In recent years, there has been much focus on the apparent heterogeneity of schizophrenic symptoms. By contrast, this article proposes a unifying account emphasizing basic abnormalities of consciousness that underlie and also antecede a disparate assortment of signs and symptoms. Schizophrenia, we argue, is fundamentally a self-disorder or ipseity disturbance that is characterized by complementary distortions of the act of awareness: hyperreflexivity and diminished self-affection. Hyperreflexivity refers to forms of exaggerated self-consciousness in which aspects of oneself are experienced as akin (...) to external objects. Diminished self-affection or self-presence refers to a weakened sense of existing as a vital and self-coinciding source of awareness and action. This article integrates recent psychiatric research and European phenomenological psychiatry with some current work in cognitive science and phenomenological philosophy. After introducing the phenomenological approach along with a theoretical account of normal consciousness and self-awareness, we turn to a variety of schizophrenic syndromes. We examine positive, then negative, and finally disorganization symptoms—attempting in each case to illuminate shared distortions of consciousness and the sense of self. We conclude by discussing the possible relevance of this approach for identifying early schizophrenic symptoms. (shrink)

Schizophrenia involves profound but enigmatic disturbances of affective or emotional life. The affective responses as well as expression of many patients in the schizophrenia spectrum can seem odd, incongruent, inadequate, or otherwise off-the-mark. Such patients are, in fact, often described in rather contradictory terms: as being prone both to exaggerated and to diminished levels of emotional or affective response. According to Ernst Kretschmer, they actually tend to have both kinds of experience at the same time. This paper attempts to explain (...) what might be termed this 'Kretschmerian paradox'. Some relevant concepts and vocabulary for affect and emotion are discussed . The need for a phenomenological approach focusing on subjective experience is suggested. Three modes of abnormal experience in schizophrenia are investigated in light of their implications for affect or emotion: alienation of the lived body ; fragmented perception and loss of affordances ; and preoccupation with a quasi-delusional world created by the self. (shrink)

This paper offers a phenomenological or hermeneutic reading—employing Heidegger's notion of the 'ontological difference'—of certain central aspects of schizophrenic experience. The main focus is on signs and symptoms that have traditionally been taken to indicate either 'poor reality-testing' or else 'poverty of content of speech' (defined in the Diagnostic and Statistical Manual of Mental Disorders III-R as: “speech that is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotyped or obscure phrases"). I argue (...) that, at least in some cases, the tendency to attribute these signs of illness to the schizophrenic patient results from a failure to recognize that such patients—as part of a quasi-solipsistic orientation and alienation from more normal, pragmatic concerns—may be grappling with issues of what Heidegger would call an ontological rather than an ontic type, issues concerned not with entities but with Being (i.e. not with objects in the world but with the overall status of the world itself). An application of the Heideggerian concept of the ontological difference has the potential to alter one's sense of the lived-worlds of such patients, of what they may be attempting to communicate, and of why communication with them so often breaks down. (shrink)

This paper uses certain of Michel Foucault's ideas concerning modern consciousness (from The Order of Things) to illuminate a central paradox of the schizophrenic condition: a strange oscillation, or even coexistence, between two opposite experiences of the self: between the loss or fragmentation of self and its apotheosis in moments of solipsistic grandeur. Many schizophrenic patients lose their sense of integrated and active intentionality; even their most intimate thoughts and inclinations may be experienced as emanating from, or under the control (...) of, some external being or mysterious foreign soul (‘I feel it is not me who is thinking’; ‘I have been programmed’). Yet the same patients may also experience the self as preeminent, all-powerful or all-knowing (‘My thoughts can influence things’; ‘This event happens because I think it'). Here one may feel confronted with the very paradigm of irrationality: profound contradictions suggesting regression to primitive ‘primary-process’ thinking or utter collapse of the higher faculties of mind. I argue, however, that these dualities so basic to schizophrenia can best be understood very differently: as consequences of a kind of alienation and hyper-self-consciousness (‘hyper- reflexivity') that is closely analogous to what occurs in the post-Kantian era of Western intellectual history. The parallel dualities of modern thought have been most extensively discussed by Foucault, who describes paradoxes, tensions and other dilemmas central to what he calls the modern ‘episteme'; these result from what Foucault sees as the modern human being's introverted and ultimately self-deceiving preoccupation with, and overvaluing of, the phenomenon of his own consciousness. Parallels between these contradictions and those characteristic of several withdrawn schizophrenic individuals are described and analysed. The paper concludes with an Afterword in which some possible neurobiological underpinnings of these schizophrenic experiences are discussed. (shrink)

