Double bookkeeping in delusions: explaining the gap between saying and doing

Delusions are usually regarded as irrational belief-like states that are symptoms of a variety of psychiatric disorders, among which are schizophrenia, dementia and delusional disorders. The doxastic account of delusions is the view that delusions are genuine instances of belief. One powerful objection to the doxastic account is that delusions are not beliefs because, differently from beliefs, they do not lead to action in the relevant circumstances. For instance, people with schizophrenic delusions may fail to manifest commitment to the content of their delusions either verbally or behaviorally. They may endorse attitudes that conflict with their delusions, provide bad reasons or no reasons at all for endorsing their delusions or fail to act on their delusions. This is also known in the literature as the phenomenon of “double bookkeeping.”