Patients suffering from depersonalization complain of feeling detached from their body, their mental states, and actions or even from themselves. In this chapter, I argue that depersonalization consists in the lack of a phenomenal feature that marks my experiences as mine, which is usually called “mineness,” and that the study of depersonalization constitutes a neglected yet incomparable probe to assess empirically the scope, role, and even the nature of mineness. Here is how I will proceed. After describing depersonalization (§2) and (...) arguing that it involves a lack of mineness (§3) I will confront a series of objections (§4). I will then spell out what depersonalization can teach us about the scope of mineness (§5), about its role and psychological function (§6) and even about its nature (§7). (shrink)

How many factors, i.e. departures from normality, are necessary to explain a delusion? Maher’s classic one-factor theory argues that the only factor is the patient’s anomalous experience, and a delusion arises as a normal explanation of this experience. The more recent two-factor theory, on the other hand, contends that a second factor is also needed, with reasoning abnormality being a potential candidate, and a delusion arises as an abnormal explanation of the anomalous experience. In the past few years, although there (...) has been an increasing number of scholars offering a variety of arguments in defence of Maher’s one-factor theory, these arguments have not been adequately addressed by two-factor theorists. This paper aims to address this gap by critically examining the arguments on three crucial issues: the intelligibility of delusions, the dissociation between anomalous experiences and delusions, and the empirical evidence of a second factor. I will argue that the Maherian notion of anomalous experience is not sufficient for explaining delusions and the two-factor theory is on the right track in its search for the missing factor in the aetiology of delusions. (shrink)

A lo largo de la tradición psicopatológica, incluso de la pre-fenomenológica, se encuentra la categorización del delirio como creencia. Jaspers asumió ese uso y lo fundó fenomenológico-existencialmente, definiendo su carácter de convicción. El concepto de creencia ha tenido un largo recorrido dentro de la historia del pensamiento, aunque recientemente se ha intensificado el debate acerca de la visión doxástica del delirio. En virtud de lo ya mencionado, en el presente artículo presentamos un análisis conceptual de la creencia, con el objetivo (...) de identificar de manera precisa los aspectos esenciales que permiten al delirio definirse según ella. De esta manera, se discutirán algunas de las principales incursiones realizadas en el concepto desde la antigüedad periplatónica hasta José Ortega y Gasset, remarcando en cada pensador las directrices esenciales de su aproximación a la creencia. A su vez, introducir al filósofo español al debate psicopatológico permitirá incluir en la discusión dos aspectos importantes que creemos pueden ser fructíferos para la discusión filosófica sobre el delirio: la diferencia entre ideas y creencias, y la vitalidad de estas últimas. Finalmente, hacemos referencia al actual debate pro- y antidoxástico, haciendo hincapié en la necesidad de considerar la amplitud del concepto de creencia en su genealogía histórica. Con base en ello estaríamos en condición de acercarnos a la visión doxástica moderada que han defendido autoras como Lisa Bortolotti. (shrink)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

The history and philosophy of affective terms and concepts contains important challenges for contemporary scientific accounts of emotion regulation. First, there is the problem of moral undertow. This arises because stipulating the ends of emotion regulation requires normative assumptions that ultimately derive from values and morals. Some historical precedents are considered to help explain and address this problem. Second, there is the problem of organization. This arises because multiple emotions are often organized and oriented in very particular ways over the (...) life of the individual in a manner that cannot be adequately explained using the concept of “emotion.” A modern variant of the traditional concept of passion is invoked to help address this problem. (shrink)

En este artículo se plantea una discusión con el enfoque doxástico de los delirios. A pesar de que esta línea de análisis ha hecho importantes aportes a la comprensión del fenómeno, tiene dificultades importantes a la hora de aportar un marco explicativo completo de los delirios, porque deja por fuera el aspecto total de la experiencia y sigue basándose implícitamente en la idea de que podemos estudiar de manera separada e independiente los aspectos físicos, cognitivos y experienciales de un fenómeno (...) tan complejo. El artículo propone que, más allá de la decisión acerca de si se debe considerar a los delirios como creencias irracionales o no, o de si se puede concebirlos como creencias en absoluto, es necesario tener en cuenta la drástica transformación del mundo entero de la experiencia que se da en el sujeto delirante, tal como lo plantea la fenomenología. (shrink)

