The standard approach to the core phenomenology of thought insertion characterizes it in terms of a normal sense of thought ownership coupled with an abnormal sense of thought agency. Recently, Fernández (2010) has argued that there are crucial problems with this approach and has proposed instead that what goes wrong fundamentally in such a phenomenology is a sense of thought commitment, characterized in terms of thought endorsement. In this paper, we argue that even though Fernández raises new issues that enrich (...) the topic, his proposal cannot rival the version of the standard approach we shall defend. (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)

Vaccination is considered a key factor in the sanitary resolution of the COVID-19 pandemic. However, vaccine hesitancy can undermine its diffusion with severe consequences on global health. While beliefs in conspiracy theories, mistrust in science and in policymakers, and mistrust in official information channels may also increment vaccine hesitancy, understanding their psychological causes could improve our capacity to respond to the pandemic. Thus, we designed a cross-sectional study with the aim of probing vaccine propensity in the Italian population and explored (...) its relationship with sociodemographic and psychological variables, and with misbeliefs in COVID-19. A battery of questionnaires was administered to a sample of 374 Italian adults during the first national lockdown. The materials included an original instrument—Beliefs in COVID-19 Inventory—and questionnaires measuring perceived stress, anxiety, death anxiety, psychological distress, psychoticism, paranoia, anger, and somatization. The exploratory factor analysis on Beliefs in COVID-19 suggested the existence of three factors: belief in conspiracy theories, mistrust in medical information, and mistrust in medicine and science. These factors were positively correlated with female sex, age, religious beliefs, psychiatric conditions, and psychological variables, while negatively correlated with education levels. We conducted a mediation analysis by means of a structural equation model, including psychological factors as predictors, beliefs in COVID-19 scales as mediators, and vaccine propensity as an outcome. The model showed that death anxiety had a direct positive effect on the propensity to get vaccinated. It also showed that death anxiety reduced the propensity to get vaccinated through a mediated path in believing in conspiracy theories, whereas paranoia was linked to a reduction in vaccination adherence with the mediation effect of mistrust in medical science. Psychological distress reduced vaccination propensity by increasing both conspiracy beliefs and mistrust. On the other hand, anxiety increased the propensity to get vaccinated through a decrease in both belief in conspiracy theories and mistrust in science. Our results suggest that psychological dimensions are differentially related to belief in conspiracy theories, to mistrust in science, and to the propensity to get vaccinated. Based on this result, we propose an original interpretation of how conspiracy beliefs build on a paranoid and suspicious attitude. We also discuss the possible clinical implications of treatment for such pathological beliefs. (shrink)

Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the “atheoretical” (...) approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry’s over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry. As a result, the field has suffered a loss of knowledge that may be difficult to recover. (shrink)

This paper explores the phenomenon of thought insertion, an experience reported by some schizophrenics where it is believed that other persons or forces are inserting thoughts into their minds. This relatively circumscribed symptom of schizophrenia raises difficult questions concerning our sense of agency for our thoughts. How is it possible that persons can think that their thoughts are not their own? Gallagher, drawing on Husserl’s early work on timeconsciousness, provides a subtle and sophisticated answer to this problem, suggesting that protention (...) may underlie our sense of agency for thinking and that the experience of inserted thoughts may occur in the event of an intermittent failure in this protentional function. More recent Husserl scholarship suggests, however, that this account may face problems on phenomenological grounds. It is argued here that our sense of agency for thinking requires more than protention, and, consequently, that the absence of protention cannot fully explain the loss of agency for thinking characterizing the experience of thought insertion. In order to contextualize this discussion of the phenomenon theoretically and, in the process, to provide an introduction to the difficulties in explaining it, this paper proceeds with a consideration of Frith’s early cognitive account of thought insertion and the contribution of Stephens and Graham in this regard. In conclusion, it is argued that, despite the merits of all three accounts presented, they remain unable to account for the phenomenon of inserted thoughts, and that we might more fruitfully understand this experience as bein a type of uncontrollable passive or autochthonous thinking. Indo-Pacific Journal of Phenomenology , Volume 6, Edition 2 August 2006. (shrink)

The human adventure in education is one of imperfect expression, punctuated by moments of insight. Education cultivates these epiphanies and nurtures their possible continuation. But even without major or minor insights, education cultivates the appreciation of the good, the beautiful, and the true. An experimentalist's sensibility lies amid the humanist's grasp of the myriad ways of trying to understand our existence. To bridge discourse is to appreciate the languages of other cultures, which reveal the nuances of life and experience.

