Skip to main content
SpringerLink
Log in

The phenomenology of hypo- and hyperreality in psychopathology

  • Published:
Phenomenology and the Cognitive Sciences Aims and scope Submit manuscript

Abstract

Contemporary perspectives on delusions offer valuable neuropsychiatric, psychoanalytic, and philosophical explanations of the formation and persistence of delusional phenomena. However, two problems arise. Firstly, these different perspectives offer us an explanation “from the outside”. They pay little attention to the actual personal experiences, and implicitly assume their incomprehensibility. This implicates a questionable validity. Secondly, these perspectives fail to account for two complex phenomena that are inherent to certain delusions, namely double book-keeping and the primary delusional experience. The purpose of this article is to address both problems, by offering an understanding “from the inside”. Our phenomenological approach is a form of “radical empathy”, and crosses the Jaspersian limits of understanding. It compares delusional experiences with variations of reality experience in everyday life, and makes use of the structure of imagination. Six factors influencing the experience of reality are discussed and illustrated by clinical and non-clinical examples. These factors are: continuity (1), materiality and resistance (2), multiplicity of sensations and perceptions (3), intensity (4), the sense of authorship (5), and the complex role of intersubjectivity (6). I suggest that experiences of hypo- and hyperreality are not restricted to pathology, but have their place in everyday life as well. Delusional phenomena can be better understood by investigating the interplay of these six factors. With this framework, the two complex phenomena consequently prove to be better understandable to us. Our approach remains within the phenomenal experience and might thereby contribute to the validity of psychopathology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. The primary delusional experience is discussed differently by other authors. Hemmo Müller-Suur (1950) characterized the experience by the “certain uncertainty”, while Klaus Conrad (1958, 83–87) described the delusional mood as part of the “trema”, preceding the apophantic phase of the delusion proper.

  2. Stanghellini’s (2013) ‘second order empathy’, and Henriksen’s (2013) notion of ‘philosophical understanding’ are similar attempts to extend our understanding of schizophrenic phenomena.

  3. This does not mean that in everyday experience, we always perceive with all sensational modalities at once. There are certainly times when we only hear, only see, or only feel someone or something that we nevertheless hold to be real. We could indeed speak of “perceptual faith” (Merleau-Ponty 2005). See factor 6 and the discussion on the interplay of these factors for further elaboration.

  4. Another reason for the hyporeality of certain hallucinations could be the disfunctioning of Victor Von Weizsäcker’s “Gestaltkreis” (1950) that continuously couples actions and perceptions. This ‘Gestaltkreis’ is thus more than the sum of a variety of perceptions and the possibility of acting on a materiality that offers resistance. This is not counted as one of the factors, as we try to stick to the phenomenal experience itself without imposing too much theory to it.

References

  • Aggernaes, A. (1972). The experienced reality of hallucinations and other psychological phenomena. An empirical analysis. Acta Psychiatrica Scandinavica, 48(3), 220–238.

    Article  Google Scholar 

  • American Psychiatric Assocation. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Assocation.

    Google Scholar 

  • Bayne, T., & Pacherie, E. (2004). Bottom-up or top-down: Campbell’s rationalist account of monothematic delusions. Philosophy, Psychiatry, & Psychology, 11(1), 1–11.

    Article  Google Scholar 

  • Blankenburg, W. (1991). Wahn und Perspektivität. Störungen im Realitätsbezug des Menschen und ihre Therapie. Stuttgart: Ferdinand Enke Verlag.

    Google Scholar 

  • Bleuler, E. (1955). Lehrbuch der Psychiatrie (9th ed). Berlin: Springer Verlag.

  • Bortolotti, L. (2010). Delusions and other irrational beliefs. Oxford: Oxford University Press.

    Google Scholar 

  • Bortolotti, L. (2011). Psychiatric classification and diagnosis: delusions and confabulations. Paradigmi, XXXIX(1), 99–112.

    Google Scholar 

  • Campbell, J. (2001). Rationality, meaning, and the analysis of delusion. Philosophy, Psychiatry, & Psychology, 8(2/3), 89–100.

    Article  Google Scholar 

  • Coltheart, M., Langdon, R., & McKay, R. (2011). Delusional belief. Annual Review of Psychology, 62, 271–298.

    Article  Google Scholar 

  • Conrad, K. (1958). Die beginnende Schizophernia. Versuch einer Gestaltanalyse des Wahns. Stuttgart: Thieme.

