Mental illnesses are emotional disorders

Philip N. Johnson-Laird

1 Introduction

Psychological illnesses are pandemic. Nearly half the population of the United States will succumb to such a disease, and suffer from anxiety, phobia, hypochondria, depression, explosive anger, or an obsessive compulsion (American Psychiatric Association, 2013). What is so odd is that their cause is psychological - a matter of thoughts and experiences rather than gross changes to the brain - yet their cure is so difficult. They are unlikely to strike a person at random: character and personality seem to make some people more vulnerable than others, and so too does a stressful situation. Scientists do not understand these illnesses. They know that the illnesses exist, that they are common, and that some treatments are helpful. But, the existence of hundreds of different sorts of psychotherapy (Herink, 1980) is a sign of ignorance.

Fifteen years ago, my colleagues and I published a theory of psychological illnesses - the hyper-emotion theory (Johnson-Laird et al., 2006; Mancini et al., 2007). This chapter aims to bring the account up to date, and it is designed for readers unfamiliar with the theory. It outlines what they need to know about emotions, how music arouses them (a useful analogy), and how humans reason. It then presents the theory and recent corroborations of its predictions about aetiology, prognosis, and treatment. Its range is wide but its focus is narrow: the hyperemotion theory; and so it omits alternative points of view.

Human beings like all social mammals have to solve everyday problems that concern their bodily environment (sickness and pain), their physical environment (food, drink, and shelter), and their social environment (cooperation, mates, rearing offspring). They cope. But, they do sometimes make terrible errors - a fact impolitic to mention to theorists who believe that human thinking cannot err (e.g., Cohen, 1981; Henle, 1978). To borrow a remark from Ramsey (1929/1990), thesetheorists are like those bridge-players who argue that you cannot break its rules, because if you do, you are no longer playing bridge. One reason that social mammals cope is that evolution led to an efficient solution to their problems: emotions.

2 The communication of emotions

Emotions perplex philosophers. Plato regarded them as a force for irrationality (e.g., Timaeus, 86b). Many others have echoed him, and so a pure intellect unsullied by emotions is often treated as an ideal - from Sherlock Holmes to Mr. Spock of Startrek fame. Such characters are to be pitied, not emulated. In contrast, Aristotle grasped the cognitive roots of emotions (e.g., Rhetoric, Book II). He remarked that when someone insults you, it makes you angry (see Politics, line 1312b30), and he recognized that some emotions have characteristic facial expressions (Physiognomies, line 805bl).

His descendant in the study of facial expressions wrote:

The power of communication between the members of the same tribe by means of language has been of paramount importance in the development of man; and the force of language is much aided by the expressive movements of the face and body. We perceive this at once when we converse on an important subject with any person whose face is concealed.

(Darwin, 1897: 354)

What Darwin analysed are the causal roots of the ways in which individuals and animals express their emotions - from dogs wagging their tails to people weeping for joy. He noted that humans recognize emotions in others without knowing their exact cues. The emotions and their recognition are innate, and the same throughout the world (ibid: 359). He speculates that the free expression of an emotion intensifies it, whereas the suppression of these signs softens the emotion (ibid: 365).

2.1 The basis of emotions

The account that my colleagues and I adopted as basis for the hyper-emotion theory is Darwinian in essence. It is the “communicative” theory of emotions developed with Keith Oatley (Oatley and Johnson-Laird, 1987, 1996; Johnson-Laird and Oatley, 1992). It acknowledges that emotions are distinct, as Darwin did, and that they communicate themselves to others. They coordinate the collective lives of social mammals. But they are also internal communications in the brain. A rudimentary cognitive evaluation suffices to trigger such a signal. It is faster than deliberate thinking, and its consequences are general rather than particular. When, for instance, a stranger is rude to you, you understand the threat (a cognitive evaluation); various changes occur in your brain (neurophysiological processes); and, as a result, hormones are released into your bloodstream, your heart pumps faster (somatic changes), and so you are ready for action; you sense anger mounting within you (a subjective feeling); you frown (a facial expression); and you say something rude in reply (an intentional action).

From a simple cognitive evaluation of the situation, emotions prepare individuals for a general course of action. Hence, many different events in the world are mapped onto a small number of categories, each of which can elicit a distinct set of physiological, behavioural, and subjective consequences appropriate to the situation. If there were many such categories, then the problem of deciding amongst them could be as time-consuming as a deliberate choice. Likewise, the repertoire of physiological changes and behaviours that an emotion elicits must be useful preparations for the wide class of events that trigger the emotion. For human beings, this repertoire includes learned actions. Fire drills prepare them for practiced actions that can be carried out without much thought, e.g., what to do to leave the building.

Theorists squabble about which, if any, of the elements is the “emotion”, about whether it is a separate entity or merely a cluster of values on multiple dimensions, and which element causes another. William James (1884) thought that your actions cause your feelings. You aren’t rude because you’re angry; you’re angry because you’re rude. This back-to-front view, however, is contrary to common sense and to the fact that total paralysis spares emotions.

