Double Bookkeeping and Doxasticism About Delusion

José Eduardo Porcher

Philosophy, Psychiatry, & Psychology, Volume 26, Number 2, June 2019,

pp. 111-119 (Article)

Published by Johns Hopkins University Press

For additional information about this article

https://muse.jhu.edu/article/727341

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 Double Bookkeeping
and Doxasticism
about Delusion
Abstract: Doxasticism about delusion is the theo-
retical stance according to which delusion is a kind of
belief. Although doxasticism is taken for granted in the
psychiatric literature, it has been a point of contention
in the philosophical literature, where it has met with a
number of objections and alternative accounts. In this
article, I aim to show how double bookkeeping, a dis-
tinctive characteristic of delusion, motivates two kinds
of arguments against doxasticism, which we may call,
respectively, the argument from action guidance and
the argument from phenomenology. After presenting
the phenomenon of double bookkeeping, I then for-
mulate and assess the ensuing arguments, concluding
with a reflection about the state of the debate about the
doxastic status of delusion and offering a few method-
ological remarks.
Keywords: delusion, belief, doxasticism, double book-
keeping, action guidance, phenomenology
C
linical delusions are commonly
thought of and characterized as beliefs,
both by psychiatrists and by the general
population. That fact is encoded in the definition
of delusion in the Glossary of Technical Terms
of the most recent edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5):
A false belief based on incorrect inference about
external reality that is firmly held despite what
almost everyone else believes and despite what
constitutes incontrovertible and obvious proof or
© 2019 by Johns Hopkins University Press
José Eduardo Porcher
evidence to the contrary. (American Psychiatric
Association, 2013, p. 819)
Although almost every aspect of this definition is
debatable, describing delusion as a type of aber-
rant belief has engendered a specialized discussion
in itself, engaging philosophers, psychiatrists, and
psychologists in the project of arriving at a precise
characterization of this class of mental states. In-
tuitively, delusions do seem like they warrant the
attribution of beliefs. This is mainly because of
patients’ verbal behavior, represented both in the
assertions of delusional subjects and the apparent
sincerity with which those assertions are made.
Take Capgras syndrome, for example. Patients
with Capgras are characterized by their inability to
recognize a loved one, a close relative, or a friend
(or sometimes multiple persons and sometimes
even animals and inanimate objects). As Adriano
Rodrigues and colleagues go on to explain:
In this monothematic delusion, the individual
recognizes overtly and straightforwardly who
that person is meant to be, upholding, however,
a firm belief to the contrary, which is anchored
in subjective cues such as an eerie feeling that
something is not quite right about that person,
complete lack of a sense of familiarity, and miss-
ing the proper affective response. Individuals with
Capgras syndrome cling to the unshakeable belief
that the original person in question was replaced
by an impostor, who cunningly is trying to fool
112  ■  PPP / Vol. 26, No. 2 / June 2019

them—with no success at all because, of course, I present and assess the ensuing arguments. I
they know better. (Rodrigues, Banzato, Dantas, conclude with a reflection about the state of the
& Dalgalarrondo, 2013, p. 522) debate about the doxastic status of delusion and
Recently, Rose, Buckwalter, and Turri (2014) offer a few methodological remarks.
have presented evidence suggesting that common-
sense psychology not only unambiguously views Double Bookkeeping
descriptions of monothematic delusions (such as
The psychotic symptoms of hallucination and
Capgras) as expressions of belief, but that it views
delusion are the hallmarks of insanity. According
these as stereotypical beliefs. Their studies show
to Jaspers, “since time immemorial, delusion has
that frequent assertion is a powerful cue to belief
been taken as the basic characteristic of mad-
attribution, more powerful than even a robust and
ness: ‘to be mad was to be deluded’” (Jaspers
consistent track record of nonverbal behavior. As
1913/1963, p. 93). “Insanity,” writes Louis Sass,
we will see, in the specialized literature the pres-
“has generally been assumed to be a matter of
ence of certain kinds of nonverbal behavior is one
perceiving things that do not exist and believing
of the main reasons supporting the abandonment
things that are not true” (p. 1). This idea has made
of the view that delusions are beliefs (henceforth
its way into contemporary psychiatric theory
doxasticism about delusion).
