I introduce definition by genus and specific difference, afterwards using it to show that Karl Jaspers rejected the classic criteria for pathologically falsified judgment: ‘Absolute conviction,’ ‘incorrigibility,’ and ‘impossibility of content.’ Next I draw attention to the primary experience of delusion. Famously, Jaspers reckoned that that experience was “ununderstandable”—usually taken to imply something negative about one’s ability to empathize with the delusion holder. All the same, I propose that it was actually our static mode of understanding that he (...) felt was defeated by the aforementioned experience, not our genetic one. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Schizophrenic Delusions, Embodiment, and the BackgroundGiovanni Stanghellini (bio)Keywordsschizophrenia, delusion, embodiment, common sense, phenomenologyIn their article Delusions, Certainty, and the Background, Rhodes and Gipps (2008) argue for a Background theory of delusions. Their central argument may be summed up as follows:• The formation and maintenance of delusions becomes intelligible once they are seen to reflect a basic disturbance. When studying delusions, the focus should be on providing an adequate (...) framework for understanding, rather than providing empirical hypotheses to be tested.• The basic disturbance in delusions, and insanity in general, is not a deficiency in reasoning or a defect in the content of experience, but rather something more fundamental.• Delusions––this is their central claim––are caused by a failure of the Bedrock of beliefs (Wittgenstein) or the Background (Searle) to adequately inform or constrain the process of belief formation.• Our Bedrock certainties are defined––following Wittgenstein––as ultimately constituted by our ability to act in the world and demonstrate our primary engagement with the world. They are born out of our everyday experience of the world, conveying our direct, pre-reflective, and practical grasp of the world, rather than expressing judgments we make about it.• Similarly, the Background is defined as those abilities and dispositions that are neither representations nor rules, that function before we can make sense of our experiences.• Wittgenstein’s Bedrock and Searle’s Background in great part overlap with Blankenburg’s pre-reflective natural self-evidence and Stanghellini’s common sense, namely, our own unreflecting know-how, a set of nonpropositional skills, capacities, and dispositions that attune us with the world.• Without a fully functioning Background, the distinctions between imaginary and real (mind and world), self and non-self, and cause and coincidence fail to be adequately drawn within experience. Also, grasping the meaning of others’ behaviors and a weakening of contextual influences are entailed by an erosion of Background sensibilities.I feel extremely sympathetic to this account and, as Rhodes and Gipps report, there are remarkable points of overlap between their and my own ideas about the formation of schizophrenic delusions. I would like to add some comments on the main theories on the basic disorders entailed in the pathogenesis of delusions and conclude with some suggestions to integrate the Background theory of delusions. [End Page 311]Syntagmatic Versus Paradigmatic Models of DelusionsLet me raise first an epistemological point: paradigmatic models of delusions––defining what a delusion is in itself and what are its borders with similar phenomena––proved to be unsatisfactory in psychopathology. As Schneider and Huber (1975) put it more that 40 years ago, “[w]hat counts in delusions is not the delusion itself... but snagging the course of the lived experience, rather than its product” (p. 2042). What we do need, to understand what delusions really are, are syntagmatic models how––delusions (in this case, delusions in persons with schizophrenia) are connected to other phenomena within a structure or a process. What we should look for, then, are the phenomena that contribute as motivationally (or causally) necessary vulnerability, that is, the basic disturbance for the development of delusions. This logically implies that we need studying delusions in fieri, or the pathways that lead to delusions themselves. I subscribe to the principle that studying delusion by merely concentrating exclusively on its crystallized forms would be like studying stroke victims to know more about hypertension (Parnas and Sass 2001). This methodological move from crystallized delusions to delusions in-the-making is quintessential to define the subtle, basic, phenomenal invariant core that characterizes a given psychopathological phenomenon and that emerges across the manifold facets of the phenomenon itself and shapes them and keeps them meaningfully interconnected.A syntagmatic model should account for (at least) the following features of schizophrenic delusions:• abnormalities in symbolization (loss of commonsense meaning of a given thing or fact),• formal aspects (e.g., revelation character, experience of centrality), and• specificity of content (e.g., metaphysical tinge).It should also be compatible with those phenomena like self-disorders (loss of sense of ownership and of agency) that are entailed in most schizophrenic symptoms (e.g., verbal–acoustic hallucinations and experiences of alien control). Finally, it should keep meaningfully... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of (...) class='Hi'>delusion has been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

In the early modern period (16?18th centuries), churches and state administrations alike strove to eradicate Evil. Neither they nor society at large accepted a conceptual differentiation between crime and sin. The two worst kinds of Evil early modern societies could imagine were organized arson and witchcraft. Although both of them were delusions, they nevertheless promoted state building. Networks of itinerant street beggars were supposed to have been paid by foreign powers to set fire in towns and villages. These vagrant arsonists (...) can be regarded as the terrorists of the early modern period. Witches were persons who had allegedly made a compact with the devil. They were thought to randomly use maleficent magic to harm individuals as well as whole regions. When law enforcement agencies and suspicious peasants or townspeople tried to identify persons who might be arsonist terrorists or witches they used the category ?Evil?. Anyone who ignored the behavioral standards of society ever so slightly could be suspected of being utterly evil. The concept of Evil linked petty, commonplace immorality and the worst crimes imaginable to each other and to the mindless hatred of demons. This pre-modern concept of the banality of Evil was called into question by the legal reforms of the 17th century. It was finally rejected by the enlightenment that negated the imagined continuum of Evil. Witches and arsonist terrorists shared a number of characteristics. They were both said to form conspiracies that mirrored everyday society like an evil twin. The crimes they perpetrated lacked any purpose or reason, they were motivated by sheer malice. The worst forms of Evil had certain qualities of an epidemic: Witchcraft and terrorism were supposed to be always on the rise. The evil people were victimizers as well as victims. The imagery of Evil even implied that the evildoers resembled those they were supposed to have harmed. The fear of terrorist vagrants and witches as well as other conspiracy theories can be traced back to the Black Death. The plague of the 14th century not only sparked anti-Semitism. It lend force and credibility to the idea of an irrationally destructive, ever-growing secret organization as the epitome of Evil. (shrink)

