In defense of the one-factor doxastic account: A phenomenal account of delusions

According to the doxastic model, delusions are beliefs. In the metacognitive model, delusions are imaginings mistaken for beliefs. I argue that endorsement of false second-order beliefs could also create unpleasant dissonance, that mentally healthy people often endorse irrational or conflicting beliefs, and that the lack of delusion-motivated action can be explained by the influence of nonbelief factors on action. The two-factor doxastic model posits irrationality as necessary, and one metric of rationality many scholars employ is whether a response is easily understood by folk psychology. A precedent for folk-psychological acceptance of contextually bizarre beliefs as a result of personal experience can already be found in the lack of imaginative resistance encountered not in response to the impossibilities portrayed in speculative fiction, but in response to the characters’ ability to incorporate these occurrences into their mental frameworks, despite them often being at odds with these characters’ bedrock understanding of the world.     

The paradoxical self: Awareness,solipsism and first-rank symptoms in schizophrenia

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 initial benefits of adopting a solipsistic stance and how despite being a maladaptive strategy, it nevertheless acts as a protective barrier for the integrity of one’s self. Lastly, I offer some suggestions for clinical practice, emphasizing the importance of understanding the patient’s suffering in any therapeutic alliance.     

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.     

THE LANGUAGE OF SCHIZOPHRENIA AND THE WORLD OF DELUSION

The bizarre language of schizophrenics is nowadays generally believed to be the meaningless breakdown product of a neurobiological disorder. The psychological significance of hallucinations and delusions also remains mysterious. Verbatim vignettes are presented from an advanced stage of a psychoanalytically informed treatment to illustrate that schizophrenics speak a meaningful language that is syntactically and morphologically similar to ordinary language, but is qualitatively different in terms of semantics and pragmatics. From a semantic perspective the ordinary distinctions between words, things, body states and actions are absent, creating words and sentences that are not representational or symbolic. It is a language of equivalence, immediacy and action as contrasted with a language of self-awareness, thoughtfulness, reflection and communication. From a pragmatic standpoint, because the language of schizophrenia makes no distinction between mind and world, it enables and supports delusional thinking. In order for the psychoanalyst to comprehend what the patient means, and couch interpretations in such a way as to convey the meaning he/she intends, analyst and patient must become aware of their inability to comprehend one another's languages and find a way to bridge the communication barrier.     

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.     

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.     

Schizophrenia or Possession?

Schizophrenia is typically a life-long condition characterized by acute symptom exacerbations and widely varying degrees of functional disability. Some of its symptoms, such as delusions and hallucinations, produce great subjective psychological pain. The most common delusion types are as follows: “My feelings and movements are controlled by others in a certain way” and “They put thoughts in my head that are not mine.” Hallucinatory experiences are generally voices talking to the patient or among themselves. Hallucinations are a cardinal positive symptom of schizophrenia which deserves careful study in the hope it will give information about the pathophysiology of the disorder. We thought that many so-called hallucinations in schizophrenia are really illusions related to a real environmental stimulus. One approach to this hallucination problem is to consider the possibility of a demonic world. Demons are unseen creatures that are believed to exist in all major religions and have the power to possess humans and control their body. Demonic possession can manifest with a range of bizarre behaviors which could be interpreted as a number of different psychotic disorders with delusions and hallucinations. The hallucination in schizophrenia may therefore be an illusion—a false interpretation of a real sensory image formed by demons. A local faith healer in our region helps the patients with schizophrenia. His method of treatment seems to be successful because his patients become symptom free after 3 months. Therefore, it would be useful for medical professions to work together with faith healers to define better treatment pathways for schizophrenia.     

‘Things said or done long ago are recalled and remembered’: The ethics of mindfulness in early Buddhism,psychotherapy and clinical psychology

I argue that current theoretical understandings of mindfulness as an attention regulation strategy for psychological stress reduction and enhanced adaptation to society may produce de-ethicised therapeutic applications. I show how understandings of mindfulness in early Buddhism, psychotherapy and clinical psychology have changed over time. Current understandings of mindfulness as a skill or technique of bringing non-judgmental awareness (or bare attention) to present moment experience are historically recent and differ from early Buddhist understandings in at least one crucial respect: definitions of mindfulness as attentional control or metacognitive awareness lack an emphasis on deep ethical reflection. As such, we need to re-ethicise our conceptual understanding of mindfulness by remembering early Buddhist texts, where mindfulness involves the cultivation of an ethically sensitive style of remembering, which has largely been lost in contemporary definitions.     

