This thesis develops a novel framework for explaining delusions. In Chapter 1, I introduce the two fundamental challenges posed by delusions: the evidence challenge lies in explaining the flagrant ways delusions flout evidence; and the specificity challenge lies in explaining the fact that patients’ delusions are often about a few specific themes, and patients rarely have a wide range of delusional or odd beliefs. In Chapter 2, I discuss the strengths and weaknesses of current theories of delusions, which typically appeal (...) to one or both of two factors: anomalous experience and reasoning abnormality. I argue that anomalous experience can help explain the specificity of delusions, but has difficulties in addressing the evidence challenge; reasoning abnormality can help address the evidence challenge, but has difficulties in explaining the specificity of delusions. This suggests that there may be an important factor that has not been captured by current theories of delusions. To search for this missing factor, in Chapter 3, I turn to normal believing. Inspired by the literature on Cartesian clarity and phenomenal dogmatism, I develop a dual-force framework of believing, according to which beliefs can be understood as the results of the interaction between the justificatory force and causal force of evidence and the justificatory force and causal force of clear experience, in which something clearly seems to be so to the subject. This framework suggests that the missing factor may be the clear experience with its distinctive phenomenal clarity that compels assent. In Chapter 4, I return to delusions, and argue that the dualforce framework can help us to get a better grip on some personal descriptions of delusions; make progress in addressing the evidence and specificity challenges of delusions; and shed new light on the underpinnings of delusions. In the end, I conclude with some remaining questions for future study. (shrink)

We challenge Gallagher’s distinction between the sense of ownership (SO) and the sense of agency (SA) as two separable modalities of experience of the minimal self and argue that a careful investigation of the examples provided to promote this distinction in fact reveals that SO and SA are intimately related and modulate each other. We propose a way to differentiate between the various notions of SO and SA that are currently used interchangeably in the debate, and suggest a more gradual (...) reading of the two that allows for various blends of SO and SA. Such an approach not only provides us with a richer phenomenology but also with a more parsimonious view of the minimal self. (shrink)

In this experimental piece of writing I want to think about the pedagogy of contact and the plight of the hikikomori or social recluse in Japan. I am interested in exploring how the hikikomori practices a kind of contactlessness or what I will call a deadly ipseity of desire. What does it mean to resist contact, to be without contact, to be without desire? What does it mean to risk contact, to risk being tactile with the other, to risk affirming (...) one’s desires? I want to generate a discussion about what has happened to desire, to its promise and possibility and why it is so difficult to anticipate or forecast what is to come. For me the BwO of hikikomori is the ruin of desire, the collapse of desire, a disaster of desire. I am pursuing a line of thought which highlights the loss of the possibility of processual schizophrenic breakthrough and in its place the becoming-autistic of the self, the perilous breakdown of the self. (shrink)

Phenomenally, we can distinguish between ownership of thought (introspective awareness) and authorship of thought (an awareness of the activity of thinking), a distinction prompted by the phenomenon of thought insertion. Does this require the independence of ownership and authorship at the structural level? By employing a Kantian approach to the question of ownership of thought, I argue that a thought being my thought is necessarily the outcome of the interdependence of these two component parts (ownership and authorship). In addition, whilst (...) still employing a Kantian approach, I speculate over possible mechanisms underlying the phenomenon of thought insertion. (shrink)

In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge (...) and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (shrink)

This paper has two themes. One is the question of how to understand the relation between inner speech and knowledge of one’s own thoughts. My aim here is to probe and challenge the popular neo-Rylean suggestion that we know our own thoughts by ‘overhearing our own silent monologues’, and to sketch an alternative suggestion, inspired by Ryle’s lesser-known discussion of thinking as a ‘serial operation’. The second theme is the question whether, as Ryle apparently thought, we need two different accounts (...) of the epistemology of thinking, corresponding to the distinction between thoughts with respect to which we are active vs passive. I suggest we should be skeptical about the assumption that there is a single distinction here. There are a number of interesting ways in which thinking can involve passivity, but they provide no support for a ‘bifurcationist’ approach to the epistemology of thinking. (shrink)

Delusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: delusions are meaningful, despite being described as irrational and implausible beliefs; some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. (...) Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions. (shrink)

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

In recent years, phenomenologically informed philosophers, psychologists and psychiatrists have attempted to import philosophical notions associated with the self into the empirical study of pathological experience. In particular, so-called ipseity disturbances have been put forward as generative of symptoms of schizophrenia, and several attempts have been made to operationalize and measure kinds and degrees of ipseity disturbances in schizophrenia. However, we find that this work faces challenges caused by the fact that the notion of ipseity is used ambiguously, both in (...) the philosophical and in the empirical discussion, and the methods employed to operationalize ipseity often portray a rather different understanding of the notion from that found in the literature that is cited as providing the philosophical foundation for the studies in question. In particular, according to the definitions found in the philosophical literature, while being phenomenologically available, the self is not represented in ipseity. However, when it comes to the empirical study of ipseity and its disturbances, the object of investigation is often a kind of explicit self-representation. As a result, it is unclear whether different researchers are really talking about the same thing. Future progress in this area will require more careful conceptual distinctions; the present article aims to contribute to this task. (shrink)

The notion of minimal, basic, pre-reflective or core self is currently debated in the philosophy of mind, cognitive sciences and developmental psychology. However, it is not clear which experiential features such a self is believed to possess. Studying the schizophrenic experience may help exploring the following aspects of the minimal self: the notion of perspective and first person perspective, the ‘mineness’ of the phenomenal field, the questions of transparency, embodiment of point of view, and the issues of agency and ownership, (...) considered as different and less fundamental than the feeling of mineness. Two clinical vignettes of patients with the diagnosis of schizophrenia will be presented: the first one, illustrating early illness stages, and the second case, of chronic schizophrenia, symptomatically marked by persistent hallucinations. Through their analysis, we will discuss the experiential dimensions of minimal self. (shrink)

Stephens and Graham maintain that in cases of thought insertion, the sense of ownership is preserved, but there is a defect in the sense of agency. However, these theorists overlook the possibility that subjectivity might be preserved despite a defect in the sense of ownership. The claim that schizophrenia centers upon a loss of a sense of ownership is supported by an examination of some of the other notable disownership symptoms of the disorder, such as bodily alienation and experiences of (...) “unworlding.” Is there a way to make sense of the “underlying characteristic modification” that ties together the various symptoms of schizophrenia and disrupts subjects’ “hold” on their own bodies and surroundings? I will argue that what accounts for subjects’ usual sense of ownership are fully embodied processes of causal-contextual information integration, which are made possible by subjects’ affective framing patterns. Attenuated affective framings lead to a loss of a sense of ownership and cause subjects to lose their “grip” on bodily sensations and mental states, which ultimately can result in experiences of thought insertion. I will conclude with some brief remarks about implications for treatment, and point to several body-centered intervention methods that might help to restore subjects’ sense of ownership. (shrink)

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion (...) and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initi... (shrink)

This article examines the supposedly incomprehensibility of schizophrenic delusions. According to the contemporary classificatory systems (DSM-IV-TR and ICD-10), some delusions typically found in schizophrenia are considered bizarre and incomprehensible. The aim of this article is to discuss the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion (...) of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning in terms of motivations, desires, and other more straightforward psychological connections between mental states is impossible in schizophrenia, we can in fact have a philosophical understanding of the schizophrenic world and of the emergence of delusions typically found in schizophrenia. (shrink)

