Tuesday, 24 April 2018

A New Defence of Doxasticism about Delusions

Today's post is by Peter Clutton is a graduate student at the Australian National University School of Philosophy (previously at Macquarie University) working on the nature and taxonomy of delusions.

In my recent article, "A new defence of doxasticism about delusions: The cognitive phenomenological defence", I enter the ongoing debate over whether delusions are beliefs (or whether they are some other, non-doxastic state). I argue that delusions are beliefs, despite the many objections to that view.

It might seem obvious that delusions are beliefs. People with delusions typically insist they believe what they say, and the fact that they do is often the very reason they come to clinical attention in the first place. Indeed, clinical manuals like the DSM define “delusion” as a type of “false belief”.

On the other hand, delusions seem to defy many preconceptions about the nature of belief. For example, we expect people to act on their beliefs, but people with delusions do not always act in expected ways: people with the Capgras delusion insist that their spouse has been replaced by an imposter, and yet they often continue to live with the supposed imposter, and do not to report their “real” spouse missing.

I argue that delusions really are beliefs, despite the fact that they violate these preconceptions about beliefs. I defend what I refer to as a “cognitive phenomenological” account of belief (based on the work of Kriegel), and argue that on this view, delusions are beliefs. On this view, beliefs are defined by the type of experience they involve. When I consider the proposition “snow is white”, for instance, I experience a certain kind of mental assent towards the proposition. That is what it is to believe that snow is white.

Thursday, 19 April 2018

Justice and the Meritocratic State

This post is by Thomas Mulligan, a faculty fellow at the Georgetown Institute for the Study of Markets and Ethics. He talks about his new book, Justice and the Meritocratic State.

A striking feature of the philosophical debate about justice is that our most popular theories are rejected by the people who would have to live under them.  Since the 1970s, libertarianism and egalitarianism have dominated political philosophy despite being unpalatable to the public; we know, for example, that “empirical studies provide almost no support for egalitarianism, understood as equality of outcomes, or for Rawls’s difference principle” (Konow 2003: 1199).

The goal of this book is to provide a theory of justice that is consonant with human intuition and more conceptually compelling than these competitors on the right and the left. Although you wouldn’t know it from our politics, there is deep normative agreement about the structure of a just economy.  Human beings across lines of gender, race, class, and culture believe that people should get their just deserts.  This is why, for example, if you pay a person less than she thinks she deserves, or more than she thinks she deserves, she is unsatisfied with her compensation.  

That justice is desert has been verified by decades of research in experimental economics, social psychology, neurology, evolutionary history, and other fields.  Rather than reject that consensus, as most philosophers would, I argue that we should embrace it, and agree that “the concepts of moral desert and justice are deeply connected, and one needs the other for a proper definition” (Rustichini and Vostroknutov 2014).

The theory of justice I advance is monistic (justice is desert and nothing else), deontological, and leads to a society that is “meritocratic” in character.  The theory rests on three principles. Principle one: Equal opportunity.  We normally want to say that the fastest runner deserves the medal on the basis of his merit.  

But this is no longer true if the other runners were hobbled before the starting gun went off.  In that case, the winner’s claim to deserve the medal is weakened, if not nullified.  As it goes for races, so too for our economy.  Justice requires that we provide robust public education, healthcare, and other forms of social support to children born into disadvantage, and that no one has a head start owing to inheritance or nepotism.

Tuesday, 17 April 2018

Distorted Memories and Self-defining Beliefs

In this post I introduce a paper I wrote with Ema Sullivan-Bissett on the epistemic benefits of clinical memory distortions, which recently appeared open access in Mind and Language. It is one of the core outputs of two recent projects, the AHRC-funded Epistemic Innocence of Imperfect Cognitions and the ERC-funded project PERFECT. The key message in the paper has received some coverage in the press (Medicalxpress, India Blooms, Laboratory Equipment, and Health Canal). 

In Keeping Mum, Marianne Talbot describes how her mother was a great storyteller before she had dementia. One of her best stories was how one day, when she was 14, she was late for school because her mother had just given birth to twins. The headmistress did not believe that that was the reason for being late and punished her, which she felt was a great injustice. When dementia advanced, the story about the twins’ birth ended up being merged with other stories (for instance, other stories about being late for school) and was repeated many times.

Martha, who had Alzheimer's disease, often told the story of how she learnt to drive, and she bought her own car, defying the doubts of her husband and her own family (Hydén & Örulv, 2009). This was something she was presumably very proud of because not many women at the time would have done the same. Aspects of her story were repeated frequently, even during the same conversation, and presented a number of inaccuracies and inconsistencies.

The distorted memories and repetitive scripts in the examples above are epistemically problematic because they involve false beliefs. However, it is important for people with dementia to repeat stories that they find central or even self-defining (the unfairly punished teenager, the defiant woman) even if details in such stories are inaccurate. Why so?

Due to serious impairments in autobiographical memory, people with dementia have been found to lose their identity, having progressively fewer and more vague beliefs about themselves and their past (see the classic Addis and Tippett, 2004) with negative effects on wellbeing. It is particularly challenging for people with dementia to integrate information about their lives before the illness into their current personal narratives. 

Thursday, 12 April 2018

False and Distorted Memories

This post is by Robert Nash. Robert A. Nash is a Senior Lecturer in Psychology at Aston University, and a recent presenter at TEDxBrum. Much of his research is focused on biases and distortions of memory, and their implications in various real-life contexts. In this post, he talks about his recent edited book (with James Ost, University of Portsmouth), entitled False and Distorted Memories.

Psychologists have been writing about and studying the reconstructive properties of memory for more than a century. Nowadays, hundreds of scientific papers are published every year that further propel our understanding of how people use memory to reconstruct the past.

So why, despite all of these decades of studies, do so many of the general public still subscribe to the idea that remembering is infallible, like the re-playing of a video recording? Why hasn’t all this scientific research had a much more tangible influence on what people believe about memory?

In our recent edited book False and Distorted Memories, we proposed that at least three factors may contribute. The first is that mistaken views of memory are difficult to change because they are deeply ingrained, not only individually but also culturally and even linguistically.

The second factor is that it can be uncomfortable for us to suppose that our autobiographical identities, our values and our viewpoints, could be based partly on fiction, and we might therefore intuitively resist entertaining such notions too seriously.

