4. Delusional Reason?

So Karl Jaspers on a good day
So far in these seminars I have been pursuing what we might call an 'apophatic psychopathology'. That is: in one way or another I have consistently been making the suggestion that, if we want to understand madness, want to do proper justice to the mad person in her madness, then we do better to understand how the things we want to say fail to do her justice - rather than reach too quickly to (cataphatically) positively characterise her mind one way or another. The risk of cataphatic theology is that, when pursued in a simply descriptive mode, it does a falsifying injustice to the divine - through applying such concepts as are non-contingently dependent upon their and our sublunar situatedness to that which is transcendent of our situation. The risk of a cataphatic psychopathology is that it similarly falsifies madness - by tacitly presuming that those conditions which are a precondition of our ordinary empathic and rationality-tracking sense-making are in play when they are not. The risk is not merely academic: the risk is that we fail to understand the mad person in her brokenness and in her terrifying disintegration by supposing that such concepts as presuppose the integration of the human subject for their cogent application do yet find application. By imagining that we do best justice to our psychotic interlocutor through understanding her we fail to even hear her - hear her in her radically diremptive distress. In the last seminar I looked at philosophical attempts to recover sense in the face of apparent nonsense; in this I consider psychological attempts to grasp the meaning of psychotic discourse by reconstructing the supposed reasoning lying behind it.

A venerable Germanic tradition in psychiatry has it that the person labouring under prototypical, 'primary', delusion is, in his delusion, unintelligible (Jaspers). If it seems otherwise, to him or even to us, this is but illusion (Gorski). Even if we were ourselves to develop just such a delusion we should not be able to understand him in it - although we could not realise this - for delusion involves 'pathologically falsified judgement' - i.e. a type of 'falsification' which goes beyond mere error to instead undermine reality contact and corrupt the form of judgement as such.

A lack of understanding of this tradition has not prevented it from, perhaps has even encouraged its, being mangled and criticised both within psychiatry and, especially, within anglophone psychology.

Mangled: what Jaspers already offered as the 'vague', 'merely external', 'superficial and incorrect' markers of delusion (extraordinary conviction; imperviousness to other experiences and counter-argument; impossible content) have been taken up to provide the basis of the definitions of delusion met with in many a textbook or diagnostic manual. (DSM-IV: ‘A false personal belief based on incorrect inference about external reality and firmly sustained in spite of what almost everyone else believes and in spite of what usually constitutes incontrovertible and obvious proof or evidence to the contrary.’). The 'correct', 'internal' criteria (pathologically falsified judgement occurring within a dirempted personality) were ignored.

Criticised: The psychiatric notion that the psychotic subject is unintelligible in her delusion has been held up as damaging to the humane engagement of the patient by the clinician - as writing her off, as it were. The valiant psychologist, however, comes to her rescue with his psychological theories, thereby restoring the idea of the psychotic individual as a genuine subject. Delusions, after all, express predictable and pertinent themes in the life of the patient (Geekie & Read). And whilst they may be strange, perhaps this is just because the psychotic subject's experience, which the delusion is a respectable enough attempt to explain, is strange (Maher). Or perhaps the delusional subject is simply making intelligible-enough mistakes in their reasoning (Garety & Freeman).

Lisa Bortolotti
In this seminar - which will be partly critical of recent psychological theorising of delusion, and partly concerned with constructive alternatives - I'll consider:
  • how use of 'merely external' markers for delusion utterly fails to do justice to what we intuitively grasp by that condition.
  • how true delusion - whilst not differing from other irrational belief by way of disrespect for procedural, epistemic and agential norms - is not helpfully understood in its delusionality by reference to such norms, but in terms of a deeper disturbance of reality contact (Bortolotti; Petrolini).
  • the different things that can be meant by 'understanding delusion' - understanding the content of a thought which a delusional utterance expresses? understanding a person's need to develop delusion? understanding just how a delusional belief emerges out of a delusional experience? - and the important possibility of their disjunction (Sass).
  • the difference between failures in reasoning and disturbances to reason. The latter being where the delusional music lies. Reason here being constituted by 'seeing' or 'getting' ('he just doesn't get it') and not just by logically proper inference making.
  • that delusionality does not involve the door of the mind being open when it should be shut or vice versa (i.e. it's not to do with failures of representation: 'reality testing is not hypothesis testing' could be our slogan here) but rather it's becoming unhinged from the doorpost of the world - i.e. becoming unmoored, ungrounded.
  • that we can grasp the nature of this lost reality contact/testing in terms of a breakdown in our ability to instantiate a distinction in thought between imagination and judgement.
  • that the source of this breakdown is unmanageable affect.


Lisa Bortolotti (2009). Delusions and Other Irrational Beliefs. Oxford: Oxford University Press.

Phillipa Garety & Daniel Freeman (1999). Cognitive approaches to delusions: a critical review of theories and evidence. British Journal of Clinical Psychology, 38, 2: 113-54.

Jim Geekie & John Read (2009). Making Sense of Madness. Routledge.

Mike Gorski (2012). Karl Jaspers on delusion: definition by genus and specific difference. Philosophy, Psychiatry, & Psychology, 19, 79-86.

Karl Jaspers (1913/1963). General Psychopathology. Manchester University Press.

Brendan Maher. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30, 98-113.

Valentina Petrolini (2017) What Makes Delusions Pathological? Philosophical Psychology 30, 4:1-22.

Louis Sass (2014). Explanation and description in phenomenological psychopathology. Journal of Psychopathology, 20, 366-376.