Abstract This article explores the interplay between crises, opportunities and democratic change in the United Kingdom. A vast body of scholarship underlines that crises open ‘windows of opportunity’ ...that can occasionally lead to radical shifts in the role of the state and the design of public policy. Even when a radical shift occurs, however, it has often proved temporary, with relationships and processes quickly reverting to pre-crisis modes once the immediacy of the crisis abates. This may not be true of our present period of crisis following the COVID-19 pandemic. The consequences of decades of underinvestment in infrastructure and increasing concentration of resources in a small minority of individuals and organisations are being exacerbated by climate change, geopolitical conflict and new waves of disease. The challenge for policymakers in the UK now is heightened by evidence that suggests that nudging, a libertarian paternalist means of promoting certain ends, is ineffective. Policymakers who have long used state neutrality between conceptions of the good as the justification for not promoting certain ends now have to confront a real ethical dilemma: coerce to achieve specific outcomes or invest in addressing the social determinants that actually affect behaviour. This article suggests that contrary to decades of opposition to redistribution among UK policymakers, only the latter is consistent with libertarian paternalism.
Naturalistic understandings that frame human experiences and differences as biological dysfunctions have been identified as a key source of epistemic injustice. Critics argue that those ...understandings are epistemically harmful because they obscure social factors that might be involved in people’s suffering; therefore, naturalistic understandings should be undermined. But those critics have overlooked the epistemic benefits such understandings can offer marginalised individuals. In this paper, I argue that the capacity of naturalistic understandings to obscure social factors does not necessarily cause epistemic injustice and can even help people to avoid some epistemic injustice. I do this by considering how some individuals with bipolar disorder deploy the neurobiological understanding of their disorder, highlighting three functions it fills for them: explanation, disclamation, and decontestation. In performing these functions, the neurobiological understanding does marginalise alternative, social perspectives on bipolar disorder. However, this can be understood as a feature rather than a bug. By marginalising alternative explanations, the neurobiological understanding can help individuals with bipolar disorder resist epistemic injustice, including, for example, the trivialisation of their experiences. Given this, critics seeking to undermine naturalistic understandings of mental disorder and other experiences in the pursuit of epistemic justice themselves risk exacerbating epistemic injustice.
Abstract
This article challenges the consensus that silences about mental disorders are there to be broken. While silence in mental disorders can be painful, even deadly, the consensus rests on an ...oversimplified understanding of silence. Drawing upon accounts from depression and bipolar memoirs, this article names and analyses some salient experiences of silence in mood disorders. It does so with two goals in mind. The first is to show that mood disorders may involve several different kinds of lived experiences of silence. This is important because even though silence is considered a promising objective symptom of depression, little has been written about lived experiences of silence in disorders that involve depression. The second is to argue against the fetishisation of breaking silence and the concomitant understandings of silence as an externally imposed and inherently negative phenomenon. This is important because some silences are not experienced as external and are even felt to be valuable, meaning that efforts to break them may be counterproductive.
This paper examines the factors that shape the political agency of psychiatric service users/survivors. I begin by outlining an Arendtian framework for thinking about political agency and its ...sources. I then use this framework to explore the politically empowering and disempowering factors that users/survivors face, drawing upon evidence from the writings of user/survivor activists and organisations, newspaper articles, and psychiatric professional publications, published in the UK between 2006 and 2016. The insights of this examination are of wider interest for two reasons. Firstly, they elucidate the obstacles to political action facing the growing number of people diagnosed with mental disorders. Secondly, they suggest what a future in which politics is increasingly fought out in medical terms means for citizens' political agency generally.
Interest in the political relevance of the emotions is growing rapidly. In light of this, Hannah Arendt’s claim that the emotions are apolitical has come under renewed fire. But many critics have ...misunderstood her views on the relationship between individuals, emotions and the political. This paper addresses this issue by reconstructing the conceptual framework through which Arendt understands the emotions. Arendt often describes the heart – where the emotions reside – as a place of darkness. I begin by tracing this metaphor through her work to demonstrate that it is meant to convey the inherently uncertain nature of emotions rather than a devaluation of them. I proceed to challenge the notion that Arendt adopts the Enlightenment dichotomy between reason and emotion. In fact, she rejects both as a basis for politics. However, she does identify some constructive roles for the emotions. I argue that fear is intrinsically connected to courage – the principal political virtue – in Arendt’s philosophy. In light of my discussion, I then reinterpret the role of compassion and pity in On Revolution, concluding that Arendt’s insights can help us avoid the potential pitfalls of the contemporary project to recuperate the emotions in politics.
This paper illustrates how concepts of mental disorder have been deployed to medicalize negative emotions and, thereby, weaken the political agency of some individuals. First, I theorise the link ...between political agency and emotions, arguing that effective political action entails the transformation of emotions into public issues. Using the British referendum on membership in the EU as a case study, I then examine how medically loaded terms and rhetoric were used to describe suffering after the vote. Finally, I argue that this generated conditions that interrupted or even reversed the transformation of subjective experiences into politically meaningful issues.
This article revisits the notorious trial of William Windham, a wealthy young man accused of lunacy. The trial in 1861–2 saw the country’s foremost experts on psychological medicine very publicly ...debate the concepts, symptoms and diagnosis of insanity. I begin by surveying the trial and the testimonies of medical experts. Their disparate assessments of Windham evoked heated reactions in the press and Parliament; these reactions are the focus of the second section. I then proceed to examine criticism of psychiatry in the newspapers more generally in the 1860s, outlining the political resistance to psychiatry and the responses of some leading psychiatrists. In conclusion, I consider what this says about the politics of medicalization at the time.
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