On today’s post, Bethany Linham explores whether delusions can be understood as a way of experiencing the world. Bethany is a PhD researcher at the University of Exeter, where her work draws on phenomenology and imagination to explore the nature of delusional experience.
 |
| Bethany Linham Delusion: bad believing, or something more? Throughout my career, I have always been struck by the overwhelmingly pathocentric approach researchers and clinicians take to delusions. There is a common tendency to lean on the assumption that delusions are mere byproducts of a faulty cognitive system – paradigmatic instances of ‘bad’, irrational beliefs. This cannot be the full story. After all, delusions have a profound effect on a subject’s life as a whole, not just on their cognitive performance. I argue that to experience a delusion is to undergo a fundamental existential shift. The foundations of one’s life world become compromised: shared spaces, objects, everyday encounters, and relationships all take on new meanings, new narratives. One’s attention is called for in unusual ways: there is an affective allure towards once unremarkable objects or interactions, which now demand action and explanation. One’s affordance space (mental or bodily) can expand and/or constrict. Furthermore, delusions can provide one with new information, new goals or missions, a renewed sense of purpose or agency, new treatment (from oneself and others) and even a new sense of identity. The list could go on (and on… and on!). Subjects live through, rather than alongside, their delusions. These explorations help illuminate how delusions are an embodied, affective, and meaningful mode of existence – not just a bad belief. Ultimately, delusions have a global (rather than local) impact on the subject and are incredibly tenacious – these features of delusion cannot be accounted for on traditional doxastic or dysfunction-based accounts. But they can on the ‘way of life’ model. To say that delusion is a way of life acknowledges the lived dimension of the phenomenon and recognises how delusion is a way of experiencing the environment – a mode of living – rather than a faulty belief or mental state. After all, you can talk people out of beliefs, but you cannot talk them out of a way of life. This framework was developed with a clear goal in mind: to de-pathologise delusion while promoting a sense of normalisation. By ‘normalisation', I mean to work on closing the gap between ‘us’ and ‘them’ frameworks. For me, it is key that when we study delusions, we keep two things in mind: (1) Delusions can arise outside of the pathological context. In fact, it is entirely possible, if not more common, for someone to have a ‘healthy’ brain yet lead a problematic life. And (2) the gap between having an ordinary and delusional experience is much smaller than what you might think. By framing delusions as a way of life, we can begin to appreciate how delusion simply marks a different way of being-in-the-world, which can be classified as negative, positive, or neutral. This has profound implications for research, treatment and intervention (i.e., importance of narrative solution-focused practice), and the development of a more phenomenologically accurate account of delusion. It also works to de-stigmatise delusion and promote epistemic justice by widening the net as to what ‘counts’ as a delusion and thus who is deserving of clinical attention and treatment. Delusion is not just an instance of bad believing - it is, fundamentally, a way of life. |