Philosophy, Psychiatry, & Psychology

Schizophrenia involves significant disturbances to inter-subjective experience, the complex nature of which have become an increasingly important area for research in the philosophy of psychiatry. In “Schizophrenia as a Problem of Other Minds,” (2021), Brighupati Singh offers a thought-provoking contribution to this trajectory by engaging Stanley Cavell’s idea of skepticism: the recognition that ordinary life is inherently fragile, and that the affective attunement between self and other is something that can be undone. Through detailed ethnographic and literary studies, primarily undertaken in the Department of Psychiatry at the All India Institute of Medical Sciences in Delhi, Singh demonstrates how patients with schizophrenia and their caregivers are forced to reckon with the fragility of ordinary life. As Singh shows, schizophrenia involves a repeated confrontation with the inherent instability of inter-subjective experience, as something contingent that can be stressed, fractured and broken apart. Drawing on three signature concepts from Cavell’s interpretation of skepticism—attunement, tempo, and negation of voice—Singh aims to show how both the breakdown and the restoration of inter-subjective experience in schizophrenia might be understood according to relations that are either attuned or mis-attuned, harmonious or disharmonious, rhythmic or arrhythmic and so on.

Singh’s appropriation of Cavellian skepticism into understanding inter-subjective experience in schizophrenia is novel, and his contention that caregivers might attune to the fragility of a patient’s lived experience by recognizing the fragility inherent in their own existence, holds significant therapeutic promise. If this approach is to be brought into meaningful dialogue with research into inter-subjective experience in schizophrenia more broadly, however, I wish to argue that misattunement, disharmony and arrhythmia between the patient and caregiver should not be understood as a loss of connection between minds, as Singh argues, but as a loss of affective attunement that is related to the loss of one’s “pre-reflective, unquestionable being-in-the-world” (Fuchs & Röhricht 2017, p. 138). Specifically, through recourse to Heidegger’s interpretation of affect and Jaspers’s conception of the delusional atmosphere, my aim in this article is to argue that the fragility of inter-subjective experience in schizophrenia is grounded in the affective atmosphere of uncanniness, of being radically not at home in the world. Further, in contrast with Singh, I suggest that, if Cavellian skepticism is interpreted in light of the radical uncertainty given by the affective atmosphere of the uncanny, then skepticism becomes commensurable with phenomenological psychopathology in several important ways. Through these clarifications, [End Page 281] it is hoped that the significant therapeutic potential of the concepts of attunement, tempo, and negation of voice might be made more salient, not as a means of appreciating the patient’s mind, but as a way of attuning to the affective atmosphere of uncanniness, with a view to restoring the patient’s being at home in the world.

As Sass and Ratcliffe have argued (Ratcliffe, 2010, 2013a; Sass, 1992, 2004; Sass & Ratcliffe, 2017), the complementary themes of Heidegger’s conception of affect and Jaspers’s idea of the delusional atmosphere afford important insight into the affective dimensions of schizophrenia. In his ‘existential-ontological’ interpretation of affect, Heidegger argues firstly that, thrown into the world, human beings (Dasein) are always already immersed in an affective “atmosphere” and disposed through attunements (Heidegger, 1995, p. 67). Second, attunements are not an interior phenomenon; they are not confined to the detached psyche of the subject, which then imposes itself upon an object. Rather, attunements exist before the subject–object distinction and are disclosive of the fact that human beings are necessarily situated in the world as being-in-the-world. Third, attunements are that which enable human beings to “encounter something that matters” (Heidegger, 1962, p. 177). Depending on how one is attuned therefore (whether through anxiety, awe, despair, boredom or wonder), the world may seem familiar or unfamiliar, boring or enticing, unraveling or static, threatening or comforting, intrusive or at a distance. This means that one’s attunements determine the varying extents to which one may feel that they belong to, or are estranged from the world (Ratcliffe, 2013b). In this...