I offer an explanation for why certain sequences of decisions strike us as irrational while others do not. I argue that we have a standing desire to tell flattering yet plausible narratives about ourselves, and that cases of diachronic behavior that strike us as irrational are those in which you had the opportunity to hide something unflattering and failed to do so.

In some neuropsychological disorders memory distortions seemingly fill gaps in people’s knowledge about their past, where people’s self-image, history, and prospects are often enhanced. False beliefs about the past compromise both people’s capacity to construct a reliable autobiography and their trustworthiness as communicators. However, such beliefs contribute to people’s sense of competence and self-confidence, increasing psychological wellbeing. Here we consider both psychological benefits and epistemic costs, and argue that distorting the past is likely to also have epistemic benefits that cannot (...) be obtained otherwise, such as enabling people to exchange information, receive feedback, and retain key beliefs about themselves. (shrink)

Editors' introduction to 3rd thematic issue on philosophy of medicine.

A good therapeutic relationship in mental health services is a predictor of positive clinical outcomes for people who seek help for distressing experiences, such as voice hearing and paranoia. One factor that may affect the quality of the therapeutic relationship and raises further ethical issues is the impact of the clinical encounter on users’ sense of self, and in particular on their sense of agency. In the paper, we discuss some of the reasons why the sense of epistemic agency may (...) be especially fragile in young people with unusual experiences and beliefs. We argue that it is important to identify and avoid behaviours that can undermine young people’s contributions as epistemic agents in the clinical encounter. (shrink)