The life of Saint Teresa of Jesus, the most famous mystic of sixteenth-century Spain, was characterized by recurrent visions and states of ecstasy. In this paper, we examine social components related to Teresa’s personal crises and the historical conditions of her times, factors that must be taken into account to understand these unusual forms of experience and behavior. Many of these factors (e.g., increasing individualism and reflexivity) are precursors of the condition of modern times. Indeed, certain parallels can be observed (...) between Saint Teresa and certain present-day psychopathological disorders. The analogy should not, however, be carried too far. Religion played a particularly crucial role in Teresa’s cultural context; as a result, it would be misleading to view her mystical experiences as resulting from a mental disorder. (shrink)

This paper offers an intellectual portrait of the French psychoanalyst, Jacques Lacan, by considering his incorporation of perspectives associated with “modernism,” the artistic and intellectual avant-garde of the first half of the twentieth century. These perspectives are largely absent in other alternatives in psychology, psychiatry, and psychoanalysis. Emphasis is placed on Lacan’s affinities with phenomenology, a tradition he criticized and to which he is often seen as opposed. Two general issues are discussed. The first is Lacan’s unparalleled appreciation of the (...) paradoxical nature of human experience, together with his treatment of paradox as almost a criterion of truth. These points are illustrated by considering Lacan’s conceptions of the self and of erotic desire. The second issue is Lacan’s focus on the “ontological dimension,” on overall styles or modalities of what might be termed “transcendental subjectivity”: namely, what he calls the registers of the “Imaginary,” the “Symbolic,” and the “Real.” By emphasizing the incommensurable yet interdependent nature of these modalities, Lacan offers a synthesis of dynamic/conflictual and formal/ontological dimensions of the human condition. This paper offers an encompassing portrait of Lacan’s major ideas that is at odds with the widespread assumption that Lacan is somehow a deeply anti-humanist thinker who derides the subjective dimension. Lacan’s most distinctive contributions are fundamentally concerned with the nature of human experience. They show strong affinities with hermeneutic forms of phenomenology inspired by Heidegger, a philosopher who focused on ontological modes of Being and considered paradox as a mark of truth. (shrink)

This paper offers a critique of a central psychopathological concept, the notion of "poor reality-testing. "Using ideas from the philosopher Ludwig Wittgenstein, I consider the nature of delusions in schizophrenia, largely through examining Daniel Paul Schreber's famous Memoirs of My Nervous Illness. Many schizophrenic individuals do not in fact mistake their fantasies for reality, as is traditionally assumed. Rather, I argue, they engage in a solipsistic mode of experience, a felt subjectivization of the lived world that is associated with a (...) stance of passivity and hyperconsciousness. I discuss the existential conditions and consequences of this stance and show that certain anomalous or paradoxical features of schizophrenic delusion are explicable on this phenomenological account. (shrink)

Impairments in cognitive coordination in schizophrenia are supported by phenomenological data that suggest deficits in the processing of visual context. Although the target article is sympathetic to such a phenomenological perspective, we argue that the relevance of phenomenological data for a wider understanding of consciousness in schizophrenia is not sufficiently addressed by the authors.

It is a Pleasure to comment on Somogy Varga’s intriguing paper, which offers welcome insight into the historical sources, changing uses, and underlying assumptions pertaining to the concept of ‘melancholia,’ especially in relationship to ‘depression.’ We found Varga’s discussion of the relationship between affect and cognition in past discussions of melancholia and depression to be illuminating, especially given the emphasis on cognitive distortions in contemporary psycho-pathology. His explanation of the gradual evolution of the depression concept from melancholia sheds interesting light (...) on current notions. All in all, we find Varga’s arguments persuasive, and are inclined to agree with him (and others whom he .. (shrink)

In "Delusion, Reality, and Intersubjectivity," Thomas Fuchs offers a superb presentation of an enactive/phenomenological approach to schizophrenic delusions—an approach that is clearly superior to the poor-reality-testing formula that has dominated thinking about delusion in psychiatry, psychoanalysis, and cognitive-behavioral theory. As he convincingly argues, two key tendencies go a long way toward accounting for the distinctive features of delusion in schizophrenia: 1) withdrawal from practical, sensori-motoric interaction with the physical environment; and 2) failure to experience reality in intersubjective terms—as a realm (...) of "participatory... (shrink)

