Delusions

Upshot: In view of Kenny’s clinical insights, Hug’s notes on the intricacies of rational vs. a-rational “knowing” in the design sciences, and Chronaki & Kynigos’s notice of mathematics teachers’ meta-communication on experiences of change, this response reframes the heuristic power of bisociation and suspension of disbelief in the light of Kelly’s notion of “as-if-ism” (constructive alternativism. Doing as-if and playing what-if, I reiterate, are critical to mitigating intra-and inter-personal relations, or meta-communicating. Their epistemic status within the radical constructivist framework is (...) cast in the context of mutually enriching conversational techniques, or language-games, inspired by Maturana’s concepts of “objectivity in parenthesis” and the multiverse. (shrink)

This paper considers psychotic symptoms in terms of false inferences or beliefs. It is based on the notion that the brain is an organ of inference that actively constructs hypotheses to explain or predict its sensations. This perspective provides a normative account of action and perception that emphasises probabilistic representations; in particular, the confidence or precision of beliefs about the world. We consider sensory attenuation deficits, catatonia and delusions as various expressions of the same core pathology: namely, an aberrant encoding (...) of precision in a predictive coding hierarchy. In predictive coding, precision is thought to be encoded by the postsynaptic gain of neurons reporting prediction error. This suggests that both pervasive trait abnormalities and florid failures of inference in the psychotic state can be linked to factors controlling postsynaptic gain—such as NMDA receptor function and neuromodulation. We illustrate these points using a biologically plausible simulation of attribution of agency—showing how a reduction in the precision of prior beliefs, relative to sensory evidence, can lead to false inference. (shrink)

because whenever an observer observes, he creates a contingent distinction between what is observed and what is by necessity left unobserved. ...

In this paper we have two main aims. First, we present an account of mood-congruent delusions in depression (hereafter, depressive delusions). We propose that depressive delusions constitute acknowledgements of self-related beliefs acquired as a result of a negatively biased learning process. Second, we argue that depressive delusions have the potential for psychological and epistemic benefits despite their obvious epistemic and psychological costs. We suggest that depressive delusions play an important role in preserving a person’s overall coherence and narrative identity at (...) a critical time, and thus can be regarded as epistemically innocent. (shrink)

The unit of selection is the concept of that ‘something’ to which biologists refer when they speak of an adaptation as being ‘for the good of’ something. Darwin identified the organism as the unit of selection because for him the ‘struggle for existence’ was an issue among individuals. Later on it was suggested that, in order to understand the evolution of social behavior, it is necessary to argue that groups, and not individuals, are the units of selection. The last addition (...) to this debate was the formulation by Dawkins, in 1976, that the genes themselves are the units of selection while the organisms are merely the temporary receptacles and vehicles for such genes. Thus, the preposterous dissolution of the organism into genes and the proteins coded by such genes has been introduced in the evolutionary discourse by neglecting that the explanations for biological phenomena can be either synchronic or diachronic, depending on the phenomenon to be explained. Therefore explanations in molecular biology are synchronic while evolutionary biology needs diachronic explanations. Nevertheless, for ultra-Darwinians such as Dawkins, efficient replication is all that biology is about. Here I develop an argument in order to show that there is nothing in molecular and cell biology that might support such a contention and that the idea of the gene as the unit of selection is incompatible with the evident evolution of biological complexity. (shrink)

The papers in this volume are drawn from a workshop on delusion and self-deception, held at Macquarie University in November of 2004. Our aim was to bring together theorists working on delusions and self-deception with an eye towards identifying and fostering connections—at both empirical and conceptual levels—between these domains. As the contributions to this volume testify, there are multiple points of contact between delusion and self-deception. This introduction charts the conceptual space in which these points of contact can be located (...) and introduces the reader to some of the general issues that frame the discussion of subsequent chapters. (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)

This collection of essays focuses on the interface between delusions and self-deception.

