Book: 'Logic on the Track of Social Change'

When I walked into Lancaster Univ. library in February, I had no idea I was being followed.

From the maths shelves, the lights switching on as you progress, I decided to walk across to the more familiar realm of sociology. Looking for something, it was nice to see the parity in lighting, even as my struggle for mathematical enlightenment continues.

Logic on the Track of Social Change    

I do use the e-library, and other e-resources, but sometimes real shelves and varying levels of mustiness (remember the 'new acquisitions' - fewer these days?) invite a bit of serendipity. Suddenly, over my shoulders, the stranger,  pointed (with four arms of course). Was it my shadow? Or, was it my unconscious that 'read': LOGIC and TRACK and SOCIAL CHANGE, on the spine of -

David Braybrooke, Bryson Brown & Peter K. Schotch (eds.), Logic on the Track of Social Change, Oxford University Press. 1995?

In the early decades of health informatics, there was much talk - and still is(?) - of  'languages for health', even languages for nursing. Coding and classification systems were constantly developing, as posted here, but while physical diagnoses were the driver, the psychosocial dimensions of person - patienthood proved more nebulous. DSM is still subject much debate.

 Chapter 8 in Braybrook et al. is brilliant: A Rules-Analysis, Following Foucault, of the Birth of Clinical Medicine.

I've been in situations when surgery is suggested for an older person, and family, friends wonder is this really necessary? This chapter literally brings the history home, and not only that, but the emergence of the hospital system, versus care at home, in the community. The social determinants of health have been ever-present. This is essential reading for students, with the history of ICD, and the history of medicine. There are insights too into public attitudes and expectations to health services and provision here in the UK and in France.

For me, and Hodges' model, the significance of Braybrook, Brown, Schotch and Byrne is that it precedes:

Sallach, D.L. Categorical Social Science: Theory, Methodology and Design. September 2012
Conference: Fourth World Congress on Social Simulation. Taipei, Taiwan.
https://www2.econ.iastate.edu/tesfatsi/Sallach2012CategoricalSoSci4.WCSS-SS.pdf

And so, I do need my own secondhand copy of  Logic on the Track of Social Change. More to follow (indeed)! ... and help still welcome and needed.

 

Previously: Re. Sallach - 'Distance: Shoulders and ships that pass...' : 'history of medicine'

ii 'GlobalMinds' - NHS study severe mental health problems

GlobalMinds has clearly stated goals and objectives. Three challenges that are highlighted:

1. Diagnosis can take years
2. Treatments target symptoms, not underlying causes
3. Half of the prescribed drugs cause severe side effects

These are, to put it mildly, highly contested issues. Diagnosis in mental health/illness is problematic in several respects, for example:

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a) Lack of Theoretical, Practical and Philosophical(?) agreement between:  Psychology Psychiatry b) Individuals are self diagnosing c) Access to mental health services can be highly structure - single-point entry d) The evidence-base for treatment of mental illness is growing,but remains contested. e) Perhaps there is a phenomena of people getting stuck, with not just a label, but a mindset?	a) Loss of trust in classification/coding schemes: DSM b) Proposed alternatives in - Power Threat Meaning Framework HiTOP c) Data defined scientifically: existing diagnosis biomarker
a) Increased awareness of mental illness, ADHD.. b) Behavioural explanations for mental illness c) The determinants of mental illness (unlike, health?) are poorly researched (hence understood) d) The vocabulary of mental illness (psychiatry) is more widely disseminated, hence used; not necessarily with full contextual understanding e) Stigma associated with mental illness is nevertheless ongoing.	a) Reduced economic productivity b) The socio-economic phenomena of NEETs c) Increased demand on welfare benefits d) The role of primary care - GPs      - fit / sick notes      - 'functional assessors' (Who is best placed?) e) Loss of mental health beds, community compensations incomplete.

This will be a space to watch: and related (global) initiatives? 

Viewed from Hodges' health career - care domains - model, it appears an individual's life chances and expectations (family, and educational experience?) can result in their life chances being frozen?

