Diplomats, military strategists and even presidents have drawn on those profiles to inform their decisions — in some cases to their benefit, in other cases at a cost.
The political profile “is perhaps most important in cases where you have a leader who dominates the society, who can act virtually without constraint,” said Dr. Jerrold Post, a psychiatrist who directs the political psychology program at George Washington University and founded the C.I.A. branch that does behavioral analysis. “And that has been the case here, with Qaddafi and Libya.”
The official dossiers are classified. But the methods are well known. Civilian psychologists have developed many of the techniques, drawing mostly on public information about a given leader: speeches, writings, biographical facts, observable behavior. The resulting forecasts suggest that “at-a-distance profiling,” as it is known, is still more an art than a science. So in a crisis like the one in Libya, it is crucial to know the assessments’ potential value and real limitations.
“Expert profilers are better at predicting behavior than a blindfolded chimpanzee, all right, but the difference is not as large as you’d hope it would be,” said Philip Tetlock, a psychologist at the Wharton School of the University of Pennsylvania and the author of “Expert Political Judgment: How Good Is It? How Can We Know?” (Princeton University, 2006), who has done profiling of his own. “There’s no secret sauce, and my impression is that often the process can be rushed,” as a leader suddenly becomes a person of intense interest.
The method with the longest track record is modeled on clinical case studies, the psychobiographies that therapists create when making a diagnosis, citing influences going back to the sandbox. The first one on record, commissioned in the early 1940s by the Office of Strategic Services, the predecessor to the C.I.A., was of Adolf Hitler; in it, the Harvard personality specialist Henry A. Murray speculated freely and luridly about Hitler’s “infinite self-abasement,” “homosexual panic” and Oedipal tendencies.
Analysts still use this clinical-case approach but now ground it far more firmly in biographical facts than on Freudian speculation or personal opinion. In a profile of Colonel Qaddafi for Foreign Policy magazine, Dr. Post concludes that the dictator, while usually rational, is prone to delusional thinking when under pressure — “and right now, he is under the most stress he has been under since taking over the leadership of Libya.”
At his core, Colonel Qaddafi sees himself as the ultimate outsider, the Muslim warrior fighting impossible odds, Dr. Post argues, and he “is indeed prepared to go down in flames.”
Characterizations of this type have been invaluable in the past. In preparation for the Camp David peace negotiations between Israel and Egypt, the C.I.A. provided President Jimmy Carter with profiles of both nations’ leaders, Menachem Begin and Anwar el-Sadat. In his memoir “Keeping Faith,” Mr. Carter credited the profiles with giving him crucial insights that helped close a peace deal.
The brief on the Egyptian president, “Sadat’s Nobel Prize Complex,” noted that Sadat “sees himself as a grand strategist and will make tactical concessions if he is persuaded his overall goals will be achieved,” and added, “His self-confidence has permitted him to make bold initiatives, often overriding his advisers’ objections.”
Yet the assessments can also be misleading, even embarrassing. Profiles of President Saddam Hussein of Iraq that circulated in the early 1990s suggested that he was ultimately a pragmatist who would give in under pressure. And in 1993, the C.I.A. reportedly provided lawmakers with a brief alleging that the Haitian leader Jean-Bertrand Aristide had a history of mental illness, including manic depression.
Mr. Aristide furiously denied it, and the report was soon discredited. In a 1994 review of the episode in Foreign Policy, Thomas Omestad wrote that the profile was “light on facts and heavy on speculation; it came closer to character assassination than character analysis.”
Intelligence specialists have learned to hedge their bets over the years, supplementing case histories with “content analysis” techniques, which look for patterns in a leader’s comments or writings. For instance, a software program developed by a researcher at Syracuse University, Margaret Hermann, evaluates the relative frequency of certain categories of words (like “I,” “me,” “mine”) in interviews, speeches and other souces and links the scores to leadership traits.
A technique used by David G. Winter, a professor of psychology at the University of Michigan, draws on similar sources to judge leaders’ motives, in particular their need for power, achievement and affiliation. The sentence “We can certainly wipe them out” reflects a high power orientation; the comment “After dinner, we sat around chatting and laughing together” rings of affiliation.
“Combine high power and high affiliation, the person is likely to reach out, whereas power and low affiliation tend to predict aggression,” said Dr. Winter, who has profiled Presidents Richard M. Nixon and Bill Clinton, among many others. “That’s the idea, though of course you can’t predict anything with certainty.”
At least one group of political profilers has incorporated that flaw itself — uncertainty — into its forecasts. Peter Suedfeld, a psychologist at the University of British Columbia who has worked with Dr. Tetlock, sifts through a leader’s words to rate a quality called integrative complexity. This is a measure of how certain people are, how confident in their judgments, whether they have considered any opposing points of view.
In a series of studies, the researchers have compared communications leading up to the outbreaks of World War I and the Korean War with those that led to a peaceful resolution, like the 1962 Cuban missile crisis. And the higher the level of acknowledged uncertainty, the less likely the leader is to pursue war, Dr. Suedfeld said.
He has not yet analyzed Colonel Qaddafi’s comments, but it doesn’t take an expert to observe that the Libyan leader sounds very certain, if not always coherent.
What is missing amid all this number crunching and modeling is any sense of which methods are most useful when. In an exhaustive review of intelligence analysis published this month, a prominent panel of social scientists strongly agreed: psychological profiling and other methods intelligence analysts use to predict behavior are sorely in need of rigorous testing.
And new ideas. In an unusual move, the Office of the Director of National Intelligence, which commissioned the report, has sponsored a kind of competition (http://goodjudgment.info), inviting people to test their own forecasting techniques, to improve intelligence analysis.
Given the challenge of predicting what leaders like Colonel Qaddafi might do, think of it as a plea for help.