A popular approach to monothematic delusions in the recent literature has been to argue that monothematic delusions involve broadly rational responses to highly unusual experiences. Campbell calls this the empiricist approach to monothematic delusions, and argues that it cannot account for the links between meaning and rationality. In place of empiricism Campbell offers a rationalist account of monothematic delusions, according to which delusional beliefs are understood as Wittgensteinian framework propositions. We argue that neither Campbell's attack on empiricism nor his rationalist (...) alternative to empiricism is successful. (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)

My question is whether a prevalent conception of morality can admit the existence of moral delusion. The conception of morality I refer to is that of a set of rules, or principles, ‘accepted’ or ‘assented’ to by persons, which stipulate that certain kinds of human act or behaviour are permitted, or required, while other kinds are to be avoided. This conception of morality can be found virtually everywhere, outside as much as within philosophy, in anthropology, sociology, political studies, history, literary (...) criticism, psychology, and law. But it is to a particular philosophical instance that I shall attend here. The instance in question is an essay by Jonathan Bennett which appeared in this journal seven years ago under the title ‘The Conscience of Huckleberry Finn’. My reason for addressing myself to Bennett's paper will become clear as I proceed. (shrink)

A “multifactorial” model should accommodate a psychological perspective, aiming to relate the phenomenology of complex visual hallucinations not only to neurobiological findings but also an understanding of the patient's psychological problems and situation in life. Greater attention needs to be paid to the role of the “lack of insight” patients may have into their hallucinations and its relationship to cognitive impairment.

In the first of our three pieces responding to Richard Dawkins's The God Delusion, David Benatar suggests that Dawkins is preaching.

The status of delusions as beliefs has taxed some of the greatest minds in psychopathology. In their paper, Mullen and Gillett (2014) reflect on this issue, addressing a number of ways in which delusions have been conceptualized, on the whole finding them inadequate. They are particularly concerned that regarding delusions simply as false factual beliefs leads to undue emphasis on criteria such as conviction, resistance to counterargument, and falsity, arguing that, in fact, these criteria do not distinguish between delusions and (...) other highly valued ideas (e.g., religious or political convictions, although these are not discussed). Mullen and Gillett make some telling points, and their paper certainly deserves .. (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.

Delusion is an exceptional test case for the principal categories of common sense and philosophical thought such as ‘reason’, ‘truth’ and ‘reality’. Via an engagement with the legacy of Freud and the most remarkable results of 20th-century psychiatry, the author’s aim is to analyse the paradoxical forms of delusion and to shed light on the logics that underlie and orient its specific modalities of temporalization, conceptualization and argumentation.

Delusions are defined as irrational beliefs that compromise good functioning. However, in the empirical literature, delusions have been found to have some psychological benefits. One proposal is that some delusions defuse negative emotions and protect one from low self-esteem by allowing motivational influences on belief formation. In this paper I focus on delusions that have been construed as playing a defensive function (motivated delusions) and argue that some of their psychological benefits can convert into epistemic ones. Notwithstanding their epistemic costs, (...) motivated delusions also have potential epistemic benefits for agents who have faced adversities, undergone physical or psychological trauma, or are subject to negative emotions and low self-esteem. To account for the epistemic status of motivated delusions, costly and beneficial at the same time, I introduce the notion of epistemic innocence. A delusion is epistemically innocent when adopting it delivers a significant epistemic benefit, and the benefit could not be attained if the delusion were not adopted. The analysis leads to a novel account of the status of delusions by inviting a reflection on the relationship between psychological and epistemic benefits. (shrink)

In this article I ask whether elaborated and systematized delusions emerging in the context of schizophrenia have the potential for epistemic innocence. Cognitions are epistemically innocent if they have significant epistemic benefits that could not be attained otherwise. In particular, I propose that a cognition is epistemically innocent if it delivers some significant epistemic benefit to a given agent at a given time, and if alternative cognitions delivering the same epistemic benefit are unavailable to that agent at that time. Elaborated (...) and systematized delusions in schizophrenia are typically false and exemplify failures of rationality and self-knowledge. Empirical studies suggest that they may have psychological benefits by relieving anxiety and enhancing meaningfulness. Moreover, these delusions have been considered as adaptive in virtue of the fact that they enable automated learning to resume after a significant disruption caused by incorrect prediction-error signalling. I argue that such psychological benefits and adaptive features also have positive epistemic consequences. More precisely, delusions can be a means to restoring epistemic functionality in agents who are overwhelmed by hypersalient experiences in the prodromal stage of psychosis. The analysis leads to a more complex view of the epistemic status of delusions than is found in the contemporary philosophical literature and has some implications for clinical practice. 1 Introduction2 Types of Delusions3 What Is Wrong with Elaborated and Systematized Delusions?4 Finding Life Meaningful5 Learning Resumed6 Epistemic Innocence7 Epistemic Benefit8 No Alternatives9 Conclusions and Implications. (shrink)

