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- Timothy J. Bayne & Elisabeth Pacherie (2004). Bottom-Up or Top-Down: Campbell's Rationalist Account of Monothematic Delusions. Philosophy, Psychiatry and Psychology 11 (1):1-11.Some otherwise rational people appear to believe strange things. Sometimes people believe that someone, usually a near relative or member of their family - often their spouse - has been replaced by an impostor. Sometimes people believe that they are dead. These two delusions – known as the Capgras and Cotard delusion respectively – are instances of monothematic delusions, for they are limited to very specific topics. Other monothematic delusions involve the delusion that one is being followed by known people in disguise (the Frégoli delusion), or that the person one sees in the mirror is someone else (mirrored-self misidentification). We will focus on the Capgras delusion.
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In some ways, someone suffering from the delusion that his or her spouse has been kidnapped and replaced with an imposter appears to believe that he or she eats dinner with an imposter every night. But the imperviousness of delusions to counter-evidence makes it hard to classify them as beliefs, and easier to classify them as imaginings. Bayne and Pacherie want to use Schwitzgebel’s dispositional account of belief to restore confidence in the doxastic character of delusion. While dispositionalism appears to allow us to classify delusions as beliefs, this allowance isn’t a robust vindication of doxasticism. The significance of the allowance can be increased by emphasizing the role of folk-psychological norms in individuating propositional attitudes. But letting those norms play a large role in the individuation of belief makes it hard to count as believers the deluded subjects who violate most such norms. Dispositionalism about belief can’t defend doxasticism about delusion.
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Current models of delusion converge in proposing that delusional beliefs are based on unusual experiences of various kinds. For example, it is argued that the Capgras delusion (the belief that a known person has been replaced by an impostor) is triggered by an abnormal affective experience in response to seeing a known person; loss of the affective response to a familiar person’s face may lead to the belief that the person has been replaced by an impostor (Ellis & Young, 1990). Similarly, the Cotard delusion (which involves the belief that one is dead or unreal in some way) may stem from a general..
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.
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.
Discussion of Timothy J. Bayne & Elisabeth Pacherie, Bottom-up or top-down: Campbell's rationalist account of monothematic delusions
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