Applying Extended Mind Theory to Psychiatry

The work of Saint Joseph’s philosopher Ginger Hoffman, Ph.D., Ph.D., reminds us of a profound aspect of philosophy: The discipline offers practical and ethical ways of being in — and seeing — the world.

Hoffman undertook her current research “Out of Our Skulls: How the Extended Mind Thesis Can Extend Psychiatry” in the interest of positing a more humane way of perceiving and labeling mental health differences, which is often a preferred term for mental disorders or illnesses.

Beginning her career as a neuroscientist, Hoffman received her doctorate from Yale University in 2000. As a volunteer in the psychiatric unit at Yale-New Haven Hospital, she says she “learned that seeing people for their brains was only part of the picture. The ethical questions of caring for people with mental differences became more and more pressing for me.”

Blending fields, Hoffman earned a second doctorate in philosophy from the Massachusetts Institute of Technology in 2009 and began her work on the ethical questions mental health professionals and their patients face.

“Out of Our Skulls,” now under review for publication, challenges the way psychiatry judges, categorizes and treats people with mental differences. Examining psychiatry through the lens of the Extended Mind Theory (Clark, A., & Chalmers, D., 1998), which states that the mind extends beyond the body to objects in the environment, helped Hoffman frame her approach to psychiatry.

“There is no agreed-upon definition of the mind by scientists or philosophers,” says Hoffman. “However, many are attracted to the idea that the best way to define the mind is by its function.”

If that is the mind’s best definition, Hoffman argues, and if we consider the example of memory, it wouldn’t matter where memory is stored. “A part of your brain or a note in your iPhone would serve the same function,” she says. According to the Extended Mind Theory, then, the mind can be made up by parts of the world, including a person’s immediate surroundings.

Although it may sound counter-intuitive, many accept the Extended Mind Theory and Hoffman believes that considering it could deeply impact the practice of psychiatry.

“If the mind extends beyond the body, but psychiatric diagnosis limits itself largely to within the confines of the body — e.g., within the individual’s skull or brain — it risks neglecting relevant information about the mind,” she explains.

Hoffman says considering this theory in the context of mental health diagnoses could change whether some individuals meet the criteria for a mental disorder, diversify the ways in which disorders are treated and, ultimately, reduce the stigma surrounding those with a diagnosis.

A patient diagnosed with Alzheimer’s disease in a doctor’s office, Hoffman explains, may not receive the same diagnosis if she is at home, surrounded by the environment that she has used to store her memory and other pieces of her mind.

According to Hoffman, the Extended Mind Theory could even be a tool to help us understand the self as more relational and less separate, and perhaps enable us to be “with and for others.”

Another strand of Hoffman’s work argues for greater understanding and better treatment of people with mental differences. “There is a tension,” she says, “between accepting someone as they are and striving for them to be better. Much of my research looks at this question, which is important to consider in order to best live our lives and be compassionate to others.”

On campus, Hoffman participates in Active Minds, a student organization aimed at increasing acceptance of mentally different individuals and combatting other forms of “saneism.” She also challenges each of her students to think about the just and ethical treatment of those with mental differences, particularly in her course “The Philosophy of Mental Illness.”

Though it may take some intellectual courage to accept the Extended Mind Theory, in Hoffman’s eyes, the benefits outweigh the risks. “It goes against our common sense to think the mind is extended,” she says, “but being intellectually courageous can help us live more ethically.”