In psychiatry some disorders of cognition are distinguished from instances of normal cognitive functioning and from other disorders in virtue of their surface features rather than in virtue of the underlying mechanisms responsible for their occurrence. Aetiological considerations often cannot play a significant classificatory and diagnostic role, because there is no sufficient knowledge or consensus about the causal history of many psychiatric disorders. Moreover, it is not always possible to uniquely identify a pathological behaviour as the symptom of a certain (...) disorder, as disorders that are likely to differ both in their causal histories and in their overall manifestations may give rise to very similar patterns of behaviour. -/- Consider delusions as an example. It wouldn’t be correct to define delusions as those beliefs people form as a result of a neurobiological deficit and a hypothesis-evaluation deficit (as some versions of the two-factor theory of delusions suggest), because for some delusions no neurobiological deficit may be found, and reasoning biases and motivational factors may be contributors to the formation of the delusion (e.g. McKay et al., 2005). Moreover, it would be a mistake to define delusions as symptoms of schizophrenia alone, because they occur also in other disorders, including dementia, amnesia, and delusional disorders. Thus, aetiological considerations may appear in the description and analysis of delusions, but do not feature prominently in their definition. -/- In this paper I argue that the surface features used as criteria for the classification and diagnosis of disorders of cognition are often epistemic in character. I shall offer two examples: confabulations and delusions are defined as beliefs or narratives that fail to meet standards of accuracy and justification. Although classifications and diagnoses based on features of people’s observable behaviour are necessary at these early stages of neuropsychiatric research, given the variety of conditions in which certain phenomena appear, I shall attempt to show that current epistemic accounts of confabulations and delusions have limitations. Epistemic criteria can guide both research and clinical practice, but fail to provide sufficient conditions for the identification of delusions and confabulations, and fail to demarcate pathological from non-pathological narratives or beliefs. -/- Another limitation of current epistemic accounts – which I shall not address here – is the excessive focus on epistemic faults of confabulations and delusions at the expense of their epistemically neutral or advantageous features (see Bortolotti and Cox, 2009). This may lead to a misconception of delusions and confabulations, and to an oversimplification in the assessment of the needs of people who require clinical treatment for their psychotic symptoms. (shrink)

This feature in Philosophy, Psychiatry, & Psychology (PPP) is intended to provide ongoing commentary on main articles previously published in PPP. The essay by Bortolotti below is a response to John Rhodes and Richard Gipps's paper in PPP (15, no. 4:295-310).Can we understand people who report delusional beliefs? In their thought-provoking paper, "Delusions, Certainty, and the Background", John Rhodes and Richard Gipps (2008) present a novel account of delusions which has two main purposes: (1) offer an explanation of the truly (...) puzzling features of delusional reports and (2) put forward a theory about what is likely to cause delusions. The authors claim that current theories of delusions that appeal to unusual .. (shrink)

Here I summarise the main arguments in Delusions and Other Irrational Beliefs [1]. The book addresses the question whether there is a rationality constraint on belief ascription and defends a doxastic account of clinical delusions.

Here I reply to the main points raised by the commentators on the arguments put forward in my Delusions and Other Irrational Beliefs (OUP, 2009). My response is aimed at defending a modest doxastic account of clinical delusions, and is articulated in three sections. First, I consider the view that delusions are inbetween perceptual and doxastic states, defended by Jacob Hohwy and Vivek Rajan, and the view that delusions are failed attempts at believing or not-quitebeliefs, proposed by Eric Schwitzgebel and (...) Maura Tumulty. Then, I address the relationship between the doxastic account of delusions and the role, nature, and prospects of folk psychology, which is discussed by Dominic Murphy, Keith Frankish, and Maura Tumulty in their contributions. In the final remarks, I turn to the continuity thesis and suggest that, although there are important differences between clinical delusions and non-pathological beliefs, these differences cannot be characterised satisfactorily in epistemic terms. (shrink)

In this paper, I articulate the thesis that most delusional beliefs are continuous with other irrational beliefs. Any interpreter with some knowledge about the cognitive and affective life of subjects with delusions can at least partially understand their reports, and explain and predict their behavior in intentional terms. I identify similarities and differences between this approach to the nature of delusions and the approach adopted by Rhodes and Gipps, who have recently defended the view that people with delusions do not (...) share the same bedrock beliefs as people without (the Background Theory of Delusions). (shrink)

In this chapter I defend the doxastic account of delusions and offer some reasons to believe that the double-bookkeeping argument against doxasticism (delusions are not beliefs because they do not drive action) should be resisted.