The third factor is that the concept of ‘false memory’ is for many people inexorably linked with controversies around putative memories of childhood trauma, a link that has arguably often skewed discussions of the countless ways—positive and negative—in which distortions of belief and memory touch our remembered lives.

Tuesday, 10 April 2018

Project PERFECT Year 4 - Michael Larkin

Today's post is provided by Project PERFECT's Co-investigator Michael Larkin from Aston University. In the post he outlines his plans for the coming months of the project.

We’ve had a good start to this final block already, with Rachel Gunn and Magdalena Antrobus both successfully defending their theses at viva before Christmas, and subsequently being awarded their doctorates. I’ve really enjoyed working with Lisa Bortolotti and these two brilliant, creative and insightful researchers. It has been really exciting to see the interdisciplinary nature of their work take on such a distinctive character: I hope that we will see the the benefits of this in future work, post-PERFECT, too. 

In Magdalena’s work, the interdisciplinary quality has taken the form of a very rigorous engagement with existing psychological evidence about the nature and context of low mood. In Rachel’s thesis, it involved conducting interviews, and engaging with phenomenological data, about the experience of unusual beliefs.  One of the things that I’m most looking forward to for this year’s work is finishing the paper that Rachel and I have started, based on some this analysis.

Thursday, 5 April 2018

Unhappiness, Sadness and Depression

This post is by Tulio Giraldi. Tulio Giraldi is a researcher and teacher of pharmacology and clinical psychology at the University of Trieste, currently Visiting Professor at the Department of Global Health & Social Science at the King’s College London. 

The topics of his basic and clinical research have been cancer chemotherapy, together with the pharmacology of the central nervous system and the responses to stress. More recently, he has been researching the role of genetic polymorphisms in mental health, and the pharmacogenetics of the response of psychiatric drugs. In this post he talks about his book Unhappiness, Sadness and Depression.

According to the World Health Organization (WHO), an epidemic of depression is spreading around the world, expected to become by 2020 the second leading cause of world disability and by 2030 to be the largest contributor to disease burden.

The serious concern for depression and antidepressant drugs led me to analyze all the available data and to write this book.What immediately appeared is that melancholic depression, since the time of Greek medicine, is a serious ailment affecting a limited proportion of the population. With the birth in the 60s of the Diagnostic and Statistic Manual of Mental Disorders (DSM) of the American Psychiatric Association, melancholic depression was transformed into the “major depressive disorder (MDD)”.

The inclusivity of the DSM diagnostic criteria are consequently responsible for the spread of depression lamented by the WHO. They do not discriminate between morbid conditions, requiring medical attention and intervention, form healthy emotional responses accompanying the adaption to stressful life events. Stressful events, including those caused by the economic crisis, occur with a worrying increasing frequency in the globalized society of today.

Just one citation can support and illuminate this perspective, and it is the title of the book written by Allen Frances, the American who chaired the task force that produced the fourth revision of Diagnostic and Statistical Manual (DSM-IV) and became critical of the current version, DSM-5. The title is: “Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life.”

Tuesday, 3 April 2018

What Makes Delusions Pathological?

Today’s post is provided by Jorge Gonçalves of IFILNOVA, Universidade Nova de Lisboa (UNL) and the Lisbon Mind & Reasoning Group (group included in IFILNOVA). In this post he provides a summary of his chapter "Why are delusions pathological?" in Hipólito, I., Gonçalves, J. Pereira, J. G. Schizophrenia and Common Sense: explaining the relation between madness and social values.

The aim of the article is to identify a characteristic of delusions: that which makes them pathological. This aim may appear a bit strange at first because one believes that delusions just are a pathological alteration of the mind. However, some authors have shown that although pathological delusions are the most studied, not all delusions have necessarily harmful consequences for the delirious subject or for others. Hence, it seems pertinent to question what makes delusions a pathological state.

“Pathological” is here understood as that which damages the subject (not that which deviates from the norm). Delusions are defined in DSM-5 as “false beliefs” but some have been argued that delusions are not beliefs but another kind of mental state. Here I adopt a model – the Multiple Realities Model - that considers delusions as experiences, not beliefs. But at the same time I admit the two perspectives are not incompatible.

The Phenomenological Multiple Realites Model of Schütz/Gallagher maintains that everyday reality is not the only reality in which consciousness can be found. There are several realities, each having a different cognitive style. Usually the so-called “accent of reality” is placed on everyday reality, which is the paramount reality. In this reality, we accept the given world without questioning it, without questioning its reality. But Schütz refers to and analyzes other realities, highlighting their relationship with everyday reality: the worlds of fantasies, dreams, scientific theory, art, children’s game, and the insane. Gallagher includes here “delusion”.

Thursday, 29 March 2018

Global Challenges in Mental Health: Children in Crisis

On 9th January at the Royal Society of Medicine an event took place, Global Mental Health: Children in Crisis

The first speaker, Vikram Patel (Harvard Medical School), presented a lecture on how to prevent mental health problems in children. He highlighted the importance of linking epidemiological and neuroscientific data. From en epidemiological perspective, deprivation is a very significant risk factor for mental health problems, comparable to what smoking is for lung cancer. And most mental health probelms begin before the age of 24. From a neuroscientific perspective, the brain is very plastic in young adulthood. The prefrontal region of the brain (linked to executive decision making) matures 5-8 years later than the limbic region (linked to basic emotional reactions).

Adversities associated with poor developmental outcomes include:
  • Malnutrition
  • Stressors
  • Infections
  • War and displacement
  • Parental ill-health
  • Abuse
The need for responsive parents and the experience of stressors (especially toxic stress, continuous state of stress without support by adults) determine the architecture of the brain and shape brain circuitry (Centre on the Developing Child, Harvard University). We need nurturing, stable and engaging enviroments for children to develop.

Vikram Patel

Theresa Betancourt

So risks factors for mental health issue are primarily (1) missing interactions with relevant adults and (2) excessive, prolonged stress. How these factors impact on health depends on the life stage of the child, whether the adversities occur in the first five years of the child's life or later on in adolescence.

