The sense of embodiment is vital for self recognition. An examination of anosognosia for hemiplegia—the inability to recognise that one is paralysed down one side of one’s body—suggests the existence of ‘online’ and ‘offline’ representations of the body. Online representations of the body are representations of the body as it is currently, are newly constructed moment by moment and are directly “plugged into” current perception of the body. In contrast, offline representations of the body are representations of what the body (...) is usually like, are relatively stable and are constructed from online representations. This distinction is supported by an analysis of phantom limb—the feeling that an amputated limb is still present—phenomena. Initially it seems that the sense of embodiment may arise from either of these types of representation; however, an integrated representation of the body seems to be required. It is suggested information from vision and emotions is involved in generating these representations. A lack of access to online representations of the body does not necessarily lead to a loss in the sense of embodiment. An integrated offline representation of the body could account for the sense of embodiment and perform the functions attributed to this sense. (shrink)

It is generally acknowledged that confabulation undermines the authority of self-attribution of mental states. But why? The mainstream answer is that confabulation misrepresents the actual state of one’s mind at some relevant time prior to the confabulatory response. This construal, we argue, rests on an understanding of self-attribution as first-person mindreading. Recent developments in the literature on folk psychology, however, suggest that mental state attribution also plays an important role in regulating or shaping future behaviour in conformity with normative expectations. (...) We explore an analogue understanding of self-attribution of mental states in terms of first-person mindshaping. The main aim of this paper is to explore how this insight alters the implications of empirical confabulation studies on first-person authority. We also indicate how this sheds new light on the phenomenon of confabulation itself. (shrink)

This review considers a number of recent theories on the neural basis of consciousness, with particular attention to the theories of Bogen, Crick, Llinás, Newman, and Changeux. These theories allot different roles to various key brain areas, in particular the reticular and intralaminar nuclei of the thalamus and the cortex. Crick's hypothesis is that awareness is a function of reverberating corticothalamic loops and that the spotlight ofintramodalattention is controlled by the reticular nucleus of the thalamus. He also proposed different mechanisms (...) for attention and intention . The current review presents a new hypothesis, based on elements from these hypotheses, includingintermodalattention and olfaction and pain, which may pose problems for Crick's original theory. This work reviews the possible role in awareness and intermodal attention and intention of the cholinergic system in the basal forebrain and the tegmentum; the reticular, the intralaminar, and the dorsomedial thalamic nuclei; the raphe and locus coeruleus; the reticular formation; the ventral striatum and extended amygdala; insula cortex, and other selected cortical areas. Both clinical and basic research data are covered. The conclusion is reached that the brain may work by largely nonlinear parallel processing and much intramodal shifts of attention may be effected by intracortical, or multiple corticothalamic mechanisms . But this is constrained by the functional anatomy of the circuits concerned and waking “awareness” is modulated by the many “nonspecific” systems . But the principal agents for intermodal attention shifts, the “searchlight,” may be two key nuclei of the cholinergic system in the mesencephalon. Clinical loss of consciousness results from damage to these nuclei but not from damage to the cholinergic nucleus basalis of the basal forebrain. (shrink)

Anosognosia for hemiplegia is the denial of neurologically-caused paralysis, and it often co-occurs with a number of distortions of belief and emotion such as somatoparaphrenia and an exaggeration of negative affect towards minor health complaints. The salience of these latter symptoms led early investigators to propose explanations of AHP which construed it as a process of motivated self-deception against the overwhelming anxiety and depression that knowledge of deficit would otherwise cause, and which was observed in hemiplegic patients without the anosognosia. (...) Since some influential critiques of this approach, however, theories of this kind have largely been rejected on the grounds that they are inappropriately “psychogenic.” What has replaced them are a class of theories which explain the lack of awareness in terms of neurocognitive deficit, with the deficit in question variously described by researchers as involving spatial awareness, motor control, and other capacities. In this paper I argue – contra claims in the literature – that the patterns of explanation which are characteristic of the psychodynamic theory are not incompatible in principle with the notion that the illness involves neurocognitive deficit. That means that these patterns of explanation can be preserved where they make good sense of the obscure attitudinal and emotional symptoms that occur in AHP – symptoms that are otherwise difficult to explain. I suggest some ways in which this fact could be accommodated by deficit theories of the illness which are based on motor deficit. (shrink)

Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

I thank Tsakiris and Fotopoulou for their insightful commentary on my target article. In particular I welcome the opportunity to revisit how the online /offline representation of the body distinction is drawn. Tsakiris and Fotopoulou raise three major points of concern with my model. First they argue that the sense of embodiment is not sufficient for self recognition. Second they show that the relationship between online and offline representations of the body cannot be the simple ‘serial construction’ relationship I advocate (...) in the target article. Third they claim that my model makes a false prediction. I agree with the first two lines of criticism. As to the first I will clarify and tone down the claims made about the role of the sense of embodiment in self recognition tasks. However, I will argue that the sense of embodiment is measured in van den Bos and Jeannerod’s study. I strongly welcome the second line of criticism Tsakiris and Fotopoulou offer. I will add some reasons to agree that the ‘serial construction’ account of the relationship between online and offline representations cannot be true. I maintain, however, that this does not affect the central thesis of target article, namely that it is an offline representation of the body that underlies the sense of embodiment. Finally, I will defend the model by arguing that it does not make the false prediction Tsakiris and Fotopoulou attribute to it. (shrink)

The traditional conception of self-deception takes it for an intrapersonal form of interpersonal deception. However, since the same subject is at the same time deceiver and deceived, this means attributing the agent a pair of contradictory beliefs. In the course of defending a deflationary conception of self-deception, Mele [1997] has challenged traditionalists to present convincing evidence that there are cases of self-deception in which what he calls the dual belief-requirement is satisfied. Levy [2009] has responded to this challenge affirming that (...) there is at least one real cases of self-deception that meets this requirement, namely, that of anosognosia. In this family of conditions, the patient apparently believes that there is nothing wrong with her while, at the same time, providing behavioral cues that indicate that the patient is somehow aware of his disease. If Levy is right, then traditionalism about self-deception could be vindicated, after having been widely abandoned due to its need to postulate exotic mental processes in order to make sense of the attribution of contradictory beliefs. In this paper, I assess whether Levy’s response to Mele’s challenge is successful by analyzing his interpretation of the empirical evidence to which he appeals. Finally, I attack the cogency of the underlying commitments about the nature of folk psychology to which one is required to defer in order to draw from conflicting evidence the attribution of contradictory beliefs. (shrink)

Mulder and colleagues [Mulder, T., Hochstenbach, J., Dijkstra, P. U., Geertzen, J. H. B. . Born to adapt, but not in your dreams. Consciousness and Cognition, 17, 1266–1271.] report that a majority of amputees continue to experience a normally-limbed body during their night dreams. They interprete this observation as a failure of the body schema to adapt to the new body shape. The present note does not question this interpretation, but points to the already existing literature on the phenomenology of (...) the phantom limb in dreams. A summary of published investigations is complemented by a note on phantom phenomena in the dreams of paraplegic patients and persons born without a limb. Integration of the available data allows the recommendation for prospective studies to consider dream content in more detail. For instance, “adaptation” to the loss of a limb can also manifest itself by seeing oneself surrounded by amputees. Such projective types of anosognosia in nocturnal dreams should also be experimentally induced in normally-limbed individuals, and some relevant techniques are mentioned. (shrink)

Previous research found that mixed handers were more likely than strong handers to update their beliefs . It was assumed that this was due to greater degrees of communication between the two cerebral hemispheres in mixed handers. Niebauer and Garvey made connections between this model of updating beliefs and metacognitive processing. The current work proposes that variations in interhemispheric interaction contribute to differences in consciousness, specifically when consciousness is used in rumination versus the metacognitive task of self-reflection. Using the Rumination–Reflection (...) Questionnaire , predictions were supported such that strong handedness was associated with self-rumination; whereas, mixed handedness was associated with increased self-reflection p values < .01, . James’s concept of the “fringe of consciousness” is used to make connections between metacognition, updating beliefs, and self-reflection. Several studies are reviewed suggesting that mixed handers experience fringe consciousness to a greater degree than strong handers. (shrink)

