In recent years, there has been a trend in psychiatry to try and explain disorders of action in terms of an over-reliance on the habitual mode of action. In particular, it has been hypothesized that compulsions in obsessive-compulsive disorder are driven by maladaptive habits. In this paper, I argue that this view of obsessive-compulsive disorder does not fit the phenomenology of the disorder in many patients and that a more refined conceptualization of habit is likely to be helpful in clarifying (...) the distinctions between disorders of action. There are thus two aims to this paper. The first is to highlight the issues pertaining to the view that compulsions are the result of an over-reliance on the habitual mode of action, leading to a loss of agentive control. The second aim is to examine the view of agentive control implicit in those accounts and see how other conceptions of agentive control might do a better job at accounting for the distinct ways in which persons suffering from pathologies of action may be said to lack control. (shrink)

This article discusses a puzzle arising from the phenomenon of insight in obsessive–compulsive disorder. “Insight” refers to an awareness or understanding of obsessive thoughts as false or irrational. I argue that a natural and plausible way of characterizing insight in OCD conflicts with several different possible explanations of the epistemic attitude underlying insight‐directed obsessive thought. After laying out the puzzle for five proposed explanations of obsessive thought and then discussing several possible ways that the puzzle might be avoided, I close (...) the article by arguing that we can avoid the puzzle by adopting a new positive view of insight‐directed obsessive thought. (shrink)

It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

Recurrent, unvarying, and seemingly purposeless patterns of action and cognition are part of normal development, but also feature prominently in several neuropsychiatric conditions. Repetitive stereotyped behaviors can be viewed as exaggerated forms of learned habits and frequently correlate with alterations in motor, limbic, and associative basal ganglia circuits. However, it is still unclear how altered basal ganglia feedback signals actually relate to the phenomenological variability of RSBs. Why do behaviorally overlapping phenomena sometimes require different treatment approaches−for example, sensory shielding strategies (...) versus exposure therapy for autism and obsessive-compulsive disorder, respectively? Certain clues may be found in recent models of basal ganglia function that extend well beyond action selection and motivational control, and have implications for sensorimotor integration, prediction, learning under uncertainty, as well as aesthetic learning. In this paper, we systematically compare three exemplary conditions with basal ganglia involvement, obsessive-compulsive disorder, Parkinson’s disease, and autism spectrum conditions, to gain a new understanding of RSBs. We integrate clinical observations and neuroanatomical and neurophysiological alterations with accounts employing the predictive processing framework. Based on this review, we suggest that basal ganglia feedback plays a central role in preconditioning cortical networks to anticipate self-generated, movement-related perception. In this way, basal ganglia feedback appears ideally situated to adjust the salience of sensory signals through precision weighting of new sensory information, relative to the precision of predictions based on prior generated models. Accordingly, behavioral policies may preferentially rely on new data versus existing knowledge, in a spectrum spanning between novelty and stability. RSBs may then represent compensatory or reactive responses, respectively, at the opposite ends of this spectrum. This view places an important role of aesthetic learning on basal ganglia feedback, may account for observed changes in creativity and aesthetic experience in basal ganglia disorders, is empirically testable, and may inform creative art therapies in conditions characterized by stereotyped behaviors. (shrink)

Emotion Review, Volume 14, Issue 1, Page 15-30, January 2022. We offer an account of mental health and well-being using the predictive processing framework. According to this framework, the difference between mental health and psychopathology can be located in the goodness of the predictive model as a regulator of action. What is crucial for avoiding the rigid patterns of thinking, feeling and acting associated with psychopathology is the regulation of action based on the valence of affective states. In PPF, valence (...) is modelled as error dynamics—the change in prediction errors over time. Our aim in this paper is to show how error dynamics can account for both momentary happiness and longer term well-being. What will emerge is a new neurocomputational framework for making sense of human flourishing. (shrink)

Delusions are usually considered as harmful and dysfunctional beliefs, one of the primary symptoms of a psychiatric illness and the mark of madness in popular culture. However, in recent times a much more positive role has been advocated for delusions. More specifically, it has been argued that delusions might be an answer to a problem rather than problems in themselves. By delivering psychological and epistemic benefits, delusions would allow people who face severe biological or psychological difficulties to survive in their (...) environment - although this has obvious epistemic costs, as the delusion is fixed and irresponsive to compelling counterevidence. In other words, it has been argued that delusions are biologically adaptive. The adaptiveness of delusions has been compared by Ryan McKay and Daniel Dennett to a shear pin, a mechanism installed in the drive engine of some machines which is designed to shear whenever the machine is about to break down. By breaking, shear pins prevent the machine from collapsing and allow it to keep functioning, although in an impaired manner. Similarly, when delusions form, they would allow a cognitive or psychological system which is about to collapse to continue its functioning, although in an impaired manner. However, this optimistic picture of delusions risks being undermined by both theoretical and empirical considerations. Using Sarah Fineberg and Philip Corlett’s recent predictive coding account as a paradigmatic model of the biological adaptiveness of delusions, I develop two objections to it: principles of parsimony and simplicity suggest that maladaptive models of delusions have an upper hand over adaptive models; and the available empirical evidence suggests that at least some delusions stand good chances of being psychologically adaptive, but it is unlikely that they also qualify as biologically adaptive. (shrink)

