Abstract: Evolutionary mismatch is a versatile concept used across fields, denoting that our evolved biology may be poorly suited to aspects of modern environments. In evolutionary psychiatry, it has become a key explanatory principle for the prevalence of psychiatric conditions in modern populations. However, some authors regard the concept as vague and in need of philosophical clarification. We introduce a novel distinction derived from Wakefield's harmful dysfunction analysis: dysfunctional trait evolutionary mismatch, representing true disorders, and functional trait evolutionary mismatch, which do not. We further identify the possibilities of latent dysfunctional mismatch, where previously harmless dysfunctions become harmful in modern contexts, and attenuated-harmful dysfunction, where previous harm has been neutralized by modern environmental change. Recognizing these distinctions can improve disorder classification, and may provide the basis for improved prevention and treatment.
This paper argues that the involuntariness of trauma recollections should play a more prominent role in our theories of post-traumatic stress disorder and acute stress disorder. The received view of these disorders takes intrusive recollections to play a central role in them, but—for reasons that the first part of this paper scrutinizes—it assigns relatively little importance to the involuntariness of those recollections. The second part of the paper shows that research into these disorders has operated with a rather imprecise conception of that involuntariness. The final part draws on the work of some twentieth century philosophers of action to show how a more precise account could be given, suggesting that that account should avoid equating involuntariness with the absence of a causally relevant intention.
Autism-related concepts shape psychiatric classification, research agendas, clinical communication, policy decisions, and forms of autistic self-understanding. Yet these concepts are often adopted, contested, or revised without sustained reflection on the roles they are meant to serve across different settings. This article examines two widely discussed terms, “neurodivergent” and “profound autism,” and argues that disputes surrounding them often reflect mismatches in conceptual function rather than disagreement about descriptive accuracy alone. Building on conceptual work in philosophy of psychiatry, conceptual ethics, and interdisciplinary autism research, the article develops a four-dimensional framework for evaluating autism-related concepts in terms of internal structure, degree of intentional design, ethical orientation, and empirical grounding. Historical and comparative analysis shows that “neurodivergent” emerged from autistic-led and cross-disability activism as a minimally structured identity concept, whereas “profound autism” was introduced in clinical and administrative contexts as a more structured category tied to research visibility, service coordination, and clinical proxies. The contrast clarifies why tensions arise when concepts designed for different tasks are assessed by the same standards. Rather than proposing conceptual uniformity, the article advances conceptual responsibility as a requirement to make explicit what concepts are being asked to do, which evidential infrastructures sustain them, whose perspectives shape them, and what trade-offs their use entails.
Oftentimes one knows what another is feeling, thinking, or intending. In many other cases, however, fellow human beings are not transparent to us, and understanding others often eludes us. We encounter psychological indeterminacy: on particular occasions it may be unclear what another is feeling, desiring, thinking, intending, and so forth. This paper closely examines how mothers of nonspeaking autistic children characterize and respond to psychological indeterminacy in their everyday interactions with their children. In phenomenological interviews with 13 mothers, the mothers describe different types of psychological indeterminacy, how they respond to it, and how they see these methods of responding as contributing to understanding their children’s mental lives and increasing their sense of connection to their children. I argue that the mothers’ insights improve our practical and theoretical understanding of psychological indeterminacy in two key respects. First, they enrich our understanding of interpretive practices when encountering psychological indeterminacy. These practices contribute to much-needed hermeneutical resources for interpreting and communicating with nonspeaking autistic individuals and suggest individual-level strategies for countering epistemic injustice in interpersonal dynamics with nonspeaking autistic individuals. Second, they introduce considerations that challenge the prevalent idea that psychological indeterminacy is entirely negative.
Although their use has been proposed for several decades as a fundamental part of mental health recovery, in recent years there has been an increasing push to integrate mutual aid groups (MAGs) into health services. While this integration could strengthen them, it risks transforming MAGs from alternatives to mere complements to psychiatric services. This article argues that the integration of mutual aid into formal health systems must be approached with caution, ensuring that such inclusion does not neutralize their transformative potential, but rather reorients care systems toward ontological pluralism, justice and epistemic dignity. To answer this question, a dialogue is proposed between theory and several programs where MAGs were the central strategy. Transversalizing care implies recognizing that different forms of healing arise from distinct worlds, logics, and ways of experiencing suffering. Without this shift, MAGs risk being neutralized, depoliticized, and absorbed by recovery systems that do not always respond to diverse forms of psychosocial suffering. The question is not how peer support can be integrated into existing mental health systems, but how these same systems can support the radical ontological shift that MAGs demand. Mechanisms are proposed to integrate these strategies into a broader care system, preserving their autonomy and managing risks of co-optation.
This paper examines Ludwig Wittgenstein’s engagement with the concept of the unconscious, both directly and indirectly, through a dialogue with Sigmund Freud’s psychoanalytic thought. Freud’s notion of the unconscious is analyzed across several contexts, with Wittgenstein’s philosophy serving as the primary framework of evaluation. The study’s originality lies in its conceptual investigation of how the idea of the unconscious can elucidate patterns of thought whose sources remain opaque and reveal the therapeutic potential that, in certain cases, accompanies its use. Such inquiry exposes tensions that Wittgenstein himself identified particularly those arising from the limits of language in describing mental states. Rejecting the treatment of concepts as explanatory foundations, Wittgenstein emphasized their practical use in ordinary language. His scattered references to the unconscious should therefore be read not as theoretical commitments but as part of his broader effort to dissolve philosophical confusion and psychological distress. His reference in the preface to Philosophical Investigations to “the darkness of this time” alludes not only to historical circumstances but also to the inner condition of human beings. The paper explores five contexts in which Wittgenstein’s engagement with the unconscious is especially revealing 1) psychoanalytic concepts in everyday language, 2) the unconscious as logically necessary, 3) language idling as symptomatic, 4) dream interpretation as persuasion, and 5) the joke and the unconscious as keys to intermediate links. These analyses reveal Wittgenstein’s philosophical method as both therapeutic and context-sensitive, bridging conceptual clarification and human experience.
This article reexamines Michel Foucault’s lifelong engagement with psychotherapy and responds to the question posed by Hubert Dreyfus: “Is there a kind of psychotherapy Foucault would positively recommend?” Foucault is often regarded as a categorical critic of psychotherapy. However, the recently published 1950s manuscript Binswanger and Existential Analysis revealed that young Foucault was deeply invested in existential analysis and sought to reform psychopathology and therapeutic practice from within. He later shifted to a position in which he forcefully condemned all forms of psychotherapy as disciplinary practices aimed at compelling the subject to conform to normative frameworks. Nevertheless, he continued to reflect on what a desirable form of psychotherapy might be. Moreover, in his final years, Foucault developed a series of studies on “practice of the self,” which he understood as a mode of subject formation distinct from discipline. He analyzed the process by which the subject becomes free and autonomous through the very effects of the power relation with the other. Although the theory of practice of the self does not directly address psychotherapy, I argue that its reconceptualization of power—not as repression but as a catalyst for self-transformation—offers significant insights into non-disciplinary forms of psychotherapy, particularly regarding the configuration of power relations within them.
