This week, doctoral researcher Rachel Gunn examines the nature of delusions.
If a subject says they believe something then I am inclined to take this at face value. The subject usually has other mundane unexamined beliefs (e.g.: I believe that when I turn a tap on water comes out) as well as examined beliefs or opinions (e.g.: I believe that liberal democracy is the best political system). Against this background of other beliefs it does not seem appropriate to ‘second guess’ the subject about his own experience. Not everyone would agree with this and some would argue that delusions do not meet the criteria for beliefs as they are irrational, do not necessarily affect behaviour and do not cohere with other beliefs.
Some propose that a delusional subject fails to monitor an imagining as being self-generated (the subject is in some sense not the agent of the imagining). This mental activity is then mislabelled (representationally) as a belief and somehow ‘given’ as true. So the delusional person has a thought with content P. He does not believe P. He imagines P. And he believes that he believes P. In this case some delusions are imaginings with a strong feeling of subjective conviction (Currie and Jureidini, 2001). This is an intriguing way of describing some delusions and might help us explain why some subjects do not seek to integrate their delusions into their lives or to act on them (we do not routinely act on our imaginings). However, there are problems here – the most obvious being that there are many examples of people acting on their delusions and integrating them into elaborate belief networks that pervade the rest of their lives - for example, the person who believes he is a millionaire, a general and a senior psychiatrist who regularly phones the bank to check on his millions, attempts to arrange to inspect local military bases and applies for a job as a chief executive of a hospital (Bentall, 2004, pp.295–6).
The other problem arises from establishing how this characterisation of delusion differs from non-delusional subjects who are ‘believers’. Our normal propositional attitudes can be manifest as beliefs, which we may not act on, which may not be integrated into the rest of our beliefs and which may also be irrational. For example I might say that I believe smoking kills people and I do not want to die sooner than necessary yet I continue to smoke. This series of un-integrated beliefs might include an unexamined belief (or sub-clinical delusion) that I am special and the detrimental effect of smoking will somehow not have an impact on me. If questioned about it I would probably concede that the (weakly held) belief that I am special is not true, yet I am unlikely to change my behaviour. Further, one could successfully argue that my behaviour and my thinking in this case is irrational but it is unlikely that one would question the belief status of my statement about smoking. Some say that delusions are non-doxastic acceptances that do not meet relevant rationality standards (Frankish, 2012) – and here I would have to question what is meant by ‘relevant rationality standards.’ Ideal (normative) rationality is not consistent in human beings and therefore one cannot deny the doxastic nature of delusions simply because they are sometimes irrational (for supporters of this position see Bayne and Pacherie, 2005; Bortolotti, 2010).
Whilst it might be true that some delusions are not beliefs this does not alter the fact that our ordinary conceptualisation of beliefs sometimes seem to have the same external characteristics as the phenomenon that Currie and Jureidini describe as imaginings mistaken as beliefs and that Frankish describes as non-doxastic acceptances. Of course, as we are unable to consistently and accurately define or describe beliefs or imaginings, I cannot say more about it here - perhaps beliefs, acceptances and imaginings are complex overlapping forms of mental activity. For more on delusion see the imperfect cognitions blog.
Other (non-electronic) references:
Bentall, R.P. (2004) Madness Explained: Psychosis and Human Nature. London: Penguin
Bortolotti, L. (2010) Delusions and other irrational beliefs. International perspectives in philosophy and psychiatry. Oxford ; New York: Oxford University Press