The Epistemic Relevance of CBT

Chloe Bamboulis, a PhD student at the University of Birmingham, works on the relationship between classic philosophical views and cognitive-behavioural therapy (CBT). In this video, she talks for three minutes about self-knowledge in Plato and in CBT. In today's post she summarises a commentary co-authored with Lisa Bortolotti on the utility of CBT, forthcoming in Philosophy, Psychiatry, and Psychology.

Chloe Bamboulis

A common idea about CBT is that it does not contribute to the person's understanding of reality (validity) but encourages ways of thinking that boost the person's wellbeing (utility). In our brief commentary, we argue that CBT can also contribute to some of the person's epistemic goals.

Suppose James comes to believe that he will not be offered his dream job, the one he is going to be interviewed for. James arrives at this self-prediction by accepting a negative automatic thought about himself as someone who does not perform well at job interviews. Accepting that things will go badly due to negative biases may give rise to the correct prediction, but this does not mean that the prediction reflects  a careful consideration of the factors that are likely to contribute to the future outcome. 

 

By inviting James to think about his past performance during interviews and getting him to realise that he actually did get a few jobs, CBT might make additional explanations for James's negative perception of himself over and beyond the thought that “he is rubbish”. What if some of the job he interviewed for in the past were extremely competitive? What if James had not shone in previous interviews because he was tired or stressed? If there is evidence against the view that James "is rubbish" at job interviews, this evidence should be taken into account. 

The mere consideration of additional evidence and alternative hypotheses enables James to imagine another reality. A reality in which not getting the next job is not the only outcome. This has implications for the discussion of the aims of CBT: the epistemic relevance of a therapeutic approach does not merely depend on whether it increases the overall number of accurate representations and correct hypotheses, but in whether it encourages grounding representations and hypotheses on experience and evidence.

 

An epistemic goal has been served by a therapeutic approach that helps James resist the power of a negative bias. If CBT can habituate people to adopt a thinking style where hypotheses are not accepted blindly, but explored and weighed up against alternatives before being accepted, this suggests a significant epistemic progress. It leads people to become more sensitive to evidence.

 

We all find obstacles on the way to pursuing our goals. When we overestimate our talents and how rosy our future will be, we are less likely to give up pursuing our goals at the first setback. We are motivated to persevere, and more likely to achieve our goals than if we had given up earlier. Some of these relevant goals may be epistemic and contribute to our exchanging information more effectively within our social environment, and gaining a better understanding of ourselves and the world. 

Finally, James's self-predictions can become self-fulfilling. If he is convinced that he will not get the job, he might not even be motivated to prepare for it. But if he thinks he has a chance, he might do his best to perform well. CBT seems to have an important role in the process of learning how to develop effective strategies to sustain future motivation.

Are Delusions Biologically Adaptive?

Today's post is by Eugenia Lancellotta, who has recently completed her doctoral project at the University of Birmingham, on the adaptiveness of delusions and delusions in OCD. Here Eugenia presents some ideas from an article she published in Review of Philosophy and Psychology in 2021, entitled: "Is the biological adaptiveness of delusions doomed?". Eugenia also discussed some themes from her research in this video interview.

Eugenia Lancellotta

How likely is it that you father has been replaced by an imposter? Or that you are the Emperor of Antarctica? These beliefs are instances of delusions: fixed, irrational beliefs that are not amenable to change in the face of compelling evidence to the contrary.

In popular culture, delusions are considered to be the mark of madness, while psychiatry usually takes them to be the symptoms of a serious mental illness. However, in countertendency to the narrative that sees delusions as pathological, some researchers working in the field of mental health have argued that delusions are biologically adaptive, i.e., that they are part of an evolutionary mechanism devised to increase the chances of survival and reproduction of an organism in a given environment. More specifically, delusions would be answers to already existing problems of a biological or psychological nature rather than problems in themselves.

Among the proponents of delusions as an adaptive mechanism there are the predictive coding theorists Fineberg and Corlett, who, in a 2016 paper, have argued that schizophrenic and some neurological delusions such as Capgras would allow ongoing function in the face of paralysing difficulty (p. 73).

