On The Philosophy of Delusions
Is a delusion a belief? It seems like a simple enough enough question to answer on face value; yes of course I believe my delusions, but is actually a quite hefty question. What constitutes a belief? Do delusions meet these standards, or do they represent some other cognitive process? How do we obtain beliefs, and do delusion follow this pattern? We will discuss these questions together promptly.
One way to look at beliefs is to see them as arational in their formation and as responding to evidence, changing as the situation changes (Bongiorno, 2021). By this definition, delusions would not be beliefs because they do not respond to evidence. However, there are different ways to respond to this quandary. Buckwalter and Turri (2014) conducted a number of experiments to see how the general public classified delusional behavior as being beliefs. The experiments involved multiple different written scenarios of a man experiencing Capgras delusion (the delusion that one’s relative or friend has been replaced by an imposter) and one other scenario of different delusional behavior. The scenarios varied with modification in the intensity of the delusional subject’s verbal commitment to the delusion as well as delusional action. Even when the delusional subject was not exhibiting significant delusional behavior, verbal commitment to the delusional still caused participants to mark him as believing the delusion. The study found overall that people attribute conflicting beliefs to people experiencing delusions, believing and not believing the delusions at the same time.
Does this sound familiar to anyone else? Many people with Psychosis have reported feeling as though their delusional beliefs are a sort of in-between, and real and not real belief at the same time. It is something I have experienced my entire life. I cannot helped but think that the Buckwalter and Turri experiment is severely lacking because they did not show the scenarios to a group of stabilized people with Psychosis. It’s all well and good to see what the public ascribes but why not ask people who have actually had delusions? I believe this to be a major flaw in the study. It is a major problem in general with cognitive research on Psychosis in my view: there are patients available they could ask questions to and find valuable information from, but they either ignore us or do not do a very good job of interviewing us.
So delusions meet a general definition of belief, but what is the mechanism by which they work? For this answer, we turn to the philosophy of Psychology. The Spinozan school states that we cannot hear a proposition without first believing it, and that rejecting a proposition takes effortful, conscious action. The theory continues that when a person is under cognitive load (their mental resources are strained), it is harder to reject or negate concepts. This goes against most people’s intuitive belief, which is that we can consider ideas and then reject them before believing them. However, there is evidence from cognitive science to support the Spinozan belief. Multiple experiments have shows that while under cognitive load, people remember falsehoods just as easily as they remember truths and that they have a more difficult time negating, but no trouble accepting statements. They do not accept the falsehoods or show trouble negating them when not under cognitive load. This is in line with the Spinozan worldview. (Mandelbaum, 2014)
What does this have to do with Psychosis? As Bongiorno (2021) and Beck et al (2011) argue, Psychotic people are under constant increased cognitive load. Hallucinations play a role in this, but additionally, the sensory floodgates in people with Psychosis do not function properly. We have aberrant salience processing, and every stimuli seems important to our nervous system. This can easily lead to overwhelm. With this constant data stream, it is easy to go into cognitive load, and when an errant thought occurs on our mind, such as “my mother is an impostor”, our minds might not have the capacity to reject it after it is initially accepted. Because rejecting a thought take additional effort after the fact (while we are still under cognitive load) and the delusion constantly has new evidence provided for it, it simply becomes too confusing and difficult to drop the belief, at least in its entirety. (Bongiorno, 2021).
As you can see, the cognitive mechanism of delusions are confusing, as this has not even gotten into the complex world of cognitive distortions that maintains delusions. I hope you found this helpful and informative, and I will see you again soon.
Citations
Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. (2011). Schizophrenia: cognitive theory, research, and therapy. Guilford Press.
Bongiorno, F. (2021) Spinozan Doxasticism About Delusions. Pacific Philosophical Quarterly, https://doi.org/10.1111/papq.12373
Buckwalter, W., & Turri, J. (2014). When Words Speak Louder than Actions: Delusion, Belief, and the Power of Assertion. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3649259
Mandelbaum, E. (2013). Thinking is Believing. Inquiry, 57(1), 55–96. https://doi.org/10.1080/0020174x.2014.858417
