Psychopathological delusions have a number of features that are curiously difficult to explain. Delusions are resistant to counterevidence and impervious to counterargument. Delusions are theoretically, affectively, and behaviorally circumscribed: delusional individuals often do not act on their delusions and often do not update beliefs on the basis of their delusions. Delusional individuals are occasionally able to distinguish their delusions from other beliefs, sometimes speaking of their “delusional reality.” To explain these features, I offer a model according to which, contrary to (...) appearances, delusions are not beliefs at all. Delusions are acceptances that are generated by pathologically powerful cognitive feelings. This model has implications for the way that we should think about non-pathological doxastic states and emotions. (shrink)

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the book (...) is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

Although delusions are typically regarded as beliefs of a certain kind, there have been worries about the doxastic conception of delusions since at least Bleuler’s time. ‘Anti-doxasticists,’ as we might call them, do not merely worry about the claim that delusions are beliefs, they reject it. Reimer’s paper weighs into the debate between ‘doxasticists’ and ‘anti-doxasticists’ by suggesting that one of the main arguments given against the doxastic conception of delusions—what we might call the functional role objection—is based on a (...) fallacy. She also draws attention to certain parallels between delusions and what she calls “nihilistic philosophical doctrines,” such as the skeptical position that we have no .. (shrink)

In this paper we defend the doxastic conception of delusions against the metacognitive account developed by Greg Currie and collaborators. According to the metacognitive model, delusions are imaginings that are misidentified by their subjects as beliefs: the Capgras patient, for instance, does not believe that his wife has been replaced by a robot, instead, he merely imagines that she has, and mistakes this imagining for a belief. We argue that the metacognitive account is untenable, and that the traditional conception of (...) delusions as beliefs should be retained. (shrink)

People suffering from severe monothematic delusions, such as Capgras, Fregoli, or Cotard patients, regularly assert extraordinary and unlikely things. For example, some say that their loved ones have been replaced by impostors. A popular view in philosophy and cognitive science is that such monothematic delusions aren't beliefs because they don't guide behaviour and affect in the way that beliefs do. Or, if they are beliefs, they are somehow anomalous, atypical, or marginal beliefs. We present evidence from five studies that folk (...) psychology unambiguously views monothematic delusions as stereotypical beliefs. This calls into question widespread assumptions in the professional literature about belief's stereotypical functional profile. We also show that folk psychology views delusional patients as holding contradictory beliefs. And we show that frequent assertion is a powerful cue to belief ascription, more powerful than even a robust and consistent track record of non-verbal behaviour. (shrink)

Chris Frith has argued that a loss of the sense of agency is central to schizophrenia. This suggests a connection between hallucinations and delusions on the one hand, and the misidentification of the subject’s imaginings as perceptions and beliefs on the other. In particular, understanding the mechanisms that underlie imagination may help us to explain the puzzling phenomena of thought insertion and withdrawal. Frith sometimes states his argument in terms of a loss of metarepresentational capacity in schizophrenia. I argue that (...) this formulation is unhelpful. (shrink)

The basic question of ontology is “What exists?”. The basic question of metaontology is: are there objective answers to the basic question of ontology? Here ontological realists say yes, and ontological anti-realists say no. (Compare: The basic question of ethics is “What is right?”. The basic question of metaethics is: are there objective answers to the basic question of ethics? Here moral realists say yes, and moral anti-realists say no.) For example, the ontologist may ask: Do numbers exist? The Platonist (...) says yes, and the nominalist says no. The metaontologist may ask: is there an objective fact of the matter about whether numbers exist? The ontological realist says yes, and the ontological anti-realist says no. Likewise, the ontologist may ask: Given two distinct entities, when does a mereological sum of those entities exist? The universalist says always, while the nihilist says never. The metaontologist may ask: is there an objective fact of the matter about whether the mereological sum of two distinct entities exists? The ontological realist says yes, and the ontological anti-realist says no. Ontological realism is often traced to Quine (1948), who held that we can determine what exists by seeing which entities are endorsed by our best scientific theory of the world. In recent years, the practice of ontology has often presupposed an ever-stronger ontological realism, and strong versions of ontological realism have received explicit statements by Fine (this volume), Sider (2001; this volume), van Inwagen (1998; this volume), and others. (shrink)

For any proposition P, it may sometimes occur that a person is not quite accurately describable as believing that P, nor quite accurately describable as failing to believe that P. Such a person, I will say, is in an "in-between state of belief." This paper argues for the prevalence of in-between states of believing and asserts the need for an account of belief that allows us intelligibly to talk about in-between believing. It is suggested that Bayesian and representationalist approaches are (...) inadequate to the task and that a Rylean dispositional account of belief might do the trick. (shrink)

Subjects with delusions profess to believe some extremely peculiar things. Patients with Capgras delusion sincerely assert that, for example, their spouses have been replaced by impostors. Patients with Cotard’s delusion sincerely assert that they are dead. Many philosophers and psychologists are hesitant to say that delusional subjects genuinely believe the contents of their delusions.2 One way to reinterpret delusional subjects is to say that we’ve misidentified the content of the problematic belief. So for example, rather than believing that his wife (...) is has been replaced by an impostor, we might say that the victim of Capgras delusion believes that it is, in some respects, as if his wife has been replaced by an impostor. Another is to say that we’ve misidentified the attitude that the delusional subject bears to the content of their delusion. So for example, Gregory Currie and co-authors have suggested that rather than believing that his wife has been replaced by an impostor, we should say that the victim of Capgras delusion merely imagines that his wife has been replaced by an impostor.3. (shrink)

Psychiatric treatment and diagnosis rests upon a richer conception of normativity than, for example, cognitive neuropsychology. This paper explores the role that considerations of rationality can play in defining this richer conception of normativity. It distinguishes two types of rationality and considers how each type can break down in different ways in delusional psychiatric disorders.

