The experiences described in the VIP transcripts are incredibly varied and yet frequently explicitly labelled by participants as "voices." How can we make sense of this? If we reflect carefully on uses of the word "voice", we see that it can express at least two entirely different concepts, which pick out categorically different phenomena. One concept picks out a speech sound (e.g. "This synthesizer has a "voice" setting"). Another concept picks out a specific agent (e.g. "I hear two voices: one (...) is a ten year-old boy…"). This chapter explores how these two concepts are related to one another in the context of voice-hearing. (shrink)

In this paper, I will present and advocate a view about what we are doing when we attribute delusion, namely, say that someone is delusional. It is an “expressivist” view, roughly analogous to expressivism in meta-ethics. Just as meta-ethical expressivism accounts for certain key features of moral discourse, so does this expressivism account for certain key features of delusion attribution. And just as meta-ethical expressivism undermines factualism about moral properties, so does this expressivism, if correct, show that certain attempts to (...) objectively define delusion are misguided. I proceed as follows. I start by examining different attempts at defining delusion, separating broadly psychiatric attempts from epistemic ones. I then present a change of approach, according to which we question whether the term “delusion” is in the business of (merely) describing reality. I then support this proposal, first, by borrowing standard lines of argument from meta-ethics (including ontological reluctance, intrinsic motivation, and deep disagreement) but also, by inference to the best explanation of some the features we see when we try to theorise about delusion (namely that it is hard to define, and that our delusion attributions are elicited by a plurality of norms). (shrink)

Predictive processing accounts of neural function view the brain as a kind of prediction machine that forms models of its environment in order to anticipate the upcoming stream of sensory stimulation. These models are then continuously updated in light of incoming error signals. Predictive processing has offered a powerful new perspective on cognition, action, and perception. In this chapter we apply the insights from predictive processing to the study of emotions. The upshot is a picture of emotion as inseparable from (...) perception and cognition, and a key feature of the embodied mind. (shrink)

Current models of auditory verbal hallucinations tend to focus on the mechanisms underlying their occurrence, but often fail to address the content of the auditory experience. In other words, they tend to ask why there are AVHs at all, instead of asking why, given that there are AVHs, they have the properties that they have. One such property, which has been largely overlooked and which we will focus on here, is why the voices are often experienced as coming from agents, (...) and often specific, individualised agents. In this article, we argue not only that the representation of agents is important in accurately describing many cases of AVH, but also that deeper reflection on what is involved in the representation of agents has potentially vital consequences for our aetiological understanding of AVH, namely, for understanding how and why AVHs come about. (shrink)

Two challenges that face popular self-monitoring theories (SMTs) of auditory verbal hallucination (AVH) are that they cannot account for the auditory phenomenology of AVHs and that they cannot account for their variety. In this paper I show that both challenges can be met by adopting a predictive processing framework (PPF), and by viewing AVHs as arising from abnormalities in predictive processing. I show how, within the PPF, both the auditory phenomenology of AVHs, and three subtypes of AVH, can be accounted (...) for. (shrink)

We welcome Cho and Wu’s suggestion that the study of auditory verbal hallucinations could be improved by contrasting and testing more explanatory models. However, we have some worries both about their criticisms of inner speech-based self-monitoring models and whether their proposed spontaneous activation model is explanatory.

Delusional misidentification is commonly understood as the product of an inference on the basis of evidence present in the subject's experience. For example, in the Capgras delusion, the patient sees someone who looks like a loved one, but who feels unfamiliar, so they infer that they must not be the loved one. I question this by presenting a distinction between “recognition” and “identification.” Identification does not always require recognition for its epistemic justification, nor does it need recognition for its psychological (...) functioning. Judgments of identification are often the product of a non-inferential mechanism. Delusional misidentification arises as the product of this mechanism malfunctioning. (shrink)

I argue for an overlooked distinction between perceptual presence and volumetric content, and flesh it out in terms of predictive processing. Within the predictive processing framework we can distinguish between agent-active and object-active expectations. The former expectations account for perceptual presence, while the latter account for volumetric content. I then support this position with reference to how experiences of presence are created by virtual reality technologies, and end by reflecting on what this means for the relationship between sensorimotor enactivism and (...) predictive processing. (shrink)