Epistemic akrasia is the phenomenon of voluntarily believing what you think you should not. Whether epistemic akrasia is possible is a matter of controversy. I argue that at least some people who suffer from obsessive–compulsive disorder are genuinely epistemically akratic. I advance an account of epistemic akrasia that explains the clinical data and provides broader insight into the nature of doxastic attitude‐formation.

Depersonalization and derealization refer to states of dissociation in which one feels a sense of alienation in relation to one’s self and environment, respectively. Whilst transient episodes often diminish without treatment, chronic experiences of DP and DR may last for years, with common treatments lacking a strong evidence base for their efficacy. We propose a theoretical explanation of DP and DR based on interoceptive predictive coding, and discuss how transient experiences of DP and DR may be induced in the non-clinical (...) population using virtual reality. Further, we review the use of heartbeat evoked potentials in detecting the neural correlates of DP and DR allowing for an objective measure of these experiences in the non-clinical population. Finally, we discuss how the induction and detection of transient experiences of DP and DR in the non-clinical population could shed light on how the brain constructs one’s sense of self and reality. (shrink)

BackgroundThere is much overlap among the symptomology of autistic spectrum disorders, obsessive compulsive disorders, and alexithymia, which all typically involve impaired social interactions, repetitive impulsive behaviors, problems with communication, and mental health.AimThis study aimed to identify direct and indirect associations among alexithymia, OCD, cardiac interoception, psychological inflexibility, and self-as-context, with the DV ASD and depression, while controlling for vagal related aging.MethodologyThe data involved electrocardiogram heart rate variability and questionnaire data. In total, 1,089 participant's data of ECG recordings of healthy resting (...) state HRV were recorded and grouped into age categories. In addition to this, another 224 participants completed an online survey that included the following questionnaires: Yale-Brown Obsessive Compulsive Scale ; Toronto Alexithymia Scale 20 ; Acceptance and Action Questionnaire ; Depression, Anxiety, and Stress Scale 21 ; Multi-dimensional Assessment of Interoceptive Awareness Scale ; and the Self-as-Context Scale.ResultsHeart rate variability was shown to decrease with age when controlling for BMI and gender. In the two SEMs produced, it was found that OCD and alexithymia were causally associated with autism and depression indirectly through psychological inflexibility, SAC, and ISen interoception.ConclusionThe results are discussed in relation to the limitations of the DSM with its categorical focus of protocols for syndromes and provide support for more flexible ideographic approaches in diagnosing and treating mental health and autism within the Extended Evolutionary Meta-Model. Graph theory approaches are discussed in their capacity to depict the processes of change potentially even at the level of the relational frame. (shrink)

The ‘scaling up’ objection says non-representational ecological-enactive accounts will be unable to explain ‘representation hungry’ cognition. Obsessive-compulsive disorder presents a paradigmatic instance of this objection, marked as it is by ‘representation hungry’ obsessive thoughts and compulsive behavior organized around them. In this paper I provide an ecological-enactive account of OCD, thereby demonstrating non-representational frameworks can ‘scale up’ to explain ‘representation hungry’ cognition. First, I outline a non-representational account of mind— a predictive processing operationalization of Sean Kelly’s theory of perception. This (...) account explains the ‘tensions’ and ‘pulls’ which guide and constrain our action-oriented and affect-laden perceptual ‘grip’ upon the world to be underwritten by an imperative to minimize prediction error. I then argue that OCD is best understood as ‘grip gone awry’— malformed predictive models signal inappropriately high error, and this results in extremely strong ‘tensions’ and ‘pulls’ which prescribe actions. Thus, I arrive at the idea that OCD is primarily constituted by ‘not just right’ feelings caused by high error signaling. Finally, I explain that this account provides a causal explanation of the non-representational existential feeling fundamental to OCD. Compulsions are considered manifestations of non-representational grip responsive to this feeling, whilst obsessions are explained to play a meta-role in the condition, being formulated by subjects in a bid to make their ‘not just right’ feeling intelligible. I explain that the meta-role obsessions play makes their representational status largely irrelevant to OCD, and so leave this an open question. Consequently, I provide a non-representational account of OCD, thereby demonstrating that ecological-enactive approaches can respond to the ‘scaling up’ objection. (shrink)