In the first 5 years of life, home, school, and neighbourhood are the most significant environments. Structured play has a very strong impact on the wellbeing of young children. Children whose parents play engagingly with them become better educated, more healthy adults, and they go on to earn more than children who did not receive the same attention.

The principles of structured play are:
  • follow the child
  • use everyday objects
  • stimulate all senses
We know now much more than we previously did about the adolescent brain. The prefrontal cortex matures well after the limbic system and that is why juveniles in all species, not just humans, are more risk-taking. In the face of social adversities, teenagers are more vulnerable. Adversities include family disruption, early age of puberty, violence in the community, digital world, use of alcohol and energy drinks, rigid social norms about gender and life choices.

Interventions at this stage cover parental involvement, activities promoting agency and participation in schools, focus on emotional competence, reducing exposure to harmful behaviours (substance abuse). Interventions that aim at enhancing agency in young people and improving school climate have the following goals:
  • Promoting social skills
  • Engaging young people in decisions
  • Making information accessible
  • Enhancing problem solving skills
Interventions with the goals above have been shown to reduce bullying and depressive symptoms. But the problems with the current programmes are that interventions are fragmented and episodic and the focus tends to be on specific behaviours and risks. Moreover, there is a lack of youth leadership and engagement, and a lack of coordination across sectors.

To try and overcome some of these issues there is a Wellcome Trust Public Engagement initiative in India inviting young people to talk openly about they feel: www.itisoktotalk.in

Tuesday, 27 March 2018

Conceptual Centrality and Implicit Bias

Today's post introduces Guillermo Del Pinal and Shannon Spaulding's paper, "Conceptual Centrality and Implicit Bias", published in Mind and Language.

Guillermo Del Pinal is a Postdoctoral Research Fellow at the University of Michigan, Ann Arbor, and Leibniz-ZAS, Berlin. He works in the philosophy of language, mind and cognitive science. His main area of research is the relation between language and general cognition, focusing on topics such as the degree of modularity of language, and the role of natural logic within the language system.

Shannon Spaulding is an Assistant Professor of Philosophy at Oklahoma State University. Her general philosophical interests are in the philosophy of mind, philosophical psychology, and the philosophy of science. The principal goal of her research is to construct a philosophically and empirically plausible account of social cognition. She also has research interests in imagination, pretense, and action theory.

How are biases encoded in our representations of social categories? Current discussions of implicit bias overwhelmingly focus on salient associations between target features and representations of social categories. Salient associations track the prominence or availability of an association between a category (e.g., WOMAN) and a feature (e.g., +FAMILY ORIENTED). These are the sorts of associations probed by the Implicit Association Test and similar priming tasks. While these kinds of associations likely encode biases which affect judgment and behavior, we believe that other kinds of biases may affect social cognition in more dramatic ways.

In Del Pinal and Spaulding (2018), we argue that some social biases are likely encoded in the dependency networks that are part of our representations of social categories. Dependency networks encode information about the inter-dependencies and degree of centrality of features in a conceptual representation. For example, +MADE FOR SITTING is a central feature of CHAIR because various other features of chairs depend on their being made for sitting. Importantly, that a feature is central for a category doesn’t entail that it is also salient: +MADE FOR SITTING, although central, need not be more salient than other (less central) features such as +HAS A BACK or +FOUR LEGS. In our view, many socially relevant biases are likely encoded in dependency networks, and can’t be picked out by measures that track merely salient or typical features.

Why does this matter? Why should we care about how, precisely, biases are encoded? Here is why …

Thursday, 22 March 2018

Knowing Emotions

This post is by Rick Furtak.  Rick Anthony Furtak is Associate Professor of Philosophy at Colorado College, where he has taught for over twelve years. In addition to the philosophy of emotions, his other main area of focus is existential thought. He is also a poet and translator who is interested in the literary aspects of philosophy and the philosophical significance of literature. In this post, he talks about his new book Knowing Emotions.

This book investigates the question of how our emotions can enable us to know.  It claims that human emotions are not just feelings of physiological disturbance: rather, they are experiences in which we apprehend significant matters of concern.  When Pascal noted that the heart has its own reasons, he indicated that our dispassionate rational faculty alone cannot grasp what is revealed in our affective experience.  Knowing Emotions seeks to explain why human emotions are indeed capable of making us aware of significant truths that we could not know by any other means.

Recent philosophical and interdisciplinary research on the emotions has been dominated by a renewal and further development of the debate over how best to characterize the intentionality of emotions as well as their bodily character.  In Knowing Emotions, I argue that intentionality and feeling are not two discrete parts of affective experience, but conceptually distinguishable aspects of a single unified response.  My account captures how an emotion’s phenomenal or “felt” quality (what it is like) is related to its intentional content (what it is about).

Tuesday, 20 March 2018

What Makes a Belief Delusional?

In December 2016 an exciting volume entitled Cognitive Confusions: Dreams, Delusions and Illusions in Early Modern Culture has been published by Legenda. The book, edited by Ita McCarthy, Kirsty Sellevold and Olivia Smith, contains a chapter authored by Ema Sullivan-Bissett, Rachel Gunn and myself on the challenges we face when we want to tell delusional beliefs apart from other beliefs.

We start with the standard DSM definition of delusions, and explain that clinical delusions are characterised by surface features of two kinds, epistemic (fixity, implausibility) and psychological (negative impact on functioning). Then we ask whether we can decide whether a type of belief is delusional by using those criteria. We consider three cases of belief that match at least some of the criteria: the belief that some thoughts have been inserted in one's mind by a third party; the belief that one has been abducted by aliens; and the belief that one is better than average at just about everything.

Discussing the similarities and differences among such beliefs -- Are they based on evidence? Are they common or rare? Do they bring any benefit? Do they help explain anomalous experience? -- is relevant to two projects that have been featured on this blog before: the Costs and Benefits of Optimism project and the PERFECT project. In the end, our goal is to show that neither the epistemic nor psychological features mentioned in the definition of delusions can help us sort delusional beliefs from non-delusional ones. Some delusions do not meet the criteria and some beliefs that we would not class as delusions do.

