Speaker: Hanna Pickard, Faculty of Philosophy, University of Oxford

Respondent: Bennett Foddy

Abstract: Effective treatment of personality disorder (PD) presents a clinical conundrum. Many of the behaviours constitutive of PD cause harm to self and others. Encouraging service users to take responsibility for this behaviour is central to treatment. Blame, in contrast, is detrimental. How is it possible to hold service users responsible for harm to self and others without blaming them? A solution to this problem is part conceptual, part practical. I offer a conceptual framework that clearly distinguishes between ideas of responsibility, blameworthiness, and blame. Within this framework, I distinguish two sorts of blame, which I call ‘detached’ and ‘affective’. Affective, not detached, blame is detrimental to effective treatment. I suggest that the practical demand to avoid affective blame is largely achieved through attention to PD service users’ past history. Past history does not eliminate responsibility and blameworthiness. Instead, it directly evokes compassion and empathy, which compete with affective blame.

Bio: Hanna is a Fellow of All Souls College, Oxford, and a Research Fellow at the Oxford Centre for Neuroethics. She is also a therapist at the Complex Needs Service, a NHS Therapeutic Community for people with personality disorder. Her research aims to integrate analytic philosophy with clinical data. She has just won a 5 year Wellcome Trust Research Fellowship to work on the nature of responsibility and morality within personality disorder.