EPISTEMOLOGY & PHILOSOPHY OF SCIENCE · 2015 · Ò.

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C AN ANOSOGNOSIA VINDICATE TRADITIONALISM ABOUT

SELF#DECEPTION?
José Eduardo Porcher – The traditional conception of self-deception takes it for an intrapersonal form of
PhD. Federal University interpersonal deception. However, since the same subject is at the same time de-
of Rio Grande do Sul, ceived and deceived, this means attributing the agent a pair of contradictory be-
Porto Alegre, Brazil. liefs. In the course of defending a deflationary conception of self-deception, Mele
E mail: (1997) has challenged traditionalists to present convincing evidence that there
[email protected] are cases of self-deception in which what he calls the dual belief-requirement is sa-
tisfied. Levy (2009) has responded to this challenge affirming that there is at least
one real cases of self-deception that meets this requirement, namely, that of ano-
sognosia. In this family of conditions, the patient apparently believes that there is
nothing wrong with her while, at the same time, providing behavioral cues that indi-
cate that the patient is somehow aware of his disease. If Levy is right, then traditio-
nalism about self-deception could be vindicated, after having been widely abando-
ned due to its need to postulate exotic mental processes in order to make sense of
the attribution of contradictory beliefs. In this paper, I assess whether Levy’s re-
sponse to Mele’s challenge is successful by analyzing his interpretation of the empi-
rical evidence to which he appeals. Finally, I attack the cogency of the underlying
commitments about the nature of folk psychology to which one is required to defer
in order to draw from conflicting evidence the attribution of contradictory beliefs.
Key words: self-deception. anosognosia. belief. contradictory beliefs. folk psycho-
logy.

Introduction

Self-deception is a psychological phenomenon with which every human being

is familiar. Since the definition of self-deception is precisely one of the points of
contention in the philosophical literature, one might as well begin by first determi-
ning the reference of the concept. There is no shortage of examples, but maybe it will
help if we confine ourselves to those which are relatable and less intricate. Consider
the following representative case:
Ann is dying of cancer and is aware of many facts, such as her long, steady
decline, pointing to this outcome, though no one has told her that her case is
terminal and she has avoided letting her doctor give her a prognosis. Suppose
further that she talks of recovery and discusses her various plans for the long
future ... the facts pointing to her death are not unmistakably prominent and her
talk of recovery is apparently sincere ... she has better than average medical
knowledge ... [but] (among other things) ... her talk of recovery lacks full
conviction (or exhibits too much apparent conviction), and ... is often followed
by depression or anxiety [Audi, 1982:134].
Despite our familiarity with this type of situation, and although the folk-psycho-
logical concept of self-deception (or its equivalents, such as fooling oneself, lying to
oneself, etc.) is used by us every day, we have yet to come up with a consensual cha-

