Tuesday, 4 May 2021

Political Epistemology

This post is by Michael Hannon and Elizabeth Edenberg. Here they present their new book, Political Epistemology (published by Oxford University Press in May 2021). The following authors have contributed to the book: Elizabeth Anderson, Kristoffer Ahlstrom-Vij, Jason Brennan, Quassim Cassam, Thomas Christiano, Elizabeth Edenberg, David Estlund, Alexander Guerrero, Michael Hannon, Jennifer Lackey, Michael P. Lynch, Fabienne Peter, Jeroen de Ridder, Regina Rini, Jennifer R. Steele, Robert B. Talisse, and Briana Toole.




As current events around the world have illustrated, epistemological issues are at the center of our political lives. It has become increasingly difficult to discern legitimate sources of evidence, misinformation spreads faster than ever, and the role of truth in politics has allegedly decayed in recent years. It is therefore no coincidence that political discourse is currently saturated with epistemic notions like ‘post-truth,’ ‘fake news,’ ‘truth decay,’ ‘echo chambers,’ and ‘alternative facts.’ These issues are part of a rapidly growing area of research called ‘political epistemology.’

The term ‘political epistemology’ only recently entered the academic lexicon, but this newly thriving field has old roots. In the Republic, Plato attacked the epistemic merits of democracy in favor of ‘epistocracy’, or rule by the knowers. In On Liberty, John Stuart Mill touted the epistemic benefits of deliberation for citizens; in Considerations on Representative Government, Mill advocated for plural voting for those with more education in order to improve the quality of political decisions. 


Elizabeth Edenberg


In “Truth and Politics”, Hannah Arendt analyzed the relationship between truth and political freedom. In Political Liberalism, John Rawls put the question of deep and persistent disagreements among citizens at the center of his political inquiry, ultimately arguing that cooperation across disagreements requires setting aside debates about the truth of particular views and instead adopting an agnostic epistemological position.

While scholars have been interested in topics at the intersection of political philosophy and epistemology at least since Plato, the past few years have witnessed an outpouring of new research in this area. For example, new work has been published on propaganda, fake news, political disagreement, conspiracy theories, voter ignorance, climate change skepticism, the epistemic harms of echo chambers, the epistemic merits of (and challenges to) democracy, and intellectual virtues and vices in politics. This rush of interest was largely sparked by the UK Brexit vote and the election of Donald Trump, but the themes that motivate this new research are deeper and more philosophical.


Michael Hannon


Our new book brings together leading political philosophers and epistemologists to explore ways in which the analytic and conceptual tools of epistemology bear on political philosophy, and vice versa. It is organized around three broad themes: truth and knowledge in politics; epistemic problems for democracy; and disagreement and polarization. This book investigates topics such as: the extent and implications of political ignorance, the value of democratic deliberation, the significance of epistemic considerations for political legitimacy, the epistemology of political disagreement, identity politics, political bullshit, and weaponized skepticism.

 

A premise underlying this collection of work is that, beyond a certain point, progress on certain foundational issues in both political philosophy and epistemology cannot be achieved without sharing insights across fields. By bringing political philosophers into conversation with epistemologists, this volume promotes more cross-pollination of ideas while also highlighting the richness and diversity of political epistemology as a newly emerging field. Our hope is that through careful analysis of the philosophical issues underlying contemporary political challenges, we can identify constructive paths forward.


Please note: There will be a virtual book launch on 20th May, 5-7pm (UK time). To register for the Zoom details, please visit this page where you also find a full schedule of the event. All welcome. 
 

Tuesday, 27 April 2021

A Variety of Causes

In today's post Paul Noordhof presents his book, A Variety of Causes (OUP 2020).




A Variety of Causes
began life as an attempt to defend a counterfactual theory of causation that covered cases of indeterminism. Its basic tools were counterfactuals like ‘if e1 were not to occur, e2 would not occur’ (where e1 and e2 are token events) and appeals to probability in the consequent of the counterfactual (so p(e2) rather than e2) to characterise a notion of chance-raising. A successful defence requires a treatment of counterfactuals, identifying the conditions under which they are true and, for the enthusiast, that means I developed further Lewis’s similarity weighting for counterfactuals placing restrictions on the requirement for perfect match and clarifying the approximate match condition. 

More complex counterfactuals were needed to deal with cases of ‘redundant’ causation, like the situation in which one cause pre-empts another candidate cause. The book defends a particular way of doing this involving non-actual situations in which the competing cause is not present together with an analysis of when a causal process is complete and a developed notion of chance-raising. One consequence that falls out of the treatment is that causation is not transitive. But all of this somewhat technical stuff became at the service of something more.

At its most basic, the analysis characterises causes to be something that, independent of their competitors raises the chance of their effect, over its mean background chance, by a complete causal chain. That is not to deny that causes come in many varieties. Some involve transmission of energy; some enable an effect to be produced while others trigger the effect; and some prevent other events from preventing the effect. Nevertheless, in contrast to other approaches, this variety of causes requires no recognition of fundamentally different kinds of causation, given different analyses. The only distinct kinds of causation the book recognises are cases of particular causation which, I argue, is fundamentally between events, and property causation which is distinguished from causation holding between properties in virtue of laws.

The varieties of causation that the book recognises did not stop there. The proposed analysis is neutral between various metaphysical frameworks: those which deny necessary connections between distinct existences such as the Humean approach and those which often assert them like the powers ontology. The orthodoxy (most famously propounded by David Lewis) is to take a successful counterfactual analysis of causation to support Humean approaches because the analysis demonstrates that appeal to necessary connections between distinct existences is not required for causation. 


Paul Noordhof

By contrast, I argue that necessary connections between distinct existences are coherent and our experience may supply evidence of their existence, which is sometimes dismissed because our experience misrepresents them. On the other hand, anti-Humeans make the mistake of presuming that their appetite for a full-blooded metaphysics appealing to necessities represents a necessary condition for causation. There are legitimate grounds for recognising causation in Humean worlds (in which there are no necessary connections between distinct existences of the required kind). Indeed, I argue that it is more plausible to allow causation in Humean worlds than phenomenal consciousness in physical worlds. Good physicalists should not reject the possibility of causation in such worlds.

My neutrality is not a misguided attempt to win friends by alienating both camps. There was another aim. The analysis shows that causation is not fundamental in one sense. The truth of causal statements depends upon facts about chance, the pattern these facts display, and what is required for a causal process to be complete. Call this the vertical sense of fundamentality. However, causation is a common structure of dependences realised in different metaphysical frameworks in different possible worlds. It is plausible that it is a required feature of any world. Call this the horizontal sense of fundamentality. The diverse ways in which causation may be realised allows for possibilities that a Humean metaphysics cannot accommodate without implying that causation cannot be present in Humean worlds. 

