A common but overlooked form of explanation in psychiatry is what I label ‘empathetic explanation’. Empathetic explanations invoke empathetic variables, which, in addition to providing an explanation of the target phenomenon, also afford an empathetic understanding of it. Focusing on the case of auditory verbal hallucination (AVH), I argue that empathetic explanation fails to provide an adequate account of the phenomenon, perniciously shapes empirical research, and confuses empathetic understanding with scientific understanding. I close by providing a general condition on the (...) legitimate application of empathetic explanation. (shrink)

Affective realism, roughly the hypothesis that you “perceive what you feel”, has recently been put forward as a novel, empirically-backed explanation of police shooting errors. The affective states involved in policing in high-pressure situations result in police officers literally seeing guns even when none are present. The aim of this paper is to (i) unpack the implications of this explanation for assessing police culpability and (ii) determine whether we should take these implications at face value. I argue that while affective (...) realism stands to diminish, if not eliminate, the moral and legal responsibilities of officers who have made shooting errors, the empirical data itself does not directly support such a radical rethink of police culpability. (shrink)

Philosophers and psychologists assume that mental imagery is a cognitive state, that it represents things as being a certain way. However, I argue that imagery is a conative state: it represents things as to be made a certain way. I challenge the traditional assumption by targeting an increasingly popular cognitive account that identifies mental imagery, such as inner speech, with predictions of sensory input. This predictive account faces both empirical and theoretical problems. The account not only fails to capture the (...) salience effects exhibited by mental imagery, it also cannot explain why subjects should not spend their lives minimizing prediction error by engaging in fantasy. These shortcomings highlight what I call the conative profile of imagery, which includes its salience, motivational, and performance effects. I argue that an alternative, conative view of imagery, according to which mental images are goal states, is best able to account for its conative profile. (shrink)

The prediction error minimization framework denotes a family of views that aim at providing a unified theory of perception, cognition, and action. In this paper, I discuss some of the theoretical limitations of PEM. It appears that PEM cannot provide a satisfactory explanation of motivated reasoning, as instantiated in phenomena such as self-deception, because its cognitive ontology does not have a separate category for motivational states such as desires. However, it might be thought that this objection confuses levels of explanation. (...) Self-deception is a personal level phenomenon, while PEM offers subpersonal explanations of psychological abilities. Thus, the paper examines how subpersonal explanations couched in the PEM framework can be thought of as related to personal level explanations underlying self-deception. In this regard, three views on the relation between personal and subpersonal explanations are investigated: the autonomist, the functionalist, and the co-evolutionary perspective. I argue that, depending on which view of the relation between the personal and subpersonal is adopted, the PEM paradigm faces a dilemma: either its explanatory ambitions should be reduced to the subpersonal domain, or it cannot provide a satisfactory account of motivated reasoning as instantiated in self-deception. (shrink)

On an ‘internalist’ picture, knowledge isn’t necessary for understanding the nature of perception and perceptual experience. This contrasts with the ‘knowledge first’ picture, according to which it’s essential to the nature of successful perceiving as a mental state that it’s a way of knowing. It’s often thought that naturalistic theorizing about the mind should adopt the internalist picture. However, I argue that a powerful, recently prominent framework for scientific study of the mind, ‘predictive processing,’ instead supports the knowledge first picture. (...) Under predictive processing, it’s intrinsic to successful perceiving that it’s a state with the kind of modal robustness that’s distinctive of knowledge, which gives us reason to think of successful perceiving along knowledge first lines. Furthermore, I argue that the predictive processing framework encourages us to conceptualize experiences which don’t amount to knowledge along knowledge first lines, as states which by their nature fall short of knowledge. (shrink)

Inner speech travels under many aliases: the inner voice, verbal thought, thinking in words, internal verbalization, “talking in your head,” the “little voice in the head,” and so on. It is both a familiar element of first-person experience and a psychological phenomenon whose complex cognitive components and distributed neural bases are increasingly well understood. There is evidence that inner speech plays a variety of cognitive roles, from enabling abstract thought, to supporting metacognition, memory, and executive function. One active area of (...) controversy concerns the relation of inner speech to auditory verbal hallucinations in schizophrenia, with a common proposal being that sufferers of AVH misidentify their own inner speech as being generated by someone else. Recently, researchers have used artificial intelligence to translate the neural and neuromuscular signatures of inner speech into corresponding outer speech signals, laying the groundwork for a variety of new applications and interventions. (shrink)

To some it is a shallow platitude that inner speech always has an auditory-phonological component. To others, it is an empirical hypothesis with accumulating support. To yet others it is a false dogma. In this chapter, I defend the claim that inner speech always has an auditory-phonological component, confining the claim to adults with ordinary speech and hearing. It is one thing, I emphasize, to assert that inner speech often, or even typically, has an auditory-phonological component—quite another to propose that (...) it always does. When forced to argue for the stronger point, we stand to make a number of interesting discoveries about inner speech itself, and about our means for discriminating it from other psycholinguistic phenomena. Establishing the stronger conclusion also provides new leverage on debates concerning how we should conceive of, diagnose, and explain auditory verbal hallucinations and “inserted thoughts” in schizophrenia. (shrink)