This study in comparative phenomenology offers a description of the lived-world of the Stimmung, an experience especially characteristic of early stages of schizophrenia. In this state, the patient will stare transfixed at an alienated perceptual world that may have one or more of several anomalous characteristics. The world may seem strangely unreal; objects may seem fragmented, or devoid of standard pragmatic meanings and manifesting instead their sheer existence; or objects and events may seem imbued with a tantalizing but ineffable quality (...) of significance. Like many schizophreniform symptoms, the Stimmung has often been considered to be radically alien, beyond the pale of an empathic comprehension. The nature of these symptoms and their role in the overall development of schizophreniform illnesses is discussed, largely through examining the experiences of “Renee,” author of the Autobiography of a Schizophrenic Girl. Certain closely analogous phenomena from the culture of early modernism are then considered— focussing primarily on works by Hugo von Hoffmansthal, a turn-of-the-century Austrian writer. The possibility of a detailed phenomenological description, as well as the existence of such close modernist parallels, would seem to contradict the widely held view that such symptoms are incomprehensible. (shrink)

The present paper offers a sympathetic yet critical examination of Michel Foucault's discussion of the contradictions inherent in the self-consciousness of the modern or post-Kantian mind. Foucault's account of the “empirico-transcendental doublet” of modern thought is shown to provide a useful mapping of humanist, anti-humanist, and postmodern responses to the reflexivity of the modern “ episteme”. Foucault is criticized for his insufficiently critical treatment of structuralism . Foucault is also defended against the charge that he undermines his own position through (...) a form of performative self-contradiction. 2012 APA, all rights reserved). (shrink)

Reviews the books, Philosophical papers, volume I: Human agency and language by Charles Taylor and Philosophical papers, volume II: Philosophy and the human sciences by Charles Taylor. Professor Taylor of McGill University is one of a number of thinkers who are attempting the difficult and important task of taking the social sciences "beyond objectivism and relativism." One of the foremost philosophers of his generation, Taylor has long devoted himself to study of the foundations of the social sciences, especially psychology and (...) political science. Now the Cambridge University Press has issued, in a two-volume set, a selection of Taylor's essays written over the last twenty years. The essays cover a wide variety of topics. Some are focussed critiques—of mainstream cognitive psychology, of Piagetian developmental psychology, and of Michel Foucault's social studies of knowledge and power, for example. Others are historical studies which trace the development of theories of language and meaning from the Renaissance to the present day. Several essays discuss the nature of the self, and seek to show the incoherence of positions which fail to take into account the human capacity for self-consciousness, choice and responsibility. "Interpretation and the Sciences of Man," perhaps the best-known essay in the collection, is a closely argued demonstration of the irreducability of human meanings and the consequent necessity for a "hermeneutic" social science. Despite their historical range and disciplinary breadth, not to mention their casual familiarity with the Anglo-Saxon, French and German philosophical traditions, Taylor's essays form an organic, if sprawling whole. No psychologist interested in the epistemological foundations of his science should neglect these stimulating and cogent articles. 2012 APA, all rights reserved). (shrink)

This work begins by proposing the need for exploring the mode of being of mental disorders. It is a philosophical study in an Aristotelian perspective, with special emphasis on the anthropological–cultural dimension. It is difficult for such an inquiry to be carried out from within psychiatry or clinical psychology, committed as these fields are to their own logic and practical conditions. The issues are, in any case, more ontological than strictly clinical in nature. We therefore turn to Aristotle, and specifically (...) his doctrine of the four “causes,” to flesh out the social and cultural dimensions of mental disorders. In accordance with the present analysis, the material cause of disorders would be found in the contingencies of life; the formal cause would pertain primarily to the way clinical conditions themselves can serve as models of ‘being ill’ in our society; the efficient cause would correspond to the patients themselves, understood as active (albeit less than fully conscious) agents as well as to the pharmaceutical industry and the mass media; the final cause would be found in different adaptive functions served by the disorder. We conclude that the “mode of being” of most (if not all) mental disorders—in particular, their status as mental disorders—can often have more to do with cultural forms than with biological factors. (shrink)

