Epistemic Benefits of Elaborated and Systematized Delusions in Schizophrenia

Doctors without ‘Disorders’

On one influential view, the problems that should attract medical attention involve a disorder, because the goals of medical practice are to prevent and treat disorders. Based on this view, if there are no mental disorders then the status of psychiatry as a medical field is challenged. In this paper, I observe that it is often difficult to establish whether the problems that attract medical attention involve a disorder, and argue that none of the notions of disorder proposed so far offers a successful demarcation criterion between medical and non-medical problems. As an illustration, I consider why delusions are considered pathological and whether they attract medical attention in virtue of being pathological, where ‘pathological’ stands for ‘being caused by a disorder’. Although there are several promising answers to what makes delusions pathological, available accounts of the pathological nature of delusions fail to distinguish delusions from other irrational beliefs that are not typically thought of as pathological; and cannot explain why delusions typically attract medical attention whereas other irrational beliefs do not.

Thinking, believing, and hallucinating self in schizophrenia

In this Personal View, we discuss the history and concept of self-disturbance in relation to the pathophysiology and subjective experience of schizophrenia in terms of three approaches: the perceptual anomalies approach of the early Heidelberg School of Psychiatry, the ipseity model, and the predictive coding framework. Despite the importance of these approaches, there has been a notable absence of efforts to compare them and consider how they might be integrated. This Personal View compares the three approaches and offers suggestions as to how they might work together, which represents a novel position. We view self-disturbances as transformations of self that form the inseparable background against which psychotic symptoms emerge. Integrating computational psychiatric approaches with those used by phenomenologists in the first two listed approaches, we argue that delusions and hallucinations are inferences produced under extraordinary conditions and are both statistically and experientially as real for patients as other mental events. Such inferences still approximate Bayes-optimality, given the personal, neurobiological, and environmental circumstances, and might be the only ones available to minimise prediction error. The added contribution we hope to make focuses on how the dialogue between neuroscience and phenomenology might improve clinical practice. We hope this Personal View will act as a timely primer and bridging point for the different approaches of computational psychiatry and phenomenological psychopathology for interested clinicians.

Are clinical delusions adaptive?

Delusions are symptoms of psychiatric disorders such as schizophrenia and dementia. By and large, delusions are characterized by their behavioral manifestations and defined as irrational beliefs that compromise good functioning. In this overview paper, we ask whether delusions can be adaptive notwithstanding their negative features. Can they be a response to a crisis rather than the source of the crisis? Can they be the beginning of a solution rather than the problem? Some of the psychological, psychiatric, and philosophical literature has recently suggested that they can. We consider different types of delusions and different ways in which they can be considered as adaptive: psychologically (e.g., by increasing wellbeing, purpose in life, intrapsychic coherence, or good functioning) and biologically (e.g., by enhancing genetic fitness). Although further research is needed to map the costs and benefits of adopting and maintaining delusional beliefs, a more nuanced picture of the role of delusions in people's lives has started to emerge.

This article is categorized under:

Philosophy > Representation

Philosophy > Knowledge and Belief

Neuroscience > Cognition

Why Is Virtual Reality Interesting for Philosophers?

This article explores promising points of contact between philosophy and the expanding field of virtual reality research. Aiming at an interdisciplinary audience, it proposes a series of new research targets by presenting a range of concrete examples characterized by high theoretical relevance and heuristic fecundity. Among these examples are conscious experience itself, “Bayesian” and social VR, amnestic re-embodiment, merging human-controlled avatars and virtual agents, virtual ego-dissolution, controlling the reality/virtuality continuum, the confluence of VR and artificial intelligence (AI) as well as of VR and functional magnetic resonance imaging (fMRI), VR-based social hallucinations and the emergence of a virtual Lebenswelt, religious faith and practical phenomenology. Hopefully, these examples can serve as first proposals for intensified future interaction and mark out some potential new directions for research.

The epistemic innocence of clinical memory distortions

In some neuropsychological disorders, distorted reports seem to fill gaps in people's memory of their past, where people's self-image, history, and prospects are often enhanced. False beliefs about the past compromise both people's capacity to construct a reliable autobiography and their trustworthiness as communicators. However, such beliefs contribute to people's sense of competence and self-confidence, increasing psychological well-being. Here, we consider both the psychological benefits and epistemic costs and argue that distorting the past is likely to also have epistemic benefits that cannot be obtained otherwise, such as enabling people to exchange information, receive feedback, and retain key beliefs about themselves.