206 Case-studies – Science studies

CAN ANOSOGNOSIA VINDICATE TRADITIONALISM…

racterization of the phenomenon. This is due to the fact that, though the
phenomenon is straightforward enough, there seems to be something amiss
with the very idea of deceiving oneself. This puzzle gave rise to a speciali-
zed debate with the translation of Jean-Paul Sartre’s Being and Nothing-
ness into English. In his discussion of “bad faith,” Sartre recognizes and
elaborates on the apparent contradiction involved in self-deception:
I must know in my capacity as deceiver the truth which is hidden from
me in my capacity as the one deceived. Better yet, I must know the
truth very exactly in order to conceal it more carefully–and this not at
two different moments, which at a pinch would allow us to reestablish
a semblance of duality–but in the unitary structure of a single project
(1949/1957, p. 49):
So the very word ‘self-deception’ carries with it an air of impossibility
if we take it to mean exactly what it seems to mean. On close inspection,
two puzzles arise from a literal interpretation of the word, each of which is
derived from one of two lexical assumptions:
1. By definition, person A deceives person B (where B may or may not be
the same person as A) into believing that p only if A knows, or at least
believes truly, that not-p and causes B to believe that p.
2. By definition, deceiving is an intentional activity: nonintentional
deceiving is conceptually impossible [Mele, 2001: 6].
The first puzzle, often called the static puzzle, concerns the possibility
of the mental state that the first lexical assumption entails, namely, the pos-
session of contradictory beliefs. The second puzzle, often called the dyna-
mic puzzle, concerns the possibility of the project that the second lexical as-
sumption entails, namely, intentionally keeping from oneself something
that one believes. For the remainder of this paper, I will deal with the first
of these difficulties.
There have been two main proposed approaches to the static puzzle.
The first one takes ‘deception’ literally, declaring self-deception to be a
form of intrapersonal deception. I will refer to this as traditionalism about
self-deception. Insofar as traditionalism entails that the belief that p and the
belief that not-p coexist in the mind of the self-deceived, the static puzzle
must be solved. The solutions proposed by traditionalists such as David Pe-
ars (1984) and Donald Davidson (1985) rest on the Freudian idea that the
best way to account for the phenomenon is to somehow split the person. Pe-
ars’s proposed solution is the most radical of these:
[There is a] subsystem ... built around the nucleus of the wish for the
irrational belief and it is organized like a person. Although it is a
separate center of agency within the whole person, it is, from its own
point of view, entirely rational. It wants the main system to form the
irrational belief and it is aware that it will not form it, if the cautionary
belief [i.e., the belief that it would be irrational to form the desired

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belief] is allowed to intervene. So with perfect rationality it stops its

intervention (1984: 87),
It is easy to see how this would solve the pending difficulties. Pears
converts the problematic characterization ‘A deceives A’ that resulted from
a literal reading into the non-problematic ‘A deceives B,’ where A and B are
different subsystems of agency within a reasonably unified system, name-
ly, the person. Because the roles of deceiver and deceived are played by
different centers of agency, the aura of paradox disappears. However, this
sort of explanation faces its own difficulties. As Mark Johnston (1988: 64)
has observed, the traditionalist view replaces a contradictory description of
the self-deceiver with one that raises its own host of problems: how can the
deceiving subsystem have the capacities to perpetrate the deception? Why
should the deceiving subsystem be interested in the deception? Does it sup-
pose that it knows what it is best for the deceived system to believe? Impor-
tantly, as Tamar Gendler observes, ‘If one of the subpersons (truly) belie-
ves that p and does not believe that not-p, and if that subperson is bothered
by this and wishes it were not the case, why would she be find it psycholo-
gically fruitful intentionally to bring someone else to believe that the oppo-
site?’ (2007: 235).
On the other hand, Davidson proposes a functional division that falls
short of literally splitting the person into separate centers of agency. His
view is that all that is needed is a boundary between conflicting attitudes:
there would be no problem in believing contradictory propositions if they
didn’t come in contact with each other. Davidson claims that it is the dra-
wing of such a boundary between our inconsistent beliefs which constitutes
the irrational step involved in self-deception, and that this step is assisted
by the nonobservance of Carl Hempel’s and Rudolf Carnap’s requirement
of total evidence for inductive reasoning–a normative principle that enjoins
us to give credence to the hypothesis most highly supported by all available
relevant evidence when choosing among a set of mutually exclusive hypo-
theses. Davidson proposes the following conditions under which an agent
A is self-deceived with respect to a proposition p:
A has evidence on the basis of which he believes that p is more apt to be
true than its negation; the thought that p, or the thought that he ought
rationally to believe p, motivates A to act in such a way as to cause
himself to believe the negation of p (1985: 88).
Nevertheless, even though Davidson’s is a more economical approach
to the characterization of the self-deceived than Pears’s, both approaches
share the assumption that ‘self-deception’ should be understood literally.
However, the ‘deception’ in self-deception may alternatively be unders-
tood as nothing more than a metaphor (an observation that originated as
early as Canfield and Gustafson, 1962). For proponents of this view,
self-deception is not to be understood as a reflexive form of deception, in