It is commonly accepted that people can, and regularly do, deceive themselves. Yet closer examination reveals a set of conceptual puzzles that make self‐deception difficult to explain. Applying the conditions for other‐deception to self‐deception generates what are known as the ‘paradoxes’ of belief and intention. Simply put, the central problem is how it is possible for me to believe one thing, and yet intentionally cause myself to simultaneously believe its contradiction. There are two general approaches taken by philosophers to account (...) for these puzzles about the self‐deceptive state and the process of self‐deception. ‘Partitioning’ strategies try to resolve the paradoxes by proposing that the mind is divided in some way that allows self‐deception to occur. ‘Reformulation’ strategies suggest that the conditions we use to define self‐deception should be modified so that the paradoxes do not arise at all. Both approaches are subject to criticism about the consequences of the strategies philosophers use, but recent cross‐disciplinary analyses of self‐deception may help shed light on the puzzles that underlie this phenomenon. (shrink)

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by delusional (...) episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

Philosophical and scientific investigations of the proprietary aspects of self—mineness or mental ownership—often presuppose that searching for unique constituents is a productive strategy. But there seem not to be any unique constituents. Here, it is argued that the “self-specificity” paradigm, which emphasizes subjective perspective, fails. Previously, it was argued that mode of access also fails to explain mineness. Fortunately, these failures, when leavened by other findings (those that exhibit varieties and vagaries of mineness), intimate an approach better suited to searching (...) for an explanation. Having an alternative in hand, one that shows promise of achieving explanatory adequacy, provides an additional reason to suspend the search for unique constituents. In short, a negative and a positive thesis are developed: we should cease looking for unique constituents and should seek to explain mineness in accord with the model developed here. This model rejects attempts to explain the phenomenon in terms of either a narrative or a minimal sense of self; it seeks to explain at a “molecular” level, one that appeals to multiple, interacting dimensions. The molecular-level model allows for the possibility that subjective perspective is distinct from a stark perspective (one that does not imply mineness). It proposes that the confounding of tacit expectations plays an important role in explaining mental ownership and its complement, disownership. But the confounding of tacit expectations is not sufficient. Because we are able to be aware of the existence of mental states that do not belong to self, we require a mechanism for determining degree of self-relatedness. One such mechanism is proposed here, and it is shown how this mechanism can be integrated into a general model of mental ownership. In the spirit of suggesting how this model might be able to help resolve outstanding problems, the question as to whether inserted thoughts belong to the patient who reports them is also considered. (shrink)

De Vignemont argues that the sense of ownership comes from the localization of bodily sensation on a map of the body that is part of the body schema. This model should be taken as a model of the sense of embodiment. I argue that the body schema lacks the theoretical resources needed to explain this phenomenology. Furthermore, there is some reason to think that a deficient sense of embodiment is not associated with a deficient body schema. The data de Vignemont (...) uses to argue that the body image does not underlie the sense of embodiment does not rule out the possibility that part of the body image I call 'offline representations' underlies the sense of embodiment. An alternative model of the sense of embodiment in terms of offline representations of the body is presented. (shrink)

Cases in which people are self-deceived seem to require that the person hold two contradictory beliefs, something which appears to be impossible or implausible. A phenomenon seen in some brain-damaged patients known as confabulation (roughly, an ongoing tendency to make false utterances without intent to deceive) can shed light on the problem of self-deception. The conflict is not actually between two beliefs, but between two representations, a 'conceptual' one and an 'analog' one. In addition, confabulation yields valuable clues about the (...) structure of normal human knowledge-gathering processes. [The hypothesis defended here is significantly altered and greatly expanded in my book Brain Fiction.]. (shrink)

We propose another positive illusion that fits with McKay & Dennett's (M&D's) criteria for adaptive misbeliefs. This illusion is pervasive in adult reasoning but we focus on its prevalence in children's developing theories. It is a strongly held conviction arising from normal functioning of the doxastic system that confers adaptive advantage on the individual.

