Three challenges to a unified understanding of delusions emerge from Radden's On Delusion (2011). Here, I propose that in order to respond to these challenges, and to work towards a unifying framework for delusions, we should see delusions as arising in inference under uncertainty. This proposal is based on the observation that delusions in key respects are surprisingly like perceptual illusions, and it is developed further by focusing particularly on individual differences in uncertainty expectations.

Body dissatisfaction has long been considered an integral component of and driving force behind anorexia nervosa. In this paper, I characterise body dissatisfaction in terms of problematic beliefs about body size and the value of thinness. I suggest two methods for understanding these beliefs. Regarding body size beliefs, I suggest focusing on certain forms of misleading phenomenal evidence that sufferers of anorexia nervosa are exposed to. Regarding beliefs about the value of thinness, I suggest focusing on the benefits of such (...) beliefs. (shrink)

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)

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)

ABSTRACTEmpiricists about monothematic delusion formation agree that anomalous experience is a factor in the formation of these attitudes, but disagree markedly on which further factors need to be specified. I argue that epistemic innocence may be a unifying feature of monothematic delusions, insofar as a judgment of epistemic innocence to this class of attitudes is one that opposing empiricist accounts can make. The notion of epistemic innocence allows us to tell a richer story when investigating the epistemic status of monothematic (...) delusions, one which resists the trade-off view of pragmatic benefits and epistemic costs. Though monothematic delusions are often characterized by appeal to their epistemic costs, they can play a positive epistemic role, and this is a surprising conclusion on which, so I argue, all empiricists can agree. Thus, I show that all empiricists have the notion of epistemic innocence at their disposal. (shrink)

Delusions are studied in two philosophical traditions: the continental or phenomenological tradition and the Anglo-American or analytic tradition. Each has its own view of delusions. Broadly stated, phenomenologists view delusions as a disturbed experience whilst most analytic researchers view them as beliefs. It is my contention that the most plausible account of delusions must ultimately incorporate valuable insights from both traditions. To illustrate the potential value of integration I provide a novel model of the Capgras delusion which describes how an (...) analytic, cognitive neuropsychological two-factor account of the Capgras delusion and the phenomenological view of delusions might be integrated. (shrink)

Bortolotti’s Delusions and Other Irrational Beliefs defends the view that delusions are beliefs on a continuum with other beliefs. A different view is that delusions are more like illusions, that is, they arise from faulty perception. This view, which is not targeted by the book, makes it easier to explain why delusions are so alien and disabling but needs to appeal to forensic aspects of functioning.

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate (...) the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience. (shrink)

A growing number of studies in both the scientific and the philosophical literature have drawn on a Bayesian predictive processing framework to account for the formation of delusions. The key here is that delusions form because of disrupted prediction error signalling. Parrott’s recent critique argues that the framework is incomplete in two respects: it leaves unclear why delusional hypotheses are selected over none at all or over more plausible alternatives; it leaves unclear how exactly it is that delusional hypotheses are (...) generated in the first place. In this paper, we defend the framework’s explanatory power by way of showing how it can go a long way in helping disentangle these concerns. We take up each of them in turn. As for the first, our argument turns on two claims: a) believing nothing, although possible in principle, may not be a viable procedure in the circumstances; b) alternative hypotheses may be rendered unavailable for selection, due to aberrant prediction errors. As for the second concern, we distinguish three ways in which delusional hypotheses may be initially acquired, all of which are based on experience broadly construed. (shrink)

Sufferers of eating disorders often hold false beliefs about their own body size. Such beliefs appear to violate norms of rationality, being neither grounded by nor responsive to appropriate forms of evidence. I defend the rationality of these beliefs. I argue that they are in fact supported by appropriate evidence, emanating from proprioceptive misperception of bodily boundaries. This argument has far‐reaching implications for the explanation and treatment of eating disorders, as well as debates over the relationship between rationality and human (...) psychology. (shrink)

In this paper I discuss the role played by disturbed phenomenology in accounting for the formation and maintenance of the Capgras delusion. Whilst endorsing a two-stage model to explain the condition, I nevertheless argue that traditional accounts prioritise the role played by some form of second-stage cognitive disruption at the expense of the significant contribution made by the patient’s disturbed phenomenology, which is often reduced to such uninformative descriptions as “anomalous” or “strange”. By advocating an interactionist model, I argue that (...) the delusional belief constitutes an attempt on the part of the patient to explain his/her initially odd and somewhat disturbed phenomenal content and, moreover, that the delusion then structures the patient’s experience such that what he/she perceives is an impostor. This fact is used to explain the delusional belief’s maintenance and resistance to revision. Thus, whilst accepting that second-stage cognitive disruption has a part to play in explaining the Capgras delusion, the emphasis here is placed on the role played by the patient’s changing phenomenal content and its congruence with the delusional belief. Unlike traditional two-stage models, which posit a unidirectional progression from experience to belief, the interactionist model advocates a two-way interaction between bottom-up and top-down processes. The application of this model to other delusional beliefs is also considered. (shrink)