I suggest that we can think of delusional misidentification in terms of systematic errors in the management of mental files. I begin by sketching the orthodox “bottom-up” aetiology of delusional misidentification. I suggest that the orthodox aetiology can be given a descriptivist or a singularist interpretation. I present three cases that a descriptivist interpretation needs to account for. I then introduce a singularist approach, one that is based on mental files, and show how it opens the way for different and (...) potentially more plausible accounts of these three cases. I reflect on how this mental files approach can be viewed either as a supplement to the orthodox aetiology, or as suggesting an altogether different aetiology. I end by addressing a concern surrounding the explanatory power of mental files. (shrink)

Although interpretivists are right to give inner speech a central role in generating self-knowledge, they mischaracterize the precise nature of this role. Inner speech is fundamentally an action, a form of speech, and provides us with self-knowledge not by being something that we perceive (or “quasi-perceive”) and interpret, but by being something that we knowingly do. Once this is appreciated, interpretivism is undermined.

This paper explores how metaphorical thinking might contribute to an aetiology of florid delusions in psychosis. We argue that this approach helps to account for the path from experience to the delusional assertion, which, though relatively straightforward for monothematic delusions like the Capgras delusion, has always been difficult to account for in florid delusions in psychosis. Our account also helps to account for double book-keeping and the relative agential inertia of the belief.

In this introduction we present the orthodox account of auditory verbal hallucinations, a number of worries for this account, and some potential responses open to its proponents. With some problems still remaining, we then introduce the problems presented by the phenomenon of thought insertion, in particular the question of how different it is supposed to be from AVHs. We then mention two ways in which theorists have adopted different approaches to voices and thoughts in psychosis, and then present the motivation (...) and composition of this special issue. (shrink)

The phenomenon of 'hearing voices,' often viewed as a symptom of schizophrenia, is commonly called, in the scientific and clinical literature, 'auditory-verbal hallucination.' However, reports of hearing soundless voices, voices that are not auditory, which go as far back as Tuttle and Kraepelin and appear in phenomenological interviews and questionnaires are relatively common. What are we to make of such reports?One option is to dismiss these claims: one cannot hear soundless voices. This dismissal could be due to a combination of (...) the following seemingly reasonable claims, each sufficient to consign the notion of 'hearing soundless voices' to the status... (shrink)

A recent debate in the literature on delusions centers on the question of whether delusions are beliefs or not. In this paper, an overlooked distinction between egocentric and encyclopedic doxastic states is introduced and brought to bear on this debate, in particular with regard to delusions of misidentification. The result is that a more accurate characterization of the delusional subject’s doxastic point of view is made available. The patient has a genuine egocentric belief (“This man is not my father”), but (...) fails to have the commonly attributed encyclopedic belief (“My father has been replaced by an impostor”). (shrink)

La concepción de Marcus sobre las creencias se aplica al debate centrado en la cuestión: "¿Son creencias los delirios?" Dos consecuencias que se siguen de ello son: i) que la cuestión "¿Son creencias los delirios?" necesita reformularse, y ii) que la respuesta es: "No, algunos pacientes que sufren delirios no creen lo que, "prima facie", parecen creer".

: One can understand the word “object” as a concrete physical object or as that which is on the receiving end of a subject-object relation, namely, that entity which a particular cognitive state or process is “of.” These latter objects are determined by the way our sensory systems exploit the ways elements of the world impinge upon our bodily surfaces. Our visual system exploits light reflected off the surfaces of objects; therefore, the objects of our visual experiences can be physical (...) objects just sitting still. Our auditory system, on the other hand, exploits sound waves caused by impacts of one sort or another, and these are events. You don’t, strictly speaking, hear a billiard ball or a car: You hear a billiard ball hit another one, or a car drive past. (shrink)

The original version of this article unfortunately has missing statement in the Acknowledgments section.

A common and popular option in defending Physicalism against the Knowledge Argument is the “phenomenal concept strategy” . PCS claims that, although ex hypothesi Mary knows all the propositions pertaining to color and experiences of color, there is at least space for the claim that she acquires a new concept, and thereby accesses these propositions under different, phenomenal modes of presentation. In short, Mary acquires new concepts upon her release and that explains her “discovery.” Here I will show there is (...) a way of saving Physicalism that does not appeal to PCS in the standard sense but entails that Mary acquires the ability to think a new kind of singular thought. In acquiring this, she gains a kind of indexical, egocentric knowledge. (shrink)

I explore the relationship between psychiatric fictionalism and the attribution of moral responsibility. My central claim is as follows. If one is a psychiatric fictionalist, one should also strongly consider being a fictionalist about responsibility. This results in the ‘intrinsic view’, namely, the view that mental illness does not just happen to interfere with moral responsibility: that interference is an intrinsic part of the narrative. I end by discussing three illustrative examples.