Stanford Encyclopedia Entry on Delusions.

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)

I argue that some cases of delusions show the inadequacy of those theories of interpretation that rely on a necessary rationality constraint on belief ascription. In particular I challenge the view that irrational beliefs can be ascribed only against a general background of rationality. Subjects affected by delusions seem to be genuine believers and their behaviour can be successfully explained in intentional terms, but they do not meet those criteria that according to Davidson (1985a) need to be met for the (...) background of rationality to be in place. (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)

Philosophers are interested in the phenomenon of thought insertion because it challenges the common assumption that one can ascribe to oneself the thoughts that one can access first-personally. In the standard philosophical analysis of thought insertion, the subject owns the ‘inserted’ thought but lacks a sense of agency towards it. In this paper we want to provide an alternative analysis of the condition, according to which subjects typically lack both ownership and authorship of the ‘inserted’ thoughts. We argue that by (...) appealing to a failure of ownership and authorship we can describe more accurately the phenomenology of thought insertion, and distinguish it from that of non-delusional beliefs that have not been deliberated about, and of other delusions of passivity. We can also start developing a more psychologically realistic account of the relation between intentionality, rationality and self knowledge in normal and abnormal cognition. (shrink)

Philosophers have been long interested in delusional beliefs and in whether, by reporting and endorsing such beliefs, deluded subjects violate norms of rationality (Campbell 1999; Davies & Coltheart 2002; Gerrans 2001; Stone & Young 1997; Broome 2004; Bortolotti 2005). So far they have focused on identifying the relation between intentionality and rationality in order to gain a better understanding of both ordinary and delusional beliefs. In this paper Matthew Broome and I aim at drawing attention to the extent to which (...) deluded subjects are committed to the content of their delusional beliefs, that is, to whether they can be regarded as authors of their beliefs (Moran 2001). We consider several levels of commitment one can have to a reported belief, delusional or otherwise, and we distinguish between _ownership_ and _authorship_ of beliefs (Gallagher 2000). After examining some examples of belief authoring (or lack thereof) in psychopathology, we argue that there is no straight-forward and unitary answer to the question whether deluded subjects author their beliefs. Nevertheless, introducing the notion of authorship in the debate can significantly contribute to the philosophical literature on the rationality of delusions and can also have important implications for diagnosis and therapy in psychiatry. (shrink)

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)

Review of Phil Gerrans' book on delusions, The Measure of Madness.

In this paper we argue that both self-deception and delusions can be understood in folk-psychological terms.

In this paper we address the ethics of adopting delusional beliefs and we apply consequentialist and deontological considerations to the epistemic evaluation of delusions. Delusions are characterised by their epistemic shortcomings and they are often defined as false and irrational beliefs. Despite this, when agents are overwhelmed by negative emotions due to the effects of trauma or previous adversities, or when they are subject to anxiety and stress as a result of hypersalient experience, the adoption of a delusional belief can (...) prevent a serious epistemic harm from occurring. For instance, delusions can allow agents to remain in touch with their environment overcoming the disruptive effect of negative emotions and anxiety. Moreover, agents are not blameworthy for adopting their delusions if their ability to believe otherwise is compromised. There is evidence suggesting that no evidence-related action that would counterfactually lead them to believe otherwise is typically available to them. The lack of ability to believe otherwise, together with some other conditions, implies that the agents are not blameworthy for their delusions. The examination of the epistemic status of delusions prompts us to acknowledge the complexity and contextual nature of epistemic evaluation, establish connections between consequentialist and deontological frameworks in epistemology, and introduce the notion of epistemic innocence into the vocabulary of epistemic evaluation. (shrink)