Rachel Gunn (who successfully completed her PhD at the University of Birmingham, working on delusions) examines the phenomenon of thought insertion by using very interesting first-person reports by people who used internet forums to share their unusual experiences. She observes that the experience affects people in different ways. For some but not for all the thought is felt like an unwelcome intrusion. For some but not for all the content of the thought also generates a compulsion to think or do certain things. Thought insertion is regarded as a symptom of schizophrenia, but whether it involves a pathological experience, whether it is a delusional belief, or whether it is harmful cannot be established without reflecting on the specifics of the individual case.

Here is one of the first-person reports Rachel analyses:
i truly do have unwanted thoughts that are forced into my head from somewhere... I mean I will have a thought saying my grandmother is a bitch. I would never ever think of my grandmother as a bitch. She is one of the greatest women I know and I adore her. So how is that a delusion? It is an intrusive thought! I sure didnt imagine it!.... i really do not think my grandmother is a bitch. i think these thoughts are evil and came from an evil being. Some thoughts however that pop into my head all of a sudden are my own thoughts and i can recognize that even though they are unwanted, but some are just plain ridiculous and mean and i know must be from an outside force. 
Star-28, ‘Forum’, Mental Health Forum (2010)

Thursday, 15 March 2018

Unbelievable Errors

This post is by Bart Streumer. Bart Streumer is Professor of Philosophy at the University of Groningen. In this post he introduces his book Unbelievable Errors, which has recently been published by Oxford University Press.

Widespread beliefs can be systematically mistaken. Take religious beliefs: if God does not exist, these beliefs are all mistaken. But you may think that some widespread beliefs cannot be mistaken in this way. For example, consider normative judgements: our beliefs about what is right or wrong, or about what there is reason to do or to believe. Could these beliefs be systematically mistaken?

In my book Unbelievable Errors, I argue that they are. I argue that normative judgements ascribe normative properties, but that these properties do not exist. This means that all normative judgements are false. For example, the belief that stealing is wrong ascribes the property of being wrong to stealing, but this property does not exist, which means that this belief is false. The belief that stealing is permissible ascribes the property of being permissible to stealing, but this property does not exist either, which means that this belief is false as well. And similar claims apply to all other normative judgements.

The view I defend in the book is known as ‘error theory’. Some philosophers accept such a theory about moral judgements. But the error theory about all normative judgements that I defend may seem so bizarre as to be simply incredible. I agree. For in addition to defending the error theory, I also argue that we cannot believe this theory. If I am right that the theory is true of judgements about reasons for belief, the theory entails that there is no reason to believe the theory. I therefore think that we only really believe the error theory if we believe that there is no reason to believe the theory. And I argue that we cannot do this: we cannot have a belief while at the same time believing that there is no reason for this belief. If so, it follows that we cannot believe the error theory.

If I am right that we cannot believe the error theory, the arguments I give in my book cannot convince anyone that this theory is true. That is why I have called the book  Unbelievable Errors. But the fact that an argument cannot convince us does not show that this argument is unsound. Moreover, I argue that our inability to believe the error theory actually makes the theory more likely to be true, since it helps to answer objections to the theory, it makes it harder to reject the arguments for the theory, and it undermines revisionary alternatives to the theory. I therefore think that our inability to believe the error theory is an advantage rather than a problem for the theory.

When we have mistaken beliefs, it is normally possible for us to see that these beliefs are mistaken. But this may not always be possible. If I am right, our normative judgements are systematically mistaken in a way that we are unable to see.

Tuesday, 13 March 2018

The Paradoxical Self

Today's post is by Clara Humpston. Clara is a Research Associate at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London.

Not long ago I completed my PhD from Cardiff University and this paper was first written a couple of years ago when I was a PhD student there.

My PhD research focused on the pathogenesis of psychotic symptoms and adopted a cognitive neuropsychiatric approach by incorporating behavioural and phenomenological investigations. In my second post for Imperfect Cognitions, I summarise my most recent theoretical paper on the paradoxical nature of self-awareness in schizophrenia, published in Philosophical Psychology.

The primary manifestations of schizophrenia in my opinion, are basic self-disturbances leading to the adoption of a solipsistic lifeworld that provides fertile ground for the development of psychotic phenomena such as first-rank symptoms. First-rank symptoms are often disruptions of one’s ego-boundary: that is, one’s demarcation between the internal and external worlds, between self and other. This paper aims to provide an integrated account of the structure of self-disorders found in schizophrenia and shed further light on the issues of paradoxicality and solipsism which are often overlooked or ignored in the clinic.

Contemporary theorists such as Louis Sass and Josef Parnas have further disentangled anomalous self-experience (‘ipseity disturbance’, from Latin ipse – ‘self’) into a combination of factors termed ‘hyperreflexivity’ and ‘diminished self-affection’, which is a dominant theory which has guided many others’ pursuits in this matter. According to Sass and Parnas, ipseity is the most fundamental, pre-reflective and vital level of the broadly defined ‘sense of self’ and concerns the ‘experiential sense of being a vital and self-identical subject of experience or first-person perspective on the world’ which is tacit and property-less, but forms the very foundation of other more complex levels of the self.

Thursday, 8 March 2018

Real Hallucinations

This post is by Matthew Ratcliffe, Professor for Theoretical Philosophy at the University of Vienna, Austria. Ratcliffe also leads the Phenomenological Psychopathology and Philosophy of Psychiatry research group. Most of his recent work addresses issues in phenomenology, philosophy of mind, and philosophy of psychiatry. He is the author of: Rethinking Commonsense Psychology: A Critique of Folk Psychology, Theory of Mind and Simulation (Palgrave, 2007), Feelings of Being: Phenomenology, Psychiatry and the Sense of Reality (Oxford University Press, 2008), and Experiences of Depression: A Study in Phenomenology (Oxford University Press, 2015).

In this post Ratcliffe presents a review of his most recent book Real Hallucinations: Psychiatric Illness, Intentionality and the Interpersonal World.

When we perceive something, we seldom wonder whether we are actually perceiving it rather than imagining or remembering it. Perceptual experience ordinarily incorporates a pre-reflective sense of perceiving, an observation that applies equally to other types of intentional states. For instance, what we imagine is usually experienced as imagined. In Real Hallucinations, I develop an account of what this sense of being in an intentional state consists of, through an exploration of various changes in the structure of intentionality that can occur in psychiatric illness.

