Inserted Thoughts and the Higher-Order Thought Theory of Consciousness

Abstract

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M” (Rosenthal D. Consciousness and mind. New York: Oxford University Press; 2005, Gennaro R. The consciousness paradox: consciousness, concepts, and higher-order thoughts. Cambridge, MA: The MIT Press; 2012. p. 127–9.). In a previous publication (Gennaro R. Somatoparaphrenia, anosognosia, and higher-order thoughts. In: Gennaro R, editor. Disturbed consciousness: new essays on psychopathology and theories of consciousness. Cambridge, MA: The MIT Press; 2015. p. 57–8), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (When self-consciousness breaks: alien voices and inserted thoughts. Cambridge, MA: The MIT Press; 2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case.