This article addresses two issues: the first is the philosopher's fear of a lawless freedom of nature. I quote Deleuze and Guattari, who explain our terror before chaos and the consequent call for help and protection. My hypothesis was that this threat of chaos has affected also the enlightened mind of Kant. Facing the possibility of chaos, the objective Kant did not exactly fear delusion and madness, which affect only fragile subjectivities, but was terrified with the chance that nature (...) does not behave regularly, i.e., that _ knowledge _ becomes impossible. The second issue is a harder and more difficult question, and it is related to the _modern_ artist’s (or genius) anguish. It is a technical or an artistical complaint. He/She finds no more given rules to create his/her artworks. Differently from the philosopher, the genius fears the silence and the absolute muteness of nature. I try to deal with these two issues by taking into account Kant’s concept of purposiveness of nature as a regulative principle. I realize that, although this sufficed to calm down the philosopher’s anxiety, it proved to be insufficient to guide the artist. The delusion and madness that threaten the genius are deeper and more extreme than those of the philosopher. In order to treat the artist’s pain, without having to abandon the connection between art and nature, that constitutes one of the most fruitful reading keys of Kant’s Aesthetics, I resort to other ideas I found reading Lacoue-Labarthe and Hannah Arendt. (shrink)

International institutions such as UNESCO are deliberating on a new standard setting instrument for neurotechnologies. This will likely lead to the adoption of a soft law document which will be the first global document specifically tailored to neurotechnologies, setting the tone for further international or domestic regulations. While some stakeholders have been consulted, these developments have so far evaded the broader attention of the neuroscience, neurotech, and neuroethics communities. To initiate a broader debate, this target article puts to discussion twenty-five (...) considerations and desiderata for recognition by a future instrument. They are formulated at different levels of abstraction, from the big picture to technical details, seek to widen the perspective of preparatory reports and transcend the narrow debate about “neurorights” which overshadows many richer and more relevant aspects. These desiderata are not an exhaustive enumeration but a starting point for discussions about what deserves and what requires protection by an international instrument. (shrink)

Berkeley’s likeness principle is the claim that “an idea can be like nothing but an idea”. The likeness principle is intended to undermine representationalism: the view (that Berkeley attributes to thinkers like Descartes and Locke) that all human knowledge is mediated by ideas in the mind which represent material objects. Yet, Berkeley appears to leave the likeness principle unargued for. This has led to several attempts to explain why Berkeley accepts it. In contrast to ‘metaphysical’ and ‘epistemological’ (...) interpretations available in the literature, in this paper I defend a ‘conceptual’ interpretation. I argue that Berkeley accepts the likeness principle on the basis of (i) his commitment to the transparency of ideas, and (ii) his account of resemblance which he sets out in his works on vision. Thus, I provide an explanation for Berkeley’s reasons for accepting the likeness principle which, appropriately, focuses on his views concerning ideas and likeness. (shrink)

Experiences of thought-insertion are a first-rank, diagnostically central symptom of schizophrenia. Schizophrenic patients who undergo such delusional mental states report being first-personally aware of an occurrent conscious thought which is not theirs, but which belongs to an external cognitive agent. Patients seem to be right about what they are thinking but mistaken about who is doing the thinking. It is notoriously difficult to make sense of such delusions. One general approach to explaining the etiology of monothematic delusions has come to (...) be known as the endorsement model. This model claims that the patient holds her delusional belief because she simply trusts her bizarre experience and takes it at face value. The content of the bizarre experience thus plays a central role in the etiology of delusions. Despite being widely discussed with respect to delusions like Capgras and Cotard, an endorsement model of thought-insertion has not yet been formulated. This article seeks to fill this void by fleshing out and defending the endorsement approach to delusions of inserted thoughts. It aims to show that such an approach can be defended against objections that have been raised in the literature. In particular, it will be argued that there is nothing wrong with the idea of being first-personally aware of a thought which is presented in consciousness as being someone else's. The upshot is that with respect to delusions of thought-insertion, the endorsement model turns out to be a viable account of why patients come to believe that someone else is inserting thoughts into their minds. (shrink)