Thoughts ii re. 2026 Lancaster Philosophy of Psychiatry Work in Progress Workshop

For me, applying Hodges' model I tend to place philosophy and psychiatry (mind, thought, belief, truth, intention ...) within the humanistic part of the model. So, Ewa Grzeszczak and - Philosophy of psychiatry and the methodology of social ontology - stood out. This is helpful as Homeostatic Property Clusters (HPC) are a useful structure, spanning bio-mathematics. As suggested previously with 'equality', we can place the philosophical non-trivial question of kinds at the centre of Hodges' model and proceed (if possible?) from there.

The requirement for a holistic, integrative and pluralistic framework is there in literature. A statement supported by Alessandra Civani's talk: 'What kind of concept is ‘incongruence’? I located a paper:

Enactive psychiatry - A pragmatic and pluralistic approach to mental health and disease

- (and now have a copy c/o and thanks to Alessandra) and am grateful to being pointed to de Haan:

An Enactive Approach to Psychiatry

 I will (must) return to these papers. Earlier on Hodges' model, I'd opined (as on 'X') how the -

• medical
• biomedical
• bio-psycho-social models - are insufficient in the 21st century.

There was a thematic feel to the presentations with Anna Golova - Self-illness ambiguity without a self-illness distinction - following nicely. The styling on the slides was an added bonus. I located an informative (co-authored) paper by Golova:

‘Is it me or my illness?’: self-illness ambiguity as a useful conceptual lens for psychiatry'

Part of the power of Hodges' model derives not so much from its duality; as its dual axes. The two axes can encompass and handle the relatedness between/within reductionism, holist perspectives, the self and otherness, illness and health (well-being).

An hours break brought us to an event which was very well attended, clearly open to the public:

6-7pm Prof Miriam Solomon – Royal Institute of Philosophy talk ‘Stigma as an actant in the history of psychiatry’

In setting out the talk's structure I liked Prof. Solomon's reference to the common, implicit "grime" theory of the dynamic of stigma, and "punching down" as a strategy for managing stigma. 'Grime' made me think of sense of smell, the grime in my father's work van, a diesel. Now so many memories are evoked with the merest whiff. More positively, the patina of physical and mental life also came to mind. You would - might think stigma has been dealt with by now, but of course we are socio-politically far from it.

There is a related podcast from 2025, which also covers Prof. Solomon's early studies. A previous paper was also noted in the slides:

Solomon, M. (2025). The Elusiveness of Hermeneutic Injustice in Psychiatric Categorizations. Social Epistemology, 39(2), 166–177. https://doi.org/10.1080/02691728.2024.2400068

 

Discussion of the DSM inevitably followed (and in the above podcast). In questions the 'reality' of severe mental illness, and suggestion of the acute challenge of managing the negative symptoms of psychoses.

 

Prof. Solomon's conclusion was well worth waiting for, including:

Stigma as an "actant" (cf. Bruno Latour's concept of an agent: causal role without intention)... DSM - ICD...

 

If stigma disappeared tomorrow, the DSM would not have the same categories. 

 

Stigma (more specifically, its management) is shaping the conceptual space, with both scientific and moral consequences.

[Added 4th March...] On Friday - Sam Fellowes, took on, or has taken on - the non-trivial issue of - Modelling psychiatric diagnoses when self-diagnosing - how does this work? Complexity was acknowledged on the first slide, with self-diagnosis, and modelling, set against the Duhem-Quine thesis. 

This technical aspect is welcome and no doubt essential given the socio-technical nature of diagnosis, touching as it does the public (society), primary care, psychiatry, service user groups, policymakers, informatics, and HM Treasury, amongst several 'stakeholders'. With the impact of the internet and social media, much (if not all?) of the vocabulary of mental health professionals has been co-opted and re-framed(?) by patient / service-user groups? It does not, for example, appear that the agency behind the DSM will be able to claim it back. Autism and ADHD were also discussed and debated. I located a previous chapter by Sam (pay-wall):

Fellowes S. Self-Diagnosis in Psychiatry and the Distribution of Social Resources. Royal Institute of Philosophy Supplement. 2023;94:55-76. doi:10.1017/S1358246123000218

 

This really is a thicket of thorns, it spreads as and wherever you go.