Drawing upon core phenomenological contributions of the last decades, the present paper provides an integrated description of the development of auditory hallucinations in schizophrenia. Specifically, these contributions are the transitional sequences of development of psychotic symptoms of schizophrenia as envisioned by Klosterkötter and rooted in the basic symptoms approach, Conrad’s Gestalt-analysis of developing psychosis, and Sass and Parnas’ self-disturbance approach. Klosterkötter’s contribution provides a general descriptive psychopathological approach to the transitional sequence of the development of auditory hallucinations. The key concepts (...) in Conrad’s proposal are discussed, as their role is central as driving forces of the process from non-psychotic symptoms to overt hallucinations. Finally, Parnas and Sass link psychiatry to philosophy and psychology, and provide an in-depth and thorough description of these phenomena in their work on schizophrenia as a disorder of consciousness and self-experience with hyper-reflexivity and diminished self-affection as key aspects. (shrink)

Theories of thought insertion have tended to favour either the content of the putatively alien thought or some peculiarity within the experience itself as a means of explaining why the subject differentiates one thought from another in terms of personal ownership. There are even accounts that try to incorporate both of these characteristics. What all of these explanations share is the view that it is unexceptional for us to experience thought as our own. The aim of this paper is to (...) consider the means by which this awareness of the myness of thought occurs. Why is it that I, as the subject of thought, typically experience a thought as mine? Using research which investigates the development of a child’s awareness of the act of thinking, I will evaluate leading explanations of thought insertion. It is my contention that by understanding the means by which the awareness of one’s ownership of thought develops, we can better assess explanations of thought insertion; and whilst, at present, no theory is fully able to explain the condition, the incorporation of developmental research suggest that we should favour one in particular. (shrink)

By examining first-person descriptions of thought insertion I show that thought insertion is a complex and heterogeneous phenomenon. People experiencing this phenomenon have huge difficulty explaining what it is like due to the bizarre nature of the experience. Through careful analysis of first-person descriptions I identify some of the characteristics of thought insertion. I then briefly examine some of the philosophical literature regarding agency, ownership and thought insertion and conclude that the standard account of the basic characteristics of thought insertion (...) is inadequate when we consider the phenomenon as it is experienced. First person descriptions suggest that thought insertion is characterised by a lack of personal ownership and not simply by a loss of agency or authorship. This is an important factor that should inform research and therapeutic intervention. We cannot hope to arrive at appropriate therapeutic intervention or identify underlying neuronal mechanisms for the experience if we cannot say what the experience actually is. I further suggest that more analysis of first-person description is required for an improved account of the phenomenology of thought insertion. (shrink)

Jennifer Radden has drawn attention to two features of delusion, ambivalence and subjectivity, which are problematic for theories of delusion that treat delusions as empirical beliefs. She argues for an ‘attitude’ theory of delusion. I argue that once the cognitive architecture of delusion formation is properly described the debate between doxastic and attitude theorists loses its edge. That architecture suggests that delusions are produced by activity in the ‘default mode network’ unsupervised by networks required for decontextualized processing. The cognitive properties (...) of these networks explain the features of delusion which generate the debate between doxastic and attitude theorists. (shrink)

Several enactive-phenomenological perspectives have pointed to affectivity as a central aspect of mental disorders. Indeed, from an enactive perspective, sense-making is an inherently affective process. A question remains on the role of different forms of affective experiences (i.e., existential feelings, atmospheres, moods, and emotions) in sense-making and, consequently, in mental disorders. This work elaborates on the enactive perspective on mental disorders by attending to the primordial role of affectivity in the self-individuation process. Inspired by Husserl’s genetic methodology and Simondonian philosophy (...) of individuation, sense-making is described as the process of progressive concretization and structuration of the self-world structures that support the intentionality of conscious experiences. Accordingly, affectivity is described as the force that anticipates a partial self-world coherence in sense-making. Structurally different types of affective experiences are integrated into the genetic picture and, on this basis, a reinterpretation and classification of certain mental disorders, such as schizophrenia, depression, and the anxiety spectrum, is provided. In this way, this work contributes to a phenomenologically informed enactive account of mental disorders as disorders of affectivity. (shrink)