Control of echolalic speech in psychotic children

Immediate echolalia, a common language disorder in psychotic children, was studied in a series of replicated single-subject designs across six schizophrenic and five normal children. In Experiment 1, each child was presented with several questions and commands, some of which set the occasion for specific, appropriate responses and some of which did not. The former were referred to as discriminative stimuli and the latter, as neutral stimuli. The psychotic children tended to echo the neutral stimuli while responding appropriately to the discriminative stimuli; the normal children, in contrast, typically echoed neither type of stimulus. In Experiment 2, three psychotic children were taught appropriate responses to each of several neutral stimuli. Following this training, the children generally responded appropriately to these stimuli without echoing. A plausible interpretation of these results is that the neutral stimuli were initially incomprehensible or meaningless to the children (whereas the discriminative stimuli were comprehensible or meaningful) and that verbal incomprehensibility may be one important determinant of immediate echolalia. Finally, the results are noteworthy in that they isolate a sufficient treatment variable (i.e., the reinforcement of alternative, nonecholalic responses) for eliminating instances of this language anomaly.     

Nonconceptualism and the cognitive impenetrability of early vision

This paper examines the relationship between cognitive impenetrability and perceptual nonconceptualism. I argue against the view, recently defended by Raftopoulos, that the (alleged) cognitive impenetrability of early vision is a necessary and sufficient condition for states of early vision and their content to be nonconceptual. I show that that view, here dubbed ‘the mutually entailing thesis’, admits two different standard interpretations depending on how we understand the property of being nonconceptual—corresponding to the distinction between the state and the content views of perceptual nonconceptualism. I first argue for the falsity of the state-nonconceptualist reading of the mutually entailing thesis, on the grounds that it mistakenly takes being nonconceptual to be a causal instead of a constitutive relationship. The content-nonconceptualist understanding of the thesis, I then argue, is disproved by plausible views regarding the content of experience. The mutually entailing thesis could only be true, I conclude, on a non-standard, causal interpretation of the notion of nonconceptual content. Yet, on that reading, the thesis would either be trivially true or would entirely fail to engage with the contemporary literature on perceptual nonconceptualism. Some potential relationships between the causal reading of the mutually entailing thesis and psychological research in this area are also briefly discussed.     

Theory of Mind in schizophrenia: first person vs third person perspective

Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind (ToM). Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states.     

Violent behavior in schizophrenic patients: relationship with clinical symptoms

Considerable evidence suggests that violent behavior observed in schizophrenic patients is motivated by psychotic symptomatology. The understanding of violence in schizophrenic patients requires consideration of psychiatric symptomatology. Objective: This study investigated the relationship between violent behavior and psychiatric symptomatology in schizophrenic patients. Method: One hundred and thirteen patients were recruited. Thirteen patients were excluded due to concomitant substance abuse six months prior to the assessment. Diagnoses were based on the SCID‐I. Psychotic symptom severity was assessed with the PANSS. Violent behaviors were assessed with the OAS. Results: Violent behaviors were associated with more severe psychotic symptomatology including hallucinations, delusions, excitement, poor impulse control, and thinking disturbances. Conclusions: Patients with exacerbation of psychotic symptomatology have an increased risk of violent behavior. It is necessary to determine which subtypes of hallucinations and delusions are implicated in the association of schizophrenia and violent behavior. Violent behavior in schizophrenic patients is a heterogeneous phenomenon best explained in the context of specific symptoms associated with violence and course of illness. The retrospective assessment of the variables raises methodological questions concerning the reliability of measurement of the impact of psychotic symptoms on violence. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

Delusions as harmful malfunctioning beliefs

Delusional beliefs are typically pathological. Being pathological is clearly distinguished from being false or being irrational. Anna might falsely believe that his husband is having an affair but it might just be a simple mistake. Again, Sam might irrationally believe, without good evidence, that he is smarter than his colleagues, but it might just be a healthy self-deceptive belief. On the other hand, when a patient with brain damage caused by a car accident believes that his father was replaced by an imposter or another patient with schizophrenia believes that “The Organization” painted the shops on a street in red and green to convey a message, these beliefs are not merely false or irrational. They are pathological. What makes delusions pathological? This paper explores the negative features because of which delusional beliefs are pathological. First, I critically examine the proposals according to which delusional beliefs are pathological because of (1) their strangeness, (2) their extreme irrationality, (3) their resistance to folk psychological explanations or (4) impaired responsibility-grounding capacities of people with them. I present some counterexamples as well as theoretical problems for these proposals. Then, I argue, following Wakefield’s harmful dysfunction analysis of disorder, that delusional beliefs are pathological because they involve some sorts of harmful malfunctions. In other words, they have a significant negative impact on wellbeing (=harmful) and, in addition, some psychological mechanisms, directly or indirectly related to them, fail to perform the jobs for which they were selected in the past (=malfunctioning). An objection to the proposal is that delusional beliefs might not involve any malfunctions. For example, they might be playing psychological defence functions properly. Another objection is that a harmful malfunction is not sufficient for something to be pathological. For example, false beliefs might involve some malfunctions according to teleosemantics, a popular naturalist account of mental content, but harmful false beliefs do not have to be pathological. I examine those objections in detail and show that they should be rejected after all.     