Both the external and internal signals of basic emotions are innate. They are evolutionarily old and dependent on systems in the brain, such as the amygdala -two subcortical organs. Their interpretation differs from the interpretation of the cognition eliciting them. It can have propositional content, and it can be expressed in language, e.g., “His insult annoyed me”. The meaning of such a proposition is composed from the meanings of its parts according to the grammatical relations amongst them. As semantic theorists say, it has a “compositional” meaning (Partee, 2014). In contrast, emotional signals have no such structure: they are more akin to one of a small set of alternative alarms. These signals propagate in the brain more rapidly than propositional messages. Their external propagation in facial and bodily expressions also has no compositional structure and is understood rapidly. You can tell a genuine smile from a posed one, but you cannot identify what cues the difference - unless you have studied the matter (Ekman and Friesen, 1982).

Emotional signals and their cognitive evaluations both can impinge on consciousness - in which case an individual is aware of a subjective feeling and of its cause. But each one may fail to impinge in this way. Individuals may be aware that they ought to feel an emotion, but experience nothing more than a sense of ‘numbness’. Or, they may feel an emotion, but have no idea why they are experiencing it. And if they are unaware of the message and the signal, they can have an unconscious emotion manifest only in bodily changes and expressive behaviour. This claim sounds Freudian. But Freud (1915) went out of his way to deny this possibility: “It is surely of the essence of an emotion that we should be aware of it, i.e. that it should become known to consciousness”.

The communicative theory identifies certain emotions as basic, such as happiness, sadness, anger, and fear, because they can be experienced without awareness

TABLE 2.1 Basic emotions that can be with or without a known object, and those that must have known objects, with their antecedents and the consequences

Emotion ± object


Consequences in expressions and behaviours


Success, achievement of goals

Continue course of actions


Loss, failure of goals

Withdraw, do nothing, cogitate


Obstruction to goals

Act aggressively


Threat to preservation

Withdraw, protect, worry

Emotion + known


Consequences in expressions


and actions

Parental love

Infant or child


Sexual love


Court, be affectionate


Rival, other

Act towards without care, ignore


Noxious entity

Expel, reject, avoid

of any cognitive message. So, individuals may feel them for no reason of which they are aware, and they can underlie moods, that is, prolonged emotional states. Other basic emotions can be experienced only with an awareness of their objects, e.g., disgust or love. In sum, basic emotions are innate, they serve an adaptive function, and they prepare individuals for a general course of action or inaction.

Table 2.1 summarizes the principal basic emotions that can be experienced without a known object and those that have necessary objects.

Originally, the communicative theory postulated that lateral inhibition in the brain led a single basic emotion to be predominant at any one time (Oatley and Johnson-Laird, 1987). But, as a result of studies in which people kept diaries of their emotions (Oatley and Duncan, 1994), it became obvious that the assumption was false. People have mixed emotions. Before an examination of more complex emotions, it is sensible to consider emotional reactions to music, because they are analogous to those that occur in psychological illnesses.

2.2 Music elicits basic emotions

For an alien, music causes a universal psychological illness. In its pure form, it has no propositional content, yet it evokes emotions. And listeners can project all sorts of content onto it. But music itself conveys no propositions - entities that can be true or false, and whose meanings are compositional. Music is common to all cultures, and almost always social - the chief exception is Western music in the concert hall.

Music is popular, its listeners say, because it arouses their emotions. Its earliest psychological studies corroborated this claim (e.g., Gilman, 1891). It elicits basic emotions (e.g., Juslin et al., 2011). It can create a surprise, but surprise is nothing more than a sudden unexpected event eliciting a basic emotion. A piece of music that you have never heard before can make you happy, and so it contains cues that elicit the cognitive evaluations leading to a basic emotion. The process has innate roots: 2-day-old hearing infants of congenitally deaf parents prefer music intended for infants than music intended for adults (Masataka, 1999). And the process is rapid: in less than a second, you know whether an excerpt is happy or sad (Peretz et al., 1998). So, what is it that moves you? If you are not a musician, you cannot really say; and if you are a musician, you may say: it is up-tempo and in a major key. And why should these factors make you feel happy? You cannot say - or you make vague circular claims, such as “major scales signify happiness”. The right answer is foreshadowed in Aristotle (Politics, 1340all et seq.) and in Helmholtz (1887/1912). Music is mimetic: it imitates the characteristic behaviours, tone of voice, and speed of thinking, which occur in different basic emotional states. When you are happy, you move and think quickly, and speak loudly with an intonation contour that leaps around for emphasis (unless you speak a ‘tone’ language). When you are sad, you move and think slowly, and speak softly with a low pitch, and not much change in your intonation contour. When you are angry, you are also quick but you shout at a high pitch. When you are fearful, you run and act in an agitated way. A bodily cause in all three of the negative basic emotions is pain.