One might think that the sense of being in one or another type of intentional state is easy enough to characterize: it is a matter of experiential content. Certain aspects of perceptual content are specific to perception in one or another modality; aspects of imagined content are specific to one or another type of imagining; and so forth. However, I show that this cannot be the case, as sense and content are dissociable. To do so, I offer a detailed examination of thought insertion (TI) and auditory verbal hallucination (AVH). I argue that many of those experiences referred to as TI and/or AVH involve a sense of perceiving something, but without the usual perceptual content.

An experiential content resembling that of inner speech, autobiographical memory, or some form of imagination comes to be associated with the sense of encountering something perceptually. In such cases, the sense of perceiving is usually incomplete and often conflicted, resulting in an intrinsically strange experience that stands out as distinct from mundane forms of intentionality. I go on to show how experiences like this tend to arise in the context of much more pervasive but less pronounced disturbances of the structure of intentionality. This approach, I suggest, also applies to many other anomalous experiences that are labeled as “delusions” and “hallucinations”.

Tuesday, 6 March 2018

Taxonomising Delusions

Colin Klein

We are philosophers working on various topics that intersect with delusions. Colin Klein works on the philosophy of neuroscience and the application of interventionist accounts of causation to this area, and has also discussed the relation between psychopathologies like somatoparaphenia and his theory of pain. Stephen Gadsby works on distorted body representations and false body size beliefs in anorexia nervosa. And Peter Clutton has defended the doxastic status of delusions—offering a cognitive phenomenological account of delusions (forthcoming)—and explored the status of delusions on the harmful dysfunction account.

Peter Clutton

Any discussion of delusions needs some criteria by which patients are grouped together as having the same delusion. In our paper, ‘Taxonomising Delusions: content or aetiology?’, we compare content-based and aetiological taxonomies of delusions, arguing in favour of the latter.

Stephen Gadsby

Most authors taxonomise delusions by the content of the delusional belief: Capgras patients believe that their spouse has been replaced by an imposter, Cotard’s delusion involves the belief that one is dead, and so on. Taxonomising by belief content has intuitive appeal. Content is often what brings patients to clinical attention in the first place, and may be all a researcher has to work with. Additionally, content appears to offer a theory-neutral starting point, in that it does not presuppose any particular theoretical explanation of the underlying causes of delusions.

We argue that these intuitive advantages are not as strong as they seem, and that an aetiological taxonomy is to be preferred: that is, we think that patients ought to be grouped by the causes of their delusions, rather than by what they believe. An aetiological taxonomy has the advantage of supporting the kinds of empirical generalisations we want from scientific taxonomies. Good taxonomies identify similarities among group members that manifest across a variety of distinct circumstances. In studying the cognitive processes that lead to delusions (and thereby learning about the normal processes of cognition, as cognitive neuropsychiatrists aim to do), we want discoveries about one patient to guide our thinking about other patients we encounter with the same problem. Taxonomising delusions by their underlying cognitive causes allows for just such projectability.

Thursday, 1 March 2018

Philosophy of Mind Workshop Series

Does philosophy have a purpose outside academia? What does philosophy look like when it’s done beyond the walls of the lecture theatre and the seminar room? And who should get to do it? I got to think quite a bit about these questions recently. It was back at the start of 2017 that I travelled to London to meet some of the senior team from mental health charity Mind in Camden to discuss the possibility of developing a series of philosophy workshops, based on project PERFECT’s research, and running them at Mind in Camden, for people with lived experience of unusual beliefs and experiences, and mental distress, as well as for service providers and mental health advocates.

Mind in Camden runs training, support and capacity building services to benefit people who are struggling with mental distress, and I saw commonalities between its values and the sorts of conceptions of mental health and rationality that we’re arguing for through PERFECT. So, the organisation was a natural partner in this collaboration. 

The idea of the workshop series was this: in groups of around 10, we would learn some philosophical techniques, and set up a receptive space for debate in which to exercise these, and then, drawing on aspects of PERFECT’s research, and inviting reflection on lived experience, we would explore and critique different theories of mental health and rationality.

It’s the first time I’ve done something like this with project PERFECT. As I sat on the 29, chugging up Marylebone Road, on my way to the first session, I did wonder to myself: would any of this be of any use – or interest – to Mind in Camden’s members?

Tuesday, 27 February 2018

Dissociative Identity Disorder, Ambivalence and Responsibility

Today's post is by Michelle Maiese, Associate Professor of Philosophy at Emmanuel College in Boston, Massachusetts. Her research focuses on topics in philosophy of mind, philosophy of psychiatry, and moral psychology.

There has been debate among philosophers about how to address issues of responsibility in cases where subjects suffer from dissociative identity disorder (DID). If one personality commits a wrongful act of which another was unaware, should we regard this individual as responsible for her actions? If we regard DID as a case in which multiple persons inhabit a single body, it may seem natural to conclude that each alter is a separate agent and that one alter is not responsible for the actions of another. However, in “Dissociative Identity Disorder, Ambivalence, and Responsibility", I argue that even once we acknowledge that a subject with DID is a single person, there are still serious reasons to question the extent to which she is responsible for her actions.

This is because a subject suffering from DID often will find it difficult to exercise autonomous agency. This individual cannot control the slide into one or another alter-state, and once she is in that state, she will lack awareness of many considerations favoring a particular course of action. In addition, due to disturbances in memory and self-awareness, the subject with DID is either incapable of remembering prior decisions, or incapable of being properly motivated by them. Even if a subject decides on a course of action, other desires and priorities may ‘take over’ once she switches to a different alter-personality. Also, there may be so much psychological fragmentation and memory loss that it becomes difficult for her to foresee what she will do or assess the long-term consequences of her actions.

I argue that these impairments in agency are the direct result of extreme ambivalence: young children who develop DID experience extreme inner conflict regarding emotional needs to which they feel deeply attached. Suppose that Sue hates her mother and wants her to die, but also loves her mother and wants to have a close relationship with her. Rationality demands that Sue alter her desires appropriately. However, suppose that Sue feels so strongly attached to both of these conflicting desires that there is no way to achieve a well-integrated, unified perspective. What allows her to avoid crumbling under the pressure of inner contradictions is the belief that her conflicting mental states belong to separate selves. That is, she both accepts certain desires and tries to rid herself of them, and those desires that seem like ‘unacceptable intruders’ are handed off to an alter-personality. This ‘handing-off’ of desires and actions thus can be understood as Sue’s attempt to mask contradictions and manage inner conflict. Although extreme dissociation may intensify emotional disturbance over the long-term, it may be in Sue’s short-term interests in the sense that it allows her to compartmentalize painful feelings and memories.

