This book offers a philosophical perspective on contemporary Tourette Syndrome scholarship, a field which has exploded over the last thirty years. Despite intense research efforts on this common neurodevelopmental condition in the age of the brain sciences, the syndrome’s causes and potential cures remain intriguingly elusive. How does this lack of progress relate to the tacitly operating philosophical concepts that shape our current thinking about Tourette Syndrome? This book foregrounds these tacit concepts and shows how they relate to “big topics” in philosophy such as time, volition, and the self. By tracing how these topics relate to current research on Tourette’s, it invites us to re-think our approach to research and care. Such re-thinking is urgently needed: individuals and families living with Tourette Syndrome remain under-serviced as pharmacological and behavioural therapies provide relief for some but not all who need support. This book highlights what questions we ask and do not ask in contemporary scholarship, thereby surfacing invisible constraints and opportunities in the field. It is of interest to scholars, health professionals, students, and affected families who want to better understand this burgeoning field of research with its conceptual controversies, approaches to aetiology, and directions for new research and improved clinical care.
Author(s): Lisa Curtis-Wendlandt
Series: Philosophy and Medicine, 145
Publisher: Springer
Year: 2023
Language: English
Pages: 267
City: Cham
Acknowledgments
Contents
Chapter 1: Introduction: First Crossings
References
Chapter 2: Clock Time and Tic Nosology
2.1 A Slippery Explanandum
2.1.1 Tourette’s in DSM-5
2.1.2 Timeless Tokens
2.2 Masking Change
2.2.1 Chronicity
2.2.2 Ontological Transmutations
2.2.3 Transience, Remission, and Tic-Free Time
2.3 The Future of Time and Tics
References
Chapter 3: Volition in the Ticcing Brain
3.1 Taking Stock of the Contemporary Debate
3.1.1 A Potpourri of Terms
3.1.2 Volition and Motor Control
3.1.3 Philosophical Tensions
3.2 Libet’s Heritage
3.2.1 Readiness Potential or Not?
3.2.2 The Vetoing Window
3.2.3 Suppressibility Remains Elusive
3.3 Consciousness Reconsidered
3.3.1 To Feel or Not to Feel, That is the Question
3.3.2 A Note from Sartre
References
Chapter 4: Freedom in a Tourettic World
4.1 Critiquing the Dominant View: Are We Getting at Freedom?
4.1.1 Minds Bent Upon Larger Purposes
4.1.2 Three Types of Intentions
4.2 Acting Freely
4.2.1 The Trouble with Too Much Control: Disrupting Skilled Habits
4.2.2 Quality of Life as Freedom in Action
4.2.3 Four Scenarios: Interactions Between Tics and Other Intentional Actions
4.3 On the Therapeutic Use of Consciousness
4.3.1 Bottom-Up or Top-Down
4.3.2 Losing Autopilot: Modes of Being in the World
4.4 Acceptance and Reappraisal
4.4.1 Can Distal Intentions Alter Tic Expression?
4.4.2 Affective Valence and Agency
References
Chapter 5: Agency and Ownership in Tic Disorders
5.1 What Experience, Please?
5.1.1 Volition-as-Experience and Volition-as-Ability
5.1.2 Pablo’s Eye-Blinking Tic (Again)
5.2 A Complex Pair: Multiple Aspects of Agency and Ownership
5.2.1 Defining the Terms
5.2.2 ‘Not Mine’ or ‘Not Me’? Understanding Alienation
5.3 Situating Tics
5.3.1 More Susceptible to Illusions of Agency
5.3.2 Less Susceptible: The Rubber Hand Illusion
5.3.3 Sense–Attribution Mismatch: Contrasting Schizophrenia and TS
5.3.4 Returning to the Narrative Scale: ‘Who’s Making that Noise?’
5.4 Toward a Psychopathology of Tic Disorders
References
Chapter 6: Tics as Intentional Actions: A Revised Taxonomy
6.1 The Trouble with Unintendedness
6.1.1 Intentional Is Not Voluntary Is Not Free
6.1.2 Enactive Spillage and Normative Load: When Things Happen Anyhow
6.1.3 The Intention-Action-Outcome Triad: Four Match-Mismatch Scenarios
6.1.4 Nonintentional Actions Revisited
6.2 Testing Our Taxonomy
6.2.1 Challenging Dichotomies
6.2.2 A Tic for Every Category?
6.2.3 Not Just Right Experiences (NJRE)
6.2.4 Tics as Nonintentional Actions
6.3 Honouring Complexity: Tics as ‘Action (Pheno)Types’
References
Chapter 7: On Reflexes and Stimuli: Tics as Nonactions
7.1 Chickens and Eggs
7.1.1 From Nonaction to the Urge-for-Action
7.1.2 Enabler or Response? Reconsidering the Urge
7.1.3 Introducing NIAT, SIAT, and EIAT
7.2 Mapping the Causal-Temporal Sequence of a Tic
7.2.1 Neural Signals and Other Stimuli
7.2.2 Premonitory Phenomena and Urges
7.2.3 Behavioural Responses: Ticcing and Tic Suppression
7.2.4 Other Behavioural Responses: Tic Facilitation and Modification
7.2.5 Cognitive-Affective Responses: Impacting Experience
7.3 Coming Full Circle
7.3.1 NIAT’s Last Straw
7.3.2 No Candy Machines or Mars Rovers
7.3.3 Hyper-Circularity: The Echo Chamber of Tics
7.4 Beginnings and Ends
References
Chapter 8: ‘No ill will’: Ticcing on Moral Grounds
8.1 Morality Is Interactive
8.1.1 Promises and Pitfalls of Neuro-Reductionism
8.1.2 The Cost of Moral Misattributions
8.1.3 Against the Interpretative Grain
8.2 Ticcing for Ticcing’s Sake
8.2.1 Criterion 1: Relative Absence of Reasons for Acting
8.2.2 Functional Tics as a Litmus Test for Our Theory
8.2.3 Four Notations for ‘Functional Overlay’
8.3 Zoning Out and Tuning In
8.3.1 Criterion 2: Directedness of Attention
8.3.2 Toward an Ethics of Moral Responsibility in Tic Disorders
References
Chapter 9: Conclusion: Beyond Causes and Cures
References