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much the same way that self-teaching is not understood as a reflexive form
of teaching.
The second approach to the static puzzle involves understanding self-
deception to be simply a form of motivated irrationality. I will refer to this as
deflationism about self-deception. Insofar as deflationism maintains that on-
ly the false or unwarranted belief exists in the mind of the self-deceived, the
static puzzle is apparently bypassed. Deflationists are, however, left with the
task of explaining what exactly the mental states involved in self-deception
are, and how they are formed and maintained. In other words, their task is ex-
plaining what the metaphor stands for. Alfred Mele, the main proponent of
deflationism, presents the following set of jointly sufficient conditions for an
agent S to be self-deceived in acquiring a belief that p:
1. The belief that p which S acquires is false.
2. S treats data relevant, or at least seemingly relevant, to the truth value of
p in a motivationally biased way.
3. This biased treatment is a nondeviant cause of S’s acquiring the belief
that p.
4. The body of data possessed by S at the time provides greater warrant for
not-p than for p (2001: 51).
Although it is certainly not a given that these conditions are indeed
jointly sufficient for self-deception to obtain, deflationism has the virtue of
at once avoiding the static puzzle and presenting a more parsimonious cha-
racterization of the self-deceived.

Mele’s challenge and Levy’s response

Having advanced the most parsimonious theory of self-deception to date,

Mele (1997) challenged traditionalists to provide convincing evidence of the
existence of instances of self-deception that satisfy what he calls the dual-be-
lief requirement, namely, the requirement that self-deceivers (at some point)
simultaneously believe that p and believe that not-p. Recently, Neil Levy
(2009) has responded to Mele’s challenge with an attempted demonstration of
the satisfaction of the dual-belief requirement. While recognizing that–given
that Mele offers merely sufficient (and not necessary) conditions–meeting the
challenge would not falsify the deflationary account, Levy points out that, if he
is successful, he will have at least undermined the argument from parsimony in
favor of deflationism and have strengthened traditionalism insofar as there
would not be a need to postulate ad hoc exotic mental processes such as the
ones invoked by Pears (and, to some extent, Davidson).1
1 However, Levy doesn’t aim at vindicating traditionalism entirely, as he doesn’t defend
intentionalism. What he does intend to do is to ‘show that the static puzzle must be solved
rather than simply dismissed’ (2009: 230).

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How may one go about demonstrating that at least some cases of

self-deception involve the simultaneous possession of contradictory be-
liefs? As Levy notes, ‘we cannot directly inspect the mind of the self-decei-
ved in order to discover that there are cases where the dual-belief require-
ment is satisfied’ (2009: 230). What one can do is to analyze the evidence
available for the attribution of contradictory beliefs to subjects in the grip
of self-deception. Levy makes it clear that he thinks that ordinary self-de-
ception may be properly characterized without the attribution of contradic-
tory beliefs, but suggests he is on to at least one case of extraordinary
self-deception that does satisfy the dual-belief requirement, making it ne-
cessary at least to amend the deflationary account. The case at hand is that
of anosognosia.
Anosognosia is a neurological condition characterized by the lack of
awareness or the underestimation of a specific deficit in sensory,
perceptual, motor, affective or cognitive functioning, brought about by
brain dysfunction (Bisiach and Geminiani, 1991; Prigatano, 2010). In the
following discussion I will follow Levy and use the term anosognosia to
refer to the unawareness of a particular motor deficit, hemiplegia –
paralysis of the arm, leg, and/or trunk on the same side of the body – as
anosognosia ‘has been studied mainly in stroke hemiplegic patients, who
may report no deficit, overestimate their abilities or deny that they are
unable to move a paretic limb’ (Orfei et al., 2007: 3075). The vast majority
of cases of anosognosia for hemiplegia follow right-brain injury and thus it
is the left side of the patient’s body that is usually paralyzed.
What leads Levy to think the case of anosognosia has any significance
for the debate on the proper characterization of self-deception is the fact
that numerous descriptions and interpretations of the denial, rationalizati-
on, and confabulation involved in cases of anosognosia invite comparison
with the motivated phenomenon of self-deception. The main source of case
reports from which Levy draws comes from Vilayanur S. Ramachandran’s
studies (1995; 1996). To understand why, according to Levy, it is tempting
to see anosognosia as a case of extreme self-deception, let us look at two re-
presentative cases. Here is a conversation between one of Ramachandran’s
patients and himself (Ramachandran and Blakeslee, 1998: 130):
“Esmerelda, how are you doing?”
“I’m fine?”
“Can you walk?”
“Yes.”
“Can you use your arms?”
“Yes.”
“Can you use your right arm?”
“Yes”.
“Can you use your left arm?”?
“Yes, I can use my left arm.”

