Clinicians and cognitive scientists typically conceive of delusions as doxastic—they view delusions as beliefs. But some philosophers have countered with anti-doxastic objections: delusions cannot be beliefs because they fail the necessary conditions of belief. A common response involves meeting these objections on their own terms by accepting necessary conditions on belief but trying to blunt their force. I take a different approach by invoking a cognitive-phenomenal view of belief and jettisoning the rational/behavioural conditions. On this view, the anti-doxastic claims can (...) be rejected outright, and doxasticism can be defended. I call this the cognitive phenomenological defence of doxasticism. (shrink)

Monothematic delusions are delusions whose contents pertain to a single subject matter. Examples include Capgras delusion, the delusion that a loved one has been replaced by an impostor, and Cotard delusion, the delusion that one is dead or does not exist. Two-factor accounts of such delusions hold that they are the result of both an experiential deficit, for instance flattened affect, coupled with an aberrant cognitive response to that deficit. In this paper we develop a new expressivist two-factor account of (...) delusion. In contrast to existing endorsement and explanationist accounts, which treat delusions as either explanations or endorsements of the contents of these disordered experiences, we hold that delusional beliefs have an expressive function: they characterize, in impressionistic terms, what the subject’s experience is like for them. We show how our account improves upon existing two-factor views in explaining the central features of monothematic delusions, in particular the way in which delusional subjects fall short of the ideal of rationality. (shrink)

: Jennifer Radden argues that there cannot be delusional pain in depression, putting forward three arguments: the argument from falsehood, the argument from epistemic irrationality, and the argument from incongruousness. Whereas delusions are false, epistemically irrational, and incongruous with the person’s experience, feeling pain from the first-person perspective cannot be false or irrational, and is congruous with the person’s experience in depression. In this commentary on Radden’s paper, we share her scepticism about the notion of delusional pain, but we find (...) the arguments from falsehood and incongruousness ultimately unconvincing, given that delusions are not always false or incongruous. Rather, we develop the argument from epistemic irrationality, suggesting that, although some aspects of pain may exhibit informational plasticity and other characteristics shared by mental states that can be assessed for their rationality, the sensory component of pain does not. Keywords: Delusion; Pain; Epistemic Irrationality; Incongruousness; Falsity; Depression Riassunto: Jennifer Radden sostiene che non può esserci dolore delirante nella depressione, proponendo tre argomentazioni che si basano sulla falsità, l'irrazionalità epistemica e l'incongruenza. Mentre i deliri sono falsi, epistemicamente irrazionali e incongruenti con l'esperienza della persona, provare dolore in prima persona non può essere falso o irrazionale ed è congruo con l'esperienza di una persona che è depressa. In questo commento all’articolo di Radden, condividiamo il suo scetticismo nei confronti della nozione di dolore delirante, ma troviamo le argomentazioni basate sulla falsità e l’incongruenza in ultima analisi non del tutto convincenti, dato che i deliri non sono sempre falsi o incongrui. Piuttosto, sviluppiamo l’argomentazione basata sull’irrazionalità epistemica, suggerendo che, sebbene alcuni aspetti del dolore possano esibire plasticità e altre caratteristiche condivise da stati mentali che vengono valutati per la loro razionalità, la componente sensoriale del dolore non lo fa. Parole chiave: Delirio; Dolore; Irrazionalità epistemica; Incongruenza; Falsità; Depressione. (shrink)

It has been argued that schizophrenic delusions are “behaviourally inert.” This is evidence for the phenomenon of “double bookkeeping,” according to which people are not consistent in their commitment to the content of their delusions. The traditional explanation for the phenomenon is that people do not genuinely believe the content of their delusions. In the article, we resist the traditional explanation and offer an alternative hypothesis: people with delusions often fail to acquire or to maintain the motivation to act on (...) their delusional beliefs. This may be due to avolition, to emotional disturbances, or to the fact that, given the peculiar content of some delusions, the surrounding environment does not support the agent’s motivation to act. (shrink)

Descartes was certain that he was thinking and he was accordingly certain that he existed. Like Descartes, we seem to be more certain of our thoughts and our existence than of anything else. What is less clear is the reason why we are thus certain. Philosophers throughout history have provided different interpretations of the cogito, disagreeing both on the kind of thoughts it characterizes and on the reasons for its cogency. According to what we may call the empiricist interpretation of (...) the cogito, I can only claim to be certain of having experiences, and this certainty, as well as that of my own existence, stems from their phenomenal and subjective character. According to rationalist interpretations, on the other hand, I am certain of having some self-reflexive propositional attitudes, and this certainty derives from their rational features. Psychiatric patients suffering from acute forms of depersonalization or of the Cotard syndrome often doubt that they think and exist, and might even believe that they don't. I argue that their study allows us to favor the empiricist interpretation of the cogito. (shrink)

The aim of this paper is twofold. First, I want to re-examine the epistemic status of elaborated delusions. Bortolotti (2016, 2020) claims that they can be epistemically innocent. However, I will show that this type of delusions is more unique than suggested by the existing analyses of their epistemic status. They typically cause more profound harms than other kinds of delusions, and in most cases, it would be counterproductive to classify them as epistemically beneficial or innocent. I will employ predictive (...) and phenomenological models of delusions and the enactivist notion of sensus communis to explain the harms and possible benefits of elaborated delusions and why I think the existing definition does not fully grasp them. Based on this analysis, I will propose changes to the conditions for epistemic innocence. (shrink)

Delusions are often thought of as the hallmark of irrationality. Accepted definitions of delusion are cast in terms of epistemic features that reflect irrationality: impossibility or falsity of con...