and practice, because what has been called poor
In their first study, Rose et al. (2014) gauge
reality-testing has become the defining criterion for
commonsense psychological attributions from
the diagnosis of psychosis, as the DSM definition
participants regarding a case of Capgras. Their
of delusion attests.
description of the case is, however, very simplistic,
However, a wealth of first-person reports
and the only information relevant to the interpre-
testifies against the generality of application of
tation of the patient’s mental state given to the
the poor reality-testing formula. Contrary to the
participants is his verbal behavior: “he would tell
DSM definition, not all delusions are “firmly sus-
his friends, family and doctors that his wife . . . had
tained.” Although unwavering conviction may be
been replaced by an impostor” (Rose et al. 2014,
the case in many manifestations, the conviction of
p. 686). As a matter of fact, however, a great num-
delusional patients is subject to fluctuation and at
ber of cases of delusion are less straightforward
least some delusional patients have insight into
than that, with conviction varying from time to
their own condition, often showing appreciation
time and verbal assertions bordering on contra-
of the implausibility of their own delusions (Ga-
diction. Indeed, when Rose et al. (2014) gauged
rety, 1998). Consider, for example, the following
their participants’ psychological attribution to a
excerpt of an interview with a patient who showed
case with an expanded description, noting that
symptoms of both Capgras and reduplicative par-
the patient “continued to always eat meals with
amnesia, maintaining that his house and family
[his wife], go to the movies with her, live in the
had been replaced by duplicates:
same house as her, and sleep in the same bed as
her” (p. 689), the patient was viewed as holding E: Isn’t that [two families] unusual?
contradictory beliefs. S: It was unbelievable!
E: How do you account for it?
It is this kind of case with which I am interested
S: I don’t know. I try to understand it myself, and
here, because their complexity tests the adequacy it was virtually impossible.
of doxasticism about delusion. My aim in this E: What if I told you I don’t believe it?
article is to show how double bookkeeping, a dis- S: That’s perfectly understandable. In fact, when
tinctive characteristic of delusions, motivates two I tell the story, I feel that I’m concocting a story .
kinds of arguments against doxasticism, which we . . It’s not quite right. Something is wrong.
may call, respectively, the argument from action E: If someone told you the story, what would
you think?
guidance and the argument from phenomenology.
S: I would find it extremely hard to believe. I
I begin by presenting the phenomenon of double should be defending myself. (Alexander, Stuss,
bookkeeping and then, in the next two sections, & Benson, 1979, p. 335)

Sass notes that this kind of ambivalence is
particularly common in schizophrenic patients
who, while deeply engaged by their delusions,
nevertheless treat them with what seems to be a
certain distance or irony, even at the height of their
psychotic periods: “Rather than mistaking the
imaginary for the real, they often appear to be liv-
ing in two parallel but separate worlds: consensual
reality and the realm of their hallucinations and
delusions” (Sass 1994, p. 21, my italics).
Following Bleuler (1911/1950, pp. 127–130),
who described this phenomenon as a kind of
“double registration,” or “double bookkeeping,”
Sass maintains that the relative internal coherence
of the patient’s thoughts is safeguarded by his or
her keeping two separate sets of mental “books.”
In the first “book,” the one used for everyday life
and social interaction and the one which non-
delusional subjects share, the patient’s thoughts
are treated as empirical beliefs subject to reality
testing by the use of intersubjective standards of
confirmation. Moreover, as empirical beliefs, these
thoughts will have the appropriate, stereotypical
connections to reasoning, action, and affect. Of
course, this represents the vast majority of even
the most floridly delusional patient’s beliefs.
