A number of philosophers have argued that psychiatric delusions threaten Donald Davidson's rationalist account of intentional agency. I argue that a careful look at both Davidson's account and psychiatric delusions shows that, in fact, the two are perfectly compatible. Indeed, a Davidsonian perspective on psychiatric delusions proves remarkably illuminating.

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)

Though the divide between reason-based and causal-explanatory approaches in psychiatry and psychopathology is old and deeply rooted, current trends involving multi-factorial explanatory models and evidence-based approaches to interpersonal psychotherapy, show that it has already been implicitly bridged. These trends require a philosophical reconsideration of how reasons can be causes. This paper contributes to that trajectory by arguing that Donald Davidson’s classic paradigm of 1963 is still a valid option.

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)

Recientemente, algunos críticos del enfoque davidsoniano de la atribución intencional han señalado que el mismo no puede ser aplicado para el caso de los delirios psiquiátricos, dado que las creencias delirantes no satisfacen los requisitos de racionalidad que este impone. En este trabajo: i) reconstruyo, a partir del análisis del caso del delirio de Capgras, la crítica a la idea de que solo podemos interpretar a un agente con creencias irracionales si mantiene aún un trasfondo de racionalidad; ii) objeto la (...) misma y argumento que este delirio no representa un verdadero contraejemplo ya que un examen adecuado del mismo muestra que los sujetos con delirio de Capgras conservan un trasfondo de racionalidad. Señalaré así, que las condiciones mínimas para que la atribución de estados intencionales tenga lugar se encuentran garantizadas. (shrink)

En el presente artículo me concentraré en el estudio filosófico de los delirios, como un caso ejemplificador del vínculo que pueden establecer la filosofía de la mente y la psiquiatría. Frente a versiones radicalmente naturalistas, que proponen variantes reduccionistas o eliminativistas para la explicación de ciertos fenómenos mentales y sus variantes “anormales”, defenderé una versión moderada de la perspectiva naturalista. Al respecto, señalaré que retener algún grado de simpatía hacia el naturalismo en las investigaciones filosóficas sobre los delirios es necesario (...) para desarrollar teorías sobre las creencias empíricamente informadas que no resulten contradictorias con los desarrollos actuales en psicología cognitiva y neurociencias. No obstante, afirmaré también que una perspectiva exclusivamente naturalista -tanto por parte de la filosofía como de la psiquiatría misma- es incapaz de dar cuenta del contexto normativo en donde juegan las creencias. Los criterios normativos, especialmente externos que se emplean para clasificar ciertas creencias como delirantes no resultan inteligibles bajo una explicación puramente natural. Por el contrario, para comprender las creencias delirantes qua delirantes, será preciso acercarnos a un abordaje híbrido que pueda contemplar las causas naturales del fenómeno así como su evaluación normativa. (shrink)

Actualmente se debate si el enfoque davidsoniano de la atribución intencional puede extenderse a casos de sujetos delirantes que sufren diversos trastornos psiquiátricos. En particular, respecto a los casos graves de esquizofrenia, se ha afirmado que debido a las características que presentan los sujetos diagnosticados, éstos no podrían satisfacer los requisitos de racionalidad estipulados por Davidson para ser considerados agentes intencionales. Por lo tanto, en tales casos no sería posible siquiera identificar los contenidos mentales de sus delirios. En este artículo (...) desafiaré esta perspectiva y, vinculando la discusión sobre racionalidad animal y racionalidad en sujetos con esquizofrenia, sostendré que, una vez revisados y matizados algunos principios del enfoque davidsoniano, éste puede extenderse gradual y legítimamente a sujetos con esquizofrenia, incluso en casos de gravedad. Asimismo, propondré dos estrategias metodológicas que permitan generar evidencia a favor de la atribución de –al menos– algunas creencias simples a estos sujetos, sin tener que dejar de tratarlos como agentes con algún grado de intencionalidad. (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)

Clinical delusions have traditionally been characterized as beliefs in psychiatry. However, philosophers have recently engaged with the empirical literature and produced a number of objections to the so-called doxastic status of delusion, stemming mainly from the mismatch between the functional role of delusions and that expected of beliefs. In response to this, an appeal to dispositionalism about the nature of belief has been proposed to vindicate the doxastic status of delusion. In this paper, I first present the objections to attributing (...) beliefs to delusional patients and the application of dispositionalism in the attempt to vindicate doxasticism. I then assess this application and some responses to the objections to the doxastic characterization. Finally, I offer some conclusions about the limits of folk-psychological concepts in the characterization and explanation of complex psychological phenomena such as delusions. (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)

Psychedelic substances elicit powerful, uncanny conscious experiences that are thought to possess therapeutic value. In those who undergo them, these altered states of consciousness often induce shifts in metaphysical beliefs about the fundamental structure of reality. The contents of those beliefs range from contentious to bizarre, especially when considered from the point of view of naturalism. Can chemically induced, radically altered states of consciousness provide reasons for or play some positive epistemic role with respect to metaphysical beliefs? In this paper, (...) I discuss a view that has been underexplored in recent literature. I argue that psychedelic states can be rationally integrated into one’s epistemic life. Consequently, updating one’s metaphysical beliefs based on altered states of consciousness does not have to constitute an instance of epistemic irrationality. (shrink)