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent (...) epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:166, FLAGE ON HUME'S ACCOUNT OF MEMORY In the Treatise Hume writes that an impression which "has been present with the mind" may "make its appearance there as an idea," and that it can appear either through the faculty of memory or the faculty of the imagination. Memory and imagination each produces its own species of idea. In "Hume on Memory and 2 Causation" Daniel Flage addresses Hume's carving (...) out of these two species. Flage's main purpose is to show that Hume has a criterion for distinguishing memory ideas from others. I will argue that Flage has not located necessary and sufficient conditions for memory in Hume's discussion of memory. I will show that if Hume intended to provide a criterion at all, it is not the criterion Flage attributes to him, and that the criterion Flage has formulated is not an improvement over what appears to be Hume's criterion. Before looking at the details of Flage's interpretation I want to mention briefly an underlying assumption of the paper. The assumption is that Hume believes that there must be a clear distinction between memories and other perceptions. The assumption is supported by the fact that Hume speaks of the species of memory. However, there is textual evidence against this assumption. In the Treatise Hume emphasizes the ways in which memories are like other perceptions. For example, Hume calls memories impressions, while in distinguishing impressions from ideas he introduces 3 memories as paradigm examples of ideas. The reason Hume calls memories impressions, I believe, is that for the purpose of inference, he takes memories to be equivalent to impressions of sense. Since Hume is willing to put memories in two seemingly incompatible categories, perhaps his primary concern is with the role they play in belief; we make causal inferences 167. from memory and sense, not from the imagination. That Hume's primary concern is with inference, and not with memory per se, is supported by the fact that both Treatise sections devoted to memory are followed by 4 sections which deal with causal inference. Hume thinks that we cannot always distinguish memories from other perceptions "in their operation." It is not clear that he thinks that there must be a sharp distinction at all, since the traditional epistemological purpose for such a distinction, to partition the veridical from the non-veridical, is not obviously Hume's purpose. However, Flage claims that there is a clear criterion of memory in the Treatise. Let's take a look at what he has found. Flage maintains that Hume has both a phenomenal criterion based on vivacity which allows us in a rough and ready way to distinguish memories from imaginings "in their operation," and a formal criterion which "provides one with insight into the complex structure of an idea of memory." (p. 169) The phenomenal criterion does not distinguish memory ideas from others, since, as Hume himself allows, non-memories (e.g. beliefs, delusions, even ideas of the imagination) can have the same vivacity as memories. (Cf. T86) The marking off of memory as a distinct species is accomplished, on Flage's view, by the formal criterion. Hume writes "The chief exercise of the memory is not to preserve the simple ideas, but their order and position." (T9) This is what Flage calls Hume's formal criterion, and Flage takes it as both necessary and sufficient for being a memory idea. Flage takes memory ideas to be what he calls relative ideas, ideas which pick out or refer to a unique item. A memory idea, on this view, is a complex idea which uniquely picks out the antecedent complex 168, impression which resembles and is the cause of the idea. Flage writes: The formal criterion is basically a causal thesis: if a particular positive idea (mental image) is a genuine idea of the memory, then at some point in the past there was a complex impression that was the cause (or the original cause) of and exactly (or closely) resembles that positive idea as an idea. (p. 172) In this formulation the criterion is a necessary condition of memory. In a subsequent formulation Flage claims its sufficiency as... (shrink)

Nietzsche’s cardinal ideas - God is Dead, Übermensch and Eternal Return of the Same - are approached here from the perspective of psychiatric phenomenology rather than that of philosophy. A revised diagnosis of the philosopher’s mental illness as manic-depressive psychosis forms the premise for discussion. Nietzsche conceived the above thoughts in close proximity to his first manic psychotic episode, in the summer of 1881, while staying in Sils-Maria (Swiss Alps). It was the anniversary of his father’s death, and also (...) of the break-up of his friendship with Wagner, the most important relationship in his life. Despite having been acquainted with these ideas from reading philosophy and literature, Nietzsche created them de novo and imbued them with very personal meaning. Surprisingly, he never defined or explained his cardinal thoughts in his published writings, perhaps because rationally he could not. A resultant hermeneutic vacuum provoked an avalanche of interpretations in secondary literature. But could these ideas be delusions? A current definition of delusion is challenged, and an attempt is made at a limited comparison between delusion, scientific/philosophical doctrine and poetic creation. It is also argued that psychosis is a way of re-living trauma, and delusions can therefore be seen as a form of reasoning that helps to make sense of the world in a state of psychotic disintegration. Far from being false beliefs, delusions are a true expression of one’s innermost feelings and pain, albeit indirectly. The relationship between early parental loss and repeated trauma, psychosis and creativity is also explored. Indo-Pacific Journal of Phenomenology , Volume 8, Edition 1 May 2008. (shrink)

Bortolotti’s Delusions and Other Irrational Beliefs defends the view that delusions are beliefs on a continuum with other beliefs. A different view is that delusions are more like illusions, that is, they arise from faulty perception. This view, which is not targeted by the book, makes it easier to explain why delusions are so alien and disabling but needs to appeal to forensic aspects of functioning.

This study aims to examine how becoming like God is handled in Avicenna’s philosophy. Basically the article is based on the need to interpret that Plato and Aristotle and Plotinus are philosophers that complement each other, not diverge, in terms of the topic of becoming like God. First and foremost I present Avicenna’s arguments using the concepts of becoming like god and becoming like the First as a springboard. Moreover, based on the context in which Avicenna (...) uses the concept of manifestation, I examine how the idea of unification with God is transformed into an intellectual ideal. In the last section, I present the connection between the journey of becoming a perfected human and becoming like god which was established in the Metaphysics volume of The Book of Healing as a section of the matter which is related to ethics. (shrink)

ago that thinking (along with speaking and acting) “like a woman” was taken as a matter of shame and weakness. The phrase remains an insult to any man who is accused of being “like a woman” in any respect. But the only reason the phrase ...