In the second “book,” in turn, intersubjective
standards of confirmation are suspended, as are
the usual connections to the patient’s other mental
states, action, and emotion. In this book, thoughts
are treated in an extremely subjective fashion (so
much so that Sass likens this cognitively unstable
attitude to an expression of solipsism). As Jennifer
Radden (2011, p. 9) notes, this view was antici-
pated by Kant who, in his Anthropology from a
Pragmatic Point of View, described delusional
states as “a play of thoughts in which he sees,
acts, and judges, not in a common world, but
rather in his own world (as in dreaming)” (Kant,
1798/2006, p. 114). John Nash made a similar
point about his delusions in explaining them to
an interviewer in the PBS documentary A Brilliant
Madness: “It’s kind of like a dream. In a dream
it’s typical not to be rational.”
With regard to how the dynamics of double
bookkeeping might work, Philip Gerrans (2013,
p. 86) provides a helpful illustration. A violent
headache might trigger the thought, “I have a
Porcher / Doxasticism about Delusion  ■ 113
brain tumor.” In the off case someone who enters
this thought in the first (intersubjective) book, that
thought is quickly canceled, because one will con-
sider alternative causes (e.g., “I banged my head
in the kitchen counter earlier today”). However,
in the case of someone who enters this thought in
the second (subjective) book, the absence of a com-
mitment towards revising or replacing the thought
if another has better epistemic credentials will
result in its adoption. As Gerrans observes, Sass’
conception of delusion “represents a psychology
trying to maintain an unstable solipsistic attitude,
which is why the patient has to keep two sets of
books but constantly struggles to reconcile them”
(Gerrans, 2013, p. 86).
In his account of double bookkeeping, Sass
focuses on what is perhaps the most famous case
in psychiatric history, namely, that of Daniel Paul
Schreber, an appellate judge in the kingdom of
Saxony who spent 13 years in mental asylums
and wrote of his experiences with schizophrenia
in Memoirs of My Nervous Illness (Schreber,
1903/1988). Such fame was due in no small part
to the fact that his account was the subject of a
major study by Freud, as well as being extensively
explored by Bleuler, and offered as an example of
schizophrenic incomprehensibility by Jaspers. The
core of Schreber’s delusional system included the
conviction that he had a mission to redeem the
world and to restore mankind to their lost state
of bliss. For this to happen, he insisted, divine
forces were preparing him for a sexual union
with God by changing him into a woman so he
could give birth to a new race of humanity. In his
memoir, Schreber offers a starkly clear description
of the delusional world and of the phenomenon
of double bookkeeping in particular.
I have to confirm . . . that my so-called delusional
system is unshakeable certainty, with the same
decisive “yes” as I have to counter . . . that my
delusions are adequate motives for action, with
the strongest possible “no.” I could even say
with Jesus Christ: “My Kingdom is not of this
world,” my so-called delusions are concerned
solely with God and the beyond, they can there-
fore never in any way influence my behavior in
any worldly matter . . . . (M 301 apud Sass, 2014,
pp. 131–132)
114  ■  PPP / Vol. 26, No. 2 / June 2019
From this passage, it is clear that Schreber’s delu-
sions were, on his own accounting of them, regis-
tered solely in the second “book,” completely inac-
cessible to objective or intersubjective standards
of confirmation that would seem to be implied by
the poor reality-testing formula, with its use of
such terms as “false,” “incorrect,” as seen in the
DSM definition. This fact is attested by the gulf
between his “so-called delusions” and his actions.
This characteristic inertia was already noted by
Bleuler, who stated that his delusional patients
“rarely follow up the logic to act accordingly, as,
for instance, to bark like a dog when they profess
to be a dog” (Bleuler, 1916/1924, p. 144) and
that “Kings and emperors, popes and redeemers
engage, for the most part, in quite banal work. . . .
None of our generals has ever attempted to act in
accordance with his imaginary rank and station”
(Bleuler 1911/1950, p. 129).