Here is an illustration of how Capgras delusion would be adaptive in their model. When someone suffers from a neurological impairment in the emotional processing of familiar faces, he expects to experience feelings of familiarity when looking at the face of a beloved person, but actually he does not get those feelings. This anomaly generates a mismatch between what one expects and what one perceives – a prediction error – which should be eliminated in order to keep the learning system going. 

By coming to believe that one’s beloved person has been replaced by an imposter – what people with Capgras delusion believe - the prediction error is eliminated, and thus the learning system is rescued. As keeping the learning system going is key to surviving and reproducing in a given environment, Capgras delusion is biologically adaptive, because it allows this in the face of paralysing difficulty, i.e., a neurological impairment in the processing of familiar faces.

In my paper, I move two objections to Fineberg and Corlett’s view. The first is that their view is less parsimonious than the more traditional maladaptive view of delusions, and thus, ceteris paribus, the latter should be preferred. The second objection is that the claim that delusions are adaptive requires empirical evidence that Fineberg and Corlett do not provide. 

Does this mean that the biological adaptiveness of delusions is doomed? I argue that a more definitive answer to this question can only come from empirical studies of a comparative kind, whose form I sketch out in my paper.

Do Delusions Have and Give Meaning?

Today's post is by Rosa Ritunnano (University of Birmingham and Melbourne), consultant psychiatrist and PhD candidate at the Institute for Mental Health, Birmingham, UK. Here she talks about a recent paper she co-authored with Lisa Bortolotti, “Do delusions have and give meaning?”, recently published in Phenomenology and the Cognitive Sciences (open access). 

Rosa Ritunnano

For many people living with psychosis, delusional experiences are hugely distressing. They are not only harmful because of the negative emotions they often carry along, but they are also dysfunctional (Miyazono, 2015). Someone who believes, for example, that everyone in their workplace is reading their thoughts and controlling their movements through a mysterious influencing machine, may feel extremely nervous, gradually withdraw from their friends and family, and give up their job. This can lead to a disruption in good functioning and may be accompanied by a constellation of symptoms attracting a diagnosis of psychosis or schizophrenia.

 

This view of delusions as irrational beliefs, which are also harmful and disruptive, currently dominates the way many psychiatrists and cognitive psychologists think about, investigate, and treat delusions. The same view is also widespread in popular culture and has been reinforced by stigmatising media coverage and work of works of fiction in literature and cinema, where people with delusions are routinely represented as irrational, unpredictable, and dangerous. Often ensuing from reflections on this set of negative features, is the argument that delusions are both devoid of meaning and strip meaning away from people’s lives.

In this new paper, we are of a different opinion. We argue that this emphasis on delusions as ‘empty speech acts’ or ‘meaningless symptoms’—more common since the operational turn in psychiatric nosology in the 1970s—has led us astray. That, notwithstanding the harmful consequences, delusions are often meaningful for the person experiencing them and, in some circumstances, they can enhance the sense that one’s life is meaningful. We share this view with phenomenological as well as psychodynamic approaches, which have often highlighted the potentially adaptive role of delusional phenomena.

 

Specifically, we argue that a more balanced understanding of delusions should acknowledge that they are not mere “glitches in the brain”, but rather outputs of a belief formation system whose primary aim is to make sense of the surrounding world. If the world stops making sense, we inexhaustibly try to find some meaning. In the case of delusions, this meaning may seem prima-facie implausible or incomprehensible to others. However, as we discuss in our paper through many examples from the empirical and philosophical literature, this apparent incomprehensibility often fades once the interlocutor obtains specific information about the experiences preceding the onset of the delusion, about the person’s life narrative or their experiential world. 

But delusions not only seem to acquire meaning once our interlocutor has been suitably informed. We argue that, in some cases, they can also confer meaningfulness to one’s life, and that adopting a delusion can even be beneficial—albeit just in one respect and in the short term. A phenomenological approach to psychopathology can help examine this counterintuitive claim.