Such compartmentalization can be paralyzing or lead to other disruptions of agency. It is notable that “competing” alter-personalities often vie for control of the body. For example, alters sometimes intervene in the lives of other alters by destroying their school work, spending their money, or hiding their things. This lack of a coherent will also is evidenced via the phenomenon of waverings, when one alter attempts to do something that is directly at odds with the goals and intentions of another. Such struggles for control should be understood as the outward signs of inner conflict. Because the subject with DID suffers from persistent and pervasive ambivalence, she does not form an integrated will and is largely incapable of restructuring it. Since her concerns and attitudes are not integrated, she is unable to arrive at an ‘all-things-considered’ judgment about what it would be best to do

If it is true that subjects with DID suffer from extreme ambivalence of the sort I describe, then it would be a mistake to regard them as responsible for their wrongful actions in the same way that we regard ordinary adults as responsible. However, although autonomy and responsibility are eroded in such cases, they do not disappear altogether. If such a subject behaves wrongfully, there certainly is ‘part’ of her that wanted to do so, and thus, the action is attributable to her. Furthermore, even if she cannot exercise self-determination, it is important to acknowledge that her overall capacity for autonomous agency remains intact. This means there may be steps she can and should take to attempt to restore her autonomy or prevent any immoral actions from occurring.

Thursday, 22 February 2018

On Folk Epistemology

Mikkel Gerken is associate professor at the University of Southern Denmark. In this post he writes about his new book ‘On Folk Epistemology. How we think and talk about knowledge’.

A central claim of my book, On Folk Epistemology. How we think and talk about knowledge, is that some folk epistemological patterns of knowledge ascriptions are best explained by cognitive biases. I argue that this approach to folk epistemology yields diagnoses of some hard puzzles of contemporary epistemology. So, On Folk Epistemology seeks to contribute to some prominent debates in contemporary epistemology. For example, I criticize contextualism, pragmatic encroachment, knowledge-first epistemology etc. If you want to check it out, there is an introduction and overview here.

In this blog post, however, I will emphasize why the study of folk epistemology is an important task. In a nutshell, it is because folk epistemology is extremely consequential. Consider, for example, the roles of knowledge ascriptions in our social interactions. We acquire the ability to think and talk about knowledge early in life. Moreover, mental and linguistic ascriptions and denials of knowledge remain extremely prominent in adulthood. Indeed, linguistic knowledge ascriptions are arguably among the most important speech acts that we engage in on a daily basis.

To ascribe knowledge to oneself or to someone else is a powerful speech act that gives the proposition said to be known a special status. Often it indicates that we are in a position to act on the proposition. Moreover, the subject to whom knowledge is ascribed is often given a stamp of social approval or disapproval. Just consider phrases such as “she is in the know” or “he doesn’t know what he is talking about.” Consequently, knowledge ascriptions are central to many of the social scripts that govern social life. So, if our knowledge ascriptions and intuitions about them are biased, we’d want to understand how and why. After all, we do not want to make our decisions about whom to trust and how to act based on biased judgments.

Understanding the biases of our folk epistemology is all the more urgent given that they may lead to social injustices. This may be the case if biases reflect stereotypes that pertain to gender, race or class. Folk epistemological biases are particularly relevant to distinctively epistemic injustices. While epistemic injustices may be caused by general “identity prejudices”, folk epistemological biases are especially relevant.

After all, they may lead us to mistakenly regard someone who in fact knows that p as not knowing it. Thus, biases of our folk epistemology may lead to “wrongs done to someone specifically in their capacity as a knower” which is Miranda Fricker’s initial conception of epistemic injustice (Fricker 2007). At present, we do not know enough about whether folk epistemological biases interact with biases pertaining to gender, race or class. Here I think of On Folk Epistemology as providing part of a framework for further research on epistemic injustice.

Tuesday, 20 February 2018

Why Moral and Philosophical Disagreements Are Especially Fertile Grounds for Rationalization

Today's post is by Jonathan Ellis, Associate Professor of Philosophy and Director of the Center for Public Philosophy at the University of California, Santa Cruz, and Eric Schwitzgebel, Professor of Philosophy at the University of California, Riverside. This is the second in a two-part contribution on their paper "Rationalization in Moral and Philosophical thought" in Moral Inferences, eds. J. F. Bonnefon and B. Trémolière, (Psychology Press, 2017) (part one can be found here).

Last week we argued that your intelligence, vigilance, and academic expertise very likely doesn't do much to protect you from the normal human tendency towards rationalization – that is, from the tendency to engage in biased patterns of reasoning aimed at justifying conclusions to which you are attracted for selfish or other epistemically irrelevant reasons – and that, in fact, you may be more susceptible to rationalization than the rest of the population. This week we’ll argue that moral and philosophical topics are especially fertile grounds for rationalization.

Here’s one way of thinking about it: Rationalization, like crime, requires a motive and an opportunity. Ethics and philosophy provide plenty of both.

Regarding motive: Not everyone cares about every moral and philosophical issue of course. But we all have some moral and philosophical issues that are near to our hearts – for reasons of cultural or religious identity, or personal self-conception, or for self-serving reasons, or because it’s comfortable, exciting, or otherwise appealing to see the world in a certain way.

On day one of their philosophy classes, students are often already attracted to certain types of views and repulsed by others. They like the traditional and conservative, or they prefer the rebellious and exploratory; they like confirmations of certainty and order, or they prefer the chaotic and skeptical; they like moderation and common sense, or they prefer the excitement of the radical and unintuitive. Some positions fit with their pre-existing cultural and political identities better than others. Some positions are favored by their teachers and elders – and that’s attractive to some, and provokes rebellious contrarianism in others. Some moral conclusions may be attractively convenient, while others might require unpleasant contrition or behavior change.

The motive is there. So is the opportunity. Philosophical and moral questions rarely admit of straightforward proof or refutation, or a clear standard of correctness. Instead, they open into a complexity of considerations, which themselves do not admit of straightforward proof and which offer many loci for rationalization.

