Delusions and Other Irrational Beliefs more

Synopsis Here is an overview of the book contents. Chapter 1: The background In Chapter one, I describe the aims of the book, offer some background information, and defend a general framework in which the question whether delusions are beliefs has important consequences for our conception of mental illness and for our understanding of the relationship between rationality, intentionality, and self knowledge. I briefly explain how a notion of rationality of beliefs can be developed, by reference to theories of belief ascription and to the relevant epistemological features of beliefs. I also summarise contemporary debates about the definition of ‘delusion’, the aetiology of delusions, and the analogies and disanalogies between clinical delusions and other superficially similar phenomena (self deception, obsessive thoughts, confabulation, and hypnotically induced beliefs). Chapter 2: Procedural rationality and belief ascription In Chapter two, I examine whether we can legitimately deny belief status to delusions by virtue of their procedural irrationality. I explain what procedural rationality is, and ask whether we are justified in thinking that delusions are procedurally irrational. Then I offer some concrete examples of the arguments against the belief status of delusions based on procedural irrationality (e.g. the bad integration argument) and assess them by reference to different cases of delusions. I argue that there are pervasive and significant failures of procedural rationality both in delusions and in beliefs—this suggests that procedural rationality should not be a constraint on the ascription of beliefs. Chapter 3: Epistemic rationality and belief ascription In Chapter three, I discuss whether delusions should be denied belief status by virtue of their epistemic irrationality. Delusions are often defined in terms of their violation of norms of epistemic rationality, but there are some interesting debates as to whether they are epistemically irrational, and to xvi SYNOPSIS what extent. I sketch some arguments against the belief status of delusions based on their alleged lack of evidential support, and their resistance to counterevidence. Then I assess these anti-doxastic arguments by reference to different types of delusions. I argue that there are pervasive and significant failures of epistemic rationality both in delusions and in beliefs. As the epistemic rationality constraint on belief ascription has numerous counterexamples, it should be abandoned. Chapter 4: Agential rationality and belief ascription In Chapter four, I assess the argument that delusions are not beliefs because subjects reporting delusions do not act on their delusions in the appropriate circumstances and cannot endorse the content of their delusions with reasons that are intersubjectively good reasons. I emphasise the special role of agential rationality in bridging the traditional divide between theoretical and practical rationality. Then I ask whether we are justified in thinking that delusions are agentially irrational. In the first part of the chapter, I discuss arguments against the belief status of delusions based on their alleged failure to guide action, and assess these arguments by reference to different types of delusions. In the second part of the chapter, I explain the relationship between authorship and agential rationality, and claim that, although most subjects with delusions are agentially irrational, many are the authors of their delusional states. Then I assess the argument that delusions are not beliefs because the subject does not endorse the content of the delusion on the basis of intersubjectively good reasons. In the end, I argue that there are pervasive and significant failures of action guidance and reason-giving in both delusions and beliefs, which undermine agential rationality as a constraint on the ascription of beliefs. Chapter 5: Beliefs and self knowledge In Chapter five, I concentrate on some of the implications of the previous discussion for the debate on the nature of delusions and for belief ascription in general. I maintain that agential irrationality with respect to a thought does not compromise the doxastic nature of that thought, or the subject’s firstperson authority over that thought. However, if the thought is neither owned nor authored by the subject reporting it, the characterisation of that thought in doxastic terms and the subject’s self knowledge with respect to that thought are at risk, as the case of ‘inserted’ thoughts illustrates. Beliefs that are self ascribed and authored are integrated in a self narrative, and contribute to SYNOPSIS xvii the construction or preservation of a conception of the self. I end by exploring the consequences of the analysis of self narratives for the status of delusions as irrational beliefs. Conclusions I summarise my conclusions on the nature of delusions and the ascription of beliefs.