    Google Scholar 

  • Davies, M., Coltheart, M., Langdon, R., & Breen, N. (2002). Monothematic delusions: towards a two-factor account. Philosophy, Psychiatry, & Psychology, 8(2/3), 133–158.

    Google Scholar 

  • De Haan, S., & Fuchs, T. (2010). The ghost in the machine: disembodiment in schizophrenia–two case studies. Psychopathology, 43(5), 327–333.

    Article  Google Scholar 

  • Farkas, K. (2014). A sense of reality. In F. MacPherson & D. Platchias (Eds.), Hallucinations (pp. 399–417). Cambridge: MIT Press.

    Google Scholar 

  • Fink, E. (1966). Studien zur Phänomenologie. 1930–1939. Den Haag: Martinus Nijhoff.

    Book  Google Scholar 

  • Fuchs, T. (2010). Phenomenology and psychopathology. In S. Gallagher & D. Schmicking (Eds.), Handbook of phenomenology and the cognitive sciences (pp. 547–573). Dordrecht: Springer.

    Google Scholar 

  • Fuchs, T. (2013). The self in schizophrenia: Jaspers, Schneider, and beyond. In G. Stanghellini & T. Fuchs (Eds.), One century of Karl Jaspers’ general psychopathology (pp. 245–257). Oxford: Oxford University Press.

    Chapter  Google Scholar 

  • Fuchs, T. (2014). Brain mythologies. Jaspers’ critique of reductionism from a current perspective. In T. Fuchs, T. Breyer, & C. Mundt (Eds.), Karl Jaspers’ philosophy and psychopathology (pp. 75–85). Heidelberg: Springer.

    Chapter  Google Scholar 

  • Fuchs, T. (2015). Pathologies of Intersubjectivity in Autism and Schizophrenia. Journal of Consciousness Studies, 22(1–2), 191–214.

    Google Scholar 

  • Fuchs, T., & De Jaegher, H. (2009). Enactive intersubjectivity: participatory sense-making and mutual incorporation. Phenomenology and the Cognitive Sciences, 8(4), 465–486.

    Article  Google Scholar 

  • Gallagher, S. (2000). Self-reference and schizophrenia: a cognitive model of immunity to error through misidentification. In D. Zahavi (Ed.), Exploring the self (pp. 203–239). Amsterdam: John Benjamins.

    Chapter  Google Scholar 

  • Gallagher, S. (2009). Delusional realities. In M. Broome & L. Bortolotti (Eds.), Psychiatry as cognitive neuroscience (pp. 245–266). Oxford: Oxford Universtity Press.

    Chapter  Google Scholar 

  • Gallagher, S. (2014). The cruel and unusual phenomenology of solitary confinement. Frontiers in Psychology, 5, 1–8.

    Article  Google Scholar 

  • Gallese, V. (2010). Embodied simulation and its role in intersubjectivity. In T. Fuchs, H. C. Sattel, & P. Henningsen (Eds.), The embodied self. Dimensions, coherence and disorders (pp. 77–91). Stuttgart: Schattauer.

    Google Scholar 

  • Henriksen, M. G. (2013). On incomprehensibility in schizophrenia. Phenomenology and the Cognitive Sciences, 12, 105–129.

    Article  Google Scholar 

  • Henriksen, M. G., & Parnas, J. (2014). Self-disorders and schizophrenia: a phenomenological reappraisal of poor insight and noncompliance. Schizophrenia Bulletin, 40(3), 542–547.

    Article  Google Scholar 

  • Hunt, H. (2000). Experiences of radical personal transformation in mysticism, religious conversion, and psychosis: a review of the varieties, processes, and consequences of the numinous. Journal of Mind and Behavior, 21(4), 353–398.

    Google Scholar 

  • Husserl, E. (1973). Zur Phänomenologie der Intersubjektivität. Zweiter Teil: 1921–1928. Den Haag: Martinus Nijhoff.

    Book  Google Scholar 

  • Husserl, E. (1983). Ideas pertaining to a pure phenomenology and to a phenomenological philosophy. Den Haag: Martinus Nijhoff.

    Google Scholar 

  • Husserl, E. (2001). Analyses concerning passive and active synthesis. Lectures on transcendental logic. Dordrecht: Kluwer Academic Publishers.