This article considers the relationship between phenomenology and behaviorism in a new perspective. First, we present the phenomenological approach of the Spanish philosopher Ortega y Gasset (1883–1953). Ortega’s perspective involves a transformation of classical phenomenology in a direction that emphasizes ‘life as action’ and ‘historical reason’ as a form of explanation. These aspects of Ortega’s approach are of interest to contemporary phenomenology, and enable phenomenology’s relationship with behaviorism to be reconsidered. Second, we present Skinner’s radical behaviorism, the variant of behaviorism (...) most relevant to phenomenology. Of particular importance here is radical behaviorism’s emphasis on final causality and its approach to ‘private events’ in terms of the interpersonal functions served by these events. Third, we propose a mutual correction, both of behaviorism by phenomenology and of phenomenology by behaviorism, in which behaviorism’s notion of the environment may better be conceptualized through the phenomenological notion of the ‘lived-world,’ and phenomenology could adopt radical behaviorism’s dialectical and constructivist perspective. Finally, we discuss several implications for understanding psychopathology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Defending a Phenomenological–Behavioral Perspective: Culture, Behavior, and ExperienceMarino Pérez-Álvarez (bio), José M. García-Montes (bio), Adolfo J. Cangas (bio), and Louis A. Sass (bio)KeywordsBehavior, contextual phenomenology, culture, experienceWe should like to express our sincere thanks to all the authors for their commentaries on our articles. Given the restrictions of space (a limitation they too had to contend with), we can only respond to a few aspects of their (...) interesting remarks. We shall reply of course on the basis of our own approach—an approach that sets out to integrate culture, behavior, and experience, and that might be termed contextual phenomenology, phenomenological behaviorism, or perhaps most accurately (albeit more awkwardly), the phenomenological–behavioral perspective.In her commentary, Ibáñez-Guerra (2008), referring to the target articles “Phenomenology and behaviorism” (Pérez-Álvarez, Sass, and Cangas 2008) and “The role of superstition in psychopathology” (García-Montes et al. 2008), wonders whether our maintaining of the spirit of Skinner, as well as our recourse to phenomenology, might not themselves represent forms of superstitious behavior. She points out that it is not always a good idea to put new wine in old barrels. For her, the new wine and new barrels would be represented by social constructivism, of which she is reminded by some aspects of our work. But in making her own case, Ibáñez-Guerra (2008) reveals certain common prejudices concerning behaviorism, prejudices that have apparently persisted even after reading our article. Thus, for example, she does not see operant behavior as incorporating intentionality (what, in the target article, is presented in terms of final causality), because she assumes that intentionality would necessarily imply a mentalist and dualist notion involving a supposed internal mental entity that causes behavior. Skinner (1974) himself noted and rejected this very assumption in a passage that clearly distinguishes his own approach from what he calls a “stimulus-response formula”: “Possibly no charge,” he wrote,is more often leveled against behaviorism or a science of behavior than that it cannot deal with purpose or intention. A stimulus-response formula has no answer, but operant behavior is the very field of purpose and [End Page 281] intention. By its nature it is directed toward the future: a person acts in order that something will happen, and the order is temporal.(pp. 55–6)The place Skinner gives to intentionality and purpose is elaborated in our target article.Furthermore, Ibáñez-Guerra (2008) assumes that, on methodological grounds, Skinner rejects all that is not observable, or at least that cannot be operationalized. This, however, is simply incorrect, at least as regards Skinner’s radical behaviorism. As the reader may recall, radical (as opposed to methodological) behaviorism is neither operationalist nor does it reject private or subjective events because of their unobservability. Indeed, Skinner specifically acknowledges that such events are in fact observable—at least for one person: the subject him- or herself. The question for Skinner is to understand how the part of the world that is only observable and experiential for oneself is constructed or formed. In the end, it turns out that radical behaviorism is more radical, in the Aristotelian ontological sense (see Pérez-Alvarez, Sass, and García-Montes 2008), than post-modern constructionism. Indeed, as we remarked, radical behaviorism can still surprise us today. Similarly, phenomenology is starting to be missed in the clinical context (Andreasen 2007). We believe that radical behaviorism and phenomenology, mutually readjusted, are in fact excellent wines for the times we live in—if only we knew how to appreciate them.In their commentary on “Phenomenology and behaviorism: A mutual readjustment,” Fletcher and Hayes (2008) argue that the philosophy and theory of Acceptance and Commitment Therapy (ACT)/Relational Frame Theory (RFT) already contain the salutary aspects of phenomenology that we highlight in our target article. Their insistence on reducing the affinities we find between phenomenology and behaviorism to ACT/RFT consists, in our view, in a scientific–technical argument that is more scientistic than strictly philosophical in nature. Their insistence on the scientific–technical argument itself implies an unclarified philosophical assumption. On what grounds do experimental data constitute the last word? Has... (shrink)