Music imitates these characteristics. It has ‘parameters’ that can vary but that tend to remain constant for some time, such as tempo, volume, pitch, timbre, the range of pitches in a melody, key, and consonance or dissonance. In tonal music, the notes in melodies and chords tend to be from a major scale or a minor scale, which have a psychological reality (Krumhansl, 1990). Scales are subsets of notes that are possible to play, of which, ignoring octaves, there are 12 in conventional Western music. For example, the C major scale contains the seven notes, C D E F G A B - the white notes on the piano, and the C minor scale replaces the note E with E flat. And musical chords are the simultaneous playing of different notes from the scale.

What makes chords consonant or dissonant is the oldest puzzle in cognitive science. It goes back to Pythagoras, and Galileo, Euler, and many others who have proposed solutions. Helmholtz (1912) discovered an essential piece of the puzzle: when two overtones from notes are close together in frequency, they create an almost painful buzz. The reason is that they stimulate regions close together on the cochlear, which is the organ in the inner ear that converts auditory vibrations into nerve impulses. But Helmoltz realized that there was a cultural factor too, because chords once judged dissonant in Western music now seem consonant. He did not identify this cultural factor. But a recent theory locates it in major and minor keys, which are at the heart of tonal music - the genre that developed around 1600 and that persists to this day in some modern concert music, in jazz, and in rock (Johnson-Laird et al., 2012). Keys are matters of culture, not innate acoustics. Those chords with notes that only co-occur in a minor key are more dissonant than those that co-occur in a major key. The combination of the two factors, painful buzz and tonal keys, predicts listeners’ ratings of dissonance for almost all the possible three-note chords and for a representative sample of four-note chords. These samples included tonal chords and those that are not. Likewise, a sequence of chords can follow tonal principles or not. Tonal chords are less dissonant in a tonal sequence than in a random sequence, whereas chords that are not tonal are highly dissonant in both contexts. In sum, consonance is pleasant, and dissonance is painful.

The communicative theory therefore postulates that music communicates cues analogous to those that humans communicate when they are in the grip of an emotion. Both sorts of cues elicit cognitive evaluations leading to basic emotions. For music, the cues are as follows (Johnson-Laird and Oatley, 2008):

Happiness: medium tempo, loud, wide range of pitches in melodies in a major scale, consonance.

Sadness: slow tempo, soft, low pitch, small range of pitches in a minor scale, mild dissonance.

Anger. rapid tempo, loud, high pitch, minor scale, large leaps in pitches in melodies, dissonance.

Anxiety: rapid tempo, moderate volume, low pitch, minor scale, dissonance.

Empirical studies show that settings of single parameters elicit appropriate emotions (for a review, see Johnson-Laird and Oatley, 2016). A major scale tends to elicit happiness, whereas minor and other scales tend to elicit negative emotions. Fast versus slow tempo has the same effect. When several parameters cue the same emotion, they increase the likelihood of its perception. A striking phenomenon occurs when music embodies conflicting cues to emotions, such as a major key but a slow tempo. Listeners experience mixed emotions. One study investigated happiness and sadness with recordings of real music (Hunter et al., 2008). And an unpublished study due to Olivia Kang exploited a computer program that creates music. The program builds up a matrix of transitions from one note to the next from a corpus of melodies. The transitions embody both pitch and rhythm. With an input of a chord sequence, the program uses the matrix to generate new melodies. With matrices based on corpora of music eliciting different basic emotions, and with appropriate settings of parameters, the resulting output is a novel piece of music expressing the relevant emotion. Kang’s study confirmed the effect with music based on three corpora of melodies (happy, sad, and anxious). But, when the parameters were set to conflicting values, the listeners were less certain about what emotion the music conveyed, and their choice of terms to characterize it referred to mixed emotions.

In sum, the cues in music communicate emotions to listeners by mimicking behaviours of those in emotional states. The auditory system uses these cues to form a model of an emotional state, which in turn transmits a signal of a basic emotion in the brain. The underlying mechanisms are in large part innate. But no answer is available to the eternal question of what adaptive advantage music confers: the problem is the lack of pertinent evidence (Lewontin, 1998).

2.3 Complex emotions

Some emotions are complex in that they can be experienced only with knowledge of the circumstances initiating them. They depend on an awareness of the relevant situation and typically on conscious inferences concerning individuals’ models of themselves. So, they can concern a comparison between actual events and alternative possibilities. These emotions therefore combine a signal of a basic emotion with a propositional message concerning the relation between a situation and a model of oneself. They include, for example, guilt, which is hatred of oneself for an action or inaction that was wrong - a deontic mistake; remorse, which is sadness in one’s behaviour in the light of a model of one’s ideal actions; and embarrassment, which is a self-conscious fear of looking bad, facing ridicule, and so on. Table 2.2 summarizes some complex emotions, their underlying basic emotions, and examples of their cognitive evaluations.

