According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision (...) in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

In order to explain delusional beliefs, one must first consider what factors should be included in a theory of delusion. Unlike a one-factor theory, a two-factor theory of delusion argues that not only anomalous experience (the first factor) but also an impairment of the belief-evaluation system (the second factor) is required. Recently, two-factor theorists have adopted various Bayesian approaches in order to give a more accurate description of delusion formation. By reviewing the progression from a one-factor theory to a two-factor (...) theory, I argue that in light of the second factor’s requirements, different proposed impairments can be unified within a consistent belief-evaluation system. Under this interpretation of the second factor, I further argue that the role of a mechanism responsible for detecting bizarreness is wrongly neglected. I conclude that the second factor is a compound system which consists of differing functional parts, one of which functions to detect bizarreness in different stages of delusion; moreover, I hold that the impairment can be one or several of these functional parts. (shrink)

Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed the (...) evidenceresponsiveness of belief and take this to show that delusions cannot be beliefs. Against this common assumption, I appeal to a large range of empirical evidence to argue that delusions are evidence-responsive in the sense that subjects have the capacity to respond to evidence on their delusion in rationally permissible ways. The extreme evidence-resistance of delusions is a consequence of powerful masking factors on these capacities, such as strange perceptual experiences, motivational factors, and cognitive biases. This view makes room for holding both that belief is constitutively evidence-responsive and that delusions are beliefs, and it has important implications for the study and treatment of delusions. (shrink)

This chapter considers some epistemic aspects of interactions with those who are believed to be delusional. The chapter makes five main claims: first, for the day-to-day purposes of most individuals, it is helpful to understand delusions as extreme epistemic failures, failures that all are guilty of to some degree. Second, one should be cautious when attributing delusions to others because to call someone delusional can act to discredit them, and this can be especially dangerous when applied to members of oppressed (...) groups. Third, delusional individuals can indeed be wronged by epistemic injustice. Fourth, epistemic responsibility for delusions needs to be extended beyond the individual holding delusional beliefs to the conditions that shape those beliefs. Finally, the virtue of epistemic humility offers several important epistemic benefits in interactions with delusional others. (shrink)

Se ha presentado mucha controversia, desde hace años, acerca de la capacidad de la psiquiatría para mantener estándares médico-científicos comparables a los de otras especialidades de la medicina. La tendencia más reciente, basada en una fuerte crítica a la última edición del dsm, hace un énfasis particular en tratar de caracterizar los trastornos mentales con base en las neurociencias y abandonar toda otra forma de abordarlos. Este artículo revisa dicha tendencia y propone un enfoque multidimensional, haciendo énfasis en la investigación, (...) con herramientas de la fenomenología, de la naturaleza experiencial de muchos trastornos psicopatológicos –especialmente las psicosis–, y mostrando su compatibilidad con el enfoque neurocientífico. (shrink)

The text concerns the role of emotions in delusion formation. Provided are definitions from DSM-V and DSM-IV-R and the problems found in those definitions. One of them, the problem of delusion formation, is described when providing cognitive theories of delusions. The core of the paper is a presentation of the emotional and affective disorders in delusions, especially Capgras delusion and Cotard delusion. The author provides a comparison of the kinds of delusions and the conclusions taken from neuroimaging studies. As a (...) result of the fact that an explanation of delusion formation focusing on emotional problems turns out to be insufficient, the author provides examples of the reasoning impairments which coexist with them. At the end of the article, some hypotheses are proposed concerning the role of emotions and reasoning in delusion formation and the relation between belief disorders and emotional disorders. (shrink)

Proceedings of the Aristotelian Society, Volume 115, Issue 3pt3, Page 277-306, December 2015.

Quasi-fideism accounts for the rationality of religious belief by embracing the idea that a subject’s most fundamental religious commitments are essentially arational. It departs from standard forms of fideism, however, by contending that this feature of religious commitment does not set it apart from belief in general. Indeed, the quasi-fideist maintains, in keeping with the Wittgensteinian hinge epistemology that underlies the view, that it is in the nature of belief in general (i.e. religious or otherwise) that it presupposes essentially arational (...) commitments, and hence that there can be no specific epistemic objection to religious belief due to it having this feature. This paper explores how quasi-fideism deals with the problems raised by fundamental religious disagreement. In particular, how is quasi-fideism to avoid the charge of epistemic relativism? It is argued that once we understand the arational nature of these fundamental commitments correctly, then quasi-fideism is able to avoid a problematic form of epistemic relativism. Relatedly, it can also explain how a subject’s basic religious commitments can change over time in rational ways. (shrink)