In the context of schizophrenia, for example, people often report uncanny changes in their basic sense of reality and in their felt sense of existing as a unified living agent (as conceptualised in the ipseity-disturbance model of schizophrenia, Sass et al., 2018). An unbearable sense of all-encompassing threat may take over, subverting previously established and familiar relations of meaning and throwing the agent into a state of radical and overwhelming uncertainty. Delusions emerging in this context can help the person make sense of unusual experiences that would otherwise seem inexplicable and cause anxiety. As a patient with schizophrenia puts it: “Delusions are an attempt to explain a very deep restlessness. It is an attempt to seek rescue in a story in which you eventually get lost” (Henriksen et al., 2010, p. 366).

Additionally, we argue that—even from an objective point of view—some people can attain superlative intellectual and creative achievements thanks to the transformative power of certain delusional experiences. In his pathographical analysis of Friedrich Hölderlin and Vincent van Gogh (1977), for instance, Karl Jaspers had already recognised the meaningful interplay between the extraordinarily talented personalities and their psychotic suffering. But he was also acutely aware, as we are, of the inescapable destructive effects of the illness over time: “Just as a diseased oyster can cause the growth of pearls, by the same token schizophrenic processes can be the cause of mental creations of singular quality” (Jaspers, 1977, p. 134).

We think that maybe there is more to delusions than the idea that the person is making an incorrect judgement about external reality, or simply ‘jumping’ to the wrong conclusion because of a cognitive dysfunction. This narrow account of delusion fails to acknowledge both the person’s life story and some basic experiential changes that affect the person’s way of seeing the world. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions.

Unconscious Inference in Delusion Formation

In this post, Federico Bongiorno (now a Postdoctoral Researcher at the University of Oxford, funded by an Analysis Trust and Mind Association award) is summarising a paper he wrote with Lisa Bortolotti while a PhD student at the University of Birmingham. The paper is entitled: "The Role of Unconscious Inference in Models of Delusion Formation" and appeared in Inference and Consciousness, a volume edited by Timothy Chan and Anders Nes and published by Routledge in 2019.

Federico Bongiorno

Brendan Maher was the first to suggest that the formation of delusions involves an inferential transition—although he denies that the inference from which delusions arise is faulty (Maher, 1992; Maher, 1999). Maher defends a view known as ‘explanationism’ (Maher, 1974; Stone and Young, 1997), according to which delusions are hypotheses adopted to explain anomalous perceptual experiences and arrived at by inferential reasoning that is neither abnormally biased nor otherwise deficient (Maher, 1974, p. 180). In essence, delusions for Maher are the product of normal reasoning processes brought to bear on some experiential aberration. 

This means that the pathological nature of the delusion does not lie in the person’s inferential reasoning, but only in the experience that generates it. It also means that no additional abnormality is needed to explain delusional belief formation and maintenance, which is why Maher’s view has become known as a one-factor theory. An alternative to explanationism is the endorsement theory, according to which the delusional belief is an acknowledgement that the anomalous experience is veridical and no inference from experience to belief is required (Pacherie et al., 2006; Bayne and Pacherie, 2004).

Delusional inference has been increasingly understood in terms of Bayesian updating. In our paper we critically evaluate an influential Bayesian model of delusional inference put forward by Coltheart, Menzies, and Sutton (2010), which we call, for simplicity, ‘the Coltheart model’. The Coltheart model has been developed with specific reference to the Capgras delusion, the belief that a person or persons dear to the deluded individual have been replaced by identical or nearly identical imposters (Capgras and Reboul-Lachaux, 1923). 

The proposal is that in Capgras the delusional hypothesis is adopted via unconscious abductive inference from abnormal data, where ‘data’ is used to refer to explananda that are not available to personal-level consciousness. In the Coltheart model the inference involved in the formation of the delusion is Bayesian rational and does not involve a reasoning impairment, though a reasoning impairment, a second factor, is postulated to explain the maintenance of the delusional belief in the face of counterevidence.

In the last decade, many theorists have pointed to the use of Bayesian framework for modelling delusional inference, with the debate revolving around the number of factors necessary for delusion formation, and the similarities and differences between the available models (e.g., Coltheart et al., 2010; McKay, 2012; Bortolotti and Miyazono, 2015; Miyazono et al., 2015; Miyazono and McKay, 2019). 

