The phenomenological role of affect in the Capgras delusion

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience.

Models of misbelief: Integrating motivational and deficit theories of delusions

The impact of our desires and preferences upon our ordinary, everyday beliefs is well-documented [Gilovich, T. (1991). How we know what isn’t so: The fallibility of human reason in everyday life. New York: The Free Press.]. The influence of such motivational factors on delusions, which are instances of pathological misbelief, has tended however to be neglected by certain prevailing models of delusion formation and maintenance. This paper explores a distinction between two general classes of theoretical explanation for delusions; the motivational and the deficit. Motivational approaches view delusions as extreme instances of self-deception; as defensive attempts to relieve pain and distress. Deficit approaches, in contrast, view delusions as the consequence of defects in the normal functioning of belief mechanisms, underpinned by neuroanatomical or neurophysiological abnormalities. It is argued that although there are good reasons to be sceptical of motivational theories (particularly in their more floridly psychodynamic manifestations), recent experiments confirm that motives are important causal forces where delusions are concerned. It is therefore concluded that the most comprehensive account of delusions will involve a theoretical unification of both motivational and deficit approaches.     

The epistemic innocence of motivated delusions

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.     

Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence

In a recent theoretical account of persecutory delusions, it is suggested that anxiety and worry are important factors in paranoid experience [Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., & Bebbington, P. E. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41(4), 331-347]. In emotional disorders worry has been understood in terms of catastrophising. In the current study, the concept of catastrophising is applied for the first time with persecutory delusions. Thirty individuals with current persecutory delusions and 30 non-clinical controls participated in a cross-sectional study. The group with persecutory delusions was also followed up at 3 months to assess predictors of delusion persistence. At its most severe, 21% of individuals with persecutory delusions had clinical worry, 68% had levels of worry comparable with treatment seeking GAD patients. Further, high levels of anxiety, worry and catastrophising were associated with high levels of persecutory delusion distress and with the persistence of delusions over 3 months. If future research replicates these findings, worry reduction interventions for individuals with persecutory delusions may be warranted.     

Restating the role of phenomenal experience in the formation and maintenance of the Capgras delusion

In recent times, explanations of the Capgras delusion have tended to emphasise the cognitive dysfunction that is believed to occur at the second stage of two-stage models. This is generally viewed as a response to the inadequacies of the one-stage account. Whilst accepting that some form of cognitive disruption is a necessary part of the aetiology of the Capgras delusion, I nevertheless argue that the emphasis placed on this second-stage is to the detriment of the important role played by the phenomenology underlying the disorder, both in terms of the formation and maintenance of the delusional belief. This paper therefore proposes an interactionist two-stage model in which the phenomenal experience of the Capgras patient is examined, emphasised, and its relation to top-down processing discussed.

Capgras delusion: a window on face recognition

Capgras delusion is the belief that significant others have been replaced by impostors, robots or aliens. Although it usually occurs within a psychiatric illness, it can also be the result of brain injury or other obviously organic disorder. In contrast to patients with prosopagnosia, who cannot consciously recognize previously familiar faces but display autonomic or covert recognition (measured by skin conductance responses), people with Capgras delusion do not show differential autonomic activity to familiar compared with unknown faces. This challenges traditional models of the way faces are identified and presents some epistemological questions concerning identity. New data also indicate that, contrary to previous evidence, covert recognition can be fractionated into autonomic and behavioural/cognitive types, which is consistent with a recently proposed modification of the modal face recognition model.     

Explaining delusions: a cognitive perspective

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.     

Delusions and hallucinations of cocaine abusers and paranoid schizophrenics: a comparative study

We compared delusions and hallucinations of 100 cocaine abusers and 100 paranoid schizophrenic subjects admitted to an East Texas state psychiatric hospital. Subjects in both groups feared that individuals or organized groups might harm them in some way, but delusions of the paranoid schizophrenic subjects were more often bizarre than those of the cocaine abuse subjects. "Cocaine bugs" (parasitosis) were more often found in the cocaine abuse subjects. Command hallucinations were found in both groups, but the commands of the schizophrenic group more often related to harming or killing others. Cocaine abusers had a greater frequency of visual hallucinations (47 to 7), distinguished by shadows, flashing lights ("snow lights"), objects moving and bugs crawling on the arm. Finally, the most distinguishing characteristics were identity delusions, possession delusions, grandiose delusions (other than identities and possessions), and delusions that their families were imposters (Capgras Syndrome) reported by paranoid schizophrenics. No such delusions were reported by the cocaine abusers.     

On incomprehensibility in schizophrenia

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.     

Phenomenology and delusions: Who put the ‘alien’ in alien control?

Although current models of delusion converge in proposing that delusions are based on unusual experiences, they differ in the role that they accord experience in the formation of delusions. On some accounts, the experience comprises the very content of the delusion, whereas on other accounts the delusion is adopted in an attempt to explain an unusual experience. We call these the endorsement and explanationist models, respectively. We examine the debate between endorsement and explanationist models with respect to the 'alien control' delusion. People with delusions of alien control believe that their actions and/or thoughts are being controlled by an external agent. Some accounts of alien control (e.g., ) are best thought of in explanationist terms; other accounts (e.g., ) seem more suited to an endorsement approach. We argue that recent cognitive and neurophysiological evidence favours an endorsement model of the delusion of alien control.     