 

The welfare bill is such that there should have been government Ministers in attendance. I have responded on behalf of clients to PIP assessments. Agencies have invited me to interview for 'Disability Assessor' roles. Not only is this a complex web, but several logics obtain: a perverse temporal logic operates, binary logic and a fixed mindset can develop so that some (vulnerable!?) individuals can get stuck. Perhaps, a social imperative steps in and disrupts, life chances: their being a NEET ('a young person who is no longer in the education system and who is not working or being trained for work'. Ecosia) is better for someone else? 

 

To unpick, make sense of this, you need a foundational universal model.

 

There is a (co-authored) paper from Giulia Russo, who presented - Epistemic and political role of experience: https://philpapers.org/rec/RUSTPO-112 from which:

'As it is widely known, epistemic injustice was introduced by Fricker (2007) to unveil power relations that have negative consequences on people as epistemic agents. She distinguished in particular two different kinds of epistemic injustice: testimonial and hermeneutical. The first kind occurs when a person (usually in a disadvantaged and oppressed role within the epistemic relation) is damaged as a knower because, as the name suggests, their testimony is overlooked, dismissed or invalidated. The second kind of epistemic injustice occurs when a person is deprived of the epistemic resources to even explain or articulate their experience of distress, or of systemic oppression. In connection to this, the concepts of neurodivergence and neurodiversity come from the political and social arena, and are born explicitly to contrast dominant pathologizing narratives in psychiatry.'

In seeking some 'test' cases to try to model relationally, Hodges' model suggests at least four - without letting the care / knowledge domains wag-the-dog. Giulia's talk was very helpful, ranging across forms of epistemic injustice (addressed by others too), identity, neurodivergence, lived experience, self-, counter- and collective narratives with references. A great resource.

 

Frank Denning, reminded me of an important phenomena, in Using Stebbing’s Directional Analysis to Evaluate ‘Mentalizing’. Talking therapies, or more properly referral to talking therapies often presents several criteria that would-be subjects must 'pass'. An ability to mentalize, can represent one. This is understanable, for effectiveness, efficiency, efficacy ... it is to be found in the manual. But, in terms of power relations, gate keeping in various forms is a literal (virtual) key to service access. Hodges' model is no different (sigh!). At what age can people start to use Hodges' model? What mentalization is involved to cognitively engage in use of Hodges' model? 

 

I struggled to obtain a copy of Stebbing's original work from 1930, but see how closely tied the work is to physics. An Internet Archive copy is poor quality. The search will continue, as I suspect there are links to Bill Ross's text on Deleuzian cosmology. It is marvellous that work from 1930 resonates today. There is: 

Janssen-Lauret, F. (Accepted/In press). Directional Analysis in Susan Stebbing’s Philosophy of Physics. In S. Chapman (Ed.), Susan Stebbing on Logic and Analysis Springer Nature. 

https://pure.manchester.ac.uk/ws/portalfiles/portal/338653274/Directional_Analysis_in_Susan_Stebbing_s_Philosophy_of_Physics_Final_.pdf

Gloria Ayob - Flourishing as mental health - was encouraging. 'TASK 1:EQUATION' a slide was titled, including emotional disorder is meta-evaluative; there are negative and positive poles, plus isomorphism between unpleasantness-pleasantness and disorder-health. I think my stomach was protesting I should have paid more attention. There is a blog post by Gloria: https://blog.oup.com/2024/12/the-concept-of-emotional-disorder/

After lunch Richard Hassall - Hermeneutical Injustice and Damaged Intellectual Self-Trust in Psychiatric Service Users, a reminder of the time and effort that needs to be put into public and patient involvement and engagement in mental health service (when this is desired). References included J.L. Austin and J.S. Bruner. A paper:

Hassall R. Sense-making and hermeneutical injustice following a psychiatric diagnosis. J Eval Clin Pract. 2024 Aug;30(5):848-854. doi: 10.1111/jep.13971. Epub 2024 Feb 20. PMID: 38375925.

https://onlinelibrary.wiley.com/doi/10.1111/jep.13971 

Scoping reviews are more common it seems: Lara Calabrese - Exploring epistemic injustice in dementia care: a scoping review and a qualitative study, plus paper [with QR code on the slide]:

Calabrese L, Brigiano M, Quartarone M, Chirico I, Trolese S, Lambiase F, Forte L, Annini A, Bortolotti L, Chattat R. I'm still here and my opinion matters: a scoping review on the experience of epistemic injustice among people living with dementia. Curr Psychol. 2025 Dec 17;45(1):s12144-025-08519-y. doi: 10.1007/s12144-025-08519-y. PMID: 41445984; PMCID: PMC7618523.