RESUMEN En este artículo se plantea una discusión con el enfoque doxástico de los delirios. A pesar de que esta línea de análisis ha hecho importantes aportes a la comprensión del fenómeno, tiene dificultades importantes a la hora de aportar un marco explicativo completo de los delirios, porque deja por fuera el aspecto total de la experiencia y sigue basándose implícitamente en la idea de que podemos estudiar de manera separada e independiente los aspectos físicos, cognitivos y experienciales de un (...) fenómeno tan complejo. El artículo propone que, más allá de la decisión acerca de si se debe considerar a los delirios como creencias irracionales o no, o de si se puede concebirlos como creencias en absoluto, es necesario tener en cuenta la drástica transformación del mundo entero de la experiencia que se da en el sujeto delirante, tal como lo plantea la fenomenología. ABSTRACT This article discusses the doxastic approach to delusions. Although this analytic approach has made important contributions to our understanding of the phenomenon, it faces serious difficulties when it comes to providing a complete explanatory framework of delusions, as it leaves out the experiential aspect. This analytic approach continues to be implicitly based on the idea that the physical, cognitive and experiential aspects of such a complex phenomenon can be studied separately. The article suggests that, in addition to merely considering whether or not delusions ought to be taken as irrational beliefs, or even as beliefs at all, it is necessary to take into account the drastic transformation of the entire experiential world of the delusional subject, as suggested by the phenomenological approach. (shrink)

Naive physics beliefs can be systematically mistaken. They provide a useful test-bed because they are common, and also because their existence must rely on some adaptive advantage, within a given context. In the second part of the commentary we also ask questions about when a whole family of misbeliefs should be considered together as a single phenomenon.

Monothematic delusions are delusions whose contents pertain to a single subject matter. Examples include Capgras delusion, the delusion that a loved one has been replaced by an impostor, and Cotard delusion, the delusion that one is dead or does not exist. Two-factor accounts of such delusions hold that they are the result of both an experiential deficit, for instance flattened affect, coupled with an aberrant cognitive response to that deficit. In this paper we develop a new expressivist two-factor account of (...) delusion. In contrast to existing endorsement and explanationist accounts, which treat delusions as either explanations or endorsements of the contents of these disordered experiences, we hold that delusional beliefs have an expressive function: they characterize, in impressionistic terms, what the subject’s experience is like for them. We show how our account improves upon existing two-factor views in explaining the central features of monothematic delusions, in particular the way in which delusional subjects fall short of the ideal of rationality. (shrink)

In this paper we review two debates in the current literature on clinical delusions. One debate is about what delusions are. If delusions are beliefs, why are they described as failing to play the causal roles that characterise beliefs, such as being responsive to evidence and guiding action? The other debate is about how delusions develop. What processes lead people to form delusions and maintain them in the face of challenges and counter-evidence? Do the formation and maintenance of delusions require (...) abnormal experience alone, or also reasoning biases or deficits? We hope to show that the focus on delusions has made a substantial contribution to the philosophy of the mind and continues to raise issues that are central to defining the concept of belief and gaining a better understanding of how people process information and learn about the world. (shrink)

Philosophers have been long interested in delusional beliefs and in whether, by reporting and endorsing such beliefs, deluded subjects violate norms of rationality (Campbell 1999; Davies & Coltheart 2002; Gerrans 2001; Stone & Young 1997; Broome 2004; Bortolotti 2005). So far they have focused on identifying the relation between intentionality and rationality in order to gain a better understanding of both ordinary and delusional beliefs. In this paper Matthew Broome and I aim at drawing attention to the extent to which (...) deluded subjects are committed to the content of their delusional beliefs, that is, to whether they can be regarded as authors of their beliefs (Moran 2001). We consider several levels of commitment one can have to a reported belief, delusional or otherwise, and we distinguish between _ownership_ and _authorship_ of beliefs (Gallagher 2000). After examining some examples of belief authoring (or lack thereof) in psychopathology, we argue that there is no straight-forward and unitary answer to the question whether deluded subjects author their beliefs. Nevertheless, introducing the notion of authorship in the debate can significantly contribute to the philosophical literature on the rationality of delusions and can also have important implications for diagnosis and therapy in psychiatry. (shrink)

I argue that some cases of delusions show the inadequacy of those theories of interpretation that rely on a necessary rationality constraint on belief ascription. In particular I challenge the view that irrational beliefs can be ascribed only against a general background of rationality. Subjects affected by delusions seem to be genuine believers and their behaviour can be successfully explained in intentional terms, but they do not meet those criteria that according to Davidson (1985a) need to be met for the (...) background of rationality to be in place. (shrink)