Contemporary epistemology has explored the notion of a hinge commitment as set out in Wittgenstein’s final notebooks, published as On Certainty. These are usually understood as essentially groundless certainties that provide the necessary framework within which rational evaluations can take place. John Greco has recently offered a striking account of hinge commitments as a distinctive kind of knowledge that he calls ‘common knowledge’. According to Greco, this is knowledge that members of the community get to have without incurring any epistemic (...) burden, and as such is fundamentally different from other kinds of knowledge. I offer a critique of Greco’s proposal. While I agree that there is a variety of knowledge that counts as common knowledge, I contend that it is not to be understood as knowledge that one gets for free as Greco suggests. Moreover, I argue that our hinge commitments do not count as common knowledge—either in Greco’s sense of the term or in the alternative manner that I set out—because properly understood they are not in the market for knowledge at all. In defence of this claim, I suggest that Greco’s conception of a hinge commitment is both missing some crucial elements and also too broad in its extension, in that it encompasses both instances of common knowledge and hinge commitments proper. (shrink)

Jakob Ohlhorst | : This paper introduces the concept of tragic self-deception. Taking the basic notion that self-deception is motivated belief against better evidence, I argue that there are extreme cases of self-deception even when the contrary evidence is compelling. These I call cases of tragic self-deception. Such strong evidence could be argued to exclude the possibility of self-deception; it would be a delusion instead. To sidestep this conclusion, I introduce the Wittgensteinian concept of certainties or hinges: acceptances that are (...) beyond evidential justification. One particular type of certainties—iHinges, which are adopted for motivational reasons—explain the phenomenon of tragic self-deception: they warrant the subject’s dismissal of the evidence without loss of rationality from the subject’s point of view. Subsequently, I deal with some objections that can be raised against this account of self-deception. | : Cet article présente le concept d’auto-illusion tragique. En prenant la notion de base selon laquelle l’auto-illusion consiste en une croyance motivée à l’encontre de meilleures preuves, je soutiens qu’il existe des cas extrêmes d’auto-illusion qui persistent même face à des preuves contradictoires incontestables. J’appelle ces cas : auto-illusion tragique. On pourrait soutenir que des preuves d’une telle force excluent la possibilité d’auto-illusion et qu’il s’agirait plutôt de délire. Afin d’éviter cette conclusion, j’introduis le concept wittgensteinien de certitudes ou de propositions charnières : des admissions qui se situent au-delà d’une justification de nature probante. Un type de certitudes en particulier – iHinges, qui sont adoptées pour des raisons d’ordre motivationnel – rend compte du phénomène d’auto-illusion tragique. Ces certitudes justifient que le sujet rejette la preuve sans que cela implique, de son propre point de vue, une perte de rationalité. Subséquemment, je traite de certaines objections qui peuvent être soulevées contre cette explication de l’auto-illusion. (shrink)

This paper offers an overview of the philosophical work on epistemic injustices as it relates to psychiatry. After describing the development of epistemic injustice studies, we survey the existing literature on its application to psychiatry. We describe how the concept of epistemic injustice has been taken up into a range of debates in philosophy of psychiatry, including the nature of psychiatric conditions, psychiatric practices and research, and ameliorative projects. The final section of the paper indicates future directions for philosophical research (...) of epistemic injustices and psychiatry, concerning neurocognitive disorders, identity prejudices in psychiatric illness, concepts of epistemic privilege in psychiatry, and the prospects for combining phenomenological psychopathology and epistemic justice. We argue that much remains to be done in the conceptualization of these epistemic injustices and suggest that this future work should be multidisciplinary in character and sensitive to the phenomenology of psychiatric conditions. (shrink)

Why do we tend to think that phenomenal consciousness poses a hard problem? The answer seems to lie in part in the fact that we have the impression that phenomenal experiences are presented to us in a particularly immediate and revelatory way: we have a sense of acquaintance with our experiences. Recent views have offered resources to explain such persisting impression, by hypothesizing that the very design of our cognitive systems inevitably leads us to hold beliefs about our own experiences (...) with certainty. I argue against this kind of “designed certainty” views. First, I claim that it is doubtful that we really hold beliefs about our own experiences with certainty—in any sense of certainty that would make our phenomenal beliefs special. Second, I claim that, even if it were the case that we hold beliefs about experiences with certainty, this would fall short of explaining our sense of acquaintance. (shrink)

Numerous studies of the beliefs of people with anorexia nervosa (AN) suggest that a subset of such individuals may experience delusions. We first describe what makes a belief delusional and conclude that such characteristics can be appropriately applied to some beliefs of people with AN. Next, we outline how delusional beliefs may relate to the broader psychopathological process in AN, including: (1) they may be epiphenomenal; (2) they may be an initial partial cause of AN; (3) they may be caused (...) by aspects of AN; or (4) they may be sustaining causes, possibly involved in reciprocal causal relations with aspects of AN. We argue that there is good reason to believe that delusional beliefs of people with AN are not merely epiphenomenal, but rather that they’re causally connected to AN. Because of this, empirical studies can be designed to test for the presence of causal relations. We describe how these studies should be designed. The results of such studies have important implications for understanding the experience of individuals with AN and for the treatment of AN. We outline these implications. (shrink)

Patients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common condition known as depersonalisation. Even though they (...) are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value. (shrink)