The transition from a cognitive evaluation to an emotion is itself unconscious and uncontrollable. You see something, and you have a rapid emotional reaction to it. You can control to some degree your behavioural expression of an emotion. You can use various other strategies such as trying to suppress the emotion itself. But evidence suggests the best strategy is to reappraise the situation creating the

TABLE 2.2 Some typical complex emotions, their underlying basic emotions, and examples of their typical cognitive evaluations

Complex emotion

Underlying basic emotion

Typical cognitive evaluations in relation to models of the self



Action succeeds by one’s own criteria



Expectation of success in relation to one’s goals



No hope (ibid.) in relation to goals of one’s life



Action or inaction fails to achieve one’s goal



Wrong action or inaction in relation to one’s ideal



Other’s situation as one evaluates it



Loss of loved one



Inability to control emotion against others



Inability to control emotion



Awareness of one’s situation as open to ridicule



Excessive pride (ibid.)



Others have wronged one



For another’s desirable attributes or possessions



For another supplanting one in a person’s love



Wrong action or inaction regarding collective ideal



Deontically wrong action or inaction regarding one’s own ideal

emotion if you are aware of it (Gross, 2002; McRae and Gross, 2020). What is indubitable is that a mere intention cannot stop the signal of a basic emotion and its outcomes. If you had such a control, then psychological illnesses would not exist to a degree that causes suffering.

The moral for psychological illnesses is that emotions can be evoked from rudimentary models outside awareness that embody nothing more than emotional characteristics of human behaviours. This primitive unconscious system creates basic emotions from music, but also from events in daily life. At the opposite extreme, if you read in an email that a dear friend has died, then this news triggers a feeling of grief- the propositional content of loss elicits a transition to an intense and uncontrollable feeling of sadness. The evaluative message is combined with the emotion it elicits and you are overcome by your awareness of the resulting grief at the feeling of loss. Figure 2.1 is a diagram representing the essentials of the communicative theory of emotions.

Awareness —>

Intentional actions





Signal —>


Behavioral expressions




Signal —>

Î evaluation

Physiological changes

Figure 2.1 A schematic diagram of the communicative theory’s account of emotional signals and propositional messages in the brain, from the initiating cognitive evaluation to its propositional message and emotional signal, and their respective outcomes. Message and signal may or may not impinge on the conscious system.

3 Thinking and reasoning

Thinking varies. It can have a goal or it can be goal-less. Without a goal, the mind wanders and one thought leads to another by association - a commonplace idea, but one for which no adequate theory exists. With a goal, thinking can be a sort of reasoning, deductive or inductive. But the goal can be too vague or too general so that it hardly constrains the process of achieving it - a person aims to compose a sonata, for instance, and so the constraints of creativity itself must take over. Psychologists divide thinking into these sorts of category in order to explain it, but its flow in daily life often moves so smoothly from one sort of process to another that you are not aware of the transitions. Indeed, you are more aware of the results of thinking than of how it proceeds from one thought to the next (Lashley, 1958).

Human reasoning is not all-powerful, despite leading to a deep understanding of mathematics and science and to sensible systems of law and governance. One source of difficulty is the human need to make sensible decisions when confronted with multiple and often incompatible goals, disparate beliefs, and the need to coordinate actions with other individuals. This social coordination of joint actions gets still worse when several people are trying to reach a decision, or when the number of beliefs to be taken into account is large. All reasoning is limited in power.

People with psychological illnesses think about them, and one influential view is that the origins of these illnesses are in faulty reasoning and irrational beliefs (Beck, 1976, 2019; Ellis, 1962). The idea is plausible, and the cognitive-behavioural therapy designed to correct these flaws is effective. So, the aim of this part of the chapter is to explain how individuals reason in daily life, and to do so it will rely on the theory of mental models (e.g., Johnson-Laird, 2006).

The basic idea is simple. People are not logicians. When they reason, they do not follow rules of inference such as those of a logic. Instead, they envisage the possibilities to which premises refer, and draw a conclusion from these mental models. A good way for you to envisage such models is to consider a building, such as a block of apartments or offices, with which you are familiar. Now, imagine that you are in, say, one such apartment or office, and have to get elsewhere on another floor in the building such as to its main entrance. Your task is to trace in the air with one finger the route that you take to get from your starting point to your destination. You can easily carry out this task. You trace the three-dimensional route with your finger. If you ask yourself how you were able to do so, the answer has to be that you had access to an internal representation of the three-dimensional layout of the building - a mental model - that enabled you to imagine the route. Some people report having visual images of the building, but many have no awareness of the model - it somehow guides their behaviour. In one experimental study, the participants likewise envisaged moving railway cars around a simple track, and in this case they constructed a kinematic model of a sequence of moves unfolding in time just as actual moves of the cars would do so (Khemlani et al., 2013). Even 10-year-old children could carry out this task, and they made many spontaneous gestures mimicking actual moves of cars. This outward sign of an inward mental simulation helped them to keep track of where the cars were, because when they were prevented from gesturing, their reasoning was worse (Bucciarelli et al., 2016).

When individuals reason from simple premises, the model theory postulates that they rely on intuitions; whereas in a task such as the rearrangement of cars on a railway, they rely on deliberations. This idea of two systems of reasoning is due to the late Peter Wason, who helped to explain performance in his well-known selection task (Wason, 1968). He invented the task to find out whether naive individuals - those with no training in science or logic - realized the importance of counterexamples to hypotheses. In the standard selection task, Wason put four cards down on the table in front of a participant as follows:

and the participants knew that each card had a letter on one side and a number on the other side.

