Thursday, 2 October 2014

Interview with Martin Davies: Delusions (Part 1)

Martin Davies
The Imperfect Cognitions blog is celebrating the launch of our new project, PERFECT. On Thursdays for the next month or so, we will publish a series of interviews with people who have inspired us to pursue the themes of the project.

As part of this series, Martin Davies (Wilde Professor of Mental Philosophy at the University of Oxford and a Fellow of Corpus Christi College) kindly agreed to answer some questions about delusions. The interview will be published in three parts.

LB: Thank you for helping us launch PERFECT! When you started working on delusions, philosophical literature on the topic was scarce. Why did you find delusions interesting to start with?

MKD: Congratulations, Lisa, on the launch of your new research project, supported by an ERC Consolidator Grant of nearly two million euros! Perfect, indeed. And thank you for the opportunity to answer some questions on your blog.

I started to learn about delusions in the early 1990s from talks that Andy Young (now Professor of Neuropsychology at the University of York) gave at early meetings of the European Society for Philosophy and Psychology.

The phenomenology and the theories were of evident interest to philosophers and psychologists and Tony Stone (a philosopher) joined with Andy Young to write a seminal interdisciplinary paper about monothematic and circumscribed delusions following brain injury (Stone and Young, 1997). My first paper on delusions was a long editorial introduction, written with Max Coltheart, for a special issue of Mind & Language, reprinted as Pathologies of Belief. Our discussion was organised around two questions: (1) Can the delusional idea or hypothesis be understood as arising in a folk psychologically intelligible way from the subject’s experience? (2) Why is that hypothesis adopted and maintained as a belief despite its utter implausibility and the uniform scepticism with which other people greet it?

Tuesday, 30 September 2014

Enacting a Phantom

Ken Pepper
This post is by Ken Pepper, who recently submitted his PhD at the University of York.

Amputees often feel 'phantom' sensations emanating from their missing limb (for a review, see Giummarra et al 2007). This entry discusses the role of action and perception in the constitution of these physically absent yet phenomenally present body parts. I urge the view that phantoms are to some extent enactive – they are constituted by active perceptual engagement with the world (see e.g. Noë 2004).
Impressed by the way in which a blind man localised sensations at the tip of his cane, Head and Homes (1911) hypothesised that his brain must update its representation of bodily posture on the fly and treat the cane as part of his arm. It turns out that they were correct; neural representations of limb locations are highly adaptable and continually modified by vision, touch, and kinaesthesia. Experiments on macaques reveal that while using a rake to retrieve food, the receptive field of neurons in somatosensory cortex – the location of the brain's inner model of the body – extends beyond the boundary of the monkeys' arm to incorporate the area occupied by the rake (Iriki, Tanaka & Iwamura1996).
Similar effects have been observed in human tool use also (Maravita and Iriki 2004, Maravita, Spence, and Driver 2003). While using a grasping tool (like the device used by park keepers to collect litter) to estimate the size of an object, the brain treats the haptic signal as originating from the tip of the tool rather than the hand (Takahashi, Diedrichsen & Watt 2009). Following this kind of tool use subjects are temporarily prone to overestimate the distance between tactile sensations on their arm, suggesting that for a short time their brains continue to represent their arm length as extended (Cardinali et al 2009).

Thursday, 25 September 2014

Understanding Beliefs

In this post, Nils J. Nilsson presents his new book, Understanding Beliefs (MIT Press). Nilsson is Kumagai Professor of Engineering, Emeritus, in the Department of Computer Science at Stanford University. He is the author of The Quest for Artificial Intelligence: A History of Ideas and Achievements.

Understanding Beliefs
by Nils Nilsson
Our beliefs constitute a large part of our knowledge of the world. We have beliefs about objects, about culture, about the past, and about the future. We have beliefs about other people, and we believe that they have beliefs as well. We use beliefs to predict, to explain, to create, to console, to entertain.