This article attempts to show the importance of the concept of superstition in understanding a range of psychological problems. With this aim, we critically analyze several constructs that, without actually using the term “superstition,” concern this phenomenon and its role in the development of mental disorders. First we discuss “Thought–Action Fusion” and “magical thinking,” two concepts from the cognitive tradition that view superstition as basically an ideational phenomenon. Second, we look at “Experiential Avoidance,” a post-Skinnerian concept that understands superstition as (...) a type of avoidance behavior for certain private events. Third, we discuss superstition as an emotional phenomenon, in particular, Jean-Paul Sartre’s phenomenological analysis of emotions as magical operations. Finally, we review a cultural approach to superstition and its influence on psychopathology. In this perspective, superstition is seen as a cultural form linked to the historical–social context, which is fostered by certain social practices or institutions, including (perhaps surprisingly) certain features of modernity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of (...) delusion has been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

This article presents an introductory overview of the interpretations of schizophrenia offered by three phenomenological psychiatrists: Eugene Minkowski (1885-1972), Wolfgang Blankenburg (b. 1928), and Kimura Bin (b. 1931). Minkowski views schizophrenia as characterized by a diminished sense of dynamic and vital connection to the world ("loss of vital contact"), often accompanied by a hypertrophy of intellectual and static tendencies ("morbid rationalism," "morbid geometrism"). Blankenburg emphasizes the patient's loss of the normal sense of obviousness or "natural self-evidence"—a loss of the usual (...) common-sense background that enables normal persons to cope easily with the social and practical world. Kimura focuses on certain distortions of self-experience: a distinctive splitting of the subjective self, alienated awareness of one's own ongoing consciousness, and profound uncertainty about the "I-ness" of the self. In addition to a summary, this article offers a comparison and critique of these three approaches. The three approaches are also considered in light of a more recent, phenomenological formulation of schizophrenia as a disorder of self-experience (an ipseity disturbance) involving hyperreflexivity and diminished self-affection (i.e., heightened awareness of aspects of experience that would normally remain tacit or presupposed and decline in the feeling of existing as a subject of awareness). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 125-132 [Access article in PDF] Incomprehensibility and Understanding:On the Interpretation of Severe Mental Illness Louis A. Sass Keywords hermeneutics, psychopathology, paradox, Wittgenstein, solipsism, delusion, principle of charity, phenomenological psychopathology. I would like to begin by thanking Rupert Read for the care he has put into reading my work, and into thinking through its implications in the context of the "new-Wittgensteinian" interpretation (...) of the thought of Ludwig Wittgenstein. This interpretation derives from an influential reading of this philosopher's early book, the Tractatus Logico-Philosophicus (1961), that is not explicitly discussed in Read's article, yet that lies behind much of his argument. Read does allude to this reading of the Tractatus when he refers to the concept of "logically alien thought" (see Conant [1992]), and by citing, in his endnotes, the Diamond, Conant, and Cerbone articles that appear in Crary and Read's edited collection, The New Wittgenstein (2000). In an earlier paper that also addresses my work, "On approaching schizophrenia through Wittgenstein," Read (2001) explicitly discusses the relevance of the new-Wittgensteinian interpretation of the Tractatus.According to this new-Wittgensteinian interpretation of the Tractatus, Wittgenstein took absolutely seriously his own realization (explicitly stated at the end of the Tractatus) that his book was internally self-contradictory, and he therefore realized that all or nearly all the sentences of the Tractatus must be totally devoid of any meaning or semantic reference. According to this austere view, the vast bulk of the Tractatus only pretends to be making meaningful statements about the nature of logic and semantics; its real purpose is to give the reader the illusion of meaning, and this it does in order to lead the reader to the eventual realization that there can in fact be no meaningful statements or thoughts at the level of self-referential abstraction at which the Tractatus pretends to be operating. Further, when Wittgenstein (1961) writes (in the famous last line of the book), "Whereof one cannot speak, thereof one must be silent" (p. 189), this statement should, supposedly, not be taken as any kind of mystical pointing toward some ineffable realm or truth, but, rather, as an austere recognition that there just are no ineffable truths—that, so to speak, there just is no mystical there there. [End Page 125]Rupert Read sees an analogy between, on the one hand, the (supposedly mistaken) readers of Wittgenstein's Tractatus who think that Wittgenstein is exploiting self-contradiction to allude to some higher, ineffable truth (i.e., something that can be pointed at even if it cannot be said), and, on the other hand, my own elucidation of Schreber's contradictions (see especially Chapter 2 of Paradoxes of Delusion [1994]) to argue that Schreber can be said to be having particular kinds of experiences, which I refer to as solipsistic or quasi-solipsistic in nature. Just as Wittgenstein's self-contradictions can (supposedly) point nowhere other than to their own failure to mean, so Schreber's self-contradictory and other nonstandard statements cannot (according to Read) be used to illuminate in any meaningful way the form of experience that supposedly lies behind them—as I, for example, have tried to do by offering a phenomenological account of Schreber and schizophrenia. Patients like Schreber and Renée cannot really be understood, just as we cannot really understand logically alien thought—which, in fact, is not really thought at all; in both cases, there is only the illusion of meaning, only the mirage of an alternative mode of thinking or of living. This, at least, is Read's new-Wittgensteinian claim.Few readers of Philosophy, Psychiatry, & Psychology will, I suspect, be familiar with these discussions centering on Wittgenstein's Tractatus, which were introduced largely by the philosophers Cora Diamond and James Conant (see Crary and Read [2000]). (I myself have found their writings fascinating and inspiring in many ways, despite my ultimate disagreement on fundamental issues.) 1 Most readers of Philosophy, Psychiatry, & Psychology will have no way of assessing the validity of this austere reading of the Tractatus... (shrink)