Their task was to select those cards that it was necessary to turn over to find out whether a hypothesis such as the following one was true or false:

If a card has an E on one side, then it has a 3 on the other side.

They were told to be parsimonious in their selections. Most people selected E and 3, some selected only E, a few selected E, 3, and 4, but hardly anyone selected E and 4. Yet, it is the correct selection, because they are the only two cards that can yield counterexamples to the hypothesis. The almost universal failure to try to falsify the hypothesis shocked philosophers and psychologists. And over several decades it has led to more than 200 published experiments investigating the task.

The theory that Wason and the present author devised to explain performance in the task used his distinction between intuitive and deliberative sorts of reasoning, now often known as system 1 and system 2. The theory was formulated in an algorithm (Johnson-Laird and Wason, 1970). We recently implemented this algorithm in a computer program simulating mental models (Ragni et al., 2018). It makes a list of those items of evidence to be selected, i.e., cards in the selection task, and in intuitive mode it begins with those to which the hypothesis refers. So, for the hypothesis mentioned previously, the system 1 list is E and 3, but sometimes just E alone, depending on whether or not the hypothesis is taken to imply its converse. Intuitions therefore have no insight into counterexamples that could falsify the hypothesis: they select only evidence that matches the hypothesis. With a partial insight, system 2 adds any further item that could verify the hypothesis, or, failing that, any that could falsify the hypothesis. So, if 3 is not on the opening list, it is now selected. But if it is already on the opening list, deliberation now adds 4, yielding the selection of E, 3, and 4. With complete insight into falsification from the outset, the deliberations of system 2 select only items that could yield potential counterexamples to the hypothesis: E and 4. Although the selection of the three cards, E, 3, and 4 was rare in the initial studies, a procedure designed to elicit the selection of counterexamples led to it being the most frequent selection of all, followed by E and 4 (Wason, 1969).

The theory makes several predictions that a meta-analysis of the data corroborated, and its account of the selection task outperforms 15 alternative theories (Ragni et al., 2018). It also allows that people make sensible selections when they are tested in a repeated version of the task that gives them feedback on the status of each selection that they make, e.g., whether E occurs with 3 or 4 on its other side. The shocking neglect of falsifying selections in the original task therefore appears to be a consequence of participants having just one chance to make a correct selection for an abstract and arbitrary hypothesis. However, when the task is presented in a deontic framework, concerning acceptable and unacceptable actions, participants are also much more likely to deliberate and to select potential counterexamples.

The two systems of reasoning have continued to be part of the model theory (e.g., Johnson-Laird, 1983: Ch. 6, 2006), and other theorists have developed their own versions of “dual process” theories, e.g., Evans (2008); Sloman (1996); Kahne-man (2011). In the recent model theory, intuitions rely on mental models, which represent what is true but not what is false, and focus on one model at a time. Consider, for instance, the following problem, in which both assertions refer to two alternative possibilities:

Either the pie is on the table or else the cake is on the table.

Either the pie isn’t on the table or else the cake is on the table.

Could both of these assertions be true at the same time?

Most people respond “yes” (Johnson-Laird et al., 2012). The model theory predicts this response, because intuition yields two mental models of what’s on the table according to the first premise:



(Words here stand in for models of the items on the table.) And it yields two mental models of what’s on the table according to the second premise:



Because the cake is on the table for both assertions, people think that they both could be true at the same time. They are wrong. Fully explicit models on which system 2 relies represent in addition what is false in each possibility; using negation to do so, and so for the two premises, they are

pie not-cake

not-pie cake


not-pie not-cake

pie cake

The cake occurs without the pie for the first assertion, but with the pie for the second assertion, and so the correct answer is that both the assertions cannot be true at the same time.

The model theory has led to many studies that have corroborated its account in comparison with alternatives based on logic or on the probability calculus (see, e.g., Johnson-Laird et al., 2015), and the computer programs that implement it are available online.1

3.1 The interaction between emotions and reasoning

If Plato and his ilk were right, then emotions, as a force for irrationality, should impede reasoning and even lead it astray. Suppose you’re trying to carry out the selection task in a state of high dudgeon. Your feelings are likely to distract you - you pay attention to the emotion rather than to the task in hand, and so you fail to select falsifying cards in the selection task. An early study of the effects of emotion on reasoning corroborated this prediction using movies to induce emotions (Oaksford et al., 1996). This result is consistent with other studies, e.g., depression distracts its sufferers from thinking about other matters (Ellis and Ashbrook, 1987).

However, as Johnson-Laird and Oatley (2000: 464) suggested, a critical matter is the pertinence of an emotion to the task in hand. If it is irrelevant - as a movie-induced emotion is to the selection task - then it is likely to impede reasoning. But if it is relevant to your reasoning, then it should focus you to rely more on deliberation, and therefore to enhance your performance. Blanchette independently had the same idea, and has corroborated it in her ingenious studies (see, e.g., Blanchette and Richards, 2004, and Chapter 4 in this book).