    Book  Google Scholar 

  • Husserl, E. (2005). Phantasy, image consciousness and memory (1898–1925). Dordrecht: Springer.

    Google Scholar 

  • Jaspers, K. (1948). Allgemeine psychopathologie (4th ed.). Berlin: Springer Verlag.

    Google Scholar 

  • Jaspers, K. (1968). The phenomenological approach in psychopathology. British Journal of Psychiatry, 114, 1313–1323.

    Article  Google Scholar 

  • Kaplan, B. (1964). The inner world of mental illness. New York: Harper and Row.

    Google Scholar 

  • Kapur, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. The American Journal of Psychiatry, 160, 13–23.

    Article  Google Scholar 

  • Kapur, S. (2004). How antipsychotics become anti-‘psychotic’ - from dopamine to salience to psychosis. Trends in Pharmacological Sciences, 25, 402–406.

    Article  Google Scholar 

  • Karon, B. P. (2003). The tragedy of schizophrenia without psychotherapy. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 31(1), 89–118.

    Article  Google Scholar 

  • Kendell, R., & Jablensky, A. (2003). Distinguishing between the validity and utility of psychiatric diagnoses. The American Journal of Psychiatry, 160(1), 4–12.

    Article  Google Scholar 

  • Kendler, K. S. (2014). The dopamine hypothesis of schizophrenia: an updated perspective. In K. S. Kendler & J. Parnas (Eds.), Philosophical issues in psychiatry III: The Nature and Sources of Historical Change (pp. 283–294). Oxford: Oxford University Press.

    Google Scholar 

  • Kendler, K. S., & Campbell, J. (2014). Expanding the domain of the understandable in psychiatric illness: an updating of the Jasperian framework of explanation and understanding. Psychological Medicine, 44(1), 1–7.

    Article  Google Scholar 

  • Kendler, K. S., & Schaffner, K. F. (2011). The dopamine hypothesis of schizophrenia: an historical and philosophical analysis. Philosophy, Psychiatry, and Psychology, 18(1), 41–63.

    Article  Google Scholar 

  • Kraepelin, E. (1904). Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. Leipzig: Verlag von Johan Ambrosius Barth.

    Google Scholar 

  • Kusters, W. (2014). Filosofie van de waanzin. Rotterdam: Lemniscaat.

    Google Scholar 

  • Maher, B. A. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30, 98–113.

    Google Scholar 

  • Merleau-Ponty, M. (2005). Phenomenology of perception. London: Routledge.

    Google Scholar 

  • Minkowski, E. (1927). La schizophrénie. Psychopathologie des schizoïdes et des schizophrènes. Paris: Payot.

    Google Scholar 

  • Minkowski, E. (1966). Traité de Psychopathologie. Paris: Presses Universitaires de France.

    Google Scholar 

  • Minkowski, E. (1995). Le temps vécu. Etudes phénoménologiques et psychopathologiques. Paris: Presses Universitaires de France.

    Google Scholar 

  • Müller-Suur, H. (1950). Das Gewissheitserlebnis beim schizophrenen und beim paranoischen Wahn. Fortschritte Der Neurologie Psychiatrie, 18, 44–51.

    Article  Google Scholar 

  • Parnas, J., Sass, L. A., & Zahavi, D. (2013). Rediscovering psychopathology: the epistemology and phenomenology of the psychiatric object. Schizophrenia Bulletin, 39(2), 270–277.

    Article  Google Scholar 

  • Ratcliffe, M. (2012). Phenomenology as a form of empathy. Inquiry, 55(5), 473–495.

    Article  Google Scholar 

  • Ratcliffe, M. (2013). Delusional atmosphere and the sense of unreality. In G. Stanghellini & T. Fuchs (Eds.), One century of Karl Jaspers’ general psychopathology (pp. 229–244). Oxford: Oxford University Press.

    Google Scholar 

  • Rhodes, J., & Gipps, R. (2008). Delusions, certainty, and the background. Philosophy, Psychiatry, & Psychology, 14(4), 295–310.

    Google Scholar 

  • Rosen Rasmussen, A., & Parnas, J. (2014). Editorial: pathologies of imagination in schizophrenia spectrum disorders. Acta Psychiatrica Scandinavica, 131(13), 1–5.

    Google Scholar 

  • Sartre, J.-P. (2004). The imaginary. A phenomenological psychology of the imagination. London: Routledge.

