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 (...) experiences and to wonder whether some accounts of delusion arising in neurological disorders can be generalized into psychotic delusion. A few points are addressed, demanding clarification and the rephrasing of some assumptions implied by the model of a secondary delusion. These points call for an interaction between clinical descriptions, neurocognitive explorations and a philosophical analysis of psychotic subjective experiences. (shrink)

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)

Chenwei Nie ([22]) argues against a Maherian one-factor approach to explaining delusion. We argue that his objections fail. They are largely based on a mistaken understanding of the approach (as committed to the claim that anomalous experience is sufficient for delusion). Where they are not so based, they instead rest on misinterpretation of recent defences of the position, and an underestimation of the resources available to the one-factor theory.

Each of us enjoys a special awareness of (some) of her mental states. The adverbial model of first-person awareness claims that to be aware of a mental state is for it to be conscious, where ‘conscious’ describes the kind of state it is, rather than denoting a form of awareness directed at it. Here, I present an argument for construing first-person awareness of intentions adverbially, by showing that this model can meet a serious challenge posed by the simulation hypothesis, which (...) draws on data about schizophrenia. (shrink)

I suggest that we can think of delusional misidentification in terms of systematic errors in the management of mental files. I begin by sketching the orthodox “bottom-up” aetiology of delusional misidentification. I suggest that the orthodox aetiology can be given a descriptivist or a singularist interpretation. I present three cases that a descriptivist interpretation needs to account for. I then introduce a singularist approach, one that is based on mental files, and show how it opens the way for different and (...) potentially more plausible accounts of these three cases. I reflect on how this mental files approach can be viewed either as a supplement to the orthodox aetiology, or as suggesting an altogether different aetiology. I end by addressing a concern surrounding the explanatory power of mental files. (shrink)

Standard accounts of delusion explain them as responses to experience. Cognitive models of feature binding in the face recognition systems explain how experiences of mismatch between feelings of "familiarity" and faces can arise. Similar mismatches arise in phenomena such as déjà and jamais vu in which places and scenes are mismatched to feelings of familiarity. These cognitive models also explain similarities between the phenomenology of these delusions and some dream states which involve mismatch between faces, feelings of familiarity and identities. (...) Given these similarities it makes sense to retain that aspect of the standard account in the face of revisionist arguments that feature binding anomalies which lead to delusions of misidentification are not consciously experienced. (shrink)

This book deals with the experience of externality, i.e. an experience, common in schizophrenia, present both in verbal hallucination and in thought insertion. The view defended is that thought insertion is a case of failed agency, experienced by the agent at the personal level as an intelligible thought with which she cannot identify. Such a case in which sense of agency and sense of subjectivity come apart reveals the existence of two dimensions in self-consciousness. Several difficulties of the solution offered (...) are discussed, in connection with the causal-explanatory role of the phenomenological features of the experience and with the view that thinking is a variety of acting. (shrink)

This essay presents a new account of thought insertion. Prevailing views in both philosophy and cognitive science tend to characterize the experience of thought insertion as missing or lacking some element, such as a ‘sense of agency’, found in ordinary first-person awareness of one's own thoughts. By contrast, I propose that, rather than lacking something, experiences of thought insertion have an additional feature not present in ordinary conscious experiences of one's own thoughts. More specifically, I claim that the structure of (...) an experience of thought insertion consists of two distinct elements: a state of ordinary first-person awareness and a sense that this state of awareness is highly unusual. In addition to modeling the experience of thought insertion, I also explain how a delusional pattern of thinking could lead someone who has this kind of experience to adopt a belief that some other entity is inserting thoughts into her mind. Finally, I briefly sketch a neurocomputational framework that could be developed to explain the sense that one's state of first-person awareness is highly irregular. (shrink)

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by delusional (...) episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

In his classic paper, “Delusional thinking and perceptual disorder,” Brendan Maher (1974) argues that psychiatric delusions are hypotheses designed to explain anomalous experiences, and are “developed through the operation of normal cognitive processes.” Consider, for instance, the Capgras delusion. Patients suffering from this particular delusion believe that someone close to them—such as a spouse, a sibling, a parent, or a child—has been replaced by an impostor: by someone who bears a striking resemblance to the “original” and who (for reasons unknown) (...) is intent on passing herself off as that individual. On Maher's view, the “Impostor Hypothesis” is the response of a rational agent to the anomalous experience it is invoked to explain. Recently, a number of philosophers have argued that Maher's analysis of delusion doesn't work when applied to the Capgras delusion. In this paper, I defend Maher's analysis against these arguments. However, my aim is not merely to defend Maher's analysis, but also to draw attention to some of the methodological problems that have led to its hasty dismissal. (shrink)

The central hypothesis of this book, Delusions and Beliefs: A Philosophical Inquiry (Routledge, 2019), is that delusions are malfunctional beliefs (Chapter 1); they belong to the category of belief (Chapter 2) but, unlike mundane false or irrational beliefs, they fail to perform some functions of belief (Chapter 3). More precisely, delusions directly or indirectly involve some malfunctioning cognitive mechanisms, which is empirically supported by the two-factor account of delusion formation (Chapter 4).

Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the tenacity with (...) which delusions are maintained, their often bizarre content, the patients’ inability to dismiss them, and their often circumscribed character. (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)

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.

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.