The neuropathologies of the self are disorders of the self and identity that occur in association with neuropathology and include perturbations of the bodily, relational, and narrative self. Right, especially medial-frontal and orbitofrontal lesions, are associated with these conditions. The ego disequilibrium theory proposes this brain pathology causes a disturbance of ego boundaries and functions and the emergence of developmentally immature styles of thought, ego functioning, and psychological defenses including denial, projection, splitting, and fantasy that the NPS patient has in (...) common with the child. I hypothesize that during brain development between approximately ages 3 and 7 immature defensive functions and fantasies tend to be replaced by mature defenses and the inhibition of fantasy a process that depends upon maturational processes within the right hemisphere. I propose a four-tiered model of the NPS that emphasizes a multifactorial approach and includes both negative and positive, bottom up and top down, and neuropsychological and psychological factors. (shrink)

A growing number of studies in both the scientific and the philosophical literature have drawn on a Bayesian predictive processing framework to account for the formation of delusions. The key here is that delusions form because of disrupted prediction error signalling. Parrott’s recent critique argues that the framework is incomplete in two respects: it leaves unclear why delusional hypotheses are selected over none at all or over more plausible alternatives; it leaves unclear how exactly it is that delusional hypotheses are (...) generated in the first place. In this paper, we defend the framework’s explanatory power by way of showing how it can go a long way in helping disentangle these concerns. We take up each of them in turn. As for the first, our argument turns on two claims: a) believing nothing, although possible in principle, may not be a viable procedure in the circumstances; b) alternative hypotheses may be rendered unavailable for selection, due to aberrant prediction errors. As for the second concern, we distinguish three ways in which delusional hypotheses may be initially acquired, all of which are based on experience broadly construed. (shrink)

L’hystérie se définit comme un déficit fonctionnel sans cause organique. Par exemple, certains patients sont incapables de se mouvoir volontairement, comme s’ils étaient véritablement paralysés, sans que l’on puisse fournir une explication physiologique. À l’inverse, les patients souffrant d’anosognosie sont véritablement paralysés, mais affirment pouvoir bouger. Ces pathologies résultent toutes deux d’un trouble de la conscience de la capacité à agir : les uns croient qu’ils ne peuvent pas agir alors qu’ils le pourraient et les autres croient pouvoir agir alors (...) qu’ils en sont incapables. Mais de quoi dépend cette forme spécifique de conscience ? En comparant ces deux syndromes miroirs, je chercherai à révéler les processus mis en jeu par la conscience de la capacité à agir et à jeter un jour nouveau sur l’hystérie. S’agit-il d’un trouble de la volonté, et si oui, à quel niveau se produit-il ? J’analyserai ainsi les relations respectives entre la conscience de la capacité d’agir et la conscience d’agir, et montrerai le rôle joué par l’image corporelle. (shrink)

There are two main pathways to investigate the sense of body ownership, (i) through the study of the conditions of embodiment for an object to be experienced as one's own and (ii) through the analysis of the deficits in patients who experience a body part as alien. Here, I propose that E is embodied if some properties of E are processed in the same way as the properties of one's body. However, one must distinguish among different types of embodiment, and (...) only self-specific embodiment can lead to feelings of ownership. I address issues such as the functional role and the dynamics of embodiment, degrees and measures of ownership, and shared body representations between self and others. I then analyse the interaction between ownership and disownership. On the one hand, I show that there is no evidence that in the Rubber Hand Illusion, the rubber hand replaces the biological hand. On the other hand, I argue that the sense of disownership experienced by patients towards their body part cannot be reduced to the mere lack of ownership. (shrink)

First-person authority, self-regulation and the problem of confabulation In this paper we discuss the implications of confabulation studies for the everyday concept of first-person authority. We argue that the results of these studies are less problematic than they are often taken to be if we understand first-person authority in terms of a capacity for self-regulation. We discuss an example of clinical confabuluation to illustrate when confabulation does become a threat to first-person authority.