Infusing Qualitative Traditions in Counseling Research Designs

Research traditions serve as a blueprint or guide for a variety of design decisions throughout qualitative inquiry. This article presents 6 qualitative research traditions: grounded theory, phenomenology, consensual qualitative research, ethnography, narratology, and participatory action research. For each tradition, the authors describe its purpose and key characteristics, outline commonly associated fieldwork activities, describe analytic approaches within the tradition, and then discuss strengths and challenges of the approach.     

Jumping to conclusions and the continuum of delusional beliefs

The present study examined the jumping to conclusions reasoning bias across the continuum of delusional ideation by investigating individuals with active delusions, delusion prone individuals, and non-delusion prone individuals. Neutral and highly self-referent probabilistic reasoning tasks were employed. Results indicated that individuals with delusions gathered significantly less information than delusion prone and non-delusion prone participants on both the neutral and self-referent tasks, (p<.001). Individuals with delusions made less accurate decisions than the delusion prone and non-delusion prone participants on both tasks (p<.001), yet were more confident about their decisions than were delusion prone and non-delusion prone participants on the self-referent task (p=.002). Those with delusions and those who were delusion prone reported higher confidence in their performance on the self-referent task than they did the neutral task (p=.02), indicating that high self-reference impacted information processing for individuals in both of these groups. The results are discussed in relation to previous research in the area of probabilistic reasoning and delusions.     

Can we learn from the clinically significant face processing deficits,prosopagnosia and capgras delusion?

This review describes two clinically significant face processing deficits, prosopagnosia and Capgras delusion, and provides new knowledge about the face recognition process by a convergence of empirical findings. These empirical findings are structured around two questions that are viewed from the perspectives of the two deficits. First is the question of hemispheric specificity, which inquires into the degree of each hemisphere's contribution to the face recognition process. Second is the question of dual neural pathways, which addresses the possibility that the face recognition process proceeds along two parallel pathways in the brain. Findings from the hemispheric specificity studies reinforce the current view that right hemisphere involvement is necessary for face recognition while left hemisphere involvement is minimal. Findings from the dual neural pathways studies reinforce the plausible but yet unproven hypothesis that two neural pathways pass information from the visual association cortex in the occipital lobe toward the temporal lobes and limbic system when faces are seen and recognized. These findings, which also indicate that each of the dual neural pathways carries different, nonredundant information, could be instrumental in showing that the pathways play different roles in the manifestations of the clinically significant face processing deficits, prosopagnosia and Capgras delusion.     

Redefining delusion based on studies of subjective paranormal ideation

The DSM-IV definition of delusion is argued to be unsatisfactory because it does not explain the mechanism for delusion formation and maintenance, it implies that such beliefs are necessarily dysfunctional (pathological), it underestimates the social component to some delusions, and it is inconsistent with research indicating that delusions can be modified through techniques such as contradiction, confrontation, and cognitive-behavioral therapy. However, a well-replicated mathematical model of magical/delusional thinking based on a study of paranormal beliefs and experiences is consistent with the hypothesis that attributional processes play a central role in delusion formation and maintenance. The model suggests attributional processes serve the adaptive function of reducing fear associated with ambiguous stimuli and delusional thinking is on a continuum with nonpathological forms. Based on this collective research an amendment to the definition of delusion is proposed and its clinical implications are addressed.     

Alasdair MacIntyre's Analysis of Tradition

I argue that, in analysing the structure and development of moral traditions, MacIntyre relies primarily on Kuhn's model of scientific tradition, rather than (as is held by at least two influential commentators) on Lakatos' model. I unpack three foci of Kuhn's conception of the sciences, namely: the ‘crisis’ conception of scientific development, what I call the ‘systematic conception’ of scientific paradigms, and the view that successive paradigms are incommensurable. I then show that these three foci are integrated into MacIntyre's account of the development of moral traditions with a surprising degree of faithfulness to Kuhn. And crucially, I argue against the overall cogency of his account, given the disparities I pinpoint between scientific and moral traditions. My overall critique is, however, fundamentally friendly, since nothing I have to say invalidates the very notion of a moral tradition, and all I am calling for are less problematic construals of that notion.     

Monothematic delusion: A case of innocence from experience

Empiricists about monothematic delusion formation agree that anomalous experience is a factor in the formation of these attitudes, but disagree markedly on which further factors (if any) need to be specified. I argue that epistemic innocence may be a unifying feature of monothematic delusions, insofar as a judgment of epistemic innocence to this class of attitudes is one that opposing empiricist accounts can make. The notion of epistemic innocence allows us to tell a richer story when investigating the epistemic status of monothematic delusions, one which resists the trade-off view of pragmatic benefits and epistemic costs. Though monothematic delusions are often characterized by appeal to their epistemic costs, they can play a positive epistemic role, and this is a surprising conclusion on which, so I argue, all empiricists can agree. Thus, I show that all empiricists have the notion of epistemic innocence at their disposal.     

Dream experience and a revisionist account of delusions of misidentification

Standard accounts of delusion explain them as responses to experience. Cognitive models of feature binding in the face recognition systems explain how experiences of mismatch between feelings of "familiarity" and faces can arise. Similar mismatches arise in phenomena such as déjà and jamais vu in which places and scenes are mismatched to feelings of familiarity. These cognitive models also explain similarities between the phenomenology of these delusions and some dream states which involve mismatch between faces, feelings of familiarity and identities. Given these similarities it makes sense to retain that aspect of the standard account in the face of revisionist arguments that feature binding anomalies which lead to delusions of misidentification are not consciously experienced.