Elisabeth Pacherie is a research fellow in philosophy at Institut Jean Nicod, Paris. Her main research and publications are in the areas of philosophy of mind, psychopathology and action theory. Her publications include a book on intentionality (_Naturaliser_ _l'intentionnalité_, Paris, PUF, 1993) and she is currently preparing a book on action and agency.

Clinical delusions are difficult to investigate in the laboratory because they co-occur with other symptoms and with intellectual impairment. Partly for these reasons, researchers have recently begun to use hypnosis with neurologically intact people in order to model clinical delusions. In this paper we describe striking analogies between the behavior of patients with a clinical delusion of mirrored self misidentification, and the behavior of highly hypnotizable subjects who receive a hypnotic suggestion to see a stranger when they look in the (...) mirror. Based on these analogies, we argue that the use of hypnosis is a reliable method to investigate the surface features of clinical delusions. But to what extent can hypnosis successfully recreate delusions? Can it also contribute to a better understanding of delusion formation? Although clinical delusions and hypnotically induced beliefs are different in etiology, some analogies can be identified in the underlying processes that characterise them, based on the two-factor theory of delusion formation. (shrink)

This chapter connects the phenomenon of double bookkeeping to two critical debates in the philosophy of delusion: one from the analytic tradition and one from the phenomenological tradition. First, I will show how the failure of action guidance on the part of some delusions suggests an argument to the standard view that delusions are beliefs (doxasticism about delusion) and how its proponents have countered it by ascribing behavioral inertia to avolition, emotional disturbances, or a failure of the surrounding environment in (...) supporting the agent’s motivation to act. Second, I will show how the mismatch between the experience of double bookkeeping and that of having the usual propositional attitudes of folk psychology suggests another, more recalcitrant argument not only against doxasticism but against the very attempt to fit delusion into folk psychology. Third, I will show how phenomenologically inspired theories of delusion, such as the multiple realities hypothesis, bypass the debates above and focus on describing and understanding the disturbances in the structure of experience undergone by patients. I conclude that the philosophical discussions ensuing from an appreciation of double bookkeeping show some of the limitations of the analytic philosophical approach to delusion. (shrink)

Stanford Encyclopedia Entry on Delusions.

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)

This article examines the supposedly incomprehensibility of schizophrenic delusions. According to the contemporary classificatory systems (DSM-IV-TR and ICD-10), some delusions typically found in schizophrenia are considered bizarre and incomprehensible. The aim of this article is to discuss the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion (...) of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning in terms of motivations, desires, and other more straightforward psychological connections between mental states is impossible in schizophrenia, we can in fact have a philosophical understanding of the schizophrenic world and of the emergence of delusions typically found in schizophrenia. (shrink)

Jennifer Radden has drawn attention to two features of delusion, ambivalence and subjectivity, which are problematic for theories of delusion that treat delusions as empirical beliefs. She argues for an ‘attitude’ theory of delusion. I argue that once the cognitive architecture of delusion formation is properly described the debate between doxastic and attitude theorists loses its edge. That architecture suggests that delusions are produced by activity in the ‘default mode network’ unsupervised by networks required for decontextualized processing. The cognitive properties (...) of these networks explain the features of delusion which generate the debate between doxastic and attitude theorists. (shrink)

Many philosophers regard the persistence of philosophical disputes as symptomatic of overly ambitious, ill-founded intellectual projects. There are indeed strong reasons to believe that persistent disputes in philosophy (and more generally in the discourse at large) are pointless. We call this the pessimistic view of the nature of philosophical disputes. In order to respond to the pessimistic view, we articulate the supporting reasons and provide a precise formulation in terms of the idea that the best explanation of persistent disputes entails (...) that they are pointless. We then show how to answer the pessimistic argument. Taking a well-known mathematical controversy as our paradigm example, we argue that some persistent disputes reflect substantive disagreements at the “meta-analytic” level, i.e., disagreements about the best way, among quite different candidates, to understand the topic at issue, and the best associated cluster of analytic truths one should accept concerning it. Moreover, our concrete example shows that such meta-analytic disagreements can in principle be settled and yield a genuine theoretical (as opposed to merely pragmatic) breakthrough. We conclude optimistically that persistent disputes can be an important means of fostering epistemic progress. (shrink)

Although delusion is one of the central concepts of psychopathology, it stills eludes precise conceptualization. In this paper, I present certain basic issues concerning the classification and definition of delusion, as well as its ontological status. By examining these issues, I aim to shed light on the ambiguity of the clinical term ‘delusion’ and its extension, as well as provide clues as to why philosophers are increasingly joining the ranks of psychiatrists, psychologists, and neuroscientists in the effort to come to (...) a comprehensive understanding of delusion. (shrink)