    Google Scholar 

  • Sass, L. A. (1994). The paradoxes of delusion. Wittgenstein, Schreber, and the Schizophrenic Mind. New York: Cornell University Press.

    Google Scholar 

  • Sass, L. A. (2013). Delusion and double book-keeping. In T. Fuchs, T. Breyer, & C. Mundt (Eds.), Karl Jaspers’ philosophy and psychopathology (pp. 125–147). Dordrecht: Springer.

    Google Scholar 

  • Sass, L. A., & Parnas, J. (2003). Schizophrenia, consciousness, and the self. Schizophrenia Bulletin, 29(3), 427–444.

    Article  Google Scholar 

  • Sass, L. A., & Pienkos, E. (2013). Delusion: the phenomenological approach. In W. Fullford, G. Davies, G. Graham, J. Sadler, & G. Stanghellini (Eds.), The oxford handbook of philosophy and psychiatry (pp. 632–657). Oxford: Oxford University Press.

    Google Scholar 

  • Schütz, A. (1945). On multiple realities. Philosophy and Phenomenological Research, 5(4), 533–576.

    Article  Google Scholar 

  • Schwartz, M., Wiggins, O., Naudin, J., & Spitzer, M. (2005). Rebuilding reality: a phenomenology of aspects of chronic schizophrenia. Phenomenology and the Cognitive Sciences, 4, 91–115.

    Article  Google Scholar 

  • Spitzer, M. (1989). Was ist Wahn? Untersuchungen zum Wahnproblem. Heidelberg: Springer.

    Book  Google Scholar 

  • Stanghellini, G. (2013). The ethics of incomprehensibility. In G. Stanghellini & T. Fuchs (Eds.), One century of Karl Jaspers’ general psychopathology (pp. 166–181). Oxford: Oxford University Press.

    Google Scholar 

  • Stompe, T., Ortwein-Swoboda, G., Ritter, K., & Schanda, H. (2003). Old wine in new bottles? Stability and plasticity of the contents of schizophrenic delusions. Psychopathology, 36, 6–12.

    Article  Google Scholar 

  • Varga, S. (2012). Depersonalization and the sense of realness. Philosophy, Psychiatry, & Psychology, 19(2), 103–113.

    Google Scholar 

  • Von Weizsäcker, V. (1950). Der Gestaltkreis. Theorie der Einheit von Wahrnehmen und Bewegen. Stuttgart: Thieme.

    Google Scholar 

  • Wegner, D. M., & Wheatley, T. P. (1999). Apparent mental causation: sources of the experience of will. American Psychologist, 54, 480–492.

    Article  Google Scholar 

  • Wittgenstein, L. (1988). Over zekerheid. Amsterdam: Boom.

    Google Scholar 

  • Zahavi, D. (2001). Beyond empathy: phenomenological approaches to intersubjectivity. Journal of Consciousness Studies, 8, 151–168.

    Google Scholar 

  • Zahavi, D. (2005). Being someone. Psyche, 11(5), 1–20.

    Google Scholar 

  • Zahavi, D. (2010). Minimal self and narrative self. In T. Fuchs, H. C. Sattel, & P. Henningsen (Eds.), The embodied self. Dimensions, coherence and disorders (pp. 3–11). Stuttgart: Schattauer.

    Google Scholar 

  • Zweig, S. (2009). Reis naar het verleden. Amsterdam: Atlas.

    Google Scholar 

Download references

Acknowledgments

I would like to thank the anonymous reviewers, Michela Summa, Samuel Thoma, Lars Siersbaek Nilsson, Wouter Kusters, Steve Velleman, Mike Finn, and Thomas Fuchs for their helpful suggestions for this article.

Author information

Authors and Affiliations

  1. Section for Phenomenological Psychiatry and Psychotherapy, Clinic for General Psychiatry - Center for Psychosocial Medicine, University Hospital Heidelberg, Voss-straße 4, 69115, Heidelberg, Germany

    Zeno Van Duppen

Authors
  1. Zeno Van Duppen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zeno Van Duppen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van Duppen, Z. The phenomenology of hypo- and hyperreality in psychopathology. Phenom Cogn Sci 15, 423–441 (2016). https://doi.org/10.1007/s11097-015-9429-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11097-015-9429-8

Keywords

Search

Navigation