delusions, acceptances, and cognitive feelings

183 Pages·2013·0.57 MB·English

DELUSIONS, ACCEPTANCES, AND COGNITIVE FEELINGS
BYRICHARDDUB
Adissertationsubmittedtothe
GraduateSchool—NewBrunswick
Rutgers,TheStateUniversityofNewJersey
inpartialfulfillmentoftherequirements
forthedegreeof
DoctorofPhilosophy
GraduatePrograminPhilosophy
Writtenunderthedirectionof
BrianMcLaughlin
andapprovedby
NewBrunswick,NewJersey
October,2013
ABSTRACTOFTHEDISSERTATION
Delusions, Acceptances, and Cognitive Feelings
byRichardDub
DissertationDirector: BrianMcLaughlin
Psychopathological delusions, such as the Capgras delusion, the Cotard delusion,
and the florid delusions that accompany schizophrenia, have a number of features
thatarecuriouslydifficulttoexplain.Delusionsareresistanttocounterevidenceand
impervioustocounterargument. Theyaretheoretically,affectively,andbehaviorally
circumscribed;delusionalindividualstendnottoactontheirdelusionsordrawap-
propriateinferencesfromthecontentoftheirdelusions. Delusionalindividualsare
occasionallyabletodistinguishtheirdelusionsfromotherbeliefs,sometimesspeak-
ingoftheir“delusionalreality.” Iarguethatthesefeaturessupportnon-doxasticism
aboutdelusions. Non-doxasticismisthethesisthat,contrarytoappearances,delu-
sionsarenotbeliefsatall. Afterdevelopingtheprospectsfornon-doxasticism,Iof-
feranovelnon-doxasticistcognitivemodel. Delusionsarepathologicalacceptances
thatarecausedbypowerfulandaberrantcognitivefeelings.
ii
Acknowledgements
As I have worked through the issues in this dissertation, my committee members
haveconstantlybeeninvaluablewellspringsofinspirationandguidance.Iowemuch
to them. Andy Egan has been a wonderful source of incisive comments about the
natureofbelief-likementalstates.Conversationwithhimisalwaysimmenselyfruit-
ful;hissuggestionsonpreviousdraftshavebeentop-notch. StephenStich’swritings
have always been a large influence on my thought and they have been a large in-
spiration of the account of cognition that I provide herein. His comments on and
criticisms of earlier versions of my proposal have have prompted many major revi-
sions to my thought. Louis Sass has been my window into an academic field other
than my own. I have learned much about delusions, phenomenology, and clinical
psychologyfromhim,andthisdissertationhasbenefitedgreatlyfromhishelp.
I have further benefited from conversations with graduate students in philoso-
phy and psychology at Rutgers and in the New York area, including (but certainly
not limited to) Josh Armstrong, Tom Donaldson, E. J. Green, Michael Johnson, Ben
Levinstein,ZakMiller,LisaMiracchi,JenniferNado,DavidRose,KarenShanton,and
JenniferWang. FrankieEganandRobertMatthewshaveadditionallyprovidedindis-
pensablecommentary.IwouldalsoliketothankmyaudiencesattheRutgersCenter
forCognitiveScience,theBritishPostgraduatePhilosophyAssociation,andtheInsti-
tuteofCognitiveScienceattheUniverstita¨tOsnabru¨ck.Extraspecialthanksmustbe
directedtoElizabethPienkosforhertirelesssupport,herpatiencewithmytravails,
herhelpinreadingdrafts,andhersharedcommitmenttomygoals.
Of course, the lion’s share of the gratitude must go to my dissertation director,
iii
Brian McLaughlin. Brian has been remarkably generous with his time and dedica-
tion;hisencouragement,suggestions,andmentorshiphaveallbeenabsolutelycru-
cial.