Over the last decade or so, several researchers have considered the predictive processing framework (PPF) to be a useful perspective from which to shed some much-needed light on the mechanisms behind psychosis. Most approaches to psychosis within PPF come down to the idea of the “atypical” brain generating inaccurate hypotheses that the “typical” brain does not generate, either due to a systematic top-down processing bias or more general precision weighting breakdown. Strong at explaining common individual symptoms of psychosis, such approaches (...) face some issues when we look at a more general clinical picture. In this paper, we propose an update on the current accounts of psychosis based on the realization that a neurotypical brain constantly generates non-actual, de-coupled, counterfactual hypotheses as part of healthy cognition. We suggest that what is going on in psychosis, at least in some cases, is not so much a generation of erroneous hypotheses, but rather an inability to correctly use the counterfactual ones. This updated view casts “accurate” cognition as more fragile and delicate, but also closes the gap between psychosis and typical cognition. (shrink)

When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I (...) present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view. (shrink)

A number of philosophers have argued in favour of extended simples on the grounds that they are needed by fundamental physics. The arguments typically appeal to theories of quantum gravity. To date, the argument in favour of extended simples has ignored the fact that the very existence of spacetime is put under pressure by quantum gravity. We thus consider the case for extended simples in the context of different views on the existence of spacetime. We show that the case for (...) extended simples based on physics is far more complex than has been previously thought. We present and then map this complexity, in order to present a much more textured picture of the argument for extended simples. (shrink)

In this enlightening book, Sam Harris argues that free will is an illusion but that this truth should not undermine morality or diminish the importance of social and political freedom; indeed, this truth can and should change the way we think about some of the most important questions in life.

A particular feature of this book is substantial "Stretch and Challenge" material throughout which allows students to develop further.

One of the most contentious ethical issues in the neonatal intensive care unit is the withdrawal of life-sustaining treatment from infants who may otherwise survive. In practice, one of the most important factors influencing this decision is the prediction that the infant will be severely intellectually disabled. Most professional guidelines suggest that decisions should be made on the basis of the best interests of the infant. It is, however, not clear how intellectual disability affects those interests. Why should intellectual disability (...) be more important than physical disability to the future interests of an infant? Is it discriminatory to base decisions on this? This paper will try to unravel the above questions. It seems that if intellectual disability does affect the best interests of the child it must do so in one of three ways. These possibilities will be discussed as well as the major challenges to the notion that intellectual disability should have a role in such decisions. The best interests of the child can be affected by severe or profound intellectual disability. It is, though, not as clear-cut as some might expect. (shrink)

We develop a new version of the causal theory of spacetime. Whereas traditional versions of the theory seek to identify spatiotemporal relations with causal relations, the version we develop takes causal relations to be the grounds for spatiotemporal relations. Causation is thus distinct from, and more basic than, spacetime. We argue that this non-identity theory, suitably developed, avoids the challenges facing the traditional identity theory.

In this chapter we argue that our concept of time is a functional concept. We argue that our concept of time is such that time is whatever it is that plays the time role, and we spell out what we take the time role to consist in. We evaluate this proposal against a number of other analyses of our concept of time, and argue that it better explains various features of our dispositions as speakers and our practices as agents.

One of the major difficulties facing presentism is the problem of causation. In this paper, I propose a new solution to that problem, one that is compatible with intrinsic, fundamental causal relations. Accommodating relations of this kind is important because (i) according to David Lewis (2004), such relations are needed to account for causation in our world and worlds relevantly similar to our own, (ii) there is no other strategy currently available that successfully reconciles presentism with relations of this kind (...) and (iii) resolving the problem of causation by accommodating intrinsic, fundamental causal relations provides the presentist with a far more general solution to the problem of causation than those currently on offer. (shrink)

Work in quantum gravity suggests that spacetime is not fundamental. Rather, spacetime emerges from an underlying, non-spatiotemporal reality. After clarifying the type of emergence at issue, I argue that standard conceptions of emergence available in metaphysics won’t work for the emergence of spacetime. I go on to consider spacetime functionalism as a way to make sense of spacetime emergence. I argue that a functionalist approach to spacetime modelled on mental state functionalism is not a viable alternative to the standard conception (...) of emergence in metaphysics. I go on to consider an alternative: ‘partial’ functionalism, whereby certain aspects of spacetime are functionalised, rather than spacetime as a whole. (shrink)