This chapter connects the phenomenon of double bookkeeping to two critical debates in the philosophy of delusion: one from the analytic tradition and one from the phenomenological tradition. First, I will show how the failure of action guidance on the part of some delusions suggests an argument to the standard view that delusions are beliefs (doxasticism about delusion) and how its proponents have countered it by ascribing behavioral inertia to avolition, emotional disturbances, or a failure of the surrounding environment in (...) supporting the agent’s motivation to act. Second, I will show how the mismatch between the experience of double bookkeeping and that of having the usual propositional attitudes of folk psychology suggests another, more recalcitrant argument not only against doxasticism but against the very attempt to fit delusion into folk psychology. Third, I will show how phenomenologically inspired theories of delusion, such as the multiple realities hypothesis, bypass the debates above and focus on describing and understanding the disturbances in the structure of experience undergone by patients. I conclude that the philosophical discussions ensuing from an appreciation of double bookkeeping show some of the limitations of the analytic philosophical approach to delusion. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Delusions are studied in two philosophical traditions: the continental or phenomenological tradition and the Anglo-American or analytic tradition. Each has its own view of delusions. Broadly stated, phenomenologists view delusions as a disturbed experience whilst most analytic researchers view them as beliefs. It is my contention that the most plausible account of delusions must ultimately incorporate valuable insights from both traditions. To illustrate the potential value of integration I provide a novel model of the Capgras delusion which describes how an (...) analytic, cognitive neuropsychological two-factor account of the Capgras delusion and the phenomenological view of delusions might be integrated. (shrink)

Cognitive theory (CT) is currently the most widely acknowledged framework used to describe the psychological processes in affective disorders like depression. The purpose of this paper is to assess the philosophical assumptions upon which CT rests. It is argued that CT must be revised due to significant flaws in many of these philosophical assumptions. The paper contains suggestions as to how these problems could be overcome in a manner that would secure philosophical accuracy, while also providing an account that is (...) better suited to explaining some of the cognitive, emotional, and bodily manifestations of affective disorders. (shrink)

In this paper, we draw on developmental findings to provide a nuanced understanding of background emotions, particularly those in depression. We demonstrate how they reflect our basic proximity (feeling of interpersonal connectedness) to others and defend both a phenomenological and a functional claim. First, we substantiate a conjecture by Fonagy & Target (International Journal of Psychoanalysis 88(4):917–937, 2007) that an important phenomenological aspect of depression is the experiential recreation of the infantile loss of proximity to significant others. Second, we argue (...) that proximity has a particular cognitive function that allows individuals to morph into a cohesive dyadic system able to carry out distributed emotion regulation. We show that elevated levels of psychological suffering connected to depressive background emotions may be explained not only in terms of a psychological loss, but also as the felt inability to enter into dyadic regulatory relations with others—an experiential constraint that decreases the individual’s ability to adapt to demanding situations. (shrink)

This paper introduces the motivation and idea behind the recently founded interdisciplinary initiative Critical Neuroscience ( http://www.critical-neuroscience.org ). Critical Neuroscience is an approach that strives to understand, explain, contextualize, and, where called for, critique developments in and around the social, affective, and cognitive neurosciences with the aim to create the competencies needed to responsibly deal with new challenges and concerns emerging in relation to the brain sciences. It addresses scholars in the humanities as well as, importantly, neuroscientific practitioners, policy makers, (...) and the public at large. Does neuroscience indeed have such wide-ranging effects or are we collectively overestimating its impacts at the expense of other important drivers of social and cultural change? Via what channels is neuroscience interacting with contemporary conceptions of selfhood, identity, and well-being? Importantly, Critical Neuroscience strives to make the results of these assessments relevant to scientific practice itself. It aspires to motivate neuroscientists to be involved in the analysis of contextual factors, historical trajectories, conceptual difficulties, and potential consequences in connection to their empirical work. This paper begins to spell out a philosophical foundation for the project by outlining examples of the interaction taking place between the neurosciences and the social and cultural contexts in which they are embedded and by exposing some of the assumptions and argumentative patterns underlying dominant approaches. Recent anthropological work will be discussed to convey a sense of the de facto interactions between neuroscientific knowledge, its promissory projections, and the self-understandings of laypeople. This can be seen as a first step towards a phenomenology of the “seductive allure” that the neurosciences are exerting upon both the academic and the popular imagination. The concept of “critique” relevant to the project's overall orientation is outlined in the final section. (shrink)

