"Sleights of mind": Delusions, defences and self-deception.

Two different modes of theorizing about delusions are explored. On the one hand is the motivational approach, which regards delusions as serving a defensive, palliative, even potentially adaptive function. On the other hand is the cognitive deficit approach, which conceptualises delusions as explicitly pathological, involving abnormalities in ordinary cognitive processes. The former approach, prominently exemplified by the psychoanalytic tradition, was predominant historically, but has been challenged in recent years by the latter. Some grievances against psychoanalytic theory are briefly discussed, and it is argued that although the reasons for psychoanalysis falling into scientific disrepute are partly justified, the psychodynamic notion that motivation has access to the mechanisms of belief formation is of potentially crucial theoretical utility. A variety of possible syntheses of the two theoretical modes are therefore explored, in the belief that the most comprehensive account of delusions will involve a theoretical unification of both styles of explanation. Along the way an attempt is made to locate the notions delusion, defence and self-deception in a shared theoretical space.