The different ways in which causation may be realised also imply different bases for causal non-symmetry (rather than asymmetry). Some of these different bases provide an objective foundation for causal non-symmetry but another draws on a non-symmetry of agency. Causation may have a human ‘interventionist’ face but this is not essential to it and does not support rejection of causation from science, by those suspicious of such an everyday metaphysical notion cropping up there. The extent to which causation is connected to agency does nothing to impugn the fact that it is a horizontally fundamental feature of reality.


Tuesday, 20 April 2021

Delusional Evidence-Responsiveness

This post is by Carolina Flores on evidence responsiveness in delusions. A paper on the same topic has been published open access in Synthese.

Carolina Flores


Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed the evidence-responsiveness of belief and take this to show that delusions cannot be beliefs.

Against this common assumption, I argue that (for the most part) delusions are evidence-responsive—in the sense that subjects have the capacity to rationally respond to evidence on their delusion. This is compatible with the patient rarely successfully exercising that capacity in the actual world, and hence with routine delusional evidence-resistance. Analogously, I might have the capacity to run a sub-40 minute 10k, but rarely be well-rested, calm, and motivated enough to actually do so.

Looking closely, there are many behavioral signs of the capacity to rationally respond to counter-evidence to delusions. For example, patients put substantial effort into avoiding counter-evidence, suggesting that, if they were to acquire that evidence, it might force them to abandon the delusion, or require much effort to avoid revising it. If that evidence would have no effect, why avoid it? More decisively, in successful CBT, patients actually respond to counter-evidence to their delusion, and thereby come to abandon it. CBT’s relatively high success rate shows that many patients have the capacity to rationally respond to such evidence. Check out the paper for a much wider range of evidence, and more detailed discussion.

If patients have such capacities, how come they fail to revise their delusional beliefs in the face of counter-evidence? The reason is that internal factors—such as strange perceptual experiences, motivation to retain the delusion, and cognitive biases that require effort to override—mask these capacities. For example, many patients have persistent altered perceptual experiences which yield apparent evidence for their delusions. And patients are often highly motivated to maintain their delusion, either because it is a pleasant one, or because abandoning it would require the painful realization that something has gone seriously amiss with them. Delusions, then, result from the layering of capacities to respond to evidence and perceptual, motivational, and cognitive masks on those capacities—something, by the way, that is also true of ordinary beliefs.

As a result, we can hold both that belief is constitutively evidence-responsive and that delusions are beliefs. This does justice to the long-standing view that believing essentially involves tracking the way things are while acknowledging that real beliefs often fall drastically short of ideal rationality, and fitting the intuitive, and useful, classification of delusions as beliefs.

Perhaps most importantly, this view has significant implications for how we treat people with delusions. It entails that patients with delusions are not outside the space of reasons—even when it comes to their delusion. Delusions do not justify seeing the patient as only an object to be managed, controlled, and studied under an objective, coldly scientific glace. It can be appropriate to reason with the patient, work to understand the reasons for their delusion, and hold them to epistemic standards. Not only should we continue to invest in CBT for delusions, but we should also reconceive the social standing accorded to people with delusions.

 

Tuesday, 13 April 2021

Imposter Syndrome and Self-Deception

Today's post is by Stephen Gadsby, from the Cognition and Philosophy Lab at Monash University, Melbourne.


Stephen Gadsby


It’s almost like the better I do, the more my feeling of inadequacy actually increases, because I’m just going, ‘Any moment, someone’s going to find out I’m a total fraud, and that I don’t deserve any of what I’ve achieved’ — Emma Watson


Emma Watson’s confession represents a characteristic feature of imposter syndrome, a condition suffered by many intelligent, driven, and successful individuals—Maya Angelou, Charles Darwin, and Albert Einstein, to name a few. People with imposter syndrome feel like frauds because they believe themselves to be less able (e.g., talented, knowledgeable, intelligent) than their peers. The truth of the matter is just the opposite: they are just as, if not more, able. They also have ample evidence in support of this, in the form of achievements, accolades, awards, and the like. A puzzling feature of the phenomenon is the way in which these individuals treat such evidence: dismissing, ignoring, and avoiding it at every turn. In my recent paper, Imposter Syndrome and Self-Deception, I offer an account of this behaviour.

It begins with the fact that humans are motivated reasoners: we reason in ways that not only track truth but advance other interests. One such interest is self-motivation. Think of the student who motivates herself to study by focusing on how unprepared she is for an upcoming exam, or the dieter who motivates himself by selectively focusing on the fatter parts of his body. These kinds of self-motivational strategies suggest a compelling hypothesis: that people with imposter syndrome shirk praise and discount their achievements in order to motivate themselves.

 

In my paper, I lay out a number of conditions that ensure negative beliefs about one’s own abilities bestow an appealing motivational benefit. One condition is a strong desire to succeed in a domain where considerable effort is required. This is a common feature of imposter syndrome, which frequently afflicts success-driven individuals in competitive and challenging environments (e.g., corporate management, academia, and professional sports). In such cases, considerable effort is required to succeed, making motivation a hot commodity.

 

Another condition is the belief that natural ability can be compensated for with hard work. There is good reason to assume that people with imposter syndrome believe such a thing. After all, they work exceptionally hard, despite believing that they lack natural ability. Indeed, many profess to working hard in order to compensate for this lack; as a self-motivational strategy, then, imposter syndrome seems to pay off.

 

For highly success driven individuals, the motivational benefit of negative self-appraisal may be precisely what is required to succeed in the environments in which they find themselves. Given the motivational benefits of imposter syndrome, perhaps we should rethink whether it necessarily ought to be eradicated; perhaps we should instead try to mitigate some of its more harmful features.

 

* Thanks to Dan Williams for useful comments.

 

Tuesday, 6 April 2021

The Epistemology and Morality of Human Kinds

In today's post, Marion Godman (Aarhus University) presents her new book, The Epistemology and Morality of Human Kinds (Routledge 2021).


Marion Godman, photo by Tariq Mikkel Khan


I have written a book about human kinds, such as kinds of gender, religion and ethnicity. In the book I try to answer questions both about how these kinds come about and what their role in science and in policy is. Here I will focus on summarizing some of what I say about the positive role that human kinds can play in science and policy. I have come to think that people (including myself) must often be convinced that there is a point to talk about human kinds before they can take an interest in what they are and how they come about. 

If I were to write a book on natural kinds, I might not have needed to spend much time on this task. After all, few would deny that it is useful to gain knowledge about alleged natural kinds, like mineralogical kinds, chemical elements and different species of mammals. With knowledge about kinds like these we can, for example, make predictions about what unencountered instances will be like, we can begin to systematize and theorize about them, and we can then use our knowledge in everything from technological innovations to environmental conservation efforts. 

But when it comes to human kinds, we don’t think of knowledge so much as all sorts of imperfect cognition. We hold prejudice against individuals in terms of their belonging to a certain race or gender, we use unfitting stereotypes in psychiatric treatment, and we engage in in-group and out-group thinking on the basis of certain categories. Why on earth should science and policy engage with human kinds in the first place? Should it not focus on treating each person as a unique individual as far as possible? 