A version of this article appeared in print on March 29, 2011, on page D1 of the New York edition.

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C.I.A. Navigator - NYT

A list of Web sites about the C.I.A. as selected by editors of The New York Times.

• C.I.A. (cia.gov)
• Center for the Study of Intelligence
• The agency's in-house research center.
• National Security Archive
• A George Washington University project.
• C.I.A. Timeline from the Federation of American Scientists
• Federation of American Scientists
• The organization's main C.I.A. page.

Documents

• The National Security Act of 1947
• Speech by Gen. Michael V. Hayden announcing document release, June 21, 2007
• Psychology of Intelligence Analysis
• Central Intelligence Agency, 1999

Other Coverage

• "The Black Sites: A rare look inside the CIA's secret interrogation program"
• (By Jane Mayer. The New Yorker. Aug. 13, 2007)
• "Intelligence, Policy, and the War in Iraq"
• (By Paul R. Pillar. Foreign Affairs, March/April 2006)
• "The Dark Side: interview with Tyler Drumheller"
• (Frontline, PBS, Feb. 15, 2006)
• "A Deadly Interrogation: Can the CIA legally kill a prisoner?"
• (By Jane Mayer. The New Yorker, Nov. 14, 2005)
• "One Expert's Verdict: The CIA Caved Under Pressure"
• (By Michael Duffy. Time, June 14, 2004)

Books about the C.I.A.

With reviews by The New York Times.

• Legacy of Ashes: The History of the CIA
• By Tim Weiner. Doubleday. 2007.
• At the Center of the Storm: My Years at the CIA
• By George Tenet. HarperCollins. 2007.
• State of War: The Secret History of the CIA and the Bush Administration
• By James Risen. Free Press. 2006.
• The One Percent Doctrine: Deep Inside America's Pursuit of its Enemies Since 9/11
• By Ron Suskind. Simon & Schuster. 2006.
• Chain of Command: The Road from 9/11 to Abu Ghraib
• By Seymour M. Hersh. HarperCollins. 2004.
• A Pretext for War: 9/11, Iraq, and the Abuse of America's Intelligence Agencies
• By James Bamford. Doubleday. 2004.
• Imperial Hubris: Why the West is Losing the War on Terror
• By Anonymous. Brassey's Inc. 2004.
• Ghost Wars:The Secret History of the CIA, Afghanistan, and bin Laden, From the Soviet Invasion to September 10, 2001
• By Steve Coll. The Penguin Press. 2004.
• "The Very Best Men: Four Who Dared - The Early Years of the CIA"
• By Evan Thomas. Simon & Schuster. 1995.
• Veil: The Secret Wars of the CIA, 1981-1987
• By Bob Woodward. Simon & Schuster. 1987.

