Friday, 23 November 2018

hinges, again

Today I've been rethinking what I recently wrote contra Bardina, Campbell, and my earlier self, on delusions as hinge propositions. I think I need to own that I failed to do justice to the good intuition lying behind their nevertheless peculiar suggestion.

The suggestion was that we can shed light on delusions, in their defining peculiarity and intransigence, by construing them as alternative hinges. For like those hinges which constitute our sanity or 'reality contact', delusions truly are reasoned from and not about; they are the still points around which investigations are to turn. The thought here is that, despite the fact that delusions and hinges are chalk and cheese - hinges necessarily being paradigms of meaning and truth, delusions being paradigms of the opposite of these - they nevertheless share something of a functional role. It now seems to me that this comparison does real work: it explains or at least makes it clearer why a delusional person is so sure (lacking in doubt) in her delusion, why she can't be reasoned out of it. It offers a deeper characterisation of this intransigence than we had before.

To try to do justice to both the similarities and the differences, I begin by remarking on the fact that hinge propositions are never articulated outside of philosophy classes, whereas it is nearly always outside of philosophy classes that delusions are articulated. Hinge propositions are rather contrived verbal formulations of certainties which really have their life in our active habits - they are forced articulations of lived certainties.

In truth we don't so much pivot around hinge propositions - we instead pivot around the unreflective lived certainties of our worldly engagements (nb Wittgenstein's 'certain things are in deed not doubted' (OC 342)). One could equally say: we pivot around features of the world. For the point of the 'hinge' metaphor is that, at the point of the hinge, thought and world are not two different matters. Thought, here, is not a matter of representation of something other than it; it's not a matter of representation at all. Rather, thought here is what it is because of how the mind is directly conditioned, in-formed, by the world.

But next, note, the delusional person does, or at least can readily, articulate their delusions. They do not so much here have a lived sense-defining certainty - after all they have, in their delusion, lost contact with reality, whereas the person who is in touch with reality is so in virtue of being hinged to it in their praxis.

What I'm getting at is that the delusional person relates to their delusion thought somewhat as the sane person relates to their world.

How are we to make sense of that?

The literature contains two suggestions. The first is phenomenological, and finds (an albeit unhappy) expression in Spitzer's idea that the delusional certainty is helpfully modelled on the certainty of psychological first-person authority. The real point is: the delusional person has (necessarily, in this domain) lost reality testing. Where 'reality testing' means: enjoying thought of a form which instantiates an appearance/reality distinction - thought of which we (the observer) can meaningfully say 'it is imagination, or, it is world-directed'. (It's so hard to resist - even though we must - putting this in what I've been calling a 'cataphatic' mode - i.e. to resist offering an explanation of it, e.g. by wanting to understand delusion better by saying of what other psychological genus it's a species!)

The second is psychoanalytic, and is there in all the major psychoanalysts who've worked with psychotic patients. It is that delusions do work for the patient, binding fragmentation, providing stabilisation - and are in this sense motivated. This gets misarticulated in the cognitivist's view that true delusions are attempted 'explanations' of bizarre experiences - but we can see why one might be tempted to put things like that (that irresistible 'cataphatic' impulse again...) whilst also finding ways to do better justice to the underlying intuition.

The position we arrive at might be summarised like this: A delusion is akin to a hinge certainty in that it plays an analogous role in the 'economy' of an individual's thought. Both stabilise, both manifest an unchallengeable certainty.

But whereas the certainty of the hinge comes from our allowing the world to be sovereign in our thought, the certainty of the delusion comes from our attempting to usurp this role. The result is incoherence: the meaningful coherence of the mind depends on resisting the allure of psychotic omnipotence, and in trusting in - settling down into - the necessarily worldly foundations of any genuine thought.

Sunday, 11 November 2018

contra bardina

In a recent paper Svetlana Bardina (2018) attempts defence of the view that delusional utterances may be understood as hinge propositions. (John Campbell (2001) first suggested this; the idea has since been flirted with by others including myself (Rhodes & Gipps, 2008) and Naomi Eilan (2001), and argued against by Tim Thornton (2008) and Rick Bellaar (2016).) She lists Danielle Moyal-Sharrock's (2004) six features of hinge propositions (they are: indubitable, foundational, nonempirical, grammatical, ineffable and enacted) and shows how delusions also embody these characteristics, or at least a good portion of them.