Madness and Modernism provides a phenomenological study of schizophrenic disorders, criticizing some standard conceptions of these disorders. Sass argues that many aspects of this group of disorders can actually involve more sophisticated (albeit dysfunctional) forms of mind and experience.

The phenomenological approach to schizophrenia has undergone something of a renaissance in Anglophone psychiatry in recent years. There has been a proliferation of works that focus on the nature of subjectivity in schizophrenia and related disorders, and that take inspiration from the work of such German and French philosophers as Husserl, Heidegger, and Merleau-Ponty, and such classical psychiatrists as Minkowski, Blankenburg, and Binswanger (Rulf 2003; Sass 2001a, 2001b). This trend includes predominantly theoretical articles, which typically incorporate clinical material as (...) well as reviews of empirical and experimental findings in psychopathology. Some very recent examples (since 2000) are studies of .. (shrink)

Various forms of anomalous self-experience can be seen as central to schizophrenia and other psychiatric disorders. We examined similarities and differences between anomalous self-experiences common in schizophrenia-spectrum disorders, as listed in the EASE , and those described in published accounts of severe depersonalization. Our aims were to consider anomalous self-experience in schizophrenia in a comparative context, to refine and enlarge upon existing descriptions of experiential disturbances in depersonalization, and to explore hypotheses concerning a possible core process in schizophrenia . Numerous (...) affinities between depersonalization and schizophrenia-spectrum experience were found: these demonstrate that rather pure forms of diminished self-affection can involve many experiences that resemble those of schizophrenia. Important discrepancies also emerged, suggesting that more automatic or deficiency-like factors—probably involving self/world or self/other confusion and erosion of first-person perspective—are more distinctive of schizophrenia-spectrum disorders. (shrink)

This paper offers a comparative study of abnormalities in the experience of space, time, and general atmosphere in three psychiatric conditions: schizophrenia, melancholia, and mania. It is a companion piece to our previous article entitled 'Varieties of Self- Experience'; here we focus on experiences of the world rather than of the self. As before, we are especially interested in similarities but also in some subtle distinctions in the forms of subjectivity associated with these three conditions. As before, we survey phenomenologicallyoriented (...) clinical and theoretical accounts as well as patient reports. Experiences involving forms of alienation from the practical and social world and a sense of uncanniness seem to be common in both schizophrenia and affective disorders. But despite some significant similarities, changes in schizophrenic subjectivity appear to be more pervasive and profound, involving experiences of fragmentation, meaninglessess, and ineffable strangeness that are rare or absent in the affective disorders. (shrink)

