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Book Forum: Psychotherapy   |    
The Contours of Agency: Essays on Themes From Harry Frankfurt
MARK D. REGO, M.D.
Am J Psychiatry 2003;160:1196-a-1197. doi:10.1176/appi.ajp.160.6.1196-a
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Milford, Conn.

Edited by Sarah Buss and Lee Overton. Cambridge, Mass., MIT Press, 2002, 381 pp., $45.00.

Although the focus of much of the discussion between clinician and patient has shifted in recent years from the dynamic unconscious to the role of symptoms, some themes remain fundamental to the psychiatric endeavor. One of the most enduring of these is that of the divided self. How a person achieves agency and a sense of self in the face of conflict, symptoms, and dilemmas is of immediate interest to the clinician and of defining interest to Harry Frankfurt.

Contours of Agency is a compilation of essays from a 1999 conference devoted to Frankfurt’s work. In it many distinguished philosophers take up points from Frankfurt’s work and offer expansions, alternatives, and straight criticism.

The work of Frankfurt, an analytic philosopher, offers insightful, stimulating, and even provocative perspectives on the divided self and related themes. Over the past 30 years, Frankfurt has given much thought to what it means to be a person (and, comparatively, what it means to fall short of this). His main essays on these reflections are contained in two slim and very accessible volumes: The Importance of What We Care About(1) and Necessity, Volition and Love(2).

For Frankfurt the fundamental dimension of our humanity is our ability to reflect on our own mental life. We can have thoughts about thoughts, feelings about feelings, etc. It is in the process of finding rectitude between these layers of experience and reflection that we work out who we are and how we live our lives. Thus, for Frankfurt, concepts such as externality (things that occur within our mental histories but are not necessarily part of our identity), wholeheartedness, identity, and will are central to understanding what kind of beings we are. Frankfurt does not seek to define humans from the outside but, rather, from the inside by route of what we care about and the extent of our efforts.

An important aspect of this work is that Frankfurt focuses not on psychopathology or ethics (although he uses examples from both fields) but on everyday experience. It is in this vein that love is, for Frankfurt, the central organizing feature of a person. This love is neither romantic nor moral; it is what we care about, and, being such, it is valuable in and of itself (i.e., without specific reference to the worth of the beloved).

The essays in Contours of Agency are too numerous to review here. Their quality will vary with the interest of the reader. Of note are "The True, the Good and the Lovable: Frankfurt’s Avoidance of Objectivity" by Susan Wolf and "Love’s Authority" by Jonathan Lear, a philosopher and trained psychoanalyst. These essays take up the difficult issue of Frankfurt’s claims about love. Frankfurt’s responses to each essay are among the most lucid and edifying parts of the collection.

As for the mental health reader, the book likely contains more finely grained arguments than desired. Although the readings do not bear directly on clinical or ethical issues (for the latter I recommend Jeanette Kennett’s recent volume [3]), the thoughtful and rigorous commentary on the bases for human agency provides a worthwhile stretching of some mental muscles that the clinician will undoubtedly call on in this era of evolving paradigms of mental illness.

Frankfurt H: The Importance of What We Care About. Cambridge, UK, Cambridge University Press, 1988
 
Frankfurt H: Necessity, Volition and Love. Cambridge, UK, Cambridge University Press, 1999
 
Kennett J: Agency and Moral Responsibility: A Commonsense Moral Psychology. Oxford, UK, Clarendon Press, 2001
 
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References

Frankfurt H: The Importance of What We Care About. Cambridge, UK, Cambridge University Press, 1988
 
Frankfurt H: Necessity, Volition and Love. Cambridge, UK, Cambridge University Press, 1999
 
Kennett J: Agency and Moral Responsibility: A Commonsense Moral Psychology. Oxford, UK, Clarendon Press, 2001
 
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