Body dissatisfaction has long been considered an integral component of and driving force behind anorexia nervosa. In this paper, I characterise body dissatisfaction in terms of problematic beliefs about body size and the value of thinness. I suggest two methods for understanding these beliefs. Regarding body size beliefs, I suggest focusing on certain forms of misleading phenomenal evidence that sufferers of anorexia nervosa are exposed to. Regarding beliefs about the value of thinness, I suggest focusing on the benefits of such (...) beliefs. (shrink)

Evidence suggests that psychopaths’ notoriously immoral behavior is due to affective rather than rational deficits. This evidence could be taken to show that, contrary to moral rationalism, moral norms are not norms of reason. Rationalists could reply either that psychopaths’ behavior is in fact primarily due to rational deficits or that affects are involved in responding to rational norms. Drawing on the work of Antonio Damasio and colleagues, I argue the latter is the better defense of moral rationalism.

There is surprising evidence that introspection of our phenomenal states varies greatly between individuals and within the same individual over time. This puts pressure on the notion that introspection gives reliable access to our own phenomenology: introspective unreliability would explain the variability, while assuming that the underlying phenomenology is stable. I appeal to a body of neurocomputational, Bayesian theory and neuroimaging findings to provide an alternative explanation of the evidence: though some limited testing conditions can cause introspection to be unreliable, (...) mostly it is our phenomenology itself that is variable. With this account of phenomenal variability, the occurrence of the surprising evidence can be explained while generally retaining introspective reliability. (shrink)

Reality testing is the process by which we distinguish our own perceptual states from imagination or episodic memory. I argue that reality testing is a metacognitive process. Since reality testing is also accomplished by creatures who lack mental state concepts, it follows that reality testing is a nonconceptual metacognitive process. I also provide prima facie evidence that reality testing is a necessary condition for prototypical cognitive states like belief. It follows that metacognition is phylogenetically and logically prior to cognition in (...) many cases. (shrink)

This paper contrasts an interactionist account of delusional misidentification with more traditional one- and two-stage models. Unlike the unidirectional nature of these more traditional models, in which the aetiology of the disorder is said to progress from a neurological disruption via an anomalous experience to a delusional belief, the interactionist account posits the interaction of top-down and bottom-up processes to better explain the maintenance of the delusional belief. In addition, it places a greater emphasis on the patient’s underlying phenomenal experience (...) in accounting for the specificity of the delusional content. The role played by patient phenomenology is examined in light of Ratcliffe’s recent phenomenological account. Similarities and differences are discussed. The paper concludes that a purely phenomenological account is unable to differentiate between non-delusional patient groups, who have what appear to be equivalent phenomenal experiences to patients suffering from delusional misidentification but without the delusional belief, and delusional groups, something the interactionist model is able to do. (shrink)

This paper provides a concise description and discussion of bottom–up and top–down approaches to misattribution of agency in schizophrenia. It explores if first-person accounts of passivity phenomena can provide support for one of these approaches. The focus is on excerpts in which the writers specifically examine their experiences of external influence. None of the accounts provides arguments that fit easily with only one of the possible approaches, which is in line with current attempts to theoretical integration.

In recent times, explanations of the Capgras delusion have tended to emphasise the cognitive dysfunction that is believed to occur at the second stage of two-stage models. This is generally viewed as a response to the inadequacies of the one-stage account. Whilst accepting that some form of cognitive disruption is a necessary part of the aetiology of the Capgras delusion, I nevertheless argue that the emphasis placed on this second-stage is to the detriment of the important role played by the (...) phenomenology underlying the disorder, both in terms of the formation and maintenance of the delusional belief. This paper therefore proposes an interactionist two-stage model in which the phenomenal experience of the Capgras patient is examined, emphasised, and its relation to top-down processing discussed. (shrink)

This paper provides a concise description and discussion of bottom–up and top–down approaches to misattribution of agency in schizophrenia. It explores if first-person accounts of passivity phenomena can provide support for one of these approaches. The focus is on excerpts in which the writers specifically examine their experiences of external influence. None of the accounts provides arguments that fit easily with only one of the possible approaches, which is in line with current attempts to theoretical integration.