Tuesday 23 August 2016

Belief, Quasi-Belief, and Obsessive-Compulsive Disorder

This post is by Robert Noggle (pictured above), Professor of Philosophy at Central Michigan University. Robert is interested in psychological conditions that appear to undermine or threaten personal autonomy. His other main interests are in normative and applied ethics. In this post he summarises his recent paper ‘Belief, Quasi-Belief, and Obsessive-Compulsive Disorder’, published in Philosophical Psychology. 

Obsessive-Compulsive Disorder (OCD) is fascinating because it can lead to a radical disconnect between professed belief on the one hand, and affect, motivation, and behaviour on the other. Someone with OCD might sincerely profess her disbelief in the idea, say, that flipping a light switch poses a significant fire hazard if you do not do it just right. Yet such a person might also feel anxiety when flipping a switch, and a strong urge to flip it repeatedly to get it just right.

Of course, psychologists face the puzzle of how people get into such a state, and how best to help them get out of it. But there is a philosophical puzzle here about how to describe the mental state of such a person. Does she believe that flipping light switches is a dangerous activity, or not? Her verbal reports will typically suggest that she does not believe in the hazards of improperly flipping switches. Yet her anxiety and urge to check and re-flip suggest just the opposite. 

It is tempting to suggest that such a person moves back and forth between believing and not believing in the danger of improperly flipped switches. But this suggestion does not pan out when we look at what goes on in one of the most common and effective treatments for OCD, a treatment called Exposure and Response Prevention, or ERP. If our compulsive switch-flipper were to undergo ERP, she would likely be asked to flip a switch once and then leave it alone.

During the early phases of treatment, we would expect her to experience anxiety and a strong urge to re-flip or check the switch. But after repeated treatments, the anxiety and compulsion would likely subside. Here is the puzzling part: During ERP, the patient appears to have contradictory beliefs at the very same instant. The fact that she submits to the treatment at all suggests that she does not believe that improperly flipped switches pose a danger. Yet her anxiety and urges to check or re-flip (which will likely be quite strong at the early stages of ERP) suggest that, at the very same time, she does believe in the danger of improperly flipped switches. Hence, we cannot explain the mental state of an OCD patient during ERP in terms of changing beliefs. 

So what is the solution to this puzzle? My suggestion appeals to a distinction between 'functionally normal' beliefs on the one hand, and 'quasi-beliefs' on the other. A functionally normal belief that P has the characteristics we normally attribute to beliefs: It is at least somewhat vulnerable to direct evidence against P; the agent will normally consciously affirm P (at least to herself); and the agent will tend to employ P as a premise in conscious practical and theoretical reasoning in a wide variety of relevant contexts. By contrast, a quasi-belief that P is extremely resistant to direct evidence of the falsity of P, and the agent may quasi-believe that P despite having no disposition to affirm that P or to use P in any conscious practical or theoretical reasoning. 

The solution I offer to the puzzle of OCD, then, is as follows: At least some cases of OCD are best understood as cases where a person has (1) a quasi-belief that P, and (2) a functionally normal belief that not-P. The quasi-belief that P causes affect and motivation that are at odds with what we would expect given her functionally normal belief that not-P. Our compulsive switch-flipper has a quasi-belief that improperly flipped switches pose a significant fire hazard, but she has a functionally normal belief that no such hazard exists.

If this solution to the puzzle of OCD is correct, then it adds to a growing body of evidence that a lot of human behaviour is driven by mental states that do not conform to the standard Humean belief-desire-action model. Mental states like the ones I am calling quasi-beliefs are sometimes invoked to explain recalcitrant emotions, and it is very tempting to invoke them to explain phobias.

However, unlike phobias, the behavioural component of OCD is far more complicated than simple avoidance behaviour. This makes OCD a better form of evidence for the claim that belief-behaviour mismatches are at least sometimes caused by mental states that have propositional content, as opposed, say, to the non-propositional 'aliefs' that Tamar Gendler introduces to explain simpler forms of belief-behaviour mismatch. In short, OCD seems to provide pretty good evidence for quasi-beliefs to which it is appropriate to attribute propositional content.


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  2. This raises a very interesting question for me, particularly so because I have (relatively mild) OCD myself, and often ask myself how I can make sense of my checking behaviour. The main question is of how I can explain my repeated checking of switches, plugs and the gas hob, given my near certainty that they are safe. But I am not sure that the introduction of the term 'quasi-belief' explains anything - rather, it merely introduces a concept that itself needs explanation. If I only quasi-believe, and do not believe, that the gas hob is still emitting gas, how can that explain why I keep checking it? I might vividly *imagine* that the gas is leaking, and that might make me wonder whether I can be sure the hob is safe. But I would also know that I am only imagining it.

    Perhaps we can make use of the idea of quasi-belief, but I wonder whether something else should not be considered. People with OCD are known for their pre-occupation with certainty - they need to feel certain, rather than merely almost certain, that (e.g.) an appliance is safe. But ask any non-OCD sufferer whether they can be completely certain it is safe, and they might answer 'no, but it doesn't matter - I don't need to be completely certain to be confident that there is no danger'. The OCD checker, by contrasts, needs this complete certainty, since s/he is vividly aware of the horror of being wrong - s/he always tried to avoid even tiny risks of major disasters. In a way, this is rational. What sufferers cannot see is that, in a wider sense, it is irrational to keep on insisting on being rational!

  3. maidmentsam@btinternet.com30 November 2016 at 08:18

    This is very useful and I wondered about how a two year old may start to formulate OCD traits, especially when the child's father, with whom the two year old spends 50% of his time, also displays mild, but often harmful, OCD traits too. And more importantly, whether this trend can be averted or minimised in the two year old. How much is genetic disposition and how much is environmentally induced due to being brought up in an extreme oppressive religious regime? It would appear that UK family courts have no perception of the dangers that they place a two year old into by granting 50% paternal access to a child so that a child can end up being in a psychological trauma and with signs of OCD, even at the age of two.
    So given that the UK family courts have repeatedly preferred to appear "modern and equality minded" give even harmful OCD fathers extensive rights of access to bring up their children, leaving the normalised mother with also 50% access, what can a mother do to help ensure that the poor effect upon the child is minimised and that any OCD traits are treated or minimised too please?


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