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“Can you point to me with your right hand?”

She pointed straight at me with her good right hand.
“Can you point to me with your left?”?
Her left hand lay motionless in front of her?
“Esmerelda, are you pointing?”
“I have severe arthritis in my shoulder; you know that, doctor. It hurts.
I can’t move my arm now.”
On other occasions she employed other excuses:?
“Well, I’ve never been very ambidextrous, doctor.”
Patients of anosognosia are prone to rationalization, making up excu-
ses in much the same way that ordinary people do when self-deceived. This
invites not only the comparison with self-deception, but the hypothesis that
the neurological mechanisms involved in both phenomena are the same or,
at least, somehow related (Hirstein, 2005).2 Some cases of anosognosia,
however, are even more stark and invite the ascription of full-blown delusi-
on.3 Here is another conversation between one of Ramachandran’s patients
and himself (Ramachandran and Blakeslee, 1998: 129):
“Mrs. Dodds, can you touch my nose with your right hand?”
She did so with no trouble.
“Can you touch my nose with your left hand?”
Her hand lay paralyzed in front of her.?
“Mrs. Dodds, are you touching my nose?”
“Yes, of course I’m touching your nose.”
“Can you actually see yourself touching my nose?”?
“Yes, I can see it. It’s less than an inch from your face.”
At this point Mrs. Dodds produced a frank confabulation, almost a hal-
lucination, that her finger was nearly touching my nose. Her vision was fi-
ne. She could see her arm perfectly clearly, yet she was insisting that she
could see the arm move? I decided to ask just one more question.
“Mrs. Dodds, can you clap?”
With resigned patience she said, “Of course I can clap.”
“Will you clap for me?”?
Mrs. Dodds glanced up at me and proceeded to make clapping move-
ments with her right hand, as if clapping with an imaginary hand near the
midline?
“Are you clapping?”?
“Yes, I’m clapping,” she replied.
As Ramachandran notes, this patient’s confabulation is on the extreme
end of the scale, as it is much more usual for patients with anosognosia to
conjure up inane excuses or rationalizations why their left arms do not mo-
2 If this were true, it would mean that self-deception might at last begin to be understood
at a lower level of description–namely, that of neurobiology. This alone makes the
comparison worth investigating.
3 This raises the interesting question of where self-deception ends and clinical delusion
begins. Cf. Bortolotti and Mameli (2012).

