Psychiatrists, doctors and nurses are witnesses of something hard to convey with words: the impressive paradox of logic and rationality that psychotic patients show with their delusions. In this book, Bortolotti and her co-authors challenge that puzzle to accomplish a seemly impossible task: to highlight what is rational within the most irrational beliefs. And, by making their case with hard facts and scientific evidence, the human part of people with delusional symptoms begins to slowly emerge.         

The book’s first chapter is an excellent introduction to delusions, in which no previous clinical or philosophical knowledge is required. Psychologists, philosophers and students can read what a delusional experience is like, told from the point of view of patients and experts themselves. 

By using clinical accounts, MRI interpretations, testimonies, statistics and social studies, Bortolotti, amongst three other recognized experts, discuss the wide spectre of delusional beliefs and their paradoxical implications in four exceptionally interesting chapters. However, what makes this book unusual is how the authors compare psychotic delusions to some of our usual everyday beliefs: from their rather persuasive point of view, the delusion of being poisoned by nurses is not so different from the common belief of people being constantly monitored by the government. As Bortolotti and her colleagues show, delusional patients score the same results as normal subjects in logic exams, whilst also getting the same grades as normal people in intelligence tests, therefore showing that delusional people have an average (or above average) intelligence and logical skills. What’s probably even more surprising in these cases, is that patients are completely aware that their beliefs make no sense to others, but they still can’t escape the strange reality they are living in.

Concluding the book with a humanistic tone in which delusions are a plausible escape-response from a severely distressed brain, Bortolotti and her colleagues, against the usual clinical practice, maintain that some patients might get epistemic and emotional benefits from keeping a bizarre delusional belief, and that a come-back-to-reality might even harm a patient’s life. Truly, the ground-breaking arguments in this book might promote a new approach to patients’ treatment in the future.

Bortolotti’s book is aimed, mainly, at philosophers interested in clinical practice, rationality and epistemology. However, I would personally recommend it to psychologists, psychiatrists, nurses and university students because of the broad frame of useful facts, discussions, studies and arguments inside the book that were used to prove Bortolotti’s arguments. The book is open access, free to anyone interested in Mental Health.

As a final note,  I found remarkable the compassionate and humanistic approach in this book because patients with delusions are frequently depicted in media as violent and irrational, and the truth is that, behind every delusion there is a rational person that is fighting with her own mind, and in need of professional help and understanding.  

© 2020 Aline Maya Paredes

Categories: Philosophical, Psychology

Keywords: delusions, philosophy