In the course of my book, I offer several answers in defence of human kinds. The first and most basic role for human kinds is that our knowledge of the human and social world must relies on some form of categorization of particular individuals into kinds just like knowledge of the natural world. True, the generalizations, which we base this knowledge upon, is less secure and less reliable than in the natural sciences. In fact, I suggest that often we are not interested in finding the strong generalisations at all; we are interested in finding reliable comparisons between different groups, say women and men, or comparisons between people with different sorts of professions. 

But not any grouping will do for such comparisons. In principle we could set out to investigate the differential mood of groups that organize their books alphabetically in comparison to the mood of those that organize their books by colour, but we tend to think that little will be learnt from this kind of exercise. Kinds of mental disorder, kinds of profession, and kinds of political affiliation seem much more relevant for generalisations and comparisons. (A good question to ask here is, “why so?” This is where theorizing about human kinds comes in.)


Sometimes, even quite often, individuals will be stereotyped by social and medical science in ways that are not true of them individually (though the link to harmful stereotyping is not well understood). This brings me to a second defence of human kinds. This is that as long as there is wrongful differential treatment in the world ranging from subtle forms of negative stereotyping to historical wrongs to practices of apartheid, then we need some way of detecting patterns of difference between certain groups. One dominant way to do this is precisely via the scientific use of comparative generalizations between different human kinds that I just described.


Say we want to find out if men and women in Denmark have the same risk of facing bankruptcy in their small businesses, or whether an indigenous group in Canada face the same risk of severe illness upon infection of COVID-19 as a non-indigenous population. This implies that we can use empirical, statistical and, if we are very lucky, experimental methods to study comparisons between the same features of different groups. Even then it is of course not sufficient to detect a difference to be able to uncover an injustice (both value judgements and explanations are typically often needed for this), my point is just that a necessary first step for change is to first discover or check for differences between human kinds.




The final defence I offer for the importance of human kinds builds on my specific account of them as historical kinds that come about through individuals learning or assimilating with past models (yes, I know that is very quick, but apart from my book I have some open access papers on historical kinds if you want to take a look). This account does some further things for motivating a scientific interest in human kinds. The first thing is that it corrects for misunderstanding about human kinds such as them typically being explained by fixed neurological or genetic differences. Human kinds are instead predominantly constrained by the available models and different pressures and needs to conform to these models.


Since they are very much part of our inherited cultural fabric, human kinds are not easy to change. In fact, it may not even desirable to change all aspects of human kinds. True, many kinds may be associated with domination and subordination (such as with gender and ethnicity in many places) and this is surely something to resist. But human kinds do also matter for learning how to navigate the world, for inhabiting a social identity that gives us both a sense of uniqueness as well as a sense of belonging.

Tuesday, 30 March 2021

Telling, Hearing and Questioning Stories in Public Dialogue

Today's post is by Katya Lukianova and Tim Steffenmeier who have recently co-authored a paper entitled: "Well, in the case of my mom… Personal stories as negotiable arguments in public forums", appeared in the Journal of Argumentation in Context.

Ekaterina (Katya) Lukianova is a program officer at the Kettering Foundation in the United States, with an interest in developing linguistic tools for analyzing public deliberation. Prior to this, she taught in the Department of English Philology and Cultural Studies at Saint Petersburg State University in Russia. Tim Steffensmeier is Professor of communication & leadership at Kansas State University. He is the founding director of Third Floor Research at the Kansas Leadership Center.


Katya Lukianova


The other day my husband and I (Katya) were having a late night chat about everything and anything after having put our two kids in bed. He was telling me a story about a friend from his student days, and how that friend, who married very young, encountered various challenges in his marriage. I thought the story was interesting, and was asking him questions. As we seemed to have exhausted the subject, my husband said “You know, I was seeing that whole situation differently from the way I used to, as I was recounting it to you. It was so long ago!”

Very often people think of dialogue, and particularly of public deliberation, as a way for people to learn from each other’s experiences, and – hopefully – to be able to understand others’ perspectives better. Various models have been proposed for how this happens; but most of them emphasize how stories told by others can help us see things differently. However, little research has been done on how storytelling and the questioning of stories in public deliberation helps people learn from their own experience, albeit with the help of others. Yet, this line of investigation into how stories are used in public dialogue can be crucial in attaining both better understanding of how deliberation works and in designing better processes.

Conveners of deliberative dialogues often hope that people will enlarge their perspectives and learn from each other’s experience. They also often emphasize that people may have a change of heart when they hear other people’s stories. This, in turn, should help people in communities find common understanding of social issues. Ultimately, it is hoped that this will enable people to cooperate better (examples of such initiatives that we are directly involved with include the National Issues Forums Institute associated with the Kettering Foundation and the Institute for Civic Discourse and Democracy at Kansas State University).


Tim Steffenmeier


However, this expectation that people will be changed in the course of dialogue may also turn some potential participants away, if they feel pressure to change their views on the basis of other people’s opinions. Our inquiry into storytelling indicates – among other things – that learning from one’s own experience through deliberative questioning is as important as learning from other people’s experiences. Personal stories in a deliberative forum are often treated differently than sacrosanct testimony – people agree to be vulnerable and subject themselves to being questioned by others. At the same time, this opens the possibility of people modifying their perspectives in a more organic, gradual, way, than just experiencing a cathartic change of mind because of another person’s testimony.

It is also worth emphasizing that personal stories in public deliberation have a different function than the kind of ultimate persuasiveness that many advocates of worthy causes expect their stories to have. For example, when public health professionals hope to use stories to educate people about COVID-19. They often assume that once the story that conveys their concern is communicated, their purpose is achieved – people will be more likely to trust them and follow their recommendations. It is, indeed, a legitimate and often effective use of the power of storytelling. However, a truly deliberative process respects the existence of competing personal stories, each of which can be questioned, and yet deserves its own respect.

Personal stories as a type of argument in public deliberation seem to have a unique function because they have the potential to invite the right combination of empathy and critical challenge to make sense of the manifold collective experience. As people tell stories in deliberative forums, they learn from each other’s stories, but also from their own stories as they discover new facets of their own experience when others question their stories. People adjust their stories and link them to broader public concern by comparing them to what they hear from others. This process is not conflict free, but it can be a productive process when people share democratic aspirations.

 

Sunday, 21 March 2021

Delusions and Meaning

Today’s post is by Rosa Ritunnano, consultant psychiatrist and PhD candidate at the Institute for Mental Health University of Birmingham. Here she talks about a recent paper she co-authored with Clara Humpston and Matthew Broome, “Finding order within the disorder: a case study exploring the meaningfulness of delusions”, published in the British Journal of Psychiatry Bulletin.