 

The paper's title here brought to mind the radio programme "Does He Take Sugar?" Questions followed regards the studies methods. Since leaving I wondered if there has been an evaluation of Dementia Friendly Communities? Are there dots to usefully joined there?

 

The final talk was delivered (with gusto - pepped me up anyway) by Jacob Barlow - Epistemic borders: experts, communities, communication. Jacob's interest in pragmatism was apparent. I look forward to reading future work, and note Liverpool 2025: ‘Problems with Pragmatism in the Philosophy of Psychiatry’.

All in all, a stimulating and enjoyable event.

v Book review: 'Categories we live by'

Our lives and careers (hopefully) are full of bridges, some recognised, but not taken, others passed-by on our way (and unseen). Before I completed my training as a student mental health nurse beginning in 1977, I saw a critical bridge between the knowledge and skills on mental health nursing and general nursing. Crossing this bridge was essential (for me) to being a registered 'nurse'.

Chapter 6 on Psychodiagnostic Categories is a gift therefore. It's a gift because another bridge emerged in 1980-1981 with the Sinclair microcomputers and advent of 'home computing'. With a ZX81 there was going to be a need to navigate this space between the what is human and what is machine. Two categories that remain key concerns today.

The DSM (Diagnostic and Statistical Manual of Mental Disorders - published by the American Psychiatric Association [APA] ) is on the chapter's first page, plus the patient, researchers, psychiatrists and the conditions learned during their medical education, contrasted with individual psychiatrist's clinical encounters with patients. 

Very quickly (the next page p.86) Murphy identifies the 'circumstantial factors' that cause mental illness. This is very positive as acknowledging the determinants across health is key, however framed, e.g. social determinants, economic, educational we must take into account all of them. Otherwise our assessment must be considered as incomplete, or at least lacking?

The utility of Prof. Murphy's short book is in how prior to the case studies we see the problem of definitions. And how what is determined is often a matter of convenience. This is a non-trivial matter - especially in health, economics, sciences, politics, future and peace studies: you get the idea...

Of immediate relevance in the USA is the need for categories for insurance purposes. It is an industry. Yes, indeed: 'The truth is that psychiatric patients vary in every possible way', p.86. Computers of course are well-equipped to help us in the creation, revision and publication - access to categories; with classification, taxonomy, nomenclature ... also in the mix. I was reminded of WHO's history of classification (see below) which I point students and colleagues to.

The way DSM is applied is explained and the politics duly noted (especially in Chap. 7). Resort to 'miscellaneous' is described as a sign that 'the categories are not necessarily picking out 'natural kinds'. I remember in the 90s, our PICK database on a community mental health project had Murphy's 'X' not otherwise specified. I don't think I read the word 'caseness', but there is a lot 'inside'!? References are ongoing. I wondered if there could be more recent examples, but perhaps this is in turn symptomatic of categorisation tending to be the rear car? Fuzziness is discussed. Plus, the observation that 'a few psychiatric categories may be true natural kinds, like gold or rainbow trout.' p.89. 

'Change' is a mantra for all disciplines in the NHS and global healthcare. So pragmatic to see how revision and change in the DSM can be used by - dare I mention - anti-psychiatry advocates and clinicians as to what change represents to these respective interest groups? At a time when research is experiencing funding changes, Murphy contrasts how DSM was developed for the use of clinicians to identify people with similar profiles, but they were not developed to identify (research - Nat. Inst. for Mental Health) underlying causes. Raising the determinants once again, p.91.

It is obvious but as personnel and Brits may look at private medicine with coding purposed for insurance purposes; there is within the NHS (public-funded healthcare) and psychiatry (a single domain too) within and the need by patients for diagnosis, and the welfare system. Here in the UK the rise of mental health in young adults, autism and waiting lists for assessment for ADHD are a moot point.  