“Mad belief” (in analogy with Lewisian “mad pain”) would be a belief state with none of the causal role characteristic of belief—a state not caused or apt to have been caused by any of the sorts of events that usually cause belief and involving no disposition toward the usual behavioral or other manifestations of belief. On token-functionalist views of belief, mad belief in this sense is conceptually impossible. Cases of delusion—or at least some cases of delusion—might be cases of belief (...) gone half-mad, cases in which enough of the functional role characteristic of belief is absent that the subject is in an “in-between” state regarding the delusive content, such that it is neither quite right to say the subject determinately believes the delusive content nor quite right to say that she determinately fails to believe that content. Although Bortolotti (2010) briefly mentions such “sliding scale” approaches to the relationship of delusion and belief, she dismisses such approaches on rather thin grounds and then later makes some remarks that seem consonant with sliding scale approaches. (shrink)

Although a common clinical phenomenon, delusions are difficult to explain and have a problematic conceptual status. Advances in understanding delusions have come from studies which involve detailed investigation of particular types of delusion. Some of this work is summarised, with the Capgras and Cotard delusions as specific examples. These are used to high-highlight questions for which there is the potential for fruitful dialogue with philosophers. Such questions include the criteria for deciding that a statement represents a belief, the extent to (...) which we integrate our beliefs into a coherent web, and the nature and limits of human rationality. (shrink)

who are unrecognizable because they are in disguise. ¼ The person I see in the mirror is not really me. ¼ A person I knew who died is nevertheless in the hospital ward today. ¼ This arm [the speaker’s left arm] is not mine it is yours; you have..

Delusions are explanations of anomalous experiences. A theory of delusion requires an explanation of both the anomalous experience _and _the apparently irrational explanation generated by the delusional subject. Hence, we require a model of rational belief formation against which the belief formation of delusional subjects can be evaluated. _Method. _I first describe such a model, distinguishing procedural from pragmatic rationality. Procedural rationality is the use of rules or procedures, deductive or inductive, that produce an inferentially coherent set of propositions. Pragmatic (...) rationality is the use of procedural rationality _in context_. I then apply the distinction to the explanation of the Capgras and the Cotard delusions. I then argue that delusions are failures of pragmatic rationality. I examine the nature of these failures employing the distinction between performance and competence familiar from Chomskian linguistics. _Results. _This approach to the irrationality of delusions reconciles accounts in which the explanation of the anomalous experience exhausts the explanation of delusion, accounts that appeal to further deficits within the reasoning processes of delusional subjects, and accounts that argue that delusions are not beliefs at all. (Respectively, one-stage, two-stage, and expressive accounts.) _Conclusion. _In paradigm cases that concern cognitive neuropsychiatry the irrationality of delusional subjects should be thought of as a performance deficit in pragmatic rationality. (shrink)

Drawing on the latest work in cognitive neuroscience, a philosopher proposes that delusions are narrative models that accommodate anomalous experiences.

In _ Psychiatry in the Scientific Image, _Dominic Murphy looks at psychiatry from the viewpoint of analytic philosophy of science, considering three issues: how we should conceive of, classify, and explain mental illness. If someone is said to have a mental illness, what about it is mental? What makes it an illness? How might we explain and classify it? A system of psychiatric classification settles these questions by distinguishing the mental illnesses and showing how they stand in relation to one (...) another. This book explores the philosophical issues raised by the project of explaining and classifying mental illness. Murphy argues that the current literature on mental illness -- exemplified by the Diagnostic and Statistical Manual of Mental Disorders -- is an impediment to research; it lacks a coherent concept of the mental and a satisfactory account of disorder, and yields too much authority to commonsense thought about the mind. He argues that the explanation of mental illness should meet the standards of good explanatory practice in the cognitive neurosciences, and that the classification of mental disorders should group symptoms into conditions based on the causal structure of the normal mind. (shrink)

Since psychiatry remains a descriptive discipline, it is essential for its practitioners to understand how the language of psychiatry came to be formed. This important book, written by a psychiatrist-historian, traces the genesis of the descriptive categories of psychopathology and examines their interaction with the psychological and philosophical context within which they arose. The author explores particularly the language and ideas that have characterised descriptive psychopathology from the mid-nineteenth century to the present day. He presents a masterful survey of the (...) history of the main psychiatric symptoms, from the metaphysics of classical antiquity to the operational criteria of today. Tracing the evolution of concepts such as memory, consciousness, will and personality, and of symptoms ranging from catalepsy and aboulia to anxiety and self-harm, this book provides fascinating insights into the subjective nature of mental illness, and into the ideas of British, Continental and American authorities who sought to clarify and define it. (shrink)