Boldly describing the mind as the idea of the body – and the body as the most immediate object of our thinking – opens the way to a solution of the mind-body problem that Descartes bequeathed to philosophers discontented with substantial forms: Thought and extension, being of different natures, cannot explain one another. But if the mind intends the body, the congruence of mental and physical events makes sense. The order and connection of ideas parallels the order and connection (...) of their objects. So thoughts can address the world; ideas, in fact, can initiate actions. The lively subjectivity and reflectiveness of ideas helps further, in overcoming skepticism, dissolving the barrier between our thinking and its intellectual objects. The causal interconnectedness of natural objects can thus motivate a level of coherence and system among ideas that speaks up for the correspondence of adequate ideas to what they represent. (shrink)

In this critical notice we review Bozickovic's recent attempt to settle two interrelated issues: (i) the issue of the cognitive significance of indexical thoughts expressed at a time in the face of difficulties posed by cases in which the subject either mistakes two objects for one or one for two different objects; (ii) that of the cognitive dynamics of temporal indexical thoughts in the face of difficulties posed by cases in which the belief seems to be retained while the proper (...) adjustments fail to be made (that is, in cases such as Rip Van Winkle's). We argue that, despite its elegance and merits, the proposal falls short of accounting for the problematic cases in their full complexity. For one thing, the intended non-modal construal of Frege's Criterion of Difference promoted by Bozickovic does not block, in our view, the "proliferation" of senses brought about by the occasion-sensitivity of the individuation of demonstrative thoughts. For another, the proposal fails to appreciate the need for the subject to have an adequate conception of the object of her thought when it comes to orienting herself in space and time. That being so, we conclude that neither (i) nor (ii) is settled. (shrink)

In chapter 3 of Delusions and Beliefs, Kengo Miyazono argues that, when delusions are pathological beliefs, they are so due to their being both harmful and malfunctional. In this brief commentary, I put pressure on Miyazono’s account of delusions as harmful malfunctioning beliefs. No delusions might satisfy the malfunction criterion and some delusions might fail to satisfy the harmfulness criterion when such conditions are interpreted as criteria for pathological beliefs. In the end, I raise a general concern about attributing pathological (...) status to single beliefs out of context, and gesture towards the idea of pathology as a failure of agency to which some beliefs can contribute but that can only be identified by considering the person as a whole. (shrink)

Localised configurations of the free electromagnetic field are constructed, possessing properties of massive, spinning, relativistic particles. In an inertial frame, each configuration travels in a straight line at constant speed, less than the speed of lightc, while slowly spreading. It eventually decays into pulses of radiation travelling at speedc. Each configuration has a definite rest mass and internal angular momentum, or spin. Each can be of “electric” or “magnetic” type, according as the radial component of the magnetic or electric field (...) vanishes in the rest frame, and each has an “antiparticle.” Any such configuration, of electric or magnetic type, is characterized in part by a set of labels (κ, ω0, σ,l, m), where ω0 is the mean of the angular frequencies of the plane waves making up the configuration, σ is the variance of those frequencies, κ is a positive constant with dimensions of action, andl, m are angular momentum “quantum numbers” withl a positive integer andm an integer such that ‖m‖≤l. The rest energy of the “particle” is κω0, its spin is κ ‖m‖, and its lifetime is of the order of 1/σ. Its antiparticle has ω0 replaced by −ω0. (shrink)

Three challenges to a unified understanding of delusions emerge from Radden's On Delusion (2011). Here, I propose that in order to respond to these challenges, and to work towards a unifying framework for delusions, we should see delusions as arising in inference under uncertainty. This proposal is based on the observation that delusions in key respects are surprisingly like perceptual illusions, and it is developed further by focusing particularly on individual differences in uncertainty expectations.

Delusional misidentification is commonly understood as the product of an inference on the basis of evidence present in the subject's experience. For example, in the Capgras delusion, the patient sees someone who looks like a loved one, but who feels unfamiliar, so they infer that they must not be the loved one. I question this by presenting a distinction between “recognition” and “identification.” Identification does not always require recognition for its epistemic justification, nor does it need recognition for (...) its psychological functioning. Judgments of identification are often the product of a non-inferential mechanism. Delusional misidentification arises as the product of this mechanism malfunctioning. (shrink)

Over the last 20 years the comparator model for delusions of control has received considerable support in terms of empirical studies. However, the original version clearly needs to be replaced by a model with a much greater degree of sophistication and specificity. Future developments are likely to involve the specification of the role of dopamine in the model and a generalisation of its explanatory power to the whole range of positive symptoms. However, we will still need to explain why symptoms (...) can be so variable and we still do not understand the origin of the most mysterious symptom of all: thought insertion. (shrink)

Monothematic delusions are delusions whose contents pertain to a single subject matter. Examples include Capgras delusion, the delusion that a loved one has been replaced by an impostor, and Cotard delusion, the delusion that one is dead or does not exist. Two-factor accounts of such delusions hold that they are the result of both an experiential deficit, for instance flattened affect, coupled with an aberrant cognitive response to that deficit. In this paper we develop a new (...) expressivist two-factor account of delusion. In contrast to existing endorsement and explanationist accounts, which treat delusions as either explanations or endorsements of the contents of these disordered experiences, we hold that delusional beliefs have an expressive function: they characterize, in impressionistic terms, what the subject’s experience is like for them. We show how our account improves upon existing two-factor views in explaining the central features of monothematic delusions, in particular the way in which delusional subjects fall short of the ideal of rationality. (shrink)

