In recent times, explanations of the Capgras delusion have tended to emphasise the cognitive dysfunction that is believed to occur at the second stage of two-stage models. This is generally viewed as a response to the inadequacies of the one-stage account. Whilst accepting that some form of cognitive disruption is a necessary part of the aetiology of the Capgras delusion, I nevertheless argue that the emphasis placed on this second-stage is to the detriment of the important role played by the (...) phenomenology underlying the disorder, both in terms of the formation and maintenance of the delusional belief. This paper therefore proposes an interactionist two-stage model in which the phenomenal experience of the Capgras patient is examined, emphasised, and its relation to top-down processing discussed. (shrink)

This paper contrasts an interactionist account of delusional misidentification with more traditional one- and two-stage models. Unlike the unidirectional nature of these more traditional models, in which the aetiology of the disorder is said to progress from a neurological disruption via an anomalous experience to a delusional belief, the interactionist account posits the interaction of top-down and bottom-up processes to better explain the maintenance of the delusional belief. In addition, it places a greater emphasis on the patient’s underlying phenomenal experience (...) in accounting for the specificity of the delusional content. The role played by patient phenomenology is examined in light of Ratcliffe’s recent phenomenological account. Similarities and differences are discussed. The paper concludes that a purely phenomenological account is unable to differentiate between non-delusional patient groups, who have what appear to be equivalent phenomenal experiences to patients suffering from delusional misidentification but without the delusional belief, and delusional groups, something the interactionist model is able to do. (shrink)

In his recent book Delusions and Beliefs, Kengo Miyazono offers a thoroughgoing defence of delusions as biologically malfunctioning beliefs, greatly elaborating on his earlier defence of this view. Miyazono has it that delusions have biological doxastic functions, and that delusions involve direct or indirect malfunctions of this kind. In this short piece, I focus on Miyazono’s defence of a two-factor approach to delusion formation as it appears in Chapter Four. Miyazono approaches his discussion of the debate between one- and two-factor (...) theories having already defended the key thesis of the book: that delusions are malfunctioning beliefs. Of course, that thesis might be thought to mesh nicely with the two-factor theorist’s claim that there is a cognitive abnormality present in delusion formation or maintenance. However, I will discuss Miyazono’s defence of the two-factor position in isolation from its role in his overall account of delusion. Miyazono abstracts away from the particulars of Max Coltheart’s two-factor view, and takes himself to be investigating the plausibility of two-factor theories without the specific commitments of Coltheart’s view. Miyazono also captures under the two-factor heading theories which locate the second factor in belief maintenance rather than just in belief formation. He puts forward a new argument for a two-factor approach which goes via inference to the best explanation. I begin by arguing that Miyazono’s starting motivation for a two-factor approach rests on a misrepresentation of the one-factor approach. Then, I turn to the four components of Miyazono’s inference to the best explanation argument, and argue that in each case, we do not have grounds for positing a second factor. (shrink)

Young and colleagues . Betwixt life and death: case studies of the Cotard delusion. In P. W. Halligan & J. C. Marshall , Method in madness: Case studies in cognitive neuropsychiatry. Mahway, NJ: Lawrence Erlbaum Associates.) have suggested that cases of the Cotard delusion result when a particular perceptual anomaly occurs in the context of an internalising attributional style. This hypothesis has not previously been tested directly. We report here an investigation of attributional style in a 24-year-old woman with Cotard (...) delusion . LU’s attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire . A new measure of causal locus: the internal, personal and situational attributions questionnaire. Personality and Individual Differences, 20, 261–264.). LU showed a significantly greater proportion of internalising attributions than the control group, both overall and for negative events specifically. The results obtained thus support an association of Cotard delusion with an internalising attributional style, and are therefore consistent with the account of Young and colleagues. The potential brain basis of Cotard delusion is discussed. (shrink)

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate (...) the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience. (shrink)

Monothematic delusions involve a single theme, and often occur in the absence of a more general delusional belief system. They are cognitively atypical insofar as they are said to be held in the absence of evidence, are resistant to correction, and have bizarre contents. Empiricism about delusions has it that anomalous experience is causally implicated in their formation, whilst rationalism has it that delusions result from top down malfunctions from which anomalous experiences can follow. Within empiricism, two approaches to the (...) nature of the abnormality/abnormalities involved have been touted by philosophers and psychologists. One-factor approaches have it that monothematic delusions are a normal response to anomalous experiences whilst two-factor approaches seek to identify a clinically abnormal pattern of reasoning in addition to anomalous experience to explain the resultant delusion. In this paper we defend a one-factor approach. We begin by making clear what we mean by atypical, abnormal, and factor. We then identify the phenomenon of interest and overview one and two-factor empiricism about its formation. We critically evaluate the cases for various second factors, and find them all wanting. In light of this we turn to our one-factor account, identifying two ways in which ‘normal response’ may be understood, and how this bears on the discussion of one-factor theories up until this point. We then conjecture that what is at stake is a certain view about the epistemic responsibility of subjects with delusions, and the role of experience, in the context of familiar psychodynamic features. After responding to two objections, we conclude that the onus is on two-factor theorists to show that the one-factor account is inadequate. Until then, the one-factor account ought to be understood as the default position for explaining monothematic delusion formation and retention. We don’t rule out the possibility that, for particular subjects with delusions there may be a second factor at work causally implicated in their delusory beliefs but, until the case for the inadequacy of the single factor is made, the second factor is redundant and fails to pick out the minimum necessary for a monothematic delusion to be present. (shrink)