In this paper, we ask questions relating to delusions and meaning, as prompted by the clinical encounter with Harry who is, in his own words, “the happiest man in the world”. Harry was referred to Early Intervention for Psychosis (EIP) services for a suspected first episode of psychosis, after telling his doctor that he had been the target of a worldwide conspiracy for more than 5 years. Harry believes that people are being told lies since the day they are born, and that we all live in a sort of “Truman Show” where the government and the NASA are using fake imagery to fool people into believing that what they see on TV is real. 


Rosa Ritunnano


Harry also believes that there is a hierarchy of people who are taunting him and this hierarchy goes up to Illuminati and the Queen. He thinks that there are lizard people in charge of the earth that have made people believe that the earth is round, when in fact it is flat. Harry is also constantly followed by people in the streets who make gestures as an indication to him that they know about him and about his past deeds. They can interfere with his thoughts, but he is now able to communicate back, putting the right thoughts into people’s minds.

One day, when talking about his current situation with me, Harry said: 
“If I went out one day and I realised that people weren’t expecting me to be there, it would be a real shock again…I would be...I don't know...?! I got so used to people expecting me to be there and lash out with them…I would feel alone again, which is what everyone else feels, like alone. So people are like a family for me, it's like a safety blanket, they make me feel so comfortable now…If I found out that they are not watching me and reading my mind, I would feel alone and crazy like everyone else. To feel like I have everyone following me around, whether it’s negative or positive, that alone is a force of power…knowing that you can influence people’s minds in the right way, I feel like Jesus (of course I’m not) but why not believe?”
While Harry’s case induced a sharp divide between clinicians in relation to issues of diagnosis, bizarreness and need for treatment, I found myself grappling with an ethical dilemma. I was called, in some ways, to make an ethically loaded decision about whether this person’s reality was too “disordered” or “dysfunctional” to be allowed within the limits of “normality”. As a clinician with ten years’ experience in psychiatry, I knew very well the DSM/ICD diagnostic criteria for psychotic disorders and I had been trained to assess risk and functioning, yet I felt unsure as to how we should best understand the sense of meaningfulness that Harry was describing.

Were Harry’s delusions the source of the problem or a response to the problem? What specifically was “dysfunctional” about them? In some ways, they seemed to be enhancing his sense of purpose, meaningfulness and belonging in his life (even if only subjectively). On the other hand, his “usual” life as socially construed (for example, holding a stable job) had been significantly impacted and he was no longer able to work.

Very limited research has investigated the relationship between delusions and the sense of meaning in life. This is in spite of empirical observations that elaborated delusions can enhance a person’s experience of meaning and purpose in life (Roberts, 1991), contribute positively to their “sense of coherence” (Bergstein et al., 2008) and also provide a sense of purpose, belonging and self-identity (Isham et al., 2019)

In addition to their explanatory value, considerations of meaning could have major implications for clinical practice, for example in relation to 1) patient-clinician communication: how should psychiatrists address delusions? (e.g., Zangrilli et al., 2014), 2) nosology: what makes a belief delusional and what makes delusions pathological? (e.g., Bortolotti et al., 2016; Petrolini 2017) and 3) treatment and medical ethics: is there a risk of iatrogenically inducing loss of meaning and subsequent depression if we eliminate self-enhancing delusions without addressing other issues?

Although we might not have all the answers yet, I believe that a phenomenological and value-based approach, along with interdisciplinary efforts from phil- and psy-disciplines, are needed to aid clinicians who often face the seemingly paradoxical coexistence of harmfulness and meaningfulness in individuals with delusions.


Tuesday, 16 March 2021

Is Gender Dysphoria a Disorder?

In this post, Antonella Mazziotta, MSc student at the Institute for Mental Health at the University of Birmingham, discusses Gender Dysphoria. Gender Dysphoria is a topic not so well understood by scientists and society with this being reflected in the type of treatments and stigma around LGBTQ+ communities. Antonella's research interests include exploring Gender Dysphoria in childhood as well as language comprehension and production in Mental Health conditions.


Antonella Mazziotta


I had the opportunity to observe how dysphoria affects transgender people, especially children, and how society plays a vital role in the psychological outcomes of treatment for young people. This led to my interest in researching the pathological features of Gender Dysphoria. Do we believe that transgender children are aware of their inner identity or simply confused and therefore have a mental disorder?

The DSM-IV called this condition ‘Gender Identity Disorder’ which was changed to ‘Gender Dysphoria’ in its latest edition, the DSM-5, because of its unethical and controversial label. The diagnosis of Gender Dysphoria in adolescents consists of symptoms signaling discomfort of the patient with their biological sex and an incongruence between their assigned gender and the expressed one. Therefore, to better understand Gender Dysphoria, the condition and its possible underlying causes we need to start from the basics. What do we mean by biological sex and gender?

Biologically speaking, sex is defined by chromosomes: XX for female and XY for male. However, there is only one set of genes (called SRY) in the Y chromosome that are important to defining the individuals’ sex. It is proven by research that SRY genes can escape from the Y chromosome and ‘jump’ into the X chromosome. It is very complicated science, and we’ll leave this type of research to geneticists, but this gives us a possible hint on where Gender Dysphoria might arise biologically. This means that we have a genetic sex, a chromosomal sex and hormonally altered male, female or non-binary sex. 

Philosophically speaking though, gender is the inner perception of identity, the one felt by the patient which is not necessarily represented by their physical characteristics. Gender Dysphoria, most of the times, starts in childhood when children begin to understand the basic differences between genders around the age of 3. This phenomenon has been numerously documented in accounts of transgender adults that describe the discomfort with their natal sex from a very young age.

Treatments for Gender Dysphoria are complex, distressing and sometimes also inhumane. There is not a specific treatment for this condition, only a series of hormone therapies which consist of blocking the natural development of the natal sex organs to allow the child to experience the desired gender for at least two years. However, such intervention can lead to a loss of fertility and hence the inability to have biological offspring in the future, in addition to the psychological confusion that such therapy may cause. 

Finally, to complete the transition process, the patient must undertake sex reassignment surgery which is also necessary by law to be finally recognised with the desired gender. This suggests that this whole process of gender reassignment is not seen as a relief for the patient rather as a relief for policy makers. As expected, a requirement of this gravity by the law created rancour in the LGBTQ+ community which considered such process unethical and a human rights violation. Not all transgender people want to permanently change their natal sex with surgery and the problem is definitely not in their genitals for a percentage of transgenders.

Going back to the starting question we can conclude by saying that perhaps societal ideologies are partly responsible for such interventions and requirements. Such treatments can be psychologically distressing during early life. In addition, recent research is unravelling the possibility of a comorbidity between Autistic Spectrum Disorder and Gender Dysphoria which should be furthered investigated to better understand both conditions (9-10).