Amelia Gangemi, Francesco Mancini, and the present author tested the effects of emotions on reasoning in an unpublished study. Their experiment manipulated whether or not psychologically healthy participants were feeling guilt, and whether or not the contents of a reasoning problem concerned guilt. The participants’ task was to infer what was possible and what was impossible according to an assertion at the end of a brief description. One group of participants had to write down a vivid account of an autobiographical episode in which they had felt guilt. A control group wrote no such account. After the experiment, the experimental group felt more guilt than the control group did, so this manipulation worked. On each trial in the experiment proper, the participants read a brief description ending with a particular assertion, e.g., they read this description to elicit guilt:

Suppose I am at my house with some friends. We decide to join some other friends in a bar. We leave the house joking amongst ourselves, but I forget to close the bathroom window. The burglar alarm rings or I feel guilt, or both.

They then had to list the possibilities and impossibilities for the final assertion. There are three main possibilities:

  • 1 The burglar alarm rings and I feel guilt.
  • 2 The burglar alarm rings (and I don’t feel guilt).
  • 3 (The burglar alarm does not ring and) I feel guilt.

And there is one impossibility:

4 The burglar alarm doesn’t ring and I don’t feel guilt.

Each of the groups of participants was further subdivided into two. In one case, the participants had to list possibilities for assertions in vignettes intended to induce guilt; and in the other case, the participants had to list possibilities for neutral assertions, which ended with an assertion: The burglar alarm rings or I feel tired, or both. Each participant carried out the task four times with different contents, and two of the vignettes had a test assertion based on “and” and two of the vignettes had a test assertion based on “or”. The results showed that those participants who were feeling guilt performed more accurately with the contents concerning guilt than the control participants who were not feeling guilt, but no reliable difference occurred between the groups tested with the neutral vignettes.

A corollary in daily life is that individuals feeling guilt should tend to reason about matters relevant to the emotion in a more expert way, thinking of possibilities that might otherwise elude them. The emotion increases motivation and improves reasoning, perhaps because it pushes individuals to deliberate, that is, to use system 2.

4 The hyper-emotional theory of psychological illnesses

Given the preceding groundwork, the theory that psychological illnesses are emotional disorders is straightforward (Johnson-Laird et al., 2006). The initial cause of such an illness is a transition to an emotion appropriate to the situation but inappropriate in its intensity. A situation elicits a cognitive evaluation, perhaps an unconscious one, that leads to an emotional signal. This signal has a variable intensity, perhaps normally distributed, and so it can be more intense than the situation warrants. Both the constitution of individuals and their everyday circumstances should affect the mean and variance of this distribution. They are aware of the emotion and often of its object, but they are not aware of what caused its excessive intensity. Their intentional efforts to control or to dismiss it are useless, and so it becomes the focus of their thought. The problem leads to deliberation - an exercise of skill that otherwise would be lacking. One side effect of this reasoning is to elicit the emotion again and to amplify it. Another side effect is that it leads to complex emotions, such as embarrassment, guilt, shame, or despair. The unfortunate individual experiences a recursive loop of mental events: cognitions that lead to emotions, which lead to further cognitions, and so on and on. But an alternative possibility is that the initial overreaction wanes, and the individual returns to a customary state of mind. The episode is over with no long-lasting effects. The difference between the self-terminating episodes and those that lead to illness is not a matter of chance. Constitution and circumstances affect the susceptibility of individuals to succumb to recursive attacks.

4.1 Evidence for the hyper-emotion theory

The theory predicts that each basic emotion can give rise to a psychological illness, and that no psychological illness can occur without a concomitant basic emotion.

TABLE 2.3 The principal psychological illnesses in terms of their underlying basic emotions and origins in the ontogeny of daily life

Ontogeny in daily life

Basic emotions

Psychological illnesses

Bodily needs



Maintenance of health



Avoidance of danger



Avoidance of noxious things


Obsessive-compulsive disorder

Socio-sexual relations and

All basic





Intermittent explosive disorder


Social anxiety

Sexual disorders

Attachment disorders

Table 2.3 presents the goals of daily life, the basic emotions they elicit, including those with known objects, and the corresponding psychological illness.

The theory predicts that psychological illnesses originate in the acquisition of an unconscious transition from a cognitive evaluation to a basic emotion. Evidence corroborating this claim comes from brain-imaging studies, which show that the amygdala is active whenever events elicit the signs and symptoms of a psychological illness, and these organs are known to mediate basic emotions (for a review, see Johnson-Laird et al., 2006). Such studies continue to proliferate for all the major psychological illnesses (e.g., Fullana et al., 2017; He et al., 2019; McCloskey et al., 2016; Shackman et al., 2017).