Humans come prepared to recognize two fundamental features of our surroundings: animate objects and agents. This recognition begins early in ontogeny and pervades our ecological and social space. This cognitive capacity reveals an important adaptation and sets the conditions for pervasive shared experiences. One feature of our species and our evolved cephalic substrates is that we are prepared to recognize self-propelled action in others. Our cultural evolution is knotted to an expanding sense of shared experiences.

This paper offers a phenomenological or hermeneutic reading—employing Heidegger's notion of the 'ontological difference'—of certain central aspects of schizophrenic experience. The main focus is on signs and symptoms that have traditionally been taken to indicate either 'poor reality-testing' or else 'poverty of content of speech' (defined in the Diagnostic and Statistical Manual of Mental Disorders III-R as: “speech that is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotyped or obscure phrases"). I argue (...) that, at least in some cases, the tendency to attribute these signs of illness to the schizophrenic patient results from a failure to recognize that such patients—as part of a quasi-solipsistic orientation and alienation from more normal, pragmatic concerns—may be grappling with issues of what Heidegger would call an ontological rather than an ontic type, issues concerned not with entities but with Being (i.e. not with objects in the world but with the overall status of the world itself). An application of the Heideggerian concept of the ontological difference has the potential to alter one's sense of the lived-worlds of such patients, of what they may be attempting to communicate, and of why communication with them so often breaks down. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (shrink)

In this paper, we use a phenomenological approach to compare the unusual ways in which language can be experienced by individuals with schizophrenia or severe mood disorders, specifically mania and melancholia. Our discussion follows a tripartite/dialectical format: first we describe traditionally observed distinctions ; then we consider some apparent similarities in the experience of language in these conditions. Finally, we explore more subtle, qualitative differences. These involve: 1, interpersonal orientation, 2, forms of attention and context-relevance, 3, underlying mutations of experience, (...) and 4, meta-attitudes toward language. Such distinctions appear to reflect significant differences in underlying forms of subjectivity; they are broadly consistent with work in phenomenological psychopathology on other aspects of experience, including body, self, and social world. An understanding of such distinctions may assist with difficult cases of differential diagnosis, while also contributing to a better understanding of suffering persons and of psychological factors underlying their disorders. (shrink)

This paper considers contradictory features of emotional or affective experience and expression in schizophrenia in light of the “Kretschmerian paradox”—the fact that schizophrenia-spectrum patients can simultaneously experience both exaggerated and diminished levels of affective response. An attempt is made to explain the paradox and explore its implications. Recent research on emotion in schizophrenia is reviewed, including subjective reports, psychophysiological measures of arousal or activation, and behavioural measures, focusing on flat-affect and negative-symptom patients. After discussing relevant concepts and vocabulary of emotion (...) (“affect”, “emotion”, “mood”, “feelings”, the “passions”), the need for a phenomenological approach focusing on subjective experience is proposed. Four modes of nonparanoid experience in schizophrenia are discussed: Bodily Alienation, Disengagement, Unworlding, and Subjectivisation. Each mode involves withdrawal from functional contexts—temporal, practical, and interpersonal—normally associated with emotional reactivity and expression; each may be accompanied by forms of non-emotional affectivity no less intense than the emotions they replace. Possible relationships between psychophysiological measures, expressive behaviour, and subjective emotional or affective response are considered. (shrink)

The dominant conception of delusion in psychiatry (in textbooks, research papers, diagnostic manuals, etc.) is predominantly epistemic. Delusions are almost always characterized in terms of their epistemic defects, i.e., defects with respect to evidence, reasoning, judgment, etc. However, there is an individualistic bias in the epistemic conception; the alleged epistemic defects and abnormalities in delusions relate to individualistic epistemic processes rather than social epistemic processes. We endorse the social epistemological turn in recent philosophical epistemology, and claim that a corresponding turn (...) is needed in the study of delusions. It is a turn from the (purely) individualistic conception, which characterizes delusions only by individualistic epistemic defects and abnormalities, to the (partially) social epistemic conception, which characterizes delusions by individualistic as well as social epistemic defects and abnormalities. This paper is intended as an initial step toward such a social epistemological turn. In particular, we will develop a new model of the development of delusions according to which testimonial abnormalities, including testimonial isolation and testimonial discount, are a causal factor in the development of delusions. (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)

