"Unsere Literatur ist voll von Klagen über den chaotischen Zustand der Systematik der Psychosen, und jeder Psychiater weiß, daß man sich auf Grund der alten Diagnosen gar nicht genügend verständigen kann. (...) So können sich mit den alten Begriffen nicht einmal die Koryphäen der Wissenschaft verständigen, und viele Patienten tragen genau so viele Diagnosen mit sich herum, als sie Anstalten besucht haben. (...) Irrtümer hindern die Wissenschaft am meisten am Fortschreiten; sie zu beseitigen hat mehr praktischen Wert, als eine neue (...) Erkenntnis zu gewinnen. Und hier ist ein ganzes Chaos von Namen beseitigt worden, hinter denen man fälschlicherweise brauchbare Krankheitsbegriffe suchte, und ein Wald von Grenzpfählen, von denen keiner an einer natürlichen Grenze stand. (...) Mit dem Namen der Dementia praecox oder der Schizophrenie bezeichnen wir eine Psychosengruppe, die bald chronisch, bald in Schüben verläuft, in jedem Stadium Halt machen oder zurückgehen kann, aber wohl keine volle Restitutio ad integrum erlaubt. Sie wird charakterisiert durch eine spezifisch geartete, sonst nirgends vorkommende Alteration des Denkens und Fühlens und der Beziehungen zur Außenwelt.". (shrink)

Drawing on the latest work in cognitive neuroscience, a philosopher proposes that delusions are narrative models that accommodate anomalous experiences.

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)

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 the formative years of psychiatry Freud, Bleuler, and Jaspers all studied Daniel Paul Schreber's Memoirs of My Nervous Illness as a model of psychotic thought. Sass provides a nuanced interpretation of Schreber's Memoirs in the context of Wittgenstein's analysis of philosophical solipsism. A dauntless critic of the illusions of philosophy, Wittgenstein likened the speculative excesses of traditional metaphysics to mental illness. Sass observes that many of the "intellectual diseases" that Wittgenstein discerned - diseases involving detachment from social existence and (...) practical concerns, and exaggerated processes of abstraction and self-consciousness - have striking affinities with the symptoms of schizophrenia. Like the philosophical solipsist, the schizophrenic may define his or her own consciousness as the center of the universe - and may experience his or her delusional world as a product of that same consciousness. (shrink)