Many philosophers and psychologists have sought to explain experiences of auditory verbal hallucinations and “inserted thoughts” in schizophrenia in terms of a failure on the part of patients to appropriately monitor their own inner speech. These self-monitoring accounts have recently been challenged by some who argue that AVHs are better explained in terms of the spontaneous activation of auditory-verbal representations. This paper defends two kinds of self-monitoring approach against the spontaneous activation account. The defense requires first making some important clarifications (...) concerning what is at issue in the dispute between the two forms of theory. A popular but problematic self-monitoring theory is then contrasted with two more plausible conceptions of what the relevant self-monitoring deficits involve. The first appeals to deficits in the neural mechanisms that normally filter or attenuate sensory signals that are the result of one’s own actions. The second, less familiar, form of self-monitoring approach draws an important analogy between Wernicke’s aphasia and AVHs in schizophrenia. This style of self-monitoring theory pursues possible connections among AVHs, inserted thoughts, and the disorganized speech characteristic formal thought disorder. (shrink)

Philosophical discussion tends to converge on the view that narratives are at the center of the emotion of grief. In this article, I expand on this kind of view. On the one hand, I argue that key strands of phenomenological and neuroscientific studies suggest that grief consists in a complex emotional process of disconfirmation-and-updating of the narrative self-model. By heuristically drawing on an analogy between binocular rivalry and grief, I show that certain salient aspects of the phenomenology of grief, such (...) as self-alienation and ambiguity, are straightforwardly reflected by this account. On the other hand, I argue that this hierarchical approach has the resources to: (i) show that both narratable and unnarratable experiences of personal loss are both instances of grief; and (ii) differentiate between narratable and unnarratable experiences of grief, without compromising the view that self-constituting narratives are at the center of the phenomenon. (shrink)

Over the last decade or so, several researchers have considered the predictive processing framework (PPF) to be a useful perspective from which to shed some much-needed light on the mechanisms behind psychosis. Most approaches to psychosis within PPF come down to the idea of the “atypical” brain generating inaccurate hypotheses that the “typical” brain does not generate, either due to a systematic top-down processing bias or more general precision weighting breakdown. Strong at explaining common individual symptoms of psychosis, such approaches (...) face some issues when we look at a more general clinical picture. In this paper, we propose an update on the current accounts of psychosis based on the realization that a neurotypical brain constantly generates non-actual, de-coupled, counterfactual hypotheses as part of healthy cognition. We suggest that what is going on in psychosis, at least in some cases, is not so much a generation of erroneous hypotheses, but rather an inability to correctly use the counterfactual ones. This updated view casts “accurate” cognition as more fragile and delicate, but also closes the gap between psychosis and typical cognition. (shrink)

Our eyes, bodies, and perspectives are constantly shifting as we observe the world. Despite this, we are very good at distinguishing between self-caused visual changes and changes in the environment: the world appears mostly stable despite our visual field moving around. This, it seems, also occurs when we are dreaming. As we visually investigate the dream environment, we track moving objects with our dream eyes, examine objects, and shift focus. These movements, research suggests, are reflected in the rapid movements or (...) saccades of our sleeping eyes. Do we really see the dream world in the same way that we see the real world? If we do, how could dreaming, usually assumed to be mind-generated hallucinations, replicate such an experience? This problem would be deflated if dreams are not hallucinations at all, but rather imagination, illusion or simply unrealistic. I argue that imagination and illusion views do not satisfactorily explain away the problem of vision and action in sleep. The imagination model is not a complete description of dreaming that is consistent with empirical research, and it is unlikely that the visual dream world is an illusion. Given that the dreaming visual experience is most likely active, hallucinatory, and at times a realistic world simulation, there are important implications for our understanding of visual perception and its relationship to movement. Evidence suggests that our dream eyes investigate the dream world as our waking eyes investigate the waking world. If changes to the unconsciously generated dream environment are perceived as external and unintentional while dream body movements are perceived as self-generated and intentional, current theory of visual perception may have to be expanded to account for how the dreaming mind generates a stable world in which we track and visually explore mind-generated objects. (shrink)

In this introduction we present the orthodox account of auditory verbal hallucinations, a number of worries for this account, and some potential responses open to its proponents. With some problems still remaining, we then introduce the problems presented by the phenomenon of thought insertion, in particular the question of how different it is supposed to be from AVHs. We then mention two ways in which theorists have adopted different approaches to voices and thoughts in psychosis, and then present the motivation (...) and composition of this special issue. (shrink)

Newly developed Bayesian perspectives on schizophrenia hold out the promise that a common underlying mechanism can account for many, if not all, of the positive symptoms of schizophrenia. If this is the case, then understanding how schizophrenic minds go awry could shine light on how healthy minds maintain a sense of self. This article investigates this Bayesian promise by examining whether the approach can indeed account for the difficulties with self-awareness experienced in schizophrenia. While I conclude that it cannot, I (...) nonetheless maintain that understanding how the self breaks down in schizophrenia tells us much about how and why the self functions in normal human circumstances. I proceed first by recounting in some detail a Bayesian interpretation of perception, schizophrenia, and self-awareness, as well as some of the empirical data supporting this interpretation, then by exploring aspects of schizophrenia that this approach leaves out. I conclude by discussing what the “left out” aspects tell us about self-awareness, thereby convincing the reader that studying patients with schizophrenia is indeed a useful avenue for understanding awareness of self. (shrink)

A neuropsychological perspective on auditory verbal hallucinations links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion. In this paper, I propose that an APS framework offers (...) a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI. (shrink)