I urge you to ask yourselves some questions. Do people with Gender Dysphoria need treatment? Is there a lack of understanding of the differences between sex and gender in society? Can we really consider Gender Dysphoria in children a phase where there is confusion about identity? Or are we just trying to accommodate society’s beliefs about what is considered normal and abnormal? Education and early prevention seem to be key, especially in those classrooms from which transgender children are normally excluded. Goal directed groups in each classroom can help both parents and children to accept diversity and practice equality.

Tuesday, 9 March 2021

Self Harm and Epistemic Injustice

In this post, Lauren Dixon examines arguments by Sullivan, Pickard, and Pearce on epistemic injustice and nonsuicidal self-injury in healthcare. Lauren argues that the notion of epistemic injustice is useful for patient care and clinician education but that harm minimisation techniques are not the way forward. Lauren is a current MSc student at the Institute for Mental Health, University of Birmingham. Her research interests include childhood well-being, bullying risk/protective factors, special educational needs and mental health advocacy.





NSSI (non-suicidal self-injury) “refers to the direct and deliberate destruction of one's own body tissue in the absence of lethal intent.” Epistemic injustice (a notion developed by Fricker, 2007) can be encompassed as failing to recognise a person as a ‘knower’ based on preconceived, and often incorrect ideas, about their identity.

Fricker argues that there are two types of epistemic injustice: Testimonial Injustice (TI) and Hermeneutical Injustice (HI). The former stipulates that a person’s word is not believed to be credible based on the listeners’ beliefs about their identity. The latter is where the person is not given the tools to impart their knowledge onto a prospective listener. It is well known that those who engage in NSSI are subject to stigmatisation within the healthcare system; so could this stigmatisation then lead to epistemic injustice?

Patrick Sullivan (2019) proposes that this population group experience both TI and HI. Patients experience TI, as they are often placed under false and negative stereotypes, such as being seen as someone who is “just” attention seeking (p. 354). Moving to HI, Sullivan argues that it is the way in which a diagnosis of NSSI is formulated and diagnosed that reduces the space to incorporate patient experience. NSSI patients often feel that the diagnostic process is “unhelpful and leaves them without any adequate means of expressing the reality of their distress.” (p. 355). This suggests that clinicians perhaps rely too heavily on diagnostic protocols when they are engaging with patients.

It is somewhat surprising then, that Sullivan appears to be in favour of harm minimisation techniques (HMT) as one way of continuing to support patients engaging in NSSI. Some examples of HMTs can be found here. In general medicine, a clinician's role is to minimise harm and suffering, not to encourage it. Sullivan’s argument, however, is that by denying the patient the opportunity to self-injure you are causing more ‘net harm’ (more harm overall). This is where EI comes in. By facilitating conversations about self-harm in recovery plans, according to Sullivan, clinicians are more accepting of patient’s account and willing to provide them with the tools to discuss self-injury freely in times of distress.

Is implementing this approach realistic, however, in all healthcare settings? I would say that Sullivan’s argument is failing to consider the deeper context surrounding why a patient self-injures. In his paper, Sullivan has only focused on the broad reasons why patients self-harm (to cope with distress) and argued that clinicians facilitating this action will allow them to feel heard and in turn, aid their recovery. Pickard and Pearce (2017) offer an alternative interpretation. They suggest that people often self-harm due to feelings of low self-worth, shame and self-hatred and thus, by facilitating self-injury in a care setting,
practitioners are reinforcing those beliefs e.g.: ‘We won’t stop you from hurting yourself because you are not worth it’. (p.2).

So instead of relieving the TI and HI felt by patients, Pickard and Pearce argue that HMTs only serve to reinforce the disabling phenomena. In conclusion, despite the evidence from Sullivan regarding HMTs improving clinician-patient relationships, given the risk of mental health deterioration (as demonstrated by Pickard & Pearce), I would conclude that HMTs are not the way forward.

Tuesday, 2 March 2021

Mental illness is a choice, but who is the agent?

Today's post is by Dan Reardon who is currently an MSc student at the Institute for Mental Health, University of Birmingham. Dan is a medical doctor and an entrepreneur who has founded multiple fitness and nutrition companies, including venture capital funded FitnessGenes. He has been featured in InStyle, The New York Times, Men’s Fitness, Inc, Well+Good, Livestrong and on Fox News, ABC News, Inside Edition, Today, BBC News, and “The Doctors.” Dan has a keen interest in the demedicalization of young people, digital wellbeing and resilience.



Dan Reardon


I have a long-held belief that mental illness is far from something that is “real” in the disease sense, and yet the rate of growth of mental disorders, both the number of potential diagnoses (described by Foucault as being an invention of 19th century reformers), and the number of people suffering, is exponential. I’ve read countless accounts of mental illness being a choice of those that “suffer”, but I’ve realised the statement is wrong. The choice to have a mental illness does not solely reside, if at all, with the person seeking counsel, but with the professional that chooses to either reinforce their career decisions, or simply decide that there is an easy way to palm off the challenges of life of that person. 

These choices are heavily reinforced if not lavishly coerced by drug companies, and within this “therapeutic domain” (Hazemeijer and Rasker, 2003), the normal individual having a challenging life becomes the patient with the diseases “anxiety and depression” (that have no biological basis), requiring medications (that don’t fix any identifiable disease) to feel a bit better about all of their life problems that remain exactly the same.

This is not to say, nor to undermine the suffering of the person seeking help, but the second these life challenges become medicalised rather than understood (Laing 1965), is the second that the sense of responsibility to deal with the problems is lost – and it becomes the responsibility of the state. But the state doesn’t fix these underlying challenges, it merely attempts to use poisons (pharmacology from the classic Greek pharmakon meaning 'poison') to make you feel a bit better about the problem or make someone else’s life a bit better/easier.




Let’s look at a stomach-churning example. In 2002 Miami Dolphins player Ricky Williams (adored by many people of all ages) made an appearance on the Oprah Winfrey Show declaring that he suffered with shyness. That sounds quite innocent given 40% of the Western world (in terms of natural temperament) is shy. But this was no ordinary declaration of shyness because Ricky was being paid by Glaxo-Smith-Klein (GSK) to go on the Oprah Winfrey show and declare his shyness. 

In the months following he would become the poster boy of the new “Social Anxiety Disorder” drug called Paxil®/Seroxat® (Paroxetine). Shyness and introversion were now a bona fide pathology (according to the DSM), with a huge opportunity to get 40-50% of the population medicated using a technique called condition branding, and in 2003 alone, sales of Paroxetine globally reached just under $5B.

Alas as if the waters here are not already murky, let’s introduce the 2004 lawsuit by the New York State Attorney suing GSK for failing to disclose important safety and efficacy data about said drug. This all came to light because a memo from 1998 from inside GSK was leaked, telling employees to withhold clinical trial findings that showed the drugs had no beneficial effects in treating adolescents.

Introverted people know all too well the challenges that they face, not least because of how they are socialized with comments like, “he needs to come out of his shell” or “he needs to participate more”, so this insecurity creates a natural “que” to be receptive to a solution to the fabricated social challenges. If you can find a que, and you can build a drug, you will find your title of stigmatization in the DSM.