These loci are so plentiful and diverse! Moral and philosophical arguments, for instance, often turn crucially on a “sense of plausibility” (Kornblith, 1999); or on one’s judgment of the force of a particular reason, or the significance of a consideration. Methodological judgments are likewise fundamental in philosophical and moral thinking: What argumentative tacks should you first explore? How much critical attention should you pay to your pre-theoretic beliefs, and their sources, and which ones, in which respects? How much should you trust your intuitive judgments versus more explicitly reasoned responses? Which other philosophers, and which scientists (if any), should you regard as authorities whose judgments carry weight with you, and on which topics, and how much?

These questions are usually answered only implicitly, revealed in your choices about what to believe and what to doubt, what to read, what to take seriously and what to set aside. Even where they are answered explicitly, they lack a clear set of criteria by which to answer them definitively. And so, if people’s preferences can influence their perceptual judgments (including possibly of size, color, and distance: Balcetis and Dunning 2006, 2007, 2010) what is remembered (Kunda 1990; Mele 2001), what hypotheses are envisioned (Trope and Liberman 1997), what one attends to and for how long (Lord et al. 1979; Nickerson 1998) . . . it is no leap to assume that they can influence the myriad implicit judgments, intuitions, and choices involved in moral and philosophical reasoning.

Furthermore, patterns of bias can compound across several questions, so that with many loci for bias to enter, the person who is only slightly biased in each of a variety of junctures in a line of reasoning can ultimately come to a very different conclusion than would someone who was not biased in the same way. Rationalization can operate by way of a series or network of “micro-instances” of motivated reasoning that together have a major amplificatory effect (synchronically, diachronically, or both), or by influencing you mightily at a crucial step (Ellis, manuscript).

We believe that these considerations, taken together with the considerations we advanced last week about the likely inability of intelligence, vigilance, and expertise to effectively protect us against rationalization, support the following conclusion: Few if any of us should confidently maintain that our moral and philosophical reasoning is not substantially tainted by significant, epistemically troubling degrees of rationalization. This is of course one possible explanation of the seeming intractability of philosophical disagreement.

Or perhaps we the authors of the post are the ones rationalizing; perhaps we are, for some reason, drawn toward a certain type of pessimism about the rationality of philosophers, and we have sought and evaluated evidence and arguments toward this conclusion in a badly biased manner? Um…. No way. We have reviewed our reasoning and are sure that we were not affected by our preferences....

Thursday, 15 February 2018

Social Media and Youth Mental Health

On 14th November there was an interesting conference at the Royal Society of Medicine on the effects of social media on mental health.

Mary Aiken (University of College Dublin) discussed the Cyber Effect, her book which addresses the risks of social media on young people (cover below). Cyber space is a space and we need to consider the impact of it on vulnerable populations such as teens. We need to factor in developmental aspects (at what age should parents let children have a smartphone?). We need to recognise the continuous evolution of behaviour and as experts we need to drive policy initiatives and develop guidelines for parents and educators.

Jon Goldin (Great Ormond Street Hospital) talked about the risks and benefits of social media for young people. Children like using social media for different reasons: they use it for communication, to express themselves, to gain confidence, for popularity, for entertainment, to develop a sense of belonging, to receive information. Social media is risky for adolescents: it may cause a lack of sleep; due to anonymity, it encourages bad behaviour such as cyberbullying; it may facilitate gambling; and it can be used to research suicide methodology.

The worrying data suggest a correlation between social media use and mental health issues. There can be advantages to the use of social media such as ready availability of information, but the reasons to worry are greater than the reasons to be optimistic unless measures are taken to regulate the use of social media. One worry concerns anorexia nervosa: whereas some sources offer support there are sites inviting people to be anorexic and offering tips to avoid food. Another worry concerns child protection such as preventing grooming and sexting.

What are the possible solutions to these problems? There needs to be more education (sex education and internet security in schools). There needs to be an acknowledgement that social media has good effects, an open discussion about it with adolescents. Social media cannot be banned entirely but there needs to be boundaries, such as no more than two hours of social media a day and no social media in the bedroom after a certain time.

Tuesday, 13 February 2018

Rationalization: Why your intelligence, vigilance and expertise probably don't protect you

Today's post is by Jonathan Ellis, Associate Professor of Philosophy and Director of the Center for Public Philosophy at the University of California, Santa Cruz, and Eric Schwitzgebel, Professor of Philosophy at the University of California, Riverside. This is the first in a two-part contribution on their paper "Rationalization in Moral and Philosophical thought" in Moral Inferences, eds. J. F. Bonnefon and B. Trémolière, (Psychology Press, 2017).

We’ve all been there. You’re arguing with someone – about politics, or a policy at work, or about whose turn it is to do the dishes – and they keep finding all kinds of self-serving justifications for their view. When one of their arguments is defeated, rather than rethinking their position they just leap to another argument, then maybe another. They’re rationalizing –coming up with convenient defenses for what they want to believe, rather than responding even-handedly to the points you're making. You try to point it out, but they deny it, and dig in more.

More formally, in recent work we have defined rationalization as what occurs when a person favors a particular view as a result of some factor (such as self-interest) that is of little justificatory epistemic relevance, and then engages in a biased search for and evaluation of justifications that would seem to support that favored view.

You, of course, never rationalize in this way! Or, rather, it doesn’t usually feel like you do. Stepping back, you’ll probably admit you do it sometimes. But maybe less than average? After all, you’re a philosopher, a psychologist, an expert in reasoning – or at least someone who reads blog posts about philosophy, psychology, and reasoning. You're especially committed to the promotion of critical thinking and fair-minded reasoning. You know about all sorts of common fallacies, and especially rationalization, and are on guard for them in your own thinking. Don't these facts about you make you less susceptible to rationalization than people with less academic intelligence, vigilance, and expertise?

We argue that no. You’re probably just as susceptible to post-hoc rationalization, maybe even more, than the rest of the population, though the ways it manifests in your reasoning may be different. Vigilance, academic intelligence, and disciplinary expertise are not overall protective against rationalization. In some cases, they might even enhance one’s tendency to rationalize, or make rationalizations more severe when they occur.