The Spinozan theory of belief fixation holds that mentally representing truth-apt propositions leads to immediately believing them. In this paper, I explore how the theory fares as a defence of doxasticism about delusions (the view that they are beliefs). Doxasticism has been criticised on the grounds that delusions typically do not abide by rational standards that we expect beliefs to conform to. If belief fixation is Spinozan, I argue, these deviations from rationality are not just compatible with, but supportive of, (...) their status as beliefs. (shrink)

Patients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common condition known as depersonalisation. Even though they (...) are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value. (shrink)

In this paper, we defend a representational approach to at least some kinds of non-human psychopathology. Mentally-ill non-human minds, in particular in delusions, obsessive-compulsive disorders and similar cognitive states, are traditionally understood in purely behavioral terms. In contrast, we argue that non-human mental psychopathology should be at least sometimes not only ascribed contentful mental representation but also understood as really having these states. To defend this view, we appeal to the interactivist account of mental representation, which is a kind of (...) a constructive approach to meaning. We follow Mark Bickhard in assuming that only an organism – either human or non-human – capable of detecting its own misrepresentations is representational. However, under his autonomy-based account of biological function these minds are incapable of misrepresentations because these minds are, ex hypothesi, unable to detect error in such representations. To solve this problem, we argue that adding a historical dimension – as in Millikan’s view on mental representations – to Bickhard’s account of function makes mental misrepresentation of mentally-ill minds possible. Using Bickhard’s dynamic account of function, it is possible to explain why delusions and other mental disorders can be seen as locally functional. However, an etiological dimension can further explain why misrepresentations seem to be globally dysfunctional. Even if representational or biosemiotic hypotheses about non-human psychopathology are difficult to confirm empirically, we defend the view that they can enrich our understanding of the causes and development of such pathologies, and may constitute a new progressive research programme. (shrink)

This paper examines the madness of Gerard de Nerval, the nineteenth-century French writer. It looks at his account of mental disturbance, how he responded to the psychiatric profession and how he reacted to being diagnosed as insane. It considers his autobiographical novella of madness, Aurelia, which he began at the suggestion of his alienist, Dr Emile Blanche, and while he was still an asylum inmate. Nerval's story raises important questions about the nature of madness. Is it, as he contended, a (...) mystical experience revealing truths about spiritual worlds inaccessible to the ‘sane’? Does psychiatry fail to understand it and inappropriately reduce it to the categories of scientific reason? Or are such notions of the spiritual value of madness guilty of the charge that they romanticise insanity? Do they make extravagant claims for an experience that is often disturbing and debilitating? What is the relationship between madness and recovery? Should an individual try to forget their experience of mental disturbance once they recover, or should they examine what the event reveals about themselves? Can the language of madness be decoded to unveil profound truths as Carl Jung and R.D. Laing have suggested, or is it, as the psychiatrist German Berrios maintains, merely a series of ‘empty speech acts’, signifying nothing? And finally, how does one avoid writing about madness, and instead write madness? (shrink)

In this paper we defend the doxastic conception of delusions against the metacognitive account developed by Greg Currie and collaborators. According to the metacognitive model, delusions are imaginings that are misidentified by their subjects as beliefs: the Capgras patient, for instance, does not believe that his wife has been replaced by a robot, instead, he merely imagines that she has, and mistakes this imagining for a belief. We argue that the metacognitive account is untenable, and that the traditional conception of (...) delusions as beliefs should be retained. (shrink)

A popular approach to monothematic delusions in the recent literature has been to argue that monothematic delusions involve broadly rational responses to highly unusual experiences. Campbell calls this the empiricist approach to monothematic delusions, and argues that it cannot account for the links between meaning and rationality. In place of empiricism Campbell offers a rationalist account of monothematic delusions, according to which delusional beliefs are understood as Wittgensteinian framework propositions. We argue that neither Campbell's attack on empiricism nor his rationalist (...) alternative to empiricism is successful. (shrink)