By contrast, we focus on the question of compatibility between, on the one hand, the Coltheart model, and on the other hand, explanationist and endorsement accounts of delusion formation. Strictly speaking, the Coltheart model is not a Maher-type explanationism, at least if one treats experience as by definition conscious. It does, however, conceptualise delusions as hypotheses serving an explanatory function. 

Because of that, the Coltheart model has been interpreted as a modern version of explanationism (Parrott, 2019; Young, 2014). We argue, however, that an explanatory function as understood here is no less compatible with an explanatory picture than an endorsement one. If that is correct, the mere presence of inference in delusion formation is not sufficient to discriminate between explanationist and endorsement accounts. 

Psychopaths as Extreme Future Discounters

This post is by Jane Kisbey, PhD student at the University of Birmingham. Jane talks about her research on psychopathy and moral responsibility in this video interview.

Jane Kisbey

Some philosophers have recognised that in psychopaths there appears to be a failing in prudential concern. Philosophers characterise this in various ways, however I offer a new conceptualisation of the psychopath. My hypothesis says that we can best understand psychopaths as extreme future discounters.

This account draws upon Neil Levy’s (2014) account to substantiate my hypothesis. However, there is a crucial difference between mine and Levy’s view. Whilst Levy thinks that psychopaths are unable to imagine what it is like to be a future person, it seems that this is not the case. It is rather that psychopaths cannot see why they should care about their future self, because for psychopaths, it is only what happens now they should care about.

Levy argues that psychopaths have an impaired ability to mental time travel (MTT). Because psychopaths possess an inability to MTT they fail to appreciate prudential reasons. In other words, they cannot understand reasons to act for their own future’s sake. Levy follows Suddendorf and Corballis’s definition of MTT:

[T]he ability to project oneself into the future or the past: to recall, in a distinctively first-person manner, past episodes and to simulate possible future scenarios in which one is personally engaged. (Suddendorf & Corballis, 2008)

MTT is analogous to episodic memory – ordinary people can not only remember that an event occurred, they can remember it “from the inside”. MTT includes imagining, remembering, and projecting oneself in the future.

Unlike Levy, I think that psychopaths are capable of MTT, it is just they do not care about their future self when they do. The main reason why I think that psychopaths retain the capacity for MTT is that when we examine the case studies in the psychiatric literature, it seems obvious that they are able to figure out and understand the consequences of their actions. However, what is striking is their reaction to those consequences. They do not seem to care about those consequences. Hervey Cleckley’s case studies support this idea:

The consequences occurred to him, but rather casually. (Cleckley, 2015)

The essential difference [between psychopaths and non-psychopaths] seems to lie in how much the consequences matter. (Cleckley, 1988)

 

It strikes me that the problem for psychopaths is not that they cannot conceive of themselves as a persistent being, but instead that they do not care about that future being. They conceptually know that they will be a future being but they just discount that. They care more about the state they are in now. 

So, it is not an inability to imagine what it is like to be a future being. Rather, it is assigning a lower value to that future than the value of your current states. So, psychopaths are extreme future discounters in the sense that they only value their current interests, and as such discount their future interests. They live in the present moment and do not care about their future self. 

Psychopaths can recognise what they will feel at a later stage, however their future feelings are not ‘real’ to them now. What they lack is normal appreciation of anything outside of their current mental states which explains their lack of prudential concern.

Facts and Values in Mortality Data during the Pandemic

Today's post is by Maria Cristina Amoretti and Elisabetta Lalumera. This is their second of two blog posts on applied philosophy of science and conceptual analysis in the time of COVID-19.

Amoretti and Lalumera

As philosophers, one of our interests is the interplay of facts and values in medical sciences. We think that debunking the myth of science as purely factual is a contribution that philosophers can usefully bring to society. We also think that science can be nevertheless objective and trustworthy, but not in virtue of being purely factual – as many philosophers have argued recently. In a recent paper, we focused on mortality statistics during the pandemic. 

Mortality data have been very salient throughout the pandemic, both at the personal level, by influencing our emotional uptake of the situation, and at the level of society, as government’s decisions are based on epidemiological models, which, in their turn, are fed by mortality data. When is someone’s death due to COVID-19 or, more specifically, when does COVID-19 qualify as the underlying cause of death? For an answer, we analyzed the rules for the certification of death issued by the World Health Organization (WHO).

