Contemporary perspectives on delusions offer valuable neuropsychiatric, psychoanalytic, and philosophical explanations of the formation and persistence of delusional phenomena. However, two problems arise. Firstly, these different perspectives offer us an explanation “from the outside”. They pay little attention to the actual personal experiences, and implicitly assume their incomprehensibility. This implicates a questionable validity. Secondly, these perspectives fail to account for two complex phenomena that are inherent to certain delusions, namely double book-keeping and the primary delusional experience. The purpose of this (...) article is to address both problems, by offering an understanding “from the inside”. Our phenomenological approach is a form of “radical empathy”, and crosses the Jaspersian limits of understanding. It compares delusional experiences with variations of reality experience in everyday life, and makes use of the structure of imagination. Six factors influencing the experience of reality are discussed and illustrated by clinical and non-clinical examples. These factors are: continuity, materiality and resistance, multiplicity of sensations and perceptions, intensity, the sense of authorship, and the complex role of intersubjectivity. I suggest that experiences of hypo- and hyperreality are not restricted to pathology, but have their place in everyday life as well. Delusional phenomena can be better understood by investigating the interplay of these six factors. With this framework, the two complex phenomena consequently prove to be better understandable to us. Our approach remains within the phenomenal experience and might thereby contribute to the validity of psychopathology. (shrink)

Confabulation is a symptom central to many psychiatric diagnoses and can be severely debilitating to those who exhibit the symptom. Theorists, scientists, and clinicians have an understandable interest in the nature of confabulation—pursuing ways to define, identify, treat, and perhaps even prevent this memory disorder. Appeals to confabulation as a clinical symptom rely on an account of memory’s function from which cases like the above can be contrasted. Accounting for confabulation is thus an important desideratum for any candidate theory of (...) memory. Many contemporary memory theorists now endorse Constructivism, where memory is understood as a capacity for constructing plausible representations of past events. Constructivism’s aim is to account for and normalize the prevalence of memory errors in everyday life. Errors are plausible constructions that, on a particular occasion have led to error. They are not, however, evidence of malfunction in the memory system. While Constructivism offers an uplifting repackaging of the memory errors to which we are all susceptible, it has troubling implications for appeals to confabulation in psychiatric diagnosis. By accommodating memory errors within our understanding of memory’s function, Constructivism runs the risk of being unable to explain how confabulation errors are evidence of malfunction. After reviewing the literature on confabulation and Constructivism, respectively, I identify the tension between them and explore how different versions of Constructivism may respond. The paper concludes with a proposal for distinguishing between kinds of false memory—specifically, between misremembering and confabulation—that may provide a route to their reconciliation. (shrink)