Clinical delusions are difficult to investigate in the laboratory because they co-occur with other symptoms and with intellectual impairment. Partly for these reasons, researchers have recently begun to use hypnosis with neurologically intact people in order to model clinical delusions. In this paper we describe striking analogies between the behavior of patients with a clinical delusion of mirrored self misidentification, and the behavior of highly hypnotizable subjects who receive a hypnotic suggestion to see a stranger when they look in the (...) mirror. Based on these analogies, we argue that the use of hypnosis is a reliable method to investigate the surface features of clinical delusions. But to what extent can hypnosis successfully recreate delusions? Can it also contribute to a better understanding of delusion formation? Although clinical delusions and hypnotically induced beliefs are different in etiology, some analogies can be identified in the underlying processes that characterise them, based on the two-factor theory of delusion formation. (shrink)

ABSTRACTThis article intends to reconsider the epistemological status of delusional beliefs on the basis of Wittgenstein’s conception of certainty. Several works over the last two decades have compared delusional beliefs with so-called hinge propositions, which – according to Wittgenstein – function as expressions of objective certainty. This gives rise to a paradox. On the one hand, delusions are compatible to Wittgensteinian certainties in some respects; on the other hand, they contradict beliefs shared by other members of the community, which makes (...) them different from ‘normal’ certainties. In order to address this issue, I use Moyal-Sharrock’s taxonomy of hinge propositions. This taxonomy allows one to distinguish between different types of hinge propositions; all types share the same features, but these features are manifested in a variety of ways. Thus, delusional beliefs might also be regarded as constituting a specific type of hinge propositions. This move makes it possible to resolve the paradox and to identify the special epistemic features of delusional beliefs. (shrink)

The imperviousness of delusions to counter-evidence makes it tempting to classify them as imaginings. Bayne and Pacherie argue that adopting a dispositional account of belief can secure the doxastic status of delusions. But dispositionalism can only secure genuinely doxastic status for mental states by giving folk-psychological norms a significant role in the individuation of attitudes. When such norms individuate belief, deluded subjects will not count as believing their delusions. In general, dispositionalism won't confer genuinely doxastic status more often than do (...) competing accounts of belief. (shrink)

A number of philosophers have argued that psychiatric delusions threaten Donald Davidson's rationalist account of intentional agency. I argue that a careful look at both Davidson's account and psychiatric delusions shows that, in fact, the two are perfectly compatible. Indeed, a Davidsonian perspective on psychiatric delusions proves remarkably illuminating.

This thesis develops a novel framework for explaining delusions. In Chapter 1, I introduce the two fundamental challenges posed by delusions: the evidence challenge lies in explaining the flagrant ways delusions flout evidence; and the specificity challenge lies in explaining the fact that patients’ delusions are often about a few specific themes, and patients rarely have a wide range of delusional or odd beliefs. In Chapter 2, I discuss the strengths and weaknesses of current theories of delusions, which typically appeal (...) to one or both of two factors: anomalous experience and reasoning abnormality. I argue that anomalous experience can help explain the specificity of delusions, but has difficulties in addressing the evidence challenge; reasoning abnormality can help address the evidence challenge, but has difficulties in explaining the specificity of delusions. This suggests that there may be an important factor that has not been captured by current theories of delusions. To search for this missing factor, in Chapter 3, I turn to normal believing. Inspired by the literature on Cartesian clarity and phenomenal dogmatism, I develop a dual-force framework of believing, according to which beliefs can be understood as the results of the interaction between the justificatory force and causal force of evidence and the justificatory force and causal force of clear experience, in which something clearly seems to be so to the subject. This framework suggests that the missing factor may be the clear experience with its distinctive phenomenal clarity that compels assent. In Chapter 4, I return to delusions, and argue that the dualforce framework can help us to get a better grip on some personal descriptions of delusions; make progress in addressing the evidence and specificity challenges of delusions; and shed new light on the underpinnings of delusions. In the end, I conclude with some remaining questions for future study. (shrink)