This paper provides a critical survey of some subtle and often overlooked disturbances of self-experience that can occur in schizophrenia, melancholia, and mania. The goal is to better understand both similarities and differences between these conditions. We present classical and contemporary studies, mostly from the phenomenological tradition, and illustrate these with patient reports. Experiential changes in five domains of selfhood are considered: Cognition, Self-Awareness, Bodily Experiences, Demarcation/Transitivism, and Existential Reorientation. We discuss: I. major differences involving self-experience between schizophrenia and affective (...) disorders; II. experiences in which these conditions nevertheless resemble each other; III. suggestions on how these experiences may still differ on a more subtle, phenomenological plane. While affective patients may undergo significant changes in self-experience, their underlying sense of basic or minimal selfhood remains intact. In schizophrenia, basic self is disturbed, and this may help to account for many characteristic disturbances of this disorder. (shrink)

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global (...) reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. (shrink)

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (shrink)

Phenomenological psychiatry has suffered from a failure to translate its insights into terms specific enough to be applied to psychiatric diagnosis or to be used in contemporary research programs. This difficulty can be understood in light of the well-known tradeoff between reliability and validity. We argue, however, that with sufficient ingenuity, phenomenological concepts can be adapted and applied in a research context. Elsewhere, we have described a phenomenologically oriented conception of schizophrenia as a self- or ipseity-disorder with two main facets: (...) decline in the sense of existing as a subject of awareness (diminished self-affection) and heightened awareness of aspects of experience that would normally remain tacit or presupposed (hyperreflexivity). This approach is consistent with Minkowski, Blankenburg, and Kimura and offers one possible synthesis of their views. Here we describe two areas of empirical research that are congruent with, or actually inspired by, a phenomenological approach emphasizing such disorders of consciousness and self-experience: (1) Phenomenologically oriented, interview studies show that, whereas negative-symptom patients generally deny any diminishment of affect and thinking, they do describe qualitative alterations of experience suggestive of hyperreflexivity and diminished self-affection. (2) Another line of research suggests that the early detection of schizophrenic symptoms may be enhanced by adopting a phenomenological approach. (shrink)

This paper outlines several of the challenges that are inherent in any attempt to communicate subjective experience to others, particularly in the context of a clinical interview. It presents the phenomenological interview as a way of effectively responding to these challenges, which may be especially important when attempting to understand the profound experiential transformations that take place in schizophrenia. Features of language experience in schizophrenia—including changes in interpersonal orientation, a sense of the arbitrariness of language, and a desire for faithful (...) communication of experience —are described, together with discussion of their relevance for the interview context. Furthermore, the interview presents a unique context in which both intersubjective and interpersonal aspects of experience will be described as well as evoked. It is proposed that phenomenological interviewers should not only be familiar with these and other experiences that can occur in schizophrenia, but also capable of applying the techniques of phenomenological and hermeneutic methods in order to understand the descriptions of interviewees with sensitivity and accuracy. (shrink)

This paper considers contradictory features of emotional or affective experience and expression in schizophrenia in light of the “Kretschmerian paradox”—the fact that schizophrenia-spectrum patients can simultaneously experience both exaggerated and diminished levels of affective response. An attempt is made to explain the paradox and explore its implications. Recent research on emotion in schizophrenia is reviewed, including subjective reports, psychophysiological measures of arousal or activation, and behavioural measures, focusing on flat-affect and negative-symptom patients. After discussing relevant concepts and vocabulary of emotion (...) (“affect”, “emotion”, “mood”, “feelings”, the “passions”), the need for a phenomenological approach focusing on subjective experience is proposed. Four modes of nonparanoid experience in schizophrenia are discussed: Bodily Alienation, Disengagement, Unworlding, and Subjectivisation. Each mode involves withdrawal from functional contexts—temporal, practical, and interpersonal—normally associated with emotional reactivity and expression; each may be accompanied by forms of non-emotional affectivity no less intense than the emotions they replace. Possible relationships between psychophysiological measures, expressive behaviour, and subjective emotional or affective response are considered. (shrink)