A different sort of corroboration is illustrated in a small-scale epidemiological study (Johnson-Laird et al., 2006: Study 1). The participants were 24 Italian psychiatrists who had to consult their records for six or so of their most recent patients diagnosed as obsessive, agoraphobic, hypochondriac, or depressed. They then answered 15 questions about these patients, and the crucial ones, unbeknownst to the psychiatrists, were whether the patient remembered the onset of the illness and which of 11 words denoting emotions was the one that the patient had reported about this occasion. The psychiatrists could choose their own emotion word if it wasn’t on the list, but they seldom had to. Only 5 patients could not recall the onset of their illness, and of the 101 who could, the overwhelming majority (83 of them) referred to basic emotions as occurring at the onset of their illness, namely, in rank-order of their frequencies: anxiety, fear, sadness, anger, and disgust. Of the remainder, the main exception was that 12 patients reported guilt, a complex emotion. The theory treats it as a complex emotion, because it depends on a self-conscious assessment, and because it does not have an innate facial expression (see, e.g., Ekman, 1993). In fact, some patients reported feeling guilty without knowing why, so perhaps the emotion is a borderline case. The most important datum, however, is that the vast majority of the patients recalled the onset of their illnesses, and those who did always reported the emotions that they experienced. People do not succumb to these illnesses without emotions.

The evidence that individuals differ in their susceptibility to psychological illness rests in part on studies of twins. Comparisons of monozygotic and dizygotic twins have shown that tendencies both to anxiety and to depression are heritable (e.g., Jang et al., 1998). More recent genetic studies have corroborated the interaction between such innate factors and the environment in which individuals live (e.g., Guintivano and Kaminsky, 2016; Lin and Tsai, 2020; Pena and Nestler, 2018).

The theory predicts that individuals with psychological illnesses should become skilled in reasoning about matters concerning their illnesses. The initial evidence corroborating this prediction was based on a study, akin to the one described previously, in which individuals enumerated what was possible and what was impossible given an assertion. It examined patients with obsessive compulsions and non-clinical controls. The patients were more accurate than the controls in enumerating the possibilities of an assertion referring to guilt, but there was no reliable difference between the groups who assessed the possibilities for a neutral assertion or for one about depression. A similar study with depressed patients and non-clinical controls also showed that the patients were better at reasoning than the controls but only when the possibilities concerned depression (see study 3, Johnson-Laird et al., 2006).

A more recent study examined the syllogistic reasoning of depressed patients and matched non-clinical controls (Gangemi et al., 2013). The patients drew more valid conclusions from premises about depression (77%) than from neutral premises (37%), and this difference was larger than the analogous difference for the control participants (33% depressing conclusions and 43% neutral conclusions). Likewise, for syllogisms with no valid conclusions, the patients responded correctly ‘nothing follows’ more often for neutral than for depressing conclusions (56% versus 8% correct rejections), and this difference was reliably larger than the analogous difference for the control participants (7% versus 28% correct rejections). A subsequent study showed the same two interactions in a comparison between a group of patients at high risk of panic attacks and a group of non-clinical controls.

The groups of participants in these studies were matched for age, gender, and level of education, which is a reasonable proxy for intelligence. Hence, overall, the evidence is that individuals suffering from psychological illnesses do not reason any worse than those who do not have such illnesses, and that the patients tend to cope better than the controls with inferences pertinent to their illnesses. This conclusion is contrary to the claim that faulty reasoning underlies psychological illnesses (pace Beck, 1976). Alas, the better reasoning of patients could lead to the persistence of their illness by way of the positive feedback loop described earlier.

A final strand of evidence concerns the typical strategies of reasoning that patients with different psychological illnesses adopt. These strategies relate to the different way in which healthy individuals select evidence to test hypotheses. As we described earlier, an intuitive approach (system 1) seeks evidence that matches the content of a hypothesis - its effect, which may not be an individual’s conscious intention, is to seek its corroboration by selecting potential examples of it. For difficult tasks, such as a selection task with an abstract hypothesis, this approach is the most frequent. In contrast, a deliberative approach (system 2) seeks evidence that has the potential to falsify a hypothesis by selecting its potential counterexamples. Certain individuals tend to adopt this approach, and certain contents in the selection task, such as deontic ones, tend to elicit this search for counterexamples (see Ragni et al., 2018).

Initial studies of patients established different characteristic strategies in reasoning. Obsessive-compulsive patients tend to feel guilt: about a third of them reported the emotion at the onset of their illness, a greater proportion than for any other of the patients in the epidemiological study (see Johnson-Laird et al., 2006: Table 6). Indeed, those suffering from obsessive thoughts and compulsions tend to consider deontic matters, such as risk to others, and to reason in a deliberative way (system 2). They focus on an action that has a danger of contamination, and leads to feelings of anxiety, and thence to guilt because it could have harmed others. They deliberate about both examples of the risk and counterexamples to it, and they conclude that they have to act to minimize it.

In contrast, other sorts of psychological illness concern deontic matters much less often, and patients’characteristic strategies are intuitive (system 1). Hypochondriacs focus on a bodily sensation and infer that they are ill, which leads to an intense anxiety. They search for evidence matching this hypothesis, and they conclude that they have to go to a doctor. A diagnosis that nothing is wrong with them elicits a further search for evidence matching their hypothesis. And so they may make further visits to doctors. Phobic patients have an analogous intuitive strategy that leads them to evaluate a particular object or situation as a cause of fear. Safety dictates that they should avoid this potential cause. Likewise, depressed individuals infer that the initial loss that provoked their sadness can never be made good: they search for evidence that matches this hypothesis, and may idealize what was lost to make a substitute impossible.