Empirical evidence suggests that people often confabulate when they are asked about their choices or reasons for action. The implications of these studies are the topic of intense debate in philosophy and the cognitive sciences. An important question in this debate is whether the confabulation studies pose a serious threat to the possibility of self-knowledge. In this paper we are not primarily interested in the consequences of confabulation for self-knowledge. Instead, we focus on a different issue: what confabulation implies for (...) the special status of self-attributions, i.e. first-person authority. In the first part of the paper, we propose that FPA is based on a capacity for self-regulation. Accordingly, FPA depends on the extent to which we are able to bridge the gap between our sayings and doings by aligning our actions with our avowed self-ascriptions and vice versa. FPA is withheld when we fail at such re-alignment. In the second part of the paper, we contrast our view with the accounts of Scaife and Bortolotti :227–249, 2018). We claim that the apparent fact that we cannot reliably distinguish, from a first-person perspective, when we are confabulating and when we are not, does not necessarily undermine FPA. We argue that a systematic failure to align our actions with our self-ascriptions and vice-versa is a genuine threat to FPA. In the last part of the paper, we introduce the concept of self-know-how—the know-how embodied in the way one is disposed to relate to oneself in making sense of oneself with or in the face of others—and briefly explored the importance of diminished or absent self-know-how in clinical cases. (shrink)

Naive physics beliefs can be systematically mistaken. They provide a useful test-bed because they are common, and also because their existence must rely on some adaptive advantage, within a given context. In the second part of the commentary we also ask questions about when a whole family of misbeliefs should be considered together as a single phenomenon.

Delusions are defined as irrational beliefs that compromise good functioning. However, in the empirical literature, delusions have been found to have some psychological benefits. One proposal is that some delusions defuse negative emotions and protect one from low self-esteem by allowing motivational influences on belief formation. In this paper I focus on delusions that have been construed as playing a defensive function (motivated delusions) and argue that some of their psychological benefits can convert into epistemic ones. Notwithstanding their epistemic costs, (...) motivated delusions also have potential epistemic benefits for agents who have faced adversities, undergone physical or psychological trauma, or are subject to negative emotions and low self-esteem. To account for the epistemic status of motivated delusions, costly and beneficial at the same time, I introduce the notion of epistemic innocence. A delusion is epistemically innocent when adopting it delivers a significant epistemic benefit, and the benefit could not be attained if the delusion were not adopted. The analysis leads to a novel account of the status of delusions by inviting a reflection on the relationship between psychological and epistemic benefits. (shrink)

This paper attempts to answer the question of what defines mnemonic confabulation vis-à-vis genuine memory. The two extant accounts of mnemonic confabulation as “false memory” and as ill-grounded memory are shown to be problematic, for they cannot account for the possibility of veridical confabulation, ill-grounded memory, and wellgrounded confabulation. This paper argues that the defining characteristic of mnemonic confabulation is that it lacks the appropriate causal history. In the confabulation case, there is no proper counterfactual dependence of the state of (...) seeming to remember on the corresponding past representation. (shrink)

It is commonly accepted that people can, and regularly do, deceive themselves. Yet closer examination reveals a set of conceptual puzzles that make self-deception difficult to explain. Applying the conditions for other-deception to self-deception generates what are known as the ‘paradoxes’ of belief and intention. Simply put, the central problem is how it is possible for me to believe one thing, and yet intentionally cause myself to simultaneously believe its contradiction. There are two general approaches taken by philosophers to account (...) for these puzzles about the self-deceptive state and the process of self-deception. ‘Partitioning’ strategies try to resolve the paradoxes by proposing that the mind is divided in some way that allows self-deception to occur. ‘Reformulation’ strategies suggest that the conditions we use to define self-deception should be modified so that the paradoxes do not arise at all. Both approaches are subject to criticism about the consequences of the strategies philosophers use, but recent cross-disciplinary analyses of self-deception may help shed light on the puzzles that underlie this phenomenon. (shrink)

This is a bibliography of books and articles on consciousness in philosophy, cognitive science, and neuroscience over the last 30 years. There are three main sections, devoted to monographs, edited collections of papers, and articles. The first two of these sections are each divided into three subsections containing books in each of the main areas of research. The third section is divided into 12 subsections, with 10 subject headings for philosophical articles along with two additional subsections for articles in cognitive (...) science and neuroscience. Of course the division is somewhat arbitrary, but I hope that it makes the bibliography easier to use. This bibliography has first been compiled by Thomas Metzinger and David Chalmers to appear in print in two philosophical anthologies on conscious experience . From 1995 onwards it has been continuously updated by Thomas Metzinger, and now is freely available as a PDF-, RTF-, or HTML-file. This bibliography mainly attempts to cover the Anglo-Saxon and German debates, in a non-annotated, fully formatted way that makes it easy to "cut and paste" from the original file. To a certain degree this bibliography also contains items in other languages than English and German - all submissions in other languages are welcome. Last update of current version: July 13th, 2001. (shrink)