Thought insertion is a common delusion in schizophrenia. People affected by it report that there are thoughts in their heads that have been inserted by a third party. These thoughts are self-generated but subjec-tively experienced as alien (hereafter, we shall call them alien thoughts for convenience). In chapter 5 of Transparent Minds, Jordi Fernández convincingly argues that the phenomenon of thought insertion can be accounted for as a pathology of self-knowledge. In particular, he argues that the application of the bypass (...) model of self-knowledge can shed light on what is amiss in people with thought insertion. In this brief commentary, we examine the proposal by Fernández, highlight some of its strengths, and raise one main objection to it. In mainstream philosophical accounts of thought insertion, people who report the delusion are thought to have ownership of the alien thoughts, but to lack a sense of agency with respect to such thoughts, and this is supposed to explain why they ascribe the thoughts to some-one else. Fernández correctly identifies the limitations of mainstream accounts of thought insertion. First, to claim that people with the delu-sion of thought insertion own the alien thoughts does not sit well with the phenomenology of thought insertion as it is reflected in people’s self-reports. Second, people do not need to experience a sense of agency with respect to a thought in order to ascribe the thought to themselves. Sense of agency is too demanding a condition for self-ascription. Fernández puts forward a novel account of thought insertion, at-tempting to solve the problems identified with mainstream accounts. He defends the view that thought insertion is a failure of self-knowledge that consists in the person failing to ascribe one of her be-liefs to herself. Similar accounts to the one Fernández develops in the chapter have been defended by Bortolotti and Broome (2009) and Pickard (2010). For Fernández, the failure in self-ascription is due to the fact that the person with thought insertion does not feel pressured to endorse the content of a belief that she has [Fernández (2013), p. 142]. Fernández explains this phenomenon in detail by reference to the bypass model of self-knowledge. When Fernández develops his own proposal, he relies on the claim that the alien thought is a belief. We challenge this claim.We agree with Fernández that, in thought insertion, the person does not ascribe the alien thought to herself and does not commit to the content of the thought being true, in spite of the thought being self-generated. Such considerations powerfully suggest to us that the alien thought is not a belief. Given the elusive nature of mental states in general and beliefs in particular, this may seem just a terminological issue. But in the present context, whether the alien thought is a belief is important in order to offer a characterisation of thought insertion that makes jus-tice to the first-person reports and other behavioural manifestations of people with the delusion. One may also argue that, as the model of self-knowledge Fernández applies to alien thoughts, that is, the bypass model, is a model of self-knowledge for beliefs, such a model could only feature in the explanation of thought insertion if alien thoughts were beliefs. But we do not think this is necessarily the case, as in the book Fernández successfully applies his bypass model to other types of mental states, such as desires. (shrink)

In this paper we review two debates in the current literature on clinical delusions. One debate is about what delusions are. If delusions are beliefs, why are they described as failing to play the causal roles that characterise beliefs, such as being responsive to evidence and guiding action? The other debate is about how delusions develop. What processes lead people to form delusions and maintain them in the face of challenges and counter-evidence? Do the formation and maintenance of delusions require (...) abnormal experience alone, or also reasoning biases or deficits? We hope to show that the focus on delusions has made a substantial contribution to the philosophy of the mind and continues to raise issues that are central to defining the concept of belief and gaining a better understanding of how people process information and learn about the world. (shrink)

In philosophy, psychiatry, and cognitive science, definitions of clinical delusions are not based on the mechanisms responsible for the formation of delusions. Some of the defining features of delusions are epistemic and focus on whether delusions are true, justified, or rational, as in the definition of delusions as fixed beliefs that are badly supported by evidence). Other defining features of delusions are psychological and they focus on whether delusions are harmful, as in the definition of delusions as beliefs that disrupt (...) good functioning. Even if the epistemic features go some way towards capturing what otherwise different instances of clinical delusions have in common, they do not succeed in distinguishing delusions as a clinical phenomenon from everyday irrational beliefs. Focusing on the psychological features is a more promising way to mark the difference between clinical and non-clinical irrational beliefs, but there is wide variability in the extent to which delusions are psychologically harmful, and some everyday irrational beliefs can affect functioning in similarly negative ways. In this chapter we consider three types of belief that share similar epistemic features and exhibit variation with respect to how psychologically harmful they are: (1) delusions of thought insertion, (2) alien abduction beliefs, and (3) self-enhancing beliefs. In the light of the similarities and differences between these cases, we highlight the difficulty in providing an answer to what makes an irrational belief delusional. (shrink)