I offer an account of thought insertion based on a certain model of self-knowledge. I propose that subjects with thought insertion do not experience being committed to some of their own beliefs. A hypothesis about self-knowledge explains why. According to it, we form beliefs about our own beliefs on the basis of our evidence for them. First, I will argue that this hypothesis explains the fact that we feel committed to those beliefs which we are aware of. Then, I will (...) point to one feature of schizophrenia that suggests that subjects with thought insertion may not be able to know their own beliefs in that way. (shrink)

Schizophrenia spectrum has been associated with a disruption of the basic sense of self, which pertains, among others, the representation of one’s own body. We investigated the impact of either implicit or explicit access to the representation of one’s own body-effectors on bodily self-awareness, in first-episode schizophrenia patients and healthy controls . We contrasted their performance in an implicit self-recognition task and in an explicit self/other discrimination task. Both tasks employed participant’s own and others’ body-effectors. Concerning the implicit task, HCs (...) were more accurate with their own than with others’ body-effectors, whereas patients did not show such self-advantage. Regarding the explicit task, both groups did not exhibit a self-advantage, and patients showed a higher percentage of self-misattribution errors. Neither self/other nor implicit/explicit effects were found in both groups when processing inanimate-objects. We propose that FES patients suffer of a disturbed implicit sense of bodily self. (shrink)

We investigate the nature of the sense of presence that usually accompanies perceptual experience. We show that the notion of a sense of presence can be interpreted in two ways, corresponding to the sense that we are acquainted with an object, and the sense that the object is real. In this essay, we focus on the sense of reality. Drawing on several case studies such as derealization disorder, Parkinson’s disease and virtual reality, we argue that the sense of reality is (...) two-way independent from the spatial and sensory contents of experience. We suggest that the sense of reality is an affective experience akin to a metacognitive feeling. Finally, we present a potentially important implication of our account for the current debate between Intentionalism and Naïve Realism. Since perception is “opaque” with respect to the reality of what is perceived, Intentionalism cannot refer to the sense of reality as what differentiates perception from sensory-like experiences such as imaginings. In contrast, Naïve Realism has an independent explanation of the specificity of perception. (shrink)

We challenge Gallagher’s distinction between the sense of ownership and the sense of agency as two separable modalities of experience of the minimal self and argue that a careful investigation of the examples provided to promote this distinction in fact reveals that SO and SA are intimately related and modulate each other. We propose a way to differentiate between the various notions of SO and SA that are currently used interchangeably in the debate, and suggest a more gradual reading of (...) the two that allows for various blends of SO and SA. Such an approach not only provides us with a richer phenomenology but also with a more parsimonious view of the minimal self. (shrink)

There has recently been a resurgence of philosophical and scientific interest in the foundations of self-consciousness, with particular focus on its altered, anomalous forms. This paper looks at the altered forms of self-awareness in Depersonalization Disorder (DPD), a condition in which people feel detached from their self, their body and the world (Derealisation). Building upon the phenomenological distinction between reflective and pre-reflective self-consciousness, we argue that DPD may alter thetransparencyof basic embodied forms of pre-reflective self-consciousness, as well as the capacity (...) to flexibly modulate and switch between the reflective and pre-reflective facets of self-awareness. Empirical evidence will be invoked in support of the idea that impaired processing of bodily signals is characteristic of the condition. We provide first-hand subjective reports describing the experience of self-detachment or fracture between an observing and an observed self. This split is compared with similar self-detachment phenomena reported in certain Buddhist-derived meditative practices. We suggest that these alterations and changes may reveal the underlying and tacit transparency that characterises the embodied and basic pre-reflective forms of self-consciousness, in the same way that a crack in a transparent glass may indicate the presence of an unnoticed window. (shrink)