Anorexia nervosa involves seemingly irrational beliefs about body size and the value of thinness. Historically, researchers and clinicians have avoided referring to such beliefs as delusions, instead opting for the label ‘overvalued ideas’. I discuss the relationship between the beliefs associated with anorexia nervosa and the distinction between delusions and overvalued ideas, as it is conceived in both European and American psychiatric traditions. In doing so, I question the benefit of applying the concepts of delusion and overvalued (...) idea to anorexia nervosa and raise some issues with contemporary use of the Brown Assessment of Beliefs scale for assessing the level of delusionality associated with the disorder. (shrink)

Introspection has traditionally been defined as a privileged way of obtaining beliefs about one’s occurrent mental states, and the idea that it is psychologically and epistemically different from non-introspective belief formation processes has been widely defended. At the same time, philosophers and cognitive scientists alike have pointed out the unreliability of introspective reports in consciousness research. In this paper, I will argue that this dissonance in the literature can be explained by differentiating between infallible and informative introspective beliefs. I will (...) argue that the latter are formed similarly to beliefs about the external world, and are therefore susceptible to similar success and failure conditions. Understanding introspection as belief-like will help to locate possible sources of error in regular as well as in pathological cases, carrying relevant implications for the relationship between experience, belief, and delusion. (shrink)

We review scholarship that examines relationships - and distinctions - between religion and delusion. We begin by outlining and endorsing the position that both involve belief. Next, we present the prevailing psychiatric view that religious beliefs are not delusional if they are culturally accepted. While this cultural exemption has controversial implications, we argue it is clinically valuable and consistent with a growing awareness of the social - as opposed to purely epistemic - function of belief formation. Finally, we review (...) research on continuities between religious and delusional cognition, which reveals that religious content is quite common in delusions and which provides tentative evidence for a positive relationship between religious belief and delusion-like belief in the general population. (shrink)

Clinically significant delusion is a symptom of a number of mental illnesses. We rely on what a person says and how she behaves in order to identify if she has this symptom and it is clear from the literature that delusions are heterogeneous and extremely difficult to define. People with active delusions were interviewed to explore what it is like to develop and experience delusion. The transcribed interview data was analysed to identify themes and narrative trajectories that (...) help to explain the phenomenon. Results showed that delusions can sometimes provide pragmatic benefits and that the genesis of some delusions can be characterised in terms of the enactivist notion of affective framing. Affective framing is a term that captures the background emotions that enable know-how in terms of goal directed action and cognition. If a person’s affective frame alters the world is no longer understood and know-how is lost. The way in which a person relates to her environment can be highly anomalous thus requiring her to find an extraordinary explanation. I argue that delusions arise as a result of a breakdown in affective framing and offer a conceptualisation of delusion supported by empirical findings. (shrink)

Introduction: Cotard delusion—the delusional belief “I am dead”—is named after the French psychiatrist who first described it: Jules Cotard (1880, 1882). Ramachandran and Blakeslee (1998) proposed that the idea “I am dead” comes to mind when a neuropathological condition has resulted in complete abolition of emotional responsivity to the world. The idea would arise as a putative explanation: if “I am dead” were true, there would be no emotional responsivity to the world. Methods: We scrutinised the literature on people (...) who expressed the delusional belief “I am dead”, looking for data on whether such patients are reported as entirely lacking in emotional responsivity. Results: In numerous cases, patients with Cotard delusion are described as experiencing emotions including anxiety, fear, guilt, distress, euphoria and worry. Conclusions: We conclude that complete absence of emotional responsivity cannot be what prompts the delusional idea that one is dead. We propose that, in at least some cases, the idea “I am dead” comes to mind in response to symptoms of depersonalisation or derealisation, often present in cases of Cotard delusion, and give examples of Cotard patients with abnormalities in various neural areas that could be responsible for the presence of such symptoms. (shrink)

This article contrasts the cognitive neuropsychiatric approach with the traditional psychiatric approaches to delusions to develop testable cognitive theories of delusions so as to render the generation of delusions psychologically understandable. It illustrates how cognitive neuropsychiatrists use the Bruce and Young model of face processing to explain the generation of misidentification delusions. The study of facial expression highlights that future cognitive neuropsychiatric study of self and non-self face processing using different representational media in patients with mirrored-self misidentification delusions will likely (...) be informative with regard to advancing scientific understanding of the putative differences between self and non-self recognition. It reviews cognitive neuropsychiatric research into the Capgras delusion and shows the distinction between overt face recognition and person identity authentication, and suggests the need for further modification of Bruce and Young's model to remove direct pathways between the person's identity module and the affective response system and to incorporate a separate integrative device. (shrink)

To what extent do self-deception and delusion overlap? In this paper we argue that both self-deception and delusions can be understood in folk-psychological terms. “Motivated” delusions, just like self-deception, can be described as beliefs driven by personal interests. If self-deception can be understood folk-psychologically because of its motivational component, so can motivated delusions. Non-motivated delusions also fit the folk-psychological notion of belief, since they can be described as hypotheses one endorses when attempting to make sense of unusual and (...) powerful experiences. We suggest that there is continuity between the epistemic irrationality manifested in self-deception and in delusion. (shrink)

We leverage the notion that abstraction enables prediction to generate novel insights and hypotheses for the literatures on attitudes and mate preferences. We suggest that ideas about liking are more abstract than experiences of liking, and that ideas about liking may facilitate mental travel beyond the here-and-now.