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Psychology of Intelligence Analysis - GS


Psychology of Intelligence Analysis - CIA Search


Psychology of Intelligence Analysis - Richards J. Heuer, Jr.




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Report details flaws in Army's handling of PTSD

Report details flaws in Army's handling of PTSD: SEATTLE (AP) -- The Army has more than doubled its number of military and civilian behavioral health workers in the past five years, but a litany of shortcomings still plagues the force when it comes to diagnosing and treating soldiers for post-traumatic stress disorder, according to an Army report being released Friday....

Autism spectrum disorder, attention-deficit/hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all share common genetic risk factors, according to the results of the largest genetic study of psychiatric disorders to date

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Psychiatric Geneticists Find Common Pathway Contributes to Multiple Disorders

via Psychiatric News Alert by noreply@blogger.com (Psychiatric News Alert) on 3/1/13

In a study published in the Lancet, the Cross-Disorder Group of the Psychiatric Genomics Consortium, supported by the National Institute of Mental Health, has performed a genomewide single-nucleotide-polymorphism (SNP) data analysis seeking to identify specific variants underlying genetic effects shared between the following five disorders: autism spectrum disorder, attention-deficit/hyperactivity disorder, bipolar disorder, major depressive disorder, and schizophrenia.

Their study is the largest to date and the first to provide evidence that specific SNPs are significantly associated with a range of psychiatric disorders. In particular, they pointed to the effects of voltage-gated calcium channels on such disorders: "Our results implicate a specific biological pathway—voltage-gated calcium-channel signaling—as a contributor to the pathogenesis of several psychiatric disorders and support the potential of this pathway as a therapeutic target for psychiatric disease."

"These important findings indicate that fundamental alterations in brain development and biology can confer vulnerability to various types of mental disorders....," Jeffrey Lieberman, M.D., president-elect of APA told Psychiatric News." Overall, the study provides an important new clue about the etiology and pathogenesis of mental disorders."

APA President Dilip Jeste, M.D., also commented: "Research of this type would help in the development of future diagnostic systems in psychiatry that are based on validated biomarkers...this important study is one step in that direction."

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International research group finds genetic link among five major psychiatric ... - Public Radio International PRI

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International research group finds genetic link among five major psychiatric ... Public Radio International PRI International research group finds genetic link among five major psychiatric diseases. Home | Stories | Health and Medicine | International research group finds genetic link among five major psychiatric diseases. Font size: Decrease font Enlarge font ... 5 Disorders Share Genetic Risk Factors, Study FindsNew York Times Share via e-mailBoston Globe Five major psychiatric disorders, including autism and bipolar disorder ...GlobalPost TIME -The Conversation -TopNews New Zealand all 58 news articles »

Largest study reveals five major psychiatric disorders share common genetic ... - Medical Xpress

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Largest study reveals five major psychiatric disorders share common genetic ... Medical Xpress These findings are particularly relevant in view of the imminent revision of classifications in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD)." Writing in a linked Comment ...

Autism, Depression Genetically Linked - ABC News

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Autism, Depression Genetically Linked ABC News The results are "new evidence that may inform a move beyond descriptive syndromes in psychiatry and towards classification based on underlying causes," Smoller said in a statement. Read this story on www.medpagetoday.com. The findings are especially ...