Toallofthesepeople,Iowemythanks.
iv
Dedication
ToLiz.
v
Table of Contents
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
TableofContents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1. Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2. Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.3. ChapterSummaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2. DelusionasNon-Belief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.1. TraditionalCharacterizationsofDelusions . . . . . . . . . . . . . . . . . 11
2.1.1. ExtensionalCharacterizations . . . . . . . . . . . . . . . . . . . . 12
2.1.2. IntensionalCharacterizations . . . . . . . . . . . . . . . . . . . . 15
2.1.2.i. Jaspers’sCharacterization . . . . . . . . . . . . . . . . . 15
2.1.2.ii. ModernPsychiatricCharacterizations . . . . . . . . . . 18
2.2. EvidenceforNon-Doxasticism . . . . . . . . . . . . . . . . . . . . . . . . 21
2.2.1. WhichFeaturesofDelusionAreMostPuzzling? . . . . . . . . . . 23
2.2.1.i. BizarrenessandUnresponsiveness . . . . . . . . . . . . 25
2.2.1.ii. Circumscription . . . . . . . . . . . . . . . . . . . . . . 27
2.2.1.iii. Double-Bookkeeping . . . . . . . . . . . . . . . . . . . 30
2.3. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3. ConceptualArgumentsandRationality . . . . . . . . . . . . . . . . . . . . 33
3.1. TheIrrationalityArgument . . . . . . . . . . . . . . . . . . . . . . . . . . 33
vi
3.2. DelusionsasIrrationalBeliefs . . . . . . . . . . . . . . . . . . . . . . . . 35
3.2.1. BortolottionIrrationality . . . . . . . . . . . . . . . . . . . . . . 35
3.2.2. ANon-DoxasticistResponse . . . . . . . . . . . . . . . . . . . . . 38
3.3. RationalityConstraintsonBeliefAscription . . . . . . . . . . . . . . . . 40
3.3.1. AHistoryofRationalityConstraints. . . . . . . . . . . . . . . . . 41
3.3.2. DoWeNeedaRationalityConstraint? . . . . . . . . . . . . . . . 43
3.3.3. DoWeNeedAnySortofConstraint? . . . . . . . . . . . . . . . . 47
3.3.3.i. IndividualAscription . . . . . . . . . . . . . . . . . . . 47
3.3.3.ii. ScientificAscription . . . . . . . . . . . . . . . . . . . . 49
3.3.4. TheErrorinRationalityConstraints . . . . . . . . . . . . . . . . 54
3.4. RationalityandtheFunctionalRoleofBelief . . . . . . . . . . . . . . . . 55
3.4.1. ConceptualAnalysis . . . . . . . . . . . . . . . . . . . . . . . . . 55
3.4.2. TowardExplanatoryArguments . . . . . . . . . . . . . . . . . . . 58
3.5. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
4. UnsuccessfulNon-DoxasticistTheories . . . . . . . . . . . . . . . . . . . . 60
4.1. RedescriptionandMetarepresentation . . . . . . . . . . . . . . . . . . . 61
4.1.1. RedescriptionAccounts . . . . . . . . . . . . . . . . . . . . . . . 61
4.1.2. Currie’sMetarepresentationalAccount . . . . . . . . . . . . . . . 65
4.1.3. CriticismofCurrie . . . . . . . . . . . . . . . . . . . . . . . . . . 68
4.2. BimaginationandIn-BetweenBelief . . . . . . . . . . . . . . . . . . . . 75
4.2.1. Egan’sBimaginationAccount . . . . . . . . . . . . . . . . . . . . 75
4.2.2. Schwitzgebel’sIn-BetweenAccount . . . . . . . . . . . . . . . . 78
4.2.3. TerminologicalDisputes . . . . . . . . . . . . . . . . . . . . . . . 81
4.2.3.i. AreDelusionsBeliefs? . . . . . . . . . . . . . . . . . . . 85
4.2.3.ii. AreDelusionsBeliefs? . . . . . . . . . . . . . . . . . . . 87
4.2.4. CriticismofEganandSchwitzgebel . . . . . . . . . . . . . . . . . 89
4.3. FrameworkPropositions . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
4.3.1. Campbell’sFrameworkPropositionAccount . . . . . . . . . . . 91
vii
4.3.2. CriticismofCampbell . . . . . . . . . . . . . . . . . . . . . . . . 94
4.4. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
5. ConceptsofBelief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