These rules, supplemented by instructions contained in the Reference Guide of the International Classification of Diseases (ICD) (WHO 2018), are adopted in most countries, so that the death certificate has the same format. According to these rules, the death certificate should contain all conditions the doctor considers causally and etiologically relevant to the person’s death, but one single underlying cause of death must be specified. It is defined as “the disease or injury that initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury” (WHO 2018, 2.17.1).

This definition underpins a mechanistic conception of causality. However, the guiding principle that should inform the selection of one single underlying cause is explicitly the possibility of prevention of deaths to the benefit of public health (WHO 2018, 2.19.2). Thus, we argued, a prudential or normative principle is used to select from among the causes pertinent to someone’s death. We also noted that the same prudential principle figures in the rules for certifying deaths due to HIV-AIDS, for analogous public health reasons, namely, to prevent the highest number of deaths.

In conclusion, a statement on a death certificate, identifying COVID-19 as the underlying cause of death, may be considered a non-purely descriptive predicate, as grounded on both factual (causal chains and the patient’s medical conditions before and at the time of death) and non-factual reasons (the importance of prevention of more deaths). We think that many arguments can be brought to defend such non-factual reasons. However, it is important to disentangle them from facts. Whereas facts can only be described, reasons can be argued for.

The Concept of Disease in the Pandemic

Today's post is by Maria Cristina Amoretti and Elisabetta Lalumera. They discuss the concept of disease in the time of COVID-19 which they also write about in a recent article in Theoretical Medicine and Bioethics. This is the first of two blog posts on applied philosophy of science and conceptual analysis in the time of COVID-19.

Maria Cristina Amoretti is Associate Professor at the University of Genoa, Department of Antiquity, Philosophy and History (DAFIST) and Vice-Director of PhilHeaD-Philosophy of Health and Disease Research Center. Elisabetta Lalumera is Assistant Professor at the University of Bologna, Department of Life Quality Studies (QUVI), and member of PhilHeaD.

Amoretti and Lalumera

During the pandemic, medical and non-medical interventions of institutions and governments became central to our lives. Sometimes we felt overwhelmed with worry and anxiety, conditions that do not favour philosophical reflection. In our paper we tried to put worry and anxiety in brackets, and critically engage with the question: What concept of disease is implicit in the interventions that institutions and governments are enforcing during the pandemic?

For doing so, we started with imagining an ideally accurate diagnostic test for COVID-19, with respect to which four classes of people can be identified: people who are positive and symptomatic (PS), positive and asymptomatic (PA), negative (N), and untested (U). Our aim was showing how different philosophical accounts of disease, amongst those discussed in the recent philosophical debate, would better describe the four classes of people. Or, alternatively, which concept of disease is implicit in certain patterns of disease and sickness judgements, like those experienced during the pandemic.

We therefore analyzed different versions of function-requiring and harm-requiring accounts of disease. Of all these, the only disease concept that, unlike the others, allows a positive sickness judgement, not only for the PS group, but also for both the PA and the U groups is the social (risk of) harm account, which equates disease with a condition associated with harm, or increased risk of harm, either to the subject or to someone other than the subject.

We then argued that the concept of disease as social (risk of) harm is the one that can be seen as implicit in many institutional interventions during the COVID-19 pandemic. Many countries have imposed strong lockdowns and quarantines for their whole population in order to suppress or mitigate the outbreak of the virus. Sickness exemptions and benefits were extended, including paid sick leave, tax credits, etc. These privileges also coincided with the imposition of social obligations and of limitations of individual freedom. What is important to our point, however, is that anyone, the U group included, was considered sick and, as an extension, diseased.

Our final point in the paper was that the concept of disease as social (risk) of harm should be adopted in emergency cases only and abandoned when the emergency is over. We gave three reasons for this conceptual revision claim. First, under the social (risk of) harm account, a condition that is harmful or potentially harmful for society is a disease irrespectively of its physiological basis. Therefore, perceived risky social deviances, such as homosexuality and drapetomania, or behavioural proclivities, such as heavy drinking, could come to be regarded as diseases. 