International research group finds genetic link among five major psychiatric ... - Public Radio International PRI

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International research group finds genetic link among five major psychiatric ... Public Radio International PRI International research group finds genetic link among five major psychiatric diseases. Home | Stories | Health and Medicine | International research group finds genetic link among five major psychiatric diseases. Font size: Decrease font Enlarge font ... 5 Psychiatric disorders share genetic linkTimes of India Study points to "shared biology" between 5 psychiatric disordersCBS News Share via e-mailBoston Globe The Takeaway -UPI.com (blog) all 58 news articles »

Children with autism had higher levels of toxic metals - Healio

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Children with autism had higher levels of toxic metals Healio Researchers reported that children with autism had higher levels of toxic metals in their blood and urine vs. healthy children. The levels of those toxic metals were associated with the severity of the disorder. “These significant associations may ... and more »

5 Psych Disorders Have Common Genetics - MedPage Today

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5 Psych Disorders Have Common Genetics MedPage Today The results are "new evidence that may inform a move beyond descriptive syndromes in psychiatry and towards classification based on underlying causes," Smoller said in a statement. The findings are especially important because of revisions to the ...

Five Major Psychiatric Disorders Genetically Linked - Medscape

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Five Major Psychiatric Disorders Genetically Linked Medscape "These findings are particularly relevant in view of the imminent revision of classifications in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases," said Dr. Smoller. The investigators add that ...

International research group finds genetic link among five major psychiatric ... - Public Radio International PRI

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International research group finds genetic link among five major psychiatric ... Public Radio International PRI International research group finds genetic link among five major psychiatric diseases. Home | Stories | Health and Medicine | International research group finds genetic link among five major psychiatric diseases. Font size: Decrease font Enlarge font ... 5 Psychiatric disorders share genetic linkTimes of India Study points to "shared biology" between 5 psychiatric disordersCBS News Autism, schizophrenia, and other psychiatric disorders share genetic ...Boston.com (blog) Wall Street Journal -UPI.com (blog) -The Takeaway all 57 news articles »

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Is Not Following Doctor's Orders a Mental Disorder?

via DSM5 in Distress by Allen J. Frances, M.D. on 3/1/13

A new way that DSM-5 mislabels the medically ill. Stress, risks factors, noncompliance, and unhealthy lifestyles will now be called a mental disorder.read more

Anti-Soviet 'Psychiatric' prisoners want diagnoses reversed - Deutsche Welle (press release)

via psychiatric diagnosis - Google News on 3/1/13

Anti-Soviet 'Psychiatric' prisoners want diagnoses reversed Deutsche Welle (press release) The film, “The Dissident," portrayed a 53-year-old Latvian lawyer who was locked up for many years in psychiatric hospitals. This kind of thing, it seems, was not an isolated incident. From the late 1960s to the mid 1980s, a group of Latvians were ...

Five Major Psychiatric Disorders Share Genetic Link - Medical News Today

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Five Major Psychiatric Disorders Share Genetic Link Medical News Today These findings are particularly relevant in view of the imminent revision of classifications in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD)." In a linked editorial comment ...

UConn Researchers Impacting Mental Health Treatment in Prison Population - UConn Advance (blog)

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UConn Advance (blog)

UConn Researchers Impacting Mental Health Treatment in Prison Population UConn Advance (blog) Researchers at the University of Connecticut Health Center are making significant contributions to the treatment of mental illness in prisoners, with their efforts earning international recognition and continued federal grant funding. With current ...

Five Major Psychiatric Disorders Share Genetic Link - Medical News Today

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Five Major Psychiatric Disorders Share Genetic Link Medical News Today These findings are particularly relevant in view of the imminent revision of classifications in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD)." In a linked editorial comment ...

Anti-Soviet 'Psychiatric' prisoners want diagnoses reversed - Deutsche Welle (press release)

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Anti-Soviet 'Psychiatric' prisoners want diagnoses reversed Deutsche Welle (press release) The film, “The Dissident," portrayed a 53-year-old Latvian lawyer who was locked up for many years in psychiatric hospitals. This kind of thing, it seems, was not an isolated incident. From the late 1960s to the mid-80s, a group of Latvians were ... and more »

Science News » Five Major Mental Disorders Share Genetic Roots

via NIMH | Recent Updates by Jules Asher on 3/1/13

Five major mental disorders share some of the same genetic risk factors, the largest genome-wide study of its kind has found.