After a brief perusal of the various meanings of phenomenology in psychopathology, the contributions to schizophrenia of phenomenological psychology in the European sense are reviewed. The last twenty years are deemed fruitful and productive. Following the central themes and motives of this literature allows us to come to a different and perhaps wider understanding of schizophrenia than that proposed currently by mainstream psychiatry. These diverse investigations converge in seeing as the core of schizophrenia the disorders related to inter-subjectivity and ipseity (...) , in turn related to what Bleuler had once called Autism. Finally, a critical discussion of the limitations and the strengths of the phenomenological approach is offered. (shrink)

People suffering from severe monothematic delusions, such as Capgras, Fregoli, or Cotard patients, regularly assert extraordinary and unlikely things. For example, some say that their loved ones have been replaced by impostors. A popular view in philosophy and cognitive science is that such monothematic delusions aren't beliefs because they don't guide behaviour and affect in the way that beliefs do. Or, if they are beliefs, they are somehow anomalous, atypical, or marginal beliefs. We present evidence from five studies that folk (...) psychology unambiguously views monothematic delusions as stereotypical beliefs. This calls into question widespread assumptions in the professional literature about belief's stereotypical functional profile. We also show that folk psychology views delusional patients as holding contradictory beliefs. And we show that frequent assertion is a powerful cue to belief ascription, more powerful than even a robust and consistent track record of non-verbal behaviour. (shrink)

The implications of commonalities in the contributions of five key thinkers in twentieth century phenomenology are discussed in relation to both original aims and contemporary projects. It is argued that, contrary to the claims of Husserl, phenomenology can only operate as hermeneutic phenomenology. Hermeneutics arose within German idealism. It began with Friedrich Ast and Heinrich Schleiermacher and was further developed by, among others, Wilhelm Dilthey and Martin Heidegger. Hermeneutics claims that current understanding is created on the basis of the prior (...) understanding taken to any new situation, in that what is initially understood or believed determines the direction and scope for inquiry or action. Subsequent action and conclustions are similarly based on what has been previously understood and believed. As a consequence, however, what may, in some cases, result is the confirmation of prior inaccurate understanding. For these reasons, it is important to be clear about how initial understandings are formed and how they inform a discipline, be it the Husserlian phenomenology of intentionality or any empirical phenomenological approach. Indo-Pacific Journal of Phenomenology , Volume 8, Edition 1 May 2008. (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)

O objetivo deste artigo é, primeiro, apresentar e considerar as críticas de Paley com mais detalhes e, em seguida, discutir algumas das aplicações significativas da fenomenologia que muitas vezes foram negligenciadas pelos pesquisadores qualitativos. Como foi amplamente demonstrado ao longo dos anos, a fenomenologia pode não apenas fazer a diferença no manuseio, análise e interpretação dos dados disponíveis, mas também em como os dados são obtidos em primeiro lugar, por exemplo, através de técnicas especiais de entrevista. Consideraremos algumas figuras centrais (...) da psicologia fenomenológica clássica e da psiquiatria fenomenológica e apresentaremos alguns dos desenvolvimentos mais recentes na ciência cognitiva. Em seguida, discutiremos três casos concretos que demonstram como a fenomenologia foi aplicada no trabalho clínico com pacientes com esquizofrenia, paralisia cerebral e negligência hemispatial. (shrink)

Louis Sass disputes that schizophrenia can be understood successfully according to the hitherto dominant models--for much of what schizophrenics say and do is neither regressive (as psychoanalysis claims) nor just faulty reasoning (as "cognitivists" claim). Sass argues instead that schizophrenics frequently exhibit hyper-rationality, much as philosophers do. He holds that schizophrenic language can after all be interpreted--if we hear it as Wittgenstein hears solipsistic language. I counter first that broadly Winchian considerations undermine both the hermeneutic conception of interpreting other humans (...) in general and Sass's hope of interpreting schizophrenics in particular. I then go on to argue that even if these Winchian considerations are not accepted, Sass in any case doesn't take sufficiently seriously Wittgenstein's use of nonsense as a term of criticism. Solipsism is not something we can understand so as to be able to understand analogically the schizophrenic's "world"--for there is no such thing as understanding it. Solipsism is nonsense, is nothing--there is no "world" there, in solipsists (as I show by reference to Cora Diamond's reading of Wittgenstein). Nor in any actually analogous cases of schizophrenia. Their "alienness" is the alienness of nothingness; roughly, of the fantasy of "logically alien thought". (shrink)