Clinical delusions are widely characterized as being pathological beliefs in both the clinical literature and in common sense. Recently, a philosophical debate has emerged between defenders of the commonsense position (doxasticists) and their opponents, who have the burden of pointing toward alternative characterizations (anti-doxasticists). In this chapter, I argue that both doxasticism and anti- doxasticism fail to characterize the functional role of delusions while at the same time being unable to play a role in the explanation of these phenomena. I (...) also argue that though a more nuanced view of belief in which mental states are more or less belief-like instills a healthy skepticism towards the precision of folk-psychological concepts, such a stance fails to be of use in building a theory of delusion that will be able to bridge different levels of explanation, such as the phenomenology and neurobiology of delusion. Thus, I advocate moving past the question ‘Are delusions beliefs?’ and their description as propositional attitudes toward the description of the processes that generate delusion, with a view toward explaining, rather than explaining away, the personal-level aspects of the phenomenon that have been made inscrutable by investing in doxastic terminology. (shrink)

Frankish's illusionism aims to replace the hard problem with the illusion problem; to explain why phenomenal consciousness seems to exist and why the illusion is so powerful. My aim, though broadly illusionist, is to explain why many other false assumptions, or delusions, are so powerful. One reason is a simple mistake in introspection. Asking, 'Am I conscious now?' or 'What is consciousness?' makes us briefly conscious in a new way. The delusion is to conclude that consciousness is always (...) class='Hi'>like this instead of asking, 'What is it like when I am not asking what it is like?' Neuroscience and disciplined introspection give the same answer: there are multiple parallel processes with no clear distinction between conscious and unconscious ones. Consciousness is an attribution we make, not a property of only some special events or processes. Notions of the stream, contents, continuity, and function of consciousness are all misguided as is the search for the NCCs. (shrink)

That postmodernism is a general cultural mood and a style in art, architecture, and literature is uncontroversial. But does postmodernism present a coherent intellectual doctrine or theory of politics, art, or life? In the discussion which follows, I will concentrate on two aspects of the intellectual pretensions of postmodernism. First, I examine the postmodernist claim that to justify the idea that the postmodern world is characterized by a general indeterminacy of meaning. Next I will look at aspects of the postmodernist (...) contention that the present age has witnessed the decline of individuality. (shrink)

I attempt to describe and defend an alternative definition of insanity. I claim that my definition follows from an adequate general understanding of legal excuse and that it describes correctly the question that jurors in the recent Andrea Yates case and others like it ought to be faced with. My essay has three parts. In the first, I briefly criticize M'Naghten- and Durham-inspired insanity statutes. In the second, I sketch and defend a general understanding of legal excuse and try (...) to show how an adequate insanity statute follows from it. Finally, in the third section, I describe and defend a rough version of the statute itself. In the course of doing so, I try to explain why I believe that statute is superior to the American Law Institute's various model insanity statutes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 135-141 [Access article in PDF] On Delusions of Sense:A Response to Coetzee and Sass Rupert Read Keywords schizophrenia, Wittgenstein, Schreber, Faulkner, Benjy, grammar, madness, Cogito The great writings on and of severe mental affliction—those for instance of Schreber, 'Renee', Donna Williams, Artaud, Faulkner's The Sound and the Fury, Coetzee's In the Heart of the Country, Kafka's "Description of a struggle," and even (I (...) would add) key parts of The Lord of the Rings—present us with something deeply enigmatic. They have, we might say, a strong grammar, a grammar—a mode of hanging together, and (in this case) of linguistically seeming to make a sense that is not our sense and that we cannot make sense of—... they have a grammar all of their own, and all of its own, a grammar that resists and rejects interpretation even as it sometimes seems to offer interpretations. 1It was Wittgenstein's view that to make mental illness unpuzzling was a mistake, or (better, perhaps) a mythologically problematic move. Wittgenstein's aim in his philosophizing was to understand what was enigmatic when it could be understood without unwisely turning it into something altogether unpuzzling... and then to acknowledge that there are some things that may remain forever puzzling, without committing oneself to the metaphysically disastrous claim that the reason they are endlessly puzzling is that they lie outside the boundaries of human life, language, or reason, as though we could peek outside those alleged boundaries to see what was there, but never truly say anything about it.There simply may be places where our understanding—phenomenological understanding, understanding of what it is like—gives out, and not because it is (or we are) merely human. For instance, perhaps one cannot capture some mental illness by intellection alone, or even perhaps at all. Perhaps the best understanding one can have of mental illness is purely negative (in a sense at least as strong as that involved in negative theology, wherein God is only defined by what it is not).Louis Sass (2003) writes I am not sure whether or not Read would accept that a philosophical position can be understandable despite its containing deep, internal logical tensions (perhaps he would not). If such understanding is possible, however, it does seem to open the way for a similar understanding of conditions like that of Schreber. (p. 127) Unfortunately, however, it is indeed not possible—that is, this notion is merely a fantasy—by my lights. Philosophical positions, all of which turn out to contain such inexorable tensions, cannot be understood: they are mirages. Solipsism, as a position, is not any better (or worse) off [End Page 135] than (say) (Metaphysical) Realism. They are both mirages, just different aspects of the same nothing. 2 Considered as positions, they are in the end literally—when one understands their logic—one and the same nothing. Wittgenstein already made this quite clear in his Tractatus. Perhaps in contrast to Sass, there is then nothing special about solipsism: it is just one mode of presentation rather than another of the illusion that there can be philosophical positions.Sass claims that in saying this kind of thing I am committed to ruling out that some mental illness can be understood or can even exist, on abstract intellectual grounds. I am not. I am simply wishing to leave open the possibility that there may be things that some people utter or seem to experience which intellection gives us little or no assistance with. If Sass wishes to deny this, then I suggest that it is he and not I who is the absolutist intellectualist here, in insisting that rewriting something deeply strange in a weaker grammar is furthering our grasp of it.My suggestion concerning Faulkner's presentation of Benjy, in my original paper, was that it is a mythological mistake to think that Faulkner provides us with the tools for giving an unpuzzling rendition of what had perhaps appeared to be "another country," inaccessible to us. Rather, Faulkner's representation... (shrink)