Five mental disorders share some of the same genes

via Uploads by NIMHgov by NIMHgov on 3/1/13

	Five mental disorders share some of the same genes National Institutes of Health-funded researchers discovered that people with disorders traditionally thought to be distinct -- autism, ADHD, bipolar disorder, major depression and schizophrenia -- were more likely to have suspect genetic variation at the same four chromosomal sites. These included risk versions of two genes that regulate the flow of calcium into cells. Bruce Cuthbert, Ph.D., director of NIMH's Division of Adult Translational Research, explains the significance of the study findings for diagnosis and treatment of mental illnesses.	From:NIMHgov Views:7 0ratings
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Five major psychiatric disorders may share common genetic risk factors

via Healio.com PSYCHIATRY RSS Feed on 2/28/13

Autism spectrum disorder, attention-deficit/hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all share common genetic risk factors, according to the results of the largest genetic study of psychiatric disorders to date.“This study indicates that some specific genetic variants confer risk to a range of psychiatric disorders that are treated as clinically distinct,” study researcher Jordan Smoller, MD, of Massachusetts General Hospital in Boston, told Psychiatric Annals. “The findings also highlight the role of calcium channel genes, which may provide a treatment target that is relevant to a range of psychiatric disorders.”

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Five major psychiatric disorders may share common genetic risk factors Healio Autism spectrum disorder, attention-deficit/hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all share common genetic risk factors, according to the results of the largest genetic study of psychiatric disorders to date. and more »

Eddie Ray Routh, Accused of Killing Chris Kyle, ‘American Sniper,’ Had Troubled Past - NYT

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Eddie Ray Routh, Accused of Killing Chris Kyle, ‘American Sniper,’ Had Troubled Past
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Eddie Ray Routh, accused of killing Chris Kyle, the author of “American Sniper,” had been released from a hospital over his parents’ objections just days before the shooting, his lawyers said.

The recent revisions to the DSM's definition of depression are based on a questionable conception of what is "normal." Why is that dangerous?

Opinionator | The Stone: Depression and the Limits of Psychiatry

from NYT > Opinion-Global by By GARY GUTTING

 