Action Guidance
The behavioral inertia seen in some delusional
patients and which seems to be a consequence of
double bookkeeping motivates one of the main
arguments against doxasticism about delusion,
namely, the argument from action guidance. It
shares its structure with other arguments that
trade on the apparent fact that the functional role
of delusion departs from that of belief (Miyazono
& Bortolotti, 2015). Hence, the general argument
can be restated by pointing to other disparities
between the functional role of delusion and that
expected of belief (e.g., inferential, affective, and
phenomenological roles). With regard to the
argument from action guidance, what matters is
the fact that, as we have seen, some patients who
seem to be convinced of their delusions neverthe-
less act as if those delusions were either untrue
or irrelevant.
As Kengo Miyazono and Lisa Bortolotti (2015)
note, the argument’s first premise is a broad func-
tionalism about belief—the idea that what it takes
for a state to be a belief is for it to play a certain
functional role—which is assumed throughout
the literature and with which I will not take is-
sue. The argument’s second premise, drawing
on clinical experience, then denies that delusion
plays the expected functional role with respect to
action guidance. Therefore, the argument goes,
those patients do not really believe the content of
their delusions.
There are at least two difficulties with this line
of argument. First, a variety of factors may explain
why, even in the grip of a delusional belief, the
patient fails to behave accordingly. To account for
localized absences of behavioral manifestations,
Tim Bayne and Elisabeth Pacherie (2005) point
out that action is not caused by cognitive states
alone, but by cognitive states in conjunction with
motivational states, and that the motivation to act
may not be acquired or sustained in some cases.
Hence, to conclude from the fact that some delu-
sional patients fail to act in the expected ways that
they do not believe the content of their delusions
is to ignore the very likely fact that the disordered
state of the delusional patient involves less than
ideal conditions for belief to influence action.
As Bortolotti (2011) explains, behavioral in-
ertia may be due to a number of internal causes,
both cognitive and affective. On the cognitive
side, Christopher Frith (1992) has proposed that
failures in the metarepresentational capacities
involved in being able to access one’s goals may
account for the inability to produce self-willed (as
opposed to stimulus-elicited) action. On the affec-
tive side, Bortolotti cites three possible causes. One
is flattened affect, which Kraepelin and Bleuler
identified with schizophrenia (and which today
would be considered a negative symptom), stating
that “Indifference seems to be the external sign
of their state. . . . The patients appear lazy and
negligent because they no longer have the urge to
do anything either of their own initiative or at the
bidding of another” (1911/1950, p. 70). Another
possible cause of behavioral inertia is avolition,
a failure to convert experience into goal-directed
action, which Kraepelin and Bleuler also identified
with schizophrenia (and which today would also
be considered a negative symptom).
Individuals with schizophrenia exhibit deficits
in their ability to couple their behavior to the
motivational properties of a stimulus despite
equivalent subjective in the moment pleasantness
and arousal ratings for these stimuli compared
with healthy controls. Furthermore, significant

correlations were noted between these deficits
and working memory impairment, particularly
for those situations requiring the maintenance of
an internal representation for the stimulus. The
authors (Heerey and Gold [2007]) conclude that
motivational deficits in schizophrenia reflect im-
pairment in the ability to translate experience into
action (Foussias & Remington, 2010, pp. 6–7).
Still another possible cause undermining
motivation is the presence of emotional distur-
bances. Here, Bortolotti cites the work of Matthew
Broome et al. (2005) on the developmental and
epidemiological factors influencing the onset of
psychosis, who observe that people at high risk
of psychosis experience distress, decreased moti-
vation, and poor socialization from an early age.
Owing to the widespread comorbidity between
schizophrenia and depression, hopelessness and
pessimism may explain why delusional patients
may find it hard to acquire or sustain a motiva-
tion to act.
Finally, aside from the cognitive and affective
aspects that are entailed in schizophrenia and de-
lusional disorders, the surrounding environment in
which delusion manifests (or the patient’s percep-
tion of it) may not support the agent’s motivation
to act. For example, because some people with
delusions may know that acting on their beliefs
might result in hospitalization, Bayne and Pacherie
(2005, p. 185) cite a fear of involuntary commit-
ment as a possible cause for the failure of some
patients to act on their delusions.