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ve when they are asked to demonstrate the use of that arm. Hence, this case
is an extraordinary case of anosognosia and ordinary cases of anosognosia
still invite comparison with everyday self-deception, albeit in an exaggera-
ted form. Levy uses this as a starting point to explore the possibility that
anosognosia might be evidence against deflationism about self-deception.
His overarching argument starts from the premises that (1) some cases of
anosognosia are cases of self-deception, and that (2) these cases warrant
the ascription of contradictory beliefs, concluding that there is at least one
kind of case of self-deception which warrants the ascription of contradicto-
ry beliefs. As a corollary of Levy’s argument, deflationism about self-de-
ception turns out to be either incorrect or at least incomplete.
Whether or not Levy’s first premise is true depends, on the one hand,
on an account of self-deception, and on the other hand, on an account of
anosognosia. Levy gives the following set of conditions for a case of ano-
sognosia to be a case of self-deception (2009: 234):
1. Subjects believe that their limb is healthy.
2. Nevertheless they also have the simultaneous belief (or strong
suspicion) that their limb is significantly impaired and they are
profoundly disturbed by this belief (suspicion).
3. Condition #1 is satisfied because condition #2 is satisfied; that is,
subjects are motivated to form the belief that their limb is healthy
because they have the concurrent belief (suspicion) that it is
significantly impaired and they are disturbed by this belief (suspicion).
Note that Levy’s characterization of self-deception is somewhat im-
precise, since he attributes to the self-deceived the desired, but unwarran-
ted belief, while leaving it open if the attitude of the self-deceived toward
the undesired state of affairs is one of belief or suspicion. (I will return to
this point.) However, from the point of view of an account of anosognosia,
the main point of contention is his third condition, which concerns the mo-
tivational origin of anosognosic beliefs. Of course, Levy is not stating that
all anosognosic beliefs are the product of the subject’s desires, but it is still
a matter of controversy that there are any motivationally formed anosogno-
sic beliefs (cf. Aimola Davies et al., 2009). Still, since the focus of this in-
vestigation is not whether or not it is true that some cases of anosognosia
are cases of self-deception, I will assume, for the sake of the argument, that
the first premise of Levy’s argument is true and turn now to his second pre-
mise–the claim that anosognosia warrants the ascription of contradictory
beliefs. To support the second premise of his argument, Levy intends to de-
monstrate that there is evidence to attribute both the desired belief that one
is not paralyzed and the undesired belief that one is paralyzed. In the next
section, I present and assess this evidence.

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Analyzing the evidence

As we have seen, anosognosic patients deny being paralyzed with ap-

parent sincerity. Importantly, this conviction has been empirically tested.
In order to answer the question ‘Is there tacit knowledge of paralysis in
anosognosia?’, Ramachandran devised an experiment in which patients
were given the choice of completing either a bimanual or a unimanual task
for larger and smaller prizes, respectively. He administered the trials to
three different patients a total of 19 times. Patients almost always chose the
bimanual task, leading Ramachandran to assert that ‘the patients either ha-
ve no “tacit knowledge”of their paralysis or, even if they do, they cannot
access this knowledge when choosing between a unimanual vs. bimanual
task’ (1995: 31). So far, then, the evidence heavily suggests that anosogno-
sic patients believe that they are not paralyzed, and that they fail to believe
that they are paralyzed. Nevertheless, Levy assembles several pieces of
evidence which, he purports, while not indisputable on its own, make a
strong case for the simultaneous attribution of the undesired belief.
First, Levy argues that there is evidence that the fact of paralysis is re-
presented in the brain of anosognosic patients (2009: 236). This is sugge-
sted by studies employing vestibular stimulation through the caloric reflex
test–a test of the vestibulo-ocular reflex that involves irrigating cold or
warm water into the external auditory canal. This test is hypothesized to
arouse the parts of the right hemisphere normally engaged in anomaly de-
tection and attention to the left side of the patient’s personal space and, no-
tably, it has been shown to lead to temporary remission of anosognosia.
More importantly, Levy cites the fact that the application of this test to ano-
sognosic patients has showed recognition that they had awareness of their
paralysis all along (Cappa et al., 1987). But note that this is not conclusive
evidence given that the might be the alleged recognition may well be an ef-
fect of hindsight bias. More importantly, however, is the question of how
something being ‘represented in the brain’ would equal something being
believed. Moreover, Hirstein (2005) suggests that we take anosognosics at
their word and that, if their brain can nevertheless represent the damage to
their limb–a possibility which is not being rejected here at all–this repre-
sentation is subpersonal and inaccessible to consciousness.
Second, Levy cites indirect evidence that the relevant proposition has
(at least) the lowest degree of personal availability to the anosognosic pa-
tient (2009: 237). Forced-choice situations have yielded evidence of impli-
cit processing in patients with hemispatial neglect–a condition in which,
after damage to one hemisphere of the brain, a deficit in attention to and
awareness of one side of personal space is observed. Neglect is defined by
the inability of a person to process and perceive stimuli on one side of the
body or environment that is not due to a lack of sensation (Unsworth:
2007). Marshall and Halligan (1988) showed a neglect patients drawings of