ABSTRACTA cognitive autopoietic system is a dynamic, self-generating, organized and self-organizing thing which self-regulates with respect to an external medium. The present model of the effect of stress on a cognitive autopoietic system captures the notion of how a priori cognitive structures, combined with external sensations, constitute the basis for the development of cognitive structures and their architecture. The ESCA model integrates the fact that the mind–environment relation has a twofold effect: on one hand, it enables self-regulation of mind, but (...) on the other hand, it poses a potential perturbation on the same, which may result in the breakdown of the self-regulation of mind. The architecture of the CS developed on the basis of the ESCA model is consistent with the manifestations of the effect of stress on mind behavior at different levels. The ESCA model predicts that the faculty to concatenate... (shrink)

ABSTRACTThis paper examines critically the notion of reflection as self-objectification and points out its insufficiency in accounting for the pathological phenomenon of hyperreflexivity. It proposes an understanding of reflection as situated and motivated from within a world and having a normative aspect that concerns the very life of the reflecting person. On this account, the paper argues, on the one hand, that both phenomenological reflection and hyperreflexivity can be viewed as forms of reflection characterized by loss of the world. On (...) the other hand, by construing the phenomenological loss as imaginative vis-à-vis the real loss of hyperreflexivity, the paper emphasizes a difference between the two domains. (shrink)

In this study I explore from a phenomenological perspective the relationship between affectivity and narrative self-understanding in depression. Phenomenological accounts often conceive of the disorder as involving disturbances of the narrative self and suggest that these disturbances are related to the alterations of emotions and moods typical of the illness. In this paper I expand these accounts by advancing two sets of claims. In the first place, I suggest that, due to the loss of feeling characteristic of the illness, the (...) narratives with which the patients identified prior to the onset of depression are altered in various ways, thus leading to the weakening or abandonment of the narratives themselves. I then move to show that these autobiographical narratives are replaced by new stories which possess a distinctive structure and I argue that this is dependent upon specific configurations of affective experience, such as existential feelings of guilt, hopelessness, and isolation, and particular forms of temporal and spatial experience. (shrink)

In the contemporary phenomenological literature it has been argued that it is possible to distinguish between two forms of selfhood: the “minimal” and “narrative” self. This paper discusses a claim which is central to this account, namely that the minimal and narrative self complement each other but are fundamentally distinct dimensions. In particular, I challenge the idea that while the presence of a minimal self is a condition of possibility for the emergence of a narrative self, the dynamics which characterise (...) narrative selfhood do not have a structuring effect on minimal self-experience. I do so by drawing on both classical and contemporary phenomenological literature to show that at least certain forms of affective experience are complex phenomena in which minimal and narrative forms of selfhood are deeply entwined. More specifically, I claim that, due to their evaluative character, intentional and non-intentional affective states convey a pre-reflective experience of constitutive aspects of the narrative self. This enables me to argue that minimal and narrative selfhood are phenomenologically inextricable. (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)

I argue that ordinary confabulation is a side-effect of an interpretive faculty that makes sense of the world by rationalising our experience within the context of a personal and cultural narrative. However, I argue that a hyperactivity of the same process manifests as schizotypy—latent schizophrenic tendencies—that can lead to extreme dissociation of interpretation from experience. I first give a phenomenological account of the process of interpretation, arguing that it is enacted through the creation of conceptual cognitive content from an originary (...) non-conceptual experience. I then ground this account in empirical evidence, showing how our direct perception is moulded and adapted as it is conceptualised to fit our individual and collective expectations. Finally, I argue that hyperactive over-interpretation results in schizotypic dissociation, thus suggesting that schizophrenia should be understood as a disorder of interpretation, the extreme end of a spectrum that includes ordinary confabulation. (shrink)

Delusions are often thought of as the hallmark of irrationality. Accepted definitions of delusion are cast in terms of epistemic features that reflect irrationality: impossibility or falsity of con...

Delusion is one of the most intriguing psychopathological phenomena and its conceptualization remains the subject of genuine debate. Claims that it is ill-defined, however, are typically grounded on essentialist expectations that a given definition should capture the core of every instance acknowledged as delusion in the clinical setting.

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.