Empirical studies showed that psychiatrists could identify these strategies even when they were described with different underlying contents (Johnson-Laird et al., 2006: Study 2). Their identifications were rapid, but they were unable to describe the cues on which they relied. Subsequent studies showed that patients themselves were able to identify their own characteristic strategies of reasoning (Gangemi et al., 2019). Obsessive patients identified protocols using their system 2 strategy of reasoning in protocols describing a different illness. They were more accurate than patients with anxiety disorders. And those suffering from various anxiety disorders were more accurate in identifying their system 1 strategy of reasoning than obsessive patients were. Independent evidence also corroborates these strategic differences (e.g., Vroling and de Jong, 2009).

4.2 Prognosis for psychological illnesses

Individuals suffering from psychological illnesses report recovering spontaneously (e.g., Sutherland, 2010). But what seems impossible is that they can do so as a result of a simple decision: emotions are not under intentional control. The hyperemotion theory implies that gradual exposure to the object or situation causing excessive anxiety should be useful. Over time, individuals should habituate and the emotion should wane (see, e.g., Vinograd and Craske, 2020). The therapy works for phobias and obsessive compulsions, and it is effective for hypochondria when patients see images and documentaries about diseases (Week et al., 2015).

Various sort of cognitive therapy are also helpful treatments for psychological illnesses (Cuijpers et al., 2016). No empirical studies have shown that other sorts of psychotherapy or psychoanalysis are more effective (David et al., 2018). But, as these authors point out, it does not follow that it is the best possible therapy. Music has been used in psychotherapy for many years (e.g., Capurso et al., 1952), and a meta-analysis of studies shows that it can alleviate depression (Aalbers et al., 2017). It is improbable that music alone can cure psychological illnesses. But one problem in assessing psychotherapies is that any sort of personal intervention may induce a Hawthorne effect: the mere fact that a therapist is trying to cure an individual may foster a beneficial ‘transference’ or a positive outcome.

To discover a better treatment for psychological illnesses, clinicians may need a better understanding of what has gone wrong in patients’ mental life. Cognitive therapies rest on the assumption that patients make faulty inferences and hold irrational beliefs. As this chapter has laboured to show, their reasoning is as good as that of control participants, and better about the topics of their illnesses. Some patients do have false beliefs, but not all do. Consider the case of an electrician who came to work in the author’s apartment. He arrived at the front door panting for breath, because he had walked up 12 flights of stairs. He couldn’t use the elevator for fear of a panic. (His sympathetic boss excluded him from jobs on higher floors.) His problem had started when he got into an elevator and for no apparent reason felt very frightened. It is not an irrational emotion, because people do get stuck in elevators. But his fear was so strong that he’d had to get out of the elevator at once. He said: “I don’t know why being in an elevator is so scary, other than the fear of losing control of myself”. As far as one can tell, he holds no irrational beliefs about elevators or self-control, because he might panic in an elevator. His main inference was to avoid getting into them - a sensible precaution. Such a case illustrates a serious empirical problem: the lack of evidence about the cognitions of people at the onset of their illnesses. Our small-scale epidemiological study suggests that most patients recall the first episode of their illness and the emotion that they felt. They may know nothing else beyond the object or cause of their emotion. Suppose that a large-scale study corroborates these findings. It follows that psychological illnesses are self-perpetuating hyperemotions. The illnesses are disorders of emotions. They should be the target of more effective therapies.

5 Conclusions

The hyper-emotion theory boils down to three principles.

  • 1 Hyper-emotions: Psychological illnesses are emotional disorders in vulnerable individuals, and their origin is a basic emotion appropriate to the situation but aberrant in its intensity. These emotions continue to occur throughout the illness, and patients cannot control them.
  • 2 Basic emotions: The taxonomy of psychological illnesses goes back to the situations that evoke basic emotions in everyday life - happiness, sadness, anger, anxiety. They can be triggered by rudimentary models of emotional behaviours as in the case of music. Other basic emotions with known objects also underlie illnesses, e.g., disgust and hatred, and patients’ reasoning can elicit complex emotions such as guilt.
  • 3 Reasoning: Uncontrollable emotions are the focus of patients’ thoughts. They think about their causes, and, as a result, they become skilful in reasoning about their illness, adopting either the intuitive strategy of system 1 or the deliberative strategy of system 2 depending on its nature. Their reasoning maintains their illness.

The theme of the present book is what the reasoning of individuals suffering from a mental pathology teaches psychologists about human reasoning. It yields two principal lessons. First, psychological illnesses show that normal processes of reasoning still occur. It is business as usual. Second, they reinforce the point that emotions, which are endemic in psychological illnesses, can improve reasoning - they can lead people to deliberate, to think of possibilities that would not otherwise occur to them, and to reach valid conclusions that they would not otherwise infer.


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