This paper explores how metaphorical thinking might contribute to an aetiology of florid delusions in psychosis. We argue that this approach helps to account for the path from experience to the delusional assertion, which, though relatively straightforward for monothematic delusions like the Capgras delusion, has always been difficult to account for in florid delusions in psychosis. Our account also helps to account for double book-keeping and the relative agential inertia of the belief.

This article will examine the claim that personal autonomy is impaired by a paradigmatic instance of serious psychopathology – namely, the condition of being delusional – in light of the hierarchical conception of personal autonomy. This conception of personal autonomy aims at yielding value‐neutral judgements about freedom and self‐governance. I will argue that when viewed from the perspective of this specific conception of autonomy, delusions do not necessarily impair an agent's personal autonomy. In order to establish this claim, I will (...) probe the general idea that delusional subjects are beset by a mental disease that is rationally incapacitating, to which the hierarchical theorist might appeal. I argue that, understood within the parameters set by the commitment to value neutrality, this idea fails to provide support for the claim that delusion necessarily impairs personal autonomy. One contribution this article makes to the effort of understanding how delusion impairs personal autonomy is to help us pinpoint the ways in which our value commitments inform our judgements of impaired personal autonomy in delusional agents. (shrink)

This article will examine the claim that personal autonomy is impaired by a paradigmatic instance of serious psychopathology – namely, the condition of being delusional – in light of the hierarchical conception of personal autonomy. This conception of personal autonomy aims at yielding value‐neutral judgements about freedom and self‐governance. I will argue that when viewed from the perspective of this specific conception of autonomy, delusions do not necessarily impair an agent's personal autonomy. In order to establish this claim, I will (...) probe the general idea that delusional subjects are beset by a mental disease that is rationally incapacitating, to which the hierarchical theorist might appeal. I argue that, understood within the parameters set by the commitment to value neutrality, this idea fails to provide support for the claim that delusion necessarily impairs personal autonomy. One contribution this article makes to the effort of understanding how delusion impairs personal autonomy is to help us pinpoint the ways in which our value commitments inform our judgements of impaired personal autonomy in delusional agents. (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)

The two commentators have examined and illuminated different aspects of the analysis of delusions that we have offered. Their discussions both raise points that clarify that analysis in helpful ways. Richard Bentall (2014) makes the telling point that distinguishing the mental phenomena that count as delusions is not always straightforward and that, at the margins, there is a perennial problem with patterns of thought that seem to fall outside the realm of shared meanings that most of us derive from our (...) experiences. The problem is evident in certain marginal conditions that come to psychiatric attention, like conversion reactions, body dysmorphic disorder, anorexia, and the many obsessions or strained .. (shrink)

RESUMEN En este artículo se plantea una discusión con el enfoque doxástico de los delirios. A pesar de que esta línea de análisis ha hecho importantes aportes a la comprensión del fenómeno, tiene dificultades importantes a la hora de aportar un marco explicativo completo de los delirios, porque deja por fuera el aspecto total de la experiencia y sigue basándose implícitamente en la idea de que podemos estudiar de manera separada e independiente los aspectos físicos, cognitivos y experienciales de un (...) fenómeno tan complejo. El artículo propone que, más allá de la decisión acerca de si se debe considerar a los delirios como creencias irracionales o no, o de si se puede concebirlos como creencias en absoluto, es necesario tener en cuenta la drástica transformación del mundo entero de la experiencia que se da en el sujeto delirante, tal como lo plantea la fenomenología. ABSTRACT This article discusses the doxastic approach to delusions. Although this analytic approach has made important contributions to our understanding of the phenomenon, it faces serious difficulties when it comes to providing a complete explanatory framework of delusions, as it leaves out the experiential aspect. This analytic approach continues to be implicitly based on the idea that the physical, cognitive and experiential aspects of such a complex phenomenon can be studied separately. The article suggests that, in addition to merely considering whether or not delusions ought to be taken as irrational beliefs, or even as beliefs at all, it is necessary to take into account the drastic transformation of the entire experiential world of the delusional subject, as suggested by the phenomenological approach. (shrink)