From an evolutionary standpoint, a default presumption is that true beliefs are adaptive and misbeliefs maladaptive. But if humans are biologically engineered to appraise the world accurately and to form true beliefs, how are we to explain the routine exceptions to this rule? How can we account for mistaken beliefs, bizarre delusions, and instances of self-deception? We explore this question in some detail. We begin by articulating a distinction between two general types of misbelief: those resulting from a breakdown in (...) the normal functioning of the belief formation system (e.g., delusions) and those arising in the normal course of that system's operations (e.g., beliefs based on incomplete or inaccurate information). The former are instances of biological dysfunction or pathology, reflecting “culpable” limitations of evolutionary design. Although the latter category includes undesirable (but tolerable) by-products of “forgivably” limited design, our quarry is a contentious subclass of this category: misbeliefs best conceived as design features. Such misbeliefs, unlike occasional lucky falsehoods, would have been systematically adaptive in the evolutionary past. Such misbeliefs, furthermore, would not be reducible to judicious – but doxastically1noncommittal – action policies. Finally, such misbeliefs would have been adaptive in themselves, constituting more than mere by-products of adaptively biased misbelief-producing systems. We explore a range of potential candidates for evolved misbelief, and conclude that, of those surveyed, onlypositive illusionsmeet our criteria. (shrink)

Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed the (...) evidenceresponsiveness of belief and take this to show that delusions cannot be beliefs. Against this common assumption, I appeal to a large range of empirical evidence to argue that delusions are evidence-responsive in the sense that subjects have the capacity to respond to evidence on their delusion in rationally permissible ways. The extreme evidence-resistance of delusions is a consequence of powerful masking factors on these capacities, such as strange perceptual experiences, motivational factors, and cognitive biases. This view makes room for holding both that belief is constitutively evidence-responsive and that delusions are beliefs, and it has important implications for the study and treatment of delusions. (shrink)

This chapter offers an interpretation of Jaspers’ distinction between explaining and understanding, which relates this distinction to that between general and singular causal claims. Put briefly, I suggest that when Jaspers talks about (mere) explanation, what he has in mind are general causal claims linking types of events. Understanding, by contrast, is concerned with singular causation in the psychological domain. Furthermore, I also suggest that Jaspers thinks that only understanding makes manifest what causation between one element of a person’s mental (...) life and another ultimately consists in – that is, the particular way in which one psychic event can emerge from or arise out of another. I contrast the resulting view both with a view on causation in psychiatry recently put forward by John Campbell, and also with another view that is the target of Campbell’s attack, which is due to Donald Davidson and Daniel Dennett. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Actualmente se debate si el enfoque davidsoniano de la atribución intencional puede extenderse a casos de sujetos delirantes que sufren diversos trastornos psiquiátricos. En particular, respecto a los casos graves de esquizofrenia, se ha afirmado que debido a las características que presentan los sujetos diagnosticados, éstos no podrían satisfacer los requisitos de racionalidad estipulados por Davidson para ser considerados agentes intencionales. Por lo tanto, en tales casos no sería posible siquiera identificar los contenidos mentales de sus delirios. En este artículo (...) desafiaré esta perspectiva y, vinculando la discusión sobre racionalidad animal y racionalidad en sujetos con esquizofrenia, sostendré que, una vez revisados y matizados algunos principios del enfoque davidsoniano, éste puede extenderse gradual y legítimamente a sujetos con esquizofrenia, incluso en casos de gravedad. Asimismo, propondré dos estrategias metodológicas que permitan generar evidencia a favor de la atribución de –al menos– algunas creencias simples a estos sujetos, sin tener que dejar de tratarlos como agentes con algún grado de intencionalidad. (shrink)

Subjects experiencing thought insertion disown thoughts they are introspectively aware of. According to what I call “the rationality hypothesis”, thought-insertion reports are not merely intelligible, but also express, or potentially express, fully rational judgments in the light of highly disruptive experience. I argue that the hypothesis is ethically and theoretically motivated, and provides two insights into the philosophical significance of reports by subjects with schizophrenia. First, the reports can be seen as evidence that rational judgments of ownership of a thought (...) prioritize agency awareness over introspective awareness of it. This point fits with an integrative account of thought insertion at the personal and mechanistic levels. Second, rational and competent uses of the first person purely based on introspection do not necessarily involve a full-fledged first-person perspective over one’s thoughts. This suggests that agency awareness, and not introspection as such, is primarily involved in determining the reference of the first person featuring in the judgments. (shrink)

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent (...) epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions. (shrink)

Circumscribed delusional beliefs can follow brain injury. We suggest that these involve anomalous perceptual experiences created by a deficit to the person's perceptual system, and misinterpretation of these experiences due to biased reasoning. We use the Capgras delusion (the claim that one or more of one's close relatives has been replaced by an exact replica or impostor) to illustrate this argument. Our account maintains that people voicing this delusion suffer an impairment that leads to faces being perceived as drained of (...) their normal affective significance, and an additional reasoning bias that leads them to put greater weight on forming beliefs that are observationally adequate rather than beliefs that are a conservative extension of their existing stock. We show how this position can integrate issues involved in the philosophy and psychology of belief, and examine the scope for mutually beneficial interaction. (shrink)