The second difficulty with the argument from
action guidance is that the characteristic behav-
ioral circumscription that functions as the argu-
ment’s second premise, though certainly observed
in many cases of delusion, is not a feature of all
delusions. Just as there are examples of the failure
of delusions to be integrated with the subject’s
behavior, there are also cases that do display such
integration and, therefore, lend support to the
attribution of belief (Bayne & Pacherie, 2005).
For example, a review of 260 cases of delusional
misidentification by Förstl, Almeida, Owen, Burns,
and Howard (1991) found that physical violence
had been noted in 18% of cases. Andrew Young
and Kate Leafhead (1996) note that all their
Cotard—a delusion characterized by a conviction
Porcher / Doxasticism about Delusion  ■ 115
that one is missing internal organs and even, in
some cases, that one is dead—patients displayed at
least some measure of congruent behaviors, such
as refusing to move, to eat, or to shower. J.M.
O’Dwyer (1990) reports that erotomania patients
commonly act on the basis of their delusion. And
Simon Wessely et al. (1993) report that 77% of a
total of 59 delusional patients acted on their delu-
sions in the month before admission.
Therefore, the argument from action guidance
has, at best, the power to undermine the general-
ity of a doxastic account of delusions, without
thereby establishing the generality of any kind of
anti-doxastic characterization—especially because
the empirical evidence just mentioned fits the
doxastic model better, thus undermining the pos-
sibility that imagination-based metacognitive ac-
counts such as that of Gregory Currie (2000) could
replace doxasticism as a general characterization
of delusion. So, if doxasticism cannot provide a
general account because it fails to include the cases
to which anti-doxasticists allude, the reverse is
also true and, thus, no positive morals seem to be
forthcoming from the debate. The moral here is
negative: the heterogeneity of the class of delusions
puts pressure on the very possibility of anyone
ever arriving at a characterization that is at once
general and precise.
Phenomenology
While the behavioral output of double book-
keeping patients cannot conclusively undermine
doxasticism about delusion, the phenomenology
of double bookkeeping departs so much from
the phenomenology of believing that it motivates
its own argument against doxasticism (Radden,
2011; Gerrans, 2013). While the argument from
action guidance begins with the statement that
to be a belief a mental state has to play a certain
functional role, the argument from phenomenol-
ogy presupposes, at a minimum, that there is
something it is like to have a belief. Like the second
premise in the argument from action guidance, the
argument from phenomenology then denies that
cases involving double bookkeeping match the
phenomenology of believing (just as such cases
allegedly fail to match the action-guiding role
116  ■  PPP / Vol. 26, No. 2 / June 2019
of belief). Therefore, such cases at least are not
instances of believing.
Double bookkeeping in delusion is accom-
panied by first-person reports that point to the
ineffability of the experience, often expressed in
figurative and metaphorical language, such as can
be seen time and again in Schreber’s memoirs. “To
make myself at least somewhat comprehensible,”
Schreber says, “I shall have to speak much in im-
ages and similes, which may at times perhaps be
only approximately correct” (1903/1988, p. 41).
As Radden observes (2011, p. 50), in trying to
avoid misleading presuppositions based on sense-
knowledge, Schreber appealed to the neurology
of his time, speaking of “nerves” while describ-
ing how he is affected during his experiences.
However, when speaking like this, Schreber is not
referring literally to the nerves of neurology, be-
cause his “nerves” are not affected physically, but
spiritually, through the mediation of supernatural
“rays.” As he explains in the following passage,
we are used to thinking of all impressions we
receive from the outer world as derived from the
five senses. However:
in the case of a human being who like myself has
entered into contact with rays and whose head is
in consequence so to speak illuminated by rays,
this is not so at all. I receive light and sound sensa-
tions which are projected directly on to my inner
nervous system by the rays; for their reception
the external organs of seeing and hearing are not
necessary. (Schreber, 1903/1988, p. 117)
Another feature of first-person reports that points
to the ineffability of some delusional experiences is
the high frequency of what Russell Hurlburt calls
“subjunctification.” A subjunctifier is “anything
that gives a sign that a subject’s utterance is not
to be confidently understood as a straightforward
description of momentary experience” (2011, p.