In her book Lean In, Sheryl Sandberg talks about how young boys on the playground that show leadership are described as “good leaders”, whereas young girls are described as “being bossy”. This is perhaps one of the many reasons why we often lack females in leadership roles, but it’s an example of the effects of stigma and how it can make outcomes in life inevitable. It’s bad enough that we had previously stigmatised shy children, but we now give them a medical diagnosis of social anxiety disorder, autism, or attention deficit disorder, with the perfect medications to fix this.

In conclusion it is my opinion that the fate of people’s mental wellbeing seems to be in the hands of mental health/healthcare practitioners, incentivized to declare a mental illness, and not to make the now contrarian statement that “your health is fine, but you need some support managing your life”, which would not be best managed by the medical profession.

Tuesday, 23 February 2021

Interview with Federico Bongiorno on Delusions

In this post, I interview Federico Bongiorno who recently completed a doctoral project on delusion formation at the University of Birmingham.


Federico Bongiorno



LB: Philosophers are intrigued by delusions. What interests you about them?

FB: There are several things that interest me about delusions, which is part of the reason why I decided to write a PhD thesis comprising of self-standing papers rather a single book-like package. I will focus on just one, the question of whether delusions can be beliefs despite being only marginally belief-like.

Participants in this debate are typically non-committal as to what beliefs are over and beyond our folk-psychological practices. So, when they ask whether delusions are or aren’t belief-like, what they want to know are things such as whether delusions play the same role as beliefs in predicting intentional behaviour, or whether they conform to the stereotypical cluster of attributes (cognitive, behavioural, phenomenal) that we would normally expect beliefs to manifest.

An aspect that has so far been largely neglected in the debate is whether delusions really are beliefs, whether there is any robust and unitary psychological entity to simultaneously fill the role set by our folk concepts of ‘belief’ and ‘delusion’. Are beliefs objects that function within scientific theories, or are they merely part of folk psychology? And are delusions belief-like in a scientific psychological sense, strictly in a folk psychological sense, both, or neither?

Addressing this gap is important, I think, for the at least the two following reasons.

First, we need to ensure that the folk concept of belief is not in conflict with the scientific kind at work in psychology and cognitive science. For otherwise, we should allow for the possibility that delusions may be consistent with one but not with the other, or vice versa.

Second, if we can make lawlike generalisations about the ways we normally fix, update, and store beliefs, then we are in a position to really tell whether the surface features of delusions are features of beliefs.

The hypothesis I explored in my PhD thesis was that delusions are the way they are, deviate from rationality in the ways they do, because of how beliefs function cognitively under highly irregular circumstances, such as anomalous sensory experiences and attentional abnormalities.

So, one thing that interests me which very few people seem to be talking about is whether the status of delusions as beliefs can be assessed outside the folk-psychological discourse, and independent of our regular sayings about belief.

LB: Some philosophers claim that delusions are endorsements of experience and other philosophers argue that delusions are explanations of the experience. What is the difference between these accounts? 

FB: One idea that has been very popular in cognitive neuropsychology and neuropsychiatry is that delusions arise as subjectively adequate responses to abnormal sensory experiences, of sight, hearing, or whatever. Call this view ‘empiricism’. Empiricism comes in at least two variants that differ concerning the specific mode in which delusions are grounded in experience: the explanationist account and the endorsement account.

As you said, on the explanationist account, delusions serve an explanatory function, they arise inferentially from one’s reasoned attempt to explain an abnormal experience. On the endorsement account, delusions are acquired immediately, non-inferentially, from experience when one takes that experience at face value.

We can illustrate the difference between these two accounts using the example of Capgras delusion, in which a close relative or spouse is believed to be a stranger and to have been replaced by an identical imposter. Both sides agree that the Capgras delusion involves an abnormal experience in response to seeing a familiar person. What is at issue is the degree of continuity between the representational content of the experience and the content of the delusion itself.

Proponents of the explanationist account will say that the content of the experience is relatively nonspecific. For instance, the experience might be a coarse-grained feeling that something is off about the person being looked at, and one would hit upon the delusional hypothesis to make sense of why the person feels off, e.g., she does because she’s not who she looks like.

By contrast, proponents of the endorsement account will take the content of the experience to be closely linked, if not identical with, the delusional content. For instance, they might think that the reason why a subject believes that the person in front of them is a stranger is because they have in fact an experience representing that person as a stranger. 

LB: Which account do you prefer? 

My preliminary answer would be neither and both. 

What I mean is that we don’t have to choose one: we can use whichever seems most appropriate depending on context. For instance, if someone believes that they are possessed by the devil because they hallucinate voices telling them to kill God, their belief is probably going to be an explanation of experience. On the other hand, if someone believes they have a second head because they hallucinate a second head, that is probably going to be an endorsement of experience.

Something else to keep in mind is that you could in principle have hybrid cases of delusions formed from a combination of endorsement and explanationist processes. Indeed, some think the Capgras delusion might be one such case: the subject would literally experience a person as a stranger at some first moment in time, and later infer that the person is an imposter to explain why she looks so much like a loved one.

So, on balance, there is no reason why we should give up one view and keep the other, given that both potentially help explain delusions.

Tuesday, 16 February 2021

Delusions Beyond Beliefs

This post is by Jasper Feyaerts, who is discussing a paper he co-authored with Mads G Henriksen, Stijn Vanheule, Inez Myin-Germeys, and Louis A Sass, entitled "Delusions beyond Beliefs", and published in The Lancet Psychiatry. With this link, there will be free access to the article for a few weeks.


Jasper Feyaerts


Delusions are commonly conceived as false beliefs that result from epistemic failures to represent reality correctly. This view has been dominant throughout the history of psychiatry, and continues to inform contemporary research and practice. In explanatory research, it underlies (neuro)cognitive attempts to explain delusions in terms of impairments or biases in cognitive reasoning. In clinical practice, it motivates cognitive-behavioral strategies focusing on the rational evaluation of delusional appraisals.

Yet despite being the standard view of delusion in psychosis research, this conception has not gone entirely unchallenged. Most notably in the tradition of phenomenological psychopathology (Sass & Pienkos, 2013; Stanghellini et al., 2019), less emphasis has been put on the erroneous or belief-like nature of delusions, than on adequately identifying the specific experiential context within which delusions occur, with a particular focus on what ‘sort’ of reality delusional individuals may ascribe to them. 

Karl Jaspers in General Psychopathology, for example, already emphasized how certain types of delusions – i.e., which he called ‘primary’ or ‘true’ delusions, and considered specific for schizophrenia – are not mere ordinary empirical beliefs, but may involve global ontological changes that affect our most basic experience of reality. “Delusion proper”, Jaspers wrote, “implies a transformation in our total awareness of reality” (page 95); “reality [for the patient] does not always carry the same meaning as that of normal reality” (page 105).