February 6, 2013, 3:45 pm

Depression and the Limits of Psychiatry

By GARY GUTTING

I've recently been following the controversies about revisions to the psychiatric definition of depression. I've also been teaching a graduate seminar on Michel Foucault, beginning with a reading of his "History of Madness." This massive volume tries to discover the origins of modern psychiatric practice and raises questions about its meaning and validity. The debate over depression is an excellent test case for Foucault's critique.
At the center of that critique is Foucault's claim that modern psychiatry, while purporting to be grounded in scientific truths, is primarily a system of moral judgments. "What we call psychiatric practice," he says, "is a certain moral tactic . . . covered over by the myths of positivism." Indeed, what psychiatry presents as the "liberation of the mad" (from mental illness) is in fact a "gigantic moral imprisonment."
Foucault may well be letting his rhetoric outstrip the truth, but his essential point requires serious consideration. Psychiatric practice does seem to be based on implicit moral assumptions in addition to explicit empirical considerations, and efforts to treat mental illness can be society's way of controlling what it views as immoral (or otherwise undesirable) behavior. Not long ago, homosexuals and women who rejected their stereotypical roles were judged "mentally ill," and there's no guarantee that even today psychiatry is free of similarly dubious judgments. Much later, in a more subdued tone, Foucault said that the point of his social critiques was "not that everything is bad but that everything is dangerous." We can best take his critique of psychiatry in this moderated sense.
Current psychiatric practice is guided by the "Diagnostic and Statistical Manual of Mental Disorders" (DSM). Its new 5^th edition makes controversial revisions in the definition of depression, eliminating a long-standing "bereavement exception" in the guidelines for diagnosing a "major depressive disorder." People grieving after the deaths of loved ones may exhibit the same sorts of symptoms (sadness, sleeplessness and loss of interest in daily activities among them) that characterize major depression. For many years, the DSM specified that, since grieving is a normal response to bereavement, such symptoms are not an adequate basis for diagnosing major depression. The new edition removes this exemption.
Disputes over the bereavement exemption center on the significance of "normal." Although the term sometimes signifies merely what is usual or average, in discussions of mental illness it most often has normative force. Proponents of the exemption need not claim that depressive symptoms are usual in the bereaved, merely that they are appropriate (fitting).
Opponents of the exemption have appealed to empirical studies that compare cases of normal bereavement to cases of major depression. They offer evidence that normal bereavement and major depression can present substantially the same symptoms, and conclude that there is no basis for treating them differently. But this logic is faulty. Even if the symptoms are exactly the same, proponents of the exemption can still argue that they are appropriate for someone mourning a loved one but not otherwise. The suffering may be the same, but suffering from the death of a loved one may still have a value that suffering from other causes does not. No amount of empirical information about the nature and degree of suffering can, by itself, tell us whether someone ought to endure it.
Foucault is, then, right: psychiatric practice makes essential use of moral (and other evaluative) judgments. Why is this dangerous? Because, first of all, psychiatrists as such have no special knowledge about how people should live. They can, from their clinical experience, give us crucial information about the likely psychological consequences of living in various ways (for sexual pleasure, for one's children, for a political cause). But they have no special insight into what sorts of consequences make for a good human life. It is, therefore, dangerous to make them privileged judges of what syndromes should be labeled "mental illnesses."
This is especially so because, like most professionals, psychiatrists are more than ready to think that just about everyone needs their services. (As the psychologist Abraham Maslow said, "If all you have is a hammer, everything looks like a nail"). Another factor is the pressure the pharmaceutical industry puts on psychiatrists to expand the use of psychotropic drugs. The result has been the often criticized "medicalization" of what had previously been accepted as normal behavior-for example, shyness, little boys unable to sit still in school, and milder forms of anxiety.
Of course, for a good number of mental conditions there is almost universal agreement that they are humanly devastating and should receive psychiatric treatment. For these, psychiatrists are good guides to the best methods of diagnosis and treatment. But when there is significant ethical disagreement about treating a given condition, psychiatrists, who are trained as physicians, may often have a purely medical viewpoint that is not especially suited to judging moral issues.
For cases like the bereavement exclusion, the DSM should give equal weight to the judgments of those who understand the medical view but who also have a broader perspective. For example, humanistic psychology (in the tradition of Maslow, Carl Rogers, and Rollo May) would view bereavement not so much a set of symptoms as a way of living in the world, with its meaning varying for different personalities and social contexts. Specialists in medical ethics would complement the heavily empirical focus of psychiatry with the explicitly normative concerns of rigorously developed ethical systems such as utilitarianism, Kantianism and virtue ethics.
Another important part of the mix should come from a new but rapidly developing field, philosophy of psychiatry, which analyzes the concepts and methodologies of psychiatric practice. Philosophers of psychiatry have raised fundamental objections to the DSM's assumption that a diagnosis can be made solely from clinical descriptions of symptoms, with little or no attention to the underlying causes of the symptoms. Given these objections, dropping the bereavement exception-a rare appeal to the cause of symptoms-is especially problematic.
Finally, we should include those who have experienced severe bereavement, as well as relatives and friends who have lived with their pain. In particular, those who suffer (or have suffered) from bereavement offer an essential first-person perspective. As Foucault might have said, the psyche is too important to be left to the psychiatrists.
Gary Gutting is a professor of philosophy at the University of Notre Dame, and an editor of Notre Dame Philosophical Reviews. He is the author, most recently, of "Thinking the Impossible: French Philosophy since 1960," and writes regularly for The Stone. He was recently interviewed in 3am magazine.