Some of our beliefs we call theories, and we are extraordinarily creative at constructing them. Theories of quantum mechanics, evolution, and relativity are examples. But so are theories about astrology, alien abduction, guardian angels, and reincarnation. All are products (with varying degrees of credibility) of fertile minds trying to find explanations for observed phenomena.

In this book, I examine beliefs: what they do for us, how we come to hold them, and how to evaluate them. We should evaluate our beliefs carefully because they influence so many of our actions and decisions. Some of our beliefs are more strongly held than others, but all should be considered tentative and changeable.

Tuesday, 23 September 2014

Bipolar Disorder Makes the Headlines

Today Magdalena Antrobus, PhD student at the University of Birmingham, comments on a news story for our new blog feature, "in the news".

The divide between humour and disgust seemed to dissolve for one British clothing retailer.

“Don’t get mad, take lithium” wrote Joy, a clothes chain, with 26 shops nationwide, on one of their greeting cards, available for sale. Spotted by one of the customers, the words trivialising bipolar disorder sparkled social media, causing anger and distress among those who could relate to the problem of manic-depressive illness, as well as among mental health charities.

Stories like this one hit the headlines now and then, exposing a lack of understanding of the nature of mental illness and questionable marketing strategies. However, what usually follows is a more or less sincere apology and withdrawal of the product of interest. The unfortunate story usually makes its exit as quickly as it makes its entrance to the national news. Not this time, though.

The response from Joy fell far short of what was expected. “If you know anyone with bipolar disorder, don't buy it for them. PROBLEM SOLVED!” And that was not the end. When asked about people with bipolar who may go in shopping for themselves, the store replied: “They'll like it one minute and hate it the next?”

Thursday, 18 September 2014

Self Harm: The Philosophical, Ethical and Policy Issues

My primary research interests are in ethics and philosophy of psychiatry. For the past ten years I have worked as a lecturer and researcher in bioethics at the Centre for Ethics in Medicine, University of Bristol.
Self Harm
by Kerry Gutridge

During the past four years, my research has focused on the ethical, legal, philosophical and policy issues of self harm. In particular, I have been concerned with the ethical questions which arise when doctors or nurses allow patients to self harm in psychiatric hospitals. I first encountered this issue when it was reported in the British press that patients were being allowed to self cut in some NHS hospitals. For example, one inpatient was allowed to keep a piece of glass in a locked draw in her room and use it to cut her knees. This idea is of course controversial. Many people find the idea of allowing patients to self harm in medical institutions at best counter intuitive and at worst sickening and morally wrong. However, I argue that in certain circumstances patients should be allowed to self harm.

Tuesday, 16 September 2014

Another Perspective on Anosognosia

Sahba Besharati
I am currently in the 3rd year of my PhD undergoing a split-site collaboration project with the University of Cape Town and University College London. This post will focus on a recent publication featured in Neuropsychological Rehabilitation with my supervisor, Katerina Fotopoulou, and our collaborator in Italy, Valentina Moro, on a prototypical form of unawareness called anosognosia for hemiplegia (AHP).

Neurological disturbances in awareness can offer an important avenue to explore the construction of the bodily self. AHP is one such example of a disorder of self-awareness, where patients have a lack of recognition or awareness of their motor paralysis following a stroke. AHP can have various clinical presentations, ranging from blatant denial of limb paralysis and associated delusional beliefs to emotional indifference of one’s motor disabilities.

Although AHP is often transient (sometimes recovering within days or weeks), motor unawareness can significantly obstruct rehabilitation efforts. For example, patients often refuse treatment or do not engage in therapy, have longer hospital stays, and are often less likely to return to independent living. Unfortunately there is currently no failsafe treatment available. However, in a recent study, Dr. Fotopoulou and colleagues showed that self-observation using video replay led to the permanent and total recovery of motor awareness in an acute patient. This is a simple, psychophysical intervention used at the bedside, where AHP patients watch a video replay of themselves falsely claiming that they can move their paralysed arm despite blatant evidence to the contrary.