In this paper I discuss the role played by disturbed phenomenology in accounting for the formation and maintenance of the Capgras delusion. Whilst endorsing a two-stage model to explain the condition, I nevertheless argue that traditional accounts prioritise the role played by some form of second-stage cognitive disruption at the expense of the significant contribution made by the patient’s disturbed phenomenology, which is often reduced to such uninformative descriptions as “anomalous” or “strange”. By advocating an interactionist model, I argue that (...) the delusional belief constitutes an attempt on the part of the patient to explain his/her initially odd and somewhat disturbed phenomenal content and, moreover, that the delusion then structures the patient’s experience such that what he/she perceives is an impostor. This fact is used to explain the delusional belief’s maintenance and resistance to revision. Thus, whilst accepting that second-stage cognitive disruption has a part to play in explaining the Capgras delusion, the emphasis here is placed on the role played by the patient’s changing phenomenal content and its congruence with the delusional belief. Unlike traditional two-stage models, which posit a unidirectional progression from experience to belief, the interactionist model advocates a two-way interaction between bottom-up and top-down processes. The application of this model to other delusional beliefs is also considered. (shrink)

Explanations of Capgras delusion and prosopagnosia typically incorporate a dual-route approach to facial recognition in which a deficit in overt or covert processing in one condition is mirror-reversed in the other. Despite this double dissociation, experiences of either patient-group are often reported in the same way – as lacking a sense of familiarity toward familiar faces. In this paper, deficits in the facial processing of these patients are compared to other facial recognition pathologies, and their experiential characteristics mapped onto the (...) dual-route model in order to provide a less ambiguous link between facial processing and experiential content. The paper concludes that the experiential states of Capgras delusion, prosopagnosia, and related facial pathologies are quite distinct, and that this descriptive distinctiveness finds explanatory equivalence at the level of anatomical and functional disruption within the face recognition system. The role of skin conductance response as a measure of ‘familiarity’ is also clarified. (shrink)

Descartes was certain that he was thinking and he was accordingly certain that he existed. Like Descartes, we seem to be more certain of our thoughts and our existence than of anything else. What is less clear is the reason why we are thus certain. Philosophers throughout history have provided different interpretations of the cogito, disagreeing both on the kind of thoughts it characterizes and on the reasons for its cogency. According to what we may call the empiricist interpretation of (...) the cogito, I can only claim to be certain of having experiences, and this certainty, as well as that of my own existence, stems from their phenomenal and subjective character. According to rationalist interpretations, on the other hand, I am certain of having some self-reflexive propositional attitudes, and this certainty derives from their rational features. Psychiatric patients suffering from acute forms of depersonalization or of the Cotard syndrome often doubt that they think and exist, and might even believe that they don't. I argue that their study allows us to favor the empiricist interpretation of the cogito. (shrink)

Basic self-awareness is the kind of self-awareness reflected in our standard use of the first-person. Patients suffering from severe forms of depersonalization often feel reluctant to use the first-person and can even, in delusional cases, avoid it altogether, systematically referring to themselves in the third-person. Even though it has been neglected since then, depersonalization has been extensively studied, more than a century ago, and used as probe for understanding the nature and the causal mechanisms of basic self-awareness. In this paper, (...) I argue that depersonalized patients indeed have an impaired basic self-awareness, and that their study allows us both to favor one specific theory of basic self-awareness and to understand what is wrong with its rivals. According to the favored theory, which I call Cartesian, we are basically self-aware in virtue of being acquainted with ourselves through introspection. (shrink)

Basic self-awareness is the kind of self-awareness reflected in our standard use of the first-person. Patients suffering from severe forms of depersonalization often feel reluctant to use the first-person and can even, in delusional cases, avoid it altogether, systematically referring to themselves in the third-person. Even though it has been neglected since then, depersonalization has been extensively studied, more than a century ago, and used as probe for understanding the nature and the causal mechanisms of basic self-awareness. In this paper, (...) I argue that depersonalized patients indeed have an impaired basic self-awareness, and that their study allows us both to favor one specific theory of basic self-awareness and to understand what is wrong with its rivals. According to the favored theory, which I call Cartesian, we are basically self-aware in virtue of being acquainted with ourselves through introspection. (shrink)

Many philosophers regard the persistence of philosophical disputes as symptomatic of overly ambitious, ill-founded intellectual projects. There are indeed strong reasons to believe that persistent disputes in philosophy (and more generally in the discourse at large) are pointless. We call this the pessimistic view of the nature of philosophical disputes. In order to respond to the pessimistic view, we articulate the supporting reasons and provide a precise formulation in terms of the idea that the best explanation of persistent disputes entails (...) that they are pointless. We then show how to answer the pessimistic argument. Taking a well-known mathematical controversy as our paradigm example, we argue that some persistent disputes reflect substantive disagreements at the “meta-analytic” level, i.e., disagreements about the best way, among quite different candidates, to understand the topic at issue, and the best associated cluster of analytic truths one should accept concerning it. Moreover, our concrete example shows that such meta-analytic disagreements can in principle be settled and yield a genuine theoretical (as opposed to merely pragmatic) breakthrough. We conclude optimistically that persistent disputes can be an important means of fostering epistemic progress. (shrink)