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When Are Conspiracy Beliefs Pathological?

This week's contribution is from Joe Pierre on his paper Conspiracy Theory Belief: A Sane Response to an Insane World? (Review of Philosophy and Psychology, 2023).

Back in 2021, Ema Sullivan-Bissett invited me to participate in a multidisciplinary workshop at the University of Birmingham to tackle the question, “are conspiracy theory beliefs pathological?” While the workshop didn’t take place until the Spring of 2023, getting together to discuss the topic and hear lectures from philosophers and psychologists whose work I knew well, but had never met in person—like Lisa Bortolotti, Karen Douglas, Stephan Lewandowsky, Anna Ichino, and Kengo Miyazono—was well worth the wait. And in the meantime, Dr. Sullivan-Bissett also invited me to contribute to a special issue of the journal Review of Philosophy and Psychology on “Conspiratorial Ideation and Psychopathology.”


Joseph Pierre

For the article I wrote, I chose the title “Conspiracy Theory Belief: A Sane Response to an Insane World?” to summarize and expand on my lecture for the workshop. The title borrows from the familiar aphorism variably attributed to Thomas Szasz or R.D. Laing that claims that “insanity is a sane response to an insane world.”

While I’m not fond of that quotation in reference to psychiatric disorders due to its dismissal of biological contributors to mental illness, I think it provides a reasonable way of understanding conspiracy theory beliefs (CTBs). As a psychiatrist doing full-time clinical work that has focused on the treatment of individuals hospitalized for psychosis, I’m confident that CTBs can usually be distinguished from delusions in various ways that I detail in my paper (e.g., delusions are false and usually about the believer, whereas CTBs are usually about world events and may turn out to be true). Consequently, characterizing conspiracy theory and other types of ideological beliefs as examples of “mass psychosis” or “mass delusion” is a pet peeve.

That conspiracy theory beliefs are as common as they are—surveys have consistently found that the majority of the population around the world believes in at least one—should be enough to conclude that they’re normal and shouldn’t be equated with delusions or symptoms of mental illness. And if we apply Jerome Wakefield’s “harmful dysfunction” definition of mental illness to CTBs, we can readily see that while they’re sometimes harmful (like when beliefs about 5G networks causing COVID-19 lead people to set cellphone towers on fire), they’re often quite innocuous (for the most part, “flat-earthers” don’t cause much trouble). So, it isn’t enough to ask whether CTBs are pathological because of the harm they sometimes cause—instead we should ask what kind of CTBs are harmful and when they are harmful.

As for the dysfunction of CTBs, psychology research has revealed an ever-expanding list of associated psychological needs and cognitive biases, but such findings represent quantitative rather than qualitative differences between those that do and don’t believe in conspiracy theories. In an earlier paper, I proposed an alternative, normalizing “socio-epistemic” framework to characterize CTB based on two key components—epistemic mistrust and misinformation. Briefly summarized, this model argues that mistrust of authoritative sources of information—which may or not be unwarranted or pathological—creates a vulnerability to misinformation and disinformation that’s ubiquitous out there in the world. 

In my view, so-called conspiracy theorists aren’t really theorizing so much as they’re “just asking questions,” “doing their own research,” “looking for answers,” and then finding them—often online—in the form of conspiratorial counter-narratives. This active search is steered by confirmation bias and motivated reasoning, but these are universal biases that apply to all of us to some degree without warranting a pathological label. Returning to the claim about CTBs being a sane response to an insane world, I make the case that epistemic mistrust and the ubiquity of conspiratorial narratives are best characterized as societal ills rather than individual dysfunctions.

At the same time, it can be useful from an interventionist perspective to model the potential harmfulness of CTB as related to belief conviction—that is, how we believe rather than what we believe. As I argue in my forthcoming book, False: How Mistrust, Disinformation, and Motivated Reasoning Lead Us to Believe Things That Aren’t True, escalating ideological commitment—whether related to CTB or not—can result in “true believers” for whom belief and identity become fused and “activists” who feel the need to do something about their beliefs which can sometimes mean defending them with violence. It is in such instances of belief that the label of individual pathology—in terms of both cause and effect—may yet be justified.

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