Grant Gillett

Delusions: A Different Kind of Belief?

Delusions are typically considered to be beliefs and analyzed as propositional attitudes, under constraints of rationality and coherence. But, whereas factual beliefs are assessed in terms of falsity and conviction, but other beliefs are not so clear-cut. The characteristics of delusions are considered here in the light of philosophical approaches to belief, and they are compared with other strongly held, nonfactual beliefs. Approaching delusions as beliefs has several drawbacks: (i) It implies that psychiatry is in the business of determining and regulating the acceptable limits of human belief; (ii) it may result in the misidentification of other strong belief as delusion; and (iii) it fails to explain the often debilitating nature of delusions. If delusions are organized and integrated into the psyche in ways that differ from ordinary beliefs, their influence on, and incongruence with, a person’s other thoughts, emotions, and behavior become more explicable, as do the persistent theoretical problems of definition and distinction in the face of a relatively robust diagnostic practice. We argue that, although accepting that delusions might reasonably be considered as a kind of belief, their wider role in the life of a psychotic patient and the ways that they seem to differ from more ordinary belief merits scrutiny.

Lacan for the Philosophical Psychiatrist

Lacan, despite being largely ignored and misunderstood in Anglo-American analytic philosophy, brings psychoanalytic theory into close contact with the philosophy of mind and psychiatry as illuminated by the continental tradition. He draws on Freud, phenomenology, existentialism, and structuralism to construct a subtle theoretical approach to the psyche according to which our engagement in discourse and our existence in the world combine to generate a many layered structure of meanings and influences that forms us. This allows him to focus on the nature and role of language and our discursively constructed self-conceptions both in the therapeutic encounter and in the maladies of the psyche. The relevance of Lacans thought for analytic philosophy of psychiatry can be explored by pursuing his links to Freud, his complex treatment of issues in the philosophy of language, and a subtle blend of existentialism and continentally inspired naturalism that paints the contours of the unconscious mind in operationally compelling terms.

Lacan, Science and Determinism

VAN STADEN AND HINSHELWOOD’S commentaries raise a number of issues, but there are two particular themes common to both that we pick up in this response. The first theme concerns the reconcilability of Lacanian theory to the disciplines of analytic philosophy and “Anglo-American positivist psychiatry.” This is closely related to the relationship between the unconscious and the empirical sciences discussed in the editorial (McConnell and Pickering 2005). The second theme concerns the relevance of Lacanian theory to our understanding of free will and the structure of the mind.