This essay argues for the necessity of a phenomenological perspective on mind and mental disorder while also emphasizing the inherent difficulty of adopting such an orientation. Here I adopt a via negativa approach—by considering three forms of error that the phenomenologists Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty recognize as needing to be guarded against, lest they subvert the project of attaining an adequate understanding of consciousness or subjectivity: namely (1) prejudices deriving from theory and common sense, (2) distorting effects (...) of reflection, and (3) what Heidegger termed the forgetting of the ontological difference. Phenomenology insists on the importance of studying subjective life while also acknowledging the epistemological paradoxes inherent to this domain—a domain whose very self-evidence is inseparable from mystery, whose visibility conceals a deeper invisibility. I consider these issues in light of phenomenology’s relevance for certain issues in psychopathology and literary representation. (shrink)

This paper offers a comparative investigation of anomalous self-experiences common in schizophrenia instrument) and those of normal individuals in an intensely introspective orientation. The latter represent a relatively pure manifestation of certain forms of exaggerated self-consciousness, one facet of the disturbance of core- or minimal-self postulated as central in schizophrenia. Significant similarities with schizophrenia-like experience were found but important differences also emerged. Affinities included feelings of passivity, fading of self or world, and alienation from thoughts, feelings, or lived-body. Differences involved (...) confusion between self and world and severe dislocation or erosion of first-person perspective, qualities unique to schizophrenia. The purpose is threefold: 1, place the putatively schizophrenic experiences of self-disorder in a broader, comparative context; 2, evaluate hypotheses concerning core processes in schizophrenia; 3, orient investigation of possible pathogenetic pathways as well as psychotherapeutic interventions. (shrink)

French thought in the twentieth century is typically described as marked by a major fault line, a rupture or grande coupure, that emerged in the 1960s, the heyday of the ‘crisis of the subject.’ Before this time French philosophy, together with associated fields, were focused on issues of subjectivity—first in the vein of Bergsonian vitalism but then shifting, with Sartre and Merleau-Ponty in the late 1930s and 1940s, to forms of phenomenology and existentialism inspired first by Husserl and then, even (...) more decisively, by Heidegger.1 But starting mid-century, developments in the ‘human sciences’ of linguistics, anthropology, and psychoanalysis began to offer a different.. (shrink)

In this response to Wiggins and Schwartz, Ratcliffe, and Stanghellini, we first wish to express our gratitude to Philosophy, Psychiatry, and Psychology for providing us the space to clarify our views and to overcome certain misunderstandings. Ratcliffe notes that our critique is "harsh," whereas Wiggins and Schwartz lament the fact that the debate "has taken the form of sometimes acid formulations and rejoinders . . . that lack the tone of mutual appreciation" (2011, 31). We deplore the fact that this (...) exchange was at all necessary, and we share Wiggins and Schwartz's concerns. However, we need to recall here and emphasize that our article originated as a response. It originated as a response to an article that was .. (shrink)

French thought no longer enjoys the kind of prominence in the Anglophone world that it did in most of the last half of the twentieth century, a time when Sartre and Camus, then Lévi-Strauss, Foucault, and Derrida exercised a decisive influence on innovative work in literary and cultural theory, the human and social sciences, and on social thought more generally. It would be a mistake, however, to exaggerate the degree to which this represents either a decline in the actual influence (...) of twentieth century French thinkers or an enervation of contemporary theorizing in France. Derridean deconstruction and Foucauldian power/knowledge analyses have, for.. (shrink)

Understanding alterations of selfhood (termed self-disorders or self-disturbances) that are considered typical of the schizophrenia-spectrum is a central focus of phenomenological research. The currently most influential way of phenomenologically conceiving self-disorders in schizophrenia is as disorders of the so-called most basic or “minimal self”. In this paper, we first highlight some challenges for the minimal self-view of self-disorders, focusing on (1) problems arising from the supposedly “essential” or “universal” nature of minimal self with respect to phenomenal awareness and (2) the (...) critical implications of alterations of self-experience in schizophrenia that involve heightened or exaggerated sense of self. In the second part, we tentatively explore how a (non-egological) transparency-view of consciousness may offer an alternative way of understanding the experiential abnormalities involved in self-disorders in schizophrenia. We discuss how such a transparency-view (1) may account for loss-of-self experiences; (2) is compatible with the key notion of “hyper-reflexivity”; and (3) can help explain instances of self-disorder involving increased sense of self. In conclusion, we consider some possible advantages of this alternative view for research on self-disorders and clinical approaches. (shrink)