In our review paper, we discuss how this phenomenological emphasis on the overall experiential context of delusions can be used to critically revisit and to enhance contemporary diagnosis, explanation and treatments for delusions. In diagnostic research, we show how claims regarding the existence of a so-called ‘continuum’ between ordinary irrational beliefs and delusions may have more to do with the vagueness and selectivity of criteria and measures used in assessing these phenomena, than with the continuous nature of delusional experience itself. 





In explanatory research, we discuss how one/two-factor-accounts and predictive models could benefit from accommodating global ontological transformations in their accounts. This could offer more specificity to the nature of anomalous experience in schizophrenia, while it also challenges the idea that delusion is always a matter of (rational or irrational) belief explaining or endorsing experience. We emphasize in particular that alterations in reality experience also alter the cognitive status of delusions. It is unclear, for example, whether straightforward believing is actually possible in a delusional world that is experienced as entirely unreal or sometimes even as somehow mind-dependent.

In therapeutic research, we suggest that the limited therapeutic benefits of current cognitive-behavioral treatments for delusions (see Jauhar et al., 2014) may be the result of applying an ordinary framework of reality experience in emphasizing rational evaluation of delusional beliefs. We argue that treatments should shift away from narrowly targeting delusions themselves (via attempts, eg., to refute or challenge them) towards altering the experiential conditions that inspire and sustain them. From a phenomenological perspective, effective treatments are most likely those that help to reduce feelings of self-alienation and uncertain embeddedness in everyday reality that are conducive to delusional experience.

Yet we also emphasize that delusions are not always experienced as a simple affliction or deficit. Indeed, for some individual with delusions, the common-sense perspective can look flat, uninspiring, and utterly constrained by conventionality, closed off from what they consider the true sources of originality and truth. As such, delusions are not only a psychopathological or psychiatric issue, they also seem to confront us with the possible contingency or ungroundedness of our ordinary reality experience.

Tuesday, 9 February 2021

Motivated Reasoning in Science

Today's post is by Josh May (University of Alabama, Birmingham). In this post, he talks about one of his papers published in Synthese and entitled "Bias in Science".


Josh May


Much discussion of the replication crisis in science has focused on the social sciences, particularly psychology. A common narrative is that the social sciences are particularly susceptible to powerful biases, such as moral and political ideology. I argue instead for a parity thesis: all areas of science are subject to bias, through the general psychological mechanism of motivated reasoning. This provides a unified framework for understanding how values influence the entire scientific enterprise.

The scientific process involves numerous decisions that can be influenced by one's values--including moral, political, and prudential values--which manifest as goals or motivations. A researcher wants badly, say, to publish in a prestigious journal in order to either advance her career or maintain her status and recognition among colleagues. Or she wants badly to maintain her industry funding, or to promote a pet theory, etc. 

These motivations can then influence her reasoning about which hypotheses to test, how to operationalize variables, how to interpret the data, whether to report certain measures, and so on. Commonly this involves wishful thinking and confirmation bias, but these are just instances of the general phenomenon of one's reasoning being influenced by one's motivations---typically ante hoc, not post hoc (see May 2018: Ch 7).

So what motivates most scientists? Drawing on case studies and surveys of scientists, I highlight four ultimate goals: knowledge, ideology, credit, and profit. Of course many scientists are motivated to produce knowledge and to acquire or maintain a job ("profit"). Researchers are also motivated to promote favored ideologies---such as libertarianism, theism, and environmentalism---for which the natural sciences also have implications (think e.g. of climate change, intelligent design, vaccines). 

What is less often recognized is that, as humans, scientists are deeply social and hierarchical creatures and thus powerfully motivated to acquire, maintain, and improve their status among peers by earning "credit" for scientific advances and achievements. Thus, even when researchers are unmoved by ideology or profit, there is always the concern to impress one's peers and move up the social ladder, even if that requires questionable research practices that conflict with the knowledge motive.

Philosophers of science have long emphasized that values influence scientific practice, in both pernicious and productive ways. I similarly do not assume that motivated reasoning is always problematic. Sometimes it produces knowledge by, say, opening up neglected avenues of inquiry (e.g. Anderson 2004) or leading to an invisible hand that guides the marketplace of ideas toward knowledge (e.g. Solomon 2001; Bright 2017).

My analysis within the motivated reasoning framework argues that the natural and social sciences are more alike than different. All domains of science are subject to motivated reasoning and often the more powerful "non-epistemic" motive is social credit, not ideology, which might seem more prevalent in the social sciences. I hope this illuminates how pervasively values influence all areas of science, whether in pernicious, productive, or even benign ways. 

Motivated reasoning is a fact of human life and thus (all) of science.

Tuesday, 2 February 2021

Psychiatry and Anti-Psychiatry in the 70s in Italy

Today's blog is by Matteo Fiorani (University of Rome, Tor Vergata) and it is the last in a series of posts associated with the special issue of the European Journal of Analytic Philosophy on Bounds of Rationality. Matteo's paper (open access) is entitled: "Rationality, Irrationality and Irrationalism in the Anti-institutional Debate in Psychiatry around the Second-Half of the 1970s in Italy".


Matteo Fiorani


The 1968 movements overwhelmed psychiatry with anti-authoritarian and anti-institutional criticism. The young protesters demanded, first of all, the rights of madness and, provocatively, of unreason. At the same time, they dismissed the dominant normality, represented by bourgeois common sense. They also affirmed the need not to repress contradictions and suffering. Emotions and affectivity were indeed part of the social and political world. From these premises it was possible to develop a deep political and cultural reflection on the boundary between reason and madness. The so-called official psychiatry and the scientific criteria that sought to distinguish with certainty between insanity and mental health, were radically challenged.

In Italy, psychiatric discourse was politicized as in no other Western country. Starting in the 1970s, in a scenario characterized by a profound cultural and political transformation within the left, anti-psychiatry became a word that was used, abused, mythologized and misunderstood. It was at the center of a veritable battle of ideas. The traditional concept of rationality and its very connection to irrationality were challenged, as was the idea of classical reason. The attempt was to redefine limits. Did madness really exist? Was it, in a perspective of overthrowing the bourgeois order, a manifestation of freedom and creativity? Or was it illness and suffering produced by life's experiences?

In my article I tried to give an account of all this. Not without difficulty, especially in the interpretation of the sources. On the one hand, in fact, the reviews of the movement, the writings of anti-establishment psychiatrists and the militants of the so-called New Left gave a sensation of hopeless desolation, made up of irrationalist drifts that simplified psychiatric discourse. They also left unresolved the many important questions about normality and madness raised since 1968. On the other hand, oral sources and individual experiences of psychiatric renewal, less visible and less recounted (and for this reason present in the paper as suggestions), warned me of the danger of excluding the positive legacy of those years, probably crushed by the depressed look of today. 