Second, in endorsing the social (risk of) harm account, the subjective and phenomenological aspects of disease would be overshadowed, as asymptomatic people would count as diseased simply because they represent a risk to society. Third, given that the social (risk of) harm account would classify not only the PS group but also the PA and U groups as diseased, the number of diseased people would dramatically increase, creating a problem of overdiagnosis and medicalization.

Isn't Everyone A Little OCD?

In today's post, Lucienne Spencer (University of Bristol) discusses the wrongful depathologization of serious mental conditions. The post is based on a paper co-authored with Havi Carel and published open access in Philosophy of Medicine.

Lucienne Spencer

The Mental Health Foundation states that ‘people with mental health problems are amongst the least likely of any group with a long-term health condition or disability to find work, be in a steady, long-term relationship, live in decent housing [or] be socially included in mainstream society’. Given the global decline in mental health following the coronavirus pandemic, addressing the marginalisation of people with psychiatric illness has never been more urgent. According to the literature, this marginalisation is grounded in sanist attitudes that portray people with psychiatric illness as ‘dangerous and frightening’, ‘incompetent to participate in “normal” activities’ and ‘morally repugnant’. 

Comic by Michael Seymour Blake
(Instagram @michaelseymourblake)

 
While some psychiatric illnesses are solely grounded in such stigmatisation (such as schizophrenia and other forms of psychosis), we argue that other psychiatric conditions may also be vulnerable to trivialisation. Have you ever heard someone say, ‘that football match last night gave me PTSD’ or ‘I can’t handle social situations, I’m so Autistic’ or even ‘I love having my kitchen organised- I’m slightly OCD’? 

When we make light of psychiatric illnesses in this way, we risk reducing a serious condition to a mere personality trait. Consequently, people with these kinds of psychiatric illnesses are more likely to be met with scepticism regarding the severity of their illness; characterised as ‘just like everyone else’, yet labelled as ‘difficult’, ‘manipulative’, or ‘attention-seeking’. Therefore, while these conditions are still subject to systematic stigmatisation, they can also be trivialised. We call this simultaneous operation of stigmatisation and trivialisation of a psychiatric illness ‘wrongful depathologisation’.

Our new article uses OCD as a case study to focus on one distinct harm that may emerge from wrongful depathologisation: epistemic injustice. First, if a condition like OCD is not perceived to be as complex or debilitating as the patient claims, testimony that goes beyond the palatable aspects of the condition is not taken seriously. This would constitute a case of testimonial injustice. 

Havi Carel

Second, wilful hermeneutical ignorance may occur if a diagnostic term, like that of ‘OCD’, is misappropriated by those who do not have the condition. Rather than using the term to refer to a serious psychiatric illness, ‘OCD’ is frequently used to describe an inclination towards tidiness and organisation. Through this misappropriation, the true meaning of the term ‘OCD’ is suppressed and loses its hermeneutical power.

We hope that the concept ‘wrongful depathologisation’ may open a space for new ways of understanding other marginalised experiences that are simultaneously stigmatised and trivialised. For example, cases of rape, sexual assault and domestic abuse, where the individual is vulnerable to stigmatisation and victim-blaming, yet their experiences may be trivialised due to cultural attitudes that normalise sexual and domestic violence. As a new contribution to the literature, we hope that the concept of wrongful depathologisation may bring to light further cases of epistemic injustice driven by the paradoxical twining of stigmatisation and trivialisation.

Belief and Evidence: An Interview with Carolina Flores

Today's post is part of a series on the AHRC funded project Deluded by Experience, ran by PI Ema Sullivan-Bissett and Co-I Paul Noordhof. In this post Harriet Stuart (Research Assistant for Deluded by Experience) interviews Carolina Flores about their research interests and most recent work. Carolina is a graduate student in Philosophy at Rutgers, New Brunswick, specialising in philosophy of mind, epistemology, and social philosophy.

Carolina Flores

HS: Your PhD work seeks to address questions around belief and interactions with evidence, how did you first become interested in these ideas?

