Abstract
Algunos autores han intentado considerar los delirios como certezas –entendidas en el sentido de Wittgenstein– debido a las similitudes que parecen existir entre sus respectivos estatus epistemológicos. Sin embargo, dicho intento ha sido criticado con agudeza, entre otras razones, porque el contenido de los delirios choca frontalmente con el contenido de las certezas, por lo que los delirios no pueden ser comprendidos debido a los cambios en las relaciones de significado. Pero es evidente que, aunque los delirios no se puedan contemplar como certezas, muchos delirios afectan de un modo u otro al sistema de certezas del paciente. Partiendo de esta base, no es descabellado pensar que dicha influencia pudiera ser también recíproca: en otras palabras, parece sumamente recomendable analizar si algunos delirios se podrían contemplar como el resultado de variaciones en certezas. En este artículo llevo a cabo dicho análisis al intentar mostrar que el origen de algunos delirios pedestres y severos puede ser hallado en lo que llamaré “ceguera a posibilidades” e “incertidumbre”, términos que he desarrollado teniendo en cuenta la obra del filósofo Ludwig Wittgenstein.
Highlights
The hundredth anniversary of the publication of Karl Jaspers’ General Psychopathology has recently been celebrated, there is no doubt that this classic of psychiatry, which became the basis of psychopathological phenomenology, continues to be relevant to contemporary psychiatry and psychopathology
I carry out such an analysis by intending to show that the origin of some pedestrian and stark delusions can be found respectively in what I will call “possibility-blindness” and “uncertainty”, terms which I have developed taking into account the work of the philosopher Ludwig Wittgenstein
A clear example of this can be found in the fact that his definition of delusion as a false belief held with incorrigible certitude despite the great deal of objective evidence of its falsity[2] turns out to be very similar to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) definition, which reads as follows: “A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary”[3]
Summary
The hundredth anniversary of the publication of Karl Jaspers’ General Psychopathology has recently been celebrated, there is no doubt that this classic of psychiatry, which became the basis of psychopathological phenomenology, continues to be relevant to contemporary psychiatry and psychopathology. I will be in a position to show that Maher’s model and its criticisms revolve around the debate about belief revision, which does not concern certainties because they cannot be modified at will In this sense, delusions and certainties seem to be independent from each other, yet section 3 will illustrate such relationship by drawing from the distinction Klee made between pedestrian and stark delusions[13]. A clear case of stark delusion is that of a woman who repeated time and again in a hospital that she died two weeks ago, around the time of her admission, and wanted to know whether she was already in heaven[15] Keeping this distinction in mind, I aim to show that pedestrian delusions can often be regarded as a case of “possibility-blindness”, a concept which I develop from the notions of aspect- and meaning-blindness that Wittgenstein exposed in his Philosophical Investigations[16]. Proposal – especially regarding the cases of uncertainty – places particular emphasis on the strangeness characteristic of delusions, to the extent that it is no surprise that the delusional subject sometimes undergoes marked emotional changes while hardly being able to express accurately what she feels and even takes for granted
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