The hyper-politicization of the psychiatric and scientific question certainly struggled to find a synthesis and a direction. Especially since the mid-1970s, the irrationalist drifts can be interpreted as the failed attempt to affirm a new rationality that was even more rigid, even if directed against the system. In this sense, even Marxism, in its various interpretations, proved unable to find a way out. However, it was not only psychiatrists who approached anti-psychiatry texts, but also students and intellectuals (an Italian peculiarity) in search of alternative tools to interpret reality.

These people wanted to free themselves from the decades-long devaluation of science, typical of Italy (in the footsteps of the neo-idealism of Benedetto Croce and Giovanni Gentile) and to open up to foreign countries, especially the United States, where science was not devalued, but complicated, and where it was possible to criticize Galilean rationality without being accused of relativism. In short, the answer to the rationality of the system was not only an aimless flight into irrationalism (which it was). It was also an attempt to hold together rationality and irrationality, intellect and affects (reason and sentiment, we could say), to build a new free and vital subjectivity.

Tuesday, 26 January 2021

Against Defining Delusion

Today's post is by Sam Wilkinson. You can read Sam's recently published paper, Expressivism about Delusion Attribution, in the European Journal of Analytic Philosophy. It appeared in a special issue on the Bounds of Rationality.



Sam Wilkinson



What is delusion? While we can point to paradigmatic cases, we have struggled to produce an uncontentious definition of delusion. In my paper, I argue that we shouldn’t have been trying to define delusion in the first place, and that it becomes clear why, once we reflect on the sort of concept that delusion is.

Delusion attribution, e.g. saying “This person is delusional”, is not (fully) fact-stating. It is not like saying “This person is 6ft tall”. It is fundamentally an evaluation. Some evaluations involve failing to adhere to an objective benchmark, while others are more fundamentally, irreducibly evaluative. One way of thinking about these fundamental kinds of evaluations is as expressive, rather than descriptive.

 

To simplify somewhat, delusion attributions are more akin to expressions of folk-epistemic bafflement. Why think that this is so? And what are the consequences of this?

First of all, it seems like delusion expresses a negative evaluation. Consider a hyperbolic use among friends (“You’re delusional if you think Manchester Utd. will win the Premiership!”). Now, one might object that, while this is an expressive use of “delusion”, this is not at all how psychiatrists use the term. Nevertheless I would insist that the calm, institutional use of the term only masks its true nature.

Secondly, as with expressivists in meta-ethics, who are motivated by a metaphysical unease with postulating moral properties we might be similarly reluctant to countenance properties of “delusionality”.





What are the consequences of the view?

First, an inability to define is to be expected. Why think that all of the many things that arouse negative reactions from our folk-epistemic sensibilities can be regimented under a strict definition?

In a related manner, if you try to characterize the sorts of things that get called delusions, you get a sort of disjunctive norm pluralism. Put simply, there are different kinds of folk-epistemic badness, but once a threshold is reached, you call that thing a delusion. Contrast, for example, reverse Othello syndrome with a bizarre delusion in the context of psychosis. You might, for example, think about the implausibility of the content. Here, the bizarre delusion (“I am the left foot of God”) scores highly, so highly in fact that you don’t even need to ask yourself about the individual’s grounds for the claim. (Though interesting, it wouldn’t remove delusional status.) In contrast, if somebody said “My wife is being faithful to me”, this is true (one hopes) of many people, and it could only be an examination of their personal situation, their resistance to evidence, etc. that would then tip them into delusional territory.

 

Since delusion attribution is an expression of bafflement, understandability takes precedence over rationality. A mother who is reluctant to believe that her son is a murderer may exhibit profound levels of epistemic irrationality, but we understand that people are reluctant to admit the guilt of loved ones. Indeed, we’d find an impartial acceptance of the evidence more troubling!

What does this mean for delusions researchers? Not much. Keep up the great work on paradigm cases of delusion. Just don’t worry about defining it.

Tuesday, 19 January 2021

Disorders of Agency on a Spectrum

Today's post is by Valentina Petrolini (University of the Basque Country – UPV/EHU). Here she talks about a recent paper she wrote, “Too Much or Too Little? Disorders of Agency on a Spectrum” published open access in a special issue of the European Journal of Analytic Philosophy on Bounds of Rationality.


Valentina Petrolini


 

“Rock You like a Hurricane” has been playing on repeat in my head since yesterday. I am unsure where it came from, although I am afraid a binge session of Stranger Things might have something to do with it. Despite my attempts, getting rid of the song proves surprisingly difficult. In my paper I characterize these episodes as mild cases of hypoagency. An action – in this case a mental one – is attributed to an agent, who is unsure about having initiated it and lacks a robust sense of control over it.


Some instances of hypoagency – such as having an 80’s song stuck in your head – strike us as relatively innocent. We may even imagine circumstances in which similar mind-wandering episodes may be beneficial. Assume that I have an important interview coming up and I cannot concentrate because my thoughts keep drifting away. Although my fantasizing might take a pessimistic turn, it might also allow me to come up with original ideas that help me succeed in the interview.


In an interesting study, Baird and colleagues show that some forms of mind-wandering might indeed support problem-solving. Other experiences of hypoagency are undoubtedly less benign. Think about phenomena such as auditory verbal hallucinations (AVH), in which a person loses grip over her own thoughts and experiences them as alien. Longden describes her voice-hearing experience along these lines: the first voices sound like “a running commentary”, but over time they grow in number and intensity and start issuing threats and commands over which she has no control.

However, there are also situations in which people experience hyperagency. A clinically-relevant example concerns cases of pathological guilt, commonly experienced by people diagnosed with schizophrenia. For instance, Saks talks about being filled with anxiety when reading the newspaper, because she would blame herself for every violent crime reported in the area. Some cases of hyperagency do not qualify as pathological. 

An interesting phenomenon in this sense is false confessions, in which people take responsibility for crimes that they have not committed. Although the idea of innocent people willing to face legal charges appears counterintuitive, studies in forensic psychology show that false confessions are relatively frequent. A famous case is portrayed in DuVernay’s series When They See Us and involves the men who came to be known as the “Exonerated Five”.




How should we think about different cases of disrupted agency? One important distinction concerns self-attribution versus feeling of agency. While self-attribution may be correct or incorrect, the feeling of agency comes in degrees. Extreme cases of hypoagency – such as AVH – exemplify situations in which self-attribution is incorrect and the subject lacks a robust feeling of agency. By contrast, in mind-wandering the perceived lack of agency usually fails to be accompanied by misattribution: even if I can’t stop thinking about the Scorpions song, I do not perceive it as externally generated. 

Things are more complex with hyperagency. Both pathological guilt and false confessions exemplify situations in which self-attribution is incorrect and the subject reports a strong feeling of agency. The difference between these cases is thus likely to be one of degree, where quantitative factors such as duration or intensity may be taken as reliable indicators.