How should we construe the unity, in affective experience, of felt bodily changes on the one hand and intentionality on the other, without forcing affective phenomena into a one-sided theoretical framework such as cognitivism? To answer this question, I will consider the specific kind of self-awareness implicit in affectivity. In particular, I will explore the idea that a bodily sense of ability is crucial for affective self-awareness. Describing the affective ways of “grasping oneself” manifest in a person’s felt sense of (...) ability will help us understand the intimate connection between bodily feelings and intentionality in affective processes. In order to illustrate these experiential structures in a concrete case, I will discuss experiential changes often reported by sufferers of depression. (shrink)

It is generally maintained that emotions consist of intentional states and /or bodily feelings. This paper offers a phenomenological analysis of guilt in severe depression, in order to illustrate how such conceptions fail to adequately accommodate a way in which some emotional experiences are said to be deeper than others. Many emotions are intentional states. However, I propose that the deepest emotions are not intentional but pre-intentional, meaning that they determine which kinds of intentional state are possible. I go on (...) to suggest that pre-intentional emotions are at the same time feelings. In so doing, I reject the distinction that is often made between bodily feelings and the world-oriented aspects of emotion. (shrink)

Worrying is the central feature of generalized anxiety disorder . Many people worry from time to time, but in GAD the worrying is prolonged and difficult to control. Worrying is a specific way of coping with perceived threats and feared situations. Meanwhile, it is not considered to be a helpful coping strategy, and the phenomenological account developed in this paper aims to show why. It builds on several phenomenological notions and in particular on Michael Wheeler's application of these notions to (...) artificial intelligence and the cognitive sciences. Wheeler emphasizes the value of 'online intelligence' as contrasted to 'offline intelligence'. I discuss and apply these concepts with respect to worrying as it occurs in GAD, suggesting that GAD patients overrate the value of detached contemplation , while underrating their embodied-embedded adaptive skills . I argue that this phenomenological account does not only help explaining why worrying is used as a coping strategy, but also why cognitive behavioral therapy is successful in treating GAD. (shrink)

Competent decision-making is required for informed consent. In this paper, I aim, from a phenomenological perspective, to identify the specific facets of competent decision-making that may form a challenge to depressed patients. On a phenomenological account, mood and emotions are crucial to the way in which human beings encounter the world. More precisely, mood is intimately related to the options and future possibilities we perceive in the world around us. I examine how possibilities should be understood in this context, and (...) how, in depression, decision-making might be compromised. I suggest that, based on this analysis, a specific emphasis and alertness in assessments of competence in depressed patients is called for. In fact, close attention should be paid to the range of future possibilities depressed patients are able to perceive. In addition, providing environmental cues to these patients might be one way of enhancing their decision-making capacity. The practical suggestions arrived at are open to empirical research. (shrink)

Recent editions of diagnostic manuals in psychiatry have focused on providing quick and efficient operationalized criteria. Notwithstanding the genuine value of these classifications, many psychiatrists have argued that the operationalization approach does not sufficiently accommodate the rich and complex domain of patients’ experiences that is crucial for clinical reasoning in psychiatry. How can we increase the role of phenomenology in the process of diagnostic reasoning in psychiatry? I argue that this could be done by adopting a clinical staging approach in (...) diagnostic reasoning in psychiatry. The approach has the resources to include the progressive nature of patients’ experiences to a much greater degree than is currently practiced. It can address the recent plea for increasing the role of phenomenology in psychiatric diagnosis by offering a model for clinical reasoning that goes beyond the operationalized, static criteria of diagnostic manuals, without depriving us of their benefits. (shrink)

This paper addresses the phenomenology of bodily feeling in depersonalization disorder. We argue that not all bodily feelings are intentional states that have the body or part of it as their object. We distinguish three broad categories of bodily feeling: noematic feeling, noetic feeling, and existential feeling. Then we show how an appreciation of the differences between them can contribute to an understanding of the depersonalization experience.

This paper integrates personal narratives with the methods of phenomenology in order to draw some general conclusions about ‘what it means’ and ‘what it feels like’ to be depressed. The analysis has three parts. First, it explores the ways in which depression disrupts everyday experiences of spatial orientation and motility. This disruption makes it difficult for the person to move and perform basic functional tasks, resulting in a collapse or contraction of the life-world. Second, it illustrates how depression creates a (...) situational atmosphere of emotional indifference that reduces the person’s ability to qualitatively distinguish what matters in his or her life because nothing stands out as significant or important anymore. In this regard, depression is distinct from other feelings because it is not directed towards particular objects or situations but to the world as a whole. Finally, the paper examines how depression diminishes the possibility for ‘self-creation’ or ‘self-making’. Restricted by the illness, depression becomes something of a destiny, preventing the person from being open and free to access a range of alternative self-interpretations, identities, and possible ways of being-in-the-world. (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)