Phenomenologists such as Husserl, Heidegger and Merleau-Ponty reject the kind of scientific naturalism or that takes empirical science to be epistemologically and metaphysically privileged over all other forms of enquiry. In this paper, I will consider one of their principal complaints against naturalism, that scientific accounts of things are oblivious to a that is presupposed by the intelligibility of science. Focusing mostly upon Husserl's work, I attempt to clarify the nature of this complaint and state it in the form of (...) an argument. I conclude that the argument is effective in exposing naturalism's reliance upon impoverished conceptions of human experience, and that it also weakens the more general case for naturalism. (shrink)

Abstract This paper proposes that adopting a ?phenomenological stance? enables a distinctive kind of empathy, which is required in order to understand forms of experience that occur in psychiatric illness and elsewhere. For the most part, we interpret other people's experiences against the backdrop of a shared world. Hence our attempts to appreciate interpersonal differences do not call into question a deeper level of commonality. A phenomenological stance involves suspending our habitual acceptance of that world. It thus allows us to (...) contemplate the possibility of structurally different ways of ?finding oneself in the world?. Such a stance, I suggest, can be incorporated into an empathetic appreciation of others' experiences, amounting to what we might call ?radical empathy? (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)

My response to the preceding essays begins with some preliminaries about my terminology, approach, and conception of rationality as a regulative ideal. I then comment on the Murphy's discussion about normal religious belief and religious delusions, and on causal assumptions challenged by Langdon's folies à deux. Responding to Gerrans's imagination-based account of delusion and Hohwy's discussion of illusions, I next try to envision what both doxastic and imagination-based approaches might have overlooked by asking whether there can be delusional feelings. Final (...) comments address the place of phenomenology within Coltheart's two-factor theorizing. (shrink)

There seem to be two kinds of pain: fundamental pain, the intensity of which is a direct function of the intensity of various pain stimuli, and pain, the intensity of which is highly modifiable by such factors as hypnotism, placebos, and the sociocultural setting in which the stimulus occurs.

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

This paper outlines several of the challenges that are inherent in any attempt to communicate subjective experience to others, particularly in the context of a clinical interview. It presents the phenomenological interview as a way of effectively responding to these challenges, which may be especially important when attempting to understand the profound experiential transformations that take place in schizophrenia. Features of language experience in schizophrenia—including changes in interpersonal orientation, a sense of the arbitrariness of language, and a desire for faithful (...) communication of experience —are described, together with discussion of their relevance for the interview context. Furthermore, the interview presents a unique context in which both intersubjective and interpersonal aspects of experience will be described as well as evoked. It is proposed that phenomenological interviewers should not only be familiar with these and other experiences that can occur in schizophrenia, but also capable of applying the techniques of phenomenological and hermeneutic methods in order to understand the descriptions of interviewees with sensitivity and accuracy. (shrink)

The US psychologist Gail Hornstein’s monograph, Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness, is an important intervention in the identity politics of the mad movement. Hornstein offers a resignified vision of mad identity that embroiders the central trope of an “anti-colonial” struggle to reclaim the experiential world “colonized” by psychiatry. A series of literal and figurative appeals makes recourse to the inner world and cultural world of the mad as well as to the ethno-symbolic cultural materials of (...) dormant nationhood. This rhetoric is augmented by a model in which the mad comprise a diaspora without an origin, coalescing into a single transnational community. The mad are also depicted as persons displaced from their metaphorical homeland, the “inner” world “colonized” by the psychiatric regime. There are a number of difficulties with Hornstein’s rhetoric, however. Her “ethnicity-and-rights” response to the oppression of the mad is symptomatic of Western parochialism, while her proposed transmutation of putative psychopathology from limit upon identity to parameter of successful identity is open to contestation. Moreover, unless one accepts Hornstein’s porous vision of mad identity, her self-ascribed insider status in relation to the mad community may present a problematic “re-colonization” of mad experience. (shrink)

This article develops a phenomenological contribution to biological psychiatry. Grounded in the principles of transformation, heterogeneity, proportionality and particularity, a paradigm of phenomenological orientation allocates to biology a role different from that assumed by official Cartesian psychiatry. First, no clear definition of what is biological may be established a priori—as a general application, and useful to each and every studied phenomenon. Biology may be understood only as the experience of ununderstandable elements within consciousness, and as belonging necessarily to a whole (...) unity of conscious experience. Second, the research agenda in biological psychiatry necessarily intersects with the investigation of the particularities of each individual clinical case with its unique characteristics. Without this, the very notion of biological psychiatry becomes merely a theoretical abstraction. Finally, the continuity of the biological agenda needs to resume the construction and investigation of psychopathological categories that cohere with the reality of the mental universe. (shrink)