In my discussion of Steven Pinker’s book, Rationality,
I referred to his observation that people tend to have a reality mindset in
the world of immediate experience and a mythology mindset when discussing
issues in the public sphere. Although that is an accurate observation about a
general tendency, delusions are also fairly common in the world of immediate
experience.
The
delusions that most of us experience are fairly harmless. For example, it may
not do you much harm to believe that you are happier than average, even if you
aren’t. That common delusion may help to explain why so many people walk around
with smiles on their faces.
For some
unfortunate people, however, the world of immediate experience includes
delusional beliefs that are symptomatic of mental ill-health. These are
referred to as clinical delusions.
The question I ask above has been prompted by my reading of Lisa Bortolotti’s recent book, Why Delusions Matter. Lisa Bortolotti is a philosopher who specializes in the philosophy of the cognitive sciences, including issues relating to mental illness. She observes that there is a strong overlap between clinical and non-clinical delusional beliefs. The non-clinical delusional beliefs that she discusses include beliefs that Pinker would associate with a mythology mindset.
A
conversation context
Bortolotti notes
that in any discussion between two people, you have a speaker and an
interpreter swapping roles as the conversation proceeds. The speaker says
something and the interpreter listens, making inferences about the speaker’s
beliefs, desires, feelings, hopes and intentions on the basis of the speaker’s
words, facial expression, tone of voice, previous behaviour and so on.
Interpretation
becomes challenging when the interpreter suspects that the speaker may be
delusional. The interpreter rarely has the information needed to assess that
the speaker’s beliefs are false, so falsity cannot be a necessary condition for
attribution of delusionality.
Three
elements are often involved when the interpreter judges the speaker to be
delusional:
- Implausibility: The interpreter finds the speaker’s beliefs to be implausible.
- Unshakeability: Speakers do not give up their beliefs in the face of counterarguments and counterevidence.
- Identity: The beliefs seem important to the image that speakers have of themselves.
Clinical
delusions
Bortolotti
offers what she describes as an “agency-in-context” model to explain clinical
delusions. She explains:
“The
adoption and maintenance of delusional beliefs are due to many factors
combining aspects of who you are and what your story is (your genes, reasoning
biases, personality, lack of scientific literacy, etc.) and aspects of how
epistemic practices operate in the society where you live.”
The
epistemic practices she refers to include what we learn at school about
knowledge acquisition, and the stigma that makes it difficult for people with
delusional beliefs to participate fully in public life.
There is no
doubt that persecutory delusions are harmful to the speaker and others. They
undermine the ability of speakers to respond appropriately to events, and often
erode their relationships with others.
However,
Lisa Bortolotti suggests that it is important for interpreters to understand
that most delusions offer some benefits for speakers. Delusions “let speakers
see the world as they want the world to be; make speakers feel important and
interesting; or give meaning to speakers’ lives, configuring exciting missions
for them to accomplish”.
Interpreters
also need to understand that the underlying problems of speakers don’t
disappear when they obtain insight about their delusions. They may become
depressed when they approach reality without the filter of their delusional
beliefs.
There is
not much to be gained by attempting to reason with people whose beliefs are
unshakeable. Bortolotti suggests that it is
probably more productive for the interpreter and speaker to share
stories rather than exchanging reasons for beliefs. Exchanging stories can show
how delusional beliefs emerged as reactions to situations that were difficult
to manage. While sharing stories, interpreters have opportunities “to practice
curiosity and empathy in finding out more” about underlying problems.
Conspiracy
delusions
From an
interpreter’s viewpoint, a speaker’s beliefs about the existence of
conspiracies often have similar characteristics to clinical delusions. They are
implausible, unshakeable, and closely tied to the speaker’s self-image.
Bortolotti
emphasizes that those who hold conspiracy delusions often claim to have special
knowledge of events – they claim to be experts, or to know who the real experts
are. Identifying as a member of a group is often also important. Non-members
often refer to members of such groups in a derogatory way e.g. QAnon supporters
and anti-vaxxers. However, people are often attracted to conspiracy delusions
promoted by like-minded people whom they trust. The act of sharing a delusional
story can be a signal of commitment to a particular group.
Comments
Lisa Bortolotti’s
book has improved my understanding of delusions in a couple of different ways.
First, it has given me a better appreciation that delusions offer some benefits
to the people who hold them, and those benefits help to explain the
unshakeability of delusional beliefs.
Second,
viewing delusions within the context of a conversation between a speaker and an
interpreter is helpful in drawing attention to the value judgements involved in
assessing whether the speaker’s beliefs are delusional.
My main
criticism of the book is that the author seems to me to be biased in favour of
“the official version” of events, even though she acknowledges that contrary
beliefs are sometimes vindicated. The most obvious example bias is her apparent
reluctance to give credence to the possibility that Covid19 may have originated in a lab in Wuhan.
I am
pleased that my reading of the book did not leave me with the impression
that the author believes that it is delusional to have an unshakeable belief in
the importance of the search for truth. In emphasizing that value judgements
are involved in assessing whether beliefs are delusional, Lisa Bortolotti seems
to me to be providing readers with a better understanding of the meaning
attached to the concept of delusion in clinical and non-clinical settings,
rather than casting doubt on the existence of reality.