116). Subjunctifier phrases—such as “I think,”
“It’s like a . . .,” “kind of,” “that’s the best way
I can think to describe it”—are qualifications,
shifting descriptions, and explicitly voiced doubts
and uncertainties that accompany introspective
reports. Consider John Nash’s assertion that his
delusions are ‘kind of like a dream.’ Or again the
patient of Alexander et al., who, when describing
what the subjective, lived dimension of his delu-
sion is like, states that “when I tell the story, I feel
that I’m concocting a story . . . It’s not quite right.
Something is wrong” (Alexander et al., 1979, p.
335). While not all patients report feeling the
same kind of atmosphere, reports of feelings are
commonplace when experience seems to beggar
description in straightforward doxastic terminol-
ogy. Consider, for example, the following remarks
by a highly ambivalent patient quoted by Sass.
I’ve never rigidly held my beliefs about Pepperidge
farms [a brand of baked foods, especially cakes]
and microwaves, but they’ve always involved a
strong feeling of fear and aversion, related to
my feeling that nothing exists—however, I have
acted consistently, over long periods of time, as
if these beliefs were unquestionably true . . . but
I’ve always had a dimension of doubt about these
beliefs, and, of course, I realize how profoundly
irrational they sound to other people . . . I would
much prefer to believe that I am delusional rather
than that all these magical events and processes
are real. (Sass, 2004, p. 79)
The difficulty of pigeonholing this kind of attitude,
whether in the category of belief in doxasticism or
as imaginative states that are misidentified by their
subjects as beliefs (in the account proposed by Cur-
rie), leads to the recognition that the subject may
have an ambiguous relationship with the content
of the delusion, such that it can play a functional
role somewhere in between that of a belief and an
imagining (Currie, 2000, p. 174).
Belief and imagination may thus be conceived
as a many-dimensional cognitive space, with two
main clusters and various outliers (Currie & Jure-
idini, 2004). Andy Egan (2009) has also proposed
such a blurring of the boundaries between belief
and imagination, but introduces a hybrid proposi-
tional attitude, “bimagination,” that he speculates
has some of the features of belief and some of the
features of imagination. While I agree that there
is no categorical distinction between belief and
imagination—both of these being vague common-
sense psychological concepts—I fail to see how re-
placing belief or imagination with “bimagination”
solves the problem of accurately characterizing
the mental state of delusional patients, especially
those who manifest double bookkeeping. While in
the case of belief the functional role and phenom-

enology do not match up with at least some cases
of delusion, in the case of bimagination nothing
seems to be gained by such a redescription. On
the other hand, Currie’s proposal, with which I
am sympathetic, does not do either doxasticism
or anti-doxasticism any favors.
It is important to note that in saying that double
bookkeeping delusional patients straightforwardly
believe, imagine or “bimagine” the content of
their delusions little is gained in terms of both un-
derstanding the experience of delusional patients
and facilitating a mechanist explanation of their
condition. Indeed, the first-person testimonies
that we have seen do not give rise to the question,
“Does the patient believe such and such?” so much
as to the etiological and explanatory questions,
“What gave rise to the patient’s experiences?”
and “Why did the patient interpret them the way
he or she did?” Even if the concept of belief or
other commonsense psychological attitudes were
sufficiently precise, it is a further question as to
why we should care about whether delusions are
anomalous beliefs, cognitive hallucinations or
some type of in-between state. “Arguably,” Bayne
observes, “what matters for many purposes is the
question of what functional role delusions actu-
ally play, rather than whether this functional role
falls within the boundary of belief or not” (Bayne,
2010, p. 332). Thus, in addition to providing
overly general characterizations that are not up
to the task of precisely describing the delusional
subject’s attitude toward their delusions, it is
worth asking ourselves if and why the language of
commonsense psychology is apt to play a relevant
role in an explanation of delusion. The vocabulary
of commonsense psychology, although a useful
tool for conceptualizing and dealing with ourselves
and others, abstracts entirely from cognitive and
neural processes, thereby putting in jeopardy the
possibility of an integrative explanation of the
phenomena.
