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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 (...) |
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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 (...) |
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Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) |
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In this paper we address the ethics of adopting delusional beliefs and we apply consequentialist and deontological considerations to the epistemic evaluation of delusions. Delusions are characterised by their epistemic shortcomings and they are often defined as false and irrational beliefs. Despite this, when agents are overwhelmed by negative emotions due to the effects of trauma or previous adversities, or when they are subject to anxiety and stress as a result of hypersalient experience, the adoption of a delusional belief can (...) |
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The question of how psychiatric classifications are made up and to what they refer has attracted the attention of philosophers in recent years. In this paper, I review the claims of authors who discuss psychiatric classification in terms referring both to the philosophical tradition of natural kinds and to the sociological tradition of social constructionism — especially those of Ian Hacking and his critics. I examine both the ontological and the social aspects of what it means for something to be (...) |
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Delusions are defined as irrational beliefs that compromise good functioning. However, in the empirical literature, delusions have been found to have some psychological benefits. One proposal is that some delusions defuse negative emotions and protect one from low self-esteem by allowing motivational influences on belief formation. In this paper I focus on delusions that have been construed as playing a defensive function (motivated delusions) and argue that some of their psychological benefits can convert into epistemic ones. Notwithstanding their epistemic costs, (...) |
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Monothematic delusions involve a single theme, and often occur in the absence of a more general delusional belief system. They are cognitively atypical insofar as they are said to be held in the absence of evidence, are resistant to correction, and have bizarre contents. Empiricism about delusions has it that anomalous experience is causally implicated in their formation, whilst rationalism has it that delusions result from top down malfunctions from which anomalous experiences can follow. Within empiricism, two approaches to the (...) |
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In this paper we review two debates in the current literature on clinical delusions. One debate is about what delusions are. If delusions are beliefs, why are they described as failing to play the causal roles that characterise beliefs, such as being responsive to evidence and guiding action? The other debate is about how delusions develop. What processes lead people to form delusions and maintain them in the face of challenges and counter-evidence? Do the formation and maintenance of delusions require (...) |
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Sense of agency is a compelling but fragile experience that is augmented or attenuated by internal signals and by external cues. A disruption in SoA may characterise individual symptoms of mental illness such as delusions of control. Indeed, it has been argued that generic SoA disturbances may lie at the heart of delusions and hallucinations that characterise schizophrenia. A clearer understanding of how sensorimotor, perceptual and environmental cues complement, or compete with, each other in engendering SoA may prove valuable in (...) |
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Does the formation of delusions involve abnormal reasoning? According to the prominent ‘two-factor’ theory of delusions (e.g. Coltheart, 2007), the answer is yes. The second factor in this theory is supposed to affect a deluded individual's ability to evaluate candidates for belief. However, most published accounts of the two-factor theory have not said much about the nature of this second factor. In an effort to remedy this shortcoming, Coltheart, Menzies and Sutton (2010) recently put forward a Bayesian account of inference (...) |
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After briefly reviewing some of the empirical and philosophical literature suggesting that there may be an adaptive role for delusion formation, we discuss the results of a recent study consisting of in-depth interviews with people experiencing delusions. We analyse three such cases in terms of the circumstances preceding the development of the delusion; the effects of the development of the delusion on the person’s situation; and the potential protective nature of the delusional belief as seen from the first-person perspective. We (...) |
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Patients with psychotic disorders experience a range of reality distortions. These often include auditory-verbal hallucinations, and thought insertion to a lesser degree; however, their mechanisms and relationships between each other remain largely elusive. Here we attempt to establish a integrative model drawing from the phenomenology of both AVHs and TI and argue that they in fact can be seen as ‘spectra’ of experiences with varying degrees of agency and ownership, with ‘silent and internal own thoughts’ on one extreme and ‘fully (...) |
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This paper explores the possibility of understanding schizophrenic delusion through the role of a primary alteration of subjective experience. Two approaches are contrasted: the first defines schizophrenic delusion as a primary symptom resisting any attempt to understand, whereas the second describes delusion as a secondary symptom, to be understood as a rational reaction of the self. The paper discusses the possibility of applying this second approach to schizophrenic delusion. This leads us to raise the issue of the specificity of psychotic (...) |