Despite these analogues or identities, the general claim strikes me (now) as utterly wrong; Thornton's arguments against Campbell, by contrast, appear to me to stand firm. For whilst Moyal-Sharrock's six features may be necessary, they are surely not sufficient, conditions on hinge propositions. Even if they tell us a lot about what makes for the hinge nature of certain propositions, they don't tell us what makes for their propositional nature. What the conditions all presuppose is that what is being said makes sense. And the definitive, paradigmatic thing about definitive, paradigmatic, expressions of delusions is: they don't make sense. Furthermore, it is definitive of hinge propositions not merely that they make (qua constitute) sense but that there is here no distinction between their meaning and their truth. 'These are my hands' said waving one's hands about: a truth of meaning at least as much as a truth of fact. So hinge propositions are, as such, truths! But: delusions are nearly always false. So it's utterly unclear how their articulations can really be said to be hinge propositions.

At this point someone may be tempted to relativise the hinge proposition, or meaning itself, to the delusional subject. 'It makes sense to him (at least, while he's in his delusion, if not later on)!' someone might say; 'It functions as a hinge proposition for him!' But what does this mean? For something to actually make sense to someone it is not enough for him to not be puzzled by it! Just as for many dream thoughts, what we have in the paradigmatic clinical cases are (what Cora Diamond calls) but illusions of meaning. But the concept of the role played in our life by the beliefs expressed in hinge propositions is the concept of a semantic role - the concept of a role that could only be played by something meaningful. It must be the case, then, if delusional utterances are to be seen as playing the role of hinge propositions, that there is in play here a distinction between something being meaningful and something seeming meaningful to the delusional subject. But it is hard to see how we can reconstruct that essential distinction if we go down the 'meaningful to him' line.

What has gone wrong? How could my earlier self, or Bardina, or Campbell, have defended this suggestion in the face of the stark delusionality, the un-hinge-dness, of psychotic belief? I suggest it comes in part from a lack of attention to the real phenomena - both to the nature of true delusion and to the nature of real clinical reason. Telling markers of this in the cognitive science literature are its runaway focus on really rather obscure delusional conditions (the standard Cotard syndrome and Capgras delusion cases), as if even these could be understood for what they are in abstraction from the delusional life of the patient (that's the wishful thought of those who try to step-wise theorise mental illness on the basis of 'monothematic' delusions) rather than any actual engagement with the kinds of psychotic thought met with in clinical practice (the delusional perception, mood, experiences and beliefs found in schizophrenia providing the best examples). (In the Bardina paper, for example, it's also telling that she speaks of 'the Cotard patient' (sic) who now  'pretends' (sic) that he's dead - clinical reality now being just miles away.) It's not as if there isn't a wealth of readily accessible first person clinical material out there to really get grounded in before risking theorising in this domain; the fact that theorising happens in abstraction from it may therefore indicate a phobic flight from delusional instabilities into the security of philosophical reason. But I think it's not just a failure to engage with real clinical narratives, as opposed to brief mentions of a psychiatrist's micro-summary of a patient's delusional content, but also a detachment of philosophical reason from the grounds of its own thoughtful praxis, that's at fault. For here philosophical thought has itself started to ape that of the schizophrenic (√† la Minkowski and Sass): it takes on a life of its own, forgetting its debt to, and loosing its anchorage in, discursive life. In this way it somehow starts to seem intelligible to suppose that so long as a delusional utterance embodies Moyal-Sharrock's six features of hinge propositions, then it too may be treated as such. (The same can be said for Spitzer's suggestion that the indubitability of delusional utterances can be modelled on the indubitability of avowals of mental states.) That hinges provide paradigms of sense, and delusions paradigms of nonsense, suddenly gets quite lost from sight.

Now perhaps it is said that whilst we can't truly say that delusional expressions function as hinge propositions for the delusional subject, she yet treats them as if they do. This 'treating them as' would then be what is supposed to be illuminating in the appeal to hinge propositions. To which I want to respond: let us agree that whilst chalk is not cheese, someone may yet treat it as such: they may, if they are so inclined, wrap it up in clingfilm, put it in the fridge, stick it between slices of bread - or for that matter may also smear cheese on the blackboard, etc. But what of it? Nobody ever doubted that the delusional patient doesn't question, takes as axiomatic, reasons not to but from, his delusional beliefs. To note that non-delusional people also don't question, and also take as axiomatic, some of their sane beliefs - i.e. those which are articulated in framework propositions - doesn't help us understand what it is to be delusional.

It's not surprising that it's tempting to theorise the delusional mind as not merely unhinged but as hinged otherwise. Tempting because we may then take ourselves to be able to offer a paradigm of intelligibility - a way to make sense of an aspect of what has gone on here for the delusional person in her delusion. (She is atypically treating treating certain atypical propositions as hinge propositions.) Tempting, perhaps, because we thereby find another way to avoid having to tolerate the dementing strangeness of a door of the mind no longer hinged to the doorpost of the world. Find a way, that is, to avoid staying with a mind now quite lost in that phantasmic, devitalised and denatured world of faery - where to think, fear or wish something can no longer be distinguished from taking it to be so - so that the terrors of a shattering contact with reality may be safely left out of consideration.