CF: My interest in these questions has a theoretical and a political source. The theoretical source was my interest, as an undergraduate, in Davidson’s idea that to have beliefs is to be rational. Though I was intrigued by this view, it was also clear to me that it is in tension with the fact that we are frequently irrational, sometimes deeply so (as in the case of delusions). In my undergraduate thesis, I attempted to address this tension in a way friendly to Davidson’s view.

Irrationality and evidence-resistance turned out to be timely topics for political reasons. I finished my undergraduate thesis the year of the Brexit referendum and Trump’s election. As a response to these events, mainstream media propagated an irrationalist narrative which blamed them on ordinary people’s stupidity and irrationality. This political context made me even more interested in understanding belief and interactions with evidence in general, and in particular in pushing back against the narrative that people are epistemically irredeemable—as I attempt to do in my dissertation.

HS: In a paper you currently have under review, you introduce the notion of epistemic styles, could you briefly introduce the notion and explain why you think this notion is beneficial in your research?

CF: I introduce the notion of epistemic styles to help explain why people interact with evidence in different ways. Epistemic styles are ways of interacting with evidence that express a unified set of epistemic values, preferences, and other epistemic parameters. My idea is that differences in what evidence one finds persuasive, how many explanations for evidence one considers, how actively one seeks out evidence, etc. can often be explained in terms of the adoption of different epistemic styles.

There are two main advantages to appealing to epistemic styles. First, it does justice to the role both of situational factors (mood, social norms, etc.) and of agency in how we interact with evidence. In my account, people flexibly take up different epistemic styles in response to situational factors, where their style then governs their interactions with evidence. In this way, appeal to epistemic styles captures the positive aspects of both virtue-based approaches, which seek to explain our epistemic behavior in terms of deep, stable character traits, and situationism, which emphasizes the influence of trivial situational factors.

Second, appealing to epistemic styles can make others’ interactions with evidence intelligible at the personal level. Thinking in terms of epistemic styles can move us from being puzzled at others’ interactions with evidence, or finding them deeply irrational, to understanding how they interact with evidence in the light of the epistemic values, preferences, etc. that they have taken up.

HS: In your recent paper ‘Delusional evidence-responsiveness’, you argue that delusions are evidence-responsive but that patients can rarely be successful in exercising their capacity to respond to evidence. Can you briefly introduce this idea and talk about how this claim relates to your notion of epistemic styles?

CF: The central idea in this paper is that delusions do not erase the patient’s rational capacities. Patients with delusions have the capacity to respond to evidence bearing on their delusions. If they were to successfully exercise their capacities, they would rationally revise. Unfortunately, unusual perceptual experiences, cognitive biases, and the desire to avoid painful beliefs interfere with these capacities. For this reason, it is very hard for patients to abandon their delusions.

This view is independent of my discussion of epistemic styles. I don’t think delusional patients necessarily take up a distinctive delusional epistemic style when interacting with evidence. That said, there is interesting research in psychiatry that suggests that delusions in schizophrenia are underwritten by a distinctive epistemic style—a view I am developing in a new paper.

HS: Your project draws from many disciplines including philosophy and psychology, what are the advantages and disadvantages of interdisciplinary work? How have you overcome any difficulties?

CF: I love getting to learn from many disciplines! It helps me cultivate a sense of wonder at how much there is to learn and discover. I also think that it has improved my work, by making it sensitive to how actual humans interact with evidence and maintain their beliefs.

One downside of this approach is that it is often overwhelming to realize how much there is to learn. I also worry about not doing justice to scholarship in other fields. To combat this, I try to get very clear on what empirical resources a project requires and then go on a focused deep dive. And I strive to continually expand my general knowledge of other disciplines.

HS: What do you hope to see as the outcomes of your work?

CF: At a theoretical level, I hope to make progress in (1) understanding the nature of belief and (2) developing a clear framework in which to understand how people interact with evidence—one which does justice both to cognitive science and to our rational agency. I hope that this will be useful in understanding delusions, conspiracist beliefs, prejudice, ideologies, political beliefs, and so on. I also hope that this work finds practical application in helping us devise better strategies for changing minds and for rationally engaging across deep disagreement.