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)
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)
Alex Oliver and Timothy Smiley provide a new account of plural logic. They argue that there is such a thing as genuinely plural denotation in logic, and expound a framework of ideas that includes the distinction between distributive and collective predicates, the theory of plural descriptions, multivalued functions, and lists.
Although excess blood collection has characterized U.S. national disasters, most dramatically in the case of September 11, periodic shortages of blood have recurred for decades. In response, I propose a new model of medical philanthropy, one that specifically uses charitable contributions to health care as blood donation incentives. I explain how the surge in blood donations following 9/11 was both transient and disaster-specific, failing to foster a greater continuing commitment to donate blood. This underscores the importance of considering blood donation (...) incentives. I defend charitable incentives as an alternative to financial incentives, which I contend would further extend neoliberal market values into health care. I explain my model's potential appeal to private foundations or public–private partnerships as a means for expanding both the pool of blood donors and the prosocial benefit of each act of blood donation. Finally I link my analysis to the empirical literature on blood donation incentives. (shrink)
This chapter offers an overview of the phenomenological approach to delusions, emphasizing what Karl Jaspers called the "true delusions" of schizophrenia. Phenomenological psychopathology focuses on the experience of delusions and the delusional world. Several features of this approach are surveyed, including emphasis on formal qualities of subjective life and questioning of standard assumptions about delusions as erroneous belief. The altered modalities of world-oriented and self-oriented experience that precede and ground delusions in schizophrenia, especially the experiences of revelation that Klaus Conrad (...) termed the outer and inner apophany, are then discussed. The chapter first considers the famous "delusional mood", then the role of ipseity-disturbance. In both cases it is explained how delusions can develop out of these distinctive alterations of perception and feeling. The classic question of the understandability or comprehensibility of schizophrenic delusion, together with the related issues of wish-fulfillment and rationalizing motives are then considered. The chapter addresses the crucial but neglected issue of the felt reality-status of delusions or the delusional world, discussing derealization, "double bookkeeping", and "double exposure". The chapter concludes by discussing delusions typically found in paranoid and affective psychoses, and monothematic delusions found in certain organic conditions. (shrink)
Increasing interest in applying the theory and practice of deliberative democracy to new and varied political contexts leads us to ask whether or not deliberation is a universal political practice. While deliberation does manifest a universal competence, its character varies substantially across time and space, a variation partially explicable in cultural terms. We deploy an intersubjective conception of culture in order to explore these differences. Culture meets deliberation where publicly accessible meanings, symbols, and norms shape the way political actors engage (...) one another in discourse. Fuller understanding of political deliberation requires comparative and historical studies of particular contexts. We look at one case from Egypt in some depth and provide shorter illustrations from Botswana, Europe, India, Japan, Madagascar, the United States, Yemen, and elsewhere. Cross-cultural learning can enrich the theory of deliberative democracy, and give democratic theory a more universal reach. (shrink)
In this paper, we use a phenomenological approach to compare the unusual ways in which language can be experienced by individuals with schizophrenia or severe mood disorders, specifically mania and melancholia. Our discussion follows a tripartite/dialectical format: first we describe traditionally observed distinctions ; then we consider some apparent similarities in the experience of language in these conditions. Finally, we explore more subtle, qualitative differences. These involve: 1, interpersonal orientation, 2, forms of attention and context-relevance, 3, underlying mutations of experience, (...) and 4, meta-attitudes toward language. Such distinctions appear to reflect significant differences in underlying forms of subjectivity; they are broadly consistent with work in phenomenological psychopathology on other aspects of experience, including body, self, and social world. An understanding of such distinctions may assist with difficult cases of differential diagnosis, while also contributing to a better understanding of suffering persons and of psychological factors underlying their disorders. (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)
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)
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)
: In 1927, Fritz Jahr, a Protestant pastor, philosopher, and educator in Halle an der Saale, published an article entitled "Bio-Ethics: A Review of the Ethical Relationships of Humans to Animals and Plants" and proposed a "Bioethical Imperative," extending Kant's moral imperative to all forms of life. Reviewing new physiological knowledge of his times and moral challenges associated with the development of secular and pluralistic societies, Jahr redefines moral obligations towards human and nonhuman forms of life, outlining the concept of (...) bioethics as an academic discipline, principle, and virtue. Although he had no immediate long-lasting influence during politically and morally turbulent times, his argument that new science and technology requires new ethical and philosophical reflection and resolve may contribute toward clarification of terminology and of normative and practical visions of bioethics, including understanding of the geoethical dimensions of bioethics. (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)
Routledge is now re-issuing this prestigious series of 204 volumes originally published between 1910 and 1965. The titles include works by key figures such asC.G. Jung, Sigmund Freud, Jean Piaget, Otto Rank, James Hillman, Erich Fromm, Karen Horney and Susan Isaacs. Each volume is available on its own, as part of a themed mini-set, or as part of a specially-priced 204-volume set. A brochure listing each title in the "International Library of Psychology" series is available upon request.
This article examines the structure of self-consciousness in people with schizophrenia. The findings indicate that our self-experience is not neutral with respect to the metaphysical status of the self and that it is important to attend carefully to the experience of the subject in order to understand schizophrenia. The results also suggest that the variable disruptions in the sense of self-presence, first-person perspective, and the phenomenality of experience in schizophrenics directly affect the minimal self and it may also have implications (...) for the narrative self. (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)
This is the first re-publication and first English translation of regulations concerning Human Experimentation which were binding law prior to and during the Third Reich, 1931 to 1945. The introduction briefly describes the duties of the Reichsgesundheitsamt, which formulated these regulations. It then outlines the basic concept of the Richtlinien for protecting subjects and patients on the one hand and for encouraging New Therapy and Human Experimentation on the other hand. Major issues, like personal responsibility of the physician or researcher, (...) teaching of ethics of research and therapy, and research and therapy on vulnerable populations, are compared with the regulations in the Nuremberg Code and subsequent regulations influenced by the Nuremberg Code. CiteULike Connotea Del.icio.us What's this? (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)
More than sixty-five black-and-white photographs as well as explanations on the aesthetic rationale and techniques used in order to produce these artworks, are featured in a representative collection of the author's thirty-eight years of ...
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.
This paper reviews moral and cultural assessments which led to the definition of brain death and calls for a similar normative consensus regarding the moral recognition and legal protection of embryonal life related to criteria of brain life. This paper differentiates between cortical brain life I, i.e., the first existence of post-mitotic stationary neurons forming the early cortical plate (54th day post conception), and cortical brain life II, i.e., the beginning of cortical neuro-neuronal synapses (after the 70th day p.c.). The (...) latter are preconditional for establishing the communicative network within the cortex and with subcortical structures. The paper conservatively calls for a tentative moral consensus that could recognize brain life I, i.e., the 54th day p.c., as a stage prior to which embryo research generally would be acceptable in accordance with principles similar to those which led to the acceptance of brain death. Other developmental stages such as fertilization, nidation, viability, as well as the ‘potentiality’ principle are less significant for the moral recognition of early human life. Keywords: brain death, brain life, embryo research, embryonal tissue CiteULike Connotea Del.icio.us What's this? (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)
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 paper, I want to make two main points. The first point is methodological: Instead of attempting to give a classical analysis or reductive definition of the term “expertise”, we should attempt an explication and look for what may be called symptoms of expertise. What this comes to will be explained in due course. My second point is substantial: I want to recommend understanding as an important symptom of expertise. In order to give this suggestion content, I begin to (...) develop an account of understanding. Finally, I will draw attention to some consequences of this approach. (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)