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Lecture

PHL383H1 Lecture Notes - Delusional Disorder, Karl Jaspers, Cognitive Behavioral Therapy


Department
Philosophy
Course Code
PHL383H1
Professor
Thomas Mathien

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February 4, 2013
Delusion and personhood as themes of Graham’s last 2 chapters
The nature of a mental disorder’s disadvantage for us is that it affects/truncates
our reasoning capacities
A delusion are usually marked by people saying strange things about who they
are, or what the world is like, or what they think, or what has happened to them,
etc.
When somebody says something about the world that gives us a bit of a shock
Some of these delusions seem like unreasonable beliefs
People hold them contrary to evidence, they cannot be shaken by evidence
This is how they are not responsive to reason
Not only delusions that are false beliefs or contrary to evidence
People believe all kinds of crazy things yet we don’t decide that they are deluded
We want to say that it’s unfortunate that they believe these things and they’re
wrong, but we wouldn’t necessarily say that they’re deluded
On the other hand some delusional beliefs could become true
Stock example: a person believes they have lots of enemies, and at least some of
the time they could be right
You can have true delusions, and manifestly false/unreasonable/not supported by
evidence beliefs that are false
Delusions are not necessarily false, but it doesn’t include the whole class of
unreasonable beliefs
What makes a delusion a delusion?
Upstream focus: a focus on what’s caused this belief or what the propensity
conditions for a delusional belief is
Downstream focus: what’s the result of having a delusional belief? How do you
manage it?
Page 194
Many delusions are somewhat reasoned out, and logically, moderately well
constructed responses to very uncommon experiences
When confronted with this experiences, these unprecedented inputs the person
constructs a way to fit in with the world
Looking upstream there’s a causal story that you can tell, but when you ask peole
questions about their beliefs, you can ask them “why do you think so?” “Does that
really make sense?” And you will observe that people can and should concede
that the conclusion they’ve drawn has no good reason for it
Construct something in response to an unprecedented and unusual experience
But you do not accept the reasonable account, you persist in the delusion
Graham’s position on the upstream focus: probably the case that some of these
thoughts that get solidified into delusions are caused by unusual experiences,
maybe the result of psychological problems, or some brain damage
The fact of the matter is that people can say about experiences, and the way they
want to respond to them may be unreasonable
If you experience something as an alien abduction, then we’re inclined to go
along with it

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Bias in favor of that initial naïve kind of automatic response to whatever
perceptual experience we have
We can be shaken when contrary evidence is pointed out
But what’s special about delusion?
Karl Jaspers
Delusions didn’t make much sense – the extreme was that it was hard to know
what to make of them at all
What could someone mean by saying they didn’t exist?
Jasper: the mark of the deluded belief is that there is some level of
incomprehensibility
It doesn’t hang together rationally
Graham is more generous about this
But in the end there is a convergence
Graham: we often decide that a belief that we would call a delusion or an
experience that we would call a deluded experience, is deluded because often the
reason it makes no sense is because we haven’t tried hard enough to make sense
of it
That there some sort of possible point of empathy that can be reached
What’s really at issue here is something Jasper’s calls the delusional mood
given their experiences and their reports, how are you likely to deal with them?
The deluded person takes them at face value and they resist attempts at persuasion
otherwise
Graham takes the issue associated with the delusional group
He’s a skeptic about Jasper’s position about delusions not making sense
Inclined to reject the Jasper’s position that a delusion in order to be a delusion
must not make sense, we cannot empathize with the deluded person
Maybe yes maybe no
Agrees with Jaspers that the deluded person to be deluded is guided in his or her
responses to the world by their delusion
Not normal rational influence, but influence on behavior
Does not mean that they automatically take the delusion as a fact about the
universe
Other people with delusions may not always act in ways that are rationally in
response to their delusion
Many delusions are related to states
Deluded belief that they’re a king (delusions of grandeur): but they do not expect
treatment or act to demand treatment which they take to be in full measure to their
delusion
They think they ought to be obeyed but they make no efforts to issue orders to
people
What makes them delusional on the Graham account is that they have some
guiding effect on behavior, they either provide reasons for choices
The belief is manifestly unreasonable and there is the resistance
Important enough to trump the reason in us
Not enough that we act in response to a deluded belief
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