Circumscribed delusional beliefs can follow brain injury. We suggest that these involve anomalous perceptual experiences created by a deficit to the person's perceptual system, and misinterpretation of these experiences due to biased reasoning. We use the Capgras delusion (the claim that one or more of one's close relatives has been replaced by an exact replica or impostor) to illustrate this argument. Our account maintains that people voicing this delusion suffer an impairment that leads to faces being perceived as drained of (...) their normal affective significance, and an additional reasoning bias that leads them to put greater weight on forming beliefs that are observationally adequate rather than beliefs that are a conservative extension of their existing stock. We show how this position can integrate issues involved in the philosophy and psychology of belief, and examine the scope for mutually beneficial interaction. (shrink)

The analysis presented in this article reveals an ambiguity and tension in human rights theory concerning the delusional person’s freedom of belief and thought. Firstly, it would appear that the concepts ‘opinion’ and ‘thought’ are defined in human rights discussion in such a way that they do include delusions. Secondly, the internal freedom to hold opinions and thoughts is defined in human rights discussion and international human rights covenants as an absolute human right which should not be restricted in any (...) situation for any reason. These views, if understood literally, imply that a person has an absolute right to hold a delusion. However, this kind of conclusion has not been made in mental health laws, the ethical principles guiding psychiatric care or the practice of psychiatry. Instead, they assume that the use of involuntary antipsychotic medication is justified even thought its purpose is to influence delusions. The ambiguity and tension in human rights theory concerning the freedom of belief and thought challenge us to develop this theory within an interdisciplinary discussion so that people with delusions are taken into account properly. (shrink)

Human rights theory generally conceptualizes freedom of thought, conscience, religion, and belief as well as freedom of opinion and expression, as offering absolute protection in what is called the forum internum. At a minimum, this is taken to mean the right to maintain thoughts in one’s own mind, whatever they may be and independently of how others may feel about them. However, if we adopt this stance, it seems to imply that there exists an absolute right to hold psychotic delusions. (...) This article takes the position that this conclusion is ethically problematic from the perspective of psychiatric treatment and the rights of persons with psychosis. The article reflects on this particular challenge and sets forth an understanding of freedom in the forum internum that might apply to situations where for various reasons it is not, necessarily accurate to maintain that persons have an absolute right to their own thoughts. For the purpose of proposing such an understanding, the article engages with current debates within human rights theory and political philosophy and analyzes discussions about psychotic delusions and the way in which involuntary treatment is justified. Based on this analysis, this article in turn conceptualizes freedom in the forum internum as ‘negative liberty’, ‘authenticity’, and ‘capability’. This article suggests that when forum internum is redefined as encompassing a right to certain internal capabilities, the right remains meaningful for persons with psychotic delusions as well. (shrink)

Experiences of thought-insertion are a first-rank, diagnostically central symptom of schizophrenia. Schizophrenic patients who undergo such delusional mental states report being first-personally aware of an occurrent conscious thought which is not theirs, but which belongs to an external cognitive agent. Patients seem to be right about what they are thinking but mistaken about who is doing the thinking. It is notoriously difficult to make sense of such delusions. One general approach to explaining the etiology of monothematic delusions has come to (...) be known as the endorsement model. This model claims that the patient holds her delusional belief because she simply trusts her bizarre experience and takes it at face value. The content of the bizarre experience thus plays a central role in the etiology of delusions. Despite being widely discussed with respect to delusions like Capgras and Cotard, an endorsement model of thought-insertion has not yet been formulated. This article seeks to fill this void by fleshing out and defending the endorsement approach to delusions of inserted thoughts. It aims to show that such an approach can be defended against objections that have been raised in the literature. In particular, it will be argued that there is nothing wrong with the idea of being first-personally aware of a thought which is presented in consciousness as being someone else's. The upshot is that with respect to delusions of thought-insertion, the endorsement model turns out to be a viable account of why patients come to believe that someone else is inserting thoughts into their minds. (shrink)

Replies to commentaries on "Can experiences be rational?", forthcoming in Analytic Philosophy.