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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 (...) |
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Pleasure, in the inclusive usages most important in moral psychology, ethical theory, and the studies of mind, includes all joy and gladness — all our feeling good, or happy. It is often contrasted with similarly inclusive pain, or suffering, which is similarly thought of as including all our feeling bad. Contemporary psychology similarly distinguishes between positive affect and negative affect.[1.. |
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I argue that ordinary confabulation is a side-effect of an interpretive faculty that makes sense of the world by rationalising our experience within the context of a personal and cultural narrative. However, I argue that a hyperactivity of the same process manifests as schizotypy—latent schizophrenic tendencies—that can lead to extreme dissociation of interpretation from experience. I first give a phenomenological account of the process of interpretation, arguing that it is enacted through the creation of conceptual cognitive content from an originary (...) |
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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 (...) |
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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 (...) |
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Despite the fact that the role of learning is recognised in empirical and theoretical work on sense of agency , the nature of this learning has, rather surprisingly, received little attention. In the present study we consider the contribution of associative mechanisms to SoA. SoA can be measured quantitatively as a temporal linkage between voluntary actions and their external effects. Using an outcome blocking procedure, it was shown that training action–outcome associations under conditions of increased surprise augmented this temporal linkage. (...) |
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Some delusional patients exhibit only a single delusional belief (or several delusional beliefs concerning a single theme): this is monothematic delusion. It contrasts with polythematic delusion, where the patient exhibits a variety of delusions concerning a variety of different themes. The neuropsychological bases of various monothematic delusions are rather well understood, and there is a well-worked-out general neuropsychological theory of monothematic delusion, the two-factor theory. Whether polythematic delusion might be explained in a similar way is an open question: I sketch (...) |
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Schizophrenia, like other pathological conditions of mental life, has not been systematically included in the general study of consciousness. By focusing on aspects of chronic schizophrenia, we attempt to remedy this omission. Basic components of Husserl’s phenomenology (intentionality, synthesis, constitution, epoche, and unbuilding) are explicated and then employed in an account of chronic schizophrenia. In schizophrenic experience, basic constituents of reality are lost and the subject must try to explicitly re-constitute them. “Automatic mental life” is weakened such that much of (...) |
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The neuropsychology of religious activity in normal and selected clinical populations is reviewed. Religious activity includes beliefs, experiences, and practice. Neuropsychological and functional imaging findings, many of which have derived from studies of experienced meditators, point to a ventral cortical axis for religious behavior, involving primarily the ventromedial temporal and frontal regions. Neuropharmacological studies generally point to dopaminergic activation as the leading neurochemical feature associated with religious activity. The ventral dopaminergic pathways involved in religious behavior most closely align with the (...) |
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Dehaene et al. (2003) showed an absence of conscious, but not masked, conflict effects when patients with schizophrenia performed a number-categorisation priming task. We aimed to replicate these influential results using a different word-categorisation priming task. Counter to Dehaene et al.'s findings, 21 patients and 20 healthy controls showed similar congruence effects for both masked and visible primes. Within patients, a reduced congruence effect for visible primes associated with longer duration of illness and more severe behavioural disorganisation. Patients, unlike controls, (...) |
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Human rights theory generally conceptualizes freedom of thought, conscience, religion, and belief as well as freedom of opinion and expression, as offering absolute protection in what is called the forum internum. At a minimum, this is taken to mean the right to maintain thoughts in one’s own mind, whatever they may be and independently of how others may feel about them. However, if we adopt this stance, it seems to imply that there exists an absolute right to hold psychotic delusions. (...) |
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The analysis presented in this article reveals an ambiguity and tension in human rights theory concerning the delusional person’s freedom of belief and thought. Firstly, it would appear that the concepts ‘opinion’ and ‘thought’ are defined in human rights discussion in such a way that they do include delusions. Secondly, the internal freedom to hold opinions and thoughts is defined in human rights discussion and international human rights covenants as an absolute human right which should not be restricted in any (...) |
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