Integrative counselling and psychotherapy: A relational approach,by Ariana Faris and Els van Ooijen

The movement towards registration of psychotherapists, especially towards statutory registration is under way across Europe. This is seen as a way of ‘protecting the public’ against abusive and/or incompetent psychotherapists. In what follows I argue that the dominant ethos of contemporary psychotherapy is based upon a metaphysics of subjectivism and that registration will reinforce this coercively through the law. My concern is that this subjectivistic notion of psychotherapy compounds the estrangement of soul (psyche) and world; that it continues, by way of rationalization and bureaucratization, the process of the ‘disenchantment of the world’. Psychology and psychotherapy are then ‘logically’ constituted out of this rupture between the psyche and nature. This closes our psychological consciousness off from a deeper ecological awareness and from a critical self-reflection on the way this rupture is maintained in psychological and psychotherapeutic theory and practice.     

Prolegomena to any Future History of Analytic Philosophy

Abstract: The careful historical and metaphilosophical attention recently bestowed upon analytic philosophy has revealed that traditional ways of defining it are inadequate. In the face of this inadequacy, contemporary authors have proposed new definitions that detach analytic philosophy from its turn of the twentieth century origins. I argue that this contemporary trend in defining analytic philosophy is misguided, and that it diminishes the likelihood of our coming to an accurate historical and metaphilosophical understanding of it. This is especially unsatisfactory since such understanding is essential to finding an adequate remedy for the widely perceived ills of contemporary analytic philosophy. I suggest that a more fruitful approach to developing such understanding might begin with treating the unity of analytic philosophy as illusory.     

Appetitive besires and the fuss about fit

Some motivational cognitivists believe that there are besires—cognitive mental states (typically moral beliefs) that share the key feature of desire (typically desire’s ‘direction of fit’) in virtue of which they are capable of being directly motivational. Besires have been criticized by Humeans and cognitivists alike as philosophically extravagant, incoherent, ad hoc, and incompatible with folk psychology. I provide a response to these standard objections to besires—one motivated independently of common anti-Humean intuitions about the motivational efficacy of moral judgments. I proceed by examining a hypothesis about the nature of appetitive desires—that these paradigmatic motivational attitudes are a mode of perceptual experience—and argue that this hypothesis is committed to the existence of besires. However, despite its commitment to besires, this hypothesis is not extravagant, incoherent, ad hoc, or incompatible with folk psychology. In other words, the standard complaints about besires all fail. The upshot is that there is nothing bizarre about besires, and motivational cognitivism takes on no additional costs by positing them.     

The Holy Trinity: Between Mystery and Analysis

Two significant strands of trinitarian theology, the analytic and the apophatic, emphasize considerations of logical consistency and divine incomprehensibility respectively. This article seeks to mediate between these two seemingly opposed lines of thought by arguing for a fuller awareness of the particular mystery associated with the trinitarian notion of ‘person’. By specifying more closely this mystery of divine personhood, I qualify an overzealous apophaticism and also open up some scope for analytic approaches. I then highlight an implication of the mystery of divine personhood that any proposition linking together person‐language and nature‐language (e.g. ‘the Son is God’) necessarily contains its own mystery and cannot be understood in analytic terms.     

What Is Music? Is There a Definitive Answer?

Philosophers frequently defend definitions by appealing to intuitions and contemporary folk classificatory norms. I raise methodological concerns that undermine some of these defenses. Focusing on Andrew Kania's recent definition of music, I argue that the way in which it has been developed leads to problems, and I show that a number of other definitions of interest to philosophers of art (and others) run into similar problems.     

Refining the Inferential Model of Scientific Understanding

In this article, I use a mental models computational account of representation to illustrate some details of my previously presented inferential model of scientific understanding. The hope is to shed some light on possible mechanisms behind the notion of scientific understanding. I argue that if mental models are a plausible approach to modelling cognition, then understanding can best be seen as the coupling of specific rules. I present our beliefs as ‘ordinary’ conditional rules, and the coupling process as one where the consequent of one ordinary rule (OR) matches and activates the antecedent of the rule to which it is coupled in virtue of the activation of an intermediate ‘inference’ rule. I argue that on this approach knowledge of an explanation is the activation of ORs in a cognitive hierarchy, while understanding is achieved when those activated ORs are also coupled via correct inference rules. I do not directly address issues regarding the plausibility of mental models themselves. This article should therefore be seen as an exercise in refining the inferential model within an already presupposed computational setting, not one of arguing for the psychological adequacy of computational approaches.