Dans ce qui suit, je décrirai un modèle pour la formation et la maintenance des délires polythématiques rencontrés dans la schizophrénie, en adéquation avec le modèle pour les délires décrit par Brendan Maher. Les délires polythématiques y sont considérés comme les conclusions d’arguments déclenchés par l’apophénie et qui comportent des erreurs de raisonnement très communes, telles que le sophisme post hoc et le bais de confirmation. Je décris tout d’abord la structure du raisonnement qui conduit au délire de référence, de (...) télépathie et d’influence, en distinguant entre les arguments délirants de type primaire, secondaire, tertiaire et quaternaire. Ces quatre niveaux d’arguments correspondent respectivement à une phase de nature instancielle, inductive, interprétative au niveau monothématique et, enfin, interprétative au niveau polythématique. Je m’attache ensuite à déterminer de manière précise quelles sont les étapes fallacieuses dans le raisonnement correspondant. J’expose également le rôle de l’apophénie dans l’élaboration des idées délirantes. Enfin, je m’attache à décrire le rôle joué par les hallucinations dans le présent modèle.We proceed to describe a model for the formation and maintenance of polythematic delusions encountered in schizophrenia, which is in adequation with Brendan Maher’s account of delusions. Polythematic delusions are considered here as the conclusions of arguments triggered by apophenia that include some very common errors of reasoning such as post hoc fallacy and confirmation bias. We describe first the structure of reasoning which leads to delusions of reference, of telepathy and of influence, by distinguishing between the primary, secondary, tertiary and quaternary types of delusional arguments. These four levels of arguments correspond to a stage the nature of which is repectively instantial, inductive, interpretative at a monothematic level and interpretative at a polythematic level. We also proceed to identify accurately the fallacious steps in the corresponding reasoning. We expose then the role of apophenia in the elaboration of delusional ideas. Lastly, we describe the role played by the hallucinations in the present model. (shrink)

RésuméCet article examine la manière dont Michel Foucault se rapporte à la psychologie et à la psychopathologie phénoménologiques dans les années 1950, à la lumière des nouvelles sources documentaires que nous avons aujourd’hui à notre disposition. Notre contribution se concentre en particulier sur le manuscrit inédit de l’un des cours donnés par Foucault à l’université de Lille entre 1952 et 1954 : le cours sur « Binswanger et la phénoménologie ». L’analyse de ce cours, conçu par Foucault dans le contexte (...) d’une réflexion philosophique sur le problème anthropologique de la psychopathologie, nous permettra enfin de restituer à Foucault la place qui lui revient dans le domaine de la « philosophie de la psychiatrie ». (shrink)

Résumé Cet article expose les tendances actuelles de ce nouveau domaine de recherche qu’est la « philosophie de la psychiatrie » à travers son évolution dans la dernière décade. La première partie se concentre sur le passage d’une approche strictement conceptuelle des thèses issues du savoir psychiatrique à une approche qui prend en compte également les dimensions sociales, pratiques et cliniques de cette discipline. La seconde partie de l’article montre comment l’exigence d’un engagement mutuel de la philosophie et de la (...) psychiatrie a été diversement perçue selon les pays engagés dans le programme de la philosophie de la psychiatrie. L’article s’intéresse en particulier à la France, où l’enthousiasme pour la « nouvelle philosophie de la psychiatrie » n’a pas eu le même retentissement sur la scène philosophique que dans les pays anglophones. Enfin cette contribution montre comment le domaine de la philosophie de la psychiatrie se présente comme un terrain fécond pour de nouvelles formes d’interaction entre la tradition analytique et la tradition continentale, en particulier à partir de la réflexion sur les thèmes de la normativité, du langage et de l’interprétation. (shrink)

The present thesis surveys different philosophical approaches to the nature of delusions: specifically, their ontology. However, since none of the various theories of the nature of delusions succeeds, I argue that there must be something problematic about the form of the analyses commonly offered. My general conclusion is that one cannot characterize delusions without taking away what it is distinctive about them.

Jaspers’s binary distinction between understanding and explanation has given way first to a proliferation of explanatory levels and now, in John Campbell’s recent work, to a conception of explanation with no distinct levels of explanation and no inbuilt rationality requirement. I argue that there is still a role for understanding in psychiatry and that is to demystify the assumption that the states it concerns are mental. This role can be fulfilled by placing rationality at the heart of understanding without a (...) commitment to the attempt to use rationality to shed light on interpretation and mindedness as though from outside those notions. Delusions still present a significant challenge to philosophical attempts at understanding, but this merely reflects the genuine clinical difficulties such states present. (shrink)