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houses, placed so that the leftmost part of the houses fell in her neglected
field. Predictably, the patient reported that the houses looked identical. Ho-
wever, the drawing of one the houses was in flames on its left side, some-
thing which the patient could not consciously see. Marshall and Halligan
then proceeded to ask the patient which house they would prefer to live in
and reliably chose the house that was not burning. Note, however, that even
if this result were undisputed (Fahle, 2003), Levy doesn’t offer grounds for
accepting evidence from neglect to apply to anosognosia across the board.
Nevertheless, even if we were to accept the evidence of implicit processing
from neglect patients to transfer to anosognosia patients, Levy again gives
us no reason to infer that that the patient believes the relevant proposition
from evidence that establishes only (if at all) what he himself terms ‘the lo-
west degree of personal availability’–that of cases of blindsight, in which
patients cannot use visual information from their blind field in everyday li-
fe, but are able to use it to guess above chance in forced-situations (Weis-
krantz, 1986).
Third, Levy claims that there is observational evidence that the expli-
citly denied knowledge guides some of the behavior of anosognosic pa-
tients, including their verbal behavior, and takes this to indicate that such
knowledge has a degree of availability somewhat above that of visual in-
formation in blindsight (2009: 237). This alleged evidence comes from two
cases reported by Ramanchandran. The first case (Ramachandran and Bla-
keslee, 1998: 139) is that of a patient who, after opting for a bimanual task
in a forced-choice situation–namely, tying her shoelaces–and failing to
complete it, went on to affirm afterwards that she had tied her shoelaces.
The second case (Ramachandran and Blakeslee, 1998: 150) is that of a pa-
tient who affirmed that his left, paralyzed arm was actually stronger than
his right, healthy arm.
Note that it isn’t obvious how these cases represent evidence that these
patients’s alleged belief that they are paralyzed guides their behavior. To
arrive at that conclusion, Levy buys into Ramachandran’s interpretation of
theses cases. According to Ramachandran, both behavioral manifestations
are indicative of what Freud called “reaction formation,” defined by Levy
as ‘the expression of a thought antithetical to the denied proposition, which
betrays its motivated nature by its very vehemence’ (2009: 237). While this
is a valid interpretation, it by no means establishes either that anosognosic
patients are somehow aware of their condition–since the manifested beha-
vior can also be interpreted as the result of a frank confabulation–or that
any motivational component is involved in anosognosia at all. Moreover,
note that once more the language employed by Levy warrants questioning
why we should get onboard with belief attribution if the evidence warrants
but only a degree of availability somewhat above that of visual information
in blindsight.
Fourth, Levy argues that there is strong evidence that the denied
knowledge is dispositionally available to anosognosic patients (2009: 237).

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Once again, Levy turns to Ramachandran, citing the fact that patients can
be gently “prodded” into eventually admitting that their arm is not wor-
king, weak and even, in some cases, paralyzed, although, as Ramachandran
and Blakeslee note, they seem unperturbed by this admission (1998: 149), a
qualification that Levy fails to acknowledge. But even if patients could be
prodded into admitting that they are paralyzed, it is by no means trivial that
we should we immediately take this as evidence that knowledge of the pa-
ralysis is dispositionally available to the patients rather than, for example,
as evidence that the patient has just acquired such knowledge. In the absen-
ce of reasons why the latter plausible interpretation is incorrect, Levy’s al-
leged evidence cannot do the required explanatory work.