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

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)

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)

In this paper we focus on the psychiatric approach of Open Dialogue and seek to explain why the intersubjective process of dialogue, one of OD’s core clinical principles, is effective in schizophrenia treatment. We address this question from an interdisciplinary viewpoint, by linking the OD approach with a theoretical account of the self as endorsed by enactive cognitive science. The paper is structured as follows: first, we introduce the OD approach and focus in particular on the principles that are characteristic (...) of the dialogical therapeutic attitude. Second, we clarify our stance on the concept of schizophrenia by relying on insights from phenomenological psychiatry. Third, we introduce an enactive perspective on mental disorders, which elaborates on phenomenological psychiatry and conceives of the self as a self-organizing system, brought forth through interactional processes. Based on this enactive approach, we draw clinical implications for schizophrenia. In the fourth and final part, we propose conceptual bridges between the OD and the enactive approach by bringing to attention the intersubjective nature of the human self and the inherent vulnerability entailed in both the self’s maintenance and in the practice of dialogue. We then propose that the dialogical stance adopted by OD is effective in supporting the recovery of a balanced sense of self precisely because it provides an intersubjective space in which clients can safely experience and maintain the basic structures underlying the socially constituted self. Since our analysis touches upon fundamental structures of the therapeutic relationship, we hope that it will also be useful to inform general psychiatric practice and help advancing a more integrative understanding of psychotherapy for schizophrenia. (shrink)

This dissertation combines two scientific disciplines and research fields, namely philosophy and psychopathology. Within such a wide field of investigation, two precise perspectives are to be adopted in this inquiry: stemming from the first field, the phenomenological perspective on subjectivity and intersubjectivity; stemming from the second, the psychopathological perspective on schizophrenia. The combination of philosophy and psychopathology has often proven fruitful. Moreover, the main motivation for such combined approach is justified by the strong belief that, when critically used, phenomenology offers (...) a viable method of studying the first-personal perspective of experience, including the experiences of people with mental disorders. Philosophical analysis can thereby be used as a means to evaluate the meaning and adequacy of psychopathological concepts and ideas. As a result, phenomenological psychopathology may help understand what is often claimed to be incomprehensible. Particularly for the understanding of schizophrenia, this is taken to be a valuable contribution. For more than twenty years now, the phenomenological approach to schizophrenia has developed a strong and influential hypothesis on the basic alterations of this disorder. Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the minimal self. Simultaneously, and often in conjunction, philosophical research on the self has vastly proliferated. The vivid interaction between these two fields makes the phenomenology of schizophrenia a good example of effective interdisciplinary work. Within the philosophical debate on subjectivity, intersubjectivity, or the relation between self and other, is currently a key topic. However, this has not significantly influenced the psychopathology of schizophrenia yet. The initial and fundamental claim of this dissertation is indeed that a renewed evaluation and inclusion of intersubjectivity, next to subjectivity, is to increase the validity of the phenomenological approach to schizophrenia. This would allow the previous hypothesis on schizophrenia as minimal self disorder to be challenged, criticized, or complemented, which would accordingly increase the significance and its clinical value. What I will attempt to do in this dissertation is then to thoroughly evaluate the role of intersubjectivity in schizophrenia. It will hence become clear what this role and its significance are. Consequently, I will finally argue that the basic alterations of schizophrenia concern both subjectivity and intersubjectivity. My argument is developed in four chapters. In the first, I introduce the topic of the self, including the distinction between the minimal and the extended self. This chapter equally introduces schizophrenia as a psychiatric concept, and three different clinical approaches are discussed, among which the phenomenological approach in most detail. After the topics of the self and schizophrenia, I introduce intersubjectivity, notably from a developmental-psychological perspective. By way of status quaestionis, I recapitulate the current research on intersubjectivity and schizophrenia. It will become clear that this research is relatively scarce. I then conclude the chapter with a full formulation of the two research questions informing this dissertation, namely Is schizophrenia an intersubjectivity-disorder? and Which self-concept is suited to define schizophrenia as a self and intersubjectivity disorder? The second chapter examines the phenomenology of intersubjectivity. The exact delineation of what is meant here by intersubjectivity will allow the reader to acknowledge its extent and variety. This chapter is aimed to provide the necessary philosophical tools to analyse schizophrenia in the light of intersubjectivity. In the third chapter I turn to psychopathology. In the first section, I analyse the work of seven major psychopathologists on schizophrenia. The goal of this section is to look for elements of intersubjectivity in their accounts of schizophrenia. Many of these psychopathologists have been influential for the development of the current self-disorder hypothesis, and the investigation intends to show how some crucial intersubjective elements in their work have been neglected. In the second section of this chapter, I focus on the symptoms, signs, and phenomena of schizophrenia that relate to intersubjectivity. This chapter finally offers all the material needed to positively answer the first research question. In the fourth chapter, I bring together psychopathology and philosophy, and I attempt to answer the two research questions. Since Chapter 3 allows me to affirmatively answer the first question, I examine whether the current self-disorder hypothesis is adequate to integrate intersubjectivity disturbances. It will appear that it is not, and the first section of this chapter consequently deals with the question why intersubjectivity and its disturbances have been neglected until now. In the second section it will become clear that no different self-concept is required, but that schizophrenia primarily concerns a particular capacity or orientation of subjectivity. I introduce the concept of open subjectivity and thereby answer the second research question. By describing schizophrenia as a disturbance of open subjectivity, I am finally able to integrate both self-disturbances and intersubjectivity-disturbances into a coherent and unified theory. To conclude this dissertation, I summarize and recapitulate its major issues, questions, and results in Chapter 5. Both clinical implications and possible future research are also discussed here. (shrink)