This thesis is set out as a collection of self-standing essays. Throughout these essays, I try to illuminate a number of controversies surrounding the way in which delusions are formed, and relatedly, their nature and epistemic standing. In Chapter 2, after an introductory chapter, I flesh out a new ‘endorsement’ approach to the Capgras delusion, the main idea being that the delusion is formed by endorsing the content of a metaphorical-perceptual state in which a loved one is represented metaphorically as (...) an imposter. In Chapter 3, I take issue with the idea, prevalent in the literature, that Bayesian accounts of inference in delusions are best characterised as versions of ‘explanationism’. Taking one such influential account as a test case, I argue that it is no more or less compatible with the endorsement alternative, which says delusions are acquired non-inferentially from experience. In Chapter 4, I examine a recent critique of predictive processing theories of delusions, according to which such theories suffer two limitations: they fail to explain why an agent believes something delusional as opposed to nothing at all or something else; they fail to explain how delusional hypotheses are generated in the first place. I suggest ways in which these concerns might be addressed. In Chapter 5, I consider how the Spinozan theory of belief fixation can improve the prospects of doxasticism about delusions. Doxasticism has been criticised on the grounds that delusions typically do not abide by rational standards which we expect beliefs to conform to. If belief fixation is Spinozan, I argue, these deviations from rationality are not just compatible with, but supportive of, their status as beliefs. In Chapter 6, I ask whether misidentification delusions formed via endorsement processes have any measure of perceptual justification. To give the best chance of getting a ‘yes’ answer, I address the question from the perspective of perceptual dogmatism, as this appears the best option if we are to grant at least defeasible justifiedness to MDs. I argue that, even so, MDs are completely unjustified. (shrink)

Neurological syndromes in which consciousness seems to malfunction, such as temporal lobe epilepsy, visual scotomas, Charles Bonnet syndrome, and synesthesia offer valuable clues about the normal functions of consciousness and ‘qualia’. An investigation into these syndromes reveals, we argue, that qualia are different from other brain states in that they possess three functional characteristics, which we state in the form of ‘three laws of qualia’. First, they are irrevocable: I cannot simply decide to start seeing the sunset as green, or (...) feel pain as if it were an itch; second, qualia do not always produce the same behaviour: given a set of qualia, we can choose from a potentially infinite set of possible behaviours to execute; and third, qualia endure in short-term memory, as opposed to non-conscious brain states involved in the on-line guidance of behaviour in real time. We suggest that qualia have evolved these and other attributes because of their role in facilitating non-automatic, decision-based action. We also suggest that the apparent epistemic barrier to knowing what qualia another person is experiencing can be overcome by using a ‘bridge’ of neurons; and we offer a hypothesis about the relation between qualia and one's sense of self. (shrink)

Hysteria has been the subject of controversy for many years, with theorists arguing about whether it is best explained by a hidden organic cause or by malingering and deception. However, it has been shown that hysterical paralysis cannot be explained in any of these terms. With the recent development of cognitive psychiatry, one may understand psychiatric and organic delusions within the same conceptual framework. Here I contrast hysterical conversion with anosognosia. They are indeed remarkably similar, though the content of their (...) respective delusions is the opposite. In hysterical paralysis, patients are not aware of their preserved ability, whereas in anosognosia for hemiplegia, patients are not aware of their disability. Four main explanations have been provided to account for anosognosia: metacognitive, attentional, motor, and motivational views. I will apply each of these accounts to hysterical paralysis and show that, at each level, hysterical conversion is the reverse of anosognosia. I will suggest that hysterical paralysis results from the interaction between attentional somatosensory amplification and affective inhibition of action. (shrink)