The attribution of contradictory beliefs

I claim that the evidence Levy presents for the presence of the undesi-
red belief, as he himself gestures at repeatedly by his choice of words, is not
enough to attribute a belief. After presenting the four pieces of evidence for
the undesired belief above, Levy concludes that ‘taken together, this evi-
dence seems to constitute a strong case for attributing to anosognosics the
belief or the strong suspicion that their limb is significantly impaired’
(2009: 238). I disagree. While what Levy presents as evidence of the pre-
sence of the undesired belief is weak on its own since, as we have seen, it
establishes but a low degree of availability, it becomes even weaker when
we simultaneously have very strong reasons to attribute the desired belief,
that is, to take anosognosic patient’s at their word.
Levy’s conclusion that we have enough evidence to attribute to the
anosognosic patient the belief that he or she is paralyzed stems from the
isolation of this evidence from the evidence that he himself points out is
enough to warrant the attribution to the anosognosic of the belief that he or
she is healthy. He then takes the sum total of the evidence to warrant the at-
tribution of contradictory beliefs to the anosognosic and, given that he un-
derstands at least some cases of anosognosia to be cases of self-deception,
he purports to have demonstrated that Mele’s dual-belief requirement
holds in at least some cases of self-deception. I argue, in turn, that even if it
were true that anosognosia is (in some cases, at least) a form of self-decep-
tion, Levy would not be right to derive an attribution of contradictory be-
liefs from evidence that pulls in two opposing directions. This is because,
in the absence of an empirical method of direct inspection of the anosogno-
sic patient’s mind (as acknowledged by Levy), belief is an explanatory, in-
terpretive, and predictive concept–a tool we use to explain, interpret, and
predict behavior. And if we’re presented with conflicting evidence, the
right response is not to attribute contradictory beliefs–since these have no
explanatory power at all–but to withhold attribution of belief and opt, inste-

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ad, for a characterization of the subject’s attitudes that doesn’t abstract

away from the cognitive processes that underlie belief attribution. For the
sake of advancing in the search for a scientific theory of the phenomena
discussed, we need to recognize that cases such as that of anosognosia, and
clinical delusions in general, are often simply not amenable to personal-le-
vel description and explanation. When it only pretends to be describing
precisely the mental states of those to which we attribute beliefs, ‘belief’
talk does more harm than good.

Conclusion

Levy rightly points out that, like self-deception, anosognosia ‘presents

us with a real-life–indeed, clinically verified–case in which agents claim
that p, while nevertheless giving clear indications that they (at least) stron-
gly suspect that not-p’ (2009: 239). Instead of relying on imaginary or lite-
rary cases of self-deception, as almost all authors contributing to the lite-
rature have done, Levy has taken an important step in bringing empirical
evidence to bear on the discussion. However, I have argued that, notwith-
standing his efforts to use anosognosia to demonstrate that Mele’s dual-be-
lief requirement for self-deception is met, Levy fails to establish this. Im-
portantly, I claim, on explanatory grounds, that Mele’s challenge is not
answerable by stipulating that evidence pulling us in the direction of oppo-
site attributions warrants our attributing contradictory beliefs to anosogno-
sic patients. In fact, after Levy’s attempted demonstration, we have nothing
really new that would warrant the attribution of contradictory beliefs to the
self-deceived, assuming that anosognosia really is (sometimes, at least) a
form of self-deception. Cases of everyday self-deception also push us in
opposite directions and give us evidence of doxastic conflict. This is preci-
sely what has fueled years of debate on what the self-deceived really belie-
ve–if they believe that p and not-p, only p, only not-p, or, as I contend, that
the question doesn’t have to have an answer, since assuming so is an over-
estimation of the preciseness of our folk-psychological vocabulary. If the
evidence of doxastic conflict alone were enough for concluding that the du-
al-belief requirement is met, then the debate would never even have started.

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