Chronic pain is a prevalent condition commonly associated with significant distress, disability, and distortion. However, not all individuals with chronic pain experience these negative effects, suggesting that pain-related suffering plays a crucial role in their emergence. This paper analyzes ‘pain-related suffering,’ distinguishing it from chronic pain and clarifying their relationship. It begins by identifying four key attributes of pain-related suffering that serve as desiderata for further analysis. Subsequently, the paper addresses the challenge of conceptualizing pain-related suffering in a way that aligns with these attributes and clarifies the conditions under which pain leads to suffering. It explores the dissociation between pain and suffering, arguing that suffering does not arise directly from pain’s intensity, persistence, unpleasantness, or functional impact but from the meaning ascribed to pain by the individual. Further, it critically examines existing theories of the ‘meaning’ that pain might hold, including the traditional view that suffering results from a perceived threat to personal integrity (Cassell, 1982) – a notion criticized for its conceptual ambiguity and misalignment with key attributes. Instead, the paper proposes that pain-related suffering arises when pain is perceived as a harmful disruption to one’s sense of self, related to embodied, interpersonal, and existential dimensions.

This paper introduces and defends the Blueprint View, a novel approach to understanding health and mental health in terms of abilities and design. It begins by addressing two key challenges for ability-based theories of health: the inclusion challenge (which abilities are relevant to health?) and the threshold challenge (to what extent do these abilities need to be present?). After rejecting influential existing approaches (Fulford 1989; Nordenfelt 2012), the paper develops its answer: the abilities relevant to health are those that the organism would have if all parts of the organism were fully functional. Inspired by Neander (1983), Wakefield (1992), and Griffiths and Matthewson (2018), selection processes determine full functionality.

In the second part, the paper extends this framework to mental health, addressing what distinguishes mental health from physical health. After critically reviewing alternative accounts (Wren-Lewis and Alexandrova 2021; Leder and Zawidzki 2023), it adopts the central tenet of Sanja Dembić's (2023) Rehability View, according to which mental health depends on the ability to respond to reasons.

This synthesis offers an account of mental health as a designed rational ability. It unifies physical and mental health under a single theoretical framework while distinguishing between them.

Traditional suicide risk assessments focus on statistical correlations between risk factors like mental illness and suicide (attempts). However, such suicide risk factors fail to identify high-risk individuals, with frequent false positives and negatives. This talk introduces the Normic account of suicide risk, a new theoretical framework that shifts from probability-based to norm-based risk assessments. Drawing on the idea of possible worlds instead of probability theory, this account evaluates risk by assessing the "normalcy" of suicidal action in terms of practical rationality. Risk increases when suicidal action is easy to rationalize based on an individual’s reasons for living and dying, while actions requiring greater explanatory effort signal lower risk. Drawing from clinical practices like Motivational Interviewing, the Normic account of suicide risk highlights the importance of exploring the agent’s motivational reasons to better assess and address suicide risk. By reframing suicide risk in terms of normative intelligibility rather than statistical likelihood, this approach offers a more person-centered and ethically sensitive framework for understanding and mitigating suicide risk, while circumventing the problem of low predictive powers of all known suicide risk factors.

Auditory verbal hallucinations (AVH), defined as experiences of hearing voices in the absence of an appropriate external stimulus, raise important clinical but also philosophical questions about the nature of hallucinations, mental agency, and delusional beliefs. A central and under-researched aspect of this experience is control (or lack thereof), i.e the extent to which, the specific manner in which, and aspects over which voice-hearers can exert control when experiencing AVH episodes. Philosophers take the lack of control to either indicate that AVHs are non-veridical perceptual experiences as opposed to other inner experiences, or to explain the feeling of alienness that voice-hearers report. I argue that the currently used and poorly understood notion of control cannot answer any such questions. In response, I suggest that, to properly understand control, we need to distinguish actual control from sense of control, and the actual agent (i.e the voice-hearer) from the imaginary one (i.e the voices heard). Specifically, I argue that the actual agent exerts different types of actual control. A sense of control correlates with the control that the actual agent attributes to the imaginary agent. This will help us better understand the notion of mental agency more generally.