Through Hodges' model we some possibly fascinating bridges, that are much less-travelled these days? In many cultures, even if we do not need permission to be sick, it needs to be recognised socially - and so politically. Society needs to deal with individuals who are ill, infirm, disabled. It's interesting then to reflect on this issue and phenomena through the lens of anthropology and medical sociology. Murphy warns to of the dangers 'of thinking of something as being the category'. In medicine a new approach is needed, as Murphy also notes. A nice bridge to chapter 7 Categories and Power.

'The case studies discussed in the previous chapters remind us that categories can be political and social tools. An old department chair of mine had the saying, "She who sets the agenda controls the meeting." We might coin a new one, "Those who make the categories control the outcomes." If your psychodiagnostic categories are made by working therapists and physicians, they might facilitate treatment- -and also benefit those practitioners. If they are made by researchers, they might not be very useful for treatment at all. And if they are made by insurance companies, all bets are off.' p.95.

Trying to take my attempts to find theoretical underpinning (category 'trying to clever') I've a diagram scribbled here. Nearby, p.100, I picked up on 'the cost of losing information or distorting reality to some degree.' Murphy picks up on the ICD Int. Classification of Diseases here. Twitter is still twitter here - thumbs up for that! There is a useful example of the impact of categories in age, pregnancy and medical attention provided.

From Chapter 8, I picked out: Naming Nature: The Clash Between Instinct and Science, by Carol Kaesuk Yoon. W. W. Norton: 2009. 352 pp. £19.99/$27.95 9780393061970 | ISBN: 978-0-3930-6197-0; and checking, I remember the book's cover. Murphy's book overall highlights the convenience of our categories, the ongoing challenges and everyday conundrums they present though the remaining chapters on Species (8); Peanut Butter, Potato Chips, Almond Milk... (9); Racial Categories (10). These all contribute, still building a coherent picture, chapter 10 vital among them with a url provided (which may have changed):

https://anthropology-tutorials-nggs7.kinsta.page/adapt/adapt_4.htm

Skin Color Adaptation

The one-drop rule (David, 1991) on p.126, is deeply troubling. Especially so given some examples of human reasoning even today. Medicine, by way of blood tests, features again. I smiled wryly reading how people from different countries have different rates of disease, e.g. 'heart disease in Scotland'. Instantly, and crackling - a deep-fried Mars bar popped into my mind. 

The things people do. You - really could read this book! 

Murphy, Gregory L. Categories we live by: how we classify everyone and everything. Cambridge, MA: The MIT Press, 2024.

Many thanks again to MIT Press for the review copy and Prof Murphy for a great read.

Previously: DSM : fuzzy : categories

Re-Inventing Schizophrenia: Updating the Construct

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Schizophrenia Research
	Re-Inventing Schizophrenia: Updating the Construct

Re-Inventing Schizophrenia: Updating the Construct. Edited by Rajiv Tandon, Matcheri Keshavan, Henry Nasrallah. Schizophrenia Research. Volume 242, Pages 1-150 (April 2022).

My source:
https://twitter.com/JeroticStefan/status/1508898715473530888?s=20&t=X61DSrPzEyLvX-FhzY5r-A

Need for bio-psycho-socio-POLITICAL perspectives - spiritual too.

Previously on W2tQ: DSM

 

Hodges' model - DSM V: the Politics of (Well-being (Health [Mental Health])) salience, books and domains

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 'salience'  ‘Salience syndrome’ replaces ‘schizophrenia’ in DSM-V and ICD-11: psychiatry’s evidence-based entry into the 21st century? J. Van Os bereavement medical, bio-psycho-social, recovery model self-efficacy self-stigma DSM5 and Ethical Relativism Ultimate terminology:  self, person, patient, service user, client,  Mr, Miss .....	Diagnostic process 'Evidence', objectivity,  repeatability, validity, treatment, drugs Credit Heidi Cartwright, Wellcome Images
The history of DSM: APA : Wikipedia stigma social services social network (size, quality) anti-psychiatry social norms? Media: Books review - essay; Stevenson, T. (2013) Mind field, FT Weekend, May 25-26. p.8.	American Psychiatric Association APA Opinion - commentary: DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice (was on Scientific American) Is Criticism of DSM-5 'Anti-psychiatry'? Goldacre: Bad Pharma .... and much more...

group - population

See also:
WHO History of the development of the International Classification of Diseases

Image: http://wellcomeimages.org/