5.1. PositingAttitudes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
5.2. TheLushandtheSparse . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
5.3. ‘Belief’intheMouthsofPhilosophers . . . . . . . . . . . . . . . . . . . 102
5.3.1. ‘Belief’asanUmbrellaTerm . . . . . . . . . . . . . . . . . . . . . 103
5.3.2. TheFunctionalRoleofBelief . . . . . . . . . . . . . . . . . . . . 107
5.4. ‘Belief’intheMouthsoftheFolk . . . . . . . . . . . . . . . . . . . . . . 113
5.4.1. FolkPsychology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
5.4.2. ‘Belief’intheVernacular . . . . . . . . . . . . . . . . . . . . . . . 115
5.4.3. SemanticsandPragmatics . . . . . . . . . . . . . . . . . . . . . . 120
5.5. ASubtypeofBelief,orNon-Belief? . . . . . . . . . . . . . . . . . . . . . 123
5.6. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
6. APositiveProposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
6.1. APreliminaryDescriptionofAcceptance . . . . . . . . . . . . . . . . . . 126
6.2. FeaturesofAcceptance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
6.2.1. AcceptanceandReasoning . . . . . . . . . . . . . . . . . . . . . 133
6.2.1.i. Type2ReasoningandSimulatedBelief . . . . . . . . . 134
6.2.1.ii. Validation . . . . . . . . . . . . . . . . . . . . . . . . . . 137
6.2.2. FormationandVolition . . . . . . . . . . . . . . . . . . . . . . . . 139
6.2.3. BehavioralEffectsandVerbalEffects . . . . . . . . . . . . . . . . 141
6.3. DelusionasAcceptance . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
6.3.1. ExplainingDouble-Bookkeeping . . . . . . . . . . . . . . . . . . 147
6.3.2. ExplainingCircumscription . . . . . . . . . . . . . . . . . . . . . 150
6.3.3. UnresponsivenesstoEvidence . . . . . . . . . . . . . . . . . . . 152
6.4. CognitiveFeelings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
6.4.1. AcceptancesandCognitiveFeelings . . . . . . . . . . . . . . . . 157
viii
6.5. TheFinalModel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
6.6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Vita . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
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1
Chapter 1
Introduction
1.1 Overview
Thisdissertationprovidesamodelofpsychoticdelusionsinwhichdelusionsarenot
beliefs.
The model responds to two different debates in the literature on delusions that
are not often brought together. The first debate concerns the etiology—the causal
origin—of delusions. How does a person suffering from a psychosis come to form
adelusionalbelief? Whydosomeindividualscometobelievethattheirspousehas
beenreplacedwithimposter?Therearetwomaintypesofanswertothesequestions.
Eachmakesadifferentclaimaboutthenumberofcognitivemechanismsthatneed
to be broken in order for a delusion to develop. One-factor theories hold that we
only need to appeal to a single impairment. Delusions are normal responses to an
anomalous, pathological experience. Two-factor theories, on the other hand, hold
that anomalousexperience isnot initself sufficient toproduce adelusion. We also
need to explain how the experience leads to a delusional belief, and why that be-
liefisnotimmediatelyrejectedforbeingbizarre. Thisrequiresustopositasecond
pathology:animpairmentorapathologicalbiasinwhatevermechanismisinvolved
inbelieffixation. Theseconddebateconcernsthecharacterizationofdelusions. Itis
commonlyassumedthatdelusionsarebeliefsofacertainsort. Theone-factor/two-
factor debate typically makes this assumption: it is typically presented as a debate
abouthowdelusionalbeliefsareformed. Theoriesthatclaimthatdelusionsarebe-
liefs are doxasticist theories. Lately, some philosophers and psychologists have ar-
guedthatdelusionsdon’tbehaveasonewouldexpectbeliefstobehave. Hence,they
conclude,delusionsarenotbeliefs. Rather,theyaresomeothersortofmentalstate.