Jakob Hohwy (2013) notes that an important
explanatory challenge involved in devising a
characterization of delusion is to provide a unify-
ing framework that would make it easier to look
downwards to the cognitive and neural mecha-
nisms underlying delusions. Characterizations that
invest in commonsense psychological terminology
Porcher / Doxasticism about Delusion  ■ 117
like “belief,” being abstractions from lower level
processes, fail to provide us with such a unifying
framework and hinder a multilevel explanation of
delusion that might arrive at correlations between,
say, phenomenology and neuroscience. For this
reason, Gerrans (2014, p. 224) suggests that we
take the advice of Dominic Murphy and let cogni-
tive neuroscience, not commonsense psychology,
determine our characterization of psychiatric
disorder in general and delusion in particular:
“we arrive at a comprehensive set of facts about
how the mind works, and then ask which of its
products and breakdowns matter for our various
projects” (Murphy, 2006, p. 105).
However, this should not be misunderstood as
entailing that the appropriate level of explanation
is the lowest, that is, molecular biology. On the
contrary, Murphy himself advocates explanatory
pluralism, eschewing the notion that there is a
fundamental level, and upholding the view that
explanations in cognitive neuropsychiatry should
include references to factors that span all levels—
from molecular biology to the cognitive and social
sciences. As Gerrans puts it, “no part of biology
or psychology has proprietary rights to psychiatric
explanation” (Gerrans, 2009, p. 113). The sugges-
tion that we should take our lead from cognitive
neuroscience and not personal-level commonsense
psychology is then perfectly at home with such an
explanatory pluralism and is only meant to drive
home the point that there is no place for such
abstractions in a causal, mechanistic explanation
of delusion (though there might perfectly well be
a place for “belief” and the like in other pragmatic
contexts, such as therapeutic and forensic).
Conclusion
In this discussion, I have shown how the phe-
nomenon of double bookkeeping engenders two
important arguments against doxasticism about
delusion. The argument from action guidance,
by far the most discussed argument against the
doxastic status of delusion, was shown to be
inconclusive owing to the possibility that cogni-
tive and affective aspects of delusion hinder the
action-guiding force of what may very well be a
delusional belief. In addition, it was shown that
118  ■  PPP / Vol. 26, No. 2 / June 2019
the empirical data on action guidance does not
support either doxasticism or anti-doxasticism.
On the other hand, I have attempted to show
that the argument from phenomenology, a less
explicitly discussed argument against doxasticism,
more forcefully undermines characterizations that
invest in doxastic terminology. In addition, I have
argued that attention to both the phenomenology
of delusion and to the prerequisites for a multilevel
causal explanation of delusion suggests the aban-
donment of imprecise, commonsense psychologi-
cal characterizations.
I hope to have also shown that the upshot of
these considerations is that delusions are highly
heterogeneous phenomena and, thus, it should
come as no surprise that some delusions are more
belief-like, while others depart from stereotypical
beliefs. A divide-and-conquer suggestion could be
made to the effect that we should recognize the
attitudinal and experiential differences between
conditions that involve complex delusional sys-
tems, such as those held by some patients suffering
from schizophrenia and those held by patients in
the grip of circumscribed monothematic delusions.
In this way, we could say that, while schizophrenic
delusions often beggar characterization in doxastic
terminology, sufferers of more circumscribed delu-
sions who do not manifest double bookkeeping do
believe the strange propositions which their verbal
and nonverbal behavior often suggests they do.
However, because the heterogeneity of delu-
sional experience testifies against the craving for
a theory of delusion as one particular kind of
psychological attitude, we need to work toward
an account that embraces this heterogeneity and
strives for precision without losing sight of the
fact that we are dealing with a class of phenomena
that might very well not be amenable to sweep-
ing general claims. For these reasons, I maintain
that, for the purposes of attempting to arrive at an
explanation of delusion that ties its phenomenol-
ogy to its cognitive and neurobiological aspects,
commonsense psychology should not take the lead.
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