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)

Delusions are often thought of as the hallmark of irrationality. Accepted definitions of delusion are cast in terms of epistemic features that reflect irrationality: impossibility or falsity of con...

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)

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)

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of “anomalous experiences”: transformations in an individual’s perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is characteristic of (...) SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs. (shrink)

The distinction of „understanding“ and „explaining“, formulated by Karl Jaspers in his „General Psychopathology“, has had a lasting effect on psychiatry. As a result, phenomenological, hermeneutic, or psychodynamic approaches have often been accorded only descriptive or epiphenomenal status, while the actual causes of mental illness have been sought in neurobiologically or genetically based explanations. In contrast, this paper defends the explanatory role of understanding and phenomenological approaches. To this end, two levels of explanation are distinguished and shown to be equally (...) justified in principle, namely, motivational explanation at the macro-level and physical explanation at the micro-level. The actual causal role of motivational, i.e., understandable connections is then demonstrated by means of a conception of circular causality, which includes downward causality. Finally, the explanatory role of phenomenological analyses is also shown in psychotic disorders that refuse motivational understanding, using the example of schizophrenic delusion. (shrink)

The philosophy of grief has directed little attention to bereavement’s impact on perceptual experience. However, misperceptions, hallucinations and other anomalous experiences are strikingly common following the death of a loved one. Such experiences range from misperceiving a stranger to be the deceased, to phantom sights, sounds and smells, to nebulous quasi-sensory experiences of the loved one’s presence. This paper draws upon the enactive sensorimotor theory of perception to offer a phenomenologically sensitive and empirically informed account of these experiences. It argues (...) that they can be understood as deriving from disruption to both sensorimotor expectations and perceived opportunities for action, stemming from the upheaval of bereavement. Different facets of the enactive sensorimotor approach can help to explain different types of post-bereavement perceptual experience. Post-bereavement misperceptions can be accounted for through the way that alterations to sensorimotor expectations can result in atypical ‘amodal completion’, while bereavement hallucinations can be understood as ‘appearances’ that fail to form part of the usual patterns of sensorimotor contingency. Quasi-sensory experiences of the presence of the deceased can be understood as resulting from changes to perceived affordances. This paper aims to demonstrate the explanatory value of key aspects of the sensorimotor approach by highlighting how they can help to explain the phenomenology of post-bereavement experiences. However, it also illuminates certain areas in which the sensorimotor approach ought to be supplemented, especially if it is to account for tight connections between perception, affect, and intersubjectivity that are salient in grief. (shrink)

The philosophy of grief has directed little attention to bereavement’s impact on perceptual experience. However, misperceptions, hallucinations and other anomalous experiences are strikingly common following the death of a loved one. Such experiences range from misperceiving a stranger to be the deceased, to phantom sights, sounds and smells, to nebulous quasi-sensory experiences of the loved one’s presence. This paper draws upon the enactive sensorimotor theory of perception to offer a phenomenologically sensitive and empirically informed account of these experiences. It argues (...) that they can be understood as deriving from disruption to both sensorimotor expectations and perceived opportunities for action, stemming from the upheaval of bereavement. Different facets of the enactive sensorimotor approach can help to explain different types of post-bereavement perceptual experience. Post-bereavement misperceptions can be accounted for through the way that alterations to sensorimotor expectations can result in atypical ‘amodal completion’, while bereavement hallucinations can be understood as ‘appearances’ that fail to form part of the usual patterns of sensorimotor contingency. Quasi-sensory experiences of the presence of the deceased can be understood as resulting from changes to perceived affordances. This paper aims to demonstrate the explanatory value of key aspects of the sensorimotor approach by highlighting how they can help to explain the phenomenology of post-bereavement experiences. However, it also illuminates certain areas in which the sensorimotor approach ought to be supplemented, especially if it is to account for tight connections between perception, affect, and intersubjectivity that are salient in grief. (shrink)