Maher proposed in 1974 that schizophrenic delusions are hypotheses formed to explain anomalous experiences. He stated that they are “rational, given the intensity of the experiences that they are developed to explain.” Two-factor theorists of delusion criticized Maher’s theory because 1) it does not explain why some patients with anomalous experiences do not develop delusions, and 2) adopting and adhering to delusional hypotheses is irrational, considering the totality of experiences and patients’ other beliefs. In this paper, the notion of the (...) intensity of experience is reappraised to uphold Maher’s basic conception. Regarding 1), I propose that differences in the intensity of anomalous experience are vital to whether the patient forms delusions, while partially reforming his rationality claim regarding 2). Although adopting delusions is irrational, it is inevitable and excusable, given the intensity of the patient’s anomalous experience. With the aid of this notion, it is maintained that anomalous experience is sufficient for the development of delusions, at least in some cases of schizophrenia. Compared to other theories of schizophrenic delusion, Maher’s theory, which embraces the notion of intensity of experience, better explains why such irrational mental states as delusions develop from anomalous experiences, and why delusional patients persist in believing specific thematic content. (shrink)

Deviant forms of human thought may provide insight into epistemic standards, such as rationality. A comparative analysis of paranoia and reinforced dogmatism suggests that reinforced dogmatism, such as pseudo-science a-la-Popper, demonstrates a primary epistemic lack of critical rationality, that is, of testability, whereas paranoia demonstrates a lack of range of alternative statements leading secondarily to a lack of testability. This reflects the importance to both epistemology and psychiatry of epistemic standards in addition to testability, such as relevance to problems, and (...) emphasizes the distinction of the context of introduction from the contexts of discovery and of justification. Key Words: context of introduction • paranoia • reinforced dogmatism • relevance • testability. (shrink)

Delusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: delusions are meaningful, despite being described as irrational and implausible beliefs; some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. (...) Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions. (shrink)

The centenary of Karl Jaspers' General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work. Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers (...) a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: Is second-order empathy possible? Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices. (shrink)

Clinical delusions have traditionally been characterized as beliefs in psychiatry. However, philosophers have recently engaged with the empirical literature and produced a number of objections to the so-called doxastic status of delusion, stemming mainly from the mismatch between the functional role of delusions and that expected of beliefs. In response to this, an appeal to dispositionalism about the nature of belief has been proposed to vindicate the doxastic status of delusion. In this paper, I first present the objections to attributing (...) beliefs to delusional patients and the application of dispositionalism in the attempt to vindicate doxasticism. I then assess this application and some responses to the objections to the doxastic characterization. Finally, I offer some conclusions about the limits of folk-psychological concepts in the characterization and explanation of complex psychological phenomena such as delusions. (shrink)

Zygon®, Volume 56, Issue 4, Page 846-873, December 2021.

The central hypothesis of this book, Delusions and Beliefs: A Philosophical Inquiry (Routledge, 2019), is that delusions are malfunctional beliefs (Chapter 1); they belong to the category of belief (Chapter 2) but, unlike mundane false or irrational beliefs, they fail to perform some functions of belief (Chapter 3). More precisely, delusions directly or indirectly involve some malfunctioning cognitive mechanisms, which is empirically supported by the two-factor account of delusion formation (Chapter 4).

Why do we tend to think that phenomenal consciousness poses a hard problem? The answer seems to lie in part in the fact that we have the impression that phenomenal experiences are presented to us in a particularly immediate and revelatory way: we have a sense of acquaintance with our experiences. Recent views have offered resources to explain such persisting impression, by hypothesizing that the very design of our cognitive systems inevitably leads us to hold beliefs about our own experiences (...) with certainty. I argue against this kind of “designed certainty” views. First, I claim that it is doubtful that we really hold beliefs about our own experiences with certainty—in any sense of certainty that would make our phenomenal beliefs special. Second, I claim that, even if it were the case that we hold beliefs about experiences with certainty, this would fall short of explaining our sense of acquaintance. (shrink)

This article examines the supposedly incomprehensibility of schizophrenic delusions. According to the contemporary classificatory systems (DSM-IV-TR and ICD-10), some delusions typically found in schizophrenia are considered bizarre and incomprehensible. The aim of this article is to discuss the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion (...) of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning in terms of motivations, desires, and other more straightforward psychological connections between mental states is impossible in schizophrenia, we can in fact have a philosophical understanding of the schizophrenic world and of the emergence of delusions typically found in schizophrenia. (shrink)