In this thesis I propose a new way of understanding depressive illness as not exclusively harmful, but as related to particular, empirically evidenced, epistemic and pragmatic benefits for the subject, alongside the associated costs. For each of the benefits considered, I provide and concisely analyse the empirical evidence both in its favour and against it, suggest ways in which these benefits could apply in the circumstances presented, discuss some outstanding problems for that application as stated, and describe potential implications. The (...) issues discussed involve topics in cognitive psychology as well as in ethics, which I regard as complementary to the debate. I take the view that depression related phenomena such as low mood, low self-esteem, and mood-congruent delusions offer potential benefits to a subject under certain circumstances, but not under others. In discussing the hypotheses presented, I argue for a more complex view of depression, which includes its potential epistemic and pragmatic benefits as well as its costs and I propose possible directions for future research. (shrink)

My discussion will focus on what is arguable the main claim of Being No One: That no such things as selves exist in the world and that nobody ever was or had a self. In discussing to what extent Metzinger can be said to argue convincingly for this claim, I will also comment on his methodological use of pathology and briefly make some remarks vis-à-vis his understanding and criticism of phenomenology.

Parnas y Sass han ofrecido una tesis acerca de la Esquizofrenia en la que indican que su núcleo básico y originario es un trastorno del self. Ese trastorno consiste en: i) una reducción o aplacamiento del self o de la ipseidad, y ii) la hiper-reflexividad, que refiere a un tipo de conciencia del self exagerada, tendiente a focalizar y objetivar los fenómenos y los procesos de la conciencia que normalmente se experimentan de modo implícito como siendo del self. La ipseidad, (...) en cuanto conciencia pre-reflexiva del self, se configura en la síntesis pasiva; lo que sugiere que el núcleo central de los delirios o de la esquizofrenia radica en un nivel pre-reflexivo de la consciencia. El objetivo de este ensayo es ofrecer un marco base, a partir de lo que Husserl ha llamado “la síntesis pasiva”, pertinente para la comprensión de ese núcleo de la esquizofrenia y el trastorno de ipseidad como un problema en un nivel pre-reflexivo de la consciencia; útil, además, para indicar que los delirios o la esquizofrenia tienen que ver más con los aspectos empíricos de la experiencia que con problemas en la racionalidad del paciente. (shrink)