While some biases are less prevalent among those who score high on standard measures of academic intelligence, others appear to be no less frequent or powerful. Stanovich, West and Toplak (2013), reviewing several studies, find that the degree of myside bias is largely independent of measures of intelligence and cognitive ability. Dan Kahan finds that on several measures people who use more “System 2” type explicit reasoning show higher rates of motivated cognition rather than lower rates (2011, 2013, Kahan et al 2011). Thinkers who are more knowledgeable have more facts to choose from when constructing a line of motivated reasoning (Taber and Lodge 2006; Braman 2009). 

Thursday, 8 February 2018

Challenges to Wellbeing

The workshop Challenges To Wellbeing: The Experience of Loneliness and Epistemic Injustice in the Clinical Encounter originated from a multi-disciplinary conversation about wellbeing and happiness. Exploring the theme of challenges to wellbeing, this conversation brought together academics from across the University, practitioners, and campaigners. The workshop was hosted by Lisa Bortolotti and Sophie Stammers for project PERFECT, and co-organised and funded by the Institute of Advanced Studies (IAS). It was held at the Centre for Professional Development (CPD) in the Medical School on the 22nd of November 2017. This is a detailed report on the talks given that day.

The workshop was divided in three sessions. Session One was dedicated to Themes from Project PERFECT.

Kathy Puddifoot started with an Introduction to Epistemic Injustice. She defined epistemic injustice and spoke about the different types that have been identified. Kathy explained that since the processes of giving and receiving knowledge are social, we rely on others for these to happen in a fair way. Epistemic injustice happens when people are wronged in their capacity as knowers and thus treated unfairly in these processes of knowledge exchange.

The first type of epistemic injustice, which was identified by Miranda Fricker, is testimonial injustice. Examples of this type of injustice are the stereotype that women depend on intuition or black people are athletic, not intelligent, or the stereotype that people with mental health issues are crazy. In cases of this type specific stereotypes determine the lack of credibility given to people from those groups.

Kathy then went on to describe the second type of epistemic injustice identified by Miranda Fricker, hermeneutical injustice. Kathy explained that people need specific resources (e.g. conceptual resources) to understand and articulate their own experiences. But as a result of how society is structured, some stigmatized groups can be denied of such resources and this puts them in a disadvantageous position within that society. Fricker’s example of this is the term sexual harassment, and Kathy added the example of postnatal depression. An important distinction here is lack of concepts within the person who has the experience and lack of conceptual resources within other people. Some members of groups have their own understanding but are not able to explain those experiences to non-group members.

The last type of epistemic injustice that Kathy talked about is testimonial silencing. Identified by Kristie Dotson, the two forms of this type of epistemic injustice are testimonial quieting (which happens when ‘an audience fails to identify the speaker as a knower’); and testimonial smothering (which happens when the speaker believes her testimony will be misinterpreted so she self-silences) Kathy said that the example Dalston gives of this second group is black domestic violence victims in the U.S. Kathy noted that epistemic injustice can be wilful and intentionally chosen or unintentional. Empirical findings suggest that implicit bias can lead people to avoid eye contact with members of certain groups. And this can cause members of these groups to silence themselves. Kathy argued that this could be a case of implicit bias leading to a form of epistemic injustice and testimonial smothering.

The second speaker was Alex Miller Tate. Alex talked about how issues of epistemic injustice emerge in the psychiatric encounter. He did so by discussing the paper Epistemic Injustice in Psychiatry by P. Crichton, H. Carel, and I. Kidd (2016). Alex explained that the focus in this paper is on testimonial injustice and that three points are argued. First, that it is psychiatric service users in their interactions with medical staff who are particularly vulnerable to testimonial injustice.

Second, a similar sort of injustice might emerge from the fact that medical professionals might enjoy undue credibility inflation. Third, two factors may contribute to these injustices: global prejudices about the mentally ill; and specific prejudices about people with specific diagnosis. The example Alex gave is people who are diagnosed with schizophrenia which are seen as intrinsically violent. This can contribute to undue credibility deflation of these people's testimonies. The recommendation made in the paper is for medical staff to develop specific dispositions to behave in ways that they actively seek to give respect and credibility to patients’ testimonies.

Alex raised two questions on this recommendation. First, stigma and prejudice are thought as extending beyond individual interactions in the psychiatric encounter, and are thought in terms of social structure. Alex argued that amongst structural failings we can find the lack of what he called socially accepted markers of credibility that psychiatric service users have. An instance of these markers is the credibility we generally give to people who are well dressed and whose personal hygiene is impeccable.

This quality can be lost in people with specific psychiatric issues. Alex argued that these markers are not shared widely enough. And even when there is nothing wrong with using markers of credibility, injustice can be perpetuated when people use them in the clinical encounter. He argued that service users might lack access to the kinds of epistemic resources that are necessary to make sense of their experience. Here the problem seems to go beyond the responsibility of the clinician. It seems to relate to how knowledge in psychiatry is produced and disseminated to the wider population. The final point in relation to epistemic resources was that it might be the case that service users develop resources themselves. This can be illustrated by service user movements. But attempts to communicate these insights to clinicians are often undervalued.

The second question Alex raised was whether service users are vulnerable to other forms of epistemic injustice apart from the ones identified by Crichton, Carel and James. Alex argued that at times the testimony involved is risky. This happens for various reasons one of them being that there is a chance of harm if the testimony is misinterpreted; and another that psychiatric professionals have power over service users which they can use appropriately or not. These are the powers of detention, the powers of enforcing treatment, powers of giving or refusing care. All of these different kinds of risks, especially in recent history and crisis care, Alex argued, are present when there is testimony about symptoms or experiences involved.

I gave the third talk On the Experience of Loneliness and Solitude. The first part of the talk was about the experience of Loneliness. I provided a review of the existing empirical research, raised some philosophical questions and concerns, and talked about loneliness in adolescence. I dedicated the second part of the talk to solitude and some of its benefits.

I started talking about how the research that has been done over the past decades has shown the influence that loneliness has on our mental and physical health. And referred to a Meta-Analysis of Interventions to Reduce Loneliness (Masi, Cheng, Hawkley and Cacioppo, 2011) where four different strategies used in interventions for alleviating loneliness are identified.