A team of professionals considers whether a patient in her early 50s is developing Alzheimer’s. The patient is not experiencing the memory symptoms typical of that disease, with so far a few years of sporadic attentional lapses as the predominant cognitive complaint. Her most dramatic symptom is her impression that two versions of her husband live with her. One is her real husband, the other a “fake.” There is no elaborated story about who the fake is or why he is (...) there, and there is little in the way of behavior consistent with the idea. To the patient, there is a vague sense that her husband doesn’t belong in the house, but no clearly articulated... (shrink)

How were the aims of philosophy and the responsibilities of philosophers conceived in ancient Greece and China? How were the learned elite recruited and controlled; how were their speculations and advice influenced by the different types of audiences they faced and the institutions in which they worked? How was a yearning for invulnerability reconciled with a sense of human frailty? In each chapter of this fascinating analysis ancient Greek and Chinese ideas and practices are used as a basis for (...) critical reflections on the predicaments we continue to face today, with a particular focus on the key Greek ideas of the equal participation of all citizens in the political process, and on the key Chinese one of a dedication to the ideal of the welfare of all under heaven. (shrink)

Ned Block argues that the higher-order (HO) approach to explaining consciousness is ‘defunct’ because a prominent objection (the ‘misrepresentation objection’) exposes the view as ‘incoherent’. What’s more, a response to this objection that I’ve offered elsewhere (Weisberg 2010) fails because it ‘amounts to abusing the notion of what-it’s-like-ness’ (xxx).1 In this response, I wish to plead guilty as charged. Indeed, I will continue herein to abuse Block’s notion of what-it’s-like-ness. After doing so, I will argue that the HO (...) approach accounts for the sense of what-it’s-like-ness that matters in a theory of consciousness. I will also argue that the only incoherence present in the HO theory is that generated by embracing Block’s controversial notion of what-it’s-like-ness, something no theorist of any stripe ought to do. Block is famous for (among other things) having introduced the notion of ‘phenomenal consciousness’ into contemporary philosophy of mind (Block 1995). This term is widely employed in the philosophical literature and it even appears in the empirical literature. But wide-speared usage has brought about divergent interpretations of the term. We can distinguish a ‘moderate’ and a ‘zealous’ reading of ‘phenomenal consciousness’. On the moderate reading, ‘phenomenal consciousness’ just means ‘experience’. Many people have embraced this sense of the term and use it to roughly pick out conscious experience involving sensory quality (states like conscious visual experiences or conscious pains, for example).2 On the zealous reading, however, phenomenal consciousness is held to be ‘distinct from any cognitive, intentional, or functional property’ (Block 1995: 234). That is, any explanation of phenomenal consciousness in exclusively cognitive, intentional, or functional terms will fail to capture, without remainder, what is really distinctive about phenomenal consciousness. Block, of course, is fully clear about embracing the zealous reading; indeed, his initial introduction of the notion is in those terms. The same ambiguity occurs with the much-used (and abused) idea of ‘what-it’s-like-ness’.. (shrink)

I argue that gendered stereotypes, gendered emotions and attitudes, and display rules can influence extrinsic regulation stages, making failure points likely to occur in gendered-context and for reasons that the emotion regulation literature has not given adequate attention to. As a result, I argue for ‘feminist emotional intelligence’ as a way to help escape these failures. Feminist emotional intelligence, on my view, is a nonideal ability-based approach that equips a person to effectively reason about emotions through an intersectional lens and (...) use emotions to inform how we think and react to the world. This includes being attuned to the ways in which the world and our emotional lives are structured by and favors men. It stresses the need to be attuned to, as well as resist and challenge gender-based stereotypes and attitudes around emotions, paying close attention to the ways those stereotypes, norms, and attitudes differ across race, class, ethnicity, et cetera. (shrink)

This paper offers a critique of a central psychopathological concept, the notion of "poor reality-testing. "Using ideas from the philosopher Ludwig Wittgenstein, I consider the nature of delusions in schizophrenia, largely through examining Daniel Paul Schreber's famous Memoirs of My Nervous Illness. Many schizophrenic individuals do not in fact mistake their fantasies for reality, as is traditionally assumed. Rather, I argue, they engage in a solipsistic mode of experience, a felt subjectivization of the lived world that is associated with (...) a stance of passivity and hyperconsciousness. I discuss the existential conditions and consequences of this stance and show that certain anomalous or paradoxical features of schizophrenic delusion are explicable on this phenomenological account. (shrink)

We review the hypothesis that the brain uses a generative model to explain the causes of sensory inputs, using prediction schemes that operate based upon assimilation of time-series sensory data. We put this hypothesis in the context of psychopathology, in particular, schizophrenia's positive symptoms. Building upon work of Helmholtz and upon theories in computational cognitive processing, we hypothesize that delusions in schizophrenia can be explained in terms of false inference. An impairment in inferring appropriate information from the sensory input reflects (...) upon the ability to assess the environment and predict outcomes. Although the inference mechanism likely involves both conscious and unconscious processes, we hypothesize that the trigger of delusions may lie within the unconscious neural pathways. A collection of computational predictive codes have been proposed for modeling perception. We discuss two examples, which may be eligible as substrates for intuitive coding. We argue that failure of the psychotic patient to choose the correct computational scheme, or the optimal range of parameters, may readily lead to an altered reconstruction of the object and false inference, feeding into the delusion mechanism. We finally propose using these models in conjunction with cognitive and imaging data, in order to obtain more testable predictions. (shrink)