Abstract
Conflicting accounts of thought insertion share the assumption of realism: that the subject of thought insertion has a thought that corresponds to the description of her thought insertion episode. I argue against realism on the grounds that we should adopt a fictionalist, anti-realist interpretation of first-person thought insertion discourse. I then offer an anti-realist account of thought insertion, according to which sufferers merely simulate having a thought with certain properties. This alternative forces us to reconsider whether cognitive explanations of schizophrenia symptoms must be intelligible, and provides for a novel view of delusion.