Text

theses

Theorists of cognitive-behavioral therapy (CBT) for schizophrenia claim that understanding aberrant experiences, such as the delusions found in persons with schizophrenia, is possible partly because delusions and non-delusional beliefs are continuous. This assumption of continuity runs contrary to the views of phenomenologically-oriented psychopathologists who emphasize the qualitative differences between delusions and non-delusional beliefs. Importantly, phenomenological and cognitive perspectives both agree that delusions can be understood to some extent. However, the two perspectives differ on how exactly one should approach an understanding of delusions. I propose that, at least in the case of delusions in schizophrenia, CBT offers conceptualizations that fail to appreciate the qualitative differences between delusions and non-delusional beliefs. Qualitative changes associated with the delusional experience, changes which have their source in disturbed experiences of self and world, suggest that certain delusions should not be understood as merely exaggerations of non-psychotic psychological processes. I will first discuss the general CBT model for delusions, including its explanatory terms and its commitment to the claim that delusions are best understood as quantitative variations of normal beliefs. I will then survey the major claims of phenomenological investigators writing about delusion and focus on the views of Jaspers specifically, who is often used as a foil by cognitive theorists in discussing how delusions can be understood. I then discuss the limitations in two lines of evidence that are often taken to support the notion of a continuum between delusions and non-delusional beliefs. One line of evidence comes from the measurement of schizophrenic-like symptoms in the non-clinical population. The second line of evidence concerns the link that depression and anxiety have with delusions. After identifying the weaknesses in interpreting this evidence as indications of continuity, I offer revisions, related to the role that anomalous experiences play, for the CBT model for delusions in schizophrenia. I also suggest that the current view of CBT regarding delusions may be well-suited for what phenomenologists have called "empirical delusions," but it may be necessary to develop somewhat different treatments that are better suited to address the ontological delusions found in schizophrenia.

ETD_7708

Psy.D.

Includes bibliographical references

by Greg Byrom

doi:10.7282/T3BV7JWR

ETD doctoral

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